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  • Question 1 - When observing a JVP, which of the following would lead to prominent v...

    Correct

    • When observing a JVP, which of the following would lead to prominent v waves?

      Your Answer: Tricuspid regurgitation

      Explanation:

      The v wave corresponds to Venous filling when the tricuspid valve is closed and venous pressure increases from venous return. In Tricuspid regurgitation there is additional blood from the regurgitant flow and thus this leads to a more prominent V wave.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13
      Seconds

  • Question 2 - Cell membrane proteins may act as: ...

    Correct

    • Cell membrane proteins may act as:

      Your Answer: All of the options

      Explanation:

      Membrane proteins perform a variety of functions including:Membrane receptor proteins relay or carry signals between the cell’s internal and external environments.Transport proteins move molecules and ions (ionic channels) across the membrane. Membrane enzymes may have many activities, such as oxidoreductase, transferase or hydrolase andCell adhesion molecules

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      7.5
      Seconds

  • Question 3 - Approximately what percentage of the world is infected with tuberculosis: ...

    Incorrect

    • Approximately what percentage of the world is infected with tuberculosis:

      Your Answer: 0.25

      Correct Answer: 0.3

      Explanation:

      One-third of the world’s population is thought to be infected with TB.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      9.2
      Seconds

  • Question 4 - A 24-year-old women presents following an overdose. Which one of the following would...

    Incorrect

    • A 24-year-old women presents following an overdose. Which one of the following would suggest anticholinergic syndrome?

      Your Answer: Bradycardia is common

      Correct Answer: Mydriasis occurs

      Explanation:

      Anticholinergic syndrome results from the inhibition of muscarinic cholinergic neurotransmission. Clinical manifestations can be remembered by the mnemonic, red as a beet, dry as a bone, blind as a bat, mad as a hatter, hot as a hare, and full as a flask. The mnemonic refers to the symptoms of flushing, dry skin and mucous membranes, mydriasis (dilated pupil) with loss of accommodation, altered mental status, fever, and urinary retention, respectively.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      21.4
      Seconds

  • Question 5 - What is the correct formula to calculate the positive predictive value?(TP = true...

    Incorrect

    • What is the correct formula to calculate the positive predictive value?(TP = true positive; FP = false positive; TN = true negative; FN = false negative)

      Your Answer: Sensitivity / (1 - specificity)

      Correct Answer: TP / (TP + FP)

      Explanation:

      Positive predictive value is the probability that subjects with a positive screening test truly have the disease.Positive predictive value = true positive / ( true positive + false positive)

    • This question is part of the following fields:

      • Medicine
      • Research Skills
      8.2
      Seconds

  • Question 6 - What is the primary cause of ketoacidosis in Type 1 diabetes? ...

    Correct

    • What is the primary cause of ketoacidosis in Type 1 diabetes?

      Your Answer: Lipolysis

      Explanation:

      in type 1 diabetics the lack of insulin in the bloodstream prevents glucose absorption, thereby inhibiting the production of oxaloacetate (a crucial precursor to the β-oxidation of fatty acids) through reduced levels of pyruvate (a by-product of glycolysis), and can cause unchecked ketone body production (through fatty acid metabolism or lipolysis) potentially leading to dangerous glucose and ketone levels in the blood.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      20.6
      Seconds

  • Question 7 - With regards to P53, which statement is NOT true? ...

    Correct

    • With regards to P53, which statement is NOT true?

      Your Answer: P53 is a RNA binding protein

      Explanation:

      P53 is a tumour suppressor gene. It is not an RNA binding protein. It has been implicated in almost all tumours. It regulates the progression from G1 to the S phase of the cell cycle and is activated in response to damaged DNA.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      23.2
      Seconds

  • Question 8 - A 68 year old female is on long term prednisolone therapy for polymyalgia...

    Incorrect

    • A 68 year old female is on long term prednisolone therapy for polymyalgia rheumatica. Which of the following would be the most suitable protection against osteoporosis?

      Your Answer: Calcium and vitamin D

      Correct Answer: Oral bisphosphonate

      Explanation:

      Prevention of osteoporosis associated with chronic glucocorticoid therapy is done by administrating bisphosphonates. Oral bisphosphonates are indicated for patients aged above 65 who have been on steroid therapy for over 3 months, so as to reduce the risk of steroid induced osteoporosis. HRT is usually done in post menopausal women who have oestrogen related bone resorption.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      31.1
      Seconds

  • Question 9 - A 50-year-old man with a history of hyperlipidaemia, currently under treatment with simvastatin...

    Incorrect

    • A 50-year-old man with a history of hyperlipidaemia, currently under treatment with simvastatin 10mg was found to have persistently high cholesterol levels. Previous attempts to increase the dose of simvastatin have resulted in myalgia. Given this history, which one of the following lipid-regulating drugs should definitely be avoided?

      Your Answer:

      Correct Answer: Bezafibrate

      Explanation:

      Both fibrates and nicotinic acid have been associated with myositis, especially when combined with a statin. However, the Committee on Safety of Medicines has produced guidance which specifically warns about the concomitant prescription of fibrates with statins concerning muscle toxicity.Bezafibrate: It is a fibric acid derivative (fibrate) that has been used as a class of agents known to decrease triglyceride levels while substantially increasing HDL-C levels.Pharmacological effects:- Increases VLDL catabolism by increasing lipoprotein and hepatic triglyceride lipase.- Decreases triglyceride synthesis by inhibiting acetyl-CoA reductase.- Decreases cholesterol synthesis by inhibiting HMG-CoA reductase.Side effects:- Hypersensitivity- Primary biliary cirrhosis- Pre-existing gallbladder disease- Concurrent use with HMG-CoA inhibitors (statins) can produce myopathy- Hepatic/renal impairment in a patient warrants dose adjustment as this drug is primarily excreted via the renal mechanism.Contraindications: Concurrent use of MAO inhibitors, hypersensitivity, pre-existing cholestasis, and pregnancy.Use: It can be used to treat Barth syndrome (characterized by dilated cardiomyopathy, neutropenia (presenting with recurrent infections), skeletal myopathy and short stature)

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 10 - What effect does osmotic diuresis have on net Na+ excretion? ...

    Incorrect

    • What effect does osmotic diuresis have on net Na+ excretion?

      Your Answer:

      Correct Answer: Markedly increased Na+ excretion 

      Explanation:

      Osmotic diuresis is the increase of urination rate caused by the presence of certain substances in the small tubes of the kidneys. The excretion occurs when substances such as glucose enter the kidney tubules and cannot be reabsorbed (due to a pathological state or the normal nature of the substance). The substances cause an increase in the osmotic pressure within the tubule, causing retention of water within the lumen, and thus reduces the reabsorption of water, increasing urine output (i.e. diuresis). Sodium, chloride, potassium are markedly excreted in osmotic diuresis.

    • This question is part of the following fields:

      • Medicine
      • Renal
      0
      Seconds

  • Question 11 - A 22-year-old university student is admitted after taking drugs at a night club....

    Incorrect

    • A 22-year-old university student is admitted after taking drugs at a night club. Which of the following features suggest she had taken ecstasy (MDMA)?

      Your Answer:

      Correct Answer: A pyrexia of 40°C

      Explanation:

      MDMA commonly known as ecstasy or molly, is a psychoactive drug primarily used as a recreational drug. The desired effects include altered sensations, increased energy, empathy, and pleasure. Features of MDMA abuse include hyponatraemia, tachycardia, hyperventilation, and hyperthermia.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 12 - Type 2 hypersensitivity is mediated by: ...

