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  • Question 1 - Nifedipine commonly causes which of the following adverse effects? ...

    Correct

    • Nifedipine commonly causes which of the following adverse effects?

      Your Answer: Ankle oedema

      Explanation:

      Most common adverse effects of Nifedipine include:
      Peripheral oedema (10-30%)
      Dizziness (23-27%)
      Flushing (23-27%)
      Headache (10-23%)
      Heartburn (11%)
      Nausea (11%)

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      10.7
      Seconds
  • Question 2 - What is the most common application of Nitrates? ...

    Correct

    • What is the most common application of Nitrates?

      Your Answer: Angina

      Explanation:

      In patients with exertional stable angina, nitrates improve exercise tolerance, time to onset of angina, and ST-segment depression during exercise testing. In combination with beta-blockers or calcium channel blockers, nitrates produce greater anti-anginal and anti-ischemic effects.
      While they act as vasodilators, coronary vasodilators, and modest arteriolar dilators, the primary anti ischemic effect of nitrates is to decrease myocardial oxygen demand by producing systemic vasodilation more than coronary vasodilation. This systemic vasodilation reduces left ventricular systolic wall stress.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      9.3
      Seconds
  • Question 3 - Which of the following medications may lessen warfarin's anticoagulant effect: ...

    Incorrect

    • Which of the following medications may lessen warfarin's anticoagulant effect:

      Your Answer: Metronidazole

      Correct Answer: Phenytoin

      Explanation:

      Phenytoin will decrease the level or effect of warfarin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
      Metronidazole will increase the level or effect of warfarin by affecting hepatic enzyme CYP2C9/10 metabolism.
      NSAIDs, when given with Warfarin, increase anticoagulation.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      146.6
      Seconds
  • Question 4 - All of the statements regarding vascular tone are correct except: ...

    Correct

    • All of the statements regarding vascular tone are correct except:

      Your Answer: Most endogenous vasodilators act by decreasing levels of cAMP or cGMP.

      Explanation:

      Most vasoconstrictors bind to G-protein coupled receptors. These mediate elevation in intracellular [Ca2+] which leads to vascular smooth muscle contraction. Important vasoconstrictors include noradrenaline, endothelin-1 and angiotensin II.

      Increased intracellular Ca2+ is as a result of the release of Ca2+from the sarcoplasmic reticulum and depolarisation and entry of Ca2+via L-type voltage-gated Ca2+channels. Most types of vascular smooth muscle do not generate action potentials – instead, the depolarisation is graded, which allows graded entry of Ca2+.
      sequestration by the sarcoplasmic reticulum Ca2+ATPase, removal from the cell by a plasma membrane Ca2+ATPase and Na+/Ca2+exchange decreases intracellular Ca2+, resulting in vasodilation. Relaxation is a result of most endogenous vasodilators when there is an increase in cyclic guanosine monophosphate (cGMP) like nitric oxide) or cyclic adenosine monophosphate (cAMP) like prostacyclin and beta-adrenergic receptor agonists. These activate protein kinases causing substrate level phosphorylation.
      Clinically effective vasodilators are L-type Ca2+channel blocker drugs.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      16.7
      Seconds
  • Question 5 - What is the main mechanism of action of dopamine as an inotropic sympathomimetic: ...

    Incorrect

    • What is the main mechanism of action of dopamine as an inotropic sympathomimetic:

      Your Answer: Dopamine receptor agonist

      Correct Answer: Beta1-receptor agonist

      Explanation:

      Dopamine is a neurotransmitter and a metabolic precursor of the catecholamines. It acts on beta1-receptors in cardiac muscle increasing cardiac contractility, and increases renal perfusion by stimulating dopamine receptors in the renal vasculature. This is of benefit in cardiogenic shock where deterioration of renal function is common.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      80.4
      Seconds
  • Question 6 - Adrenocorticotropic hormone release from the anterior pituitary is stimulated by which of the...

    Incorrect

    • Adrenocorticotropic hormone release from the anterior pituitary is stimulated by which of the following:

      Your Answer: Cortisol

      Correct Answer: Corticotropin-releasing hormone

      Explanation:

      ACTH secretion is stimulated by corticotropin-releasing hormone (CRH) from the hypothalamus.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      34.2
      Seconds
  • Question 7 - Which of the following hormones is dysfunctional in diabetes insipidus: ...

    Correct

    • Which of the following hormones is dysfunctional in diabetes insipidus:

      Your Answer: Antidiuretic hormone

      Explanation:

      Diabetes insipidus (DI) may result from a deficiency of ADH secretion (cranial DI) or from an inappropriate renal response to ADH (nephrogenic DI). As a result, fluid reabsorption at the kidneys is impaired, resulting in large amounts of hypotonic, dilute urine being passed with a profound unquenchable polydipsia.
      The biochemical hallmarks of DI are:
      High plasma osmolality (> 295 mOsm/kg)
      Low urine osmolality (< 300 mOsm/kg)
      Hypernatraemia (> 145 mmol/L)
      High urine volume

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      7.5
      Seconds
  • Question 8 - By which of the following is mean arterial pressure (MAP) primarily determined? ...

    Incorrect

    • By which of the following is mean arterial pressure (MAP) primarily determined?

      Your Answer: Total peripheral resistance and heart rate

      Correct Answer: Total peripheral resistance and cardiac output

      Explanation:

      Mean arterial pressure (MAP) = Cardiac output (CO) x Total peripheral resistance (TPR).

      Cardiac output is dependent on the central venous pressure (CVP). CVP, in turn, is highly dependent on the blood volume.
      Any alterations of any of these variables will likely change MAP.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      28.4
      Seconds
  • Question 9 - ACE inhibitors are indicated for all of the following EXCEPT for: ...

    Correct

    • ACE inhibitors are indicated for all of the following EXCEPT for:

      Your Answer: Angina

      Explanation:

      ACE inhibitors have many uses and are generally well tolerated. They are indicated for:

      • Heart failure
      • Hypertension
      • Diabetic nephropathy
      • Secondary prevention of cardiovascular events

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      7.5
      Seconds
  • Question 10 - Nitric oxide release from endothelium is stimulated by all of the following EXCEPT...

    Incorrect

    • Nitric oxide release from endothelium is stimulated by all of the following EXCEPT for:

      Your Answer: Shear stress

      Correct Answer: Noradrenaline

      Explanation:

      Nitric oxide (NO) production by the endothelium is increased by factors that elevate intracellular Ca2+, including local mediators such as bradykinin, histamine and serotonin, and some neurotransmitters (e.g. substance P). Increased flow (shear stress) also stimulates NO production and additionally activates prostacyclin synthesis. The basal production of NO continuously modulates vascular resistance; increased production of nitric oxide acts to cause vasodilation. Nitric oxide also inhibits platelet activation and thrombosis.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      11.4
      Seconds
  • Question 11 - The mechanism of action of abciximab is by: ...

    Correct

    • The mechanism of action of abciximab is by:

      Your Answer: Blocking the binding of fibrinogen to GPIIb/IIIa receptor sites

      Explanation:

      Abciximab is a glycoprotein IIb/IIIa inhibitors and prevents platelet aggregation by blocking the binding of fibrinogen to receptors on platelets.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      4.4
      Seconds
  • Question 12 - Which of the following is not true regarding the structure and function of...

    Incorrect

    • Which of the following is not true regarding the structure and function of glomerular filtration membrane?

      Your Answer: Fenestrated capillaries give greater permeability

      Correct Answer: The absence of a basement membrane reduces impedance to filtration

      Explanation:

      The glomerular filtration membrane is composed of fenestrated capillary endothelium, basement membrane, and filtration slits. It is an organized, semipermeable membrane preventing the passage of most of the proteins into the urine.

      The anatomical arrangement of the glomerular filtration membrane maximizes the surface area available for filtration. The arrangement of its arterioles results in high hydrostatic pressures and facilitates filtration.

      Fenestrated capillary endothelium of the glomerular filtration membrane is with relatively large pores. It allows the free movement of plasma proteins and solutes but still restricts the movement of blood cells.

      Filtration slits are the smallest filters and restrict the movement of plasma proteins but still allow free movement of ions and nutrients.

      The glomerular basement membrane (GBM) is a critical component of the glomerular filtration membrane. Thus, it is not true that its absence will reduce the resistance of flow. The basement membrane is true to be more selective and contains negatively charged glycoproteins. However, it still allows free passage of water, nutrients, and ions. Severe structural abnormalities of the GBM can result in protein (albumin) leakage.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      37.2
      Seconds
  • Question 13 - Regarding postural hypotension, which of the following statements is INCORRECT: ...

    Correct

    • Regarding postural hypotension, which of the following statements is INCORRECT:

      Your Answer: Postural hypotension usually causes a reflex bradycardia.

      Explanation:

      On standing from a prone position, gravity causes blood to pool in veins in the legs. Central venous pressure (CVP) falls, causing a fall in stroke volume and cardiac output (due to Starling’s law) and thus a fall in blood pressure. Normally this fall in BP is rapidly corrected by the baroreceptor reflex which causes venoconstriction (partially restoring CVP), and an increase in heart rate and contractility, so restoring cardiac output and blood pressure. Impaired autonomic nervous activity in the elderly accounts for the greater likelihood of postural hypotension. Any symptoms of dizziness, blurred vision or syncope is due to a transient fall in cerebral perfusion that occurs before cardiac output and mean arterial pressure (MAP) can be corrected.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      37.7
      Seconds
  • Question 14 - You are about to give an antimuscarinic agent to a 55 year-old male...

    Correct

    • You are about to give an antimuscarinic agent to a 55 year-old male patient. Which of the following conditions will make you with stop the administration, since it is a contraindication to antimuscarinic agents?

      Your Answer: Prostatic enlargement

      Explanation:

      Antimuscarinic medications may impair the contractility of bladder smooth muscle, resulting in acute urine retention in men with BPH, and should be avoided or used with caution.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      13.3
      Seconds
  • Question 15 - The following all cause a right shift in the oxygen dissociation curve EXCEPT...

    Correct

    • The following all cause a right shift in the oxygen dissociation curve EXCEPT for:

      Your Answer: Foetal haemoglobin

      Explanation:

      A decreased affinity of haemoglobin for oxygen (and hence increased ease of dissociation), shown by a right shift in the oxygen dissociation curve, is caused by a fall in pH, a rise in PCO2(the Bohr effect) and an increase in temperature. These changes occur in metabolically active tissues such as in exercise, and encourage oxygen release. The metabolic by-product 2,3-diphosphoglycerate (2,3 -DPG) also causes a right shift; 2, 3 -DPG may also be raised in chronic anaemia, chronic lung disease, or at high altitude. Foetal haemoglobin (HbF) binds 2, 3 -DPG less strongly than does adult haemoglobin (HbA), and so the HbF dissociation curve lies to the left of that for HbA, reflecting its higher oxygen affinity. This helps transfer oxygen from mother to foetus.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      9.6
      Seconds
  • Question 16 - Which of the following statements is correct regarding hyponatraemia? ...

    Correct

    • Which of the following statements is correct regarding hyponatraemia?

      Your Answer: Correction of serum sodium that is too rapid can precipitate central pontine myelinolysis.

      Explanation:

      Hyponatraemia refers to a serum sodium concentration < 135 mmol/L.
      It is safer to quickly correct acute hyponatremia than chronic hyponatremia but correction should not be too fast, especially in chronic hyponatraemia, because of the risk of central pontine myelinolysis. Hyponatraemia is usually associated with a low plasma osmolality.
      Under normal circumstances, if serum osmolality is low, then urine osmolality should also be low because the kidneys should be trying to retain solute.
      In SIADH, excess ADH causes water retention, but not the retention of solute. Therefore, urine that is concentrated and relatively high in sodium is produced, even though the serum sodium is low (urine osmolality > 100 mosmol/kg).

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      31.7
      Seconds
  • Question 17 - You are reviewing a patient with hypocalcaemia secondary to hypoparathyroidism. Parathyroid hormone (PTH)...

    Incorrect

    • You are reviewing a patient with hypocalcaemia secondary to hypoparathyroidism. Parathyroid hormone (PTH) acts to increased calcium reabsorption at which of the following sites in the nephron:

      Your Answer: Descending loop of Henle

      Correct Answer: Distal convoluted tubule

      Explanation:

      Parathyroid hormone (PTH) is a peptide hormone synthesised by the chief cells of the parathyroid glands, located immediately behind the thyroid gland. PTH is primarily released in response to decreasing plasma [Ca2+] concentration. PTH acts to increase plasma calcium levels and decrease plasma phosphate levels.
      Parathyroid hormone (PTH) acts to increase calcium reabsorption in the distal tubule of the nephron (by activating Ca2+entry channels in the apical membrane and the Ca2+ATPase pump in the basolateral membrane) and increase phosphate excretion by inhibiting reabsorption in the proximal tubule of the nephron.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      19.4
      Seconds
  • Question 18 - Which of the following statements is correct regarding the partial pressure of oxygen...

    Incorrect

    • Which of the following statements is correct regarding the partial pressure of oxygen during respiration?

      Your Answer: Exhaled PO 2 < Alveolar PO 2 < Inhaled PO 2

      Correct Answer: Exhaled PO 2 > Alveolar PO 2

      Explanation:

      Because of humidification, inspired PO2 in the airways is less than inhaled PO2.
      Because of gas exchange, alveolar PO2 is less than inhaled or inspired PO2.
      Because of mixing with anatomical dead space (air that has not taken part in gas exchange, exhaled PO2 is greater than alveolar O2, and therefore that has relatively higher PO2 on the way out, but is less than inhaled or inspired PO2.
      Typical values for a resting young healthy male (in kPa) are shown below:
      -Inhaled air: PO221.2, PCO20.0
      -Inspired air in airways (after humidification): PO219.9, PCO20.0
      -Alveolar air (after equilibrium with pulmonary capillaries): PO213.3, PCO25.3
      -Exhaled air (after mixing with anatomical dead space air): PO215.5, PCO24.3

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      46.2
      Seconds
  • Question 19 - A 59-year-old man presents with a goitre, increased sweating, weight loss, and palpitations....

    Correct

    • A 59-year-old man presents with a goitre, increased sweating, weight loss, and palpitations. A diagnosis of hyperthyroidism is suspected.

      What is the most appropriate first-line investigation?

      Your Answer: TSH level

      Explanation:

      A thyroid function test is used in the diagnosis of hyperthyroidism.
      Serum TSH should be the first-line investigation for patients with suspected hyperthyroidism as it has the highest sensitivity and specificity for hyperthyroidism.

      A normal TSH level almost always excludes the diagnosis, though there are rare exceptions to this.

      Antithyroglobulin antibodies are commonly present in Graves’ disease, but the test has a sensitivity of 98% and specificity of 99, and is not widely available.

      Radioactive iodine uptake scan using iodine-123 – shows low uptake in thyroiditis but high in Graves’ disease and toxic multinodular goitre. It is however, not first-line investigation in this case

      Thyroid ultrasound scan – is a cost-effective and safe alternative to the radioactive iodine uptake scan.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      11.2
      Seconds
  • Question 20 - Compliance is decreased by all but which one of the following: ...

    Incorrect

    • Compliance is decreased by all but which one of the following:

      Your Answer: Pulmonary fibrosis

      Correct Answer: Aging

      Explanation:

      Factors increasing compliance:
      Old age
      Emphysema

      Factors decreasing compliance:
      Pulmonary fibrosis
      Pulmonary oedema
      Atelectasis
      Extremes of lung volumes (at higher lung volumes the compliance of the lung becomes less as the lung becomes stiffer)

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      15.4
      Seconds
  • Question 21 - Which of the following ions normally has the highest concentration in intracellular fluid: ...

    Correct

    • Which of the following ions normally has the highest concentration in intracellular fluid:

      Your Answer: K +

      Explanation:

      Potassium (K+) is the principal intracellular ion; approximately 4 mmol/L is extracellular (3%) and 140 mmol/L intracellular (97%).

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      15.2
      Seconds
  • Question 22 - Gastric emptying is inhibited by all of the following EXCEPT for: ...

    Correct

    • Gastric emptying is inhibited by all of the following EXCEPT for:

      Your Answer: Parasympathetic stimulation

      Explanation:

      Gastric emptying is decreased by:
      Enterogastric inhibitory reflexes stimulated by – Distension of the duodenum, The presence of fats in the duodenum (by stimulating release of cholecystokinin), A fall in the pH of chyme in the duodenum, An increase in the osmolality of chyme in the duodenum, Irritation of the mucosal lining of the duodenum, Hormones: Cholecystokinin, Secretin

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      9.2
      Seconds
  • Question 23 - A 54-year-old woman has been visiting her GP with symptoms of tiredness, muscle...

    Correct

    • A 54-year-old woman has been visiting her GP with symptoms of tiredness, muscle weakness and headaches. She is known to be hypertensive and takes amlodipine to control this. Her blood results today show that her potassium level is low at 3.0 mmol/L, and her sodium level is slightly elevated at 146 mmol/L.
      Which of the following is the SINGLE most appropriate INITIAL investigation?

      Your Answer: Plasma renin and aldosterone levels

      Explanation:

      Primary hyperaldosteronism occurs when there are excessive levels of aldosterone independent of the renin-angiotensin axis. Secondary hyperaldosteronism occurs due to high renin levels.
      The causes of primary hyperaldosteronism include:
      Adrenal adenoma (Conn’s syndrome) – the most common cause of hyperaldosteronism (,80% of all cases). These are usually unilateral and solitary and are more common in women.
      Adrenal hyperplasia – this accounts for ,15% of all cases. Usually, bilateral adrenal hyperplasia (BAH) but can be unilateral rarely. More common in men than women.
      Adrenal cancer – a rare diagnosis but essential not to miss
      Familial aldosteronism – a rare group of inherited conditions affecting the adrenal glands
      The causes of secondary hyperaldosteronism include:
      Drugs – diuretics
      Obstructive renal artery disease – renal artery stenosis and atheroma
      Renal vasoconstriction – occurs in accelerated hypertension
      Oedematous disorders – heart failure, cirrhosis and nephrotic syndrome
      Patients are often asymptomatic. When clinical features are present, the classically described presentation of hyperaldosteronism is with:
      Hypertension
      Hypokalaemia
      Metabolic alkalosis
      Sodium levels can be normal or slightly raised
      Other, less common, clinical features include:
      Lethargy
      Headaches
      Muscle weakness (from persistent hypokalaemia)
      Polyuria and polydipsia
      Intermittent paraesthesia
      Tetany and paralysis (rare)
      Often the earliest sign of hyperaldosteronism is from aberrant urea and electrolytes showing hypokalaemia and mild hypernatraemia. If the patient is taking diuretics, and the diagnosis is suspected, these should be repeated after the patient has taken off diuretics.
      If the diagnosis is suspected, plasma renin and aldosterone levels should be checked. Low renin and high aldosterone levels (with a raised aldosterone: renin ratio) is suggestive of primary aldosteronism.
      If the renin: aldosterone ratio is high, then the effect of posture on renin, aldosterone and cortisol can be investigated to provide further information about the underlying cause of primary hyperaldosteronism. Levels should be measured lying at 9 am and standing at noon:
      If aldosterone and cortisol levels fall on standing, this is suggestive of an ACTH dependent cause, e.g. adrenal adenoma (Conn’s syndrome)
      If aldosterone levels rise and cortisol levels fall on standing, this is suggestive of an angiotensin-II dependent cause, e.g. BAH
      Other investigations that can help to distinguish between an adrenal adenoma and adrenal hyperplasia include:
      CT scan
      MRI scan
      Selective adrenal venous sampling

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      84.1
      Seconds
  • Question 24 - Which of the following best describes digoxin: ...

    Correct

    • Which of the following best describes digoxin:

      Your Answer: A positive inotrope and negative chronotrope

      Explanation:

      Digoxin is a cardiac glycoside used in the treatment of atrial fibrillation and flutter, and congestive cardiac failure. It acts by inhibiting the membrane Na/K ATPase in cardiac myocytes. This raises intracellular sodium concentration and increases intracellular calcium availability indirectly via Na/Ca exchange. The increase in intracellular calcium levels causes an increases the force of myocardial contraction (positive inotrope), and slows the heart rate (negative chronotrope).

