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Question 1
Incorrect
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Which one of the following diuretics is associated with metabolic acidosis?
Your Answer: Thiazide
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 2
Incorrect
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The most resistant area in the brain to hypoxia is:
Your Answer:
Correct Answer: Brain stem
Explanation:The structures in the brainstem are more resistant to hypoxia than the cerebral cortex and the rest of the brain structures.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 3
Incorrect
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Somatostatin is responsible for?
Your Answer:
Correct Answer: Decreased gastrin release
Explanation:Somatostatin is an inhibitory hormone secreted from the D cells of the Pancreatic Islets. It causes the inhibition of gastrin (decreasing stomach acid production), CCK (decreasing gallbladder motility), gastrin inhibitory peptide and secretin. Gastrin production is also inhibited by secretin, GIP, VIP, glucagon and calcitonin.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 4
Incorrect
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The proportion of individuals within a population affected by disease at a specific time point, based on positive testing for serum antibodies is known as:
Your Answer:
Correct Answer: Sero-Prevalence
Explanation:In immunology, seroconversion is the time period during which a specific antibody develops and becomes detectable in the blood. After seroconversion has occurred, the disease can be detected in blood tests for the antibody. Sero-prevalence includes individuals who are antibody positive for a specific infection at a specific point in time.
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 5
Incorrect
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Question 6
Incorrect
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Which of the following stimulates glucagon release?
Your Answer:
Correct Answer: Exercise
Explanation:Studies have shown a small increase in glucagon levels during stress tests and exercise. This occurs in response to the reduction of blood glucose levels during physical activity; epinephrine levels are also a stimulus for the release of glucagon during exercise, since it suppresses insulin, which accounts for its stimulatory effects on glucagon. The use of stored fats for energy during exercise also stimulates the release of glucagon.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 7
Incorrect
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What is the function of cytotoxic T cells?
Your Answer:
Correct Answer: Kill by inserting perforins and by initiating apoptosis
Explanation:Cytotoxic T cells, once activated, approach the infected cell, insert perforins and release granzymes inducing apoptosis.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 8
Incorrect
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The structure of haemoglobin A in adults includes
Your Answer:
Correct Answer: Haem, globin polypeptide chains α and β
Explanation:Haemoglobin A (HbA), also known as adult haemoglobin or α2β2, is the most common human haemoglobin tetramer, comprising over 97% of the total red blood cell haemoglobin. It consists of two alpha chains and two beta chains.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 9
Incorrect
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Which of the following skin conditions is not associated with diabetes mellitus?
Your Answer:
Correct Answer: Sweet's syndrome
Explanation:Diabetic dermadromes constitute a group of cutaneous conditions commonly seen in people with diabetes with longstanding disease. Conditions included in this group are:- Acral dry gangrene- Carotenosis- Diabetic dermopathy- Diabetic bulla- Diabetic cheiroarthropathy- Malum perforans- Necrobiosis lipoidica- Limited joint mobility- Scleroderma- Waxy skin is observed in roughly 50%. Sweet’s syndrome is also known as acute febrile neutrophilic dermatosis has a strong association with acute myeloid leukaemia. It is not associated with diabetes mellitus.
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 10
Incorrect
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Which of the following derivatives of proopiomelanocortin is an opioid peptide?
Your Answer:
Correct Answer: ß-endorphin
Explanation:ß-endorphin is an endogenous opioid neuropeptide which is mainly synthesized and stored in the anterior pituitary gland, derived from the precursor proopiomelanocortin (POMC). Some studies have shown that immune system cells are also capable of synthesizing ß-endorphin. β-endorphin is thought to exert a tonic inhibitory influence upon GNRH secretion and to be an important regulator of reproductive function.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 11
Incorrect
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What are the major motor proteins that interact with microtubules?
Your Answer:
Correct Answer: Kinesin and dynein
Explanation:The major motor proteins that interact with microtubules are kinesin, which usually moves toward the (+) end of the microtubule, and dynein, which moves toward the (−) end.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 12
Incorrect
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The tectum as part of the Midbrain contains which structure important in visual reflexes.
Your Answer:
Correct Answer: Superior colliculus
Explanation:The tectum is a part of the midbrain, specifically, the dorsal part of the midbrain. The tectum consists of the superior and inferior colliculi. The superior colliculus is involved in preliminary visual processing and control of eye movement.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 13
Incorrect
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The right border of the heart corresponds to which line on the surface of the chest?
Your Answer:
Correct Answer: Line drawn from the 3rd right costal cartilage to the 6th right costal cartilage
Explanation:The right border corresponds to a line drawn from the 3rd right costal cartilage to the 6th right costal cartilage; this border is slightly convex to the right.