    Incorrect

    • Type 2 hypersensitivity is mediated by:

      Your Answer:

      Correct Answer: IgG, IgM & complement

      Explanation:

      In type II hypersensitivity the antibodies, IgG and IgM bind to antigens to form complexes that activate the classical pathway of complement to eliminate cells presenting foreign antigens.

    • This question is part of the following fields:

      • Immunology
      • Medicine
      0
      Seconds

  • Question 13 - The enzyme that catalyses the final step in glycogen synthesis is: ...

    Incorrect

    • The enzyme that catalyses the final step in glycogen synthesis is:

      Your Answer:

      Correct Answer: Glycogen synthase

      Explanation:

      Glycogen synthase is a key enzyme in glycogenesis, the conversion of glucose into glycogen. This enzyme combines excess glucose residues one by one into a polymeric chain for storage as glycogen.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds

  • Question 14 - Regarding Polymerase Chain Reaction, all are true except: ...

    Incorrect

    • Regarding Polymerase Chain Reaction, all are true except:

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 15 - A 23-year-old female known with schizophrenia is being reviewed in the emergency department....

    Incorrect

    • A 23-year-old female known with schizophrenia is being reviewed in the emergency department. Her mother claims that she has been 'staring' for the past few hours but has now developed abnormal head movements and has gone 'cross-eyed'. On examination, the patient's neck is extended and positioned to the right. Her eyes are deviated upwards and are slightly converged. Given the likely diagnosis, what is the most appropriate treatment?

      Your Answer:

      Correct Answer: Procyclidine

      Explanation:

      The most probable diagnosis in this patient is an oculogyric crisis, that is most appropriately managed with procyclidine or benztropine (antimuscarinic). An oculogyric crisis is a dystonic reaction to certain drugs or medical conditions.Features include:Restlessness, agitationInvoluntary upward deviation of the eyesCauses:PhenothiazinesHaloperidolMetoclopramidePostencephalitic Parkinson’s diseaseManagement:Intravenous antimuscarinic agents like benztropine or procyclidine, alternatively diphenhydramine or ethopropazine maybe used.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 16 - A 62-year-old software developer with lung cancer is currently taking MST 30mg bd...

    Incorrect

    • A 62-year-old software developer with lung cancer is currently taking MST 30mg bd for pain relief. What dose of oral morphine solution should he be prescribed for breakthrough pain?

      Your Answer:

      Correct Answer: 10 mg

      Explanation:

      The total daily morphine dose is 30 x 2 = 60 mg. Therefore, the breakthrough dose should be one-sixth of this, 10 mg.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 17 - The right border of the heart corresponds to which line on the surface...

    Incorrect

    • The right border of the heart corresponds to which line on the surface of the chest?

      Your Answer:

      Correct Answer: Line drawn from the 3rd right costal cartilage to the 6th right costal cartilage

      Explanation:

      The right border corresponds to a line drawn from the 3rd right costal cartilage to the 6th right costal cartilage; this border is slightly convex to the right.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 18 - A 30-year-old female presented with upper abdominal pain. She was diagnosed with an...

    Incorrect

    • A 30-year-old female presented with upper abdominal pain. She was diagnosed with an unknown coagulopathy and has a previous history of stroke. She has been on warfarin therapy for the past 4 months. Her international normalised ratio (INR) was stabilised between 2.5 and 3.0. Noticing abnormal coagulation results, her surgeon has requested a medical consult.Her blood investigations revealed:White cell count: 13 × 109/lHaemoglobin (Hb): 11 g/dlActivated partial thromboplastin time (APTT): NormalPlatelets: 140 × 109/lINR: 6.0Pancreatic enzymes and liver function tests were normal.Other investigations:An ultrasound of the abdomen was normal.An upper GI endoscopy revealed mild gastritis. What is the most appropriate step to be taken regarding warfarin therapy?

      Your Answer:

      Correct Answer: Stop warfarin and observe

      Explanation:

      The most appropriate treatment in this patient would be to stop warfarin therapy and keep the patient under observation.The drugs that lead to enhanced potency of warfarin include: disulfiram, trimethoprim-sulphamethoxazole, metronidazole, phenylbutazone, aspirin, heparin, and clofibrate. Liver disease, thrombocytopenia, hyperthyroidism also increase the oral anticoagulant potency.If the patient has minor bleeding and the international normalized ratio (INR) is >6.0, warfarin should be stopped; the INR should be rechecked daily and in addition to the stoppage of warfarin, vitamin K 2.5 mg oral or 0.5 mg intravenously should also be administered.In a patient with INR of 2.0 or 3.0, it takes two or three times longer for that individual’s blood to clot than someone who is not taking any anticoagulants. Most patients on warfarin have an INR goal of 2 to 3.If there is major bleeding then prothrombin complex concentrates 50 u/kg or fresh-frozen plasma 15 ml/kg may be considered.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 19 - Concerning surface anatomy, where is the base of the heart ...

    Incorrect

    • Concerning surface anatomy, where is the base of the heart

      Your Answer:

      Correct Answer: 2nd left costal to 3rd right costal cartilage

      Explanation:

      The base of the heart, also known as the superior border of the heart corresponds to a line connecting the inferior border of the 2nd left costal cartilage to the superior border of the 3rd right costal cartilage.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 20 - Which one of the following interventions has the least role in management of...

    Incorrect

    • Which one of the following interventions has the least role in management of acne rosacea?

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      0
      Seconds

  • Question 21 - What is the function of the pro-apoptotic Bcl-2 family of proteins, Bax and...

    Incorrect

    • What is the function of the pro-apoptotic Bcl-2 family of proteins, Bax and Bak?

      Your Answer:

      Correct Answer: Form permissive pores in the mitochondrial membrane

      Explanation:

      The pro-apoptotic proteins in the BCL-2 family, including Bax and Bak, normally act on the mitochondrial membrane to promote permeabilization and release of cytochrome C and ROS, that are important signals in the apoptosis cascade. Growing evidence suggests that activated BAX and/or Bak form an oligomeric pore, MAC in the mitochondrial outer membrane. This results in the release of cytochrome c and other pro-apoptotic factors from the mitochondria, often referred to as mitochondrial outer membrane permeabilization, leading to activation of caspases.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 22 - Generalized vasoconstrictors include: ...

    Incorrect

    • Generalized vasoconstrictors include:

      Your Answer:

      Correct Answer: Norepinephrine, endothelin, angiotensin ii

      Explanation:

      Vasopressin, angiotensin II, adrenaline and endothelin are generalized vasoconstrictors.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 23 - A 70-year-old male presents with chest pain. His past medical history includes hypertension...

    Incorrect

    • A 70-year-old male presents with chest pain. His past medical history includes hypertension and angina. He continues to smoke about 20 cigarettes per day despite being advised about lifestyle modifications.Blood investigations obtained in the emergency department show:Na+: 133 mmol/lK+: 3.3 mmol/lUrea: 4.5 mmol/lCreatinine: 90 μmol/lWhich among the following is the most likely explanation for the abnormalities seen in the above investigations?

      Your Answer:

      Correct Answer: Bendroflumethiazide therapy

      Explanation:

      The blood investigations in this patient reveal hyponatremia as well as hypokalaemia. Among the options provided, Bendroflumethiazide therapy can cause the above presentation with the electrolyte disturbances. Note:- Spironolactone is a potassium-sparing diuretic that is associated with hyperkalaemia.- Enalapril therapy can cause side effects of dizziness, hypotension, cough, and rarely a rash.- Felodipine therapy can cause side effects of dizziness, headache, cough, and palpitations.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 24 - Which factor produced by the endothelium is responsible for the regulation of vascular...

    Incorrect

    • Which factor produced by the endothelium is responsible for the regulation of vascular cell growth?

      Your Answer:

      Correct Answer: Vascular endothelial growth factor (VEGF)

      Explanation:

      VEGF is produced by the endothelial cells and is the major growth factor responsible for causing vasculogenesis. Some isoforms of this growth factor also have a prominent role in formation of lymphatic vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 25 - High titre of which of the following antibodies is not considered diagnostic for...

    Incorrect

    • High titre of which of the following antibodies is not considered diagnostic for the mentioned disease?

      Your Answer:

      Correct Answer: Rheumatoid factor in rheumatoid arthritis (RA)

      Explanation:

      Diagnosis of RA is mainly based on clinical features (e.g., morning stiffness, symmetrical joint swelling) and laboratory tests (e.g., anti-CCP). Rheumatoid factor is not very specific for this disease and hence has low reliability. X-ray findings (e.g., soft tissue swelling or joint space narrowing) occur late in the disease and are therefore not typically used for diagnosis.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 26 - A 18-year-old girl is brought to A&E having ingested at least 16 tablets...

    Incorrect

    • A 18-year-old girl is brought to A&E having ingested at least 16 tablets of paracetamol 8 hours earlier. What should her immediate management consist of?

      Your Answer:

      Correct Answer: Intravenous N-acetylcysteine

      Explanation:

      Activated charcoal is useful if given within one hour of the paracetamol overdose. Liver function tests, INR and prothrombin time will be normal, as liver damage may not manifest until 24 hours or more after ingestion.The antidote of choice is intravenous N-acetylcysteine, which provides complete protection against toxicity if given within 10 hours of the overdose.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 27 - Which of the following causes the closure of the ductus arteriosus during birth?...

    Incorrect

    • Which of the following causes the closure of the ductus arteriosus during birth?

      Your Answer:

      Correct Answer: Reduced levels of prostaglandins

      Explanation:

      Ductus arteriosus is kept open by the prostaglandin E2 which is a vasodilator. At birth the high levels of cyclooxygenase blocks the production of prostaglandins which results in the closure of the ductus arteriosus.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 28 - What is the function of gap junctions? ...

    Incorrect

    • What is the function of gap junctions?

      Your Answer:

      Correct Answer: Diffusion of small molecules between neighbouring cells

      Explanation:

      Gap junctions are a specialized intercellular connection between a multitude of cell-types. They directly connect the cytoplasm of two cells, which allows various molecules, ions and electrical impulses to directly pass through a regulated gate between cells.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 29 - Which of the atrial pressure changes represents the a-wave of the JVP ...

    Incorrect

    • Which of the atrial pressure changes represents the a-wave of the JVP

      Your Answer:

      Correct Answer: Atrial systole

      Explanation:

      The a-wave created on the venous pulse curve occurs as a result of atrial systole. Due to the pressure build-up in the atria, it causes a back pressure in the vena cava. This pressure is exerted on the valve and this back pressure is what causes a slight increase in the venous pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 30 - The action of progesterone on different organs/systems includes: ...

    Incorrect

    • The action of progesterone on different organs/systems includes:

      Your Answer:

      Correct Answer: Breasts: stimulation of lobular and alveolar development

      Explanation:

      Progesterone is a sex hormone which affects mainly the reproductive system. In the breasts, it mediates the lobuloalveolar maturation to allow for milk production; this is done in conjunction with prolactin. It acts to maintain female reproductive and sex characteristics.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 31 - Which of the following best describes the cardiac muscle? ...

    Incorrect

    • Which of the following best describes the cardiac muscle?

      Your Answer:

      Correct Answer: Striated and involuntary

      Explanation:

      Cardiac muscle (heart muscle) is an involuntary, striated muscle that is found in the walls and histological foundation of the heart, specifically the myocardium. Cardiac muscle is one of three major types of muscle, the others being skeletal and smooth muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 32 - Select the correct statement regarding terminal bronchioles: ...

    Incorrect

    • Select the correct statement regarding terminal bronchioles:

      Your Answer:

      Correct Answer: Terminal bronchioles form part of the conducting zone

      Explanation:

      Bronchioles divide into even smaller bronchioles, called terminal bronchioles, which are 0.5mm or less in diameter. Terminal bronchioles in turn divide into smaller respiratory bronchioles which divide into alveolar ducts. Terminal bronchioles mark the end of the conducting division of air flow in the respiratory system while respiratory bronchioles are the beginning of the respiratory division where actual gas exchange takes place. Terminal bronchioles are lined with simple cuboidal epithelium containing club cells. Terminal bronchioles contain a limited number of ciliated cells and no goblet cells. Club cells are non-ciliated, rounded protein secreting cells. Their secretions are a non-stick, proteinaceous compound (surfactant) to maintain the airway in the smallest bronchioles.

    • This question is part of the following fields:

      • Medicine
      • Respiratory
      0
      Seconds

  • Question 33 - Ventricular depolarization plus ventricular repolarization is shown by the _____ interval ...

    Incorrect

    • Ventricular depolarization plus ventricular repolarization is shown by the _____ interval

      Your Answer:

      Correct Answer: QT

      Explanation:

      The QT interval represents ventricular depolarization as well as ventricular repolarization.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 34 - When is the blood pressure at its lowest during pregnancy? ...

    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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 35 - Endothelial cells produce the following substance(s): ...

    Incorrect

    • Endothelial cells produce the following substance(s):

      Your Answer:

      Correct Answer: All of the above

      Explanation:

      Endothelial cells produce thromboxane, prostacyclins, nitric oxides, endothelins, IL-1 and TNF.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 36 - In RFLP (restriction fragment length polymorphism), the DNA fragments are separated by length...

    Incorrect

    • In RFLP (restriction fragment length polymorphism), the DNA fragments are separated by length through a process known as:

      Your Answer:

      Correct Answer: Agarose gel electrophoresis

      Explanation:

      Samples of DNA from individuals are broken into pieces by restriction enzymes and the fragments are separated according to their lengths via gel electrophoresis. Although now largely obsolete due to the rise of inexpensive DNA sequencing technologies, RFLP analysis was the first DNA profiling technique inexpensive enough to see widespread application.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 37 - Renin is secreted by which of the following cells? ...

    Incorrect

    • Renin is secreted by which of the following cells?

      Your Answer:

      Correct Answer: Juxtaglomerular cells

      Explanation:

      The juxtaglomerular cells are cells in the kidney that synthesize, store, and secrete the enzyme renin. They are specialized smooth muscle cells mainly in the walls of the afferent arterioles, and some in the efferent arterioles, that deliver blood to the glomerulus.

    • This question is part of the following fields:

      • Medicine
      • Renal
      0
      Seconds

  • Question 38 - The mitochondrial chromosome is a circular DNA molecule. They encode for proteins needed...

    Incorrect

    • The mitochondrial chromosome is a circular DNA molecule. They encode for proteins needed for ATP production. These proteins are also essential for:

      Your Answer:

      Correct Answer: Apoptotic cell death

      Explanation:

      The intrinsic pathway or the mitochondrial pathway of apoptosis is activated due to the loss of BCL-2 and other antiapoptotic proteins. This loss results in the increased membrane permeability and release of cytochrome C which activates caspases downstream resulting in apoptosis.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 39 - Which cells produce the immunoglobulin proteins involved in mediating humoral immunity? ...

    Incorrect

    • Which cells produce the immunoglobulin proteins involved in mediating humoral immunity?

