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  • Question 1 - 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
      9
      Seconds

  • Question 2 - Which of the following enzymes are involved in Phase I drug metabolism? ...

    Incorrect

    • Which of the following enzymes are involved in Phase I drug metabolism?

      Your Answer: UDP-glucuronosyl transferases

      Correct Answer: Alcohol dehydrogenase

      Explanation:

      Drug metabolism can be broadly classified into:Phase I (functionalization) reactions: also termed non-synthetic reactions, they include oxidation, reduction, hydrolysis, cyclization and de-cyclization. The most common and vital reactions are oxidation reactions. (Of the given enzymes only Alcohol dehydrogenase is involved in phase I drug metabolism. Succinate dehydrogenase, is a vital enzyme involved in the Kreb’s cycle and the mitochondrial electron transport chain). They are mainly catalysed by Cytochrome P-450 enzyme.Phase II (conjugation) reactions: occur following phase I reactions, they include reactions: glucuronidation and sulphate conjugation, etc. They are mostly catalysed by UDP-glucuronosyltransferase enzyme. Other phase II enzymes include: sulfotransferases, N-acetyltransferases, glutathione S-transferases and methyltransferases.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      16
      Seconds

  • Question 3 - What percentage of blood to the liver is supplied by hepatic artery? ...

    Correct

    • What percentage of blood to the liver is supplied by hepatic artery?

      Your Answer: 25%

      Explanation:

      The liver receives a dual blood supply from the hepatic portal vein and hepatic arteries. The hepatic portal vein delivers approximately 75% of the liver’s blood supply, and carries venous blood drained from the spleen, gastrointestinal tract, and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remaining quarter of its blood flow.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      4.3
      Seconds

  • Question 4 - A 33-year-old electrical technician presents following an overdose. Anticholinergic syndrome is suspected. Which...

    Incorrect

    • A 33-year-old electrical technician presents following an overdose. Anticholinergic syndrome is suspected. Which of the following is true?

      Your Answer: Physostigmine is the treatment of choice

      Correct Answer: Mydriasis occurs

      Explanation:

      Anticholinergic syndrome occurs following overdose with drugs that have prominent anticholinergic activity including tricyclic antidepressants, antihistamines and atropine. Features include dry, warm, flushed skin, urinary retention, tachycardia, mydriasis (dilated pupils) and agitation.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      19.3
      Seconds

  • Question 5 - Nucleic acids are split into nucleotides in the: ...

    Incorrect

    • Nucleic acids are split into nucleotides in the:

      Your Answer:

      Correct Answer: Intestine

      Explanation:

      The pancreas is the major source for all the digestive enzymes including nucleases which split nucleic acids into nucleotides primarily in the small intestine.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds

  • Question 6 - Erythropoietin is synthesized by which cells of the nephron? ...

    Incorrect

    • Erythropoietin is synthesized by which cells of the nephron?

      Your Answer:

      Correct Answer: Tubular interstitial cells

      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:

      • Medicine
      • Renal
      0
      Seconds

  • Question 7 - 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 8 - Which intestinal cells play a major role in secretory immunity? ...

    Incorrect

    • Which intestinal cells play a major role in secretory immunity?

      Your Answer:

      Correct Answer: M cells

      Explanation:

      M cells are specialized epithelial cells of the MALT or mucosa-associated lymphoid tissues. They transport antigens from the intestinal lumen to cells of the immune system, thereby initiating an immune response. T and B cells are lymphocytes found in blood. Mucous cells secrete mucous and can be considered as a part of innate immunity. Chief cells in the gastric mucosa secret pepsin.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 9 - An important enzyme in renal tissue responsible for the conversion of glutamine to...

    Incorrect

    • An important enzyme in renal tissue responsible for the conversion of glutamine to glutamate and the subsequent production of NH4 is called?

      Your Answer:

      Correct Answer: Glutaminase

      Explanation:

      Glutaminase catalyses the following reaction:Glutamine + H2O → Glutamate + NH3

    • This question is part of the following fields:

      • Medicine
      • Renal
      0
      Seconds

  • Question 10 - A 82-year-old woman admitted following a fractured neck of femur has been discharged....

    Incorrect

    • A 82-year-old woman admitted following a fractured neck of femur has been discharged. On review, she is making good progress but consideration is given to secondary prevention of further fractures. What is the most appropriate step in the prevention of further fractures?

      Your Answer:

      Correct Answer: Start oral bisphosphonate

      Explanation:

      In such a clinical scenario, NICE guidelines support initiating treatment with bisphosphonates without waiting for a DEXA scan.Osteoporosis is defined as low bone mineral density caused by altered bone microstructure ultimately predisposing patients to low-impact, fragility fractures.Management:Vitamin D and calcium supplementation should be offered to all women unless the clinician is confident they have adequate calcium intake and are vitamin D repleteAlendronate is the first-line treatment. Around 25% of patients cannot tolerate alendronate, usually due to upper gastrointestinal problems. These patients should be offered risedronate or etidronate.Strontium ranelate and raloxifene are recommended if patients cannot tolerate bisphosphonates.Other medications that are useful in the treatment of osteoporosis are denosumab, teriparatide, raloxifene, etc.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 11 - Which of the following structures is not part of the conducting system of...

    Incorrect

    • Which of the following structures is not part of the conducting system of the heart?

      Your Answer:

      Correct Answer: Ventricular wall

      Explanation:

      The conduction system of the heart consists of the SA node, AV node, internodal pathway between these two nodes, Bundle of His and the purkinje fibers

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 12 - Erythropoietin is synthesized by which cells of the nephron? ...

    Incorrect

    • Erythropoietin is synthesized by which cells of the nephron?

      Your Answer:

      Correct Answer: Tubular interstitial cells

      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:

      • Medicine
      • Renal
      0
      Seconds

  • Question 13 - Which of the following is an example of a ketone body? ...

    Incorrect

    • Which of the following is an example of a ketone body?

      Your Answer:

      Correct Answer: Acetoacetate

      Explanation:

      Ketone bodies are three water-soluble molecules (acetoacetate, beta-hydroxybutyrate, and their spontaneous breakdown product, acetone) that are produced by the liver from fatty acids during periods of low food intake (fasting), carbohydrate restrictive diets, starvation, prolonged intense exercise, alcoholism or in untreated (or inadequately treated) type 1 diabetes mellitus.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds

  • Question 14 - Where are the cell bodies to the preganglionic neurons located? ...

    Incorrect

    • Where are the cell bodies to the preganglionic neurons located?

      Your Answer:

      Correct Answer: Midbrain

      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. These cranial nerves take origin from the midbrain.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 15 - The isoforms of nitric oxide synthase which are found in the nervous system...

    Incorrect

    • The isoforms of nitric oxide synthase which are found in the nervous system (NOS1) and endothelial cells (NOS3) are activated by agents that increase which of the following intracellular electrolytes?

      Your Answer:

      Correct Answer: Ca

      Explanation:

      Synthesis of nitric oxide is stimulated by activation of the NMDA receptors by certain agents. This leads to opening of the Calcium channels and an influx of calcium into the cell. This will activate the nitric oxide synthase. Nitric oxide is produced on demand.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 16 - 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 17 - During which phase of the cardiac cycle does most of the ventricular filling...

    Incorrect

    • During which phase of the cardiac cycle does most of the ventricular filling occur?

      Your Answer:

      Correct Answer: Ventricular diastole

      Explanation:

      During the phase of ventricular diastole when the heart muscle relaxes and all the valves are open, blood flows easily into the heart. This is the phase of rapid ventricular filling. During isovolumetric contraction and relaxation the volume of blood in the heart does not change. During ventricular ejection blood enters into the aorta and pulmonary vessels.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 18 - 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 19 - When looking at the JVP what does the c wave signify: ...

    Incorrect

    • When looking at the JVP what does the c wave signify:

      Your Answer:

      Correct Answer: Isovolumetric ventricular contraction

      Explanation:

      The C wave signifies a rise in the atrial pressure during isovolumetric contraction due to the tricuspid valve bulging into the atria.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 20 - A 24-year-old women presents following an overdose. Which one of the following would...

    Incorrect

    • A 24-year-old women presents following an overdose. Which one of the following would suggest anticholinergic syndrome?

      Your Answer:

      Correct Answer: Mydriasis occurs

      Explanation:

      Anticholinergic syndrome results from the inhibition of muscarinic cholinergic neurotransmission. Clinical manifestations can be remembered by the mnemonic, red as a beet, dry as a bone, blind as a bat, mad as a hatter, hot as a hare, and full as a flask. The mnemonic refers to the symptoms of flushing, dry skin and mucous membranes, mydriasis (dilated pupil) with loss of accommodation, altered mental status, fever, and urinary retention, respectively.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 21 - A 53 year old female, longstanding case of rheumatoid arthritis comes for a...

    Incorrect

    • A 53 year old female, longstanding case of rheumatoid arthritis comes for a review. Which of the following features are commonly associated with her condition?

      Your Answer:

      Correct Answer: Proximal interphalangeal joint involvement in the hands

      Explanation:

      Rheumatoid arthritis is a polyarthritis that results in symmetrical pain and swelling of the affected joints (also at rest). It particularly affects the metacarpophalangeal joints (MCPJs) and proximal interphalangeal joints (PIPJs), not the distal interphalangeal joints (DIPs). Ulcerative colitis and IBD are associated with seronegative arthritides, not RA. The condition can also cause various extra-articular manifestations such as ocular symptoms, rheumatoid nodules and pulmonary fibrosis. Scleritis, episcleritis and keratoconjunctivitis sicca are more common than uveitis. Early intervention with disease-modifying antirheumatic drugs (DMARDs) plays a decisive role in successful treatment.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 22 - A study is developed to look at the potential of hip protectors to...

    Incorrect

    • A study is developed to look at the potential of hip protectors to reduce femoral neck fractures in elderly nursing home patients. The study included 800 patients randomly selected with an average age of 82 years of age. The data was collected over a two year period and the patients were randomly put in the standard care group or the hip protector group. From the 400 patients assigned to the hip protector group, 10 had a femoral neck fracture over the two year period. From the 400 patients assigned to the standard care group, 20 had a femoral neck fracture over the two year period. What is the correct value regarding the absolute risk reduction?

      Your Answer:

      Correct Answer: 0.025

      Explanation:

      Absolute risk reduction (ARR) – also called risk difference (RD) – is the most useful way of presenting research results to help your decision-making. In this example, the ARR is 8 per cent (20 per cent – 12 per cent = 8 per cent). This means that, if 100 children were treated, 8 would be prevented from developing bad outcomes. Another way of expressing this is the number needed to treat (NNT). If 8 children out of 100 benefit from treatment, the NNT for one child to benefit is about 13 (100 ÷ 8 = 12.5). CER = 20 / 400 = 1 / 20 = 0.05, EER = 10 / 400 = 0.025, ARR =CER – EER = 0.025

    • This question is part of the following fields:

      • Medicine
      • Research Skills
      0
      Seconds

  • Question 23 - Which of the following groups are purines? ...

    Incorrect

    • Which of the following groups are purines?

      Your Answer:

      Correct Answer: Adenine, guanine, hypoxanthine

      Explanation:

      There are many naturally occurring purines. They include the nucleobases, adenine and guanine. Other notable purines are hypoxanthine, xanthine), theobromine, caffeine, uric acid and isoguanine.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds

  • Question 24 - Which of the following drugs is NOT bacteriostatic? ...

    Incorrect

    • Which of the following drugs is NOT bacteriostatic?

      Your Answer:

      Correct Answer: Penicillin

      Explanation:

      Bactericidal antibiotics kill bacteria directly whereas bacteriostatic antibiotics slow their growth or reproduction. Tetracycline is a bacteriostatic antibiotic. Erythromycin which is a macrolide is mainly a bacteriostatic antibiotic but can show bactericidal action depending on the dose. Sulphonamides are mainly bacteriostatic. Penicillin inhibits cell wall synthesis therefore it is considered as bactericidal. Chloramphenicol is primarily a bacteriostatic antibiotic which inhibits protein synthesis and can exhibit bactericidal action in high concentrations.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      0
      Seconds

  • Question 25 - The SA and AV nodes are usually supplied by which artery? ...

    Incorrect

    • The SA and AV nodes are usually supplied by which artery?

      Your Answer:

      Correct Answer: Right coronary artery

      Explanation:

      The right coronary artery supplies the right atrium, right ventricle, SA and AV nodes.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 26 - Most of the venous blood returns to the heart through the: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Coronary sinus and anterior cardiac veins

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 27 - A 56 year old woman taking procainamide develops drug induced erythematosus. Which of...

    Incorrect

    • A 56 year old woman taking procainamide develops drug induced erythematosus. Which of the following features is the most characteristic of this condition?

      Your Answer:

      Correct Answer: It may occur with chlorpromazine

      Explanation:

      Drug induced lupus is usually positive for antinuclear and antihistone antibodies, typically without renal or neurologic involvement. However, pulmonary involvement is common. Drugs that can induce lupus include isoniazid, hydralazine, procainamide, chlorpromazine, and other anticonvulsants.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      0
      Seconds

  • Question 28 - 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 29 - What catalyses the conversion of adenosine to inosine? ...

    Incorrect

    • What catalyses the conversion of adenosine to inosine?

      Your Answer:

      Correct Answer: Adenosine deaminase

      Explanation:

      Adenosine deaminase (ADA) is an enzyme involved in purine metabolism. It is needed for the breakdown of adenosine from food and for the turnover of nucleic acids in tissues. ADA irreversibly deaminates adenosine, converting it to the related nucleoside inosine by the substitution of the amino group for a keto group.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds

  • Question 30 - A 85 year old male with a history of Alzheimer's dementia was brought...

    Incorrect

    • A 85 year old male with a history of Alzheimer's dementia was brought into Casualty by family members, who stated that he had episodes of aggression. Which of the following drugs is most suitable as the pharmacological management for this presentation?

      Your Answer:

      Correct Answer: Risperidone

      Explanation:

      Regarding the pharmacological management, Risperidone is the most suitable drug from the given answers as it is recommended for the treatment of aggression associated with moderate to severe Alzheimer’s disease. Quetiapine and Benzodiazepine are not recommended.

    • This question is part of the following fields:

      • Geriatrics
      • Medicine
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (1/1) 100%
Medicine (2/4) 50%
Pharmacology (0/2) 0%
Gastrointestinal (1/1) 100%
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