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Question 1
Correct
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Regarding Polymerase Chain Reaction, all are true except:
Your Answer: There is a linear rise of DNA copies during amplification.
Explanation:All are true except there is a linear rise of DNA copies during amplification. There is an exponential rise in amplification of DNA.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 2
Correct
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Which one of the following interventions has the least role in management of acne rosacea?
Your Answer: Low-dose topical corticosteroids
Explanation:Mild cases are often not treated at all, or are simply covered up with normal cosmetics and avoiding sun exposure. Therapy for the treatment of rosacea is not curative, and is best measured in terms of reduction in the amount of facial redness and inflammatory lesions. The two primary modalities of rosacea treatment are topical and oral antibiotic agents (including metronidazole and tetracyclines). Laser therapy may be appropriate for patients with prominent telangiectasia.
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 3
Incorrect
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Which three parietal cell agonists bind at the basolateral membrane at specific receptors respectively: M3 , H2 , CCK-B, to stimulate acid secretion?
Your Answer: Acetylcholine , histamine, gs
Correct Answer: Acetylcholine, histamine , gastrin
Explanation:The three agonists of parietal cell secretion are gastrin, acetylcholine and histamine. Parietal cells are responsible for the secretion of HCl and intrinsic factor.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 4
Correct
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There is a measure of dispersion of a set of data from its mean. Which of following is the best term which can describe the above?
Your Answer: Standard deviation (root mean square deviation)
Explanation:Standard deviation is defined as the measure of dispersion of a set of data from its mean. It measures the absolute variability of a distribution; the higher the dispersion or variability, the greater is the standard deviation and greater will be the magnitude of the deviation of the value from their mean.
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This question is part of the following fields:
- Medicine
- Research Skills
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Question 5
Correct
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Which of the following intercellular connections is important in endothelial barrier function?
Your Answer: Tight junctions
Explanation:Tight junctions surround the apical margins of the epithelial cells such as in the intestinal mucosa and the choroid plexus. They are also important to the endothelial barrier function. They are made up of ridges that adhere to each other strongly at the cell junction, obliterating the space completely between the cells.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 6
Correct
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What is the most common cause of primary hyperaldosteronism?
Your Answer: Bilateral idiopathic adrenal hyperplasia
Explanation:Primary aldosteronism, also known as primary hyperaldosteronism or Conn’s syndrome, is excess production of the hormone aldosterone by the adrenal glands resulting in low renin levels. Primary hyperaldosteronism has a number of causes. About 66% of cases are due to enlargement of both adrenal glands and 33% of cases are due to an adrenal adenoma that produces aldosterone. Other uncommon causes include adrenal cancer and an inherited disorder called familial hyperaldosteronism
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 7
Incorrect
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Where is the myenteric plexus (Auerbach’s plexus) located in the GIT?
Your Answer: Between the outer longitudinal muscle layer and the adventitia
Correct Answer: Between the outer longitudinal and middle circular muscle layers.
Explanation:A part of the enteric nervous system, the myenteric plexus exists between the longitudinal and circular layers of muscularis externa in the gastrointestinal tract. It is found in the muscles of the oesophagus, stomach, and intestine.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 8
Correct
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Closure of the tricuspid valve is marked by which of the following features of the jugular venous waveform?
Your Answer: c wave
Explanation:The jugular venous pressure (JVP) classically has three upward deflections and two downward deflections. The upward deflections are the a (atrial contraction), c (ventricular contraction and resulting bulging of tricuspid into the right atrium during isovolumetric systole) and v = venous filling. The downward deflections of the wave are the x (the atrium relaxes and the tricuspid valve moves downward) and the y descent (filling of ventricle after tricuspid opening).
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 9
Incorrect
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An 86 year old woman accidentally inhaled her hearing aid due to her advanced Alzheimer's dementia. Upon clinical examination, her respiratory rate is found to be 35, and thus a bronchoscopy is recommended. According to which of the following would you obtain consent for this patient?
Your Answer: Relatives/next of kin will have to consent for the patient
Correct Answer: The procedure does not require a written consent
Explanation:This is an emergency case regarding a patient with impaired cognitive functioning. This is why the procedure does not require a written consent. In any other case where the patient has a normal mental capacity, the consent would be obtained as an informed written consent. In this case however, the suggested procedure is almost a matter of life and death, the doctor being required to act on behalf of the patient to her optimal advantage. Under English law no other person can consent to treatment on behalf of an adult, though it is desirable that next of kin are consulted before treating an adult without consent. Recent legislation gives legal authority to people appointed by the patient, or by the state, or a relative or carer, to consent (or refuse) on behalf of the patient. A mini-mental score may not adequately identify those unable to give consent.
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This question is part of the following fields:
- Geriatrics
- Medicine
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Question 10
Correct
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A 42 year old female with a history of SLE presents with an exacerbation of wrist pain. Which of the following markers would be the most suitable for monitoring disease activity?
Your Answer: Anti-dsDNA titres
Explanation:A high level of anti-dsDNA in the blood is strongly associated with lupus and is often significantly increased during or just prior to a flare-up. When the anti-dsDNA is positive and the person tested has other clinical signs and symptoms associated with lupus, it means that the person tested likely has lupus. This is especially true if an anti-Sm test is also positive.In the evaluation of someone with lupus nephritis, a high level (titre) of anti-dsDNA is generally associated with ongoing inflammation and damage to the kidneys.A very low level of anti-dsDNA is considered negative but does not exclude a diagnosis of lupus. Only about 65-85% of those with lupus will have anti-dsDNA.Low to moderate levels of the autoantibody may be seen with other autoimmune disorders, such as Sjögren syndrome and mixed connective tissue disease (MCTD).
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 11
Incorrect
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The function of the Golgi apparatus is
Your Answer: Cellular detoxification and drug metabolism
Correct Answer: Maturation of peptides secreted by the rER into functional proteins by glycosylation
Explanation:Steroidogenesis is a multi-step process that occurs in two organelles, the endoplasmic reticulum (ER) and the mitochondrion. The Golgi apparatus is a major collection and dispatch station of protein products received from the endoplasmic reticulum (ER). Proteins synthesized in the ER are packaged into vesicles, which then fuse with the Golgi apparatus. The majority of proteins synthesized in the rough ER undergo glycosylation which occurs in the Golgi apparatus. Glycosylation mainly refers in particular to the enzymatic process that attaches glycans to proteins, lipids, or other organic molecules. These cargo proteins are modified and destined for secretion via exocytosis or for use in the cell. The Golgi apparatus is also involved in lipid transport and lysosome formation.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 12
Correct
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What is the principle site of action of adrenocorticotrophic hormone (ACTH)?