      Your Answer:

      Correct Answer: Differentiated forms of B lymphocytes known as plasma cells

      Explanation:

      After the B cells have been activated by a certain antigens, they transform into plasma cells. These plasma cells are responsible for the generation of antibodies (or immunoglobulins Ig) which are also known as regulators of humoral immunity. There are fives classes of Ig: IgA, IgG, IgM, IgE and IgD

    • This question is part of the following fields:

      • Immunology
      • Medicine
      0
      Seconds

  • Question 40 - A study is carried out to assess the efficacy of a new anti-epileptic...

    Incorrect

    • A study is carried out to assess the efficacy of a new anti-epileptic drug for children with absence seizures. The total number of the children selected for the study was 400, from which 150 children were assigned to take the new drug and 250 children were assigned in the control group. After a period of four months, only 15 children taking the new drug had a seizure compared to 100 children from the control group who had seizure. What is the correct value regarding the relative risk reduction?

      Your Answer:

      Correct Answer: 75%

      Explanation:

      Relative risk reduction (RRR) tells you by how much the treatment reduced the risk of bad outcomes relative to the control group who did not have the treatment. In the previous example, the relative risk reduction of fever and rash in the group of the children on the intervention was 40 per cent (1 – 0.6 = 0.4 or 40 per cent). RRR = (EER -CER) / CER = (0.1 – 0.4) / 0.4 = -0.75 or 75% reduction.

    • This question is part of the following fields:

      • Medicine
      • Research Skills
      0
      Seconds

  • Question 41 - An 80-year-old woman with advanced COPD has been admitted to the medicine ward...

    Incorrect

    • An 80-year-old woman with advanced COPD has been admitted to the medicine ward in an unconscious state. She appears to have an acute lower respiratory tract infection. After consulting with an anaesthesiologist it was concluded that she was not a candidate for intensive care unit admission and thus, a decision was made to start the patient on doxapram therapy. Which of the following best fits the characteristics of doxapram?

      Your Answer:

      Correct Answer: It is contraindicated in hyperthyroidism

      Explanation:

      The two statements that fit the characteristics of doxapram are, epilepsy is a contraindication for doxapram use and concurrent use with theophylline may increase agitation.Doxapram is a central respiratory stimulant. In clinical practice, doxapram is usually used for patients who have an acute exacerbation of chronic obstructive pulmonary disease (COPD) who are unsuitable for admission to the intensive therapy unit for ventilatory support. Doxapram infusion may buy an extra 24 h to allow for recovery.Contraindications include: ischaemic heart disease, epilepsy, cerebral oedema, acute stroke, asthma, hypertension, hyperthyroidism, and pheochromocytoma. The infusion may worsen agitation and dyspnoea and lead to hypertension, nausea, vomiting and urinary retention.Drug interactions:Concomitant administration of doxapram and aminophylline (theophylline) can cause increased skeletal muscle activity, agitation, and hyperactivity.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 42 - The end- diastolic ventricular volume is about? ...

    Incorrect

    • The end- diastolic ventricular volume is about?

      Your Answer:

      Correct Answer: 130 ml

      Explanation:

      The end diastolic volume in a healthy individual is about 130 ml.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 43 - Which of the following statements are true regarding human herpesvirus eight ...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      0
      Seconds

  • Question 44 - A 60-year-old male is under treatment with azathioprine after a renal transplant. During...

    Incorrect

    • A 60-year-old male is under treatment with azathioprine after a renal transplant. During his review, he complains of pain and swelling over his left great toe. Investigations reveal hyperuricemia. Suspecting gout, he was started on allopurinol. Subsequently, he develops aplastic anaemia. Which of the following is the most appropriate reason for his bone marrow failure?

      Your Answer:

      Correct Answer: Mercaptopurine toxicity

      Explanation:

      The cause for bone marrow suppression in this patient is most probably mercaptopurine toxicity.Azathioprine is metabolized to 6-mercaptopurine (6-MP), which itself is metabolized by xanthine oxidase. Xanthine oxidase inhibition by allopurinol leads to the accumulation of 6-MP which then precipitates bone marrow failure. This may be potentially fatal if unrecognized.Clinical presentation:Toxicity symptoms include gastrointestinal symptoms, bradycardia, hepatotoxicity, myelosuppression.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 45 - How does pregnancy affect the cardiac output of a patient? ...

    Incorrect

    • How does pregnancy affect the cardiac output of a patient?

      Your Answer:

      Correct Answer: Increased cardiac output due to increase in heart rate and stroke volume

      Explanation:

      Cardiac Output increases to a similar degree as the blood volume. During the first trimester cardiac output is 30-40% higher than in the non-pregnant state. Steady rises are shown on Doppler echocardiography, from an average of 6.7 litres/minute at 8-11 weeks to about 8.7 litres/minute flow at 36-39 weeks; they are due, primarily, to an increase in stroke volume (35%) and, to a lesser extent, to a more rapid heart rate (15%). There is a steady reduction in systemic vascular resistance (SVR) which contributes towards the hyperdynamic circulation observed in pregnancy

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 46 - Embryologically the anterior pituitary is formed from? ...

    Incorrect

    • Embryologically the anterior pituitary is formed from?

      Your Answer:

      Correct Answer: Rathkes pouch

      Explanation:

      The ectoderm, located in the roof of the pharynx, forms Rathke’s pouch, which comes into contact with the ectoderm of the developing brain. The pouch eventually separates from the pharynx, becoming the anterior pituitary.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 47 - What are the three main structures in the portal triad (portal space)? ...

    Incorrect

    • What are the three main structures in the portal triad (portal space)?

      Your Answer:

      Correct Answer: Branch of hepatic artery, branch of portal vein, bile ductules

      Explanation:

      A portal triad (also known as portal field, portal area, or portal tract) is a distinctive arrangement in the liver. It is a component of the hepatic lobule. It consists of the following five structures:

      • Proper hepatic artery
      • Hepatic portal vein
      • Common bile duct
      • Lymphatic vessels
      • Branch of the vagus nerve

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      0
      Seconds

  • Question 48 - Which statement is correct regarding mRNA? ...

    Incorrect

    • Which statement is correct regarding mRNA?

      Your Answer:

      Correct Answer: mRNAs are mainly found in the nucleus and cytoplasm of a cell.

      Explanation:

      mRNA is transcribed from DNA and is carried to the cytosol to be translated. Hence it is mainly found in the cytosol and the nucleus of a cell. It is single stranded and contains the base uracil instead of thymine.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 49 - When during the cell cycle do the centrioles replicate? ...

    Incorrect

    • When during the cell cycle do the centrioles replicate?

      Your Answer:

      Correct Answer: G1 phase

      Explanation:

      During G1 phase the cell will prepare for cell division. All the organelles will start to duplicate in this phase and the cell will begin to grow whilst proteins are also synthesized.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 50 - Near the transcription site of a gene, the site at which RNA polymerase...

    Incorrect

    • Near the transcription site of a gene, the site at which RNA polymerase and its cofactors bind is known as the:

      Your Answer:

      Correct Answer: Promotor

      Explanation:

      Transcription will begin when the RNA polymerase II binds to the promotor. The promotor is a sequence of 25 nucleotides found upstream from the start site of transcription. This promotor sequence is known as the TATA box. Transcription factors also bond along with RNA polymerase to this site to form a complex. However some may bind to regulatory elements proximal to the promotor site.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 51 - The following products of the vascular endothelium produce vasodilation except: ...

    Incorrect

    • The following products of the vascular endothelium produce vasodilation except:

      Your Answer:

      Correct Answer: Endothelin

      Explanation:

      Vascular endothelial growth factor (VEGF) is a signal protein produced by cells that stimulates vasculogenesis and angiogenesis. It is part of the system that restores the oxygen supply to tissues when blood circulation is inadequate. VEGF’s normal function is to create new blood vessels during embryonic development, new blood vessels after injury, muscle following exercise, and new vessels (collateral circulation) to bypass blocked vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 52 - A 82-year-old woman admitted following a fractured neck of femur has been discharged....

    Incorrect

    • A 82-year-old woman admitted following a fractured neck of femur has been discharged. On review, she is making good progress but consideration is given to secondary prevention of further fractures. What is the most appropriate step in the prevention of further fractures?

      Your Answer:

      Correct Answer: Start oral bisphosphonate

      Explanation:

      In such a clinical scenario, NICE guidelines support initiating treatment with bisphosphonates without waiting for a DEXA scan.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.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 53 - Choose the correct statement. The cells of the liver… ...

    Incorrect

    • Choose the correct statement. The cells of the liver…

      Your Answer:

      Correct Answer: Help to maintain the normal blood glucose level.

      Explanation:

      Synthesis of vitamin D3 takes place in both the liver and in the kidneys. The liver is responsible for an intermediate step and final synthesis takes place in the kidneys. Immunoglobulins are manufactured by plasma cells in respective organs where there is antigen exposure. The liver plays a major role in maintaining blood glucose levels by converting excess glucose to glycogen and converting glycogen back to glucose in time of need. Hepatocytes have enzymes that can deactivate steroid hormones.

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      0
      Seconds

  • Question 54 - After exercise, O2 debt repay may take up to: ...

    Incorrect

    • After exercise, O2 debt repay may take up to:

      Your Answer:

      Correct Answer: 90 min

      Explanation:

      Physical activity or exercise requires oxygen for production of ATP or energy via aerobic pathways of energy production. When the amount of oxygen that reaches muscles depletes, cells start producing energy anaerobically by partial breakdown of glucose resulting in lactic acid. Lactic acid should be removed from cells as it causes muscle fatigue. Oxygen is needed to oxidize lactic acid in to carbon dioxide and water and this need is known as oxygen debt. The existence of an oxygen debt explains why we continue to breathe deeply and quickly for a while after exercise. This may take up from 60 – 90 mins.

    • This question is part of the following fields:

      • Medicine
      • Respiratory
      0
      Seconds

  • Question 55 - Glucose is typically removed from the urine by…? ...

    Incorrect

    • Glucose is typically removed from the urine by…?

      Your Answer:

      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.

    • This question is part of the following fields:

      • Medicine
      • Renal
      0
      Seconds

  • Question 56 - Excitation-contraction coupling in cardiac muscle involves all of the following except: ...

    Incorrect

    • Excitation-contraction coupling in cardiac muscle involves all of the following except:

      Your Answer:

      Correct Answer: Binding of Ca2+ to calmodulin

      Explanation:

      In the excitation contraction coupling model, an action potential is transmitted to the fibrils of a fiber through the T tubule system. It triggers the release of Ca 2+ from the terminal cisterns. Depolarization of the T tubules activates the sarcoplasmic reticulum through the dihydropyridine receptors. These are voltage gates calcium channels. Calcium binds to calmodulin during contraction of the smooth muscle and not the cardiac muscles.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 57 - Which of the following stimulate the release of aldosterone from the adrenal cortex?...

    Incorrect

    • Which of the following stimulate the release of aldosterone from the adrenal cortex?

      Your Answer:

      Correct Answer: Angiotensin 2

      Explanation:

      Angiotensin II also stimulates the secretion of the hormone aldosterone from the adrenal cortex. Aldosterone causes the renal tubules to increase the reabsorption of sodium and water into the blood, while at the same time causing the excretion of potassium (to maintain electrolyte balance).

    • This question is part of the following fields:

      • Medicine
      • Renal
      0
      Seconds

  • Question 58 - The percentage of blood supplied to the liver by the hepatic artery is?...

    Incorrect

    • The percentage of blood supplied to the liver by the hepatic artery is?

      Your Answer:

      Correct Answer: 25%

      Explanation:

      The liver receives a dual blood supply from the hepatic portal vein and hepatic arteries. The hepatic portal vein delivers approximately 75% of the liver’s blood supply, and carries venous blood drained from the spleen, gastrointestinal tract, and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remaining quarter of its blood flow. Oxygen is provided from both sources; approximately half of the liver’s oxygen demand is met by the hepatic portal vein, and half is met by the hepatic arteries

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      0
      Seconds

  • Question 59 - With regards to the function of the p53 protein produced by the p53...

    Incorrect

    • With regards to the function of the p53 protein produced by the p53 gene, which of the following statements is incorrect?

      Your Answer:

      Correct Answer: It permits repair of mutations and other defects in RNA

      Explanation:

      P53 has many mechanisms of anticancer function and plays a role in apoptosis, genomic stability, and inhibition of angiogenesis. In its anti-cancer role, p53 works through several mechanisms:It can activate DNA repair proteins when DNA has sustained damage. Thus, it may be an important factor in aging.It can arrest growth by holding the cell cycle at the G1/S regulation point on DNA damage recognitionIt can initiate apoptosis (i.e., programmed cell death) if DNA damage proves to be irreparable.It is essential for the senescence response to short telomeres.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 60 - In which area is depolarization initiated? ...

    Incorrect

    • In which area is depolarization initiated?

      Your Answer:

      Correct Answer: SA node

      Explanation:

      SA node is the pacemaker of the heart. It determines the rate of contractions. It is the place where depolarization is initiated. It exhibits phase 4 depolarization or automaticity. Electrical impulses then spread to the AV node, purkinje fibers, bundle of his and the ventricular muscles.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 61 - Psoriatic arthropathy most commonly presents with which of the following types of arthritis?...

    Incorrect

    • Psoriatic arthropathy most commonly presents with which of the following types of arthritis?

      Your Answer:

      Correct Answer: Peripheral asymmetric oligoarthropathy

      Explanation:

      Most patients with psoriatic arthritis present with monoarthritis or asymmetric oligoarthritis. The most common form of the disease is the one involving a few joints of the peripheral skeleton with a distinct asymmetry of symptoms. Involvement of the smaller joints of the hands and feet, especially distal interphalangeal joints, seems to be a characteristic feature. Arthritis mutilans is a rare and severe complication of psoriatic arthritis.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 62 - A 28 year old woman presents with painful genital ulceration. She reports that...

    Incorrect

    • A 28 year old woman presents with painful genital ulceration. She reports that these attacks have been recurrent over the past 4 years. She has been treated previously with oral acyclovir but this has had little effect on the duration of her symptoms. Over the past year, she has noticed almost weekly attacks of mouth ulcers that heal slowly. Past medical history is significant for treatment of thrombophlebitis two years ago. Which of the following is the most likely diagnosis?

      Your Answer:

      Correct Answer: Behcet's syndrome

      Explanation:

      Behçet disease is a rare vasculitic disorder that is characterized by a triple-symptom complex of recurrent oral aphthous ulcers, genital ulcers, and uveitis. The systemic manifestations can be variable. Ocular disease has the greatest morbidity, followed by vascular disease generally from active vasculitis. Cutaneous manifestations can occur in up 75% of patients with Behcet disease and can range from acneiform lesions, to nodules and erythema nodosum. GI manifestations can be severe. Differentiating Behçet disease from active inflammatory bowel disease can be clinically difficult. Herpes would have ideally responded to acyclovir. Sarcoidosis does not have genital and oral ulcerations.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 63 - A 50-year-old patient was started on ezetimibe, for his cholesterol a few days...

    Incorrect

    • A 50-year-old patient was started on ezetimibe, for his cholesterol a few days back. Which among the following statements is true regarding ezetimibe?

