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  • Question 1 - A 78 year old woman presents to the clinic complaining of left sided...

    Correct

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

      Your Answer: Commence prednisolone

      Explanation:

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

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      10.8
      Seconds

  • Question 2 - A 26 year old woman is 32 weeks pregnant. She has a history...

    Incorrect

    • A 26 year old woman is 32 weeks pregnant. She has a history of Sjogren Syndrome. The foetus would be at a risk for which of the following?

      Your Answer: Hydrops fetalis

      Correct Answer: All correct

      Explanation:

      Women with Sjögren syndrome are likely to experience more complications during pregnancy than women without an autoimmune disease as the anti-Ro and anti-La antibodies cross the placenta and lead to various life threatening complications. Studies show a high incidence of poor fetal outcomes for these patients. Congenital heart block, neonatal lupus, congestive cardiac failure, hydrops fetalis can all be caused as a result of Sjogren syndrome.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      19.2
      Seconds

  • Question 3 - Which of the following stimuli increase growth hormone secretion? ...

    Incorrect

    • Which of the following stimuli increase growth hormone secretion?

      Your Answer: Insulin-like growth factor I (IGF-I)

      Correct Answer: Ghrelin

      Explanation:

      Ghrelin is a hormone which serves as an endogenous ligand for the growth hormone secretagogue receptor. It acts on the pituitary and the hypothalamus by affecting the vagus nerve. It acts on the somatotrophs of the anterior pituitary, GHRH-secreting neurons, and on GHIH-secreting neurons in the hypothalamus, causing a time-dependent and pulsatile stimulation over the secretion of growth hormone.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      7.4
      Seconds

  • Question 4 - Cells responsible for completely renewing the epithelium of the intestine are located: ...

    Incorrect

    • Cells responsible for completely renewing the epithelium of the intestine are located:

      Your Answer: At the base of the microvilli

      Correct Answer: At the base of the crypts

      Explanation:

      Epithelial cells are renewed every 4-5 days through a process of renewal and migration. Renewal relies on proliferative cells or stem cells that reside at the crypt base of the intestinal glands. Crypts are epithelial invasions into the underlying connective tissue.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      7.1
      Seconds

  • Question 5 - What percentage of blood to the liver is supplied by hepatic artery? ...

    Incorrect

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

      Your Answer:

      Correct 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
      0
      Seconds

  • Question 6 - Which heart sounds are matched correctly? ...

    Incorrect

    • Which heart sounds are matched correctly?

      Your Answer:

      Correct Answer: All of the above

      Explanation:

      In healthy adults, there are two normal heart sounds often described as a lub and a dub (or dup), that occur in sequence with each heartbeat. These are the first heart sound (S1) and second heart sound (S2), produced by the closing of the atrioventricular valves and semilunar valves, respectively. In addition to these normal sounds, a variety of other sounds may be present including heart murmurs, adventitious sounds, and gallop rhythms S3 and S4. S3 is thought to be caused by the oscillation of blood back and forth between the walls of the ventricles initiated by blood rushing in from the atria. The reason the third heart sound does not occur until the middle third of diastole is probably that during the early part of diastole, the ventricles are not filled sufficiently to create enough tension for reverberation. S4 when audible in an adult is called a presystolic gallop or atrial gallop. This gallop is produced by the sound of blood being forced into a stiff or hypertrophic ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 7 - The following is true of the sinus node: ...

    Incorrect

    • The following is true of the sinus node:

      Your Answer:

      Correct Answer: It generates impulses automatically & at a quicker rate than other cardiac cells

      Explanation:

      The SA node exhibits automaticity. It generates the impulses to which the heart beats. It fires at a faster speed than the rest of the nervous components of the heart i.e. the AV nodes, purkinje fibers. This is the reason when the SA node fails the heart beats to the rhythm of the AV node.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 8 - Which of the following acute phase reactants increases the most dramatically in the...

    Incorrect

    • Which of the following acute phase reactants increases the most dramatically in the first hour following injury?

      Your Answer:

      Correct Answer: C-reactive protein

      Explanation:

      Measurement of acute-phase proteins, especially C-reactive protein, is a useful marker of inflammation. It correlates with the erythrocyte sedimentation rate (ESR), however not always directly. This is due to the ESR being largely dependent on elevation of fibrinogen, an acute phase reactant with a half-life of approximately one week. This protein will therefore remain higher for longer despite removal of the inflammatory stimuli. In contrast, C-reactive protein (with a half-life of 6-8 hours) rises rapidly and can quickly return to within the normal range if treatment is employed.

    • This question is part of the following fields:

      • Immunology
      • Medicine
      0
      Seconds

  • Question 9 - Which of the following is true with AV nodal delay? ...

    Incorrect

    • Which of the following is true with AV nodal delay?

      Your Answer:

      Correct Answer: Shortened by sympathetic stimulation

      Explanation:

      AV nodal delay Is about 0.1s before the action potential spreads to the ventricles. It is shortened by stimulation of the sympathetic nervous system and lengthened by stimulation of the parasympathetic system.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 10 - Which of the following has the shortest duration: ...

    Incorrect

    • Which of the following has the shortest duration:

      Your Answer:

      Correct Answer: Atrial systole

      Explanation:

      Atrial systole: 0.1s

      Atrial diastole: around 0.4s

      Ventricular diastole: 0.4-0.53s

      Ventricular systole: 0.27s

      PR interval: 0.12-0.2 s

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 11 - The axons of which neurons serve as the only output from the cerebellar...

    Incorrect

    • The axons of which neurons serve as the only output from the cerebellar cortex?

      Your Answer:

      Correct Answer: Purkinje

      Explanation:

      The cerebellar cortex consist of 3 layers. The molecular layer, the granule cell layer and the Purkinje cell layer in the middle. The Purkinje cells project into the deep cerebellar nuclei. They are the only output cells of the cerebellar cortex.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 12 - The transport of the di- and tri-peptides into enterocytes is by: ...

    Incorrect

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

      Your Answer:

      Correct Answer: H+ dependent peptide transporter 1

      Explanation:

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

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 13 - The main breakdown of fatty acids (by B-oxidation) occurs in which part of...

    Incorrect

    • The main breakdown of fatty acids (by B-oxidation) occurs in which part of the cell?

      Your Answer:

      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.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      0
      Seconds

  • Question 14 - Which of the given adverse effects should be anticipated following the administration of...

    Incorrect

    • Which of the given adverse effects should be anticipated following the administration of an anticholinesterase?

      Your Answer:

      Correct 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

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      0
      Seconds

  • Question 15 - The process by which DNA fragments are separated by gel and transferred onto...

    Incorrect

    • The process by which DNA fragments are separated by gel and transferred onto a membrane sheet is called:

      Your Answer:

      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.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 16 - In Jugular vein pressure the “a” wave represents? ...

    Incorrect

    • In Jugular vein pressure the “a” wave represents?

      Your Answer:

      Correct Answer: Atrial systole

      Explanation:

      The jugular venous pressure (JVP, sometimes referred to as jugular venous pulse) is the indirectly observed pressure over the venous system via visualization of the internal jugular vein. It can be useful in the differentiation of different forms of heart and lung disease. Classically three upward deflections and two downward deflections have been described: The upward deflections are the a (atrial contraction), c (ventricular contraction and resulting bulging of tricuspid into the right atrium during isovolumetric systole) and v = venous filling.The downward deflections of the wave are the x (the atrium relaxes and the tricuspid valve moves downward) and the y descent (filling of ventricle after tricuspid opening).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 17 - Free radicals are best defined by which of the following statements. ...

    Incorrect

    • Free radicals are best defined by which of the following statements.

      Your Answer:

      Correct Answer: Atoms or molecules with unpaired electrons

      Explanation:

      Free radicals form when one of weak bond between electrons is broken and an uneven number of electrons remain. This means the electron is unpaired, making it chemically reactive and attempt to steal an electron from a neighbouring molecule to stabilize itself.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      0
      Seconds

  • Question 18 - von Willebrand factor stabilises which clotting factor? ...

    Incorrect

    • von Willebrand factor stabilises which clotting factor?

      Your Answer:

      Correct Answer: Factor VIII

      Explanation:

      Von Willebrand factor’s primary function is binding to other proteins, in particular factor VIII, and it is important in platelet adhesion to wound sites. It is not an enzyme and, thus, has no catalytic activity. Factor VIII degrades rapidly when not bound to vWF. Factor VIII is released from vWF by the action of thrombin.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      0
      Seconds

  • Question 19 - Where would one normally find venous valves? ...

    Incorrect

    • Where would one normally find venous valves?

      Your Answer:

      Correct Answer: Saphenous vein

      Explanation:

      The intima of the limb veins is folded at intervals to form venous valves that prevent retrograde flow. There are no valves present in the very small veins, the great veins, or the veins in the brain and viscera.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 20 - Dietary starch is mainly: ...

    Incorrect

    • Dietary starch is mainly:

      Your Answer:

      Correct Answer: Amylopectin

      Explanation:

      Dietary starch consists of two types of molecules: the linear and helical amylose and the branched amylopectin. Starch generally contains 20 to 25% amylose and 75 to 80% amylopectin by weight but depends in the plant. Glycogen, the glucose store of animals, is a more branched version of amylopectin.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      0
      Seconds

  • Question 21 - The coronary sinus drains into the: ...

    Incorrect

    • The coronary sinus drains into the:

      Your Answer:

      Correct Answer: Right atrium

      Explanation:

      The coronary sinus drains into the right atrium. 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
      0
      Seconds

  • Question 22 - Concerning the sleep-wake cycle, Melatonin is secreted by which structure in the brain...

    Incorrect

    • Concerning the sleep-wake cycle, Melatonin is secreted by which structure in the brain following which environmental conditions?

      Your Answer:

      Correct Answer: Pineal gland, darkness

      Explanation:

      Melatonin is secreted by the pineal gland located in the midline attached to the posterior roof of the third ventricle in the brain. Melatonin affects circadian rhythm in the body or the sleep wake cycle. The precursor to melatonin is serotonin and the rate limiting enzyme that converts serotonin to melatonin is low during the day time and reaches its peak during the night.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 23 - What is the most abundant cell type in the central nervous system called?...

    Incorrect

    • What is the most abundant cell type in the central nervous system called?

      Your Answer:

      Correct Answer: Astrocyte

      Explanation:

      Astrocytes are the supporting cells of the central nervous system. There are two types; the fibrous type is found in the white matter and the protoplasmic type in the grey matter. They are the most abundant cell type in the CNS.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

  • Question 24 - Under normal conditions (where n represents the number of chromosome pairs), just before...

    Incorrect

    • Under normal conditions (where n represents the number of chromosome pairs), just before mitosis begins, how many chromosomes are contained in the nucleus of each somatic cell:

      Your Answer:

      Correct Answer: 4n

      Explanation:

      In a normal somatic cell there are 2n chromosome but in a replicating cell just before mitosis the chromosomes duplicate but are still joined via the centrosome. Thus there are 4n chromosomes. After completion of mitosis the number goes back to 2n.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      0
      Seconds

  • Question 25 - Select the correct statement regarding the portal vein. ...

    Incorrect

    • Select the correct statement regarding the portal vein.

      Your Answer:

      Correct Answer: It drains most of the gastrointestinal tract and the spleen.

      Explanation:

      The portal vein supplies 75% of total blood flow to the liver and enters the liver centrally via the porta hepatis. Portal venous flow increases after meals. The portal vein receives blood from the intestines via the superior and inferior mesenteric veins, from the stomach via gastric veins and from the spleen and pancreas via the splenic vein.

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      0
      Seconds

  • Question 26 - 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 27 - All of the following are consistent with the indicator dilution method except--- ...

    Incorrect

    • All of the following are consistent with the indicator dilution method except---

      Your Answer:

      Correct Answer: In thermodilution, the indicator used is warm saline

      Explanation:

      In thermodilution, the indicator used is cold saline.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 28 - The interventricular septum is supplied anteriorly by the? ...

    Incorrect

    • The interventricular septum is supplied anteriorly by the?

      Your Answer:

      Correct Answer: Left anterior descending artery

      Explanation:

      The anterior interventricular artery or left anterior descending artery supplies the anterior 2/3rds of the interventricular septum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      0
      Seconds

  • Question 29 - 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 30 - The cerebellum consists of which three cell layers? ...

    Incorrect

    • The cerebellum consists of which three cell layers?

      Your Answer:

      Correct Answer: Granular, purkinje, molecular

      Explanation:

      The cerebellar cortex consist of 3 layers; the molecular layer, the granular cell layer and the Purkinje cell layer in the middle.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Connective Tissue (1/2) 50%
Medicine (1/4) 25%
Endocrinology (0/1) 0%
Gastrointestinal (0/1) 0%
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