Your Answer: Adrenal gland
Explanation:Adrenocorticotropic hormone, also known as ACTH or corticotropin, is a polypeptide tropic hormone. It is synthesized by the corticotropic cells of the anterior pituitary. It works by regulating the secretion of glucocorticoid hormones from the cortex cells in the adrenal gland. It binds to the melanocortin (MC) 2 receptors on the surface of the adrenal zona glomerulosa cells, producing cortisol.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 13
Incorrect
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The thalamus is a large collection of neuronal groups within the diencephalons which participates in:
Your Answer: Limbic functions only
Correct Answer: Sensory, motor and limbic
Explanation:The thalamus has multiple functions. It is the relay station for every sensory system (except olfactory, regulates the sleep-wake cycle and consciousness and also relays motor information.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 14
Correct
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The transporter responsible for most glucose absorption in the lumen of the small intestine is called?
Your Answer: SGLT 1
Explanation:GLUT = Glucose transporter. GLUT are a family of proteins of different types. GLUT 1 is mainly expressed in erythrocytes, whereas GLUT 2 is mainly expressed by, liver cells and renal tubular cells. GLUT 5 is a sucrose transporter in enterocytes. SGLT- Sodium-dependent glucose cotransporter or sodium-glucose linked transporter are a family of proteins of different types. SGLT1 transporter is found in the intestinal mucosa of the small intestine and SGLT2 in the proximal tubule of the nephron.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 15
Correct
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Question 16
Incorrect
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Question 17
Incorrect
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Selectins
Your Answer: Interact with protein ligands on leucocytes only
Correct Answer: Interact with carbohydrate ligands or mucin complexes on leucocytes and endothelial cells
Explanation:Selectins are involved in constitutive lymphocyte homing, and in chronic and acute inflammation processes, including post-ischemic inflammation. Each selectin has a carbohydrate recognition domain that mediates binding to specific glycans on apposing cells.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 18
Incorrect
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In DNA cloning and sequencing, the bases in nucleotides chains are bound together by:
Your Answer: Adenine
Correct Answer: Hydrogen bonding.
Explanation:Nucleotides will always bind together via hydrogen bonds. There are two hydrogen bonds present between thymine and adenine and three hydrogen bonds present between guanine and cytosine.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 19
Incorrect
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A 50-year-old man is admitted with nausea and excessive drowsiness after taking an antihistamine tablet with grapefruit juice. Which of the following liver enzyme systems is affected by grapefruit juice causing the given side effect?
Your Answer: Sulfation
Correct Answer: Cytochrome p450 3A4
Explanation:The cytochrome p450 3A4 enzyme system in the liver is affected by grapefruit juice. Patients taking antihistamines should be advised to avoid drinking grapefruit juice. This is because constituents of grapefruit juice such as naringin and bergamottin inhibit CYP3A4 in the liver, particularly at high doses, leading to decreased drug elimination via hepatic metabolism and can increase potential drug toxicities. Inhibition of this enzyme system leads to reduced metabolism of antihistamines leading to an increased incidence of side effects like excessive drowsiness and nausea as in this patient.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 20
Incorrect
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Organophosphates, such as Sarin, have been used as chemical-warfare agents by terrorists. Which of the following statements is true concerning organophosphate poisoning?
Your Answer:
Correct Answer: Atropine is useful in the management of organophosphate poisoning
Explanation:The principal action of organophosphates is the inhibition of acetylcholinesterase’s, therefore leading to the accumulation of acetylcholine at muscarinic receptors (miosis, hypersalivation, sweating, diarrhoea, excessive bronchial secretions), nicotinic receptors (muscle fasciculations and tremor) and in the central nervous system (anxiety, loss of memory, headache, coma). Removal from the source of the organophosphate, adequate decontamination, supplemental oxygen and atropine are the initial treatment measures. Pralidoxime, an activator of cholinesterase, should be given to all symptomatic patients.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 21
Incorrect
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The predominant site in the lymph node where B lymphocytes are found is:
Your Answer:
Correct Answer: Cortex
Explanation:The cortex of the lymph node consists of the lymphoid nodules and sinusoids and posses a germinal centre from which B cells proliferate. The cortex of the lymph node predominately consists of B cells.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 22
Incorrect
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Regarding carbohydrates absorption;
Your Answer:
Correct Answer: Intestinal absorption of sugars is inhibited by the drug phlorizin
Explanation:The main role of insulin is in the uptake of glucose from blood to tissues where it is metabolised. Glycose transporters in the intestines do not depend on the action of insulin. Phlorizin is a competitive inhibitor of SGLT1 and SGLT2 because it competes with glucose for the binding site, reducing intestinal and renal glucose transport.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 23
Incorrect
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Phosphate absorption in the proximal tubules is via which transporting molecule?
Your Answer:
Correct Answer: Na/Pi co transporter
Explanation:Sodium/phosphate cotransporters are located in the renal proximal tubular brush border, and are the key elements in proximal tubular phosphate reabsorption and phosphate homeostasis.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 24
Incorrect
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What landmark divides the frontal and parietal lobes?
Your Answer:
Correct Answer: Central sulcus
Explanation:The central sulcus divides the frontal lobe from the parietal lobe. It contains the motor cells for the movement function of the body.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 25
Incorrect
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ANP and BNP in the circulation act on the kidney to?
Your Answer:
Correct Answer: Increase sodium excretion
Explanation:The physiologic actions of BNP are similar to those of ANP and include decrease in systemic vascular resistance and central venous pressure as well as an increase in natriuresis (sodium excretion). The net effect of these peptides is a decrease in blood pressure due to the decrease in systemic vascular resistance and, thus, afterload.
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This question is part of the following fields:
- Medicine
- Renal
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Question 26
Incorrect
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In a 60kg adult male with normal mean arterial pressure and oxygen consumption, what proportion of the cardiac output at rest goes to the brain?
Your Answer:
Correct Answer: 10-15%
Explanation:The rate of cerebral blood flow in the adult is typically 750 millilitres per minute, which is 10-15% of the cardiac output. On average around 13.9% of cardiac output is distributed to the brain.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 27
Incorrect
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Which of the following statements are true regarding human herpesvirus eight
Your Answer:
Correct Answer: It is sexually transmitted.
Explanation:Kaposi’s sarcoma-associated herpesvirus (KSHV) is the eighth human herpesvirus or HHV-8. This virus causes Kaposi’s sarcoma, a cancer commonly occurring in AIDS patients, as well as primary effusion lymphoma and some types of multicentric Castleman’s disease. It is one of seven currently known human cancer viruses, or oncoviruses. The mechanisms by which the virus is contracted are not well understood. Healthy individuals can be infected with the virus and show no signs or symptoms, due to the immune system’s ability to keep the infection in check. Infection is of particular concern to the immunosuppressed. Cancer patients receiving chemotherapy, AIDS patients and organ transplant patients are all at a high risk of showing signs of infection. The virus is sexually transmitted.
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 28
Incorrect
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The coronary sinus, which empties into the right atrium, serves to?
Your Answer:
Correct Answer: Drain the venous supply of the myocardium
Explanation:The coronary sinus is a collection of veins joined together to form a large vessel that collects blood from the heart muscle (myocardium). It delivers deoxygenated blood to the right atrium, as do the superior and inferior vena cava.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 29
Incorrect
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The haemostatic plug formation in response to injured blood vessel wall is stimulated by exposure of which substance to platelets?
