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Question 1
Correct
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Choose the standard method for comparing distributions in data sets (such as between the expected frequency of an event and the observed frequency of an event) from the list of options.
Your Answer: Chi squared (X²) test
Explanation:The Chi-squared test evaluates if two variables are related. The other statistical tests mentioned do not perform this function.
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This question is part of the following fields:
- Medicine
- Research Skills
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Question 2
Correct
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Which one of the following transporters is involved in facilitated diffusion?
Your Answer: GLUT2
Explanation:GLUT 2 is a bidirectional transporter, allowing glucose to flow in 2 directions via facilitated diffusion. Is expressed by renal tubular cells, liver cells and pancreatic beta cells. It is also present in the basolateral membrane of the small intestine epithelium.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 3
Incorrect
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VIP, GIP and somatostatin play an inhibitory role in gastric acid secretion by inactivating?
Your Answer: Parietal cells
Correct Answer: G cells
Explanation:Gastrin is secreted from the G cells. VIP, GIP and somatostatin all inhibit acid production by inhibiting the G cells.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 4
Correct
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Which is the primary lymphoid organ?
Your 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.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 5
Correct
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Which of the following statements is true of the beta- lactams:
Your 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.
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 6
Incorrect
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A sarcomere is the area between:
Your Answer:
Correct Answer: Two adjacent z lines
Explanation:The area that lies between the two adjacent Z lines is known as a sarcomere and is the contractile unit of the muscle. The line passing in the middle of the myosin filaments is the M line. It also passes through the middle of the sarcomere.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 7
Incorrect
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The effects of β1 stimulation include the following
Your Answer:
Correct Answer: Increased strength of contraction
Explanation:β1 stimulation include the phosphorylation of L type Ca++ channels and phospholamban and increased Ca++ influx from myocytes.
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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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Where is the aqueous humor normally reabsorbed?
Your Answer:
Correct Answer: Canal of schlemm
Explanation:Aqueous humor is a clear protein free fluid secreted by the ciliary body, it travels to the anterior chamber through the pupil and is absorbed through a network of trabeculae into the canal of schlemm
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This question is part of the following fields:
- Medicine
- Neurology
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Question 9
Incorrect
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Absolute refractory period in a cardiac action potential graph occurs during.
Your Answer:
Correct Answer: All of the above
Explanation:Absolute refractory period (ARP): the cell is completely unexcitable to a new stimulus and occurs from phase 0 – 2 i.e. depolarisation, early repolarisation and plateau phase.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 10
Incorrect
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A 22-year-old female is brought to the emergency department by her friends following the consumption of an unknown drug whilst clubbing. Which of the following features point towards the use of ecstasy?
Your Answer:
Correct Answer: Temperature of 39.5ºC
Explanation:Hyperthermia (Temperature 39.5 C) points towards the use of ecstasy.MDMA (3,4 – methylenedioxymethamphetamine), or more commonly known as Molly or Ecstasy, is a synthetic psychoactive substance.Patients who consumed MDMA may present in a tachycardic, hypertensive, hyperthermic, and agitated state. Adverse effects, even at minor recreational doses, include increased muscle activity (such as bruxism, restless legs, and jaw clenching), hyperactivity, insomnia, difficulty concentrating and feelings of restlessness.Treatment of MDMA overdose:Emphasis should be on maintaining the airway along with the stabilization of breathing and circulation.Patients may present obtunded due to hyponatremia requiring endotracheal intubation.For the hyperthermic patient, evaporative cooling along with ice packs to the groin and axilla are beneficial.Patients who present in severe toxicity within one hour of ingestion can receive activated charcoal PO or via an NG tube. Antipyretics, such as acetaminophen, should be avoided as they have no role and can worsen an already compromised liver.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 11
Incorrect
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The ‘c’ wave in JVP corresponds more closely with:
Your Answer:
Correct Answer: Isovolumetric contraction
Explanation:The jugular venous pressure (JVP, sometimes referred to as jugular venous pulse) is the indirectly observed pressure over the venous system via visualization of the internal jugular vein. It can be useful in the differentiation of different forms of heart and lung disease. Classically three upward deflections (peaks) and two downward deflections (troughs) have been described:The upward deflections are the a (atrial contraction), c (ventricular contraction and resulting bulging of tricuspid into the right atrium during isovolumetric systole) and v = venous filling.The downward deflections of the wave are the x (the atrium relaxes and the tricuspid valve moves downward) and the y descent (filling of ventricle after tricuspid opening).
