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  • Question 1 - Treatment of an acute attack of gout with allopurinol may result in which...

    Correct

    • Treatment of an acute attack of gout with allopurinol may result in which of the following?

      Your Answer: Exacerbation and prolongation of the attack

      Explanation:

      Initiation of allopurinol treatment during an attack can exacerbate and prolong the episode. Thus treatment should be delayed until the attack resolves.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      9.4
      Seconds

  • Question 2 - The cerebellum consists of which three cell layers? ...

    Correct

    • The cerebellum consists of which three cell layers?

      Your Answer: Granular, purkinje, molecular

      Explanation:

      The cerebellar cortex consist of 3 layers; the molecular layer, the granular cell layer and the Purkinje cell layer in the middle.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      6.4
      Seconds

  • Question 3 - Translation usually begins at which codon? ...

    Correct

    • Translation usually begins at which codon?

      Your Answer: AUG

      Explanation:

      The start codon is the first codon of a messenger RNA (mRNA) transcript translated by a ribosome. The start codon always codes for methionine in eukaryotes and the most common start codon is AUG.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      3.4
      Seconds

  • Question 4 - Which receptor type is associated with the inhibition of pancreatic endocrine secretion? ...

    Incorrect

    • Which receptor type is associated with the inhibition of pancreatic endocrine secretion?

      Your Answer: M2

      Correct Answer: Α2

      Explanation:

      The activation of alpha 2-adrenergic receptors in pancreatic beta-cells works by inhibiting the secretion of insulin.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      14.4
      Seconds

  • Question 5 - Which glucose transporter is responsible for the uptake of dietary glucose from the...

    Correct

    • Which glucose transporter is responsible for the uptake of dietary glucose from the gut?

      Your Answer: SGLT1

      Explanation:

      SGLT 1 is responsible for the uptake of glucose via secondary active transport from the small intestine and the renal tubules.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      959.8
      Seconds

  • Question 6 - Which of the following biochemical profiles is seen in a normal 65 year...

    Incorrect

    • Which of the following biochemical profiles is seen in a normal 65 year old female? (in comparison to a normal 24 yr. old female)

      Your Answer: Decreased FSH, LH; decreased oestrogen, progesterone

      Correct Answer: Increased FSH, LH; decreased oestrogen, progesterone

      Explanation:

      During menopause, a woman’s number of ovarian follicles becomes depleted; as a result, oestrogen and progesterone levels drop, and LH and FSH levels increase. One of the criteria to diagnose menopause is the absence of menstrual period for a year, along with a serum FSH level increased to 30 mIU/ml or higher. LH also rises with the onset of menopause.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      1546.8
      Seconds

  • Question 7 - A 70-year-old woman is having trouble in speaking following a stroke. Her limbs...

    Correct

    • A 70-year-old woman is having trouble in speaking following a stroke. Her limbs are paralyzed, both left upper and lower limbs. Which anatomical site is most likely affected?

      Your Answer: Internal capsule

      Explanation:

      – The given scenario is typical of lesion in internal capsule. – Memory impairment is caused by a hippocampal lesion, – Impairment of arousal, facial paresis, visual field defect, facial paresis, hemiataxia, and hemispacial neglect are just some of the conditions caused by thalamic lesion. – Brainstem stroke on the other hand causes breathing abnormality, altered consciousness, and blood pressure disorder.

    • This question is part of the following fields:

      • Geriatrics
      • Medicine
      98.1
      Seconds

  • Question 8 - Concerning surface anatomy, where is the aortic valve found? ...

    Incorrect

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

      Your Answer: Situated in the right second intercostal space underneath the sternum

      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
      8.5
      Seconds

  • Question 9 - What is the function of migrating motor complex ...

    Incorrect

    • What is the function of migrating motor complex

      Your Answer: Stimulate peristalsis following ingestion of food

      Correct Answer: Clears the gut of luminal contents in preparation of the next meal

      Explanation:

      Migrating motor complexes (MMC) are waves of electrical activity that sweep through the intestines in a regular cycle during fasting. These motor complexes trigger peristaltic waves, which facilitate transportation of indigestible substances such as bone, fiber, and foreign bodies from the stomach, through the small intestine, past the ileocecal sphincter, and into the colon. The MMC occurs every 90–120 minutes during the interdigestive phase (between meals), and is responsible for the rumbling experienced when hungry. It also serves to transport bacteria from the small intestine to the large intestine, and to inhibit the migration of colonic bacteria into the terminal ileum.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      11.8
      Seconds

  • Question 10 - Which of the following receptors are found in the liver? ...

    Incorrect

    • Which of the following receptors are found in the liver?

      Your Answer: Just β

      Correct Answer: α1, β2

      Explanation:

      Liver consists of the sympathetic Alpha 1 and beta 2 receptors.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      15.6
      Seconds

  • Question 11 - The nucleus tractus solitaries is medullary nucleus that processes the following inputs except:...

    Incorrect

    • The nucleus tractus solitaries is medullary nucleus that processes the following inputs except:

      Your Answer: Visceral sensation from the gut and thoracic organs

      Correct Answer: Sensory input from the semi-circular canal (CN VIII)

      Explanation:

      Located in the brain stem is a series of purely sensory nuclei known as tractus solitaries. Inputs of the nucleus tractus solitaries include:Taste information from the facial nerve (anterior 2/3 of the tongue), glossopharyngeal nerve (posterior 1/3) and vagus nerve (small area on the epiglottis).Sensory information from the ear (auricular branch of the vagus nerve).Chemoreceptors and mechanoreceptors of the general visceral afferent pathway (GVA) in the carotid body via glossopharyngeal nerve, aortic bodies, and the sinoatrial node, via the vagus nerve.Chemically and mechanically sensitive neurons of the general visceral afferent pathway (GVA) with endings located in the heart, lungs, airways, gastrointestinal system, pharynx, and liver via the glossopharyngeal and vagus nerves.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      51.3
      Seconds

  • Question 12 - The enzyme responsible for telomeres maintaining their length after cell division is called:...

    Incorrect

    • The enzyme responsible for telomeres maintaining their length after cell division is called:

      Your Answer: Telomere transcriptase

      Correct Answer: Telomerase

      Explanation:

      Telomerase is the enzyme responsible for maintenance of the length of telomeres by addition of guanine-rich repetitive sequences. Telomerase activity is exhibited in gametes and stem and tumor cells.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      41.1
      Seconds

  • Question 13 - Which of the following statements is false regarding the bioavailability of a drug?...

    Correct

    • Which of the following statements is false regarding the bioavailability of a drug?

      Your Answer: The bioavailability of a drug given orally is often affected by the degree of renal elimination

      Explanation:

      Renal elimination of a drug has no role in altering the bioavailability of a drug.The bioavailability of a drug is the proportion of the drug which reaches systemic circulation. Mathematically, bioavailability is the AUCoral/AUCiv x 100%, where AUC = area under the concentration-time curve following a single (oral or iv) dose. Other options are true:By definition, the bioavailability of a drug given intravenously is 100%.Drugs given orally that undergo high pre-systemic (first-pass) metabolism in the liver or gut wall have a low bioavailability e.g. lidocaine. Bioavailability is also affected by the degree of absorption from the gut and this can change depending on gut motility and administration of other drugs.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      30.7
      Seconds

  • Question 14 - Regarding the surface anatomy of the orifices of the heart, where is the...

    Correct

    • Regarding the surface anatomy of the orifices of the heart, where is the aortic valve located?

      Your Answer: Opposite the left 3rd intercostal space to the left of 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
      45.1
      Seconds

  • Question 15 - Antibiotic resistance may happen by: ...

    Correct

    • Antibiotic resistance may happen by:

      Your 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
      9.3
      Seconds

  • Question 16 - The steps of cardiac cycle in sequence are: ...

    Correct

    • The steps of cardiac cycle in sequence are:

      Your Answer: Isovolumic contraction, ejection, isovolumic relaxation, passive ventricular filling, active ventricular filling.

      Explanation:

      The cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat, and so includes the diastole, the systole, and the intervening pause.1st stage: diastole, or passive filling is when the semilunar valves (the pulmonary valve and the aortic valve) close, the atrioventricular (AV) valves (the mitral valve and the tricuspid valve) open, and the whole heart is relaxed. 2nd stage: atrial systole, is when the atrium contracts, and blood flows from atrium to the ventricle (active filling).3rd stage: isovolumic contraction is when the ventricles begin to contract, the AV and semilunar valves close, and there is no change in volume. 4th stage: ventricular ejection, is when the ventricles are contracting and emptying, and the semilunar valves are open. 5th stage: isovolumic relaxation time, pressure decreases, no blood enters the ventricles, the ventricles stop contracting and begin to relax, and the semilunar valves close due to the pressure of blood in the aorta.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      81.9
      Seconds

  • Question 17 - In the urea cycle, which substance is formed in the mitochondria? ...

    Incorrect

    • In the urea cycle, which substance is formed in the mitochondria?

      Your Answer: Ornithine

      Correct Answer: Carbamoyl phosphate

      Explanation:

      Before the urea cycle begins ammonia is converted to carbamoyl phosphate in the mitochondria.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      4.2
      Seconds

  • Question 18 - A 20 year old male student presents to the clinic with swelling of...

    Correct

    • A 20 year old male student presents to the clinic with swelling of his face, hands and feet along with diffuse abdominal pain. He has a history of similar recurrent episodes since he was 10 years old, with each episode lasting 2-3 days. Examination reveals swelling on face, hands, feet but no sign of urticaria. Family history is significant for similar episodes in the mother who experienced these since childhood, and a brother who passed away following respiratory distress at age of 8 during one such episode. Which of the following tests would be the most helpful in reaching the diagnosis?

      Your Answer: C1 esterase inhibitor

      Explanation:

      Hereditary C1 inhibitor deficiency leads to recurrent angioedema without urticaria or pruritus. Physical triggers include dental work, surgery or intubation. Medical triggers include angiotensin-converting enzyme (ACE) inhibitor, tamoxifen, oestrogen-containing medications (e.g., hormone replacement therapy and oral contraceptives). It is diagnosed on the basis of low levels of C1 esterase inhibitor or elevated levels of dysfunctional C1 esterase inhibitor. C4 levels are low between attacks. IgE levels, eosinophils, skin prick tests and RASTs are helpful in other allergic conditions and asthma but not of use in this case.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      19.1
      Seconds

  • Question 19 - What is pendrin? ...

    Correct

    • What is pendrin?

      Your Answer: Cl-/i- antiporter

      Explanation:

      Pendrin is an anion exchange transporter; it is a sodium-independent chloride-iodine exchanger which also accepts formate and bicarbonate. It is present in many different types of cells in the body, particularly the inner ear, thyroid, and kidney. Mutations in pendrin are associated with Pendred syndrome, which causes syndromic deafness and thyroid disease.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      6.1
      Seconds

  • Question 20 - A 25-year-old student consumed a bottle of vodka at a party, the next...

    Incorrect

    • A 25-year-old student consumed a bottle of vodka at a party, the next day he finds that he feels excessively thirsty and is passing more urine than usual. Which of the following mechanisms best explains the polyuria due to excessive alcohol consumption?

      Your Answer:

      Correct Answer: Ethanol inhibits ADH secretion

      Explanation:

      Ethanol reduces the calcium-dependent secretion of anti-diuretic hormone (ADH) by blocking channels in the neurohypophyseal nerve terminal.Thus, ethanol’s inhibitory effect helps to explain the increased diuresis experienced during intoxicated states as well as increased free water loss; without appropriate ADH secretion, more water is excreted by the kidneys.Nausea associated with hangovers is mainly due to vagal stimulation to the vomiting centre. Following a particularly severe episode of alcohol excess, people may experience tremors due to increased glutamate production by neurons to compensate for the previous inhibition by ethanol.Management of alcoholism:Nutritional support: – Alcoholic patients should receive oral thiamine if their ‘diet may be deficient’.Pharmacological management:- Benzodiazepines for acute withdrawal- Disulfiram promotes abstinence – alcohol intake causes a severe reaction due to inhibition of acetaldehyde dehydrogenase. Patients should be aware that even small amounts of alcohol (e.g. In perfumes, foods, mouthwashes) can produce severe symptoms. Contraindications include ischaemic heart disease and psychosis.- Acamprosate reduces craving, known to be a weak antagonist of NMDA receptors, improves abstinence in placebo-controlled trials.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 21 - The hippocampus is involved in the memory of: ...

    Incorrect

    • The hippocampus is involved in the memory of:

      Your Answer:

      Correct Answer: Facts

      Explanation:

      The hippocampus plays an important role in forming new memories about experienced events. Some researchers say that hippocampus plays a major role in declarative memory for example memory of facts.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 22 - Myelin sheath in the CNS is produced by? ...

    Incorrect

    • Myelin sheath in the CNS is produced by?

      Your Answer:

      Correct Answer: Oligodendrocytes

      Explanation:

      CNS myelin is produced by special cells called oligodendrocytes. PNS myelin is produced by Schwann cells. The two types of myelin are chemically different, but they both perform the same function — to promote efficient transmission of a nerve impulse along the axon.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 23 - Most of the venous blood returns to the heart through the: ...

    Incorrect

    • Most of the venous blood returns to the heart through the:

      Your Answer:

      Correct Answer: Coronary sinus and anterior cardiac veins

      Explanation:

      Most of the venous blood returns to the heart via the coronary sinus and the anterior cardiac veins which drain into the right atrium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 24 - Which of the given adverse effects should be anticipated following the administration of...

    Incorrect

    • Which of the given adverse effects should be anticipated following the administration of an anticholinesterase?

