00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Mins)
  • Question 1 - All of the following statement about the microcirculation are correct except: ...

    Incorrect

    • All of the following statement about the microcirculation are correct except:

      Your Answer: Arteriole vasoconstriction tends to cause an increase in absorption of fluid.

      Correct Answer: Over the capillary bed, there is a net absorption of fluid.

      Explanation:

      The hydrostatic pressure along the length of the capillary is usually greater than plasma oncotic pressure. As a result, there is a small net filtration of fluid from the capillary into the interstitial space. The regulation of blood flow into the microcirculation is via the vasoconstriction of small arterioles, which is activated by the sympathetic nervous system through numerous nerve endings in their walls. Unlike proteins, most ions and small molecules diffuse easily across capillary walls and thus the crystalloid osmotic pressure they exert is roughly the same on either side of the capillary wall. Because the plasma colloid osmotic pressure is higher than interstitial colloid osmotic, fluid is drawn intravascularly. A reduction of hydrostatic capillary pressure and transient increase in absorption of fluid is a result of arteriolar constriction.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      792.8
      Seconds
  • Question 2 - Which of the following statements is not true regarding ion channels? ...

    Correct

    • Which of the following statements is not true regarding ion channels?

      Your Answer: Ion channels provide a charged, hydrophobic pore through which ions can diffuse across the lipid bilayer.

      Explanation:

      Ion channels are pore-forming protein complexes that facilitate the flow of ions across the hydrophobic core of cell membranes. They are present in the plasma membrane and membranes of intracellular organelles of all cells, and perform essential physiological functions. They provide a charged, hydrophilic pore through which ions can move across the lipid bilayer. They are selective for particular ions and their pores may be opened or closed. Because of this ability to open and close, ion channels allow the cell to have the ability to closely control the movement of ions across the membrane. Gating refers to the transition between an open and closed ion channel state, and is brought about by a conformationational change in the protein subunits that open or close the ion-permeable pore.
      Ion channels can be:
      1. voltage-gated these are regulated according to the potential difference across the cell membrane or
      2. ligand-gated – these are regulated by the presence of a specific signal molecule.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      258.9
      Seconds
  • Question 3 - A 20-year-old with type I diabetes mellitus has an episode of hypoglycaemia following...

    Correct

    • A 20-year-old with type I diabetes mellitus has an episode of hypoglycaemia following inadvertent administration of too much insulin.

      The mechanism by which insulin causes glucose to be transported into cells is?

      Your Answer: Facilitated diffusion

      Explanation:

      The only mechanism by which insulin facilitates uptake of glucose into cells is by facilitated diffusion through a family of hexose transporters.

      The major transporter used for glucose uptake is GLUT4. GLUT4 is made available in the plasma membrane by the action of insulin.
      When insulin concentrations are low, GLUT4 transporters are present in cytoplasmic vesicles, where they are cannot be used for transporting glucose.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      171.5
      Seconds
  • Question 4 - A 32 year old woman presents with episodes of flushing, headaches and palpitations....

    Correct

    • A 32 year old woman presents with episodes of flushing, headaches and palpitations. On examination her blood pressure is significantly elevated. Which of the following is the most likely diagnosis:

      Your Answer: Pheochromocytoma

      Explanation:

      Phaeochromocytomas are catecholamine-secreting tumours which occur in about 0.1% of patients with hypertension. In about 90% of cases they arise from the adrenal medulla. The remaining 10%, which arise from extra-adrenal chromaffin tissue, are termed paragangliomas. Common presenting symptoms include one or more of headache, sweating, pallor and palpitations. Less commonly, patients describe anxiety, panic attacks and pyrexia. Hypertension, whether sustained or episodic, is present in at least 90% of patients. Left untreated phaeochromocytoma can occasionally lead to hypertensive crisis, encephalopathy, hyperglycaemia, pulmonary oedema, cardiac arrhythmias, or even death.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      532.1
      Seconds
  • Question 5 - Pancreatic ductal alkaline fluid secretion is mainly stimulated by which of the following hormones:...

    Correct

    • Pancreatic ductal alkaline fluid secretion is mainly stimulated by which of the following hormones:

      Your Answer: Secretin

      Explanation:

      Pancreatic exocrine secretion is controlled by:
      Parasympathetic stimulation which enhances secretion of both the enzyme and aqueous components
      Sympathetic stimulation which inhibits pancreatic secretion
      Secretin which stimulates secretion of the alkaline-rich fluid from ductal cells
      Cholecystokinin which stimulates secretion of the enzyme-rich fluid from acinar cellsSomatostatin which inhibits secretion from both acinar and ductal cells
      Gastrin which stimulates pancreatic acinar cells to secrete digestive enzymes

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      444.7
      Seconds
  • Question 6 - Which of the following conditions require IV Lidocaine administration? ...

    Correct

    • Which of the following conditions require IV Lidocaine administration?

      Your Answer: Refractory ventricular fibrillation in cardiac arrest

      Explanation:

      IV Lidocaine is indicated in Ventricular Arrhythmias or Pulseless Ventricular Tachycardia (after defibrillation, attempted CPR, and vasopressor administration)

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      288.1
      Seconds
  • Question 7 - Regarding the human cell, which of the following cell organelles is responsible for...

    Correct

    • Regarding the human cell, which of the following cell organelles is responsible for the production of ATP:

      Your Answer: Mitochondria

      Explanation:

      Mitochondria are membrane-bound organelles that are responsible for the production of the cell’s supply of chemical energy. This is achieved by using molecular oxygen to utilise sugar and small fatty acid molecules to generate adenosine triphosphate (ATP). This process is known as oxidative phosphorylation and requires an enzyme called ATP synthase. ATP acts as an energy-carrying molecule and releases the energy in situations when it is required to fuel cellular processes. Mitochondria are also involved in other cellular processes, including Ca2+homeostasis and signalling. Mitochondria contain a small amount of maternal DNA.
      Mitochondria have two phospholipid bilayers, an outer membrane and an inner membrane. The inner membrane is intricately folded inwards to form numerous layers called cristae. The cristae contain specialised membrane proteins that enable the mitochondria to synthesise ATP. Between the two membranes lies the intermembrane space, which stores large proteins that are required for cellular respiration. Within the inner membrane is the perimitochondrial space, which contains a jelly-like matrix. This matrix contains a large quantity of ATP synthase.
      Mitochondrial disease, or mitochondrial disorder, refers to a group of disorders that affect the mitochondria. When the number or function of mitochondria in the cell are disrupted, less energy is produced and organ dysfunction results.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      13.3
      Seconds
  • Question 8 - Pressure across the wall of a flexible tube (the transmural pressure) increases wall...

    Incorrect

    • Pressure across the wall of a flexible tube (the transmural pressure) increases wall tension and extends it.

      Which law best describes transmural pressure?

      Your Answer: Poiseuille’s law

      Correct Answer: Laplace’s law

      Explanation:

      The transmural pressure (pressure across the wall of a flexible tube) can be described by Laplace’s law which states that:
      Transmural pressure = (Tw) / r
      Where:
      T = Wall tension
      w = Wall thickness
      r = The radius
      A small bubble with the same wall tension as a larger bubble will contain higher pressure and will collapse into the larger bubble if the two meet and join.

      Fick’s law describes the rate of diffusion in a solution

      Poiseuille’s law is used to calculate volume of flow rate in laminar flow

      Darcy’s law describes the flow of a fluid through a porous medium.

      Starling’s law describes cardiac haemodynamics as it relates to myocyte contractility and stretch.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      590.9
      Seconds
  • Question 9 - What is the main mechanism of action of dobutamine as an inotropic sympathomimetic:...

    Correct

    • What is the main mechanism of action of dobutamine as an inotropic sympathomimetic:

      Your Answer: Beta1-receptor agonist

      Explanation:

      Dobutamine directly stimulates the beta1-adrenergic receptors in the heart and increases contractility and cardiac output with little effect on the rate. In addition action on beta2-receptors causes vasodilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      68
      Seconds
  • Question 10 - Cardiac myocytes contract by excitation-contraction coupling, very much like skeletal myocytes. On the...

    Incorrect

    • Cardiac myocytes contract by excitation-contraction coupling, very much like skeletal myocytes. On the other hand, calcium-induced calcium release (CICR) is a mechanism that is unique to Cardiac myocytes. The influx of calcium ions (Ca 2+) into the cell causes a 'calcium spark,' which causes more ions to be released into the cytoplasm.

      In CICR, which membrane protein in the sarcoplasmic reticulum is involved?

      Your Answer: Sarcoplasmic and endoplasmic reticulum ATP-ase

      Correct Answer: Ryanodine receptor

      Explanation:

      Cardiac myocytes contract by excitation-contraction coupling, just like skeletal myocytes. Heart myocytes, on the other hand, utilise a calcium-induced calcium release mechanism that is unique to cardiac muscle (CICR). The influx of calcium ions (Ca2+) into the cell causes a ‘calcium spark,’ which causes more ions to be released into the cytoplasm.

      An influx of sodium ions induces an initial depolarisation, much as it does in skeletal muscle; however, in cardiac muscle, the inflow of Ca2+ sustains the depolarisation, allowing it to remain longer. Due to potassium ion (K+) inflow, CICR causes a plateau phase in which the cells remain depolarized for a short time before repolarizing. Skeletal muscle, on the other hand, repolarizes almost instantly.

      The release of Ca2+ from the sarcoplasmic reticulum is required for calcium-induced calcium release (CICR). This is mostly accomplished by ryanodine receptors (RyR) on the sarcoplasmic reticulum membrane; Ca2+ binds to RyR, causing additional Ca2+ to be released.

    • This question is part of the following fields:

      • Basic Cellular Physiology
      • Physiology
      131.7
      Seconds
  • Question 11 - Low levels of which of the following arterial blood gas parameters stimulate the...

    Correct

    • Low levels of which of the following arterial blood gas parameters stimulate the peripheral chemoreceptors?

      Your Answer: Arterial pO 2

      Explanation:

      Chemoreceptors are activated when the chemical composition of their immediate surroundings changes.

      Peripheral chemoreceptors, together with central chemoreceptors, regulate respiratory functions. They detect changes in arterial blood oxygen levels. Decreased arterial Po2 (partial pressure of oxygen) reflexly stimulates peripheral chemoreceptors.

      When peripheral chemoreceptors detect changes in arterial blood oxygen, they will trigger cardiorespiratory changes such as an increase in breathing and blood pressure. These reflexes are important for maintaining homeostasis during hypoxemia.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      294.8
      Seconds
  • Question 12 - From which of the following cell types are platelets derived? ...

    Correct

    • From which of the following cell types are platelets derived?

      Your Answer: Megakaryocytes

      Explanation:

      Synthesis of platelets occurs in the bone marrow by fragmentation of megakaryocytes cytoplasm, derived from the common myeloid progenitor cell. The average time for differentiation of the human stem cell to the production of platelets is about 10 days. The major regulator of platelet formation is thrombopoietin and 95% of this is produced by the liver. Normal platelet count is 150 – 450 x 109/L and the normal lifespan of a platelet is about 10 days. Usually about one-third of the marrow output of platelets may be trapped at any one time in the normal spleen.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      25.4
      Seconds
  • Question 13 - The ECG of a patient presenting with a history of intermittent palpitations has...

    Correct

    • The ECG of a patient presenting with a history of intermittent palpitations has a prolonged QT interval.

      Which of these can cause prolongation of the QT interval on the ECG?

      Your Answer: Hypomagnesaemia

      Explanation:

      The causes of a prolonged QT interval include:

      Hypomagnesaemia
      Hypothermia
      Hypokalaemia
      Hypocalcaemia
      Hypothyroidism
      Jervell-Lange-Nielsen syndrome (autosomal dominant)
      Romano Ward syndrome (autosomal recessive)
      Ischaemic heart disease
      Mitral valve prolapse
      Rheumatic carditis
      Erythromycin
      Amiodarone
      Quinidine
      Tricyclic antidepressants
      Terfenadine
      Methadone
      Procainamide
      Sotalol

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      34.5
      Seconds
  • Question 14 - Which of the following is NOT a typical clinical feature of hypoglycaemia: ...

    Correct

    • Which of the following is NOT a typical clinical feature of hypoglycaemia:

      Your Answer: Polyuria

      Explanation:

      Clinical features of hypoglycaemia:
      Autonomic  symptoms: Sweating, feeling hot, anxiety/agitation, palpitations, shaking, paraesthesia, dizziness
      Neuroglycopaenic symptoms: Weakness, blurred vision, difficulty speaking, poor concentration, poor coordination, drowsiness, confusion, seizures, coma
      Other symptoms: Nausea, fatigue, hunger

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      21.7
      Seconds
  • Question 15 - A patient is referred for lung function tests on account of a history...

    Correct

    • A patient is referred for lung function tests on account of a history of breathlessness and cough.

      Which statement about lung volumes is correct?

      Your Answer: The tidal volume is the volume of air drawn in and out of the lungs during normal breathing

      Explanation:

      The tidal volume(TV) is the amount of air that moves in and out of the lungs with each respiratory cycle. In a healthy male, the usual volume is 0.5 L (,7 ml/kg body mass).

      The vital capacity(VC) is the maximum amount of air that can be exhaled following maximal inspiration. The usual volume in a healthy male is 4.5 L.

      The residual volume(RV) is the amount of air remaining in the lungs after maximum expiration. The usual volume in a healthy male is 1.0 L.

      The inspiratory reserve volume(IRV) is the maximum amount of air that can be breathed in forcibly after normal inspiration. The usual volume in a healthy male is 3.0 L.

      The expiratory reserve volume(ERV) is the volume of air that can be breathed out forcibly after normal expiration. The usual volume in a healthy male is 1.0 L.

      Total lung capacity(TLC) is the volume of air the lungs can accommodate. TLC = RV+VC. The usual volume in a healthy male is 5.5 L.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      93.4
      Seconds
  • Question 16 - The resting membrane potential of a neurone is usually about: ...

    Correct

    • The resting membrane potential of a neurone is usually about:

      Your Answer: -70 mV

      Explanation:

      In most neurones the resting potential has a value of approximately -70 mV. The threshold potential is generally around -55 mV. Initial depolarisation occurs as a result of a Na+influx through ligand-gated Na+channels. Action potential is an all or nothing response; because the size of the action potential is constant, the intensity of the stimulus is coded by the frequency of firing of a neuron. Repolarisation occurs primarily due to K+efflux.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      125.4
      Seconds
  • Question 17 - Which of the following statements is correct regarding the lymphatic system? ...

    Correct

    • Which of the following statements is correct regarding the lymphatic system?

      Your Answer: Lymphatic vessels contain both smooth muscle and unidirectional valves.

      Explanation:

      Fluid filtration out of the capillaries is usually slightly greater than fluid absorption into the capillaries. About 8 L of fluid per day is filtered by the microcirculation and returns to the circulation by the lymphatic system. Lymphatic capillaries drain into collecting lymphatics, then into larger lymphatic vessels. Both of these containing smooth muscle and unidirectional valves. From this point, lymph is propelled by smooth muscle constriction and vessel compression by body movements into afferent lymphatics. It then goes to the lymph nodes where phagocytes remove bacteria and foreign materials. It is here that most fluid is reabsorbed by capillaries, and the remainder returns to the subclavian veins via efferent lymphatics and the thoracic duct. The lymphatic system has a major role to play in the body’s immune defence and also has a very important role in the absorption and transportation of fats.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      90.7
      Seconds
  • Question 18 - Regarding carbon dioxide transport in the blood, which of the following statements is...

    Incorrect

    • Regarding carbon dioxide transport in the blood, which of the following statements is CORRECT:

      Your Answer: Carbon dioxide is formed from the dissociation of bicarbonate ions.

      Correct Answer: Deoxygenated haemoglobin acts as a buffer for H+ ions.

      Explanation:

      CO2generated in the tissues and water combine to form carbonic acid which readily dissociates to form HCO3-and H+. The first part of this reaction is very slow in plasma, but is accelerated dramatically by the enzyme carbonic anhydrase present in red blood cells. Bicarbonate is therefore formed preferentially in red cells, from which it freely diffuses down its concentration gradient into plasma where it is transported to the lungs. The red cell membrane is impermeable to H+ions which remain in the cell. To maintain electroneutrality, Cl-ions diffuse into the cell to replace HCO3-, an effect known as the chloride shift. Deoxygenated haemoglobin acts as a buffer for H+, allowing the reaction to continue.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      96.6
      Seconds
  • Question 19 - Oedema can occur as a result of any of the following WITH THE...

    Incorrect

    • Oedema can occur as a result of any of the following WITH THE EXCEPTION OF:

      Your Answer: Increased venous pressure

      Correct Answer: Increased interstitial hydrostatic pressure

      Explanation:

      Oedema is defined as a palpable swelling produced by the expansion of the interstitial fluid volume. A variety of clinical conditions are associated with the development of oedema, including heart failure, cirrhosis, and nephrotic syndrome. The development of oedema requires an alteration in capillary dynamics in a direction that favours an increase in net filtration and also inadequate removal of the additional filtered fluid by lymphatic drainage. Oedema may form in response to an elevation in capillary hydraulic pressure (which increases the delta hydraulic pressure) or increased capillary permeability, or it can be due to disruption of the endothelial glycocalyx, decreased interstitial compliance, a lower plasma oncotic pressure (which reduces the delta oncotic pressure), or a combination of these changes. Oedema can also be induced by lymphatic obstruction since the fluid that is normally filtered is not returned to the systemic circulation.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      189.9
      Seconds
  • Question 20 - The only statement that is correct regarding diffusion is which of the following?...

    Incorrect

    • The only statement that is correct regarding diffusion is which of the following?

      Your Answer: The rate of diffusion across a membrane is described by Darcy's law.

      Correct Answer: The permeability of a membrane is related to the membrane thickness and composition.

      Explanation:

      Passive diffusion is a process that describes the movement down a concentration gradient. This process accounts for movement across small distances like within the cytosol or across membranes. Factors that affect the diffusion of a substance across a membrane are the permeability (p) of the membrane, a difference in concentration across the membrane and the membrane area over which diffusion occurs. The membrane thickness and composition, and the diffusion coefficient of the substance also affects the permeability. Fick’s law describes the rate of diffusion of a substance within a solution, which can be modified to describe the rate of diffusion across a membrane.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      251.5
      Seconds
  • Question 21 - Which of the following causes increased aldosterone secretion: ...

    Incorrect

    • Which of the following causes increased aldosterone secretion:

      Your Answer: Hypokalaemia

      Correct Answer: Decreased blood volume

      Explanation:

      Decreased blood volume stimulates the secretion of renin (because of decreased renal perfusion pressure) and initiates the renin-angiotensin-aldosterone cascade. Angiotensin-converting enzyme (ACE) inhibitors block the cascade by decreasing the production of angiotensin. Hyperosmolarity stimulates antidiuretic hormone (ADH) [not aldosterone] secretion. Hyperkalaemia, not hypokalaemia, directly stimulates aldosterone secretion by the adrenal cortex. ANP inhibits renin secretion, thereby inhibiting the production of angiotensin and aldosterone.

    • This question is part of the following fields:

      • Physiology
      • Renal
      99.3
      Seconds
  • Question 22 - Which of the following is a physiological function that is mediated by a...

    Incorrect

    • Which of the following is a physiological function that is mediated by a hormone released by the posterior pituitary:

      Your Answer: Decrease in calcium levels

      Correct Answer: Water retention

      Explanation:

      Antidiuretic hormone (ADH), released by the posterior pituitary, acts on the kidneys to increase water permeability in the distal nephron allowing greater water reabsorption and concentration of urine. Prolactin, from the anterior pituitary, is responsible for milk production. The thyroid hormones, from the thyroid gland, are responsible for an increase in basal metabolic rate (stimulated by TSH from the anterior pituitary). FSH/LH, from the anterior pituitary, are responsible for maturation of egg and sperm. Calcitonin, from the thyroid gland, is responsible for decreasing calcium levels.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      30.8
      Seconds
  • Question 23 - A 17-year-old male patient diagnosed with cystic fibrosis is experiencing shortness of breath,...

    Correct

    • A 17-year-old male patient diagnosed with cystic fibrosis is experiencing shortness of breath, coughing, and flu-like symptoms. His X-ray results shows atelectasis, or collapsed lung, specifically in his lower right lung. All of the following statements are true regarding collapsed lungs, except for which one.

      Your Answer: Atelectasis is an example of a perfusion defect

      Explanation:

      Atelectasis is a complete or partial collapse of the lung. It occurs when the alveoli deflate or are filled with alveolar fluid. It is considered a ventilation defect of the alveoli due to cystic fibrosis. It is not a perfusion defect. A perfusion defect will produce pathological dead space in which the lung alveoli are ventilated adequately but are not perfused, and there is no gas exchange. While with atelectasis, the alveoli remain perfused. However, there is impaired oxygen delivery and intrapulmonary shunting of blood will be present in the collapsed area. Since there is no exchange of gas at the capillary-alveolar interface of the collapsed segments, the pulmonary capillary blood will have similar PO2 and PCO2.

    • This question is part of the following fields:

      • Physiology
      • Respiratory Physiology
      318.3
      Seconds
  • Question 24 - Which of the following is NOT an adverse effect associated with warfarin therapy:...

    Correct

    • Which of the following is NOT an adverse effect associated with warfarin therapy:

      Your Answer: Neutropenia

      Explanation:

      Adverse effects of warfarin:
      The most common adverse effect of warfarin is bleeding

      Other common adverse effects of warfarin include nausea, vomiting, diarrhoea, jaundice, hepatic dysfunction, pancreatitis, pyrexia, alopecia, purpura, and rash

      Skin necrosis is a rare but serious adverse effect of warfarin; treatment with warfarin should be stopped if warfarin related skin necrosis is suspected

      Calciphylaxis is a rare, but a very serious condition that causes vascular calcification and cutaneous necrosis

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      217.9
      Seconds
  • Question 25 - Intrinsic factor is secreted by which of the following cell types in the...

    Incorrect

    • Intrinsic factor is secreted by which of the following cell types in the stomach:

      Your Answer: Chief cells

      Correct Answer: Parietal cells

      Explanation:

      Intrinsic factor is essential for the absorption of the small amounts of vitamin B12 normally present in the diet from the terminal ileum. The parietal cells of the stomach produce intrinsic factor, and following a gastrectomy, the absorption of vitamin B12 will be markedly reduced, and a deficiency state will exist.

    • This question is part of the following fields:

      • Gastrointestinal
      • Physiology
      146.7
      Seconds
  • Question 26 - Which of the following factors does NOT decrease glucagon secretion: ...

    Correct

    • Which of the following factors does NOT decrease glucagon secretion:

      Your Answer: Catecholamines

      Explanation:

      Factors that increase glucagon secretion:
      ↓ Blood glucose
      ↑ Amino acids
      Cholecystokinin
      Catecholamines
      Acetylcholine

      Factors that decrease glucagon secretion:
      ↑ Blood glucose
      Insulin
      Somatostatin
      Fatty acids, ketoacids

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      129
      Seconds
  • Question 27 - A 68-year-old patient shows Low calcium levels and is on dialysis for chronic...

    Correct

    • A 68-year-old patient shows Low calcium levels and is on dialysis for chronic kidney disease.

      What percentage of total serum calcium is in the form of free or ionised Ca 2+?

      Your Answer: 50%

      Explanation:

      Approximately half of total serum calcium is in the free or ionised Ca2+ state, 40% is attached to plasma proteins (mostly albumin), and the remaining 10% is in complexes with organic ions like citrate and phosphate. The ionized form is the only one that works.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      118.7
      Seconds
  • Question 28 - The syndrome of inappropriate antidiuresis due to excessive antidiuretic hormone (ADH) secretion is...

    Correct

    • The syndrome of inappropriate antidiuresis due to excessive antidiuretic hormone (ADH) secretion is diagnosed in a male patient with a history of recurrent hyponatraemia.

      Which of the following produces ADH?

      Your Answer: Hypothalamus

      Explanation:

      Antidiuretic hormone (ADH), commonly known as vasopressin, is a peptide hormone that controls how much water the body retains.

      It is produced in the magnocellular and parvocellular neurosecretory cells of the paraventricular nucleus and supraoptic nucleus in the hypothalamus from a prohormone precursor. It is subsequently carried to the posterior pituitary via axons and stored in vesicles.

      The secretion of ADH from the posterior pituitary is regulated by numerous mechanisms:
      Increased plasma osmolality: Osmoreceptors in the hypothalamus detect an increase in osmolality and trigger ADH release.

      Stretch receptors in the atrial walls and big veins detect a decrease in atrial pressure as a result of this (cardiopulmonary baroreceptors). ADH release is generally inhibited by atrial receptor firing, but when the atrial receptors are stretched, the firing reduces and ADH release is promoted.
      Hypotension causes baroreceptor firing to diminish, resulting in increased sympathetic activity and ADH release.
      An increase in angiotensin II stimulates angiotensin II receptors in the hypothalamus, causing ADH production to increase.

      The main sites of action for ADH are:
      The kidney is made up of two parts. ADH’s main job is to keep the extracellular fluid volume under control. It increases permeability to water by acting on the renal collecting ducts via V2 Receptors (via a camp-dependent mechanism). This leads to a decrease in urine production, an increase in blood volume, and an increase in arterial pressure as a result.

      Vascular system: Vasoconstriction is a secondary function of ADH. ADH causes vasoconstriction via binding to V1 Receptors on vascular smooth muscle (via the IP3 signal transduction pathway). An increase in arterial pressure occurs as a result of this.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      81.4
      Seconds
  • Question 29 - A patient in a high-dependency unit complains of severe and painful muscle cramps....

    Incorrect

    • A patient in a high-dependency unit complains of severe and painful muscle cramps. His total corrected plasma calcium level is 1.90 mmol/L.

      What is the most likely underlying cause?

      Your Answer: Hyperthyroidism

      Correct Answer: Rhabdomyolysis

      Explanation:

      Hypocalcaemia occurs when there is abnormally low level of serum calcium ( >2.2 mmol/l) after correction for the serum albumin concentration.

      Rhabdomyolysis causes hyperphosphatemia, and this leads to a reduction in ionised calcium levels.

      Patients with rhabdomyolysis are commonly cared for in a high dependency care setting.

      Addison’s disease, hyperthyroidism, thiazide diuretics and lithium all cause hypercalcaemia.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      346.2
      Seconds
  • Question 30 - A patient presents to ED with heartburn for which they already take regular...

    Incorrect

    • A patient presents to ED with heartburn for which they already take regular antacids. Which of the following drugs can be affected if taken with antacids:

      Your Answer: Dabigatran

      Correct Answer: Digoxin

      Explanation:

      Antacids should preferably not be taken at the same time as other drugs since they may affect absorption. When antacids are taken with acidic drugs (e.g. digoxin, phenytoin, chlorpromazine, isoniazid) they cause the absorption of the acidic drugs to be decreased, which causes low blood concentrations of the drugs, which ultimately results in reduced effects of the drugs. Antacids taken with drugs such as pseudoephedrine and levodopa increase absorption of the drugs and can cause toxicity/adverse events due to increased blood levels of the drugs. Antacids that contain magnesium trisilicate and magnesium hydroxide when taken with some other medications (such as tetracycline) will bind to the drugs, and reduce their absorption and effects.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      60.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (4/6) 67%
Physiology (16/26) 62%
Basic Cellular (4/5) 80%
Endocrine Physiology (2/3) 67%
Endocrine (3/4) 75%
Gastrointestinal (1/3) 33%
Pharmacology (3/4) 75%
Basic Cellular Physiology (0/2) 0%
Respiratory Physiology (3/3) 100%
Cardiovascular Physiology (1/1) 100%
Respiratory (0/1) 0%
Renal (0/1) 0%
Renal Physiology (1/1) 100%
Passmed