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 12
Incorrect
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A 50-year-old male was under treatment for bipolar disease. He was brought to the emergency department as he had become increasingly confused over the past two days. He had vomiting and diarrhoea. He was also consuming and passing a lot of water.On examination, he was disoriented. He had vertical nystagmus and was ataxic.What two investigations are likely to lead to the correct diagnosis?
Your Answer:
Correct Answer: Desmopressin test and serum lithium level
Explanation:Desmopressin test (done to differentiate nephrogenic diabetes insipidus from central diabetes insipidus), and serum lithium levels can together confirm a diagnosis of lithium-induced nephrogenic diabetes insipidus.Bipolar disease is most often managed with mood stabilizers like lithium. This patient develops gastrointestinal symptoms followed by an acute confusional state associated with polyuria and polydipsia. These symptoms are suggestive of diabetes insipidus.In a case where these symptoms occur in a bipolar patient under treatment, lithium-induced nephrogenic diabetes insipidus should be considered as the most probable cause.Lithium intoxication can present with symptoms of nausea, vomiting, mental dullness, action tremor, weakness, ataxia, slurred speech, blurred vision, dizziness, especially vertical nystagmus and stupor or coma. Diffuse myoclonic twitching and nephrogenic diabetes insipidus can also occur. Such a clinical syndrome occurs above the serum level of lithium of 1.5–2.0 mEq/L.Management: – Correcting electrolyte abnormalities in patients with acute disease is critical and often life-saving.- Treatment should be initiated with parenteral fluids to replete hypovolemia (normal saline at 200-250 mL/h), followed by administration of hypotonic fluid (0.5% normal saline). – On the restoration of the volume status of the patient forced diuresis should be initiated by the administration of parenteral furosemide or bumetanide accompanied by continued intravenous hypotonic fluid administration to maintain volume status.- Polyuria is managed with hydrochlorothiazide combined with amiloride, acetazolamide.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 13
Incorrect
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Which of the following is a function of Vitamin C?
Your Answer:
Correct Answer: Hydroxylation of proline to hydroxyproline for collagen synthesis
Explanation:Vitamin C acts as an electron donor for eight different enzymes: Three enzymes (prolyl-3-hydroxylase, prolyl-4-hydroxylase, and lysyl hydroxylase) that are required for the hydroxylation of proline and lysine in the synthesis of collagen.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 14
Incorrect
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All of the following are associated with yellow nail syndrome except:
Your Answer:
Correct Answer: Cardiomegaly
Explanation:Yellow nail syndrome is a very rare medical syndrome that includes pleural effusions, lymphedema (due to under development of the lymphatic vessels) and yellow dystrophic nails. Approximately 40% will also have bronchiectasis. It is also associated with chronic sinusitis and persistent coughing and it usually affects adults.
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 15
Incorrect
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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.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 16
Incorrect
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A 60 year old male presents with thickened patches of skin over his knuckles and extensor surfaces that are consistent with Gottron's papules. Results reveal an elevated creatine kinase. Diagnosis of dermatomyositis is suspected. Which of the following autoantibody is most specific for this condition?
Your Answer:
Correct Answer: Anti-Mi-2 antibodies
Explanation:Anti–Mi-2 antibodies are highly specific for dermatomyositis, but sensitivity is low; only 25% of patients with dermatomyositis demonstrate these antibodies. A positive antinuclear antibody (ANA) finding is common in patients with dermatomyositis, but is not necessary for diagnosis. Anti-Jo-1 antibodies are mostly associated with polymyositis. Anti Scl-70 antibodies and anti centromere antibodies are most commonly found in systemic scleroderma.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 17
Incorrect
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A 30-year-old agitated male was brought to the emergency department by his friend. Though there is little previous history, the friend believes that he has been suffering from depression for several years, and his medications have been changed by his general practitioner quite recently.On examination the patient is agitated and confused, his pupils are dilated. He also has tremors, excessive sweating, and grinding of teeth. His heart rate is 118 beats/min, which is regular, and is febrile with a temperature of 38.5°C.What is the most probable diagnosis?
Your Answer:
Correct Answer: Serotonin syndrome
Explanation:The most probable diagnosis in this patient is serotonin syndrome.The serotonin syndrome is a cluster of symptoms and signs (range from barely perceptible tremor to life-threatening hyperthermia and shock). It may occur when SSRIs such as citalopram, escitalopram, fluoxetine, fluoxetine, paroxetine, and sertraline that impair the reuptake of serotonin from the synaptic cleft into the presynaptic neuron are taken in combination with monoamine oxidase inhibitors or tricyclic antidepressants. It has also been reported following an overdose of selective serotonin reuptake inhibitors (SSRIs) alone.Treatment:Most cases of serotonin syndrome are mild and will resolve with removal of the offending drug alone. After stopping all serotonergic drugs, management is largely supportive and aimed at preventing complications. Patients frequently require sedation, which is best facilitated with benzodiazepines.Antipsychotics should be avoided because of their anticholinergic properties, which may inhibit sweating and heat dissipation.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 18
Incorrect
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Which of the following stimuli increase growth hormone secretion?
Your Answer:
Correct Answer: Ghrelin
Explanation:Ghrelin is a hormone which serves as an endogenous ligand for the growth hormone secretagogue receptor. It acts on the pituitary and the hypothalamus by affecting the vagus nerve. It acts on the somatotrophs of the anterior pituitary, GHRH-secreting neurons, and on GHIH-secreting neurons in the hypothalamus, causing a time-dependent and pulsatile stimulation over the secretion of growth hormone.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 19
Incorrect
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Mean intra pleural pressure at rest with inspiration can reach:
Your Answer:
Correct Answer: -6 mmHg
Explanation:It is a negative pressure as it is lower than the atmospheric pressure. It can start from -2.5 and reach around -6 mmHg
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This question is part of the following fields:
- Medicine
- Respiratory
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Question 20
Incorrect
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What is the mode of action of amiodarone?
Your Answer:
Correct Answer: Potassium channel blocker
Explanation:Amiodarone is a class III antiarrhythmic drug. Class III antiarrhythmics are potassium channel blockers, they prolong duration of action potential with resulting prolongation of effective refractory period.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 21
Incorrect
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Which area in the GIT lacks Basic Electrical Rhythm?
Your Answer:
Correct Answer: Oesophagus
Explanation:The basal or basic electrical rhythm acts to coordinate peristalsis and are initiated in the interstitial cells of Cajal, specialized pacemaker cells located in the wall of the stomach, below the oesophagus.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 22
Incorrect
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Which of the following cells are attracted to the surface of endothelium by selectins?
Your Answer:
Correct Answer: Neutrophils
Explanation:Selectins are expressed on the surface of the endothelium. P selectins are released from weibel-palade bodies and E selectins are induced by cytokines (TNF and IL-1). They bind to receptors on the neutrophils called saiyl lewis X.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 23
Incorrect
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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.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 24
Incorrect
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A 26-year-old student has been brought to the emergency department in a confused state. His friends report that he has been complaining of headaches for the past few weeks. He has a low-grade fever and on examination is noted to have abnormally pink mucosa. What is the most likely diagnosis?
Your Answer:
Correct Answer: Carbon monoxide poisoning
Explanation:Confusion and pink mucosae are typical features of CO poisoning.The patient often presents, most commonly with headaches, and other symptoms like malaise, nausea, and dizziness.Carbon monoxide (CO) poisoning, considered as the great imitator of other diseases as the patients present with a myriad of symptoms. The carbon monoxide diffuses rapidly across the pulmonary capillary membrane binding to the haem molecule with a very high affinity (240 times that of oxygen) forming carboxy-haemoglobin (COHb). Non-smokers have a baseline COHb of ,3% while smokers have a baseline COHb of 10-15%.Features of carbon monoxide toxicity- Headache: 90% of cases- Nausea and vomiting: 50%- Vertigo: 50%- Confusion: 30%- Subjective weakness: 20%- Severe toxicity: ‘pink’ skin and mucosae, hyperpyrexia, arrhythmias, extrapyramidal features, coma, deathTreatment:Use of Hyperbaric oxygen therapy (HBOT) for treating mild to moderate CO poisoning is not routine.The selection criteria for HBOT in cases of CO poisoning include:• COHb levels > 20-25%• COHb levels > 20% in pregnant patient • Loss of consciousness• Severe metabolic acidosis (pH <7.1)• Evidence of end-organ ischemia (e.g., ECG changes, chest pain, or altered mental status)
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 25
Incorrect
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Which of the following acts on the pancreas to secrete pancreatic juice that is rich in enzymes?
Your Answer:
Correct Answer: CCK
Explanation:CCK (Cholecystokinin): CCK is released by the duodenum in response to the presence of fats and proteins in the small intestine. It stimulates the pancreas to secrete enzyme-rich pancreatic juice, which aids in the digestion of fats, proteins, and carbohydrates. It also stimulates the gallbladder to contract and release bile.
Secretin: Secretin is released by the duodenum in response to acidic chyme entering from the stomach. It primarily stimulates the pancreas to release bicarbonate-rich pancreatic juice to neutralize the acid, but it does not primarily stimulate enzyme secretion.
Gastrin: Gastrin is produced by G-cells in the stomach. It stimulates gastric acid secretion by the stomach, not pancreatic enzyme secretion.
Chymotrypsin: Chymotrypsin is an enzyme produced by the pancreas. It does not act to stimulate the pancreas; rather, it is a component of the pancreatic juice that helps digest proteins.
Elastase: Elastase is also an enzyme produced by the pancreas. Like chymotrypsin, it is involved in the digestion of proteins and does not stimulate the pancreas.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 26
Incorrect
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The sympathetic supply to the stomach comes from the:
Your Answer:
Correct Answer: Celiac plexus
Explanation:The vagus nerve supplies the stomach and up to proximal two-thirds of the large intestine and has parasympathetic stimulation. The sympathetic chain which begins at the level of he 1st thoracic vertebra and extends up to 3rd lumbar vertebra gives off the celiac plexus which mainly supplies the stomach. The mesenteric plexus mainly supplies the small intestine and is located below the celiac plexus in the sympathetic chain.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 27
Incorrect
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Osteopetrosis occurs as a result of a defect in:
Your Answer:
Correct Answer: Osteoclast function
Explanation:It is a metabolic bone disease caused by defective osteoclastic resorption of immature bone. Osteopetrosis is also known as marble bone disease. Osteoclasts are unable to adequately acidify bone matrix. Impaired bone resorption leads to overly dense bone that is more likely to fracture. It is usually treated with bone marrow transplant and high dose calcitriol.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 28
Incorrect
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Sympathetic supply to the stomach is derived from
Your Answer:
Correct Answer: T5-T9 spinal segments via the coeliac ganglion
Explanation:Parasympathetic innervation to the stomach is from the vagus nerve and the sympathetic innervation is from the T5-T9 spinal segments via the coeliac ganglion through the greater splanchnic nerve.
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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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Compact/cortical bone makes up
Your Answer:
Correct Answer: The outer layer of most bones and accounts for 80% of bone in the body
Explanation:Cortical, lamellar, or compact bone, is more dense than spongy bone and it forms the rigid, outer layer of bones, also called cortex. It consists of packed osteons, with a central osteonic canal surrounded by concentric rings. Spaces called lacunae are filled with osteocytes, and channels called canaliculi go from the lacunae to the osteonic canal. The strength of cortical bone allows it to support the body and protect organs. It also stores different elements, such as calcium.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 30
Incorrect
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The pyloric sphincter is largely made up of thickening of
Your Answer:
Correct Answer: The circular muscle layer
Explanation:The pyloric sphincter, or valve, is a strong ring of smooth muscle (circular muscle layer) at the end of the pyloric canal which lets food pass from the stomach to the duodenum. It controls the outflow of gastric contents into the duodenum. It receives sympathetic innervation from the celiac ganglion.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 31
Incorrect
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In the blood supply of the heart, ‘dominance’ refers to the coronary artery which supplies the?
Your Answer:
Correct Answer: Posterior interventricular artery
Explanation:Dominance of the coronary artery system is defined by the artery that gives rise to the posterior interventricular artery. Dominance of the right coronary artery is more common (68%). It gives rise to the large posterior interventricular branch which goes down to the apex of the heart.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 32
Incorrect
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Where do the spinothalamic axons decussate?
Your Answer:
Correct Answer: Spinal cord
Explanation:The second order neurons from the spinothalamic tract cross obliquely to the opposite side in the anterior grey and white commissure within one segment of the spinal cord.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 33
Incorrect
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Where does most fat digestion begin?
Your Answer:
Correct Answer: Duodenum
Explanation:Digestion of some fats can begin in the mouth where lingual lipase breaks down some short chain lipids into diglycerides. However fats are mainly digested in the small intestine (in the duodenum). The presence of fat in the small intestine produces hormones that stimulate the release of pancreatic lipase from the pancreas and bile from the liver which helps in the emulsification of fats for absorption of fatty acids.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 34
Incorrect
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During which phase of the cell cycle does transcription of DNA synthesis molecules occur?
Your Answer:
Correct Answer: S
Explanation:DNA synthesis occurs in the S phase of the cell cycle. In the G1 phase the cell prepares to divide. In G2 the cellular organelles divide and in the M phase mitosis occur. In the G0 phase the cell becomes quiescent and does not divide further.
Interphase is composed of G1 phase (cell growth), followed by S phase (DNA synthesis), followed by G2 phase (cell growth). At the end of interphase comes the mitotic phase, which is made up of mitosis and cytokinesis and leads to the formation of two daughter cells.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 35
Incorrect
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With regards to splenic micro-architecture which is not contained within the red pulp
Your Answer:
Correct Answer: Malpighian corpuscles
Explanation:Red pulp is responsible for mechanical filtration of red blood cells and is composed of sinusoids, which are filled with blood, splenic cords of reticular fibers and a marginal zone bordering on white pulp. White pulp provides an active immune response through humoral and cell-mediated pathways. Composed of nodules, called Malpighian corpuscles. These are composed of: lymphoid follicles, rich in B-lymphocytes and periarteriolar lymphoid sheaths (PALS), rich in T-lymphocytes.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 36
Incorrect
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Currents caused by opening of which of the following channels contribute to the repolarization phase of the action potential of the ventricular muscle fibers?
Your Answer:
Correct Answer: Potassium channels
Explanation:Depolarization occurs due to opening of the voltage gated sodium channels. Repolarization occurs due to opening of the voltage gates potassium channels causing an out flux of potassium ions, decreasing the membrane potential towards resting potential.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 37
Incorrect
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Question 38
Incorrect
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Which of the following suggests the presence of mitral regurgitation as well as mitral stenosis?
Your Answer:
Correct Answer: Displaced apex beat
Explanation:Mitral stenosis on its own does not lead to left ventricular dilatation and hence a displaced apex beat. Thus a displaced apex beat is suggestive of mixed mitral disease. The other options occur in mitral stenosis.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 39
Incorrect
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Question 40
Incorrect
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Where is the lower border of the liver usually found?
Your Answer:
Correct Answer: 10th rib anterior axillary line on right
Explanation:Assessment of liver margins is important clinically to determine the size of the liver and is done via percussion during the physical examination. The liver typically extends from the fifth intercostal space or 6th rib to the right costal margin in the midclavicular line and the 10th rib on anterior axillary line.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 41
Incorrect
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If UA = concentration of A in urine, V = urine flow per unit time, and PA = arterial plasma level of A, renal clearance of A is equal to?
Your Answer:
Correct Answer: (UA x V)/PA
Explanation:Renal clearance = [Urine concentration (UA) x Urine flow (V)]/[Plasma concentration (PA)]
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This question is part of the following fields:
- Medicine
- Renal
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Question 42
Incorrect
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With regard to X-linked disorders which of the following are true:
Your Answer:
Correct Answer: X linked recessive disorders usually present in males and only very rarely present in homozygous females
Explanation:X linked disorders are more common in males as they only need one mutated copy of the X chromosome to manifest the disease with full severity while the females need two X chromosomes to manifest the disease, even with one defected X chromosome the severity is less than that seen in males.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 43
Incorrect
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In the gastric mucosa, which of the following cells is known to secrete gastric lipase?
Your Answer:
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 44
Incorrect
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Question 45
Incorrect
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The largest energy reserves among both lean and obese subjects are from?
Your Answer:
Correct Answer: Fatty acids
Explanation:The energy required for sustained exercise is provided by the oxidation of two fuels, glucose stored as glycogen in the liver and muscle, and long-chain fatty acids, stored as adipose tissue triglycerides. The latter provides the largest energy reserve in the body.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 46
Incorrect
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Which of the following occurs during a Valsalva manoeuvre?
Your Answer:
Correct Answer: An initial rise in blood pressure
Explanation:The Valsalva maneuver involves forced expiration against a closed glottis. It has several phases, each affecting the cardiovascular system differently:
- Phase I: During the initial forced expiration against the closed glottis, there is a transient rise in intrathoracic pressure, which compresses the thoracic aorta and causes a brief increase in blood pressure.
- Phase II: Continued straining leads to decreased venous return to the heart, reducing cardiac output and causing a drop in blood pressure. This phase is characterized by a compensatory increase in heart rate.
- Phase III: Upon releasing the strain, there is a sudden drop in intrathoracic pressure, which momentarily decreases blood pressure.
- Phase IV: Blood pressure then rises rapidly as venous return to the heart is restored, leading to increased cardiac output. This is often followed by a reflex bradycardia (slow heart rate).
Given these phases, the most accurate statement about what occurs during the Valsalva maneuver is the initial rise in blood pressure (Phase I).
Other options explained:
- Forced inspiration against a closed glottis: Incorrect. The Valsalva maneuver involves forced expiration, not inspiration, against a closed glottis.
- Low intrathoracic pressures throughout: Incorrect. The Valsalva maneuver involves high intrathoracic pressures due to forced expiration.
- Disruption of autonomic function: Incorrect. The Valsalva maneuver affects autonomic function but does not disrupt it. Instead, it triggers autonomic responses to changes in blood pressure and heart rate.
- No change: Incorrect. The Valsalva maneuver causes significant changes in blood pressure and heart rate.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 47
Incorrect
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Which hormone secreting cell of the human anterior pituitary gland secretes growth hormone?
Your Answer:
Correct Answer: Somatotroph
Explanation:Somatotroph cells are responsible for the production of growth hormone. Somatotrophs occupy nearly 40% of the total surface area of the anterior pituitary, and they are acidophilic in nature.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 48
Incorrect
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Absorption of fructose is via:
Your Answer:
Correct Answer: Facilitated diffusion
Explanation:Dietary fructose may be ingested as a monosaccharide or as a disaccharide. Sucrose is hydrolysed by sucrase to produce equal amounts of glucose and fructose and in this form, is usually completely absorbed. Fructose is mostly absorbed in the small intestine through GLUT-5 transporter mediated facilitative diffusion. This is an energy independent process.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 49
Incorrect
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How does the proximal convoluted tubule excrete H+?
Your Answer:
Correct Answer: Via Na+/H+ antiporter.
Explanation:H+ secretion from cells across the luminal membrane is mostly in exchange for Na+ ions, and to a small extent, through a proton ATPase. Secreted H+ react with filtered HC03- to form H2CO3.
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This question is part of the following fields:
- Medicine
- Renal
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Question 50
Incorrect
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Interruption of the left optic tract will result in which visual field defect?
Your Answer:
Correct Answer: Right homonymous hemianopia
Explanation:Right homonymous hemianopia is due to a lesion or pressure on the left optic tract. Total blindness of the left eye is due to a complete occlusion of the left optic nerve. Bipolar hemianopia is due to a midline chiasmal lesion. Left nasal hemianopia due to a lesion involving the left perichiasmal area. Right homonymous inferior quadrantanopia is due to involvement of the lower left optic radiations.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 51
Incorrect
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Question 52
Incorrect
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Which of the following is the most common causative organism in infective endocarditis?
Your Answer:
Correct Answer: Streptococcus viridans
Explanation:Viridans Alpha-haemolytic streptococci, that are present in the mouth are the most frequently isolated microorganisms when the infection is acquired in a community setting. In contrast, Staphylococcus blood stream infections are frequently acquired in a health care setting where they can enter the blood stream through procedures that cause break in the integrity of skin like surgery, catheterisation or during access of long term indwelling catheters or secondary to intravenous injection of recreational drugs.Prosthetic valve endocarditis is commonly caused by Staphylococcus epidermidis as it is capable of growing as a biofilm on plastic surfaces
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 53
Incorrect
-
One of the functions of the spleen with regards to red blood cells is:
Your Answer:
Correct Answer: To filter and remove aged and abnormal red blood cells
Explanation:The spleen plays important roles in regard to red blood cells (also referred to as erythrocytes) and the immune system. It removes old red blood cells and holds a reserve of blood, which can be valuable in case of haemorrhagic shock, and also recycles iron. As a part of the mononuclear phagocyte system, it metabolizes haemoglobin removed from senescent erythrocytes. The globin portion of haemoglobin is degraded to its constitutive amino acids, and the haem portion is metabolized to bilirubin, which is removed in the liver.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 54
Incorrect
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Question 55
Incorrect
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What is the main reason for checking the urea and electrolytes prior to commencing a patient on amiodarone?
Your Answer:
Correct Answer: To detect hypokalaemia
Explanation:All antiarrhythmic drugs have the potential to cause arrhythmias. Coexistent hypokalaemia significantly increases this risk.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 56
Incorrect
-
Which of the following factors serve to decrease cardiac output?
Your Answer:
Correct Answer: Standing from a lying position
Explanation:Sleep has no effect on the cardiac output. Anxiety, excitement, increased body temperature and pregnancy will increase the cardiac output. Standing from a lying position will decrease the cardiac output transiently.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 57
Incorrect
-
Coronary vasoconstriction can be caused by:
Your Answer:
Correct Answer: Beta blockage
Explanation:Coronary arteries contain alpha and beta receptors. The alpha receptor stimulates vasoconstriction and beta receptors stimulate vasodilation. When the chronotropic and inotropic effects of noradrenergic receptors are blocked by a B blocking drug, stimulation of the noradrenergic nerves will cause coronary vasoconstriction.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 58
Incorrect
-
The pressure in the sinusoids is normally:
Your Answer:
Correct Answer: Lower than portal venous pressure
Explanation:The direction of transport of nutrients in the portal vein occurs from the portal vein to the hepatic sinusoids. Thus, he pressure of sinusoids should be lower than the pressure of he portal vein.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 59
Incorrect
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Choose the correct answer: The cerebrocerebellum…
Your Answer:
Correct Answer: All options are correct
Explanation:Cerebrocerebellum is comprised of two lateral regions, the cerebellar hemispheres and communicates with the cerebral cortex. It is principally responsible for controlling coordination of movement. Three fiber bundles carry the input and output of the cerebellum. There are three cerebellar peduncles with different connections and functions. The three are mainly, superior, middle and inferior. The superior cerebellar peduncle is also known as the “Brachium conjunctivum”. It predominantly contains efferent fibers from the cerebellar nuclei, as well as some afferents from the spinocerebellar tract. The efferent pathways include cerebellorubral, dentatothalamic, and fastigioreticular fibers. These are tracts projecting from the deep cerebellar nuclei to the thalamus and red nucleus. The middle cerebellar peduncle connects to the pontine nucleus and the dorsal spinocerebellar tracts run through the superior cerebellar peduncle
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This question is part of the following fields:
- Medicine
- Neurology
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Question 60
Incorrect
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Which of the following do not pass through the cavernous sinus?
Your Answer:
Correct Answer: CN 2
Explanation:Oculomotor nerve (N3), trochlear nerve (N4), ophthalmic and mandibular divisions of the trigeminal nerve (N5) pass along its lateral border. The abducent nerve (N6) passes through it along with the internal carotid artery.
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This question is part of the following fields:
- Medicine
- Neurology
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