      Your Answer:

      Correct Answer: Bradycardia and miosis

      Explanation:

      Bradycardia and miosis should be anticipated following the administration of anticholinesterases.Anticholinesterase agents include the following medications:- Pyridostigmine, neostigmine, and edrophonium which play a significant role in the diagnosis and the management of myasthenia gravis.- Rivastigmine, galantamine and donepezil are cholinesterase inhibitors found to be significantly useful in the management of Alzheimer’s disease.Mechanism of action and pharmacological effects:Inhibition of cholinesterase increases the level and the duration of action of acetylcholine within the synaptic cleft. Thus, cholinergic effects such as a reduction in heart rate (bradycardia), miosis (pupillary constriction), increased secretions, increased gastrointestinal motility and reduction in BP may occur with anticholinesterases.Toxins such as organophosphates and carbamates also are primarily anticholinergic and cause the following typical SLUDGE symptoms:- Salivation- Lacrimation- Urination- Diaphoresis- Gastrointestinal upset- Emesis

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 25 - During strenuous exercise the PO2 of mixed venous blood is: ...

    Incorrect

    • During strenuous exercise the PO2 of mixed venous blood is:

      Your Answer:

      Correct Answer: 25 mmHg

      Explanation:

      During strenuous exercise the PO2 of mixed venous blood is less than 30 mmHg.

    • This question is part of the following fields:

      • Medicine
      • Respiratory
      0
      Seconds

  • Question 26 - A 67 year old man reports weight loss. Labs show a raised alkaline...

    Incorrect

    • A 67 year old man reports weight loss. Labs show a raised alkaline phosphatase at 290 U/L (normal range 35-120). Plain radiographs reveal sclerotic lesions of the bone. Which of the following is the most likely cause of these findings?

      Your Answer:

      Correct Answer: Prostate cancer

      Explanation:

      Osteoblastic (or sclerotic) bony metastases, characterized by deposition of new bone, present in prostate cancer, carcinoid, small cell lung cancer, Hodgkin lymphoma or medulloblastoma. The other cancers listed in the options are osteolytic.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 27 - Digoxin causes: ...

    Incorrect

    • Digoxin causes:

      Your Answer:

      Correct Answer: Increase in cytosolic calcium concentration

      Explanation:

      Digoxin is a positive inotrope which inhibits NA/K ATPase, increases cardiac contractility and can cause hypokalaemia.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 28 - Cyclic AMP is formed from ATP via which enzyme ...

    Incorrect

    • Cyclic AMP is formed from ATP via which enzyme

      Your Answer:

      Correct Answer: Adenylate cyclase

      Explanation:

      Cyclic AMP is synthesized from ATP by adenylate cyclase located on the inner side of the plasma membrane and anchored at various locations in the interior of the cell.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 29 - The endothelium of the sinusoids has the following important function: ...

    Incorrect

    • The endothelium of the sinusoids has the following important function:

      Your Answer:

      Correct Answer: Highly fenestrated, large subendothelial spaces, many macrophages

      Explanation:

      Substances absorbed in the intestines reach the liver via the portal vein and contain toxic substances that needs to be detoxified in hepatocytes. Thus, hepatic sinusoids are fenestrated and contain large spaces which allows passage of substances freely. These fenestrations are rich in Kupffer cells which are macrophages.

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      0
      Seconds

  • Question 30 - Carbohydrates digestion starts in the ...

    Incorrect

    • Carbohydrates digestion starts in the

      Your Answer:

      Correct Answer: Mouth

      Explanation:

      Digestion begins in the mouth with the secretion of saliva and its digestive enzymes. Food is formed into a bolus by the mechanical mastication and swallowed into the oesophagus from where it enters the stomach through the action of peristalsis.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 31 - 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
      0
      Seconds

  • Question 32 - Factors influencing cardiac output include which of the following? ...

    Incorrect

    • Factors influencing cardiac output include which of the following?

      Your Answer:

      Correct Answer: All of the above

      Explanation:

      There is a correlation between resting CO and body surface area. The output per min per square meter of body surface (the cardiac index) averages 3.2l.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 33 - Absorption of fructose is via: ...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 34 - 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 35 - Selectins ...

    Incorrect

    • Selectins

      Your Answer:

      Correct Answer: Interact with carbohydrate ligands or mucin complexes on leucocytes and endothelial cells

      Explanation:

      Selectins are involved in constitutive lymphocyte homing, and in chronic and acute inflammation processes, including post-ischemic inflammation. Each selectin has a carbohydrate recognition domain that mediates binding to specific glycans on apposing cells.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 36 - Which of the following involving the scalp may produce alopecia (hair loss)? ...

    Incorrect

    • Which of the following involving the scalp may produce alopecia (hair loss)?

      Your Answer:

      Correct Answer: Discoid lupus erythematosus

      Explanation:

      Causes of hair loss include:

      • Dissecting cellulitis
      • Fungal infections (such as tinea capitis)
      • Folliculitis
      • Secondary syphilis
      • Demodex folliculorum
      • Lupus erythematosus (hair loss may be permanent due to scarring of the hair follicles).

      Psoriasis and seborrheic dermatitis commonly involve the scalp but do not produce hair loss.

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      0
      Seconds

  • Question 37 - The blood supply to the liver is by ...

    Incorrect

    • The blood supply to the liver is by

      Your Answer:

      Correct Answer: Hepatic artery and hepatic portal vein

      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.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 38 - Which of the following may be a feature of primary hyperaldosteronism? ...

    Incorrect

    • Which of the following may be a feature of primary hyperaldosteronism?

      Your Answer:

      Correct Answer: Muscular weakness

      Explanation:

      Primary hyperaldosteronism or Conn’s syndrome is characterised by hypertension which may cause poor vision or headaches. Occasionally there may be muscular weakness, muscle spasms, tingling sensations, or excessive urination. Complications include cardiovascular disease such as stroke, myocardial infarction, kidney failure, and abnormal heart rhythms.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 39 - Regarding transportation of iron in the body, the process in which iron is...

    Incorrect

    • Regarding transportation of iron in the body, the process in which iron is transported from the enterocyte into the blood occurs using which transporter protein:

      Your Answer:

      Correct Answer: Ferroportin

      Explanation:

      Divalent metal transporter 1 (DMT1) transport several divalent metals including iron across the enterocyte’s cell membrane into the cell. The cell can then release it into the body via the only known iron exporter in mammals, ferroportin.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds

  • Question 40 - A 26-year-old student has been brought to the emergency department in a confused...

    Incorrect

    • 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)

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 41 - A 16 year old previously well male presents with a 4 day history...

    Incorrect

    • A 16 year old previously well male presents with a 4 day history of fever, lethargy and a generalized macular rash. There is no significant previous medical history and the patient has not travelled abroad either. Vitals are as follows: Temp: 38.5BP: 125/75mmHgPulse: 100/min On auscultation the chest was clear and no heart murmur was heard. Examination also reveals a non blanching widespread macular rash over the chest and abdomen. There is swelling of interphalangeal joints of both hands and feet associated with mild tenderness. Lymph nodes are palpable over the supraclavicular, axillary and inguinal areas. Abdominal examination reveals palpable mass on both right and left hypochondrium. Lab results are given below:Haemoglobin (Hb) 13.5 g/dlWhite cell count (WCC) 14.0 × 109/lPlatelets 380 × 109/lSodium 145 mmol/lPotassium 4.8 mmol/lCreatinine 89 μmol/lRheumatoid factor NegativeAntinuclear antibody NegativeAnti-dsDNA NegativeASO titre Not detectedElectrocardiogram (ECG) Sinus rhythmWhat is the most likely underlying diagnosis?

      Your Answer:

      Correct Answer: Systemic Still’s disease

      Explanation:

      People with Systemic Juvenile Idiopathic Arthritis (also known as Stills disease) can have recurrent fevers, a macular rash, joint pain, joint deformities, an enlarged liver and/or spleen, and can occasionally have polyserositis, lung involvement or pericardial effusions. Rheumatoid factor and antinuclear antibodies are usually negative. Treatment is with non-steroidal anti-inflammatory drugs (NSAIDs) and the prognosis is better than for adult rheumatoid arthritis.In pauciarticular Still’s disease, antinuclear antibodies are present. Large joints are affected and most patients develop classic features of seronegative spondylarthritis.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 42 - Which enzyme is responsible for the conversion of testosterone to dihydrotestosterone? ...

    Incorrect

    • Which enzyme is responsible for the conversion of testosterone to dihydrotestosterone?

      Your Answer:

      Correct Answer: 5α-reductase

      Explanation:

      The enzyme 5α-reductase synthesizes DHT from testosterone in the prostate, testes, hair follicles, and adrenal glands. This enzyme reduces the 4,5 double-bond of the testosterone. Relative to testosterone, DHT is much more potent as an agonist of the androgen receptor.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 43 - The interstitium of the kidney is most hypertonic in the: ...

    Incorrect

    • The interstitium of the kidney is most hypertonic in the:

      Your Answer:

      Correct Answer: Papillary tip of the medulla

      Explanation:

      The medullary interstitium is the tissue surrounding the loop of Henle in the renal medulla. It functions in renal water reabsorption by building up a high hypertonicity, which draws water out of the thin descending limb of the loop of Henle and the collecting duct system. This hypertonicity, in turn, is created by an efflux of urea from the inner medullary collecting duct.

    • This question is part of the following fields:

      • Medicine
      • Renal
      0
      Seconds

  • Question 44 - 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 45 - Which one of the following conditions is least likely to be associated with...

    Incorrect

    • Which one of the following conditions is least likely to be associated with pyoderma gangrenosum?

      Your Answer:

      Correct Answer: Syphilis

      Explanation:

      The following are conditions commonly associated with pyoderma gangrenosum:

      Inflammatory bowel disease:

      • Ulcerative colitis
      • Crohn’s disease

      Arthritides:

      • Rheumatoid arthritis
      • Seronegative arthritis

      Haematological disease:

      • Myelocytic leukaemia
      • Hairy cell leukaemia
      • Myelofibrosis
      • Myeloid metaplasia
      • Monoclonal gammopathy

      Autoinflammatory disease:

      • Pyogenic sterile arthritis, pyoderma gangrenosum, and acne syndrome (PAPA syndrome)
      • Granulomatosis with polyangiitis

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      0
      Seconds

  • Question 46 - Cholinergic neurons that pass into a retrograde direction activate neurons that release: ...

    Incorrect

    • Cholinergic neurons that pass into a retrograde direction activate neurons that release:

      Your Answer:

      Correct Answer: Substance P and acetyl choline

      Explanation:

      Serotonin activates sensory neurons that activate the myenteric plexus. Cholinergic neurons passing in a retrograde direction in the myenteric plexus activate neurons that release substance P and acetylcholine, causing smooth muscle contraction.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 47 - Microfilaments exist in: ...

    Incorrect

    • Microfilaments exist in:

      Your Answer:

      Correct Answer: All of the options

      Explanation:

      Microfilaments, also called actin filaments, are filamentous structures in the cytoplasm of cells and form part of the cytoskeleton.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 48 - Which of the following hormones would stimulate secretion of TSH? ...

    Incorrect

    • Which of the following hormones would stimulate secretion of TSH?

      Your Answer:

      Correct Answer: TRH

      Explanation:

      Thyrotropin-releasing hormone, also known as TRH, thyrotropin-releasing factor, TRF is a hormone produced by the hypothalamus. It functions as a releasing hormone, promoting the production of thyroid-stimulating hormone or thyrotropin and prolactin.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 49 - With regard to cell membrane proteins: ...

    Incorrect

    • With regard to cell membrane proteins:

      Your Answer:

      Correct Answer: Carriers are involved in facilitated diffusion

      Explanation:

      Pumps use a source of free energy such as ATP to transport ions against a gradient and is an example of active transport. Unlike channel proteins which only transport substances through membranes passively, carrier proteins can transport ions and molecules either passively through facilitated diffusion, or via secondary active transport. Channels are either in open state or closed state. When a channel is opened, it is open to both extracellular and intracellular. Pores are continuously open to both environments, because they do not undergo conformational changes. They are always open and active.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 50 - Anti-gastroesophageal reflux mechanisms include the following except: ...

    Incorrect

    • Anti-gastroesophageal reflux mechanisms include the following except:

      Your Answer:

      Correct Answer: Peristaltic movements of the oesophagus

      Explanation:

      The lower oesophageal sphincter contracts preventing reflux of acid into the oesophagus. The sling muscles of the stomach, the crura of the diaphragm and the phreno-oesophageal ligament all play an important role in constricting the lower portion of the oesophagus and preventing reflux. Peristaltic movements do not stop the acid reflux.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 51 - A 65-year-old man presents to you three weeks after initiating metformin for type...

    Incorrect

    • A 65-year-old man presents to you three weeks after initiating metformin for type 2 diabetes mellitus. His body mass index is 27.5 kg/m^2. At a dose of 500mg TDS the patient has experienced significant diarrhoea. Even on reducing the dose to 500mg BD his symptoms persisted. What is the most appropriate next step in this patient?

      Your Answer:

      Correct Answer: Start modified release metformin 500mg od with evening meal

      Explanation:

      Here, the patient seems to be intolerant to standard metformin. In such cases, modified-release preparations is considered as the most appropriate next step. There is some evidence that these produce fewer gastrointestinal side-effects in patients intolerant of standard-release metformin.Metformin is a biguanide and reduces blood glucose levels by decreasing the production of glucose in the liver, decreasing intestinal absorption and increasing insulin sensitivity. Metformin decreases both the basal and postprandial blood glucose.Other uses: In Polycystic Ovarian Syndrome (PCOS), Metformin decreases insulin levels, which then decreases luteinizing hormone and androgen levels. Thus acting to normalize the menstruation cycle.Note:Metformin is contraindicated in patients with severe renal dysfunction, which is defined as a glomerular filtration rate (GFR) less than 30 ml/min/1.732m2. Metformin overdose has been associated with hypoglycaemia and lactic acidosis, for this reason, it has a black box warning for lactic acidosis.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 52 - Which of the following statements is not true about mitochondrial chromosomes? ...

    Incorrect

    • Which of the following statements is not true about mitochondrial chromosomes?

      Your Answer:

      Correct Answer: Mitochondrial chromosomes play no role in the transmission of disease from generation to generation.

      Explanation:

      All the above mentioned statements are true except that mitochondrial DNA is passed from the mother to the child. If the child inherits the defective mitochondrial gene it will manifest some form of the disease. Commonly inherited diseases related to mitochondrial abnormality are Leber hereditary optic neuropathy and myoclonic epilepsy with ragged red fibers (MERRF).

