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  • Question 1 - Which of the following is responsible for converting inactive cortisone to active cortisol...

    Correct

    • Which of the following is responsible for converting inactive cortisone to active cortisol in the adrenal gland?

      Your Answer: 11βHSD type 1

      Explanation:

      11β-Hydroxysteroid dehydrogenase, also known as HSD-11β or 11β-HSD, is a group of enzymes which catalyse the interconversion of active cortisol and corticosterone with inert cortisone and 11-dehydrocorticosterone.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      34.2
      Seconds

  • Question 2 - The following is true in relation to coronary venous drainage? ...

    Correct

    • The following is true in relation to coronary venous drainage?

      Your Answer: Most venous return ultimately drains into right atrium via the coronary sinus

      Explanation:

      Most of the venous blood returns to the heart via the coronary sinus and the anterior cardiac veins. Apart from these there are other vessels that drain directly into the heart chambers

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      35
      Seconds

  • Question 3 - 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: K

      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
      29.2
      Seconds

  • Question 4 - What is the mechanism of action of sumatriptan? ...

    Correct

    • What is the mechanism of action of sumatriptan?

      Your Answer: 5-HT1 agonist

      Explanation:

      Triptans are specific 5-HT1 agonists used in the acute treatment of migraine. They are generally used as first-line therapy in combination with an NSAID or paracetamol.

      Sumatriptan acts as an agonist on 5-HT1B/1D receptors by inducing vasoconstriction in the basilar artery and blood vessels within the dura mater. The drug reduces peripheral nociception either by selective cranial vasoconstriction or by affecting trigeminovascular nerves.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      7.6
      Seconds

  • Question 5 - Select one true statement about haemoglobin synthesis… ...

    Incorrect

    • Select one true statement about haemoglobin synthesis…

      Your Answer: Is inhibited by erythropoietin.

      Correct Answer: Occurs in the cytosol of developing red cells.

      Explanation:

      Haemoglobin (Hb) is synthesized in a complex series of steps. The haem part is synthesized in a series of steps in the mitochondria and the cytosol of immature red blood cells, while the globin protein parts are synthesized by ribosomes in the cytosol. Production of Hb continues in the cell throughout its early development from the proerythroblast to the reticulocyte in the bone marrow.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      5.1
      Seconds

  • Question 6 - The length of DNA is generally measured in terms of the number of:...

    Incorrect

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

      Your Answer:

      Correct Answer: Base pairs

      Explanation:

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

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 7 - G cells release which of the following substances ...

    Incorrect

    • G cells release which of the following substances

      Your Answer:

      Correct Answer: Gastrin

      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 8 - Where is the carotid sinus located? ...

    Incorrect

    • Where is the carotid sinus located?

      Your Answer:

      Correct Answer: After the bifurcation of the carotid artery, on the internal carotid

      Explanation:

      The carotid sinus is a small dilation in the internal carotid artery just above its bifurcation into the external and internal carotid branch. Baroreceptors are present at this dilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 9 - The pyloric sphincter is largely made up of thickening of ...

    Incorrect

    • The pyloric sphincter is largely made up of thickening of

      Your Answer:

      Correct Answer: The circular muscle layer

      Explanation:

      The pyloric sphincter, or valve, is a strong ring of smooth muscle (circular muscle layer) at the end of the pyloric canal which lets food pass from the stomach to the duodenum. It controls the outflow of gastric contents into the duodenum. It receives sympathetic innervation from the celiac ganglion.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 10 - A 39 year old woman with a history of rheumatoid arthritis has recently...

    Incorrect

    • A 39 year old woman with a history of rheumatoid arthritis has recently been switched from methotrexate to leflunomide. Monitoring of full blood count and LFTs has been carried out. Which of the following parameters should also be monitored in this case?

      Your Answer:

      Correct Answer: Blood pressure

      Explanation:

      Blood pressure should be routinely measured as leflunomide may cause hypertension and thus an increase in BP. It doesn’t cause changes in blood sugar levels, peak expiratory flow rate or haematuria.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 11 - Which of the following correctly describes stages in the formation of CSF? ...

    Incorrect

    • Which of the following correctly describes stages in the formation of CSF?

      Your Answer:

      Correct Answer: All of the above

      Explanation:

      All the above are true for the formation of CSF

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 12 - A patient with a VIPoma (VIP secreting tumour) is likely to exhibit which...

    Incorrect

    • A patient with a VIPoma (VIP secreting tumour) is likely to exhibit which of the following?

      Your Answer:

      Correct Answer: Severe diarrhoea

      Explanation:

      Vasoactive inhibitory peptide (VIP) is found in the nerves innervating the GIT. It markedly stimulates the secretion of intestinal electrolytes and also with them water. This results in secretary diarrhoea. Along with that it also relaxes intestinal smooth muscle including the sphincters, it also results in dilation of the peripheral blood vessels and along with this its also inhibits gastric acid secretions. A VIPoma will exaggerate all this.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 13 - 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 14 - The amount of a substance taken up by an organ (or whole body)...

    Incorrect

    • The amount of a substance taken up by an organ (or whole body) per unit time is = (the arterial level - the venous level) * the blood flow. This statement describes?

      Your Answer:

      Correct Answer: The Fick principle

      Explanation:

      The essence of the Fick principle is that blood flow to an organ can be calculated using a marker substance if the following information is known:- Amount of marker substance taken up by the organ per unit time- Concentration of marker substance in arterial blood supplying the organ- Concentration of marker substance in venous blood leaving the organ

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 15 - 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 16 - A 75-year-old man has presented to the clinic with a complaint of disturbed...

    Incorrect

    • A 75-year-old man has presented to the clinic with a complaint of disturbed sleep. The physician has prescribed temazepam. Which of the following best describes the mechanism of action of this drug?

      Your Answer:

      Correct Answer: Enhances the effect of gamma-aminobutyric acid

      Explanation:

      Temazepam is an orally available benzodiazepine used in the therapy of insomnia. The soporific activity of the benzodiazepines is mediated by their ability to enhance gamma-aminobutyric acid (GABA) mediated inhibition of synaptic transmission through binding to the GABA-A receptor.The recommended initial dose for insomnia is 7.5 mg before bedtime, increasing as needed to a maximum dose of 30 mg. The most common side effects of temazepam are dose-related and include daytime drowsiness, lethargy, ataxia, dysarthria, and dizziness.Tolerance develops to these side effects, but tolerance may also develop to the effects on insomnia.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 17 - Which one of the following transporters is involved in facilitated diffusion? ...

