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Question 1
Correct
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Question 2
Incorrect
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Select one true statement about haemoglobin synthesis…
Your Answer: Produces the tetramer α2ß2 as the end result.
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.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 3
Incorrect
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Which of the following provides the sympathetic nervous supply to the stomach?
Your Answer: Splanchnic plexus
Correct Answer: Coeliac plexus
Explanation:Parasympathetic innervation to the stomach is from the vagus nerve and the sympathetic innervation is from the coeliac plexus.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 4
Correct
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Which of the following runs in the upper part of the falx cerebri?
Your Answer: Superior sagittal sinus
Explanation:Falx cerebri is a sickle cell fold of dura between the two hemispheres. Its posterior part blends with the superior part of the tentorium cerebelli. The superior sagittal sinus runs in its upper fixed margin, the inferior sagittal sinus in the free concave margin and the straight sinus along its attachment to the tentorium cerebelli.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 5
Incorrect
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Which glucose transporter is responsible for the uptake of glucose in ß cells?
Your Answer: GLUT 1
Correct Answer: GLUT 2
Explanation:Glucose transporter 2, also known as GLUT2 is a transmembrane carrier protein which is not insulin dependent. It is found in the liver and the pancreatic islet ß cells, where it functions as the primary glucose transporter that allows the transfer of glucose between these organs and blood.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 6
Correct
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What is the mechanism of action of carbimazole?
Your 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).
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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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Question 8
Incorrect
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A lesion that interrupts one optic nerve causes blindness:
Your Answer: That spares the macula of the involved eye
Correct Answer: In the eye on the same side as the optic nerve
Explanation:The optic nerve on each side contains medial and lateral fibers originating from the retina. Medial fibers cross at the optic chiasm and become the optic tract ending in the visual cortex of the occipital lobe. If there is a lesion interrupting the “optic nerve” on one side, the same side eye will be completely blind.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 9
Correct
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During strenuous exercise the following arterial change can take place in a fit athlete:
Your Answer: No change takes place
Explanation:The changes which occur in arterial pH, PO2 and PCO2 values during exercise are usually small. Arterial PO2 often rises slightly because of hyperventilation although it may eventually fall at high work rates. During vigorous exercise, when sufficient oxygen for flux through the Krebs cycle is not available, the increased reliance on glycolysis results in increased accumulation of lactic acid, which initially leads to an increase in PaCO2 . However, this is counteracted by the stimulation of ventilation and as a result PaCO2 is decreased. This provides some respiratory compensation for further lactic acid production and prevents a decline in blood pH, which remains nearly constant during moderate exercise.
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This question is part of the following fields:
- Medicine
- Respiratory
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Question 10
Correct
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Choose the standard method for comparing distributions in data sets (such as between the expected frequency of an event and the observed frequency of an event) from the list of options.
Your Answer: Chi squared (X²) test
Explanation:The Chi-squared test evaluates if two variables are related. The other statistical tests mentioned do not perform this function.
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This question is part of the following fields:
- Medicine
- Research Skills
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Question 11
Correct
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Where does the pituitary gland lie?
Your 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.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 12
Incorrect
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Question 13
Incorrect
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Arterioles stemming from the coronary artery can also empty into the heart directly via the:
Your Answer: All arterioles empty into the coronary sinus or anterior cardiac vein
Correct Answer: Arteriosinusoidal vessels
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. They include arteriosinusoidal vessels, which connect the arterioles to the heart chambers. The thebesian veins drain the capillaries into the chambers and the arterioluminal vessels drain small arteries directly into the chambers.
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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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Which of the following is correct regarding lead poisoning?
Your Answer: Is associated with a macrocytic anaemia
Correct Answer: Causes a peripheral neuropathy due to demyelination
Explanation:Lead can be absorbed through the skin and by inhalation. It is associated with iron deficiency and a microcytic anaemia. The most common gastrointestinal symptoms are abdominal colic and constipation.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 15
Correct
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Which of the following predominate in the adrenal medulla?
Your Answer: Epinephrine secreting cells
Explanation:Chromaffin cells, also known as pheochromocytes, are cells located in the adrenal medulla which specialize in the synthesis, storage, and secretion of catecholamines: 80% epinephrine and 20% norepinephrine is released into the bloodstream. For this reason, they are considered to be neuroendocrine cells.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 16
Correct
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A 65-year-old man, after suffering from a pathological rib fracture, complains of recurrent infection. Bone marrow aspiration revealed a calcium level of 3.9 mmol/l and alkaline phosphatase level of 160u/l. What type of cell would be found in abundance in the marrow spear?
Your Answer: Plasma cells
Explanation:Multiple myeloma or plasma cell myeloma, is a cancer of plasma cells, responsible for producing antibodies. It often, presents early with no symptoms followed by bone pain and pathological fractures (metastases), raised calcium levels, bleeding, frequent infections, and anaemia. It usually occurs around the age of 61 and is more common in men than women.
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This question is part of the following fields:
- Geriatrics
- Medicine
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Question 17
Correct
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A 28 year old man was rushed to the hospital after experiencing sudden onset chest pain while playing football. He has never felt such pain in the past. However, one of his uncles had a similar sudden discomfort at a young age and he passed away following a heart problem. The following vitals are recorded on examination:BP: 101/74 mmHgRR: 22 breaths/minPR: 87 beats/min Physical examination reveals abnormally long fingers and on asking the man to hold the opposite wrist, the thumb and little finger overlap each other. He is not taking any medication regularly and past medical/surgical history is not significant. He admits to smoking half pack of cigarettes/day for the last 10 years but denies abusing any illicit drugs. Which of the following explanation most likely explains the disease process in this man?
Your Answer: A defect of the glycoprotein structure which usually wraps around elastin
Explanation:Aortic dissection is defined as separation of the layers within the aortic wall. Tears in the intimal layer result in the propagation of dissection (proximally or distally) secondary to blood entering the intima-media space. This can be caused as a result of both congenital or acquired factors like chronic uncontrolled hypertension. This patient shows no sign of hypertension but his physical examination hints towards Marfan Syndrome. Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder affecting the microfibrils and elastin in connective tissue throughout the body. MFS is associated with pathological manifestations in the cardiovascular system (e.g., mitral valve prolapse, aortic aneurysm, and dissection), the musculoskeletal system (e.g., tall stature with disproportionately long extremities, joint hypermobility), and the eyes (e.g., subluxation of the lens of the eye). Decreased collagen production occurs in ageing, hydroxylation defects are present in vitamin C deficiency, copper deficiency affecting lysyl oxidase enzyme occurs in Menke’s disease.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 18
Correct
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In the life cycle of plasmodium species:
Your Answer: Merozoites are released from the liver and enter the red blood cell
Explanation:Plasmodium is a genus of parasitic protozoa, many of which cause malaria in their hosts. The parasite always has two hosts in its life cycle: a Dipteran insect host and a vertebrate host. Sexual reproduction always occurs in the insect, making it the definitive host.The life-cycles of Plasmodium species involve several different stages both in the insect and the vertebrate host. These stages include sporozoites, which are injected by the insect vector into the vertebrate host’s blood. Sporozoites infect the host liver, giving rise to merozoites and (in some species) hypnozoites. These move into the blood where they infect red blood cells. In the red blood cells, the parasites can either form more merozoites to infect more red blood cells, or produce gametocytes which are taken up by insects which feed on the vertebrate host. In the insect host, gametocytes merge to sexually reproduce. After sexual reproduction, parasites grow into new sporozoites, which move to the insect’s salivary glands, from which they can infect a vertebrate host bitten by the insect.
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 19
Correct
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Question 20
Correct
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A 60-year-old patient diagnosed with Type-2 diabetes mellitus is not responding to dietary modifications and weight reduction. He needs to be started on an oral hypoglycaemic agent. Which among the following statements regarding oral hypoglycaemic agents is true?
Your Answer: Acarbose inhibits α-glucosidase
Explanation:Different Oral Hypoglycaemic Agents (OHAs) and their respective mechanism(s) of action include:• Sulfonylureas (such as, glipizide, gliclazide, glimepiride) – bind to ATP sensitive Potassium channels (K – ATP channels) in the 𝝱 cells of the islets of the pancreas. Inhibition of these channels lead to an altered resting membrane potential in these cells causing an influx of calcium which increases insulin secretion.• Meglitinides (like Repaglinide) through a different receptor, they similarly regulate K – ATP channels thereby causing an increase in insulin secretion.• Biguanides (e.g., Metformin) increase the hepatic AMP-activated protein kinase activity leading to reduced gluconeogenesis and lipogenesis and increased insulin-mediated uptake of glucose in muscles. (it doesn’t increase insulin secretion)• Thiazolidinediones (rosiglitazone, pioglitazone) bind to PPAR-𝝲 and increase peripheral uptake of glucose and decrease hepatic glucose production.• α-Glucosidase inhibitors (such as acarbose, miglitol, voglibose) competitively inhibit α-glucosidase enzymes in the intestine that digest the dietary starch thus, inhibiting the polysaccharide reabsorption as well as metabolism of sucrose to glucose and fructose.• DPP-4 inhibitors (sitagliptin, saxagliptin, vildagliptin, linagliptin, alogliptin) prolong the action of glucagon-like peptide. This leads to inhibition of glucagon release, increase in insulin secretion and a decrease in gastric emptying leading to a decrease in blood glucose levels.• SGLT2 inhibitors (dapagliflozin and canagliflozin) inhibit glucose reabsorption in the proximal tubules of the renal glomeruli leading to glycosuria which in-turn reduces blood glucose levels.Note: Side effects of pioglitazone are weight gain, pedal oedema, bone loss and precipitation of congestive cardiac failure.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 21
Correct
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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
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 22
Correct
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The brainstem contains which of the following structures?
Your Answer: The midbrain, pons and medulla
Explanation:Brain stem is the base of the brain that connects the brain to the spinal cord. It consists of the mid brain, pons and medulla oblongata.
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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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Which of the following phases in depolarization and repolarization of cardiac muscle cells are caused by the inactivation of Na+ channels?
Your Answer: Phase 1 : rapid repolarization
Explanation:Phase 0 is caused by the sodium current. Voltage gated sodium channels open leading to the influx of sodium into the cardiac muscle cell. Phase 1 is the rapid transient repolarization phase which is caused by the inactivation of the voltage gated sodium channels and opening of the voltage gated potassium channels along with opening of the slow calcium channels. Phase 2 which is the plateau is caused by opening of the slow calcium channels. Phase 4 is caused by closing of the slow calcium channels and opening of the potassium channels leading to efflux of potassium leading to the establishment of the resting membrane potential.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 24
Correct
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What is the blood supply to the liver?
Your Answer: Hepatic artery and hepatic portal vein
Explanation:The liver receives a dual blood supply from the hepatic portal vein and hepatic arteries. The hepatic portal vein delivers approximately 75% of the liver’s blood supply, and carries venous blood drained from the spleen, gastrointestinal tract, and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remaining quarter of its blood flow. Oxygen is provided from both sources; approximately half of the liver’s oxygen demand is met by the hepatic portal vein, and half is met by the hepatic arteries
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 25
Incorrect
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The main breakdown of fatty acids (by B-oxidation) occurs in which part of the cell?
Your Answer: Cytoplasm
Correct Answer: Mitochondria
Explanation:Once inside the mitochondria, the β-oxidation of fatty acids occurs via five recurring steps:Activation by ATPOxidation by FAD,Hydration,Oxidation by NAD+,Thiolysis,The final product is acetyl-CoA, the entry molecule for the citric acid cycle.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 26
Correct
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The pressure in the sinusoids is normally:
Your Answer: Lower than portal venous pressure
Explanation:The direction of transport of nutrients in the portal vein occurs from the portal vein to the hepatic sinusoids. Thus, he pressure of sinusoids should be lower than the pressure of he portal vein.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 27
Correct
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What is the effect of catecholamines (i.e. increased heart rate) on the pressure volume loop?
Your Answer: Shifts the diastolic pressure curve upward and leftward
Explanation:Catecholamines have a positive ionotropic and chronotropic effect on the heart. The ventricles develop greater tension during systole resulting in an increase in the stroke volume. The increase in stroke volume results in a decrease in the end diastolic volume. This pushes the loop towards the left and upwards.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 28
Incorrect
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Question 29
Incorrect
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The haustral pattern seen in the normal colon is produced by
Your Answer: Valvulae conniventes
Correct Answer: Taenia coli
Explanation:The haustra (singular haustrum) of the colon are the small pouches caused by sacculation (sac formation), which give the colon its segmented appearance. The teniae coli run the length of the large intestine. Because the taeniae coli are shorter than the intestine, the colon becomes sacculated between the taeniae coli, forming the haustra.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 30
Incorrect
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Which of the following cells will degranulate and release histamine when binding to IgE?
Your Answer:
Correct Answer: Basophils
Explanation:Basophils have protein receptors on their cell surface that bind IgE, an immunoglobulin involved in microparasite defence and allergy. When activated, basophils degranulate to release histamine, proteoglycans (e.g. heparin and chondroitin), and proteolytic enzymes (e.g. elastase and lysophospholipase).
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This question is part of the following fields:
- Haematology
- Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY
