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Question 1
Incorrect
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Choose the correct answer: The interposed nuclei…
Your Answer: All of the above
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.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 2
Correct
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Which of the following are true when it comes to tumour suppressor genes:
Your Answer: All of the options are true
Explanation:All of the above mentioned statements are true regarding tumour suppressor genes. Tumour suppressor genes generally follow the two-hit hypothesis, which implies that both alleles that code for a particular protein must be affected before an effect is manifested.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 3
Correct
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Which one of the following leads to decreased prolactin levels?
Your Answer: Dopamine
Explanation:Dopamine has an important effect on the regulation of prolactin secretion. Dopamine binds to type-2 dopamine receptors of the lactotroph cells that are functionally linked to membrane channels and G proteins and suppresses the high secretory activity of the pituitary lactotrophs.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 4
Incorrect
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Major supplies of glycogen are found in ….
Your Answer: Liver and adipose tissues
Correct Answer: Liver and skeletal muscle
Explanation:The two major sites of glycogen storage are the liver and skeletal muscle. The concentration of glycogen is higher in the liver than in muscle however more glycogen is stored in skeletal muscle due to its greater mass.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 5
Incorrect
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A 40-year-old man is admitted to the Emergency Department in a confused state. He tells you that he consumed two bottles of antifreeze. On examination, his pulse is 120 bpm and blood pressure is 140/90 mmHg. An arterial blood gas analysis shows uncompensated metabolic acidosis. He is transferred to the high dependency unit and ethanol is given via a nasogastric tube. How does ethanol help this patient?
Your Answer: Inhibits alcohol dehydrogenase
Correct Answer: Competes with ethylene glycol for alcohol dehydrogenase
Explanation:Ethanol competes with ethylene glycol for alcohol dehydrogenase and thus, helps manage a patient with ethylene glycol toxicity.Ethylene glycol is a type of alcohol used as a coolant or antifreezeFeatures of toxicity are divided into 3 stages:Stage 1: (30 min to 12 hours after exposure) Symptoms similar to alcohol intoxication: confusion, slurred speech, dizziness (CNS depression)Stage 2: (12 – 48 hours after exposure) Metabolic acidosis with a high anion gap and high osmolar gap. Also tachycardia, hypertensionStage 3: (24 – 72 hours after exposure) Acute renal failureManagement has changed in recent times:Fomepizole, an inhibitor of alcohol dehydrogenase, is now used first-line in preference to ethanol.Ethanol has been used for many years works by competing with ethylene glycol for the enzyme alcohol dehydrogenase this limits the formation of toxic metabolites (e.g. glycolaldehyde and glycolic acid) which are responsible for the hemodynamic/metabolic features of poisoning.Haemodialysis has a role in refractory cases.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 6
Incorrect
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Which one of the following diuretics is associated with metabolic acidosis?
Your Answer: Furosemide
Correct Answer: Acetazolamide
Explanation:Acetazolamide is in the diuretic and carbonic anhydrase inhibitor families of medication. It works by decreasing the amount of hydrogen ions and bicarbonate in the body and can thus cause metabolic acidosis and electrolyte changes (hypokalaemia, hyponatremia).
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 7
Correct
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A 71-year-old woman residing in a nursing home for a couple of years complains of drooling of saliva and sudden difficulty in swallowing while eating. She is a known hypertensive on treatment. What would be your next step?
Your Answer: Endoscopy
Explanation:Dysphagia or difficulty in swallowing. Endoscopy allows for visual examination of the oesophagus and is indicated in patients with dysphagia to determine the underlying aetiology, exclude malignant and premalignant conditions, assess the need for therapy, and perform therapy including dilation.
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This question is part of the following fields:
- Geriatrics
- Medicine
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Question 8
Incorrect
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The small opening in the cochlea through which the upper scala vestibuli and lower scala tympani communicates is called the:
Your Answer: Oval window
Correct Answer: Helicotrema
Explanation:The helicotrema is the part of cochlear labyrinth where the scala tympani and the scala vestibuli meet.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 9
Incorrect
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Which of the following statements is most suitable to describe necrosis?