    Incorrect

    • Which one of the following transporters is involved in facilitated diffusion?

      Your Answer:

      Correct Answer: GLUT2

      Explanation:

      GLUT 2 is a bidirectional transporter, allowing glucose to flow in 2 directions via facilitated diffusion. Is expressed by renal tubular cells, liver cells and pancreatic beta cells. It is also present in the basolateral membrane of the small intestine epithelium.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 18 - Which of the following forms the language areas of the cerebral cortex? ...

    Incorrect

    • Which of the following forms the language areas of the cerebral cortex?

      Your Answer:

      Correct Answer: All of the above

      Explanation:

      Broca’s area, Wernicke’s area, the submarginal sulcus and the angular gyrus all form the language areas of the cerebral cortex.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 19 - Which part of the ECG represents ventricular repolarisation? ...

    Incorrect

    • Which part of the ECG represents ventricular repolarisation?

      Your Answer:

      Correct Answer: T wave

      Explanation:

      Ventricular repolarisation is denoted by the T wave.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 20 - The consensual light reflex is co-ordinated mainly in the: ...

    Incorrect

    • The consensual light reflex is co-ordinated mainly in the:

      Your Answer:

      Correct Answer: Edinger-Westphal nucleus

      Explanation:

      The consensual light reflex occurs when an individual’s right eye is shielded and light shines into the left eye, constriction of the right pupil will occur, as well as the left. This is because the afferent signal sent through one optic nerve connects to the Edinger-Westphal nucleus, whose axons run to both the right and the left oculomotor nerves.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 21 - Which of the following factors is not completely produced in the liver? ...

    Incorrect

    • Which of the following factors is not completely produced in the liver?

      Your Answer:

      Correct Answer: Factor viii

      Explanation:

      Factor VIII is produced in liver sinusoidal cells and endothelial cells outside of the liver throughout the body. This protein circulates in the bloodstream in an inactive form, bound to another molecule called von Willebrand factor, until an injury that damages blood vessels occurs.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 22 - The basic taste “umami” is mediated by glutamate acting on a metabotropic receptor...

    Incorrect

    • The basic taste “umami” is mediated by glutamate acting on a metabotropic receptor named:

      Your Answer:

      Correct Answer: mGluR4

      Explanation:

      Umami taste or savoury taste is one of the five basic tastes described as meaty or brothy. Umami taste receptors typically respond to Glutamate. Biochemical studies have identified the taste receptors responsible for the sense of umami as modified forms of mGluR4, mGluR1 and taste receptor type 1 (T1R1), all of which have been found in all regions of the tongue bearing taste buds.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 23 - Which of the following conditions is associated with eosinophilia? ...

    Incorrect

    • Which of the following conditions is associated with eosinophilia?

      Your Answer:

      Correct Answer: Ascaris

      Explanation:

      Eosinophilia can be idiopathic (primary) or, more commonly, secondary to another disease. In the Western World, allergic or atopic diseases are the most common causes, especially those of the respiratory or integumentary systems. In the developing world, parasites are the most common cause e.g. Ascaris

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds

  • Question 24 - What is the average life span of platelets? ...

    Incorrect

    • What is the average life span of platelets?

      Your Answer:

      Correct Answer: 8 days

      Explanation:

      The average life span of circulating platelets is 8 to 9 days.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds

  • Question 25 - Sinus bradycardia may be caused by disease of which of the following: ...

    Incorrect

    • Sinus bradycardia may be caused by disease of which of the following:

      Your Answer:

      Correct Answer: Right coronary artery

      Explanation:

      Disease of the right coronary artery may cause sinus bradycardia and AV nodal block.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 26 - Concerning surface anatomy, where is the base of the heart ...

    Incorrect

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

      Your Answer:

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

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 27 - The position of the kidneys besides the vertebral column retroperitoneally spans levels: ...

    Incorrect

    • The position of the kidneys besides the vertebral column retroperitoneally spans levels:

      Your Answer:

      Correct Answer: T12 – L3

      Explanation:

      The asymmetry within the abdominal cavity, caused by the position of the liver, typically results in the right kidney being slightly lower and smaller than the left, and being placed slightly more to the middle than the left kidney. The left kidney is approximately at the vertebral level T12 to L3, and the right is slightly lower.

    • This question is part of the following fields:

      • Medicine
      • Renal
      0
      Seconds

  • Question 28 - Select a factor which stimulates glucagon secretion. ...

    Incorrect

    • Select a factor which stimulates glucagon secretion.

      Your Answer:

      Correct Answer: Protein meal

      Explanation:

      Several studies have shown that glucagon levels are increased in individuals with a high protein diet. It is still debated, however, whether this type of diet affects insulin levels as well.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 29 - Absolute refractory period in a cardiac action potential graph occurs during. ...

    Incorrect

    • Absolute refractory period in a cardiac action potential graph occurs during.

      Your Answer:

      Correct Answer: All of the above

      Explanation:

      Absolute refractory period (ARP): the cell is completely unexcitable to a new stimulus and occurs from phase 0 – 2 i.e. depolarisation, early repolarisation and plateau phase.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 30 - 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
      0
      Seconds

  • Question 31 - The small opening in the cochlea through which the upper scala vestibuli and...

    Incorrect

    • The small opening in the cochlea through which the upper scala vestibuli and lower scala tympani communicates is called the:

      Your Answer:

      Correct Answer: Helicotrema

      Explanation:

      The helicotrema is the part of cochlear labyrinth where the scala tympani and the scala vestibuli meet.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 32 - In DNA cloning and sequencing, the bases in nucleotides chains are bound together...

    Incorrect

    • In DNA cloning and sequencing, the bases in nucleotides chains are bound together by:

      Your Answer:

      Correct Answer: Hydrogen bonding.

      Explanation:

      Nucleotides will always bind together via hydrogen bonds. There are two hydrogen bonds present between thymine and adenine and three hydrogen bonds present between guanine and cytosine.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 33 - Bile salts are responsible for: ...

    Incorrect

    • Bile salts are responsible for:

      Your Answer:

      Correct Answer: The emulsification of fats

      Explanation:

      The main function of bile acids is to allow digestion of dietary fats and oils by acting as a surfactant that emulsifies them into micelles, allowing them to be colloidally suspended in the chyme before further processing.

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      0
      Seconds

  • Question 34 - Which of the following are exclusively innervated by parasympathetic nerves? ...

    Incorrect

    • Which of the following are exclusively innervated by parasympathetic nerves?

      Your Answer:

      Correct Answer: Circular muscle of iris

      Explanation:

      Circular muscle of iris is exclusively supplied by the parasympathetic nerves.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 35 - Which of the following is the most common route of hepatitis B transmission...

    Incorrect

    • Which of the following is the most common route of hepatitis B transmission worldwide?

      Your Answer:

      Correct Answer: Perinatal transmission

      Explanation:

      The virus is transmitted by exposure to infectious blood or body fluids. Infection around the time of birth or from contact with other people’s blood during childhood is the most frequent method by which hepatitis B is acquired in areas where the disease is common. In areas where the disease is rare, intravenous drug use and sexual intercourse are the most frequent routes of infection. Perinatal transmission is the most common and without intervention, a mother who is positive for HBsAg has a 20% risk of passing the infection to her offspring at the time of birth. This risk is as high as 90% if the mother is also positive for HBeAg.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 36 - Why does arterial blood pressure drop during pregnancy? ...

    Incorrect

    • Why does arterial blood pressure drop during pregnancy?

      Your Answer:

      Correct Answer: Progesterone relaxes vascular smooth muscle

      Explanation:

      Progesterone relaxes vascular smooth muscle thus resulting In a decrease in total peripheral resistance. This accounts for the increase in the cardiac output.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 37 - Where are the cell bodies of preganglionic neurons located? ...

    Incorrect

    • Where are the cell bodies of preganglionic neurons located?

      Your Answer:

      Correct Answer: Lateral column

      Explanation:

      The cell bodies of the preganglionic neurons are located in the lateral grey column of the spinal cord and in the motor nuclei of the 3rd, 7th, 9th and 10th cranial nerves.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 38 - 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 39 - A 22-year-old university student is admitted after taking drugs at a night club....

    Incorrect

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

      Your Answer:

      Correct Answer: A pyrexia of 40°C

      Explanation:

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

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 40 - What is the mechanism of action of carbimazole? ...

    Incorrect

    • What is the mechanism of action of carbimazole?

      Your Answer:

      Correct Answer: Inhibition of the iodination of tyrosine

      Explanation:

      Carbimazole is used to treat hyperthyroidism. Carbimazole is a pro-drug as after absorption it is converted to the active form, methimazole. Methimazole prevents thyroid peroxidase enzyme from coupling and iodinating the tyrosine residues on thyroglobulin, hence reducing the production of the thyroid hormones T3 and T4 (thyroxine).

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 41 - Myocardial contractility is improved by: ...

    Incorrect

    • Myocardial contractility is improved by:

      Your Answer:

      Correct Answer: Caffeine

      Explanation:

      Caffeine and other theophyllines breakdown cAMP and have a positive ionotropic effect on the heart. Drugs like quinidine, procainamide and conditions like hypoxia and hypercapnia decreases the contractility of the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 42 - Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms ...

    Incorrect

    • Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms

      Your Answer:

      Correct Answer: Increased phosphorylation of phosholamban

      Explanation:

      Phosphorylation of phospholamban, which increases calcium ATPase activity and sequestration of calcium in the sarcoplasmic reticulum. An increased rate of relaxation is explained because cAMP also activates the protein phospholamban, situated on the membrane of the SR, that controls the rate of uptake of calcium into the SR. The latter effect explains enhanced relaxation (lusitropic effect).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 43 - An 82 year old male woke up experiencing incoherent speech - he is...

    Incorrect

    • An 82 year old male woke up experiencing incoherent speech - he is also finding it difficult to find the right words to explain his thoughts. Doctors have examined him, and everything else appears to be normal. They have also found that his comprehension is good. From the list of options, choose the anatomical site which in this instance, is most likely affected.

      Your Answer:

      Correct Answer: Broca’s Area

      Explanation:

      The combination of good comprehension but poor speech quality in this patient is consistent with damage to the Broca’s area. The Wernicke’s area is responsible for the understanding of speech, and so is not consistent with this patient.

    • This question is part of the following fields:

      • Geriatrics
      • Medicine
      0
      Seconds

  • Question 44 - The majority of corticospinal tract fibers decussate in the: ...

    Incorrect

    • The majority of corticospinal tract fibers decussate in the:

      Your Answer:

      Correct Answer: Medulla

      Explanation:

      The corticospinal tract is a descending motor path way that begins in the cerebral cortex and decussates in the pyramids of the medulla.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 45 - In the normal adult, haematopoiesis is present ...

    Incorrect

    • In the normal adult, haematopoiesis is present

      Your Answer:

      Correct Answer: Axial skeleton and proximal ends of long bones

      Explanation:

      In children, haematopoiesis occurs in the marrow of the long bones such as the femur and tibia. In adults, it occurs mainly in the pelvis, cranium, vertebrae, and sternum.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds

  • Question 46 - Southern Blotting and DNA probes: ...

    Incorrect

    • Southern Blotting and DNA probes:

      Your Answer:

      Correct Answer: DNA fragments are separated by gel electrophoresis and transferred onto membrane sheets in southern blotting

      Explanation:

      A Southern blot is a method used in molecular biology for detection of a specific DNA sequence in DNA samples. Southern blotting combines transfer of electrophoresis-separated DNA fragments to a filter membrane and subsequent fragment detection by probe hybridization. The other forms of blotting involve the use of RNA and proteins.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 47 - Endothelial cells produce the following substance(s): ...

    Incorrect

    • Endothelial cells produce the following substance(s):

      Your Answer:

      Correct Answer: All of the above

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 48 - Which of the following is a method for measurement of cardiac output? ...

    Incorrect

    • Which of the following is a method for measurement of cardiac output?

      Your Answer:

      Correct Answer: Indicator dilution method

      Explanation:

      There are two methods of calculating the cardiac output in humans other than doppler with echocardiography: The direct Fick’s method and the indicator dilution method. In the indicator dilution technique, a known amount of a substance such as a dye or, more commonly, a radioactive isotope is injected into an arm vein and the concentration of the indicator in serial samples of arterial blood is determined. The output of the heart is equal to the amount of indicator injected divided by its average concentration in arterial blood after a single circulation through the heart.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 49 - In which organelle is the intrinsic apoptotic pathway initiated? ...

    Incorrect

    • In which organelle is the intrinsic apoptotic pathway initiated?

      Your Answer:

      Correct Answer: Mitochondria

      Explanation:

      Apoptosis is a programmed form of cell death involving the degradation of cellular constituents by a group of cysteine proteases called caspases. The caspases can be activated through either the intrinsic (mitochondrial mediated) or extrinsic (death receptor mediated) apoptotic pathways.

      The intrinsic apoptotic pathway, also known as the mitochondrial pathway, is primarily initiated within the mitochondria. This pathway is activated in response to various internal stimuli, such as DNA damage, oxidative stress, and other cellular stresses.

      When the intrinsic pathway is triggered, several events occur in the mitochondria:

      1. Release of cytochrome c: Cytochrome c is released from the mitochondrial intermembrane space into the cytoplasm.
      2. Formation of the apoptosome: Cytochrome c in the cytoplasm binds to apoptotic protease activating factor-1 (Apaf-1) and procaspase-9, forming a complex known as the apoptosome.
      3. Activation of caspase-9: The apoptosome activates caspase-9, an initiator caspase.
      4. Caspase cascade: Activated caspase-9 then activates executioner caspases, such as caspase-3, leading to the execution phase of apoptosis, which results in the orderly dismantling of the cell.

      The mitochondria play a crucial role in this pathway by regulating the release of pro-apoptotic factors that are essential for the activation of downstream apoptotic processes.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 50 - Which of the following is not true regarding mitochondrial chromosome disorders? ...

    Incorrect

    • Which of the following is not true regarding mitochondrial chromosome disorders?

      Your Answer:

      Correct Answer: Because mitochondrial chromosomes have no introns in their genes, any point mutation has a low likelihood of having an effect.

      Explanation:

      Any point mutation in any part of the mitochondrial DNA will lead to a mutated mitochondria and will likewise have its ill effect on the body.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 51 - An 18 year old boy, thin with a tall stature, and a high...

    Incorrect

    • An 18 year old boy, thin with a tall stature, and a high arched palate arrives at the hospital with a spontaneous pneumothorax. He is accompanied by his brother who has a similar appearance. You suspect Marfan's Syndrome. The gene encoding which of the following proteins is defective in this condition?

      Your Answer:

      Correct Answer: Fibrillin-1

      Explanation:

      A variety of proteins compose the structure of microfibrils, the most prominent of which are the two fibrillins. Fibrillin-1 a scaffolding protein is encoded by FBN1 on human chromosome 15q21 and fibrillin-2 is encoded by FBN2 on 5q23. Mutations in FBN1 produce Marfan syndrome, a pleiotropic autosomal dominant connective tissue disorder with prominent manifestations in the skeleton, eye and cardiovascular system. A number of conditions related to Marfan syndrome are also due to FBN1 mutations.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 52 - The AV Node: ...

    Incorrect

    • The AV Node:

      Your Answer:

      Correct Answer: It decelerates impulses passing to the ventricles

      Explanation:

      The action potentials in the sinoatrial (SA) and atrioventricular (AV) nodes are largely due to Ca2+, with no contribution by Na+ influx. The depolarization continues to conduct slowly through the atrioventricular (AV) node. The AV node is located in the right posterior portion of the interatrial septum. This is small and bean-shaped. The atrial conductive system is organized so that the cardiac impulse does not travel from the atria into the ventricles too rapidly; this delay allows the atria to empty before ventricular contraction begins. It is the AV node and its adjacent conductive fibers that delay this transmission into the ventricles. Conduction through the AV Node is represented on the ECG by the PR interval.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 53 - Colipase is secreted in an inactive form. Its activation in the intestinal lumen...

    Incorrect

    • Colipase is secreted in an inactive form. Its activation in the intestinal lumen is by

      Your Answer:

      Correct Answer: Trypsin

      Explanation:

      The enzyme trypsin exists in pancreatic juice in the inactive form trypsinogen, it is activated by the intestinal enterokinase in intestinal juice. Trypsin can then activate other protease enzymes and catalyse the reaction pro-colipase → colipase. Colipase is necessary, along with bile salts, to enable lipase function.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 54 - Concerning S3, which of the following statements is INCORRECT? ...

    Incorrect

    • Concerning S3, which of the following statements is INCORRECT?

      Your Answer:

      Correct Answer: Coincide with atrial contraction

      Explanation:

      A third heart sound also called a ventricular gallop occurs at the beginning of diastole after S2 and is lower in pitch than S1 or S2 as it is not of valvular origin. The third heart sound is benign in youth, some trained athletes, and sometimes in pregnancy but if it re-emerges later in life it may signal cardiac problems, such as a failing left ventricle as in dilated congestive heart failure (CHF). 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. It may also be a result of tensing of the chordae tendineae during rapid filling and expansion of the ventricle. In other words, an S3 heart sound indicates increased volume of blood within the ventricle. An S3 heart sound is best heard with the bell-side of the stethoscope (used for lower frequency sounds). A left-sided S3 is best heard in the left lateral decubitus position and at the apex of the heart, which is normally located in the 5th left intercostal space at the midclavicular line. A right-sided S3 is best heard at the lower-left sternal border. The way to distinguish between a left and right-sided S3 is to observe whether it increases in intensity with inhalation or exhalation. A right-sided S3 will increase on inhalation, while a left-sided S3 will increase on exhalation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 55 - Regarding Gene Knockout Mouse Models, all are true except: ...

    Incorrect

    • Regarding Gene Knockout Mouse Models, all are true except:

      Your Answer:

      Correct Answer: In knockout mouse models a gene is turned on through targeted mutation

      Explanation:

      In knockout mouse models, a gene is not turned on but rather turned off or “knocked out” through targeted mutation. This involves disrupting or deleting the gene to study the effects of its loss of function. Knockout models are crucial for understanding the roles of specific genes, particularly those with unknown functions.

      The other statements are true:

      • Knockout models are important in studying the roles of sequenced genes with unknown function.
      • RFLP (Restriction Fragment Length Polymorphisms) can be subcategorized as SLP (single locus probe) and MLP (multi locus probe).
      • RFLP analysis is slow and cumbersome and is now largely obsolete, having been replaced by more efficient techniques.
      • Sequence changes involved in RFLP can be analyzed more quickly by PCR (Polymerase Chain Reaction).

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 56 - What is the most abundant hormone release by the thyroid? ...

    Incorrect

    • What is the most abundant hormone release by the thyroid?

      Your Answer:

      Correct Answer: T4

      Explanation:

      T3 and T4 are the two tyrosine-based hormones produced and secreted by the thyroid gland. Although T3 is the active form of the hormone, and thus, it is much more potent; T4 is the most abundant hormone secreted by the thyroid (93% of the total thyroid secretion) and it also has a longer half life since it binds to proteins much more strongly.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 57 - The thalamic main input from the cortex is via which tracts? ...

    Incorrect

    • The thalamic main input from the cortex is via which tracts?

      Your Answer:

      Correct Answer: Thalamocortical pathway

      Explanation:

      The thalamus is connected to cerebral cortex via the thalamocortical radiation.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 58 - Which of the following statements is true regarding herpes simplex virus type I:...

    Incorrect

    • Which of the following statements is true regarding herpes simplex virus type I:

      Your Answer:

      Correct Answer: More than half of the population is infected.

      Explanation:

      HSV-1 is often acquired orally during childhood. It may also be sexually transmitted, including contact with saliva, such as kissing and mouth-to-genital contact (oral sex). HSV-2 is primarily a sexually transmitted infection, but rates of HSV-1 genital infections are increasing. HSVs may persist in a quiescent but persistent form known as latent infection, notably in neural ganglia. HSV-1 tends to reside in the trigeminal ganglia, while HSV-2 tends to reside in the sacral ganglia, but these are tendencies only, not fixed behaviour. The virus can be reactivated by illnesses such as colds and influenza, eczema, emotional and physical stress, gastric upset, fatigue or injury, by menstruation and possibly exposure to bright sunlight. Genital Herpes may be reactivated by friction. Shingles is due to a reactivation of varicella zoster virus (VZV).

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      0
      Seconds

  • Question 59 - Type 2 hypersensitivity is mediated by: ...

    Incorrect

    • Type 2 hypersensitivity is mediated by:

      Your Answer:

      Correct Answer: IgG, IgM & complement

      Explanation:

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

    • This question is part of the following fields:

      • Immunology
      • Medicine
      0
      Seconds

  • Question 60 - Which among the following antihypertensives is centrally acting? ...

    Incorrect

    • Which among the following antihypertensives is centrally acting?

      Your Answer:

      Correct Answer: Moxonidine

      Explanation:

      Moxonidine and alpha-methyl dopa are centrally acting antihypertensives and modify blood pressure through modifying sympathetic activity.Other options:Verapamil is a calcium antagonist.Minoxidil and hydralazine are both vasodilators.Phenoxybenzamine is an alpha-blocker.Adverse effects:Dry mouth and somnolence were the most frequently reported adverse events, followed by headache, dizziness, nausea and allergic skin reactions.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 61 - Which area in the GIT lacks Basic Electrical Rhythm? ...

    Incorrect

    • Which area in the GIT lacks Basic Electrical Rhythm?

      Your Answer:

      Correct Answer: Oesophagus

      Explanation:

      The basal or basic electrical rhythm acts to coordinate peristalsis and are initiated in the interstitial cells of Cajal, specialized pacemaker cells located in the wall of the stomach, below the oesophagus.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 62 - A 43 year old man with hemochromatosis presents with a painful and swollen...

    Incorrect

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

      Your Answer:

      Correct Answer: Positively birefringent rhomboid-shaped crystals

      Explanation:

      Pseudogout is a paroxysmal joint inflammation due to calcium pyrophosphate crystal deposition (calcium pyrophosphate dihydrate). Arthrocentesis should be performed, especially in acute cases. Polarized light microscopy: detection of rhomboid-shaped, positively birefringent CPPD crystals. Synovial fluid findings: 10,000-50,000 WBCs/μL with > 90% neutrophils. X-ray findings: cartilage calcification of the affected joint (chondrocalcinosis). Fibrocartilage (meniscus, annulus fibrosus of intervertebral disc) and hyaline cartilage (joint cartilage) may be affected.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 63 - What is the most important way in which heat is lost from the...

    Incorrect

    • What is the most important way in which heat is lost from the body?

      Your Answer:

      Correct Answer: Radiation and conduction

      Explanation:

      The body maintains a constant core temperature by balancing heat loss and heat gain. The mechanisms of heat loss are: radiation, evaporation, convection and conduction. Out of these mechanisms, the most important under normal conditions are radiation, through which body heat is given off to the surrounding atmosphere; and conduction, in which the body releases heat into the objects it comes into contact with.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 64 - Which of the following conditions is least likely to exhibit the Koebner phenomenon?...

    Incorrect

    • Which of the following conditions is least likely to exhibit the Koebner phenomenon?

      Your Answer:

      Correct Answer: Lupus vulgaris

      Explanation:

      The Koebner phenomenon refers to skin lesions appearing on lines of trauma, exposure to a causative agents including: molluscum contagiosum, warts and toxicodendron dermatitis or secondary to scratching rather than an infective or chemical cause include vitiligo, psoriasis, lichen planus, lichen nitidus, pityriasis rubra pilaris, and keratosis follicularis (Darier disease).

    • This question is part of the following fields:

      • Dermatology
      • Medicine
      0
      Seconds

  • Question 65 - What is the main function of vitamin E? ...

    Incorrect

    • What is the main function of vitamin E?

      Your Answer:

      Correct Answer: It is an antioxidant

      Explanation:

      Vitamin E has many biological functions, the antioxidant function being the best known. Other functions include enzymatic activities, gene expression, and neurological function(s).

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds

  • Question 66 - The transport of the di- and tri-peptides into enterocytes is by: ...

    Incorrect

    • The transport of the di- and tri-peptides into enterocytes is by:

      Your Answer:

      Correct Answer: H+ dependent peptide transporter 1

      Explanation:

      Peptides longer that four amino acids are not absorbed. There is abundant absorption of di and tri peptidases in the small intestine. They are absorbed into the epithelial cell of the small intestine via a transporter called Peptide Transporter 1 by co transport with H+ ions.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 67 - Regarding the formation of CSF, which of the following is true? ...

    Incorrect

    • Regarding the formation of CSF, which of the following is true?

      Your Answer:

      Correct Answer: Its composition resembles that of brain ECF

      Explanation:

      In normal adults CSF volume is around 125ml to 150ml. Turnover of entire volume of cerebrospinal fluid a day is about 3 to 4 times a day. Composition of CSF is similar to that of plasma except that CSF is nearly protein-free compared with plasma and has a different electrolyte level. About 80% of CSF is produced by the choroid plexus. It is also produced by a single layer of column shaped ependymal cells. The composition and rate of CSF generation depends on several factors and is influenced by hormones and the content and pressure of blood and CSF.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 68 - A 32 year old woman presents with a painful elbow which she has...

    Incorrect

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

      Your Answer:

      Correct Answer: Pain on wrist extension against resistance

      Explanation:

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

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 69 - Cross-bridges between actin and myosin filaments contain: ...

    Incorrect

    • Cross-bridges between actin and myosin filaments contain:

      Your Answer:

      Correct Answer: Calcium ions

      Explanation:

      At rest troponin I is bound to actin and tropomyosin and covers the site where the myosin head interacts with actin. When calcium enters into the muscle, it binds with troponin C and causes a structural change in troponin I which moves out of the myosin binding site and causes the cross bridges between the actin and myosin filaments to occur.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 70 - 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 71 - The conversion of fructose to fructose 1-phosphate is catalysed by: ...

    Incorrect

    • The conversion of fructose to fructose 1-phosphate is catalysed by:

      Your Answer:

      Correct Answer: Fructokinase

      Explanation:

      The first step in the metabolism of fructose is the phosphorylation of fructose to fructose 1-phosphate by fructokinase.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds

  • Question 72 - 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:

      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
      0
      Seconds

  • Question 73 - A 78 year old woman presents to the clinic complaining of left sided...

    Incorrect

    • A 78 year old woman presents to the clinic complaining of left sided temporal headaches and jaw claudication that has been going on for a month. A left temporal artery biopsy is negative. Results show:Hb: 130g/lPlatelets: 359*109/lWBC: 10*109/lCRP: 89mg/lWhich of the following options would be the next best step in the management of this patient?

      Your Answer:

      Correct Answer: Commence prednisolone

      Explanation:

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

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 74 - Troponin I is inhibited by calcium binding to: ...

    Incorrect

    • Troponin I is inhibited by calcium binding to:

      Your Answer:

      Correct Answer: Troponin c

      Explanation:

      At rest troponin I is bound to actin and tropomyosin and covers the site where the myosin head interacts with actin. When calcium enters into the muscle, it binds with troponin C and cause a structural change in troponin I which moves out of the myosin binding site and causes the cross bridges between the actin and myosin filaments to occur.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 75 - Which of the following features do mast cells and basophils have in common:...

    Incorrect

    • Which of the following features do mast cells and basophils have in common:

      Your Answer:

      Correct Answer: Are essential for immediate type-hypersensitivity reactions

      Explanation:

      Anaphylaxis is a severe immediate allergic reaction of rapid onset affecting many body systems. It is due to the release of inflammatory mediators and cytokines from mast cells and basophils. Basophils are the least common of the granulocytes, representing about 0.5 to 1% of circulating white blood cells. However, they are the largest type of granulocyte. They are responsible for inflammatory reactions during immune response, as well as in the formation of acute and chronic allergic diseases, including anaphylaxis, asthma, atopic dermatitis and hay fever. They can perform phagocytosis (cell eating), produce histamine and serotonin that induce inflammation, and heparin that prevents blood clotting. Mast cells are similar in appearance and function. Both cell types store histamine, a chemical that is secreted by the cells when stimulated.

    • This question is part of the following fields:

      • Immunology
      • Medicine
      0
      Seconds

  • Question 76 - Where is the most erythropoietin produced? ...

    Incorrect

    • Where is the most erythropoietin produced?

      Your Answer:

      Correct Answer: Kidneys

      Explanation:

      Erythropoietin is produced by interstitial fibroblasts in the kidney in close association with peritubular capillary and proximal convoluted tubule. It is also produced in perisinusoidal cells in the liver. While liver production predominates in the fetal and perinatal period, renal production is predominant during adulthood.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds

  • Question 77 - A 28 year old male arrives at the clinic complaining of fever, arthralgia...

    Incorrect

    • A 28 year old male arrives at the clinic complaining of fever, arthralgia and urethritis. On examination, the ankle is swollen and there is a pustular rash on the dorsal foot. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Disseminated gonorrhoea

      Explanation:

      DGI presents as two syndromes: 1) a bacteremic form that includes a triad of tenosynovitis, dermatitis, and polyarthralgias without purulent arthritis and 2) a septic arthritis form characterized as a purulent arthritis without associated skin lesions. Many patients will have overlapping features of both syndromes. Time from infection to clinical manifestations may range from 1 day to 3 months. There is no travel history and the rash of Lyme disease is not purulent. Reactive arthritis presents with conjunctivitis, urethritis and arthritis usually with a red hot tender and swollen joint.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 78 - The coronary sinus, which empties into the right atrium, serves to? ...

    Incorrect

    • The coronary sinus, which empties into the right atrium, serves to?

      Your Answer:

      Correct Answer: Drain the venous supply of the myocardium

      Explanation:

      The coronary sinus is a collection of veins joined together to form a large vessel that collects blood from the heart muscle (myocardium). It delivers deoxygenated blood to the right atrium, as do the superior and inferior vena cava.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 79 - Absorption of protein antigens i.e. bacterial and viral proteins takes place in the:...

    Incorrect

    • Absorption of protein antigens i.e. bacterial and viral proteins takes place in the:

      Your Answer:

      Correct Answer: Microfold cells (m cells) of the intestine

      Explanation:

      M cells are specialized epithelial cells. They have a high capacity of transcytosis of microorganisms and macromolecules. They rapidly uptake antigens and present them to immune cells associated with the gut. In contrast to absorptive enterocytes, M cells do not exert direct defence mechanisms to antigens and pathogens in the intestinal cavity. Crypts of Lieberkühn are located mainly in the small intestine and large intestine and the main function is to replenish epithelial cells and to secrete intestinal enzymatic juice as well as mucous. Brunner’s glands empty into intestinal glands and their main function is to secrete mucin and to form a protective mucus layer on the duodenal epithelial cells to protect it from acidic chyme coming from the stomach. Islets of Langerhans are located in the pancreas and secrets insulin mainly. Mucosa associated lymphoid tissue plays a role in inducing immune response after presentation of antigens.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 80 - Regarding short-chain fatty acids, all the following are true except: ...

    Incorrect

    • Regarding short-chain fatty acids, all the following are true except:

      Your Answer:

      Correct Answer: They are produced in the small intestine but their absorption occurs in the colon

      Explanation:

      Short chain fatty acids (SCFAs) have carbon chains of 2-5 carbon atoms. They are produced in the large intestine and are also absorbed there. They exert a trophic effect on the colonic epithelial layer in absorption of sodium. In the absence of short chain fatty acids there is a loss of sodium and water. Transport of SCFA is coupled with sodium thus absorption leads to the accumulation in the lumen of HCO3, a rise in pH, fall in pCO2 and stimulation of Na+ and water transport. The effect on Na+ transport is thought to indicate the presence of a Na+/H+ exchange in the cell membrane.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 81 - A 50-year-old woman under treatment for manic-depressive psychosis presents in an unconscious state...

    Incorrect

    • A 50-year-old woman under treatment for manic-depressive psychosis presents in an unconscious state after an episode of seizure on the street. Her husband who accompanied her into the ER reported that they argued about 6-7 hours ago. On examination, she is found to be hypertonic with a GCS of 8, BP: 90/60 mmHg and a pulse of 105 bpm. Blood investigations revealed a lithium level of 3.2 mmol/L. She was intubated and ventilated. Which of the following is the most appropriate immediate management in this case?

      Your Answer:

      Correct Answer: N saline should be started iv

      Explanation:
      1. Normal saline (N saline) should be started IV: Intravenous normal saline is recommended to enhance renal excretion of lithium. Adequate hydration is crucial because lithium is primarily excreted by the kidneys, and maintaining good urine output can help reduce lithium levels.
      2. Dialysis: This is considered the most effective treatment for severe lithium toxicity, especially when serum levels are significantly elevated (typically >2.5 mmol/L) and the patient presents with severe symptoms such as seizures, altered mental status, or renal impairment. Given the patient’s lithium level of 3.2 mmol/L and her critical condition, dialysis is necessary to rapidly reduce lithium levels.

      The other options are less appropriate or ineffective in this context:

      • Gastric lavage should be considered: This is not typically recommended for lithium poisoning because lithium is rapidly absorbed and lavage is unlikely to be effective several hours post-ingestion.
      • Activated charcoal is likely to be effective: Activated charcoal does not effectively bind lithium and is not recommended for lithium poisoning.
      • 5% dextrose should be started IV: While maintaining hydration is important, normal saline is preferred over dextrose solutions in this context to promote renal excretion of lithium.
      • Dialysis is not normally required unless levels are above 5 mmol/L: This statement is incorrect. Dialysis is often required at lower levels, particularly in cases of severe toxicity or if the patient is symptomatic, as seen in this case.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 82 - Bile acids will be prevented from being absorbed by resection of which part...

    Incorrect

    • Bile acids will be prevented from being absorbed by resection of which part of the gastrointestinal tract?

      Your Answer:

      Correct Answer: Ileum

      Explanation:

      Bile acids (also called bile salts) are produced in the liver, secreted into the biliary system, stored in the gallbladder and are released after meals stimulated by cholecystokinin. They are important for the digestion and absorption of fats (lipids) in the small intestine. Usually over 95% of the bile acids are absorbed in the terminal ileum and are taken up by the liver and resecreted.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds

  • Question 83 - Which of the following supplies the AV node? ...

    Incorrect

    • Which of the following supplies the AV node?

      Your Answer:

      Correct Answer: Right coronary artery

      Explanation:

      The AV node is supplied by the right coronary artery near the origin of the posterior IV artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 84 - Select the correct statement regarding the 4th heart sound, it? ...

    Incorrect

    • Select the correct statement regarding the 4th heart sound, it?

      Your Answer:

      Correct Answer: Can be heard in atrial systole.

      Explanation:

      The fourth heart sound is not normally audible in a normal adult. It occurs as a consequence of ventricular hypertrophy. It is caused by filling of the ventricle by atrial systole.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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  • Question 85 - Which one of the following statements regarding epidemiological measures is correct? ...

    Incorrect

    • Which one of the following statements regarding epidemiological measures is correct?

      Your Answer:

      Correct Answer: Cross-sectional surveys can be used to estimate the prevalence of a condition in the population

      Explanation:

      The incidence rate is the number of new cases per population at risk in a given time period. For example, if a population initially contains 1,000 non-diseased persons and 28 develop a condition over two years of observation, the incidence proportion is 28 cases per 1,000 persons per two years, i.e. 2.8% per two years.Prevalence is the proportion of a particular population found to be affected by a medical condition (typically a disease or a risk factor such as smoking or seat-belt use). It is derived by comparing the number of people found to have the condition with the total number of people studied, and is usually expressed as a fraction, as a percentage, or as the number of cases per 10,000 or 100,000 people.Incidence should not be confused with prevalence, which is the proportion of cases in the population at a given time rather than rate of occurrence of new cases. Thus, incidence conveys information about the risk of contracting the disease, whereas prevalence indicates how widespread the disease is.

    • This question is part of the following fields:

      • Medicine
      • Research Skills
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  • Question 86 - With regards to the deiodinases, where would you find D1? ...

    Incorrect

    • With regards to the deiodinases, where would you find D1?

      Your Answer:

      Correct Answer: Liver

      Explanation:

      The liver produces an important amount of T3 by outer ring deiodination thanks to its elevated concentration of type I deiodinase. It can also be found in the kidney.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
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      Seconds

  • Question 87 - What is the role of cyclin and cyklin-dependent kinases in mitosis: ...

    Incorrect

    • What is the role of cyclin and cyklin-dependent kinases in mitosis:

      Your Answer:

      Correct Answer: Phosphorylation of proteins that make up pre-replication complexes

      Explanation:

      There are certain regulators of the cell cycles that mediate progression through the cell cycle. These are cyclins and cyklin-dependent kinases (CDKs). They form a complex that phosphorylates protein involved in the cell cycle.

    • This question is part of the following fields:

      • Genetics
      • Medicine
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  • Question 88 - Which vagus nerve mainly supplies the AV node? ...

    Incorrect

    • Which vagus nerve mainly supplies the AV node?

      Your Answer:

      Correct Answer: Left vagus

      Explanation:

      As the AV node develops from the left side of the embryo It is supplied by the left vagus nerve.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
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      Seconds

  • Question 89 - 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
      0
      Seconds

  • Question 90 - What is the mode of action of bisphosphonates? ...

    Incorrect

    • What is the mode of action of bisphosphonates?

      Your Answer:

      Correct Answer: Inhibit osteoclasts

      Explanation:

      Bisphosphonates are analogues of pyrophosphate, a molecule which decreases demineralisation in bone. They inhibit osteoclasts by reducing recruitment and promoting apoptosis.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 91 - If UA = concentration of A in urine, V = urine flow per...

    Incorrect

    • If UA = concentration of A in urine, V = urine flow per unit time, and PA = arterial plasma level of A, renal clearance of A is equal to?

      Your Answer:

      Correct Answer: (UA x V)/PA

      Explanation:

      Renal clearance = [Urine concentration (UA) x Urine flow (V)]/[Plasma concentration (PA)]

    • This question is part of the following fields:

      • Medicine
      • Renal
      0
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  • Question 92 - A 42 year old male arrives at the clinic due to cough and...

    Incorrect

    • A 42 year old male arrives at the clinic due to cough and haemoptysis. Examination shows nasal mucosal ulceration. The doctor suspects Wegener's granulomatosis. Which anatomical area would be most commonly involved in this condition?

      Your Answer:

      Correct Answer: Lungs

      Explanation:

      Granulomatosis with polyangiitis (GPA, previously known as Wegener’s granulomatosis) is a systemic vasculitis that affects both small and medium-sized vessels. Patients typically initially suffer from a limited form that may consist of constitutional symptoms and localized manifestations such as chronic sinusitis, rhinitis, otitis media, ocular conditions. In later stages, more serious manifestations may arise, including pulmonary complications and glomerulonephritis, although the skin, eyes, and heart may also be involved but these lesions are less common. Diagnosis is based on laboratory testing (positive for PR3-ANCA/c-ANCA), imaging, and biopsy of affected organs, which demonstrate necrotizing granulomatous inflammation. GPA is treated with immunosuppressive drugs, typically consisting of glucocorticoids combined with methotrexate, cyclophosphamide, or rituximab. Relapses are common and the following systems are affected: Lower respiratory tract (95% of cases), renal involvement (80% of cases), skin lesions (45% of cases), ocular involvement (45% of cases) and cardiac involvement (33% of cases).

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
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  • Question 93 - A 55 year old cardiac patient is comfortable at rest but heavy housework...

    Incorrect

    • A 55 year old cardiac patient is comfortable at rest but heavy housework results in fatigue, palpitations or dyspnoea. What New York Heart Association class best describes the severity of their disease?

      Your Answer:

      Correct Answer: NYHA Class II

      Explanation:

      New York Heart Association functional classification:

      Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities.

      Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion.

      Class III: marked limitation of any activity; the patient is comfortable only at rest.

      Class IV: any physical activity brings on discomfort and symptoms occur at rest.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 94 - Which ion channel does not contribute to the myocardial action potential? ...

    Incorrect

    • Which ion channel does not contribute to the myocardial action potential?

      Your Answer:

      Correct Answer: Chloride channel

      Explanation:

      The upstroke in the cardiac action potential is due to opening of the sodium channels and an influx of sodium into the cell. The initial repolarization phase is due to transient opening of the potassium channels along with calcium channels. Influx of calcium causes the prolonged plateau phase of the action potential. Delayed opening of the rectifier potassium channel and delayed closure of the calcium channel leads to the repolarization phase of cardiac action potential.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 95 - A 33 year old female presents with dyspnoea, myalgia, arthralgia and a skin...

    Incorrect

    • A 33 year old female presents with dyspnoea, myalgia, arthralgia and a skin rash. The presence of which of the following antibodies would be the most specific for SLE?

      Your Answer:

      Correct Answer: Anti-Sm

      Explanation:

      Anti-Sm antibodies are essential for diagnosis of SLE, especially in anti-dsDNA-negative patients. ANA are also found in 95% of the patients with SLE but they may also occur with other conditions like Juvenile inflammatory arthritis, chronic activity hepatitis, and Sjogren’s syndrome. Anti-Ro, although also found with SLE are more characteristic of Sjogren Syndrome. RF is usually associated with rheumatoid arthritis and cANCA with Wegener’s granulomatosis, Churg Strauss, and microscopic polyangiitis.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 96 - Choose the correct statement regarding trabecular bone: ...

    Incorrect

    • Choose the correct statement regarding trabecular bone:

      Your Answer:

      Correct Answer: All of the options are correct

      Explanation:

      Trabecular, spongy or cancellous bone. It is located inside the cortical bone and makes up around 20% of all bone in the body. It is made of spicules or plates with a high surface to volume ratio, where many cells sit on the surface of the end plates. It receives its nutrients from the extracellular fluid (ECF), exchanging about 10 mmol of calcium every 24 hours.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

  • Question 97 - In cardiac muscle, which of the following is directly responsible for the release...

    Incorrect

    • In cardiac muscle, which of the following is directly responsible for the release of Ca2+ stored in the sarcoplasmic reticulum (calcium-induced calcium release)?

      Your Answer:

      Correct Answer: Ryanodine receptor (RyR)

      Explanation:

      Ryanodine receptor (RyR) is a ligand-gated Ca2+ channel with Ca2+ as its natural ligand. In skeletal muscle, Ca2+ entry from ECF by this route is not required for Ca2+ release. Instead, the DHPR that serves as the voltage sensor unlocks release of Ca2+ from the nearby SR via physical interaction with the RyR. The release is amplified through ca-induced ca release. However, in cardiac muscle, it is the influx of extracellular Ca2+ through the voltage-sensitive DHPR in the T system that triggers ca-induced ca release trough the RyR at the SR.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 98 - The main source of nutrients in the liver is via the ...

    Incorrect

    • The main source of nutrients in the liver is via the

      Your Answer:

      Correct Answer: Portal vein

      Explanation:

      The portal vein or hepatic portal vein is a blood vessel that carries blood from the gastrointestinal tract and spleen to the liver. This blood is rich in nutrients that have been extracted from food, and the liver processes these nutrients; it also filters toxins that may have been ingested with the food. 75% of total liver blood flow is through the portal vein, with the remainder coming from the hepatic artery proper.

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      0
      Seconds

  • Question 99 - Regarding the myofilament molecules, which of the following contains binding sites for calcium...

    Incorrect

    • Regarding the myofilament molecules, which of the following contains binding sites for calcium that helps to initiate contraction?

      Your Answer:

      Correct Answer: Troponin c

      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 100 - Where does the pituitary gland lie? ...

    Incorrect

    • Where does the pituitary gland lie?

      Your Answer:

      Correct Answer: In a pocket of the sphenoid bone at the base of the brain

      Explanation:

      The pituitary lies in a small depression in the sphenoid bone, known as the sella turcica or Turkish saddle.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Endocrinology (1/1) 100%
Medicine (4/5) 80%
Cardiovascular (1/1) 100%
Gastrointestinal (1/2) 50%
Pharmacology (1/1) 100%
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