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Question 1
Incorrect
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Which of the following acute phase reactants increases the most dramatically in the first hour following injury?
Your Answer: Fibrinogen
Correct Answer: C-reactive protein
Explanation:Measurement of acute-phase proteins, especially C-reactive protein, is a useful marker of inflammation. It correlates with the erythrocyte sedimentation rate (ESR), however not always directly. This is due to the ESR being largely dependent on elevation of fibrinogen, an acute phase reactant with a half-life of approximately one week. This protein will therefore remain higher for longer despite removal of the inflammatory stimuli. In contrast, C-reactive protein (with a half-life of 6-8 hours) rises rapidly and can quickly return to within the normal range if treatment is employed.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 2
Incorrect
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The process of DNA amplification and quantification is called:
Your Answer: Blotting
Correct Answer: PCR
Explanation:PCR/polymerase chain reaction is a procedure carried out in a test tube that can be used on the smallest amount of DNA to amplify it, allowing for millions of copies of specific nucleotides to be made.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 3
Incorrect
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Question 4
Incorrect
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A 51-year-old real estate agent takes hydrocortisone 20mg in the mornings and 5mg at night for Addison’s disease. The endocrinology consultant would like her to take prednisolone instead. What dose of prednisolone should be started?
Your Answer: 25 mg
Correct Answer: 7 mg
Explanation:1mg Prednisolone = 4mg hydrocortisone, so the actual equivalent daily dose is 7mg.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 5
Correct
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Stem cell characteristics include the following except
Your Answer: Differentiation and proliferation into progenitor cells committed to multiple cell lines
Explanation:The classical definition of a stem cell requires that it possess two properties:Self-renewal: the ability to go through numerous cycles of cell division while maintaining the undifferentiated state.Potency: the capacity to differentiate into specialized cell types. In the strictest sense, this requires stem cells to be either totipotent or pluripotent to be able to give rise to any mature cell type
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This question is part of the following fields:
- Haematology
- Medicine
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Question 6
Correct
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Which of the following structures is not part of the conducting system of the heart?
Your Answer: Ventricular wall
Explanation:The conduction system of the heart consists of the SA node, AV node, internodal pathway between these two nodes, Bundle of His and the purkinje fibers
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 7
Correct
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Lymphoid stem cells give rise to the following cells:
Your Answer: T cells, b cells and natural killer cells
Explanation:T Cells, B Cells and NK Cells (and all other Innate lymphoid cells) are unique to the lymphocyte family, but dendritic cells are not. Dendritic cells of identical appearance but different markers are spread throughout the body, and come from either lymphoid and myeloid lineages.
Myeloid stem cells lead to myeloblasts, which evolve into macrophages, monocytes, neutrophils, basophils, and eosinophils.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 8
Incorrect
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The midbrain, medulla and pons, contain the following cranial nerve nuclei?
Your Answer: CN 7 – 12
Correct Answer: CN 3 - 12
Explanation:The cranial nerves (with the exception of I and II) originate in the brainstem, which includes the midbrain, the pons, and the medulla.
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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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The channel that coalesces the small pancreatic duct radicles before joining the common bile duct is known as the:
Your Answer: Duct of Oddi
Correct Answer: Duct of Wirsung
Explanation:The small ducts from the pancreas coalesce into a single duct known as the pancreatic duct or the duct of Wirsung. It usually joins the bile duct at the ampulla of Vater before entering the duodenum.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 10
Correct
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Which of the flowing plasma proteins has the greatest affinity for T4?
Your Answer: Thyroxin-binding globulin
Explanation:There are three principal plasma thyroid hormone-binding proteins, thyroxine-binding globulin (TBG), transthyretin (TTR), and albumin. TBG is synthesized in the liver and due to its relatively high affinity for iodothyronines, binds and carries approximately 70–75% of circulating T4 and T3.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 11
Incorrect
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Where in the gastrointestinal tract are valvulae conniventes?
Your Answer: Colon
Correct Answer: Jejunum
Explanation:The circular folds (valves of Kerckring or valvulae conniventes) are large valvular flaps projecting into the lumen of the small intestine.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 12
Incorrect
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Cells mediating innate immunity include:
Your Answer: T lymphocytes
Correct Answer: Natural killer cells
Explanation:Natural killer cells have features of both innate and adaptive immunity. They play an important part in defence against tumours and viruses. They are non specific and do not generate immunological memory
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This question is part of the following fields:
- Immunology
- Medicine
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Question 13
Correct
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The process in which tissue thromboplastin activates factor VII is best known as:
Your Answer: The extrinsic pathway
Explanation:In the tissue factor pathway (extrinsic), following damage to the blood vessel, FVII leaves the circulation and comes into contact with tissue factor (TF) expressed on tissue-factor-bearing cells (stromal fibroblasts and leukocytes), forming an activated complex (TF-FVIIa).
