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Question 1
Correct
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Where is the carotid sinus located?
Your Answer: After the bifurcation of the carotid artery, on the internal carotid
Explanation:The carotid sinus is a small dilation in the internal carotid artery just above its bifurcation into the external and internal carotid branch. Baroreceptors are present at this dilation.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 2
Incorrect
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Concerning the functional unit of the liver, which segment is most susceptible to hypoxic damage?
Your Answer: Zone 4
Correct Answer: Zone 3
Explanation:From a metabolic perspective, the functional unit is the hepatic acinus (terminal acinus), each of which is centred on the line connecting two portal triads and extends outwards to the two adjacent central veins. The periportal zone I is nearest to the entering vascular supply and receives the most oxygenated blood, making it least sensitive to ischemic injury while making it very susceptible to viral hepatitis. Conversely, the centrilobular zone III has the poorest oxygenation, and will be most affected during a time of ischemia.
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This question is part of the following fields:
- Hepatobiliary
- Physiology
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Question 3
Correct
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Which of the following pathology terms refers to programmed cell death?
Your Answer: Apoptosis
Explanation:Apoptosis is described as programmed cell death. The cell release certain proapoptotic mediators that regulate this cell death.
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This question is part of the following fields:
- Cell Biology
- Physiology
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Question 4
Correct
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Near the transcription site of a gene, the site at which RNA polymerase and its cofactors bind is known as the:
Your Answer: Promotor
Explanation:Transcription will begin when the RNA polymerase II binds to the promotor. The promotor is a sequence of 25 nucleotides found upstream from the start site of transcription. This promotor sequence is known as the TATA box. Transcription factors also bond along with RNA polymerase to this site to form a complex. However some may bind to regulatory elements proximal to the promotor site.
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This question is part of the following fields:
- Genetics
- Physiology
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Question 5
Incorrect
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Pre-oxygenation is done prior to intubation to extend the ‘safe apnoea time’. Which lung volume or capacity is the most important store of oxygen in the body?
Your Answer: Inspiratory reserve volume
Correct Answer: Functional residual capacity
Explanation:The administration of oxygen to a patient before intubation is called pre-oxygenation and it helps extend the ‘safe apnoea time’. The Functional residual capacity (FRC) is the volume of gas that remains in the lungs after normal tidal expiration. It is the most important store of oxygen in the body. The aim of pre-oxygenation is to replace the nitrogen in the FRC with oxygen. Apnoea can be tolerated for longer periods before critical hypoxia develops if the FRC is large. Patients with reduced FRC reach critical hypoxia more rapidly.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 6
Incorrect
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What type of intercellular connection found between cardiac muscle fibers allow for the spread of excitation from one cell to another?
Your Answer: Desmosomes
Correct Answer: Gap junctions
Explanation:The cardiac muscles have gap junctions in-between the cells. They form low resistance passages, which allow ions to diffuse through every muscle fiber rapidly and result in the cardiac muscles functioning as a syncytium, without any protoplasmic bridges involved.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 7
Incorrect
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Which structure forms the major part of the sternocostal surface of the heart?
Your Answer: Left atrium
Correct Answer: Right ventricle
Explanation:The anterior (sternocostal) surface is formed mainly by the right ventricle.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 8
Correct
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Carotid bodies...
Your Answer: Are located at the bifurcation of the carotid arteries bilaterally
Explanation:The carotid body is a small cluster of chemoreceptors and supporting cells located near the fork (bifurcation) of the carotid artery (which runs along both sides of the throat).The carotid body detects changes in the composition of arterial blood flowing through it, mainly the partial pressure of oxygen, but also of carbon dioxide. Furthermore, it is also sensitive to changes in pH and temperature. Carotid bodies trigger an action potential through the afferent fibers of the glossopharyngeal nerve,
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 9
Incorrect
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The coronary arteries supply which part of the heart’s subendocardial region exclusively in diastole?
Your Answer: All chambers of the heart ( all of the above if you want )
Correct Answer: Left ventricle
Explanation:It is only during diastole that the blood flows to the subendocardial portion of the left ventricle, as the heart muscle relaxes and the coronary arteries regain their patency.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 10
Correct
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Question 11
Incorrect
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Which statement is incorrect regarding nociceptor C fibers…
Your Answer: Activity in the fiber activates a slow pain response
Correct Answer: They are thinly myelinated
Explanation:Group C nerve fibers are unmyelinated and have a small diameter, which means they conduct impulses at a low velocity. They carry sensory information and nociception.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 12
Incorrect
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Angina pectoris develops when the flow through the coronary artery becomes:
Your Answer: Glucose deficient
Correct Answer: Oxygen deficient
Explanation:Angina pectoris develops when stenosis ( >70%) of the artery occurs as a result of formation of an atherosclerotic plaque. This leads to a decrease in the O2 carried to the thickened heart muscle by the blood, leading to the characteristic chest pain associated with angina pectoris.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 13
Incorrect
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A 60-year-old man presents with marked breathlessness. He has with a history of ischaemic heart disease. On examination, there is coarse bibasal crackles, marked peripheral oedema and chest X-ray taken is consistent with severe pulmonary oedema. RR is 28 per minute. Which receptor is responsible for detecting pulmonary oedema and the subsequent increase in respiratory rate?
Your Answer: Aortic baroreceptors
Correct Answer: Juxtacapillary receptors
Explanation:Pulmonary oedema causes stimulation of the Juxtacapillary receptors (J receptors) leading to a reflex increase in breathing rate. These receptors are also thought to be involved in the sensation of dyspnoea. The J receptors are sensory cells and are located within the alveolar walls in juxtaposition to the pulmonary capillaries. Aortic baroreceptor are involved in detecting blood pressure Central chemoreceptors detect changes in CO2 and hydrogen ion within the brain Atrial volume receptors regulate plasma volume
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 14
Incorrect
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Calcium is transported over the brush border in the gut, via which transporter / channel?
Your Answer: TRPV 5
Correct Answer: TRPV 6
Explanation:Transient Receptor Potential Vanilloid 6 or TRPV 6 is a calcium channel located in the cell membrane which is present in a variety of organs, including small intestine, oesophagus, stomach, colon, placenta, kidney, and uterus. In the intestine, it is located in the apical brush-border membrane of the enterocyte, regulating the entry of calcium into the cell.
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This question is part of the following fields:
- Endocrinology
- Physiology
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Question 15
Correct
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The formation of superoxide is catalysed by which enzyme?
Your Answer: NADPH oxidase
Explanation:Superoxide is biologically toxic and is deployed by the immune system to kill invading microorganisms. In phagocytes, superoxide is produced in large quantities by the enzyme NADPH oxidase for use in oxygen-dependent killing mechanisms of invading pathogens.
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This question is part of the following fields:
- Cell Biology
- Physiology
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Question 16
Incorrect
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The residual cleft of the intermediate lobe of the pituitary is lined by follicles resembling which human gland?
Your Answer: Pancreatic
Correct Answer: Thyroid
Explanation:The cells located between the two main pituitary lobes form what is known as the intermediate pituitary. This area secretes melanocyte-stimulating hormone and it is only a few cell layers thick. It is rich in follicles filled with colloid, and lined by basophilic cells. This configuration resembles that of another important gland: the thyroid.
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This question is part of the following fields:
- Endocrinology
- Physiology
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Question 17
Incorrect
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A 19-year-old with a longstanding history of asthma presents to the ED with worsening symptoms of cough and wheeze and a peak expiratory flow rate (PEFR) measurement is taken. Which statement concerning PEFR is true?
Your Answer: PEFR increases with increasing airway resistance
Correct Answer: PEFR is dependent upon the patient's height
Explanation:The maximum flow rate generated during a forceful exhalation, after maximal inspiration is the peak expiratory flow rate (PEFR). PEFR is dependent upon initial lung volume. It is, therefore, dependant on patient’s age, sex and height. PEFR is dependent on voluntary effort and muscular strength of the patient. PEFR is decreased with increasing airway resistance, e.g. in asthma, and it correlates well with the forced expiratory volume in one second (FEV1) value measured in spirometry. This correlation decreases in patients with asthma as airflow decreases.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 18
Correct
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Question 19
Incorrect
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Where are the cell bodies of preganglionic neurons located?
Your Answer: Spinothalamic tract
Correct Answer: Lateral column
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.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 20
Incorrect
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Where does the anterior pituitary receive most of its blood supply?
Your Answer: Suprachiasmatic nucleus
Correct Answer: Portal hypophysial vessels
Explanation:The anterior pituitary receives its arterial supply from the superior hypophyseal artery, which is a branch of the internal carotid that forms a capillary around the hypothalamus; thus forming the hypothalamo-hypophysial portal system.
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This question is part of the following fields:
- Endocrinology
- Physiology
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Question 21
Incorrect
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Which mechanism of action does Trimethoprim use?
Your Answer: Inhibit DNA gyrase
Correct Answer: Inhibit Folic Acid metabolism
Explanation:Trimethoprim binds to dihydrofolate reductase and inhibits the reduction of dihydrofolic acid (DHF) to tetrahydrofolic acid (THF). THF is an essential precursor in the thymidine synthesis pathway and interference with this pathway inhibits bacterial DNA synthesis.
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This question is part of the following fields:
- Infectious Diseases
- Physiology
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Question 22
Incorrect
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Which of the following foods do NOT contain high levels of folate?
Your Answer: Yeast
Correct Answer: Green leafy vegetables
Explanation:Folate naturally occurs in a wide variety of foods, including vegetables (particularly dark green leafy vegetables), fruits and fruit juices, nuts, beans, peas, dairy products, poultry and meat, eggs, seafood, grains, and some beers. Avocado, beetroot, spinach, liver, yeast, asparagus, and Brussels sprouts are among the foods with the highest levels of folate
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This question is part of the following fields:
- Haematology
- Physiology
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Question 23
Incorrect
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Which afferent information is carried by the dorsal column?
Your Answer: Pressure
Correct Answer: Proprioception/ discriminative touch
Explanation:The posterior grey column (dorsal column) is responsible for carrying the sensation of proprioception, two-point discrimination, and vibration to the nucleus proprius, situated anterior to the substantia gelatinosa throughout the spinal cord.
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This question is part of the following fields:
- Neurology
- Physiology
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Question 24
Incorrect
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A 27 year old man presents with a regular tachycardia of 190 bpm. He is healthy and has no past medical history. Blood pressure and bloods are all within normal parameters however the ECG confirms a narrow complex tachycardia. The tachycardia persists after giving IV adenosine 3mg and then 6mg. What should be the next step in management of this patient?
Your Answer: IV amiodarone 900mg
Correct Answer: IV 12mg adenosine
Explanation:For narrow complex tachycardias with no compromise then vagal manoeuvres should be trialled first. The Valsalva manoeuvre should be the first vagal manoeuvre tried and works by increasing intra-thoracic pressure and affecting baroreceptors (pressure sensors) within the arch of the aorta. It is carried out by asking the patient to hold his/her breath while trying to exhale forcibly as if straining during a bowel movement. Adenosine, an ultra-short-acting AV nodal blocking agent, is indicated if vagal manoeuvres are not effective. Adenosine may be safely used during pregnancy. After giving 3mg of adenosine with no effect, 6mg should be tried. If this fails then 12mg should be trialled. If adenosine fails then Verapamil or a beta blocker can be used as alternatives. If the patient is hemodynamically unstable or other treatments have not been effective, synchronized electrical cardioversion may be used.
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This question is part of the following fields:
- Cardiovascular
- Physiology
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Question 25
Incorrect
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What causes increased insulin sensitivity?
Your Answer: Adrenal glucocorticoids
Correct Answer: Exercise
Explanation:Physical activity, through its effect on insulin sensitivity, is one of the main modifiable risk factors for type 2 diabetes. It is estimated that by each weekly 500 kcal increment in exercise related energy consumption, the lifetime risk of suffering from type 2 diabetes is reduced by 9%. Up to two hours after exercise, glucose uptake is elevated due to insulin independent mechanisms; however, insulin sensitivity remains increased for at least 16 hours after exercising.
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This question is part of the following fields:
- Endocrinology
- Physiology
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Question 26
Incorrect
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Question 27
Incorrect
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Neutrophils are attracted to an infected area by:
Your Answer: Peroxidases
Correct Answer: Chemokines
Explanation:The major role of chemokines is to act as a chemoattractant to guide the migration of cells like neutrophils to the site of infection.
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This question is part of the following fields:
- Immunology
- Physiology
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Question 28
Incorrect
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What is the role of cyclin and cyklin-dependent kinases in mitosis:
Your Answer: Causes splitting of the centromere
Correct Answer: Phosphorylation of proteins that make up pre-replication complexes
Explanation:There are certain regulators of the cell cycles that mediate progression through the cell cycle. These are cyclins and cyklin-dependent kinases (CDKs). They form a complex that phosphorylates protein involved in the cell cycle.
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This question is part of the following fields:
- Genetics
- Physiology
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Question 29
Incorrect
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Which one of the following is not part of the WHO diagnostic criteria for the metabolic syndrome?
Your Answer: Central obesity
Correct Answer: High LDL
Explanation:The World Health Organization 1999 criteria require the presence of any one of diabetes mellitus, impaired glucose tolerance, impaired fasting glucose or insulin resistance, AND two of the following:Blood pressure: ≥ 140/90 mmHgDyslipidaemia: triglycerides (TG): ≥ 1.695 mmol/L and high-density lipoprotein cholesterol (HDL-C) ≤ 0.9 mmol/L (male), ≤ 1.0 mmol/L (female)Central obesity: waist: hip ratio > 0.90 (male); > 0.85 (female), or body mass index > 30 kg/m2Microalbuminuria: urinary albumin excretion ratio ≥ 20 µg/min or albumin: creatinine ratio ≥ 30 mg/g
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This question is part of the following fields:
- Endocrinology
- Physiology
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Question 30
Incorrect
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In the malaria life cycle , parasites which remain dormant in the liver are known as :
Your Answer: Merozoites
Correct Answer: Hypnozoites
Explanation: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
- Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
