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Question 1
Correct
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Which of the following is responsible for converting inactive cortisone to active cortisol in the adrenal gland?
Your Answer: 11βHSD type 1
Explanation:11β-Hydroxysteroid dehydrogenase, also known as HSD-11β or 11β-HSD, is a group of enzymes which catalyse the interconversion of active cortisol and corticosterone with inert cortisone and 11-dehydrocorticosterone.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 2
Incorrect
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The reflex responses activated by cold are controlled by which area?
Your Answer: Thalamus
Correct Answer: Posterior hypothalamus
Explanation:The posterior nucleus of the hypothalamus is responsible for thermoregulation and thermogenesis. Studies have shown that the neurons in the posterior hypothalamus which mediate the reflex of shivering are sensitive to temperature; damage to this nucleus produces hypothermia.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 3
Correct
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Interruption of the entero-hepatic circulation causes:
Your Answer: The amount of fat in the stool to be increased
Explanation:Enterohepatic circulation refers to the circulation of biliary acids, bilirubin, drugs, or other substances from the liver to the bile, followed by entry into the small intestine, absorption by the enterocyte and transport back to the liver. One of the causes of the interruption of enterohepatic circulation is the resection of the ileum where fat is mainly absorbed. Fat malabsorption results in increased fat in stools. Pale stools and dark urine is caused by obstruction of the biliary ductal system especially the common bile duct where urobilin and stercobilin are formed.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 4
Incorrect
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The alpha amylases hydrolyse which linkages in the ingested polysaccharides?
Your Answer: 1:6α linkages
Correct Answer: 1:4α linkages
Explanation:Alfa amylase hydrolyses the α (1-4) glyosidic bonds in amylose and amylopectin and leave primarily maltose.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 5
Correct
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Which statement is incorrect regarding nociceptor C fibers…
Your Answer: They are thinly myelinated
Explanation:Group C nerve fibers are unmyelinated and have a small diameter, which means they conduct impulses at a low velocity. They carry sensory information and nociception.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 6
Incorrect
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Glucose is typically removed from the urine by…?
Your Answer: Active diffusion
Correct Answer: Secondary active transport
Explanation:Glucose, amino acids, inorganic phosphate, and some other solutes are resorbed via secondary active transport through co-transporters driven by the sodium gradient out of the nephron.
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This question is part of the following fields:
- Medicine
- Renal
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Question 7
Correct
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The following is true of the sinus node:
Your Answer: It generates impulses automatically & at a quicker rate than other cardiac cells
Explanation:The SA node exhibits automaticity. It generates the impulses to which the heart beats. It fires at a faster speed than the rest of the nervous components of the heart i.e. the AV nodes, purkinje fibers. This is the reason when the SA node fails the heart beats to the rhythm of the AV node.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 8
Incorrect
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Which one of the following statements best describes a type II statistical error?
Your Answer: The p value fails to reach statistical significance
Correct Answer: The null hypothesis is accepted when it is false
Explanation:In statistical hypothesis testing there are 2 types of errors:- type I: the null hypothesis is rejected when it is true – i.e. Showing a difference between two groups when it doesn’t exist, a false positive. – type II: the null hypothesis is accepted when it is false – i.e. Failing to spot a difference when one really exists, a false negative.
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This question is part of the following fields:
- Medicine
- Research Skills
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Question 9
Correct
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Which part of the cerebellum is primarily responsible for equilibrium and eye movements?
Your Answer: Vestibulocerebellum
Explanation:The vestibulocerebellum develops at the same time as the vestibular apparatus in the inner ear. Its regulates balance between agonist and antagonist muscle contractions of the spine, hips, and shoulders during rapid movements.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 10
Incorrect
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Dietary starch is mainly:
Your Answer: Amylose
Correct Answer: Amylopectin
Explanation:Dietary starch consists of two types of molecules: the linear and helical amylose and the branched amylopectin. Starch generally contains 20 to 25% amylose and 75 to 80% amylopectin by weight but depends in the plant. Glycogen, the glucose store of animals, is a more branched version of amylopectin.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 11
Correct
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Which of the following substances is involved in the respiratory burst by the neutrophil?
Your Answer: NADPh oxidase
Explanation:Catalase Degrades H2O2 to H20 and O2, Superoxide Dismutase Forms H2O2, Myeloperoxidase Converts Br/I/Cl to acids
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This question is part of the following fields:
- Immunology
- Medicine
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Question 12
Correct
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Presence of which of the following indicates a worse prognosis in rheumatoid arthritis?
Your Answer: Anti-CCP antibodies
Explanation:Rheumatoid arthritis is both common and chronic, with significant consequences for multiple organ systems. Anti-cyclic citrullinated peptide (anti-CCP) antibody testing is particularly useful in the diagnosis of rheumatoid arthritis, with high specificity, presence early in the disease process, and ability to identify patients who are likely to have severe disease and irreversible damage. However, its sensitivity is low, and a negative result does not exclude disease. Anti-CCP antibodies have not been found at a significant frequency in other diseases to date, and are more specific than rheumatoid factor for detecting rheumatoid arthritis. The other factors that are mentioned do not play a key prognostic role.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 13
Incorrect
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In Hirschsprung disease which one is incorrect
Your Answer: The absence of peristalsis in the aganglionic region causes the symptoms
Correct Answer: Due to congenital absence of myenteric and submucosal plexuses
Explanation:During normal prenatal development, cells from the neural crest migrate into the large intestine (colon) to form the networks of nerves called the myenteric plexus (Auerbach plexus) (between the smooth muscle layers of the gastrointestinal tract wall) and the submucosal plexus (Meissner plexus) (within the submucosa of the gastrointestinal tract wall). In Hirschsprung’s disease, the migration is not complete and part of the colon lacks these nerve bodies that regulate the activity of the colon. The affected segment of the colon cannot relax and pass stool through the colon, creating an obstruction.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 14
Correct
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Which of the following is a product of D cells
Your Answer: Somatostatin
Explanation:Somatostatin is secreted by D cells, HCL and intrinsic factor secreted by parietal cells. Trefoil peptides are secreted by mucus secreting goblet cells and gastrin releasing peptide (grp) by post-ganglionic fibers of the vagus nerve (which innervate the G cells of the stomach).
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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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A 42 year old obese man complains of a painful swollen ankle. The pain has worsened over the past 2 weeks. He is a diabetic and gives a history of recent alcohol consumption. Joint aspirate shows rhomboid crystals with numerous neutrophils. Radiological examination shows evidence of chondrocalcinosis. Which of the following is the most likely diagnosis?
Your Answer: Pseudogout
Explanation:Pseudogout is a paroxysmal joint inflammation due to calcium pyrophosphate crystal deposition (calcium pyrophosphate dihydrate). Aetiology includes mostly idiopathic (primary form) and secondary form occurring as a result of joint trauma, familial chondrocalcinosis, hyperparathyroidism, hemochromatosis, gout, hypophosphatemia. Clinical presentation: Often asymptomatic. Acute (pseudogout attack): monoarthritis (rarely oligoarthritis), mostly affecting the knees and other large joints (e.g., hips, wrists, and ankles). It may become chronic (can affect multiple joints). Osteoarthritis with CPPD (most common form of symptomatic CPPD): progressive joint degeneration with episodes of acute inflammatory arthritis typical of pseudogout attacks. Arthrocentesis should be performed, especially in acute cases. Polarized light microscopy: detection of rhomboid-shaped, positively birefringent CPPD crystals. Synovial fluid findings: 10,000-50,000 WBCs/μL with > 90% neutrophils. X-ray findings: cartilage calcification of the affected joint (chondrocalcinosis). Fibrocartilage (meniscus, annulus fibrosus of intervertebral disc) and hyaline cartilage (joint cartilage) may be affected.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 16
Correct
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A 25-year-old male presents to the emergency department with fever, sweating, hyperventilation and breathing difficulty. He also complains of a continuous ringing sensation in both his ears for the past couple of days. He admits to consuming a lot of over the counter painkillers for the past few days. Which of the following drugs is the most likely cause of these symptoms?
Your Answer: Aspirin
Explanation:The presence of tinnitus, fever and hyperventilation are clues for aspirin (salicylate) toxicity. Clinical Presentation of salicylate toxicity can include:• Pulmonary manifestations include: Hyperventilation, hyperpnea, severe dyspnoea due to noncardiogenic pulmonary oedema, fever and dyspnoea due to aspiration pneumonitis• Auditory symptoms caused by the ototoxicity of salicylate poisoning include: Hard of hearing and deafness, and tinnitus (commonly encountered when serum salicylate concentrations exceed 30 mg/dL).• Cardiovascular manifestations include: Tachycardia, hypotension, dysrhythmias – E.g., ventricular tachycardia, ventricular fibrillation, multiple premature ventricular contractions, asystole – with severe intoxication, Electrocardiogram (ECG) abnormalities – E.g., U waves, flattened T waves, QT prolongation may reflect hypokalaemia.• Neurologic manifestations include: CNS depression, with manifestations ranging from somnolence and lethargy to seizures and coma, tremors, blurring of vision, seizures, cerebral oedema – With severe intoxication, encephalopathy• GI manifestations include: Nausea and vomiting, which are very common with acute toxicity, epigastric pain, GI haemorrhage – More common with chronic intoxication, intestinal perforation, pancreatitis, hepatitis – Generally in chronic toxicity; rare in acute toxicity, Oesophageal strictures – Reported as a very rare delayed complication• Genitourinary manifestations include: Acute kidney injury (NSAID induced Nephropathy) is an uncommon complication of salicylate toxicity, renal failure may be secondary to multisystem organ failure.• Hematologic effects may include prolongation of the prothrombin and bleeding times and decreased platelet adhesiveness. Disseminated intravascular coagulation (DIC) may be noted with multisystem organ failure in association with chronic salicylate toxicity.• Electrolyte imbalances like: Dehydration, hypocalcaemia, acidaemia, Syndrome of inappropriate antidiuretic hormone secretion (SIADH), hypokalaemiaManagement of these patients should be done in the following manner:• Secure Airway, Breathing, and Circulation• Supportive therapy• GI decontamination• Urinary excretion and alkalization• Haemodialysis
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 17
Correct
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Regarding the length of systole and diastole which of the following is true?
Your Answer: The duration of systole is more fixed than diastole
Explanation:The duration of systole is more fixed than the duration of diastole. When the heart rate increases the timing of systole remains more or less the same however, diastole decreases.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 18
Correct
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The process where by DNA fragments are separated by size and charge is called:
Your Answer: Gel electrophoresis
Explanation:Fragments of DNA of varying length can be separated on the basis of their charge and their size by a process called gel electrophoresis. Because DNA contains negatively charged phosphate groups, it will migrate in an electric field toward the positive electrode. Shorter chains migrate more rapidly through the pores of the gel, and thus separation depends on length. DNA bands in the gel can be visualized by various techniques including staining with dyes and autoradiography.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 19
Correct
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Which caspase is part of both the intrinsic and extrinsic apoptotic pathways?
Your Answer: Caspase-3
Explanation:Once initiator caspases are activated in both the intrinsic and extrinsic pathway, they produce a chain reaction, activating several other executioner caspases (Caspase 3, Caspase 6 and Caspase 7).
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 20
Incorrect
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Choose the correct statement about Aminoglycosides and Chloramphenicol
Your Answer: Aminoglycosides work on Ribosome 50 S peptidyl transferase
Correct Answer: Chloramphenicol works on Ribosome 50 S peptidyl transferase
Explanation:Aminoglycoside is a category of traditional Gram-negative antibacterial therapeutic agents that inhibit protein synthesis. Aminoglycoside antibiotics display bactericidal activity against gram-negative aerobes and some anaerobic bacilli where resistance has not yet arisen, but generally not against Gram-positive and anaerobic Gram-negative bacteria.Chloramphenicol is a bacteriostatic by inhibiting protein synthesis. It prevents protein chain elongation by inhibiting the peptidyl transferase activity of the bacterial ribosome. It specifically binds to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit, preventing peptide bond formation.