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      23.6
      Seconds
  • Question 25 - Which of the following is an action of glucagon: ...

    Correct

    • Which of the following is an action of glucagon:

      Your Answer: Stimulates glycogenolysis

      Explanation:

      Glucagon is a peptide hormone that is produced and secreted by alpha cells of the islets of Langerhans, which are located in the endocrine portion of the pancreas. The main physiological role of glucagon is to stimulate hepatic glucose output, thereby leading to increases in glycaemia. It provides the major counter-regulatory mechanism to insulin in maintaining glucose homeostasis.
      Hypoglycaemia is the principal stimulus for the secretion of glucagon but may also be used as an antidote in beta-blocker overdose and in anaphylaxis in patients on beta-blockers that fail to respond to adrenaline.
      Glucagon then causes:
      Glycogenolysis
      Gluconeogenesis
      Lipolysis in adipose tissue
      The secretion of glucagon is also stimulated by:
      Adrenaline
      Cholecystokinin
      Arginine
      Alanine
      Acetylcholine
      The secretion of glucagon is inhibited by:
      Insulin
      Somatostatin
      Increased free fatty acids
      Increased urea production

      Glycolysis is the metabolic pathway that converts glucose into pyruvate. The free energy released by this process is used to form ATP and NADH. Glycolysis is inhibited by glucagon, and glycolysis and gluconeogenesis are reciprocally regulated so that when one cell pathway is activated, the other is inactive and vice versa.

      Glucagon has a minor effect of enhancing lipolysis in adipose tissue. Lipolysis is the breakdown of lipids and involves the hydrolysis of triglycerides into glycerol and free fatty acids. It makes fatty acids available for oxidation.

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
      33.9
      Seconds
  • Question 26 - All of the following are indications for beta-blockers EXCEPT for: ...

    Correct

    • All of the following are indications for beta-blockers EXCEPT for:

      Your Answer: Raynaud's disease

      Explanation:

      Beta-blockers are contraindicated in Raynaud’s syndrome.
      Beta-blockers may be indicated in:
      Hypertension
      Pheochromocytoma (only with an alpha-blocker)
      Angina
      Secondary prevention after ACS
      Arrhythmias including atrial fibrillation
      Heart failure
      Thyrotoxicosis
      Anxiety
      Prophylaxis of migraine
      Essential tremor
      Glaucoma

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      9.8
      Seconds
  • Question 27 - On her most recent blood tests, a 55 year-old female with a history of hypertension...

    Correct

    • On her most recent blood tests, a 55 year-old female with a history of hypertension was discovered to be hypokalaemic. She  is diagnosed with primary hyperaldosteronism.

      Which of the following is a direct action of aldosterone?

      Your Answer: Secretion of H + into the distal convoluted tubule

      Explanation:

      Aldosterone is a steroid hormone produced in the adrenal cortex’s zona glomerulosa. It is the most important mineralocorticoid hormone in the control of blood pressure. It does so primarily by promoting the synthesis of Na+/K+ATPases and the insertion of more Na+/K+ATPases into the basolateral membrane of the nephron’s distal tubules and collecting ducts, as well as stimulating apical sodium and potassium channel activity, resulting in increased sodium reabsorption and potassium secretion. This results in sodium conservation, potassium secretion, water retention, and a rise in blood volume and blood pressure.

      Aldosterone is produced in response to the following stimuli:

      Angiotensin II levels have risen.
      Potassium levels have increased.
      ACTH levels have risen.
      Aldosterone’s principal actions are as follows:
      Na+ reabsorption from the convoluted tubule’s distal end
      Water resorption from the distal convoluted tubule (followed by Na+)
      Cl is reabsorbed from the distal convoluted tubule.
      K+ secretion into the convoluted distal tubule’s 
      H+ secretion into the convoluted distal tubule’s 

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      18.2
      Seconds
  • Question 28 - A patient complains of stomach ache. You see a midline scar in the...

    Correct

    • A patient complains of stomach ache. You see a midline scar in the epigastric area when you examine the abdomen. Upon further interrogation, the patient reveals that she had a subtotal gastrectomy for recurring stomach ulcers several years ago. The stomach mucosa secretes a variety of vital compounds, and her ability to secrete some of these molecules has been harmed as a result of his surgery.

      The stomach D-cells secrete which of the following substances?

      Your Answer: Somatostatin

      Explanation:

      Somatostatin-producing cells present in the pyloric antrum, duodenum, and pancreatic islets are known as D-cells or delta-cells. Somatostatin inhibits gastric acid secretion by acting directly on acid-producing parietal cells in the stomach via a G-protein coupled receptor. By suppressing the release of other hormones such as gastrin, secretin, and histamine, somatostatin can indirectly reduce stomach acid output, slowing the digesting process.
      The table below summarizes the many cell types found in the stomach, as well as the substances secreted by each cell type and the function of the secretion:

      Cell type/ Substance secreted/ Function of secretion
      Parietal cells/ Hydrochloric acid/ Kills microbes and activates pepsinogen
      Parietal cells/ Intrinsic factor/Binds to vitamin B12 and facilitates its absorption
      Chief cells/ Pepsinogen/ Protein digestion
      Chief cells/ Gastric lipase/ Fat digestion
      G-cells/ Gastrin/ Stimulates gastric acid secretion
      Enterochromaffin-like cells (ECL cells) /Histamine/ Stimulates gastric acid secretion
      Mucous-neck cells/ Mucous and bicarbonate/ Protects stomach epithelium from acid
      D-cells/ Somatostatin/ Inhibits gastric acid secretion

    • This question is part of the following fields:

      • Gastrointestinal Physiology
      • Physiology
      51.5
      Seconds
  • Question 29 - A 30-year-old woman was involved in a road traffic accident and had a...

    Incorrect

    • A 30-year-old woman was involved in a road traffic accident and had a class I haemorrhage.

      Which physiological parameter is consistent with a diagnosis of class I haemorrhage?

      Your Answer: Pulse rate of 115 bpm

      Correct Answer: Increased pulse pressure

      Explanation:

      There are 4 classes of haemorrhage. Classification is based on clinical signs and physiological parameters.

      In CLASS I:Blood loss (ml) is < or = 750
      Blood loss(% blood volume) < or = 15%
      Pulse rate (bpm) is <100
      Respiratory rate is 14-20
      Urine output (ml/hr) is >30
      Pulse pressure is normal or increased
      Systolic BP is normal
      CNS/mental status patient is slightly anxious

      In CLASS II:
      Blood loss (ml) is 750 – 1500
      Blood loss(% blood volume) is 15 – 30%
      Pulse rate (bpm) is 100 – 120
      Respiratory rate is 20-30
      Urine output (ml/hr) is 20-30
      Pulse pressure is decreased
      Systolic BP is normal
      CNS/mental status patient is mildly anxious

      In CLASS III:
      Blood loss (ml) is 1500 – 2000
      Blood loss(% blood volume) is 30- 40%
      Pulse rate (bpm) is 120 – 140
      Respiratory rate is 30-40
      Urine output (ml/hr) is 5-15
      Pulse pressure is decreased
      Systolic BP is decreased
      CNS/mental status patient is anxious, confused

      In CLASS IV:
      Blood loss (ml) is >2000
      Blood loss(% blood volume) is >40%
      Pulse rate (bpm) is >140
      Respiratory rate is >40
      Urine output (ml/hr) is negligible
      Pulse pressure is decreased
      Systolic BP is decreased
      CNS/mental status patient is confused, lethargic

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      25.2
      Seconds
  • Question 30 - Which of the following is NOT an effect of gastrin: ...

    Correct

    • Which of the following is NOT an effect of gastrin:

      Your Answer: Stimulation of insulin release

      Explanation:

      Gastrin acts to:
      Stimulate acid secretion from parietal cells (both directly and indirectly by stimulating release of histamine from ECL cells)
      Stimulate pepsinogen secretion from chief cells
      Increase gastric motility
      Stimulate growth of gastric mucosa

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      18
      Seconds

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