Your Answer:
Correct Answer: Collagen
Explanation:When the endothelium is damaged, the normally isolated, underlying collagen is exposed to circulating platelets, which bind directly to collagen with collagen-specific glycoprotein Ia/IIa surface receptors. This adhesion is strengthened further by von Willebrand factor (vWF), which is released from the endothelium and from platelets.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 30
Incorrect
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Lipid- lowering drugs like Lovastatin reduce cholesterol synthesis by inhibiting which enzyme?
Your Answer:
Correct Answer: HMG-CoA reductase
Explanation:Statins, also known as HMG-CoA reductase inhibitors, are a class of lipid-lowering medications. Statins have been found to reduce cardiovascular disease (CVD) and mortality in those who are at high risk.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 31
Incorrect
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Around 30 patients have been admitted to the hospital following a suspected chemical attack in the city. The patients are extremely unwell, with symptoms of excessive salivation, lacrimation, diarrhoea, and emesis. Sarin gas was suspected as the most likely agent used in the attack. What is the mechanism of action of this chemical agent?
Your Answer:
Correct Answer: Inhibition of acetylcholinesterase
Explanation:Sarin acts by inhibiting acetylcholinesterase.Sarin gas is a highly toxic synthetic organophosphorus compound which causes inhibition of the enzyme acetylcholinesteraseSarin gas is a highly toxic synthetic organophosphorus compound which causes inhibition of the enzyme acetylcholinesterase. This results in high levels of acetylcholine (ACh).The effects of excessive ACh can be remembered by the mnemonic DUMBELLS:DiarrhoeaUrinationMiosis/muscle weaknessBronchorrhea/BradycardiaEmesisLacrimationSalivation/sweatingOrganophosphate insecticide poisoning:One of the effects of organophosphate poisoning is inhibition of acetylcholinesteraseFeatures can be predicted by the accumulation of acetylcholine (mnemonic = SLUD)SalivationLacrimationUrinationDefecation/diarrhoeacardiovascular: hypotension, bradycardiamiosis, muscle fasciculation.Organophosphate poisoning is treated with the anti-muscarinic atropine.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 32
Incorrect
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A 45-year-old woman has been diagnosed with T1N1M1 malignancy in the left breast, with metastases detectable in the lower thoracic vertebrae and the left lung. Before the initiation of treatment of this patient with trastuzumab, which is the most important investigation to perform?
Your Answer:
Correct Answer: Echo
Explanation:Before the initiation of trastuzumab, an echocardiography is a must to rule out any pre-existing cardiac abnormalities as trastuzumab is cardiotoxic.Trastuzumab (Herceptin) is a monoclonal antibody directed against the HER2/neu receptor. It is used mainly in metastatic breast cancer although some patients with early disease are now also given trastuzumab.Adverse effects include:Flu-like symptoms and diarrhoea are common.Cardiotoxicity: – Risk increases when anthracyclines are used concomitantly. – Trastuzumab-induced cardiac dysfunctions are regarded as less severe and largely reversible because primary cardiomyocyte do not show ultrastructure changes unlike those associated with anthracycline-induced cardiotoxicity. – Primary myocyte injury does not occur in patients who were treated with trastuzumab.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 33
Incorrect
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Where is thyroglobulin produced?
Your Answer:
Correct Answer: Thyrocytes
Explanation:Thyroglobulin, or Tg, is a protein that functions as the precursor to thyroid hormones. It is synthesized by thyrocytes and then secreted into the colloid. It also functions as a negative-feedback regulator of thyroid hormone biosynthesis.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 34
Incorrect
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In the functional unit of the liver (acinus), the oxygenation…
Your Answer:
Correct Answer: Reduces towards the centre
Explanation:Cells located close to the portal triad or peripheral zone which consist of arterioles from the hepatic artery are the most oxygenated cells. Cells in the central zone are least oxygenated and mainly receive blood supply from the central vein which is a branch of the hepatic vein.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 35
Incorrect
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The oesophagus is lined by
Your Answer:
Correct Answer: Stratified squamous epithelium
Explanation:The wall of the oesophagus from the lumen outwards consists of mucosa, submucosa (connective tissue), layers of muscle fibers between layers of fibrous tissue, and an outer layer of connective tissue. The mucosa is a stratified squamous epithelium of around three layers of squamous cells, which contrasts to the single layer of columnar cells of the stomach. The transition between these two types of epithelium is visible as a zig-zag line. Most of the muscle is smooth muscle although striated muscle predominates in its upper two thirds.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 36
Incorrect
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Question 37
Incorrect
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The production of bile is increased by: Stimulation of the ____ nerve and the hormone ____.
Your Answer:
Correct Answer: Vagus, CCK
Explanation:Cholecystokinin is synthesized and secreted by enteroendocrine cells in the duodenum, the first segment of the small intestine, and causes the release of digestive enzymes and bile from the pancreas and gallbladder, respectively. It also acts as a hunger suppressant. Release of CCK is stimulated by monitor peptide released by pancreatic acinar cells as well as CCK-releasing protein, a paracrine factor secreted by enterocytes in the gastrointestinal mucosa. In addition, release of acetylcholine by the parasympathetic nerve fibers of the vagus nerve also stimulate its secretion.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 38
Incorrect
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Cranial nerves VI, VII, VIII enter/exit the base of the brain at the:
Your Answer:
Correct Answer: Ponto-medullary junction
Explanation:Cranial nerves III, IV and V exit from the pons, VI, VII, VIII exit from the pontomedullary junction and cranial nerve IX, X, XI, XII exit from the medulla.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 39
Incorrect
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Which statement is incorrect?
Your Answer:
Correct Answer: Translation begins when the triplet (UGA) encoding for methionine is encountered.
Explanation:Translation being when the codon for methionine is encountered which is AUG not UGA. This process is known as initiation. All the other options are correct.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 40
Incorrect
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What is pendrin?
Your Answer:
Correct Answer: Cl-/i- antiporter
Explanation:Pendrin is an anion exchange transporter; it is a sodium-independent chloride-iodine exchanger which also accepts formate and bicarbonate. It is present in many different types of cells in the body, particularly the inner ear, thyroid, and kidney. Mutations in pendrin are associated with Pendred syndrome, which causes syndromic deafness and thyroid disease.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 41
Incorrect
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Bile acids will be prevented from being absorbed by resection of which part of the gastrointestinal tract?
Your Answer:
Correct Answer: Ileum
Explanation:Bile acids (also called bile salts) are produced in the liver, secreted into the biliary system, stored in the gallbladder and are released after meals stimulated by cholecystokinin. They are important for the digestion and absorption of fats (lipids) in the small intestine. Usually over 95% of the bile acids are absorbed in the terminal ileum and are taken up by the liver and resecreted.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 42
Incorrect
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The actions of thrombin result directly in the release of:
Your Answer:
Correct Answer: Fibrin monomers
Explanation:Thrombin in turn acts as a serine protease that converts soluble fibrinogen into insoluble strands of fibrin, as well as catalysing many other coagulation-related reactions.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 43
Incorrect
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A 28 year old man was rushed to the hospital after experiencing sudden onset chest pain while playing football. He has never felt such pain in the past. However, one of his uncles had a similar sudden discomfort at a young age and he passed away following a heart problem. The following vitals are recorded on examination:BP: 101/74 mmHgRR: 22 breaths/minPR: 87 beats/min Physical examination reveals abnormally long fingers and on asking the man to hold the opposite wrist, the thumb and little finger overlap each other. He is not taking any medication regularly and past medical/surgical history is not significant. He admits to smoking half pack of cigarettes/day for the last 10 years but denies abusing any illicit drugs. Which of the following explanation most likely explains the disease process in this man?
Your Answer:
Correct Answer: A defect of the glycoprotein structure which usually wraps around elastin
Explanation:Aortic dissection is defined as separation of the layers within the aortic wall. Tears in the intimal layer result in the propagation of dissection (proximally or distally) secondary to blood entering the intima-media space. This can be caused as a result of both congenital or acquired factors like chronic uncontrolled hypertension. This patient shows no sign of hypertension but his physical examination hints towards Marfan Syndrome. Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder affecting the microfibrils and elastin in connective tissue throughout the body. MFS is associated with pathological manifestations in the cardiovascular system (e.g., mitral valve prolapse, aortic aneurysm, and dissection), the musculoskeletal system (e.g., tall stature with disproportionately long extremities, joint hypermobility), and the eyes (e.g., subluxation of the lens of the eye). Decreased collagen production occurs in ageing, hydroxylation defects are present in vitamin C deficiency, copper deficiency affecting lysyl oxidase enzyme occurs in Menke’s disease.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 44
Incorrect
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What is the mechanism of action of carbimazole?
Your Answer:
Correct Answer: Inhibition of the iodination of tyrosine
Explanation:Carbimazole is used to treat hyperthyroidism. Carbimazole is a pro-drug as after absorption it is converted to the active form, methimazole. Methimazole prevents thyroid peroxidase enzyme from coupling and iodinating the tyrosine residues on thyroglobulin, hence reducing the production of the thyroid hormones T3 and T4 (thyroxine).
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 45
Incorrect
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All valves are closed in which phase of the cardiac cycle?
Your Answer:
Correct Answer: Isovolumetric relaxation
Explanation:The cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat, and so includes the diastole, the systole, and the intervening pause.The first stage, diastole, is when the semilunar valves (the pulmonary valve and the aortic valve) close, the atrioventricular (AV) valves (the mitral valve and the tricuspid valve) open, and the whole heart is relaxed. The second stage, atrial systole, is when the atrium contracts, and blood flows from atrium to the ventricle.The third stage, isovolumic contraction is when the ventricles begin to contract, the AV and semilunar valves close, and there is no change in volume. The fourth stage, ventricular ejection, is when the ventricles are contracting and emptying, and the semilunar valves are open. During the fifth stage, isovolumic relaxation time, pressure decreases, no blood enters the ventricles, the ventricles stop contracting and begin to relax, and the semilunar valves close due to the pressure of blood in the aorta.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 46
Incorrect
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Most of the venous blood returns to the heart through the:
Your Answer:
Correct Answer: Coronary sinus and anterior cardiac veins
Explanation:Most of the venous blood returns to the heart via the coronary sinus and the anterior cardiac veins which drain into the right atrium.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 47
Incorrect
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A 18-year-old female is brought to the emergency department by her boyfriend. He is concerned that she may have taken an overdose of her mom's morphine sulphate pills after being depressed about her mother, who is dying of carcinoma of the breast.Which of the following may point towards his suspicion?
Your Answer:
Correct Answer: Sweating
Explanation:Excessive sweating points towards a morphine overdose.Morphine is considered the classic opioid analgesic with which other painkillers are compared. Like other medications in this class, morphine has an affinity for delta, kappa, and mu-opioid receptors.Most commonly used in pain management, morphine provides major relief to patients afflicted with pain.Among the more common adverse effects of morphine use is constipation. Other side effects include nausea, vomiting, drowsiness, and confusion. Psychological and physical dependence may occur.Other side effects include bronchospasm, angioedema, urinary retention, ureteric or biliary spasm, dry mouth, sweating, rash, facial flushing, vertigo, tachycardia, bradycardia, palpitations, orthostatic hypotension, hypothermia, restlessness, mood change, hallucinations, seizures (adults and children) and miosis, headache and allergic reactions (including anaphylaxis) and decreased libido or potency.Raised intracranial pressure occurs in some patients. Muscle rigidity may occur with high doses. Elevated liver enzymes may occur due to biliary sphincter constriction. Large doses can lead to respiratory depression, circulatory failure, and coma.Treatment of opioid overdose:Initial treatment of overdose begins with supportive care.Naloxone is a pure competitive antagonist of opiate receptors and has no agonistic activity. The drug is relatively safe and can be administered intravenous, intramuscular, subcutaneous or via the endotracheal tube.Alternatively, nalmefene and naltrexone maybe considered.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 48
Incorrect
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The positive inotropic effect of digoxin is due to?
Your Answer:
Correct Answer: Inhibition of the sodium potassium ATPase in the myocardium
Explanation:Digitalis compounds are potent inhibitors of cellular Na+/K+-ATPase. This ion transport system moves sodium ions out of the cell and brings potassium ions into the cell. By inhibiting the Na+/K+-ATPase, cardiac glycosides cause the intracellular sodium concentration to increase. This then leads to an accumulation of intracellular calcium via the Na+/Ca++ exchange system. In the heart, increased intracellular calcium causes more calcium to be released by the sarcoplasmic reticulum, thereby making more calcium available to bind to troponin-C, which increases contractility (inotropy).
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 49
Incorrect
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What is the structure of nucleosomes?
Your Answer:
Correct Answer: Strands of double strand DNA + histones
Explanation:DNA is packed and condensed by binding to histone proteins. The double stranded DNA forms a complex with histone proteins which is called a nucleosome. There are 8 histone proteins contained in one core of nucleosome.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 50
Incorrect
-
When is the blood pressure at its lowest during pregnancy?
Your Answer:
Correct Answer: Second trimester
Explanation:It is lowest during the second trimester.
Previous studies have reported changes in blood pressure (BP) throughout pregnancy, and it was generally accepted that in clinically healthy pregnant women, BP falls gradually at first trimester, reaching the lowest around 22–24 weeks, rising again from 28 weeks, and reaching preconception levels by 36 weeks of gestation
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 51
Incorrect
-
Where is retinol mainly stored?
Your Answer:
Correct Answer: Liver
Explanation:Vitamin A is a group of unsaturated nutritional organic compounds that includes retinol, retinal, retinoic acid, and several provitamin A carotenoids (most notably beta-carotene). The liver stores a multitude of substances, including glucose (in the form of glycogen), vitamin A (1–2 years’ supply), vitamin D (1–4 months’ supply), vitamin B12 (3–5 years’ supply), vitamin K, iron, and copper.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 52
Incorrect
-
Which of the following is the most common causative organism in infective endocarditis?
Your Answer:
Correct Answer: Streptococcus viridans
Explanation:Viridans Alpha-haemolytic streptococci, that are present in the mouth are the most frequently isolated microorganisms when the infection is acquired in a community setting. In contrast, Staphylococcus blood stream infections are frequently acquired in a health care setting where they can enter the blood stream through procedures that cause break in the integrity of skin like surgery, catheterisation or during access of long term indwelling catheters or secondary to intravenous injection of recreational drugs.Prosthetic valve endocarditis is commonly caused by Staphylococcus epidermidis as it is capable of growing as a biofilm on plastic surfaces
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 53
Incorrect
-
A 23 year old male patient presents with urethritis for the last 2 weeks that has not responded to antibiotics. Lately he has developed an onset of new range of symptoms that are linked to his HLA B27 positivity. Which of the following signs is not related to Reiter's syndrome?
Your Answer:
Correct Answer: A mild fever with a generalised macular rash
Explanation:Reactive arthritis, (formerly known as Reiter’s syndrome), is an autoimmune condition that occurs after a bacterial infection of the gastrointestinal or urinary tract. It is categorized as a seronegative spondylarthritis because of its association with HLA-B27. Reactive arthritis primarily affects young men and usually presents with musculoskeletal or extra‑articular symptoms. The characteristic triad consists of arthritis, conjunctivitis, and urethritis. The diagnosis is based on clinical features such as patient history and physical examination; there are no specific tests for reactive arthritis. Treatment is primarily symptomatic and consists of the administration of NSAIDs, as most patients recover spontaneously. Dermatologic manifestations include skin lesions of the glans resembling psoriasis (balanitis circinata); hyperkeratinisation of the palms and soles (keratoderma blenorrhagicum)
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 54
Incorrect
-
Corticospinal tracts are located in the ___ of the white matter.
Your Answer:
Correct Answer: Anterior and lateral funiculi
Explanation:The corticospinal tract is a descending or a motor tract which projects nerve fibers from the cortex of the cerebrum down to different levels of the spinal cord. The descending corticospinal tract descends from the origin, through the corona radiata, posterior half of the lateral ventricle, and enters the midbrain through the cerebral peduncle. In the medulla they form the medullary pyramids on either side of midline as lateral and anterior fibers.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 55
Incorrect
-
Which of the following components regulate cardiac output?
Your Answer:
Correct Answer: All of the above
Explanation:Cardiac output is regulated by the autonomic nervous system with sympathetic nerves having a positive chronotropic and inotropic effect and parasympathetic nerves having the opposite effect. An increase in preload will increase cardiac output likewise an afterload increase will also increase cardiac output.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 56
Incorrect
-
The largest energy reserves among both lean and obese subjects are from?
Your Answer:
Correct Answer: Fatty acids
Explanation:The energy required for sustained exercise is provided by the oxidation of two fuels, glucose stored as glycogen in the liver and muscle, and long-chain fatty acids, stored as adipose tissue triglycerides. The latter provides the largest energy reserve in the body.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 57
Incorrect
-
Myocyte action potentials – Choose the false statement:
Your Answer:
Correct Answer: Repolarisation is due to net k+ influx
Explanation:Final repolarization (phase 3) to the resting membrane potential (phase 4) is due to closure of the Ca2+ channels and a slow, delayed increase of K+ efflux through various types of K+ channels.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 58
Incorrect
-
The complete oxidation of 1 molecule of glucose to CO2 and H20 produces a total of __ATP.
Your Answer:
Correct Answer: 38
Explanation:Textbooks often state that 38 ATP molecules can be made per oxidised glucose molecule during cellular respiration (2 from glycolysis, 2 from the Krebs cycle, and about 34 from the electron transport system). However, this maximum yield is never quite reached because of losses due to leaky membranes as well as the cost of moving pyruvate and ADP into the mitochondrial matrix, and current estimates range around 29 to 30 ATP per glucose.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 59
Incorrect
-
With regards to environmental temperature, for each degree Celsius of elevation, the metabolic rate rises?
Your Answer:
Correct Answer: 0.14
Explanation:An increase in body temperature is associated with a higher metabolic rate. Evidence suggests that an increase of 1°C in your body temperature increases your metabolism by 10 to 14%.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 60
Incorrect
-
Question 61
Incorrect
-
What is the isolated effect of B2 stimulation on the coronaries?
Your Answer:
Correct Answer: Vasodilatation
Explanation:Norepinephrine and epinephrine are agonists for all adrenergic receptor subtypes, although with varying affinities. Based on their physiology and pharmacology, adrenergic receptors have been divided into two principal types: alpha and beta. These types have been further differentiated into alpha-1, alpha-2, b1, and b2 receptors.
Alpha-1 Receptors are located on postsynaptic cells in smooth muscle and elicit vasoconstriction.
Alpha-2 receptors are localized on presynaptic membranes of postganglionic nerve terminals that synthesize norepinephrine. When activated by catecholamines, alpha-2 receptors act as negative feedback controllers, inhibiting further norepinephrine release.
Activation of myocardial b1 receptors stimulates the rate and strength of cardiac contraction, and consequently increases cardiac output. b1 Receptor activation also stimulates renin release from the kidney. Another class of antihypertensive agents acts by inhibiting b1 receptors.
Activation of b2 receptors by epinephrine relaxes vascular smooth muscle and results in vasodilation.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 62
Incorrect
-
The residual cleft of the intermediate lobe of the pituitary is lined by follicles resembling which human gland?
Your Answer:
Correct Answer: Thyroid
Explanation:The cells located between the two main pituitary lobes form what is known as the intermediate pituitary. This area secretes melanocyte-stimulating hormone and it is only a few cell layers thick. It is rich in follicles filled with colloid, and lined by basophilic cells. This configuration resembles that of another important gland: the thyroid.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 63
Incorrect
-
Question 64
Incorrect
-
Question 65
Incorrect
-
Number of cases that are infected at a specific point in time
Your Answer:
Correct Answer: Prevalence
Explanation:Prevalence in epidemiology is the proportion of a population found to have a condition (typically a disease or a risk factor such as smoking or seat-belt use). It is arrived at by comparing the number of people found to have the condition with the total number of people studied, and is usually expressed as a fraction, as a percentage or as the number of cases per 10,000 or 100,000 people. Point prevalence is the proportion of a population that has the condition at a specific point in time. Period prevalence is the proportion of a population that has the condition at some time during a given period (e.g., 12 month prevalence), and includes people who already have the condition at the start of the study period as well as those who acquire it during that period. Lifetime prevalence (LTP) is the proportion of a population that at some point in their life (up to the time of assessment) have experienced the condition
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 66
Incorrect
-
Which of the following regulates the calcium release channels?