Your Answer: Shrinking of cytoplasm and condensation of nucleus.
Correct Answer: Significant inflammatory response
Explanation:Necrosis is the death of most or all of the cells in an organ or tissue due to disease, injury, or failure of the blood supply. Cellular death due to necrosis does not follow the (regulated) apoptotic signal transduction pathway, but rather various receptors are activated, and result in the loss of cell membrane integrity and an uncontrolled release of products of cell death into the extracellular space. This initiates in the surrounding tissue an inflammatory response which attracts leukocytes and nearby phagocytes which eliminate the dead cells by phagocytosis.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 10
Incorrect
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A patient has been diagnosed with multi-drug resistant tuberculosis and is currently bring treated with rifampicin, isoniazid, and pyrazinamide. He is commenced on streptomycin.Which among the following is the most likely neurological side-effect of streptomycin?
Your Answer: Optic nerve
Correct Answer: Vestibular damage
Explanation:Vestibular damage is a neurological side effect of streptomycin.Streptomycin is an aminoglycoside bactericidal antibiotic. It is used in the treatment of tularaemia and resistant mycobacterial infections.The most common neurological side-effect is vestibular damage leading to vertigo and vomiting. Cochlear damage is less frequent and results in deafness. Other side-effects include rashes, angioneurotic oedema, and nephrotoxicity.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 11
Incorrect
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A 24 year old man presents to the clinic complaining of lower limb joint pain and lower backache for the past 2 weeks. He remembers getting a mild gastrointestinal infection while in Spain 6 weeks ago that settled spontaneously. There has been eye irritation that has now settled. Past surgical history includes an appendectomy 3 years back. Vital examination shows a temperature of 37.5 C. Lab results reveal a normal WBC and raised ESR. Which of the following is true?
Your Answer: A rash is commonly seen in such patients
Correct Answer: Rheumatoid factor is likely to be negative
Explanation:Reactive arthritis, (formerly known as Reiter’s syndrome), is an autoimmune condition that occurs after a bacterial infection of the gastrointestinal or urinary tract. It is categorized as a seronegative spondylarthritis because of its association with HLA-B27. Reactive arthritis primarily affects young men and usually presents with musculoskeletal or extra‑articular symptoms. The characteristic triad consists of arthritis, conjunctivitis, and urethritis. The diagnosis is based on clinical features such as patient history and physical examination; there are no specific tests for reactive arthritis. Treatment is primarily symptomatic and consists of the administration of NSAIDs, as most patients recover spontaneously. extraarticular dermatologic manifestations include skin lesions of the glans resembling psoriasis (balanitis circinata); hyperkeratinisation of the palms and soles (keratoderma blenorrhagicum), oral ulcers. There usually is no rash and the diagnosis is unrelated to the presence of rheumatoid factor. This is a clinical diagnosis.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 12
Incorrect
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A 64 year old woman who is of Asian descent and is diabetic (controlled by diet) presents with generalized body aches and difficulty rising from sitting for the last few months. Her blood glucose levels are in the normal range. Lab examination reveals normal blood cell count, low serum phosphate, calcium at the lower range, and raised alkaline phosphatase levels. Radiological examination shows which of the following?
Your Answer: Osteolytic areas with bone destruction
Correct Answer: Linear areas of low density
Explanation:Osteomalacia is a condition due to defective mineralization of osteoid. Occurs as a result of Vitamin D deficiency secondary to poor dietary intake and sun exposure, malabsorption e.g., inflammatory bowel disease and gastrointestinal bypass surgery. Radiological findings include reduced bone mineral density (a non specific finding), inability to radiologically distinguish vertebral body trabeculae (the film appears poor quality), looser pseudo fractures, fissures, or narrow radiolucent lines (these are the characteristic findings). Osteolytic or punched out lesions may be seen with multiple myeloma and bony metastases. Areas of sclerosis may be observed with conditions like osteosclerosis and Paget disease. A Brodie abscess is a subacute osteomyelitis, which may persist for years before progressing to a chronic, frank osteomyelitis.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 13
Correct
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The posterior aspect of the interventricular septum is supplied by:
Your Answer: A branch of the right coronary artery
Explanation:The posterior aspect of the heart is supplied by the posterior interventricular artery which is a branch of the right coronary artery.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 14
Incorrect
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Complement system help dispose waste products after which natural process?
Your Answer: Infection
Correct Answer: Apoptosis
Explanation:The complement system is a part of the immune system that enhances (complements) the ability of antibodies and phagocytic cells to clear microbes and damaged cells from an organism or apoptosis. It is part of the innate immune system.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 15
Correct
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Which one of the following is a risk factor for torsade de pointes?
Your Answer: Hypothermia
Explanation:The following is a list of factors associated with an increased tendency toward torsades de pointes:- Hypokalaemia (low blood potassium)- Hypomagnesemia (low blood magnesium)- Hypocalcaemia (low blood calcium)- Bradycardia (slow heartbeat)- Heart failure- Left ventricular hypertrophy- Hypothermia- Subarachnoid haemorrhage- Hypothyroidism
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 16
Correct
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Where is most of the filtered sodium reabsorbed?
Your Answer: Proximal tubule
Explanation:Renal reabsorption of sodium (Na+) is a part of renal physiology. It uses Na-H antiport, Na-glucose symport, sodium ion channels (minor). It is stimulated by angiotensin II and aldosterone, and inhibited by atrial natriuretic peptide. Most of the reabsorption (65%) occurs in the proximal tubule.
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This question is part of the following fields:
- Medicine
- Renal
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Question 17
Correct
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Which of the given adverse effects should be anticipated following the administration of an anticholinesterase?
Your 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
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 18
Incorrect
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Question 19
Correct
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The conversion of haem to bilirubin is catalysed by which of these enzymes?
Your Answer: Biliverdin reductase
Explanation:Bilirubin is created by the activity of biliverdin reductase on biliverdin, a green tetrapyrrolic bile pigment that is also a product of haem catabolism.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 20
Incorrect
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The following can cause steatorrhea except
Your Answer: Diseases of the distal ileum
Correct Answer: Diseases that destroy the endocrine portion of the pancreas
Explanation:Dietary fats and lipids are usually efficiently digested and over 90% absorbed. Impaired digestion or absorption can result in fatty stools. Possible causes include exocrine (not endocrine) pancreatic insufficiency, with poor digestion from lack of lipases, loss of bile salts, which reduces micelle formation, and small intestinal disease producing malabsorption. Various other causes including certain medicines that block fat absorption, or indigestible or excess oil/fat in diet.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 21
Incorrect
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Which of the following limits the duration of inspiration and increases respiratory rate?
Your Answer: Ventral respiratory group
Correct Answer: Pneumotaxic centre
Explanation:The mechanism of control of ventilation is an interplay of multiple regions in the brain. The medullary respiratory centre sets the basic rhythm of breathing and the pons modifies the output of the medullary centres. There are two pontine centres: apneustic and pneumotaxic.
The pnuemotaxic centre controls inspiratory time. Increased signals to this area increases respiratory rate. The dorsal respiratory group (DRG) integrates input from the stretch receptors and the chemoreceptors in the periphery and is composed mainly of inspiratory neurons. The DRG controls the basic rhythm of breathing by triggering inspiratory impulses. The ventral respiratory group (VRG) generates breathing rhythm and integrates data coming into the medulla and contains both inspiratory and expiratory neurons. They are primarily active in exercise and stress.