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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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A 30-year-old female presented with upper abdominal pain. She was diagnosed with an unknown coagulopathy and has a previous history of stroke. She has been on warfarin therapy for the past 4 months. Her international normalised ratio (INR) was stabilised between 2.5 and 3.0. Noticing abnormal coagulation results, her surgeon has requested a medical consult.Her blood investigations revealed:White cell count: 13 × 109/lHaemoglobin (Hb): 11 g/dlActivated partial thromboplastin time (APTT): NormalPlatelets: 140 × 109/lINR: 6.0Pancreatic enzymes and liver function tests were normal.Other investigations:An ultrasound of the abdomen was normal.An upper GI endoscopy revealed mild gastritis. What is the most appropriate step to be taken regarding warfarin therapy?
Your Answer:
Correct Answer: Stop warfarin and observe
Explanation:The most appropriate treatment in this patient would be to stop warfarin therapy and keep the patient under observation.The drugs that lead to enhanced potency of warfarin include: disulfiram, trimethoprim-sulphamethoxazole, metronidazole, phenylbutazone, aspirin, heparin, and clofibrate. Liver disease, thrombocytopenia, hyperthyroidism also increase the oral anticoagulant potency.If the patient has minor bleeding and the international normalized ratio (INR) is >6.0, warfarin should be stopped; the INR should be rechecked daily and in addition to the stoppage of warfarin, vitamin K 2.5 mg oral or 0.5 mg intravenously should also be administered.In a patient with INR of 2.0 or 3.0, it takes two or three times longer for that individual’s blood to clot than someone who is not taking any anticoagulants. Most patients on warfarin have an INR goal of 2 to 3.If there is major bleeding then prothrombin complex concentrates 50 u/kg or fresh-frozen plasma 15 ml/kg may be considered.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 15
Incorrect
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Question 16
Incorrect
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Impulse conduction through the AV node is slow and depends on the action potential produced by which of the following.
Your Answer:
Correct Answer: Calcium flux
Explanation:The action potentials in the SA and AV nodes are largely due to Ca2+, with no contribution by Na+ influx.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 17
Incorrect
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Tumour necrosis factor is a cytokine. What is its major function?
Your Answer:
Correct Answer: Promotion of inflammation
Explanation:Tumour necrosis factor (TNF) is a cytokine that has a wide variety of functions. It can cause cytolysis of certain tumour cell lines; it is involved in the induction of cachexia; it is a potent pyrogen, causing fever by direct action or by stimulation of interleukin-1 secretion; it can stimulate cell proliferation and induce cell differentiation under certain conditions.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 18
Incorrect
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The process by which RNA fragments are separated by gel electrophoresis and transferred onto a membrane sheet is called:
Your Answer:
Correct Answer: Northern blotting
Explanation:Blots of the gel can be made from using nitrocellulose paper. Northern blots are produced when a fragment of radioactive DNA hybridize with RNA on a nitrocellulose blot of a gel and southern blots are produced when DNA hybrize with DNA on a nitrocellulose blot of the gel.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 19
Incorrect
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During quiet breathing the diaphragm’s role accounts for what percent of respiration?
Your Answer:
Correct Answer: 75%
Explanation:The contraction of the diaphragm accounts for approximately 75% of the air movement during normal breathing.
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This question is part of the following fields:
- Medicine
- Respiratory
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Question 20
Incorrect
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Initial depolarization of cardiac muscle is due to influx of:
Your Answer:
Correct Answer: Na+
Explanation:Initial depolarization of the cardiac muscle results from opening of the sodium voltage gated channels. This results in the influx of sodium and an increase in the membrane potential towards threshold. Potassium efflux results in repolarization.
The cardiac action potential has 5 phases:
- Phase 0—depolarization because of the opening of fast sodium channels. Potassium flux also decreases.
- Phase 1—partial repolarization because of a rapid decrease in sodium ion passage as fast sodium channels close.
- Phase 2—plateau phase in which the movement of calcium ions out of the cell, maintains depolarization.
- Phase 3—repolarization, sodium, and calcium channels all close and membrane potential returns to baseline.
- Phase 4—resting membrane potential (−90 mV), resulting from the activity of the Na+/K+ ATPase pump which creates a negative intracellular potential because of the exchange of three sodium ions for only two potassium ions.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 21
Incorrect
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Neutrophils are key components of the innate immune system. They contain numerous primary and secondary granules involved in killing and digesting microorganisms. With regard to defensins, they are:
Your Answer:
Correct Answer: Naturally occurring cysteine-rich antibacterial and antifungal polypeptides
Explanation:Cationic antimicrobial peptides, including defensins, cathelicidins, and thrombocidins, provide important initial defences against invading microbes. These peptides bind the bacterial membrane and form pores, killing the bacterium by hypo-osmotic lysis.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 22
Incorrect
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Question 23
Incorrect
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An 18 year old girl presents with short history of marked, right hip pain and an associated limp. She has a history of acute lymphoblastic leukaemia for which she completed treatment for last six months.
Your Answer:
Correct Answer: Avascular necrosis of the femoral head
Explanation:Avascular necrosis (AVN) of the femoral head is a pathological process that results from disruption of the blood supply to the bone and occurs most commonly in the femoral epiphysis. Patients usually present with pain and limited joint motion. The mechanism involves impaired circulation to a specific area that ultimately becomes necrotic. AVN is most frequently associated with high doses of oral and intravenous corticosteroids and prolonged duration of therapy. Cancer patients receiving chemotherapy are usually also treated with corticosteroids.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 24
Incorrect
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The heart rate can be accelerated by:
Your Answer:
Correct Answer: Exercise and thyroid hormones
Explanation:The firing of the SA node will increase due to exercises and as the thyroid hormone has a chronotropic effect on the heart, it too will result in an increase in the heart rate via stimulation of the adrenergic receptors of the heart. As during exercise the sympathetic nervous system is activated, it will directly have an positive chronotropic effect on the heart.
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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 collection of genes that are termed the major histocompatibility complex (MHC) are found on:
Your Answer:
Correct Answer: Short arm of chromosome 6
Explanation:Histocompatibility, or tissue compatibility, is the property of having the same, or sufficiently similar, alleles of a set of genes called human leukocyte antigens (HLA). HLA is the human form of the major histocompatibility complex (MHC) genes found in all vertebrates. On a population level there is a great number of different alleles at each HLA locus on the short arm of chromosome 6
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This question is part of the following fields:
- Immunology
- Medicine
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Question 26
Incorrect
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Carcinogens found in cigarette smoke can transform proto-oncogenes to oncogenes through:
Your Answer:
Correct Answer: Point mutations in genomic DNA
Explanation:80% of the pancreatic cancers are environmentally influenced by smoking which increases the risk by 50%. Mutation can occur in the KRAS, p16, SMAD4, and TP53 genes among other tumour suppression genes. Smoking can be implicated in transformation of all these genes. Apart from KRAS all the genes are inactivated in pancreatic cancer. As KRAS is the most commonly altered gene, mutation occurs as point mutation. As smoking is the most common aetiology in pancreatic cancer, and KRAS is the most important gene that is altered. Most commonly cigarette smoke causes point mutation.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 27
Incorrect
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During which stage does the mitotic apparatus dissolute?
Your Answer:
Correct Answer: Telophase
Explanation:In telophase the nuclear envelope along with the nucleolus will reappear. The daughter nuclei will enlarge as the chromosome will decondense again. Along with this, cytokinesis will occur. At the end of cytokinesis the daughter centrioles will move from the poles to the intercellular bridge where they will be disassembled and complete the separation of the daughter cells
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This question is part of the following fields:
- Genetics
- Medicine
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Question 28
Incorrect
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Why is tissue plasminogen activator (tPa) a valuable treatment used in myocardial infarction and stroke?
Your Answer:
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 29
Incorrect
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Which of the following is the most common clinical feature of carbon monoxide poisoning?
Your Answer:
Correct Answer: Headache
Explanation:Carbon monoxide (CO) poisoning:It is considered as the great imitator of other diseases as the patients present with a myriad of symptoms. The carbon monoxide diffuses rapidly across the pulmonary capillary membrane binding to the haem molecule with a very high affinity (240 times that of oxygen) forming carboxy-haemoglobin (COHb). Non-smokers have a baseline COHb of ,3% while smokers have a baseline COHb of 10-15%.Clinical features of carbon monoxide toxicity:Headache: 90% of cases (most common clinical feature)Nausea and vomiting: 50%Vertigo: 50%Confusion: 30%Subjective weakness: 20%Severe toxicity: ‘pink’ skin and mucosa, hyperpyrexia, arrhythmias, extrapyramidal features, coma, deathCherry red skin is a sign of severe toxicity and is usually a post-mortem finding.Management• 100% oxygen• Hyperbaric oxygen therapy (HBOT)The use of Hyperbaric oxygen therapy (HBOT) for treatment mild to moderate CO poisoning is not routine.The selection criteria for HBOT in cases of CO poisoning include:• COHb levels > 20-25%• COHb levels > 20% in pregnant patient • Loss of consciousness• Severe metabolic acidosis (pH <7.1)• Evidence of end-organ ischemia (e.g., ECG changes, chest pain, or altered mental status)
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 30
Incorrect
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Which of the following suggests the presence of mitral regurgitation as well as mitral stenosis?
Your Answer:
Correct Answer: Displaced apex beat
Explanation:Mitral stenosis on its own does not lead to left ventricular dilatation and hence a displaced apex beat. Thus a displaced apex beat is suggestive of mixed mitral disease. The other options occur in mitral stenosis.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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