Your Answer:
Correct Answer: Calstabin 2
Explanation:Ca2+ is released from the SR through a Ca2+ release channel, a cardiac isoform of the ryanodine receptor (RyR2), which controls intracytoplasmic [Ca2+] and, as in vascular smooth-muscle cells, leads to the local changes in intracellular [Ca2+] called calcium sparks. A number of regulatory proteins, including calstabin 2, inhibit RyR2 and, thereby, the release of Ca2+ from the SR.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 67
Incorrect
-
A 73-year-old female is being reviewed in the osteoporosis clinic. She had a fracture of her left hip 5 years ago and was started on alendronate. Following the development of persistent musculoskeletal pain, alendronate was replaced with risedronate, which was also stopped for similar reasons. Strontium ranelate was therefore started but was also stopped due to the development of deep vein thrombosis in the right leg. Her current T-score is -4.1. A decision is made to start a trial of denosumab. What is the mechanism of action of denosumab?
Your Answer:
Correct Answer: Inhibits RANK ligand, which in turn inhibits the maturation of osteoclasts
Explanation:The principal mechanism by which strontium inhibits osteoclast activity is by enhancing the secretion of osteoprotegerin (OPG) and by reducing the expression of the receptor activator of nuclear factor κB ligand (RANKL) in osteoblasts.Osteoporosis is defined as low bone mineral density caused by altered bone microstructure ultimately predisposing patients to low-impact, fragility fractures.Management:Vitamin D and calcium supplementation should be offered to all women unless the clinician is confident they have adequate calcium intake and are vitamin D repleteAlendronate is the first-line treatment. Around 25% of patients cannot tolerate alendronate, usually due to upper gastrointestinal problems. These patients should be offered risedronate or etidronate.Strontium ranelate and raloxifene are recommended if patients cannot tolerate bisphosphonates.Other medications that are useful in the treatment of osteoporosis are denosumab, teriparatide, raloxifene, etc.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 68
Incorrect
-
What is the most common cardiac defect seen in patients with Down’s syndrome?
Your Answer:
Correct Answer: Atrioventricular septal defect
Explanation:The rate of congenital heart disease in new-borns with Down syndrome is around 40%. Of those with heart disease, about 80% have an atrioventricular septal defect or ventricular septal defect with the former being more common. Mitral valve problems become common as people age, even in those without heart problems at birth.[3] Other problems that may occur include tetralogy of Fallot and patent ductus arteriosus.[38] People with Down syndrome have a lower risk of hardening of the arteries
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 69
Incorrect
-
A 72 year old female, known with rheumatoid arthritis for last 17 years, presents with recurrent attacks of red eyes with a sensation of grittiness. Which of the following is most likely cause of the red eyes?
Your Answer:
Correct Answer: keratoconjunctivitis sicca
Explanation:Rheumatoid arthritis is an inflammatory systemic disease associated with some extraarticular manifestations. Keratoconjunctivitis sicca, episcleritis, scleritis, corneal changes, and retinal vasculitis are the most common ocular complications among extraarticular manifestations of RA. The overall prevalence of keratoconjunctivitis sicca also known as dry eye syndrome among patients of RA is 21.2% and is the most common with sense of grittiness in the eyes.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 70
Incorrect
-
Bile salts are responsible for:
Your Answer:
Correct Answer: The emulsification of fats
Explanation:The main function of bile acids is to allow digestion of dietary fats and oils by acting as a surfactant that emulsifies them into micelles, allowing them to be colloidally suspended in the chyme before further processing.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 71
Incorrect
-
A patient with achalasia
Your Answer:
Correct Answer: Has decreased production of vasoactive intestinal polypeptide (VIP)
Explanation:Oesophageal achalasia is an oesophageal motility disorder involving the smooth muscle layer of the oesophagus and the lower oesophageal sphincter (LES). It is characterized by incomplete LES relaxation, increased LES tone, and lack of peristalsis of the oesophagus (inability of smooth muscle to move food down the oesophagus) in the absence of other explanations like cancer or fibrosis. In achalasia, there is loss of nitric oxide (NO) and vasoactive intestinal polypeptide (VIP) releasing inhibitory neurons.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 72
Incorrect
-
A 26 year old woman is 32 weeks pregnant. She has a history of Sjogren Syndrome. The foetus would be at a risk for which of the following?
Your Answer:
Correct Answer: All correct
Explanation:Women with Sjögren syndrome are likely to experience more complications during pregnancy than women without an autoimmune disease as the anti-Ro and anti-La antibodies cross the placenta and lead to various life threatening complications. Studies show a high incidence of poor fetal outcomes for these patients. Congenital heart block, neonatal lupus, congestive cardiac failure, hydrops fetalis can all be caused as a result of Sjogren syndrome.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 73
Incorrect
-
During bone growth-the epiphysis are separated from the diaphysis by actively proliferating cartilage known as:
Your Answer:
Correct Answer: Epiphysial plate
Explanation:The epiphysial plate, physis, or growth plate, is a hyaline cartilage plate located near the ends of long bones; it consists of growing tissue. It is found in children and teenagers; in adults, it is replaced by an epiphysial line or epiphysial closure. The epiphysial plate is divided into zones: zone of reserve, proliferation, maturation and hypertrophy, calcification, and ossification.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 74
Incorrect
-
Concerning S3, which of the following statements is INCORRECT?
Your Answer:
Correct Answer: Coincide with atrial contraction
Explanation:A third heart sound also called a ventricular gallop occurs at the beginning of diastole after S2 and is lower in pitch than S1 or S2 as it is not of valvular origin. The third heart sound is benign in youth, some trained athletes, and sometimes in pregnancy but if it re-emerges later in life it may signal cardiac problems, such as a failing left ventricle as in dilated congestive heart failure (CHF). S3 is thought to be caused by the oscillation of blood back and forth between the walls of the ventricles initiated by blood rushing in from the atria. The reason the third heart sound does not occur until the middle third of diastole is probably that during the early part of diastole, the ventricles are not filled sufficiently to create enough tension for reverberation. It may also be a result of tensing of the chordae tendineae during rapid filling and expansion of the ventricle. In other words, an S3 heart sound indicates increased volume of blood within the ventricle. An S3 heart sound is best heard with the bell-side of the stethoscope (used for lower frequency sounds). A left-sided S3 is best heard in the left lateral decubitus position and at the apex of the heart, which is normally located in the 5th left intercostal space at the midclavicular line. A right-sided S3 is best heard at the lower-left sternal border. The way to distinguish between a left and right-sided S3 is to observe whether it increases in intensity with inhalation or exhalation. A right-sided S3 will increase on inhalation, while a left-sided S3 will increase on exhalation.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 75
Incorrect
-
Which of the following is NOT an effect of a positive inotropic agent on the heart?
Your Answer:
Correct Answer: It decreases the rate of rise in ventricular blood pressure during systole
Explanation:Inotropic agents increase the contractility of the heart as well as the rate of rise in ventricular blood pressure during systole, generating a greater pressure and increasing the stroke volume e.g. like catecholamines do.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 76
Incorrect
-
Select the correct statement about the microanatomy of the thyroid gland.
Your Answer:
Correct Answer: The capillaries adjacent to thyroid cells have a fenestrated endothelium.
Explanation:Fenestrated capillaries have a very thin endothelium, which is perforated by numerous fenestrations or pores. Hormones are usually released into these capillaries, reaching their target cells through the circulatory system.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 77
Incorrect
-
Coronary arteries fill up during
Your Answer:
Correct Answer: Diastole
Explanation:During contraction of the ventricular myocardium (systole), the subendocardial coronary vessels (the vessels that enter the myocardium) are compressed due to the high ventricular pressures. This compression results in momentary retrograde blood flow (i.e., blood flows backward toward the aorta) which further inhibits perfusion of myocardium during systole. However, the epicardial coronary vessels (the vessels that run along the outer surface of the heart) remain open. Because of this, blood flow in the sub endocardium stops during ventricular contraction. As a result, most myocardial perfusion occurs during heart relaxation (diastole) when the subendocardial coronary vessels are open and under lower pressure.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 78
Incorrect
-
A 46 year old male, known with Rheumatoid Arthritis presents with a swollen and painful right ankle. No drug allergies are reported. On examination, the vitals are as follows: Temp: 38.8BP: 90/60 mmHgPulse: 110/min. Right ankle examination reveals tenderness, warmth, erythema and tense joint effusion. Blood samples including blood cultures are collected and fluid resuscitation is initiated. Which of the following interventions would be most appropriate for this man?
Your Answer:
Correct Answer: Administer i.v. flucloxacillin, and arrange joint aspiration urgently
Explanation:Although microscopic analysis of joint fluid aspirate and culture is the basis of septic arthritis diagnosis and should usually be collected before the administration of antibiotics, the patient is showing signs of septic shock. A delay in antibiotics might lead to worsening of symptoms so they are administered first.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 79
Incorrect
-
Which of the following is NOT true of the parasympathetic control of the heart?
Your Answer:
Correct Answer: It can be blocked by beta blockers
Explanation:Parasympathetic fibers do not innervate the Beta receptors on the heart. They are innervated by the sympathetic nerve fibers. Then a beta blocker such as propranolol will block the sympathetic outflow and increase the parasympathetic tone of the heart.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 80
Incorrect
-
Which one of the following nerve fibers has the fastest conduction velocity?
Your Answer:
Correct Answer: α fiber
Explanation:α nerve fibers are characterized by being highly myelinated, which confers them with fast conduction properties. They innervate extrafusal skeletal muscle fibers, and their conduction velocity is between 80-120 m/s.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 81
Incorrect
-
A 31 year old female with systemic lupus erythematosus wants to know if she has any predisposing factors for the disease. Which of the following carries the greatest risk of developing SLE?
Your Answer:
Correct Answer: Monozygotic twin
Explanation:An overall concordance rate in monozygotic twins was documented to be 25% as compared to dizygotic twins with 3%. First degree relatives have a chance of around 3% of developing the disease. Caucasians show an increase frequency of HLA-B8. The Japanese lupus patients had a stronger association with HLA-DR2.
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This question is part of the following fields:
- Connective Tissue
- Medicine
-
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Question 82
Incorrect
-
Where is the lower border of the liver usually found?
Your Answer:
Correct Answer: 10th rib anterior axillary line on right
Explanation:Assessment of liver margins is important clinically to determine the size of the liver and is done via percussion during the physical examination. The liver typically extends from the fifth intercostal space or 6th rib to the right costal margin in the midclavicular line and the 10th rib on anterior axillary line.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 83
Incorrect
-
A 45 year old man presents with fever, malaise, weight loss and myalgias that have been occurring for a month. You suspect polyarteritis nodosa and arrange for some lab investigations. Which of the following abnormality would most likely be present?
Your Answer:
Correct Answer: Elevated creatinine
Explanation:People with polyarteritis nodosa often exhibit anaemia of chronic disease. Leucocytosis and eosinophilia may also be present. ANCA is only rarely positive. As polyarteritis nodosa affects the kidneys as well, the creatinine is elevated in most cases.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 84
Incorrect
-
With regards to the cell cycle, which phase represents period of cell growth that divides the end of DNA synthesis and the beginning of somatic cell division?
Your Answer:
Correct Answer: Gap 2
Explanation:Interphase is divided into three phases: G1 (first gap), S (synthesis), and G2 (second gap). During all three parts of interphase, the cell grows by producing proteins and cytoplasmic organelles. However, chromosomes are replicated only during the S phase. Thus, a cell grows (G1), continues to grow as it duplicates its chromosomes (S), grows more and prepares for mitosis (G2), and finally divides (M) before restarting the cycle.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 85
Incorrect
-
What is the mode of action of amiodarone?
Your Answer:
Correct Answer: Potassium channel blocker
Explanation:Amiodarone is a class III antiarrhythmic drug. Class III antiarrhythmics are potassium channel blockers, they prolong duration of action potential with resulting prolongation of effective refractory period.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 86
Incorrect
-
H+ ions used in the production of acid by parietal cells is produced with the help of which enzyme?
Your Answer:
Correct Answer: Carbonic anhydrase ii
Explanation:Carbonic anhydrase enzyme catalyses the rapid interconversion of carbon dioxide and water to bicarbonate and protons (or vice versa). This is a reversible reaction that takes place in the gastric parietal cells.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 87
Incorrect
-
“Ploidy” is a term used to refer to the number of chromosomes in cells. Cancer cells are commonly:
Your Answer:
Correct Answer: Aneuploidy
Explanation:Cancer cells most commonly undergo disordered cell growth and cell division. This results in an additional number of chromosomes called aneuploidy. This is a characteristic of cancer cells along with variation in differentiation of the cells.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 88
Incorrect
-
According to the Vaughan William's classification of antiarrhythmic agents, lidocaine is a:
Your Answer:
Correct Answer: Class Ib agent
Explanation:Lidocaine is an example of class IB antiarrhythmics.The Vaughan-Williams classification of antiarrhythmicsI: Membrane stabilizing agentsIA: Quinidine, Procainamide, DisopyramideIB: Lidocaine, MexiletineIC: Propafenone, Flecainide II: β blockers – Propranolol, EsmololIII: Agents widening AP – Amiodarone, Dronedarone, Dofetilide, Ibutilide, SotalolIV: Calcium channel blockers – Verapamil, DiltiazemV: Miscellaneous – Digoxin, adenosine, magnesium
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 89
Incorrect
-
Cytochrome p450 enzymes expressed in hepatocytes serve to?
Your Answer:
Correct Answer: Facilitate oxidations or hydrolysis of drugs.
Explanation:Cytochrome p 450 are a family of proteins involved in drug metabolism which accounts for about 75% of the total metabolism. Most drugs are deactivated directly or by facilitated excretion from the body.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 90
Incorrect
-
Normal parents have a child with a recessive condition, Tay Sachs. The chance of them having a normal child is?
Your Answer:
Correct Answer: 75%
Explanation:The chance for normal parents having a child with a recessive disease is 1:4 or 25%. As both the parents are heterozygous for this condition. They have a 3:4 chance of having a normal child or 75%.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 91
Incorrect
-
A 39 year old woman with a history of rheumatoid arthritis has recently been switched from methotrexate to leflunomide. Monitoring of full blood count and LFTs has been carried out. Which of the following parameters should also be monitored in this case?
Your Answer:
Correct Answer: Blood pressure
Explanation:Blood pressure should be routinely measured as leflunomide may cause hypertension and thus an increase in BP. It doesn’t cause changes in blood sugar levels, peak expiratory flow rate or haematuria.
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This question is part of the following fields:
- Connective Tissue
- Medicine
-
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Question 92
Incorrect
-
The primary sensory cortex is:
Your Answer:
Correct Answer: Brodmann area 3,1,2
Explanation:A Brodmann area in the brain is defined by cytoarchitecture, histology and organization of cells:Primary somatosensory cortex is areas 3,1, and 2Primary Motor 4Premotor 6Primary Visual 17Primary Auditory 41Brocas 44
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This question is part of the following fields:
- Medicine
- Neurology
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Question 93
Incorrect
-
Which one of these features is typical of dermatomyositis?
Your Answer:
Correct Answer: Gottron's papules over knuckles of fingers
Explanation:Dermatomyositis is a long-term inflammatory disorder which affects muscles. Its symptoms are generally a skin rash and worsening muscle weakness in the proximal muscles (for example, the shoulders and thighs) over time. These may occur suddenly or develop over months. Other symptoms may include weight loss, fever, lung inflammation, or light sensitivity. Complications may include calcium deposits in muscles or skin.The skin rash may manifest as aheliotrope (a purplish color) or lilac, but may also be red. It can occur around the eyes along with swelling, as well as the upper chest or back ( shawl sign) or V-sign above the breasts and may also occur on the face, upper arms, thighs, or hands. Another form the rash takes is called Gottron’s sign which are red or violet, sometimes scaly, slightly raised papules that erupt on any of the finger joints (the metacarpophalangeal joints or the interphalangeal joints)
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This question is part of the following fields:
- Dermatology
- Medicine
-
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Question 94
Incorrect
-
Question 95
Incorrect
-
Which of the following factors is most likely to lead to an increase in serum cortisol levels?
Your Answer:
Correct Answer: Severe emotional stress
Explanation:Cortisol is widely known as the stress hormone. Alterations in cortisol levels have been found in relation to mood disorders, illness, trauma, pain, fear, exertion, and anxiety, amongst other stimuli.
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This question is part of the following fields:
- Endocrinology
- Medicine
-
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Question 96
Incorrect
-
A 68 year old male, previously diagnosed with osteoarthritis presents to your clinic with acute on chronic pain in his big toe. Past history is significant for hypertension for which he takes Bendroflumethiazide 5mg daily. Examination reveals an erythematous, red hot metatarsophalangeal joint that has a knobbly appearance. X-ray shows punched out bony cysts. Which of the following would be the most appropriate long term management for this patient?
Your Answer:
Correct Answer: Stop Bendroflumethiazide and substitute a calcium antagonist
Explanation:The most likely diagnosis is chronic tophaceous gout, which is classically associated with chronic renal impairment or long term diuretic therapy. There is tophus formation due to urate crystal deposition in and around the joint. These tophi can also form in the bones and soft tissues. Renal manifestations with uric acid include nephrolithiasis and uric acid nephropathy. Whenever there is an acute on chronic attack of gout, the inciting cause must be established and in case of diuretic use, they should be immediately replaced with another medication. Allopurinol is never started during an acute episode. it is first allowed to settle before administration of allopurinol. Although dietary restriction must be observed in people with a propensity of gout, this scenario clearly presents diuretics as the cause.
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This question is part of the following fields:
- Connective Tissue
- Medicine
-
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Question 97
Incorrect
-
Myelin sheath in the CNS is produced by?
Your Answer:
Correct Answer: Oligodendrocytes
Explanation:CNS myelin is produced by special cells called oligodendrocytes. PNS myelin is produced by Schwann cells. The two types of myelin are chemically different, but they both perform the same function — to promote efficient transmission of a nerve impulse along the axon.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 98
Incorrect
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A 28 year old female presents to the rheumatology clinic for review. She has a history of adult onset Still's disease and complains of joint pains and persistent skin rash despite undergoing treatment with methotrexate and etanercept. On examination, an erythematous macular rash and active synovitis is noted. CRP is high (95 mg/dl). Which of the following interventions would be most appropriate?
Your Answer:
Correct Answer: Anakinra
Explanation:Adult onset Still’s disease (AOSD) is an uncommon systemic inflammatory disease on the clinical spectrum of autoinflammatory disorders. Its presentation and clinical course may result in several well-differentiated phenotypes: from a systemic and highly symptomatic pattern to a chronic articular pattern. Overproduction of numerous pro-inflammatory cytokines is observed in AOSD. Anakinra, a human interleukin (IL)-1R antagonist, has recently been approved in the treatment of AOSD. Denosumab is a RANK ligand inhibitor used in the treatment of osteoporosis. Mepolizumab is used in the treatment of severe asthma with elevated eosinophils. There is some evidence to support the use of tocilizumab, an anti-IL6 monoclonal antibody in adult onset Still’s, but there is stronger data favouring the use of tocilizumab in the treatment of rheumatoid arthritis. Rituximab is usually reserved for patients who are unresponsive to anakinra.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 99
Incorrect
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Neutrophils are attracted to an infected area by:
Your Answer:
Correct Answer: Chemokines
Explanation:The major role of chemokines is to act as a chemoattractant to guide the migration of cells like neutrophils to the site of infection.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 100
Incorrect
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A 30-year-old female presents with a 4-day history of diarrhoea and vomiting. She has been unable to keep fluids down for 4 days and has been treated with metoclopramide. She develops a dystonic reaction. What is the most appropriate treatment for this woman?
Your Answer:
Correct Answer: Benztropine
Explanation:Acute dystonic reactions (extrapyramidal symptoms) such as spasmodic torticollis, trismus, and oculogyric crises can occur following the administration of metoclopramide or stemetil and thus, neither is recommended for the treatment of nausea in young women.
Such reactions respond well to treatment with benztropine or procyclidine.
– Benztropine: It is an anticholinergic medication with significant CNS penetration. A single dose of benztropine 1 to 2 mg IV followed by 1 to 2 mg p.o twice a day for up to 7 days to prevent a recurrence. Subsequently, both the offending agent and those from the same group should be avoided.
– Alternatively, diphenhydramine can be used intravenously (up to a dose of 50mg) or intramuscularly followed by p.o therapy every 6 hours for 1 to 2 to prevent a recurrence.- Second-line therapy with IV benzodiazepines is reserved for those patients who do not respond to anticholinergics.
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This question is part of the following fields:
- Medicine
- Pharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY