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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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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: It is an inhibitor of the cytochrome P450 enzyme system
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.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 15
Correct
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Amino acid reabsorption occurs most markedly in the?
Your Answer: Proximal convoluted tubule
Explanation:Renal protein reabsorption is the part of renal physiology that deals with the retrieval of filtered proteins, preventing them from disappearing from the body through the urine. Almost all reabsorption takes place in the proximal tubule. Only ,1% is left in the final urine.
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This question is part of the following fields:
- Medicine
- Renal
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Question 16
Correct
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In the microanatomy of the pituitary gland, the pituicytes present are in fact modified forms of which cells?
Your Answer: Astrocytes
Explanation:Pituicytes are glial cells present in the pars nervosa, the posterior pituitary gland. Their irregular shape resembles that of astrocytes, and their cytoplasm also has intermediate filaments. They differ from astrocytes in that they have large cytoplasmic lipid droplets.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 17
Incorrect
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Which of the following tracts are involved in the control of vital functions?
Your Answer: Spinocerebellar
Correct Answer: Reticulospinal
Explanation:Reticulospinal tract pass down from the reticular formation of the mid brain, pons and medulla. It descends in the lateral white column. Both sets of fibers enter the anterior grey column and may facilitate or inhibit the gamma and alpha neurons. By this means the reticulospinal tract controls voluntary and reflex activities. It also contains the descending autonomic fiber, thus providing a pathway for the hypothalamus to control the sympathetic and parasympathetic pathways.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 18
Correct
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What is the isolated effect of B2 stimulation on the coronaries?
Your Answer: Vasodilatation
Explanation:Norepinephrine and epinephrine are agonists for all adrenergic receptor subtypes, although with varying affinities. Based on their physiology and pharmacology, adrenergic receptors have been divided into two principal types: alpha and beta. These types have been further differentiated into alpha-1, alpha-2, b1, and b2 receptors.
Alpha-1 Receptors are located on postsynaptic cells in smooth muscle and elicit vasoconstriction.
Alpha-2 receptors are localized on presynaptic membranes of postganglionic nerve terminals that synthesize norepinephrine. When activated by catecholamines, alpha-2 receptors act as negative feedback controllers, inhibiting further norepinephrine release.
Activation of myocardial b1 receptors stimulates the rate and strength of cardiac contraction, and consequently increases cardiac output. b1 Receptor activation also stimulates renin release from the kidney. Another class of antihypertensive agents acts by inhibiting b1 receptors.
Activation of b2 receptors by epinephrine relaxes vascular smooth muscle and results in vasodilation.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 19
Incorrect
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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: It has a half-life of 12 h
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.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 20
Correct
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Regarding the innervation of the cerebral blood vessels, postganglionic sympathetic neurons have their cell bodies in the:
Your Answer: Superior cervical ganglia
Explanation:The superior cervical ganglion (SCG) is a part of autonomic system which plays a major role in maintaining homeostasis of the body. This ganglion innervates structures in the head and neck and is the largest and the most superiorly located ganglion. The SCG provides sympathetic innervation to structures within the head, including the pineal gland, the blood vessels in the cranial muscles and the brain, the choroid plexus, the eyes, the lacrimal glands, the carotid body, the salivary glands, and the thyroid gland. The postganglionic axons of the SCG innervate the internal carotid artery and form the internal carotid plexus. The internal carotid plexus carries the postganglionic axons of the SCG to the eye, lacrimal gland, mucous membranes of the mouth, nose, and pharynx, and numerous blood-vessels in the head.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 21
Incorrect
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The superior orbital fissure is the site of entry/exit for which of the following group of nerves?
Your Answer: CN III, IV, V3, VI
Correct Answer: CN III, IV, V1, VI
Explanation:The superior and inferior divisions of oculomotor nerve (III), trochlear nerve (IV), lacrimal, frontal and nasociliary branches of ophthalmic V1 and the abducens nerve (VI)
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This question is part of the following fields:
- Medicine
- Neurology
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Question 22
Incorrect
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Which enzyme is responsible for the removal of acetylcholine from the synapse?
Your Answer: Acetyl-coenzyme a
Correct Answer: Acetylcholinesterase
Explanation:Acetylcholinesterase is the enzyme that is responsible for breaking down acetylcholine into choline and acetate. Both of these molecules are transported back to the presynaptic neuron to be synthesized again. This enzyme is attached to the collagen fibers of the basement membrane in the synaptic cleft.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 23
Incorrect
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Which one of the following diseases is correctly matched with the animal reservoir:
Your Answer: Leishmaniasis = Cats
Correct Answer: Leptospirosis = Rats
Explanation:Creutzfeldt–Jakob disease = consuming beef or beef products.Brucellosis = ingestion of unpasteurized milk or undercooked meat from infected animals.Leptospirosis is transmitted by both wild and domestic animals. The most common animals that spread the disease are rodents.Lyme disease is transmitted to humans by the bite of infected ticks of the Ixodes genus.Leishmaniasis is a disease caused by protozoan parasites of the genus Leishmania and spread by the bite of certain types of sandflies.
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 24
Incorrect
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Which of the following best describe N. Meningitides?
Your Answer: Gram negative bacilli
Correct Answer: Gram negative cocci
Explanation:Neisseria meningitidis, often referred to as meningococcus, is a gram negative bacterium that can cause meningitis and other forms of meningococcal disease such as meningococcaemia, a life-threatening sepsis. The bacterium is referred to as a coccus because it is round, and more specifically, diplococcus because of its tendency to form pairs. About 10% of adults are carriers of the bacteria in their nasopharynx.
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 25
Incorrect
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In the malaria life cycle , parasites which remain dormant in the liver are known as :
Your Answer: Sporozoites
Correct Answer: Hypnozoites
Explanation:The life-cycles of Plasmodium species involve several different stages both in the insect and the vertebrate host. These stages include sporozoites, which are injected by the insect vector into the vertebrate host’s blood. Sporozoites infect the host liver, giving rise to merozoites and (in some species) hypnozoites. These move into the blood where they infect red blood cells. In the red blood cells, the parasites can either form more merozoites to infect more red blood cells, or produce gametocytes which are taken up by insects which feed on the vertebrate host. In the insect host, gametocytes merge to sexually reproduce. After sexual reproduction, parasites grow into new sporozoites, which move to the insect’s salivary glands, from which they can infect a vertebrate host bitten by the insect
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 26
Incorrect
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The end product of trehalase action on oligosaccharides is
Your Answer: A molecule of fructose and maltose
Correct Answer: Two glucose molecules
Explanation:Disaccharides are glycoside hydrolases, enzymes that break down certain types of sugars called disaccharides into simpler sugars called monosaccharides.Examples of disaccharides:Lactase (breaks down lactose into glucose and galactose)Maltase (breaks down maltose into 2 glucoses)Sucrase (breaks down sucrose into glucose and fructose)Trehalase (breaks down trehalose into 2 glucoses)
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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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A 75 year old man was brought to the clinic by his wife because lately he has lost interest in activities he previously enjoyed. His wife is worried and claims he's generally withdrawn. What would exclude depression in favour of dementia?
Your Answer: Reduced libido
Correct Answer: Urinary incontinence
Explanation:Urinary incontinence is not a usual symptom of depression. A depressed patient is usually capable of maintaining control of his body sphincters. In dementia, however, urinary incontinence is an important and late symptom of the disease, non-related to any urinary tract pathology. It is rather related to the cognitive impairment caused by dementia.
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This question is part of the following fields:
- Geriatrics
- Medicine
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Question 28
Incorrect
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The function of Troponin T in cardiac muscle is?
Your Answer: Escape into the circulation during acute coronary syndrome to allow for a diagnosis of NSTEMI
Correct Answer: Allows attachment of troponin components to tropomyosin
Explanation:Troponin T binds the troponin components to tropomyosin. Troponin I inhibits the interaction of myosin with actin, and troponin C contains the binding sites for the Ca2+ that helps initiate contraction.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 29
Incorrect
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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.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 30
Incorrect
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What is the function of the macula densa, located in the wall of the thick ascending limb?
Your Answer:
Correct Answer: Tubuloglomerular feedback.
Explanation:Macula densa cells sense changes in sodium chloride level, and will trigger an autoregulatory response to increase or decrease reabsorption of ions and water to the blood (as needed) in order to alter blood volume and return blood pressure to normal. Tubuloglomerular feedback is one of several mechanisms the kidney uses to regulate glomerular filtration rate (GFR). It involves the concept of purinergic signalling, in which an increased distal tubular sodium chloride concentration causes a basolateral release of adenosine from the macula densa cells. This initiates a cascade of events that ultimately brings GFR to an appropriate level.
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This question is part of the following fields:
- Medicine
- Renal
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SESSION STATS - PERFORMANCE PER SPECIALTY
