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Question 1
Incorrect
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Which hormone results in the production of pancreatic juice rich in enzymes but low in volume?
Your Answer: Pancreatic polypeptide
Correct Answer: Cholecystokinin
Explanation:Cholecystokinin (CCK) mediates digestion in the small intestine by inhibiting gastric emptying and decreasing gastric acid secretion. It stimulates the acinar cells of the pancreas to release a juice rich in pancreatic digestive enzymes, hence the old name pancreozymin.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 2
Incorrect
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Which statement is correct about the clinical state of methemoglobinemia?
Your Answer: It is due to carbon monoxide reacting with haemoglobin.
Correct Answer: May arise due to a hereditary deficiency of NADH.
Explanation:Methaemoglobin is a form of haemoglobin that contains ferric [Fe3+] iron and has a decreased ability to bind oxygen. Spontaneously formed methaemoglobin is normally reduced by protective enzyme systems, e.g., NADH methaemoglobin reductase, hence a deficiency of NADH may result in increased levels of methaemoglobin
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This question is part of the following fields:
- Haematology
- Medicine
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Question 3
Correct
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Which of the following substances is involved in the respiratory burst by the neutrophil?
Your Answer: NADPh oxidase
Explanation:The respiratory burst is a rapid release of reactive oxygen species (ROS) from neutrophils and other phagocytes. This process is crucial for the destruction of pathogens. The key components and enzymes involved in the respiratory burst include:
- NADPH oxidase: This enzyme complex plays a central role in the respiratory burst by converting oxygen (O2) into superoxide anion (O2•-), a reactive oxygen species. This is the initial step in the production of various ROS.
- Superoxide dismutase (SOD): This enzyme converts superoxide anion (O2•-) into hydrogen peroxide (H2O2). While SOD is involved in the pathway, the respiratory burst is initiated by NADPH oxidase.
- Myeloperoxidase (MPO): This enzyme uses hydrogen peroxide (H2O2) to produce hypochlorous acid (HOCl) from chloride ions (Cl-), which is a potent antimicrobial agent. Myeloperoxidase also produces other reactive species using halide ions.
- Catalase: This enzyme degrades hydrogen peroxide (H2O2) into water (H2O) and oxygen (O2). While catalase helps to protect the cell from oxidative damage by breaking down H2O2, it is not involved in the generation of ROS during the respiratory burst.
- Adenylate cyclase: This enzyme is involved in the production of cyclic AMP (cAMP) from ATP and is not directly related to the respiratory burst.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 4
Correct
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The process where by DNA fragments are separated by size and charge is called:
Your Answer: Gel electrophoresis
Explanation:Fragments of DNA of varying length can be separated on the basis of their charge and their size by a process called gel electrophoresis. Because DNA contains negatively charged phosphate groups, it will migrate in an electric field toward the positive electrode. Shorter chains migrate more rapidly through the pores of the gel, and thus separation depends on length. DNA bands in the gel can be visualized by various techniques including staining with dyes and autoradiography.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 5
Correct
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Concerning protein digestion:
Your Answer: Most protein digestion occurs in the duodenum
Explanation:Human pepsinogens can be divided into two immunochemically distinct groups: Pepsinogen I (PG I) and Pepsinogen II (PGII). PG I is secreted mainly by chief cells in the fundic mucosa whereas PGII is secreted by the pyloric glands and the proximal duodenal mucosa. Maximal acid secretion correlates with PG I. Most protein digestion occurs in the duodenum/jejunum. Pepsin functions best in an acidic environment and specifically at a pH of 1.5 to 3.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 6
Correct
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A 72-year-old with varicose veins complains of swollen, red, itchy legs. Which is the most likely diagnosis?
Your Answer: Varicose eczema
Explanation:Varicose eczema is a common problem, particularly in elderly patients due to stasis or blood pooling from insufficient venous return; the alternative name of varicose eczema comes from a common cause of this being varicose veins. It is often mistaken for cellulitis, but cellulitis is rarely bilateral and is painful rather than itchy.
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 7
Correct
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Choose the most correct missing words to complete the statement: A portion of circulating growth hormone is bound to the ____ receptor and activates the ____ pathway that mediates its effect.
Your Answer: Growth hormone receptor (extracellular domain), jak 2stat
Explanation:The growth hormone receptor is a transmembrane protein involved in the STATs, MAPK and PI3-kinase/Akt pathways. The JAK-STAT signalling pathway is activated by different ligands, such as growth hormone, interferon and interleukin. This pathway is involved in the expression of genes associated with oncogenesis, immunity, proliferation, differentiation and apoptosis. Errors in these pathways can produce leukaemia’s and other myeloproliferative disorders.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 8
Incorrect
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Gastrin activates all of the following cells except:
Your Answer: Chief cells
Correct Answer: Mucus neck cells
Explanation:The G cell is a type of cell in the stomach and duodenum that secretes gastrin. It works in conjunction with gastric chief cells and parietal cells. G cells are found deep within the pyloric glands of the stomach antrum, and occasionally in the pancreas and duodenum. Gastrin-releasing peptide, as well as the presence of amino acids in the stomach, stimulates the release of gastrin from the G cells. Gastrin stimulates enterochromaffin-like cells to secrete histamine. Gastrin also targets parietal cells by increasing the amount of histamine and the direct stimulation by gastrin, causing the parietal cells to increase HCl secretion in the stomach.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 9
Correct
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The interstitium of the kidney is most hypertonic in the:
Your Answer: Papillary tip of the medulla
Explanation:The medullary interstitium is the tissue surrounding the loop of Henle in the renal medulla. It functions in renal water reabsorption by building up a high hypertonicity, which draws water out of the thin descending limb of the loop of Henle and the collecting duct system. This hypertonicity, in turn, is created by an efflux of urea from the inner medullary collecting duct.
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This question is part of the following fields:
- Medicine
- Renal
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Question 10
Incorrect
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The ENaC Transporter occurs in which part of the renal tubule?
Your Answer: Basolateral surface of proximal tubule
Correct Answer: Collecting duct
Explanation:The epithelial sodium channel (ENaC) is a membrane-bound ion channel that is selectively permeable to Na+ ions. It is involved primarily in the reabsorption of sodium ions at the collecting ducts of the kidney’s nephrons.
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This question is part of the following fields:
- Medicine
- Renal
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Question 11
Incorrect
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Regarding the cardiac muscle striations as viewed under the microscope, which areas are dark?
Your Answer: H band and m line
Correct Answer: A band and z line
Explanation:Dark bands: a, h. Dark line: z. Clear band: i, m
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 12
Correct
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Compact/cortical bone makes up
Your Answer: The outer layer of most bones and accounts for 80% of bone in the body
Explanation:Cortical, lamellar, or compact bone, is more dense than spongy bone and it forms the rigid, outer layer of bones, also called cortex. It consists of packed osteons, with a central osteonic canal surrounded by concentric rings. Spaces called lacunae are filled with osteocytes, and channels called canaliculi go from the lacunae to the osteonic canal. The strength of cortical bone allows it to support the body and protect organs. It also stores different elements, such as calcium.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 13
Incorrect
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Which of the following is a physiological effect of pregnancy on the kidney?
Your Answer: Increased creatinine
Correct Answer: Decreased creatinine
Explanation:A pregnant woman may experience an increase in kidney and ureter size. The glomerular filtration rate (GFR) commonly increases by 50%, returning to normal around 20 weeks postpartum. Plasma sodium does not change because this is offset by the increase in GFR. There is decreased blood urea nitrogen (BUN) and creatinine and potentially glucosuria (due to saturated tubular reabsorption).
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This question is part of the following fields:
- Medicine
- Renal
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Question 14
Incorrect
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The heart rate can be accelerated by:
Your Answer: Stimulation of pain fibers in the trigeminal nerve
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 15
Incorrect
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Which of the following happens when anterograde neurons are stimulated?
Your Answer: Receptive relaxation of the git musculature
Correct Answer: Smooth muscle relaxation ahead of the stimulus
Explanation:Nitric oxide is thought to act as an anterograde neurotransmitter. Nitric oxide causes relaxation of smooth muscles ahead of the stimulus. Clinically it is used as a potent vasodilator.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 16
Incorrect
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What is the function of migrating motor complex
Your Answer: Stimulate peristalsis following ingestion of food
Correct Answer: Clears the gut of luminal contents in preparation of the next meal
Explanation:Migrating motor complexes (MMC) are waves of electrical activity that sweep through the intestines in a regular cycle during fasting. These motor complexes trigger peristaltic waves, which facilitate transportation of indigestible substances such as bone, fiber, and foreign bodies from the stomach, through the small intestine, past the ileocecal sphincter, and into the colon. The MMC occurs every 90–120 minutes during the interdigestive phase (between meals), and is responsible for the rumbling experienced when hungry. It also serves to transport bacteria from the small intestine to the large intestine, and to inhibit the migration of colonic bacteria into the terminal ileum.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 17
Correct
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Question 18
Incorrect
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Which one of the following is a cause of a soft second heart sound?
Your Answer: Aortic regurgitation
Correct Answer: Aortic stenosis
Explanation:Second heart sound (S2) forms the dub of lub-dub and is composed of components A2 and P2. •   loud: hypertension•   soft: AS•   fixed split: physiological split (normally occurs during inhalation), right bundle branch block, pulmonary stenosis, and atrial septal defect.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 19
Correct
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Regarding transportation of iron in the body, the process in which iron is transported from the enterocyte into the blood occurs using which transporter protein:
Your Answer: Ferroportin
Explanation:Divalent metal transporter 1 (DMT1) transport several divalent metals including iron across the enterocyte’s cell membrane into the cell. The cell can then release it into the body via the only known iron exporter in mammals, ferroportin.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 20
Correct
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Pacemaker cells in the SA node and the AV node are connected by?
Your Answer: Gap junctions
Explanation:Gap junctions allows for rapid propagation of the action potential from one cell to the other. The cells of the heart are connected by gap junctions.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 21
Correct
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Water hammer pulse is found in:
Your Answer: Aortic insufficiency
Explanation:Watson’s water hammer pulse is the medical sign which describes a pulse that is bounding and forceful, rapidly increasing and subsequently collapsing, as if it were the sound of a water hammer that was causing the pulse. A water hammer was a Victorian toy in which a tube was half filled with fluid, the remainder being a vacuum. The child would invert and reinvert the tube; each time the impact of the fluid at each end would sound like a hammer blow. This is associated with increased stroke volume of the left ventricle and decrease in the peripheral resistance leading to the widened pulse pressure of aortic regurgitation.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 22
Incorrect
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In the clotting mechanism, activation of factor IX can occur through the direct actions of:
Your Answer: Factor XIa & XIIa
Correct Answer: Factor VIIa & XIa
Explanation:Factor IX is processed to remove the signal peptide, glycosylated and then cleaved by factor XIa (of the contact pathway) or factor VIIa (of the tissue factor pathway). When activated into factor IXa, in the presence of Ca2+, membrane phospholipids, and a Factor VIII cofactor, it hydrolyses one arginine-isoleucine bond in factor X to form factor Xa. Factor IX is inhibited by antithrombin.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 23
Correct
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The main breakdown of fatty acids (by B-oxidation) occurs in which part of the cell?
Your 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 24
Correct
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A 35-year-old female has been recently diagnosed with hypertension. She's sexually active and is not using any birth control other than barrier method. Which among the following antihypertensives is contraindicated in this patient?
Your Answer: Lisinopril
Explanation:Among the following hypertensives, lisinopril (an ACE inhibitor) is contraindicated in patients who are planning for pregnancy.Per the NICE guidelines, when treating the woman in question, she should be treated as if she were pregnant given the absence of effective contraception. ACE inhibitors such as lisinopril are known teratogens and most be avoided.Drugs contraindicated in pregnancy:AntibioticsTetracyclinesAminoglycosidesSulphonamides and trimethoprimQuinolonesOther drugs:ACE inhibitors, angiotensin II receptor antagonistsStatinsWarfarinSulfonylureasRetinoids (including topical)Cytotoxic agentsThe majority of antiepileptics including valproate, carbamazepine, and phenytoin are known to be potentially harmful.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 25
Correct
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Question 26
Correct
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The hippocampus is involved in the memory of:
Your Answer: Facts
Explanation:The hippocampus plays an important role in forming new memories about experienced events. Some researchers say that hippocampus plays a major role in declarative memory for example memory of facts.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 27
Correct
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A deficiency in Cyanocobalamin leads to which clinical deficiency syndrome?
Your Answer: Pernicious anaemia
Explanation:The main syndrome of vitamin B12 deficiency is pernicious anaemia. It is characterized by a triad of symptoms:Megaloblastic anaemiaGastrointestinal symptoms &Neurological symptoms
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 28
Incorrect
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Regarding the innervation of cerebral blood vessels, which of the following triggers a vasoconstrictor effect?
Your Answer: Substance P
Correct Answer: Neuropeptide-Y
Explanation:Substance P is a potent vasodilator, VIP or vasoactive intestinal peptide has vasodilator properties in the intestines. PHM 27 is a potent calcitonin receptor agonist; endogenous analogue of human VIP. CGRP or Calcitonin Gene-Related Peptide is a vasodilator which is found to play an important role in migraines. Neuropeptide Y is a strong vasoconstrictor.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 29
Correct
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Which of the following describes a principal action of insulin?
Your Answer: Inhibition of phosphorylase and gluconeogenic enzymes
Explanation:Insulin stimulates glycolysis and lipogenesis, but inhibits gluconeogenesis. Insulin promotes the dephosphorylating of glycogen phosphorylase, therefore suppressing glycogenolysis. Insulin also inhibits FOX3, FOX4, and FOX6 and their ability to promote hepatic gluconeogenesis.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 30
Incorrect
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Where is the normal upper border of the liver situated?
Your Answer: 3rd rib midclavicular line on right
Correct Answer: 6th rib midclavicular line on right
Explanation:Assessment of liver margins is important clinically to determine the size of the liver and is done via percussion during the physical examination. The liver typically extends from the fifth intercostal space or 6th rib to the right costal margin in the midclavicular line and the 10th rib on anterior axillary line.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY