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 53 - Which of the following conditions does not influence the cardiac output? ...

    Incorrect

    • Which of the following conditions does not influence the cardiac output?

      Your Answer:

      Correct Answer: Sleep

      Explanation:

      Sleep has no effect on the cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 54 - Coronary arteries fill up during ...

    Incorrect

    • Coronary arteries fill up during

      Your Answer:

      Correct Answer: Diastole

      Explanation:

      During contraction of the ventricular myocardium (systole), the subendocardial coronary vessels (the vessels that enter the myocardium) are compressed due to the high ventricular pressures. This compression results in momentary retrograde blood flow (i.e., blood flows backward toward the aorta) which further inhibits perfusion of myocardium during systole. However, the epicardial coronary vessels (the vessels that run along the outer surface of the heart) remain open. Because of this, blood flow in the sub endocardium stops during ventricular contraction. As a result, most myocardial perfusion occurs during heart relaxation (diastole) when the subendocardial coronary vessels are open and under lower pressure.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 55 - The lower oesophageal sphincter is under neural control. Which of the following causes...

    Incorrect

    • The lower oesophageal sphincter is under neural control. Which of the following causes contraction of the intrinsic sphincter?

      Your Answer:

      Correct Answer: Acetylcholine

      Explanation:

      The lower oesophageal sphincter (LOS) is a specific region of the oesophageal circular smooth muscle. It allows the passage of a food bolus to the stomach and prevents the reflux of gastric contents into the oesophagus. The tone of the LOS is myogenic in origin and depends on smooth muscle properties that lead to the opening of Ca2+ channels but can also be modulated by enteric motor neurons, the parasympathetic and sympathetic extrinsic nervous system and several neurohumoral substances. Nitric oxide causes LOS relaxation. Acetylcholine and tachykinins are involved in the LOS contraction.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 56 - A 42 year old obese man complains of a painful swollen ankle. The...

    Incorrect

    • A 42 year old obese man complains of a painful swollen ankle. The pain has worsened over the past 2 weeks. He is a diabetic and gives a history of recent alcohol consumption. Joint aspirate shows rhomboid crystals with numerous neutrophils. Radiological examination shows evidence of chondrocalcinosis. Which of the following is the most likely diagnosis?

      Your Answer:

      Correct Answer: Pseudogout

      Explanation:

      Pseudogout is a paroxysmal joint inflammation due to calcium pyrophosphate crystal deposition (calcium pyrophosphate dihydrate). Aetiology includes mostly idiopathic (primary form) and secondary form occurring as a result of joint trauma, familial chondrocalcinosis, hyperparathyroidism, hemochromatosis, gout, hypophosphatemia. Clinical presentation: Often asymptomatic. Acute (pseudogout attack): monoarthritis (rarely oligoarthritis), mostly affecting the knees and other large joints (e.g., hips, wrists, and ankles). It may become chronic (can affect multiple joints). Osteoarthritis with CPPD (most common form of symptomatic CPPD): progressive joint degeneration with episodes of acute inflammatory arthritis typical of pseudogout attacks. Arthrocentesis should be performed, especially in acute cases. Polarized light microscopy: detection of rhomboid-shaped, positively birefringent CPPD crystals. Synovial fluid findings: 10,000-50,000 WBCs/μL with > 90% neutrophils. X-ray findings: cartilage calcification of the affected joint (chondrocalcinosis). Fibrocartilage (meniscus, annulus fibrosus of intervertebral disc) and hyaline cartilage (joint cartilage) may be affected.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 57 - Which one of the following statements best describes a type II statistical error?...

    Incorrect

    • Which one of the following statements best describes a type II statistical error?

      Your Answer:

      Correct Answer: The null hypothesis is accepted when it is false

      Explanation:

      In statistical hypothesis testing there are 2 types of errors:- type I: the null hypothesis is rejected when it is true – i.e. Showing a difference between two groups when it doesn’t exist, a false positive. – type II: the null hypothesis is accepted when it is false – i.e. Failing to spot a difference when one really exists, a false negative.

    • This question is part of the following fields:

      • Medicine
      • Research Skills
      0
      Seconds

  • Question 58 - Inhibition of cell division at the end of G1 occurs through: ...

    Incorrect

    • Inhibition of cell division at the end of G1 occurs through:

      Your Answer:

      Correct Answer: Unphosphorolated retinoblastoma protein (uRb)

      Explanation:

      A cell’s decision to enter, or re-enter, the cell cycle is made before S-phase in G1 at what is known as the restriction point, and is determined by the combination of promotional and inhibitory extracellular signals that are received and processed. Ultimately unphosphorylated Rb acts as an inhibitor of G1.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 59 - Which of the following statements regarding influenza virus is correct? ...

    Incorrect

    • Which of the following statements regarding influenza virus is correct?

      Your Answer:

      Correct Answer: Influenza is a RNA virus

      Explanation:

      The Orthomyxoviruses are a family of RNA viruses that includes six genera: Influenza virus A, Influenza virus B, Influenza virus C, Isavirus, Thogotovirus and Quaranjavirus.The mechanism of the evolutionary force of antigenic shift allows influenza viruses to exchange genes with strains that infect different species. Under this mechanism, a human influenza virus could exchange genes with an avian strain, and that is how pandemic strains arise.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      0
      Seconds

  • Question 60 - Gastrin activates all of the following cells except: ...

    Incorrect

    • Gastrin activates all of the following cells except:

      Your Answer:

      Correct Answer: Mucus neck cells

      Explanation:

      The G cell is a type of cell in the stomach and duodenum that secretes gastrin. It works in conjunction with gastric chief cells and parietal cells. G cells are found deep within the pyloric glands of the stomach antrum, and occasionally in the pancreas and duodenum. Gastrin-releasing peptide, as well as the presence of amino acids in the stomach, stimulates the release of gastrin from the G cells. Gastrin stimulates enterochromaffin-like cells to secrete histamine. Gastrin also targets parietal cells by increasing the amount of histamine and the direct stimulation by gastrin, causing the parietal cells to increase HCl secretion in the stomach.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 61 - Water hammer pulse is found in: ...

    Incorrect

    • Water hammer pulse is found in:

      Your Answer:

      Correct Answer: Aortic insufficiency

      Explanation:

      Watson’s water hammer pulse is the medical sign which describes a pulse that is bounding and forceful, rapidly increasing and subsequently collapsing, as if it were the sound of a water hammer that was causing the pulse. A water hammer was a Victorian toy in which a tube was half filled with fluid, the remainder being a vacuum. The child would invert and reinvert the tube; each time the impact of the fluid at each end would sound like a hammer blow. This is associated with increased stroke volume of the left ventricle and decrease in the peripheral resistance leading to the widened pulse pressure of aortic regurgitation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 62 - Which of the following stimulates glucagon release? ...

    Incorrect

    • Which of the following stimulates glucagon release?

      Your Answer:

      Correct Answer: Exercise

      Explanation:

      Studies have shown a small increase in glucagon levels during stress tests and exercise. This occurs in response to the reduction of blood glucose levels during physical activity; epinephrine levels are also a stimulus for the release of glucagon during exercise, since it suppresses insulin, which accounts for its stimulatory effects on glucagon. The use of stored fats for energy during exercise also stimulates the release of glucagon.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 63 - An elderly man presents with fever of 38°C and a very severe headache....

    Incorrect

    • An elderly man presents with fever of 38°C and a very severe headache. His BP is 85/50 mm Hg. He has neck stiffness and photophobia. What is the most appropriate management?

      Your Answer:

      Correct Answer: CT head

      Explanation:

      In elderly patients, symptoms suggestive of meningitis could be due to an intracranial mass lesion (such as abscess, tumour or an intracerebral haematoma). Therefore elderly patients are increased risk of cerebral herniation from an LP. A CT head should be done before an LP to exclude a mass lesion.

    • This question is part of the following fields:

      • Geriatrics
      • Medicine
      0
      Seconds

  • Question 64 - The axons of the POST ganglionic neurons are mostly? ...

    Incorrect

    • The axons of the POST ganglionic neurons are mostly?

      Your Answer:

      Correct Answer: C fibers

      Explanation:

      According to Erlanger- Grasser classification preganglionic fibers are B fibers whereas post ganglionic fibers are C fibers.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 65 - Which of the following values of bone mineral density measured by DEXA would...

    Incorrect

    • Which of the following values of bone mineral density measured by DEXA would signify osteopenia?

      Your Answer:

      Correct Answer: T score of -2.2

      Explanation:

      DEXA T Scores:Normal T-score ≥ −1.0Osteopenia −2.5 < T-score < −1.0Osteoporosis T-score ≤ −2.5Severe osteoporosis T-score ≤ −2.5 with fragility fracture

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 66 - Which mechanism of action do Quinolones use? ...

    Incorrect

    • Which mechanism of action do Quinolones use?

      Your Answer:

      Correct Answer: Inhibit DNA gyrase

      Explanation:

      The quinolones are a family of synthetic broad-spectrum antibiotic drugs. Quinolones exert their antibacterial effect by preventing bacterial DNA from unwinding and duplicating.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      0
      Seconds

  • Question 67 - In the basal ganglia, the Lentiform nucleus is formed by which two nuclei?...

    Incorrect

    • In the basal ganglia, the Lentiform nucleus is formed by which two nuclei?

      Your Answer:

      Correct Answer: Putamen and Globus pallidus

      Explanation:

      The Basal Ganglia are composed of the following structures: Caudate, putamen, Globus pallidus, subthalamic nucleus and substantia nigra.

      The Lentiform nucleus is a biconvex structure located within the basal ganglia of the brain. It is composed of two nuclei:

      1. Putamen: This is the outer part of the Lentiform nucleus and is involved in regulating movements and various types of learning.
      2. Globus pallidus: This is the inner part of the Lentiform nucleus and is divided into two segments: the external segment (GPe) and the internal segment (GPi). It plays a key role in the regulation of voluntary movement.

      These two structures together form the Lentiform nucleus, which is an integral part of the basal ganglia system involved in motor control.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 68 - The function of Troponin T in cardiac muscle is? ...

    Incorrect

    • The function of Troponin T in cardiac muscle is?

      Your Answer:

      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.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 69 - What is the normal portal venous pressure? ...

    Incorrect

    • What is the normal portal venous pressure?

      Your Answer:

      Correct Answer: 6 mm hg

      Explanation:

      Portal venous pressure is the blood pressure in the hepatic portal vein, and is normally between 5-10 mmHg

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      0
      Seconds

  • Question 70 - Lipid- lowering drugs like Lovastatin reduce cholesterol synthesis by inhibiting which enzyme? ...

    Incorrect

    • Lipid- lowering drugs like Lovastatin reduce cholesterol synthesis by inhibiting which enzyme?

      Your Answer:

      Correct Answer: HMG-CoA reductase

      Explanation:

      Statins, also known as HMG-CoA reductase inhibitors, are a class of lipid-lowering medications. Statins have been found to reduce cardiovascular disease (CVD) and mortality in those who are at high risk.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds

  • Question 71 - Where are the baroreceptors of the great arteries located? ...

    Incorrect

    • Where are the baroreceptors of the great arteries located?

      Your Answer:

      Correct Answer: In the adventitia

      Explanation:

      Arterial baroreceptors are located in the aortic arch and carotid sinuses, and are formed by small nerve endings present in the adventitia of these vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 72 - Choose the correct answer: The interposed nuclei… ...

    Incorrect

    • Choose the correct answer: The interposed nuclei…

      Your Answer:

      Correct Answer: Are the emboliform and globose nuclei in the paravermis

      Explanation:

      The interposed nuclei are a part of deep cerebellar complex and are composed of the globose nucleus and the emboliform nucleus. It receives afferent fibers from the anterior lobe of the cerebellum and sends output via the superior cerebellar peduncle to the red nucleus.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 73 - Where would one normally find venous valves? ...

    Incorrect

    • Where would one normally find venous valves?

      Your Answer:

      Correct Answer: Saphenous vein

      Explanation:

      The intima of the limb veins is folded at intervals to form venous valves that prevent retrograde flow. There are no valves present in the very small veins, the great veins, or the veins in the brain and viscera.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 74 - What is the primary problem of achalasia ...

    Incorrect

    • What is the primary problem of achalasia

      Your Answer:

      Correct Answer: Deficiency of myenteric plexus at the lower oesophageal sphincter

      Explanation:

      Oesophageal achalasia is an oesophageal motility disorder involving the smooth muscle layer of the oesophagus is characterized by the failure of the lower oesophageal sphincter (LES) relaxation and aperistalsis, caused primarily by the loss of the inhibitory innervation of the oesophageal myenteric plexus.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 75 - The oesophagus is lined by ...

    Incorrect

    • The oesophagus is lined by

      Your Answer:

      Correct Answer: Stratified squamous epithelium

      Explanation:

      The wall of the oesophagus from the lumen outwards consists of mucosa, submucosa (connective tissue), layers of muscle fibers between layers of fibrous tissue, and an outer layer of connective tissue. The mucosa is a stratified squamous epithelium of around three layers of squamous cells, which contrasts to the single layer of columnar cells of the stomach. The transition between these two types of epithelium is visible as a zig-zag line. Most of the muscle is smooth muscle although striated muscle predominates in its upper two thirds.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 76 - Which is true of the citric acid cycle? ...

    Incorrect

    • Which is true of the citric acid cycle?

      Your Answer:

      Correct Answer: Involves a series of reactions where oxaloacetate is regenerated

      Explanation:

      The cycle consumes acetate (in the form of acetyl-CoA) and water, reduces NAD+ to NADH, and produces carbon dioxide as a waste by-product. The NADH generated by the citric acid cycle is fed into the oxidative phosphorylation (electron transport) pathway. At the end of each cycle, the four-carbon oxaloacetate has been regenerated, and the cycle continues. The net result of these two closely linked pathways is the oxidation of nutrients to produce usable chemical energy in the form of ATP. Acetyl-CoA, is the starting point for the citric acid cycle and in eukaryotic cells, the citric acid cycle occurs in the matrix of the mitochondrion. Though the Krebs cycle does not directly require oxygen, it can only take place when oxygen is present because it relies on by-products and is therefore an aerobic process.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 77 - A 22-year-old female is brought to the emergency department by her friends following...

    Incorrect

    • 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.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 78 - Where does one find the thyroid receptors? ...

    Incorrect

    • Where does one find the thyroid receptors?

      Your Answer:

      Correct Answer: Cell nucleus

      Explanation:

      Unlike many of the steroid receptors, inactive receptors for T3 are located in the nucleus. T4 is first converted into T3 within the cytoplasm of the cell, T3 then enters the nucleus and binds to its receptor. The hormone-receptor complex can now bind to DNA and activate specific genes.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 79 - Which mechanism of action does Penicillin use? ...

    Incorrect

    • Which mechanism of action does Penicillin use?

      Your Answer:

      Correct Answer: Inhibit cell wall synthesis

      Explanation:

      Bacteria constantly remodel their peptidoglycan cell walls, simultaneously building and breaking down portions of the cell wall as they grow and divide. β-Lactam antibiotics inhibit the formation of peptidoglycan cross-links in the bacterial cell wall; this is achieved through binding of the four-membered β-lactam ring of penicillin to the enzyme DD-transpeptidase. As a consequence, DD-transpeptidase cannot catalyse formation of these cross-links, and an imbalance between cell wall production and degradation develops, causing the cell to rapidly die.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      0
      Seconds

  • Question 80 - A 42 year old female with a history of SLE presents with an...

    Incorrect

    • A 42 year old female with a history of SLE presents with an exacerbation of wrist pain. Which of the following markers would be the most suitable for monitoring disease activity?

      Your Answer:

      Correct Answer: Anti-dsDNA titres

      Explanation:

      A high level of anti-dsDNA in the blood is strongly associated with lupus and is often significantly increased during or just prior to a flare-up. When the anti-dsDNA is positive and the person tested has other clinical signs and symptoms associated with lupus, it means that the person tested likely has lupus. This is especially true if an anti-Sm test is also positive.In the evaluation of someone with lupus nephritis, a high level (titre) of anti-dsDNA is generally associated with ongoing inflammation and damage to the kidneys.A very low level of anti-dsDNA is considered negative but does not exclude a diagnosis of lupus. Only about 65-85% of those with lupus will have anti-dsDNA.Low to moderate levels of the autoantibody may be seen with other autoimmune disorders, such as Sjögren syndrome and mixed connective tissue disease (MCTD).

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 81 - Blood from the hepatic veins drains into the? ...

    Incorrect

    • Blood from the hepatic veins drains into the?

      Your Answer:

      Correct Answer: Inferior vena cava

      Explanation:

      The hepatic veins are the veins that drain de-oxygenated blood from the liver into the inferior vena cava.

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      0
      Seconds

  • Question 82 - Which part of the cerebellum is primarily responsible for equilibrium and eye movements?...

    Incorrect

    • Which part of the cerebellum is primarily responsible for equilibrium and eye movements?

      Your Answer:

      Correct Answer: Vestibulocerebellum

      Explanation:

      The vestibulocerebellum develops at the same time as the vestibular apparatus in the inner ear. Its regulates balance between agonist and antagonist muscle contractions of the spine, hips, and shoulders during rapid movements.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 83 - During bone growth-the epiphysis are separated from the diaphysis by actively proliferating cartilage...

    Incorrect

    • During bone growth-the epiphysis are separated from the diaphysis by actively proliferating cartilage known as:

      Your Answer:

      Correct Answer: Epiphysial plate

      Explanation:

      The epiphysial plate, physis, or growth plate, is a hyaline cartilage plate located near the ends of long bones; it consists of growing tissue. It is found in children and teenagers; in adults, it is replaced by an epiphysial line or epiphysial closure. The epiphysial plate is divided into zones: zone of reserve, proliferation, maturation and hypertrophy, calcification, and ossification.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
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  • Question 84 - Regarding the innervation of the cerebral blood vessels, postganglionic sympathetic neurons have their...

    Incorrect

    • Regarding the innervation of the cerebral blood vessels, postganglionic sympathetic neurons have their cell bodies in the:

      Your Answer:

      Correct 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.

    • This question is part of the following fields:

      • Medicine
      • Neurology
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  • Question 85 - Which heart sounds are matched correctly? ...

    Incorrect

    • Which heart sounds are matched correctly?

      Your Answer:

      Correct Answer: All of the above

      Explanation:

      In healthy adults, there are two normal heart sounds often described as a lub and a dub (or dup), that occur in sequence with each heartbeat. These are the first heart sound (S1) and second heart sound (S2), produced by the closing of the atrioventricular valves and semilunar valves, respectively. In addition to these normal sounds, a variety of other sounds may be present including heart murmurs, adventitious sounds, and gallop rhythms S3 and S4. S3 is thought to be caused by the oscillation of blood back and forth between the walls of the ventricles initiated by blood rushing in from the atria. The reason the third heart sound does not occur until the middle third of diastole is probably that during the early part of diastole, the ventricles are not filled sufficiently to create enough tension for reverberation. S4 when audible in an adult is called a presystolic gallop or atrial gallop. This gallop is produced by the sound of blood being forced into a stiff or hypertrophic ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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  • Question 86 - The following determines the strength of contraction ...

    Incorrect

    • The following determines the strength of contraction

      Your Answer:

      Correct Answer: Plateau phase

      Explanation:

      The plateau phase which follows is unique to myocytes and results from a small, but sustained inward calcium current through L-type calcium channels lasting 200-400 ms. This calcium influx is caused by a combined increase in permeability of the cell and especially the sarcolemmal membranes to calcium. This plateau (or refractory) phase in myocyte action potential prevents early reactivation of the myocytes and directly determines the strength of contraction

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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  • Question 87 - Where is the myenteric plexus (Auerbach’s plexus) located in the GIT? ...

    Incorrect

    • Where is the myenteric plexus (Auerbach’s plexus) located in the GIT?

      Your Answer:

      Correct Answer: Between the outer longitudinal and middle circular muscle layers.

      Explanation:

      A part of the enteric nervous system, the myenteric plexus exists between the longitudinal and circular layers of muscularis externa in the gastrointestinal tract. It is found in the muscles of the oesophagus, stomach, and intestine.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
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  • Question 88 - Which of the following is the most common causative organism in infective endocarditis?...

    Incorrect

    • 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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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  • Question 89 - With regard to X linked disorders which of the following are true ...

    Incorrect

    • 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:

      All are true for autosomal recessive disorders. Dominance rules for sex-linked gene loci are determined by their behaviour in the female: because the male has only one allele (except in the case of certain types of Y chromosome aneuploidy), that allele is always expressed regardless of whether it is dominant or recessive.

    • This question is part of the following fields:

      • Genetics
      • Medicine
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  • Question 90 - The extrinsic coagulation pathway is initiated by activation of which clotting factor? ...

    Incorrect

    • The extrinsic coagulation pathway is initiated by activation of which clotting factor?

      Your Answer:

      Correct Answer: Factor VII

      Explanation:

      The tissue factor pathway (extrinsic) begins 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).

    • This question is part of the following fields:

      • Haematology
      • Medicine
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  • Question 91 - The haustral pattern seen in the normal colon is produced by ...

    Incorrect

    • The haustral pattern seen in the normal colon is produced by

      Your Answer:

      Correct Answer: Taenia coli

      Explanation:

      The haustra (singular haustrum) of the colon are the small pouches caused by sacculation (sac formation), which give the colon its segmented appearance. The teniae coli run the length of the large intestine. Because the taeniae coli are shorter than the intestine, the colon becomes sacculated between the taeniae coli, forming the haustra.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
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  • Question 92 - Visual pathways - Choose the true statement: ...

    Incorrect

    • Visual pathways - Choose the true statement:

      Your Answer:

      Correct Answer: The lateral geniculate nucleus, magnocellular & parvocellular pathways project to the primary visual cortex

      Explanation:

      The optic chiasm is made by the decussation of optic fibers on the nasal side. The magnocellular pathway carries signals for detection of movement. The parvocellular pathway carries cells for detection of shape, size, colour and clarity. The lateral geniculate nucleus (LGN) is the relay centre in the thalamus for he visual pathway. It has layers of magnocellular cells and parvocellular cells that are interleaved with layers of koniocellular cells. The LGN is the main central connection for the optic nerve to the occipital lobe, particularly the primary visual cortex.

    • This question is part of the following fields:

      • Medicine
      • Neurology
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  • Question 93 - Pancreatic juice is usually? ...

    Incorrect

    • Pancreatic juice is usually?

      Your Answer:

      Correct Answer: Alkaline

      Explanation:

      Pancreatic juice is alkaline in nature and has a high amount of bicarbonate ions. About 1500 ml is secreted every day. It also contains a large quantity of enzymes in the inactive form.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
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  • Question 94 - Functions of the glossopharyngeal nerve include the following except: ...

    Incorrect

    • Functions of the glossopharyngeal nerve include the following except:

      Your Answer:

      Correct Answer: Proprioceptive input from muscles of the tongue and larynx

      Explanation:

      The glossopharyngeal nerve is a mixed nerve consisting of both sensory and motor fibers. It has several branches and five distinct general functions:Branchial motor- Special visceral efferent- supplies the Stylopharyngeus muscle and superior constrictor muscle.Visceral motor- general visceral efferent- provides parasympathetic innervation of the parotid gland.Visceral sensory- general visceral afferent- carries visceral sensory information from the carotid sinus and carotid body.General sensory- general somatic afferent- provides general sensory information from the inner surface of the tympanic membrane, upper pharynx and posterior one third of the tongue.Visceral afferent- special visceral afferent- provides taste sensation from the posterior one third of the tongue including the circumvallate papillae.

    • This question is part of the following fields:

      • Medicine
      • Neurology
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  • Question 95 - Glucose absorption in the small intestine is coupled with which of the following...

    Incorrect

    • Glucose absorption in the small intestine is coupled with which of the following electrolytes?

      Your Answer:

      Correct Answer: Na

      Explanation:

      Sodium-glucose linked transporter are family of proteins of different types. SGLT1 transporter is found in the intestinal mucosa of the small intestine and absorbs glucose via cotransport of Na+ ions.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
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  • Question 96 - 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 97 - A 42-year-old female with type 1 diabetes who has undergone a renal transplant...

    Incorrect

    • A 42-year-old female with type 1 diabetes who has undergone a renal transplant is being reviewed. She is taking azathioprine and tacrolimus for immunosuppression.Which among the following is correct regarding the given immunosuppressive agents?

      Your Answer:

      Correct Answer: Tacrolimus is a calcineurin inhibitor

      Explanation:

      Tacrolimus is a calcineurin inhibitor used as an immunosuppressive agent used for prophylaxis of organ rejection post-transplant.Pharmacology: Calcineurin inhibition leads to reduced T-lymphocyte signal transduction and IL-2 expression. It has a half-life of 12 hours (average).Other off-label indications for the use of tacrolimus include Crohn disease, graft-versus-host disease (GVHD), myasthenia gravis, rheumatoid arthritis.Adverse effects of tacrolimus includes: Cardiovascular: Angina pectoris, cardiac arrhythmias, hypertensionCentral nervous system: Abnormal dreams, headaches, insomnia, tremors.Dermatologic: Acne vulgaris, alopecia, pruritis, rashEndocrine and metabolic: Decreased serum bicarbonate, decreased serum iron, new-onset diabetes mellitus after transplant (NODAT), electrolyte disturbances.Gastrointestinal: Abdominal pain, nausea, vomiting, diarrhoeaGenitourinary: Urinary tract infectionHepatic: Abnormal hepatic function testsNeuromuscular and skeletal: Arthralgia, muscle crampsOphthalmic: Blurred vision, visual disturbanceOtic: Otalgia, otitis media, tinnitusRenal: Acute renal failureOther options:Sirolimus (a macrolide) is an mTOR inhibitor that blocks the response to IL-2 and has a half-life of 12–15 hours. Azathioprine inhibits purine synthesis, an essential step in the proliferation of white cells and has a half-life of around 5 hours.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
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  • Question 98 - With regard to the endothelial structure, the epithelium constitute: ...

    Incorrect

    • With regard to the endothelial structure, the epithelium constitute:

      Your Answer:

      Correct Answer: Simple squamous

      Explanation:

      The single layer of squamous epithelium lining the heart and blood vessels is known as the endothelium.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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  • Question 99 - Choose the correct statement about Aminoglycosides and Chloramphenicol ...

    Incorrect

    • Choose the correct statement about Aminoglycosides and Chloramphenicol

      Your Answer:

      Correct Answer: Chloramphenicol works on Ribosome 50 S peptidyl transferase

      Explanation:

      Aminoglycoside is a category of traditional Gram-negative antibacterial therapeutic agents that inhibit protein synthesis. Aminoglycoside antibiotics display bactericidal activity against gram-negative aerobes and some anaerobic bacilli where resistance has not yet arisen, but generally not against Gram-positive and anaerobic Gram-negative bacteria.Chloramphenicol is a bacteriostatic by inhibiting protein synthesis. It prevents protein chain elongation by inhibiting the peptidyl transferase activity of the bacterial ribosome. It specifically binds to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit, preventing peptide bond formation.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
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  • Question 100 - Choose the correct answer: The cerebrocerebellum… ...

    Incorrect

    • 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

    • This question is part of the following fields:

      • Medicine
      • Neurology
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SESSION STATS - PERFORMANCE PER SPECIALTY

Medicine (11/19) 58%
Pharmacology (2/2) 100%
Neurology (1/4) 25%
Metabolism (1/2) 50%
Gastrointestinal (1/2) 50%
Endocrinology (1/2) 50%
Geriatrics (1/1) 100%
Cardiovascular (2/3) 67%
Genetics (0/1) 0%
Infectious Diseases (1/1) 100%
Connective Tissue (1/1) 100%
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