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 21
Incorrect
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Which of the following structures of the cardiac conduction system is located in the right posterior portion of the interatrial septum?
Your Answer: SA node
Correct Answer: AV node
Explanation:AV node is located at the right posterior portion of the interatrial septum.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 22
Incorrect
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Growth hormone deficiency causes?
Your Answer: Protein anabolism
Correct Answer: Decreased epiphyseal growth
Explanation:Growth hormone deficiency is caused by conditions affecting the pituitary gland, such as tumours. Its effects depend on the age of the patient: in infancy and childhood, growth failure is most likely to occur. The epiphyseal plate is the area in long bones where growth occurs, and it is the area affected by growth hormone deficiency. Poor growth/shortness is the main symptom of GH deficiency in children, usually resulting in growth at about half the usual rate for age.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 23
Correct
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Intermediate filaments achieve cell to cell contact via:
Your Answer: Desmosomes
Explanation:At the plasma membrane, some keratins interact with desmosomes (cell-cell adhesion) and hemidesmosomes (cell-matrix adhesion) via adapter proteins.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 24
Correct
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A 47-year-old male with type II diabetes mellitus presents to your clinic with a history suggestive of erectile dysfunction. You decide to start him on sildenafil citrate. What is the mechanism of action of this drug?
Your Answer: Phosphodiesterase type V inhibitor
Explanation:Sildenafil (Viagra) is a phosphodiesterase type V inhibitor used in the treatment of impotence.Contraindications:- Patients taking nitrates and related drugs such as nicorandil- Hypotension- Recent stroke or myocardial infarction (NICE recommend waiting 6 months)Side-effects:Visual disturbances e.g. cyanopsia, non-arthritic anterior ischaemic NeuropathyNasal congestionFlushingGastrointestinal side-effectsHeadache
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 25
Correct
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With regards to the Na+/K+ ATPase, which one of the following is correct?
Your Answer: 3 Na+ released into the extracellular fluid
Explanation:Na+/K+ pump or sodium–potassium pump is an enzyme found in the plasma membrane. This pumping is active (i.e. it uses energy from ATP) and is important for cell physiology. Its simple function is to pump 3 sodium ions out for every 2 potassium ions taken in and since they both have equal ionic charges, this creates a electrochemical gradient between a cell and its exterior.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 26
Incorrect
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Concerning surface anatomy, where is the mitral valve found?
Your Answer: Situated in the 4th intercostal space in the anterior axillary line
Correct Answer: Situated in the 4th intercostal space to the left of the sternum
Explanation:The mitral valve is situated in the left 4th intercostal space just beneath the sternum.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 27
Incorrect
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Which of the following is not a cause of drug-induced hepatitis?
Your Answer: Amiodarone
Correct Answer: Ethambutol
Explanation:Although rare, ocular toxicity in the form of optic neuritis (most commonly retrobulbar neuritis) has been well documented as a side effect of ethambutol. It is renally excreted and not associated with hepatitis.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 28
Incorrect
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In the gastric mucosa, which of the following cells is known to secrete gastric lipase?
Your Answer: Stem cell
Correct Answer: Chief cell
Explanation:Chief cells produce pepsinogen and gastric lipase. Parietal cells produce stomach acid and intrinsic factor.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 29
Incorrect
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In paralytic ileus the following are true except:
Your Answer: Parkinson's Disease is not a known cause.
Correct Answer: Opioid blocking drugs will exacerbate the symptoms
Explanation:Paralytic ileus causes adynamic intestinal obstruction or decreased peristalsis and the most common reason being postoperative ileus. Opioid drugs like morphine are given for pain management and cause decreased peristalsis in the gut resulting in constipation. Theoretically opioid blocking drugs or opioid antagonists can increase peristalsis and can alleviate paralytic ileus symptoms.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 30
Correct
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What is the most common cardiac defect seen in patients with Down’s syndrome?
Your 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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SESSION STATS - PERFORMANCE PER SPECIALTY