      Your Answer:

      Correct Answer: Its principal action is to reduce intestinal cholesterol absorption

      Explanation:

      Ezetimibe is a cholesterol-lowering agent that acts to prevent cholesterol absorption by directly inhibiting cholesterol receptors on enterocytes.It does not affect the absorption of drugs (e.g. digoxin, thyroxine) or fat-soluble vitamins (A, D and K) as the anion-exchange resins do. It does not affect the cytochrome P450 enzyme system.The increased risk of myositis associated with the statins is not seen with ezetimibe.The most common adverse effects include headache, runny nose, and sore throat. Less common reactions include body aches, back pain, chest pain, diarrhoea, joint pain, fatigue, and weakness.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 64 - In the event of an overdose, haemodialysis is ineffective as a treatment modality...

    Incorrect

    • In the event of an overdose, haemodialysis is ineffective as a treatment modality for which of the following drugs?

      Your Answer:

      Correct Answer: Tricyclics

      Explanation:

      Tricyclic compounds can’t be cleared by haemodialysis.Drugs that can be cleared with haemodialysis include: (BLAST)- Barbiturate- Lithium- Alcohol (inc methanol, ethylene glycol)- Salicylates- Theophyllines (charcoal hemoperfusion is preferable)Drugs which cannot be cleared with haemodialysis include:- Tricyclics- Benzodiazepines- Dextropropoxyphene (Co-proxamol)- Digoxin- Beta-blockers

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 65 - Which lipoprotein is responsible for lowering of plasma lipids? ...

    Incorrect

    • Which lipoprotein is responsible for lowering of plasma lipids?

      Your Answer:

      Correct Answer: HDL

      Explanation:

      High-density lipoproteins (HDL) are one of the five major groups of lipoproteins. Lipoproteins are complex particles composed of multiple proteins which transport all fat molecules (lipids) around the body within the water outside cells. Unlike the larger lipoprotein particles which deliver fat molecules to cells, HDL particles remove fat molecules from cells.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds

  • Question 66 - A 43 year old man with hemochromatosis presents with a painful and swollen...

    Incorrect

    • A 43 year old man with hemochromatosis presents with a painful and swollen right knee. X-ray shows extensive chondrocalcinosis but no fracture. Given the most likely diagnosis, which of the following would be present in the joint fluid aspirate?

      Your Answer:

      Correct Answer: Positively birefringent rhomboid-shaped crystals

      Explanation:

      Pseudogout is a paroxysmal joint inflammation due to calcium pyrophosphate crystal deposition (calcium pyrophosphate dihydrate). 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.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 67 - The initial rapid depolarization in the action potential of cardiac muscle cells is...

    Incorrect

    • The initial rapid depolarization in the action potential of cardiac muscle cells is due to:

      Your Answer:

      Correct Answer: Opening of voltage-gated Na+ channels

      Explanation:

      The initial depolarization of the action potential in a cardiac muscle cell is due to the sodium current generated by opening of the voltage gated sodium channels leading to an influx of sodium ions into the cell and raising the membrane potential towards threshold.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 68 - In which phase do chromosomes in the nucleus become condensed into well-defined chromosomes?...

    Incorrect

    • In which phase do chromosomes in the nucleus become condensed into well-defined chromosomes?

      Your Answer:

      Correct Answer: Metaphase

      Explanation:

      Prophase begins when the nucleus envelope disintegrates and the chromosomes start to condense. The chromosomes consist of two sister chromatids that are joined at a constriction known as centromere. When the cell reaches the metaphase the chromosomes are completely condensed and ready to align on the equatorial plate

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 69 - An obstruction in a pulmonary artery causes impaired perfusion to an area in...

    Incorrect

    • An obstruction in a pulmonary artery causes impaired perfusion to an area in the lung. The gas values in the unperfused alveoli at sea level will be:

      Your Answer:

      Correct Answer: PO2 = 149 C02 =0

      Explanation:

      Partial pressure of oxygen at sea level is approximately 160 mmHg. Partial pressure of oxygen in alveoli is around 150 mmHg and in an arteriole is around 80-100 mmHg. Partial pressure of carbon dioxide is around 35 mmHg in alveolar air and around 40 mmHg in the arteriole.

    • This question is part of the following fields:

      • Medicine
      • Respiratory
      0
      Seconds

  • Question 70 - Which factors increase the end-diastolic volume? ...

    Incorrect

    • Which factors increase the end-diastolic volume?

      Your Answer:

      Correct Answer: Constriction of veins

      Explanation:

      End diastolic volume is also known as preload. It is the amount of blood the heart contracts against. Constriction of veins will decrease venous pooling and increase venous return, hence increasing the end diastolic volume. Standing will increase venous pooling hence decreasing venous return and end diastolic volume. Raised intrapericardial pressure will also decrease venous return and hence end diastolic volume.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 71 - Changes in cadherin expression are associated with ...

    Incorrect

    • Changes in cadherin expression are associated with

      Your Answer:

      Correct Answer: Tumour metastatic potential

      Explanation:

      Cadherins play a role in maintaining cell and tissue structure, and in cellular movement. The E-cadherin–catenin complex plays a key role in cellular adhesion; loss of this function has been associated with greater tumour metastasis.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 72 - Normal eukaryote somatic cells have: ...

    Incorrect

    • Normal eukaryote somatic cells have:

      Your Answer:

      Correct Answer: 23 pairs of chromosomes

      Explanation:

      A normal somatic eukaryotic cell contains 46 chromosomes i.e. 23 pairs.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 73 - A 32 year old woman presents with a painful elbow which she has...

    Incorrect

    • A 32 year old woman presents with a painful elbow which she has been feeling for the past two weeks. Which of the following will be consistent with a diagnosis of tennis elbow?

      Your Answer:

      Correct Answer: Pain on wrist extension against resistance

      Explanation:

      Lateral epicondylitis (tennis elbow) is an overuse injury of the hand and finger extensor tendons that originate in the lateral humeral epicondyle that occurs following repeated or excessive pronation/supination and extension of the wrist (e.g., in racquet sports). Clinical features include pain and tenderness over the lateral epicondyle and along extensor muscles and thickening of the tendons. The examiner holds the patient’s hand with the thumb placed over the lateral epicondyle – The patient makes a fist, supinates the forearm, deviates radially, and extends the fist against the examiner’s resistance which will result in pain over the lateral epicondyle. Conservative treatment includes rest, physiotherapy and orthotic braces. If this fails corticosteroids and lidocaine injections are employed. Surgery is indicated in patients with persistent symptoms despite 6 months of conservative treatment. Excision of abnormal tendon tissue; longitudinal incisions (tenotomies) in scarred and fibrotic areas to promote healing.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 74 - Antibiotic resistance may happen by: ...

    Incorrect

    • Antibiotic resistance may happen by:

      Your Answer:

      Correct Answer: By enzymes which inactivate the drug

      Explanation:

      The three main mechanisms of antibiotic resistance are, enzymatic degradation of antibacterial drugs, alteration of bacterial proteins that are antimicrobial targets, and changes in membrane permeability to antibiotics.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      0
      Seconds

  • Question 75 - Which of the following statements is true of the beta- lactams: ...

    Incorrect

    • Which of the following statements is true of the beta- lactams:

      Your Answer:

      Correct Answer: Co-amoxiclav is more likely to cause obstructive jaundice than amoxicillin

      Explanation:

      β-lactam antibiotics are a class of broad-spectrum antibiotics, consisting of all antibiotic agents that contain a β-lactam ring in their molecular structures. This includes penicillin derivatives (penams), cephalosporins (cephems), monobactams, and carbapenems. Most β-lactam antibiotics work by inhibiting cell wall biosynthesis in the bacterial organism and are the most widely used group of antibiotics. Bacteria often develop resistance to β-lactam antibiotics by synthesizing a β-lactamase, an enzyme that attacks the β-lactam ring. To overcome this resistance, β-lactam antibiotics are often given with β-lactamase inhibitors such as clavulanic acid. Immunologically mediated adverse reactions to any β-lactam antibiotic may occur in up to 10% of patients receiving that agent (a small fraction of which are truly IgE-mediated allergic reactions). Rarely, cholestatic jaundice has been associated with Co-amoxiclav (amoxicillin/clavulanic acid). The reaction may occur up to several weeks after treatment has stopped, and usually takes weeks to resolve. It is more frequent in men, older people, and those who have taken long courses of treatment; the estimated overall incidence is one in 100,000 exposures.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      0
      Seconds

  • Question 76 - Microtubule disassembly: ...

    Incorrect

    • Microtubule disassembly:

      Your Answer:

      Correct Answer: Occurs at the positive and negative end

      Explanation:

      Dynamic instability refers to the coexistence of assembly and disassembly at the ends of a microtubule. The microtubule can dynamically switch between growing and shrinking phases in this region. Although both assembly and disassembly occur at both ends they occur preferentially at the (+) end.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 77 - A 60 year old male presents with one month history of generalized headache,...

    Incorrect

    • A 60 year old male presents with one month history of generalized headache, fever and malaise. He also complains of scalp sensitivity while combing his hair. In order to confirm the diagnosis, which of the following would be the definite test?

      Your Answer:

      Correct Answer: Temporal artery biopsy

      Explanation:

      Temporal arteritis is a chronic large- and medium-sized vessel vasculitis that typically involves the temporal arteries. Classical symptoms include temporal headaches, jaw claudication, amaurosis fugax. Physical exam shows scalp tenderness, palpation of the temporal area may demonstrate an absent pulse, knot-like swelling, and vision loss. Lab results reveal an increased erythematous sedimentation rate and C-reactive protein. Temporal artery biopsy confirms the diagnosis. Management approach: high-dose systemic corticosteroids should be promptly administered even before the diagnosis is established. Temporal artery biopsy confirms the diagnosis. Inability to manage this or administer glucocorticoids might lead to development of blindness.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 78 - Café-au-lait spots are seen in each of the following, except: ...

    Incorrect

    • Café-au-lait spots are seen in each of the following, except:

      Your Answer:

      Correct Answer: Friedreich's ataxia

      Explanation:

      Café-au-lait spots are hyperpigmented lesions that vary in colour from light brown to dark brown, with borders that may be smooth or irregular.

      Causes include:

      • Neurofibromatosis type I
      • McCune–Albright syndrome
      • Legius syndrome
      • Tuberous sclerosis
      • Fanconi anaemia
      • Idiopathic
      • Ataxia-telangiectasia
      • Basal cell nevus syndrome
      • Benign congenital skin lesion
      • Bloom syndrome
      • Chediak-Higashi syndrome
      • Congenital nevus
      • Gaucher disease
      • Hunter syndrome
      • Maffucci syndrome
      • Multiple mucosal neuroma syndrome
      • Noonan syndrome
      • Pulmonary Stenosis
      • Silver–Russell syndrome
      • Watson syndrome
      • Wiskott–Aldrich syndrome

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      0
      Seconds

  • Question 79 - Which enzyme is deficient in the inborn error of metabolism called galactosemia? ...

    Incorrect

    • Which enzyme is deficient in the inborn error of metabolism called galactosemia?

      Your Answer:

      Correct Answer: Galactose-1-phosphate uridyl transferase

      Explanation:

      Galactosaemia is a rare genetic autosomal recessive metabolic disorder. Lactose is broken down by the enzyme lactase into glucose and galactose. In individuals with galactosemia, the enzymes needed for further metabolism of galactose (Galactose-1-phosphate uridyltransferase) are severely diminished or missing entirely, leading to toxic levels of galactose 1-phosphate in various tissues.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds

  • Question 80 - When looking at the JVP what does the c wave signify: ...

    Incorrect

    • When looking at the JVP what does the c wave signify:

      Your Answer:

      Correct Answer: Isovolumetric ventricular contraction

      Explanation:

      The C wave signifies a rise in the atrial pressure during isovolumetric contraction due to the tricuspid valve bulging into the atria.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 81 - Which of the following statements is true regarding chromosomes? ...

    Incorrect

    • Which of the following statements is true regarding chromosomes?

      Your Answer:

      Correct Answer: All are true

      Explanation:

      All of the above mentioned statements are true regarding chromosomes.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 82 - Myocardium requires more oxygen to expel blood in: ...

    Incorrect

    • Myocardium requires more oxygen to expel blood in:

      Your Answer:

      Correct Answer: A stenotic aortic valve

      Explanation:

      In aortic valve stenosis, increased ventricular pressure Is needed to expel the blood into the aorta. Increased pressure means increased contractility hence increase O2 consumption by the heart muscles.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 83 - What is the most common cardiac defect seen in patients with Down’s syndrome?...

    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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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  • Question 84 - The collection of genes that are termed the major histocompatibility complex (MHC) are...

    Incorrect

    • The collection of genes that are termed the major histocompatibility complex (MHC) are found on:

      Your Answer:

      Correct Answer: Short arm of chromosome 6

      Explanation:

      Histocompatibility, or tissue compatibility, is the property of having the same, or sufficiently similar, alleles of a set of genes called human leukocyte antigens (HLA). HLA is the human form of the major histocompatibility complex (MHC) genes found in all vertebrates. On a population level there is a great number of different alleles at each HLA locus on the short arm of chromosome 6

    • This question is part of the following fields:

      • Immunology
      • Medicine
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  • Question 85 - Calcium needed for cardiac muscle contraction is made available during which phase of...

    Incorrect

    • Calcium needed for cardiac muscle contraction is made available during which phase of the action potential?

      Your Answer:

      Correct Answer: 2

      Explanation:

      It is made available during the plateau phase of the action potential i.e. phase 2. During the plateau phase of the action potential, Calcium from the extracellular fluid enters through the L type of calcium channels. This entry triggers the release of more calcium from the sarcoplasmic reticulum via the ryanodine receptors.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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  • Question 86 - A clinical trial is conducted to study the benefits of a new oral...

    Incorrect

    • A clinical trial is conducted to study the benefits of a new oral medication to improve the symptoms of patients with asthma. In the trial 400 patients with asthma, half were given the new medication and half a placebo. Three months later they are asked to rate their symptoms using the following scale: much improved, slight improvement, no change, slight worsening, significantly worse. What is the most appropriate statistical test to see whether the new medication is beneficial?

      Your Answer:

      Correct Answer: Mann-Whitney U test

      Explanation:

      The type of significance test used depends on whether the data is parametric (can be measured, usually normally distributed) or non-parametric.Parametric tests:Student’s t-test – paired or unpaired*Pearson’s product-moment coefficient – correlationNon-parametric tests:Mann-Whitney U test – unpaired dataWilcoxon signed-rank test – compares two sets of observations on a single samplechi-squared test – used to compare proportions or percentagesSpearman, Kendall rank – correlation.The outcome measured is not normally distributed, i.e. it is non-parametric. This excludes the Student’s t-tests. We are not comparing percentages/proportions so the chi-squared test is excluded. The Mann–Whitney U test is a nonparametric test of the null hypothesis that it is equally likely that a randomly selected value from one sample will be less than or greater than a randomly selected value from a second sample.This test can be used to investigate whether two independent samples were selected from populations having the same distribution.

    • This question is part of the following fields:

      • Medicine
      • Research Skills
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  • Question 87 - The length of DNA is generally measured in terms of number of: ...

    Incorrect

    • The length of DNA is generally measured in terms of number of:

      Your Answer:

      Correct Answer: Base pairs

      Explanation:

      As DNA is made up of nucleotides, its length is measured by the number of base pairs in the DNA molecules.

    • This question is part of the following fields:

      • Genetics
      • Medicine
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  • Question 88 - Direct conduction from the atrium to the ventricles is prevented by: ...

    Incorrect

    • Direct conduction from the atrium to the ventricles is prevented by:

      Your Answer:

      Correct Answer: Annulus fibrosus

      Explanation:

      The annulus fibrosus disconnects the syncytium complex. The atria are rapidly activated however the activation peters out when the insulating layer-the annulus fibrosus-is reached.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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  • Question 89 - A 35 year old sales representative presents with severe pain going down her...

    Incorrect

    • A 35 year old sales representative presents with severe pain going down her neck and right arm. She admits that this pain is worse on sitting and driving for long periods. Past history is significant for two previous road traffic accidents. Examination reveals weakness and sensory loss over C5/C6 nerve distribution. There is pain with neck movement and particularly extension. Which of the following investigations would be the most helpful in this case?

      Your Answer:

      Correct Answer: MRI scan of the cervical spinal cord

      Explanation:

      Cervical radiculopathy is usually due to compression or injury to a nerve root by a herniated disc or degenerative changes. Levels C5 to T1 are the most commonly affected. It is usually, but not always, accompanied by cervical radicular pain, a sharp and shooting pain that travels from the neck and down the upper limb and may be severe. This needs to be differentiated from pain referred from the musculoskeletal (somatic) structures in the neck, which may be aching rather than sharp, and is more severe in the neck than in the upper limb. The neurological signs of cervical radiculopathy depend on the site of the lesion. The patient may have motor dysfunction, sensory deficits or alteration in tendon reflexes. While pain is a common presenting symptom, not all radiculopathies are painful (i.e. only motor deficits may be obvious). CT scanning cannot accurately demonstrate the commonest cause for cervical radiculopathy (disc herniation) without myelography, which requires hospital admission, lumbar puncture and the use of contrast. In patients with cervical radiculopathy, MRI is the imaging technique of choice for the detection of root compression by disc herniation and osteophytes. MRI allows the nerve roots to be directly visualised. Nerve conduction studies are also useful in determining the nerve roots that are involved.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
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  • Question 90 - The length of DNA is generally measured in terms of the number of:...

    Incorrect

    • The length of DNA is generally measured in terms of the number of:

      Your Answer:

      Correct Answer: Base pairs

      Explanation:

      As DNA is made up of nucleotides, its length is measured by the number of base pairs in the DNA molecules.

    • This question is part of the following fields:

      • Genetics
      • Medicine
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  • Question 91 - In the body what are fatty acids broken down to? ...

    Incorrect

    • In the body what are fatty acids broken down to?

      Your Answer:

      Correct Answer: Acetyl Co A

      Explanation:

      Fatty acids are broken down into acetyl Co A. The acetyl-CoA produced by beta oxidation enters the citric acid cycle in the mitochondrion by combining with oxaloacetate to form citrate.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
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  • Question 92 - Concerning surface anatomy, where is the aortic valve found? ...

    Incorrect

    • Concerning surface anatomy, where is the aortic valve found?

      Your Answer:

      Correct Answer: Situated in the left third intercostal space underneath the sternum

      Explanation:

      The aortic valve is situated in the left 3rd intercostal space just beneath the sternum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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  • Question 93 - Which of the following are true when it comes to tumour suppressor genes:...

    Incorrect

    • Which of the following are true when it comes to tumour suppressor genes:

      Your Answer:

      Correct Answer: All of the options are true

      Explanation:

      All of the above mentioned statements are true regarding tumour suppressor genes. Tumour suppressor genes generally follow the two-hit hypothesis, which implies that both alleles that code for a particular protein must be affected before an effect is manifested.

    • This question is part of the following fields:

      • Genetics
      • Medicine
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  • Question 94 - Which of the following is correct regarding lead poisoning? ...

    Incorrect

    • Which of the following is correct regarding lead poisoning?

      Your Answer:

      Correct Answer: Causes a peripheral neuropathy due to demyelination

      Explanation:

      Lead can be absorbed through the skin and by inhalation. It is associated with iron deficiency and a microcytic anaemia. The most common gastrointestinal symptoms are abdominal colic and constipation.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
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  • Question 95 - Which of the following statements is true regarding pulsus alternans? ...

    Incorrect

    • Which of the following statements is true regarding pulsus alternans?

      Your Answer:

      Correct Answer: It is found in association with a third heart sound

      Explanation:

      Pulsus alternans is a physical finding with arterial pulse waveform showing alternating strong and weak beats. It is almost always indicative of left ventricular systolic impairment, and carries a poor prognosis. A pathological third heart sound is usually associated.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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  • Question 96 - Which is the primary lymphoid organ? ...

    Incorrect

    • Which is the primary lymphoid organ?

      Your Answer:

      Correct Answer: Thymus

      Explanation:

      Lymphoid organs consist of lymph nodes, the thymus, spleen and tonsils. The thymus is the primary lymphoid organ as it is the organ in which the T cells mature.

    • This question is part of the following fields:

      • Immunology
      • Medicine
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  • Question 97 - Which of the following is an example of a ketone body? ...

    Incorrect

    • Which of the following is an example of a ketone body?

      Your Answer:

      Correct Answer: Acetoacetate

      Explanation:

      Ketone bodies are three water-soluble molecules (acetoacetate, beta-hydroxybutyrate, and their spontaneous breakdown product, acetone) that are produced by the liver from fatty acids during periods of low food intake (fasting), carbohydrate restrictive diets, starvation, prolonged intense exercise, alcoholism or in untreated (or inadequately treated) type 1 diabetes mellitus.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
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  • Question 98 - With regards to the cell cycle, which phase represents period of cell growth...

    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.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
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  • Question 99 - Presence of which of the following indicates a worse prognosis in rheumatoid arthritis?...

    Incorrect

    • Presence of which of the following indicates a worse prognosis in rheumatoid arthritis?

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
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  • Question 100 - A 35-year-old male was brought to you in a confused state. Although not...

    Incorrect

    • A 35-year-old male was brought to you in a confused state. Although not your patient, you can make out that the man has a history of schizophrenia, and has recently had his medications altered. Clinically, you find evidence of a lower respiratory tract infection, and blood investigations indicate a neutropenic picture.What is the most likely drug causing the neutropenia?

      Your Answer:

      Correct Answer: Clozapine

      Explanation:

      Clozapine can cause neutropenia or agranulocytosis.Clozapine is an atypical antipsychotic used in the treatment of schizophrenia, and in patients who are intolerant to, or unresponsive to other antipsychotics. It is a weak D2-receptor and D1-receptor blocking activity, with noradrenolytic, anticholinergic, and antihistaminic properties.Many antipsychotic drugs can occasionally cause bone marrow depression, but agranulocytosis is particularly associated with clozapine.Other side effects include:Hypotension, tachycardiaFever, sedation, seizures (with high doses)Appetite increaseConstipationHeartburnWeight gainExtrapyramidal symptomsAgranulocytosisNeuroleptic malignant syndrome

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (1/1) 100%
Medicine (4/8) 50%
Cell Biology (1/1) 100%
Infectious Diseases (0/1) 0%
Pharmacology (0/1) 0%
Research Skills (0/1) 0%
Endocrinology (1/1) 100%
Genetics (1/1) 100%
Connective Tissue (0/1) 0%
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