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This question is part of the following fields:
- Medicine
- Respiratory
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Question 22
Incorrect
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Choose the correct answer: The cerebrocerebellum…
Your Answer: Is charged with co-ordination of limb movements
Correct Answer: All options are correct
Explanation:Cerebrocerebellum is comprised of two lateral regions, the cerebellar hemispheres and communicates with the cerebral cortex. It is principally responsible for controlling coordination of movement. Three fiber bundles carry the input and output of the cerebellum. There are three cerebellar peduncles with different connections and functions. The three are mainly, superior, middle and inferior. The superior cerebellar peduncle is also known as the “Brachium conjunctivum”. It predominantly contains efferent fibers from the cerebellar nuclei, as well as some afferents from the spinocerebellar tract. The efferent pathways include cerebellorubral, dentatothalamic, and fastigioreticular fibers. These are tracts projecting from the deep cerebellar nuclei to the thalamus and red nucleus. The middle cerebellar peduncle connects to the pontine nucleus and the dorsal spinocerebellar tracts run through the superior cerebellar peduncle
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This question is part of the following fields:
- Medicine
- Neurology
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Question 23
Correct
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The triangle with the heart at its centre, using limb leads is called:
Your Answer: Einthoven
Explanation:The Einthoven triangle is formed by placing the limb leads on both the arms and on the left leg with the heart in the centre.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 24
Incorrect
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The positive inotropic effect of digoxin is due to?
Your Answer: Stimulation of calcium channels
Correct Answer: Inhibition of the sodium potassium ATPase in the myocardium
Explanation:Digitalis compounds are potent inhibitors of cellular Na+/K+-ATPase. This ion transport system moves sodium ions out of the cell and brings potassium ions into the cell. By inhibiting the Na+/K+-ATPase, cardiac glycosides cause the intracellular sodium concentration to increase. This then leads to an accumulation of intracellular calcium via the Na+/Ca++ exchange system. In the heart, increased intracellular calcium causes more calcium to be released by the sarcoplasmic reticulum, thereby making more calcium available to bind to troponin-C, which increases contractility (inotropy).
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 25
Incorrect
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The process by which DNA fragments are separated by gel and transferred onto a membrane sheet is called:
Your Answer: Northern blotting
Correct Answer: 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.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 26
Correct
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Which of the following drug can cause galactorrhoea?
Your Answer: Metoclopramide
Explanation:Metoclopramide causes extrapyramidal effects (especially in children and young adults), hyperprolactinaemia, and occasionally tardive dyskinesia on prolonged administration. Also reported are drowsiness, restlessness, diarrhoea, depression, neuroleptic malignant syndrome, rashes, pruritus, oedema.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 27
Incorrect
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Which of the following is not a cause of drug-induced hepatitis?
Your Answer: Methyldopa
Correct Answer: Ethambutol
Explanation:Although rare, ocular toxicity in the form of optic neuritis (most commonly retrobulbar neuritis) has been well documented as a side effect of ethambutol. It is renally excreted and not associated with hepatitis.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 28
Incorrect
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Cholinergic nerves from the vagus innervate the SA and AV nodes via which receptor in the heart?
Your Answer: B1 receptor
Correct Answer: M2 receptor
Explanation:M2 receptor is found in the heart. M3 and M4 are associated with smooth muscle.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 29
Incorrect
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Why is tissue plasminogen activator (tPa) a valuable treatment used in myocardial infarction and stroke?
Your Answer: It activates thrombin
Correct Answer: It forms plasmin from its inactive precursor
Explanation:tPA is a serine protease involved in the breakdown of blood clots. It functions by converting plasminogen, an inactive precursor, into plasmin, an active enzyme. Plasmin then degrades fibrin, the main protein component of blood clots, leading to clot dissolution. This mechanism is particularly valuable in the treatment of myocardial infarction (heart attack) and ischemic stroke, where timely dissolution of the clot can restore blood flow to affected tissues and reduce damage.
Therefore, the correct answer is:
- It forms plasmin from its inactive precursor
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This question is part of the following fields:
- Haematology
- Medicine
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Question 30
Correct
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In most somatic cells telomeres progressively shorten as:
Your Answer: The cell divides
Explanation:Telomere length shortens with age. Progressive shortening of telomeres leads to senescence, apoptosis, or oncogenic transformation of somatic cells, affecting the health and lifespan of an individual. Telomeres prevent the chromosomes from shortening and prevent the coding portion of the DNA from being lost, thus allowing the cell to replicate indefinitely. During replication telomeres may be lost resulting in cell death.
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This question is part of the following fields:
- Genetics
- Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY
