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  • Question 1 - Calculate the stroke volume in an adult male with the following parameters:

    Heart...

    Correct

    • Calculate the stroke volume in an adult male with the following parameters:

      Heart rate 70 beats/min

      Arterial [O2] 0.24 ml O2/min

      Venous [O2] 0.16 ml O2/mi

      Whole body O2 consumption 500 ml/min

      Pulmonary diastolic pressure 15 mmHg

      Pulmonary systolic pressure 25 mmHg

      Wedge pressure 5 mmHg.

      Your Answer: 90 ml

      Explanation:

      Fick’s principle states that, VO2 = (CO × CAO2) – (CO × CVO2) where VO2 = oxygen consumption, CO = cardiac output, CAO2 = oxygen concentration of arterial blood and CVO2 = oxygen concentration of venous blood. Thus, CO = VO2/CAO2– CVO2, CO = 500/0.24–0.16, CO = 500/0.8, CO = 6.25 l/min. Cardiac output is also given by product of stroke volume and heart rate. Thus, stroke volume = cardiac output / heart rate = 6.25/70 × 1000 stroke volume = 90 ml approximately.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      330.5
      Seconds
  • Question 2 - Ventricular filling follows a delay caused by? ...

    Correct

    • Ventricular filling follows a delay caused by?

      Your Answer: AV node

      Explanation:

      The AV node is a conducting tissue found between the atria and the ventricles of the heart. It conducts electrical signal from the atria to the ventricles and acts a delaying mechanism preventing the atria and the ventricles from contracting at the same time. This decremental conduction prevents premature ventricular contraction in cases such as atrial fibrillation. A delay in the AV node is the reason for the PR segment seen on the ECG. In certain types of supraventricular tachycardia, a person could have two AV nodes; this will cause a loop in electrical current and uncontrollably rapid heart beat. When this electricity catches up with itself, it will dissipate and return to a normal heart rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      11.5
      Seconds
  • Question 3 - Which statement is correct regarding secretions from the adrenal glands? ...

    Correct

    • Which statement is correct regarding secretions from the adrenal glands?

      Your Answer: Aldosterone is producd by the zona glomerulosa

      Explanation:

      The secretions of the adrenal glands by zone are:

      Zona glomerulosa – aldosterone

      Zona fasciculata – cortisol and testosterone

      Zona reticularis – oestradiol and progesterone

      Adrenal medulia – adrenaline, noradrenaline and dopamine.

    • This question is part of the following fields:

      • Physiology
      • Renal
      65.9
      Seconds
  • Question 4 - Renal function is an indication of the state of the kidney, measured by glomerular...

    Incorrect

    • Renal function is an indication of the state of the kidney, measured by glomerular filtration rate (GFR). In a healthy person, GFR would be greatly increased by: 

      Your Answer: An increase in mean arterial pressure from 90 mmHg to 140 mmHg

      Correct Answer: Substantial increases in renal blood flow

      Explanation:

      An increase in the rate of renal blood flow (RBF) greatly increases the glomerular filtration rate (GFR). The more plasma available (from increased RBF), the more filtrate is formed. Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal (kidney) glomerular capillaries into the Bowman’s capsule per unit time. Central to the physiologic maintenance of GFR is the differential basal tone of the afferent and efferent arterioles.

    • This question is part of the following fields:

      • Physiology
      • Renal
      34.2
      Seconds
  • Question 5 - Thalamic syndrome will most likely result in: ...

    Correct

    • Thalamic syndrome will most likely result in:

      Your Answer: Hyperaesthesia

      Explanation:

      Signs and symptoms of thalamic syndrome include contralateral hemi anaesthesia, burning or aching sensation in one half of a body (hyperaesthesia), often accompanied by mood swings.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      7
      Seconds
  • Question 6 - In which situation is a stretch reflex such as knee jerk likely to...

    Correct

    • In which situation is a stretch reflex such as knee jerk likely to be exaggerated?

      Your Answer: In upper motor neuron lesion

      Explanation:

      A stretch reflex is a monosynaptic reflex that causes muscle contraction in response to stretching within that muscle. The sensory apparatus in a muscle that are sensitive to stretch are the muscle spindles. The patellar (knee jerk) reflex is an example. In upper motor neuron lesions, the stretch reflexes tend to be brisk due to loss of inhibitory signals on gamma neurons through the lateral reticulospinal tract.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      3.6
      Seconds
  • Question 7 - A 60 year old patient with a history of carcinoma of the head...

    Correct

    • A 60 year old patient with a history of carcinoma of the head of the pancreas, and obstructive jaundice presents with a spontaneous nose bleed and easy bruising. What is the most likely reason for this?

      Your Answer: Vitamin-K-dependent clotting factors deficiency

      Explanation:

      Vitamin K is a fat soluble vitamin requiring fat metabolism to function properly to allow for its absorption. People with obstructive jaundice develop vitamin k deficiency as fat digestion is impaired. Vit K causes carboxylation of glutamate residue and hence regulates blood coagulation including: prothrombin (factor II), factors VII, IX, X, protein C, protein S and protein Z.

    • This question is part of the following fields:

      • General
      • Physiology
      9.6
      Seconds
  • Question 8 - A 30-year-old man is brought to the emergency department suffering from extreme dehydration,...

    Correct

    • A 30-year-old man is brought to the emergency department suffering from extreme dehydration, and subsequent hypotension and tachycardia. Which part of the kidney will compensate for this loss?

      Your Answer: Collecting ducts

      Explanation:

      The collecting duct system of the kidney consists of a series of tubules and ducts that physically connect nephrons to a minor calyx or directly to the renal pelvis. The collecting duct system is the last component of the kidney to influence the body’s electrolyte and fluid balance. In humans, the system accounts for 4–5% of the kidney’s reabsorption of sodium and 5% of the kidney’s reabsorption of water. At times of extreme dehydration, over 24% of the filtered water may be reabsorbed in the collecting duct system.

    • This question is part of the following fields:

      • Physiology
      • Renal
      17.3
      Seconds
  • Question 9 - Which part of the nephron would have to be damaged to stop the...

    Correct

    • Which part of the nephron would have to be damaged to stop the reabsorption of the majority of salt and water?

      Your Answer: Proximal tubule

      Explanation:

      The proximal tubule is the portion of the duct system of the nephron of the kidney which leads from Bowman’s capsule to the loop of Henle. It is conventionally divided into the proximal convoluted tubule (PCT) and the proximal straight tubule (PST). The proximal tubule reabsorbs the majority (about two-thirds) of filtered salt and water. This is done in an essentially iso-osmotic manner. Both the luminal salt concentration and the luminal osmolality remain constant (and equal to plasma values) along the entire length of the proximal tubule. Water and salt are reabsorbed proportionally because the water is dependent on and coupled with the active reabsorption of Na+. The water permeability of the proximal tubule is high and therefore a significant transepithelial osmotic gradient is not possible.

    • This question is part of the following fields:

      • Physiology
      • Renal
      8.1
      Seconds
  • Question 10 - Increased resistance to flow of blood in cerebral vessels is most likely seen...

    Incorrect

    • Increased resistance to flow of blood in cerebral vessels is most likely seen in:

      Your Answer: Inhalation of a gas mixture enriched with CO2

      Correct Answer: Elevation in systemic arterial pressure from 100 to 130 mmHg

      Explanation:

      Constant cerebral blood flow is maintained by autoregulation in the brain, which causes an increase in local vascular resistance to offset an increase in blood pressure. There will be an increase in cerebral blood flow (and decrease in resistance to cerebral blood flow) with a decrease in arterial oxygen or an increase in arterial CO2. Similarly, a decrease in viscosity will also increase the blood flow. Due to increased brain metabolism and activity during a seizure, there will also be an increase in the cerebral blood flow.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      14.3
      Seconds
  • Question 11 - Gastric acid secretion is stimulated by which of the following? ...

    Correct

    • Gastric acid secretion is stimulated by which of the following?

      Your Answer: Gastrin

      Explanation:

      Gastric acid secretion is stimulated by three factors:

      – Acetylcholine, from parasympathetic neurones of the vagus nerve that innervate parietal cells directly

      – Gastrin, produced by pyloric G-cells

      – Histamine, produced by mast cells.

      Gastric acid is inhibited by three factors:

      – Somatostatin

      – Secretin

      – Cholecystokinin

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      3.3
      Seconds
  • Question 12 - A lesion involving the lateral portion of the dorsal columns at the level...

    Incorrect

    • A lesion involving the lateral portion of the dorsal columns at the level of the nape of the neck will most likely affect:

      Your Answer:

      Correct Answer: Vibratory sensations from the ipsilateral arm

      Explanation:

      At the level mentioned in the question, the lateral portion of dorsal columns comprises of the fasciculus cuneatus. Axons carrying the sensations of touch, vibration and proprioception from the ipsilateral arm enter the spinal cord and ascend in the fasciculus cuneatus, synapsing in the nucleus cuneatus of the caudal medulla. Secondary neurons from this nucleus give rise to internal arcuate fibres, which decussate and ascend to the thalamus as the medial lemniscus. Tertiary neurons from there project to the ipsilateral somatosensory cortex. Thus, any damage to the fasciculus cuneatus will result in a deficit in tactile, proprioceptive and vibratory sensations in the ipsilateral arm, and not the contralateral arm.

      Fine motor control of the fingers is mainly carried by the ipsilateral lateral corticospinal tract in the lateral funiculus of the cord. Motor control of the contralateral foot is carried by the ipsilateral corticospinal tract in the lateral funiculus of the cord. Lack of sweating of the face could be produced by interruption of sympathetic innervation. Proprioception from the ipsilateral leg is carried by the fasciculus gracilis in the medial part of the dorsal columns.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 13 - In a hypertensive patient with secondary hyperaldosteronism, aldosterone is released mainly in response...

    Incorrect

    • In a hypertensive patient with secondary hyperaldosteronism, aldosterone is released mainly in response to:

      Your Answer:

      Correct Answer: Angiotensin II

      Explanation:

      Secondary hyperaldosteronism in hypertension is either due to primary renin overproduction by the kidneys or renin overproduction secondary to decreased renal blood flow. The main stimulus for aldosterone release are adrenocorticotrophic hormone (ACTH), angiotensin II and high plasma K+ levels. Low plasma Na+ might also stimulate the adrenal cortex. Fluid overload will reduce aldosterone secretion. Atrial natriuretic peptide is secreted under conditions of expanded extracellular volume and will not lead to aldosterone secretion.

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      0
      Seconds
  • Question 14 - What is the role of factor VII in coagulation? ...

    Incorrect

    • What is the role of factor VII in coagulation?

      Your Answer:

      Correct Answer: Initiates the process of coagulation in conjunction with tissue factor

      Explanation:

      The main role of factor VII is to initiate the process of coagulation along with tissue factor (TF). TF is found in the blood vessels and is not normally exposed to the bloodstream. When a vessel is injured tissue factor is exposed to blood and circulating factor VII. Factor VII is converted to VIIa by TF.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 15 - A 40 year old man suffered severe trauma following a MVA. His BP...

    Incorrect

    • A 40 year old man suffered severe trauma following a MVA. His BP is 72/30 mmhg, heart rate of 142 beats/mins and very feeble pulse. He was transfused 3 units of blood and his BP returned to 100/70 and his heart rate slowed to 90 beats/min. What decreased after transfusion?

      Your Answer:

      Correct Answer: Total peripheral resistance

      Explanation:

      The patient is in hypovolemic shock, he is transfused with blood, this fluid resuscitation will result in a decreased sympathetic discharge and adequate ventricular filling which will result in the decreases TPR with an increased CO and cardiac filling pressures

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 16 - A 78-year-old diabetic man undergoes renal function tests. Which of the following substances...

    Incorrect

    • A 78-year-old diabetic man undergoes renal function tests. Which of the following substances will be the most accurate for measuring glomerular filtration rate (GFR)?

      Your Answer:

      Correct Answer: Inulin

      Explanation:

      Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal glomerular capillaries into the Bowman’s capsule per unit time. Clinically, this is often measured to determine renal function. Inulin was originally used as it is not reabsorbed by the kidney after glomerular filtration, therefore its rate of excretion is directly proportional to the rate of filtration of water and solutes across the glomerular filter. However, in clinical practice, creatinine clearance is used to measure GFR. Creatinine is an endogenous molecule, synthesised in the body, that is freely filtered by the glomerulus (but also secreted by the renal tubules in very small amounts). Creatinine clearance exceeds GFR due to creatinine secretion, and is therefore a close approximation of the GFR.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 17 - A 50 year old man was admitted to the surgical ICU following a...

    Incorrect

    • A 50 year old man was admitted to the surgical ICU following a hemicolectomy for carcinoma of the caecum. A full blood count revealed: haematocrit = 30%, erythrocytes = 4 × 106/μ, haemoglobin level = 8 g/dl. To determine the likely cause of his anaemia, red blood cell indices were calculated. Which RBC indices are correct?

      Your Answer:

      Correct Answer: MCHC = haemoglobin concentration/haematocrit

      Explanation:

      Mean corpuscular haemoglobin concentration (MCHC) is calculated simply by dividing the haemoglobin concentration (8 g/dl) by the haematocrit (0.3). The normal range is 31–36 g/dl. This patient has a hypochromic anaemia (MCHC = 8/0.3 = 26.7 g/dl). Dividing the haemoglobin concentration × 10 by erythrocyte number yields mean corpuscular haemoglobin (MCH). Normal range is 25.4–34.6 pg/cell and this patient has a significantly reduced cellular haemoglobin content (MCH = 8 × 10/4 = 20 pg/cell). Mean corpuscular volume (MCV) is calculated by dividing haematocrit × 1000 by erythrocyte number (4 × 106/μl). Normal range is 80–100 fl and this patient has a microcytic anaemia (MCV = 0.3 × 1000/4 = 75 fl). Microcytic, hypochromic anaemia is characteristic for iron-deficiency.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 18 - A 76-year-old woman is diagnosed with diabetes mellitus after a urine test revealed...

    Incorrect

    • A 76-year-old woman is diagnosed with diabetes mellitus after a urine test revealed she has glucosuria. Glucosuria may occur due to inadequate glucose reabsorption at:

      Your Answer:

      Correct Answer: Proximal convoluted tubule

      Explanation:

      Glucose is reabsorbed almost 100% via sodium–glucose transport proteins (apical) and GLUT (basolateral) in the proximal convoluted tubule. Glycosuria or glucosuria is a condition of osmotic diuresis typical in those suffering from diabetes mellitus. Due to a lack of insulin, plasma glucose levels are above normal. This leads to saturation of receptors in the kidneys and glycosuria usually at plasma glucose levels above 11 mmol/l. Rarely, glycosuria is due to an intrinsic problem with glucose reabsorption within the kidneys (such as Fanconi syndrome), producing a condition termed renal glycosuria.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 19 - Where is factor VIII predominantly synthesised? ...

    Incorrect

    • Where is factor VIII predominantly synthesised?

      Your Answer:

      Correct Answer: Vascular endothelium

      Explanation:

      Factor VIII is an important part of the coagulation cascade. Deficiency causes haemophilia A. It is synthesised predominantly by the vascular endothelium and is not affected by liver disease. In the circulation it is bound to von Willebrand factor and it forms a stable complex with it. It is activated by thrombin or factor Xa and acts as a co factor to factor IXa to activate factor X which is a co factor to factor Va. Thrombin cleaves fibrinogen in fibrin and forms a meshwork to trap RBC and platelets to form a clot.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 20 - Which of the following is a likely cause of jaundice? ...

    Incorrect

    • Which of the following is a likely cause of jaundice?

      Your Answer:

      Correct Answer: Hepatic disease if plasma albumin is low and serum aminotransferase elevations > 500 units

      Explanation:

      Jaundice can occur due to any of the possible causes and treatment depends upon diagnosing the correct condition. Mild hyperbilirubinemia with normal levels of aminotransferase and alkaline phosphatase is often unconjugated (e.g., due to haemolysis or Gilbert’s syndrome rather than hepatobiliary disease). Moderate or severe hyperbilirubinemia along with increased urinary bilirubin (bilirubinuria), high alkaline phosphatase or aminotransferase levels suggest hepatobiliary disease. Hyperbilirubinemia produced by any hepatobiliary disease is largely conjugated. In this case, other blood tests include hepatitis serology for suspected hepatitis, prothrombin time (PT) or international normalised ratio (INR), albumin and globulin levels, and antimitochondrial antibody levels (suspected primary biliary cirrhosis). Low albumin and high globulin levels suggest chronic rather than acute liver disease. In cases where there is only a an elevation of alkaline phosphatase, γ-glutamyl transpeptidase (GGT) levels should be checked – the levels of which will be found high in hepatobiliary disease, but not in bone disorder which can also lead to elevated alkaline phosphatase levels. In diseases of hepatobiliary origin, aminotransferase elevations > 500 units suggest a hepatocellular cause, whereas disproportionate increases of alkaline phosphatase (e.g., alkaline phosphatase > 3 times normal and aminotransferase < 200 units) suggest cholestasis. Because hepatobiliary disease alone rarely causes bilirubin levels > 30 mg/dl, higher levels are suggestive of a combination of severe hepatobiliary disease and haemolysis or renal dysfunction. Imaging is best for diagnosing infiltrative and cholestatic causes of jaundice. Liver biopsy is rarely needed, but can be of use in intrahepatic cholestasis and in some types of hepatitis.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 21 - Decreased velocity of impulse conduction through the atrioventricular node (AV node) in the...

    Incorrect

    • Decreased velocity of impulse conduction through the atrioventricular node (AV node) in the heart will lead to:

      Your Answer:

      Correct Answer: Increased PR interval

      Explanation:

      AV node damage may lead to an increase in the PR interval to as high as 0.25 – 0.40 s (normal = 0.12 – 0.20 s). In the case of severe impairment, there might be a complete failure of passage of impulses leading to complete block. In this case, the atria and ventricles will beat independently of each other.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 22 - A cerebellar tremor can be differentiated from a Parkinsonian tremor in that: ...

    Incorrect

    • A cerebellar tremor can be differentiated from a Parkinsonian tremor in that:

      Your Answer:

      Correct Answer: It only occurs during voluntary movements

      Explanation:

      Cerebellar disease leads to intention tremors, which is absent at rest and appears at the onset of voluntary movements. In comparison, Parkinson’s tremor is present at rest. Frequency of tremor is a less reliable means to differentiate between the two as the oscillation amplitude of the tremor is not constant throughout a voluntary action.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 23 - Renin is secreted by pericytes in the vicinity of the afferent arterioles of the...

    Incorrect

    • Renin is secreted by pericytes in the vicinity of the afferent arterioles of the kidney from the juxtaglomerular cells. Plasma renin levels are decreased in patients with:

      Your Answer:

      Correct Answer: Primary aldosteronism

      Explanation:

      Primary aldosteronism, also known as primary hyperaldosteronism or Conn’s syndrome, is excess production of the hormone aldosterone by the adrenal glands resulting in low renin levels. Most patients with primary aldosteronism (Conn’s syndrome) have an adrenal adenoma. The increased plasma aldosterone concentration leads to increased renal Na+ reabsorption, which results in plasma volume expansion. The increase in plasma volume suppresses renin release from the juxtaglomerular apparatus and these patients usually have low plasma renin levels. Salt restriction and upright posture decrease renal perfusion pressure and therefore increases renin release from the juxtaglomerular apparatus. Secondary aldosteronism is due to elevated renin levels and may be caused by heart failure or renal artery stenosis.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 24 - Calculate the cardiac output of a patient with the following measurements: oxygen uptake...

    Incorrect

    • Calculate the cardiac output of a patient with the following measurements: oxygen uptake 200 ml/min, oxygen concentration in the peripheral vein 7 vol%, oxygen concentration in the pulmonary artery 10 vol% and oxygen concentration in the aorta 15 vol%.

      Your Answer:

      Correct Answer: 4000 ml/min

      Explanation:

      The Fick’s principle states that the uptake of a substance by an organ equals the arteriovenous difference of the substance multiplied by the blood flowing through the organ. We can thus calculate the pulmonary blood flow with pulmonary arterial (i.e., mixed venous) oxygen content, aortic oxygen content and oxygen uptake. The pulmonary blood flow, systemic blood flow and cardiac output can be considered the same assuming there are no intracardiac shunts. Thus, we can calculate the cardiac output. Cardiac output = oxygen uptake/(aortic − mixed venous oxygen content) = 200 ml/min/(15 ml O2/100 ml − 10 ml O2/100 ml) = 200 ml/min/(5 ml O2/100 ml) = 200 ml/min/0.05 = 4000 ml/min.

      It is crucial to remember to use pulmonary arterial oxygen content and not peripheral vein oxygen content, when calculating the cardiac output by Fick’s method.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 25 - Evaluation of a 60-year old gentleman, who has been a coal miner all...

    Incorrect

    • Evaluation of a 60-year old gentleman, who has been a coal miner all his life and is suspected to have pulmonary fibrosis reveals the following: FEV1 of 75% (normal > 65%), arterial oxygen saturation 92%, alveolar ventilation 6000 ml/min at a tidal volume of 600 ml and a breathing rate of 12 breaths/min. There are also pathological changes in lung compliance and residual volume. Calculate his anatomical dead space.

      Your Answer:

      Correct Answer: 100 ml

      Explanation:

      Dead space refers to inhaled air that does not take part in gas exchange. Because of this dead space, taking deep breaths slowly is more effective for gas exchange than taking quick, shallow breaths where a large proportion is dead space. Use of a snorkel by a diver increases the dead space marginally. Anatomical dead space refers to the gas in conducting areas such as mouth and trachea, and is roughly 150 ml (2.2 ml/kg body weight). This corresponds to a third of the tidal volume (400-500 ml). It can be measured by Fowler’s method, a nitrogen wash-out technique. It is posture-dependent and increases with increase in tidal volume. Physiological dead space is equal to the anatomical dead space plus the alveolar dead space, where alveolar dead space is the area in the alveoli where no effective exchange takes place due to poor blood flow in capillaries. This physiological dead space is very small normally (< 5 ml) but can increase in lung diseases. Physiological dead space can be measured by Bohr’s method. Total ventilation per minute (minute ventilation) is given by the product of tidal volume and the breathing rate. Here, the total ventilation is 600 ml times 12 breaths/min = 7200 ml/min. The problem mentions alveolar ventilation to be 6000 ml/min. Thus, the difference between the alveolar ventilation and total ventilation is 7200 – 6000 ml/min = 1200 ml/min, or 100 ml per breath at 12 breaths per min. This 100 ml is the dead space volume.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 26 - Electrophoresis is used to detect antibodies (immunoglobulins) in a blood sample from the...

    Incorrect

    • Electrophoresis is used to detect antibodies (immunoglobulins) in a blood sample from the umbilical artery of a new born. Which antibodies have the highest percentage in a new-born?

      Your Answer:

      Correct Answer: IgG

      Explanation:

      IgG is a monomeric immunoglobulin. It is formed by two heavy chains and two light chains and has two binding sites. Its is the most abundant antibody that is equally distributed in the blood and the tissues. It is the only antibody that can pass through the placenta and thus the only antibody present in the baby after it is born. There are four subclasses: IgG1 (66%), IgG2 (23%), IgG3 (7%) and IgG4 (4%). IgG1, IgG3 and IgG4 cross the placenta easily

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 27 - During cardiac catheterisation, if the blood sample from the catheter shows an oxygen...

    Incorrect

    • During cardiac catheterisation, if the blood sample from the catheter shows an oxygen saturation of 70%, and the pressure ranging from 12 to 24 mm Hg, it implies that the catheter tip is located in the:

      Your Answer:

      Correct Answer: Pulmonary artery

      Explanation:

      Normal values for various parameters are as follows:

      Systolic arterial blood pressure (SBP): 90–140 mmHg.

      Diastolic arterial blood pressure: 60–90 mmHg.

      Mean arterial blood pressure (MAP): SBP + (2 × DBP)/3 (normal range: 70-105 mmHg).

      Right atrial pressure (RAP): 2–6 mmHg.

      Systolic right ventricular pressure (RVSP): 15–25 mmHg.

      Diastolic right ventricular pressure (RVDP): 0–8 mmHg.

      Pulmonary artery pressure (PAP): Systolic (PASP) is 15-25 mmHg and Diastolic (PADP) is 8–15 mmHg.

      Pulmonary artery wedge pressure (PAWP): 6–12 mmHg.

      Left atrial pressure (LAP): 6–12 mmHg.

      Thus, the given value indicates that the position of catheter tip is likely to be in the pulmonary artery.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 28 - A 31-year-old woman is diagnosed with adrenal hyperplasia, and laboratory samples are taken...

    Incorrect

    • A 31-year-old woman is diagnosed with adrenal hyperplasia, and laboratory samples are taken to measure serum aldosterone and another substance. Which is most likely to be the other test that was prescribed to this patient?

      Your Answer:

      Correct Answer: Plasma renin

      Explanation:

      The evaluation of a patient in whom hyperaldosteronism is first to determine that hyperaldosteronism is present (serum aldosterone) and, if it is present, to differentiate primary from secondary causes of hyperaldosteronism. The aldosterone-to-renin ratio (ARR) is the most sensitive means of differentiating primary from secondary causes of hyperaldosteronism as it is abnormally increased in primary hyperaldosteronism, and decreased or normal but with high renin levels in secondary hyperaldosteronism.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 29 - A syndrome responsible for failure to absorb vitamin B12 from the GIT is...

    Incorrect

    • A syndrome responsible for failure to absorb vitamin B12 from the GIT is called?

      Your Answer:

      Correct Answer: Pernicious anaemia

      Explanation:

      Pernicious anaemia is a type of autoimmune disease in which antibodies form against the parietal cells or intrinsic factor. Intrinsic factor is required for the absorption of vitamin B12. Blood testing typically shows a macrocytic, normochromic anaemia and low levels of serum vitamin B12. A Schilling test can then be used to distinguish between pernicious anaemia, vitamin B12 malabsorption and vitamin B12 deficiency. Symptoms include shortness of breath, pallor and diarrhoea etc.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 30 - Dysarthria, nystagmus and a tremor worsening with directed movement are likely to be...

    Incorrect

    • Dysarthria, nystagmus and a tremor worsening with directed movement are likely to be seen in:

      Your Answer:

      Correct Answer: Cerebellar disease

      Explanation:

      The given symptoms are seen in diseases affecting the cerebellum. A cerebellar tremor is a slow tremor that occurs at the end of a purposeful movement. It is seen in cerebellar disease, such as multiple sclerosis or some inherited degenerative disorders and chronic alcoholism. Classically, tremors are produced in the same side of the body as a one-sided lesion. Cerebellar disease can also result in a wing-beating’ type of tremor called rubral or Holmes’ tremor – a combination of rest, action and postural tremors. Other signs of cerebellar disease include dysarthria (speech problems), nystagmus (rapid, involuntary rolling of the eyes), gait problems and postural tremor of the trunk and neck.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 31 - A medical student is asked to calculate the net pressure difference in a...

    Incorrect

    • A medical student is asked to calculate the net pressure difference in a capillary wall, considering: Interstitial fluid hydrostatic pressure = –3 mmHg, Plasma colloid osmotic pressure = 28 mmHg, Capillary hydrostatic pressure = 17 mmHg, Interstitial fluid colloid osmotic pressure = 8 mmHg, and Filtration coefficient = 1. Which is the correct answer?

      Your Answer:

      Correct Answer: 0 mmHg

      Explanation:

      The rate of filtration at any point along a capillary depends on a balance of forces sometimes called Starling’s forces after the physiologist who first described their operation in detail. The Starling principle of fluid exchange is key to understanding how plasma fluid (solvent) within the bloodstream (intravascular fluid) moves to the space outside the bloodstream (extravascular space). Fluid movement = k[(pc– pi)–(Πc– Πi)] where k = capillary filtration coefficient, pc = capillary hydrostatic pressure, pi= interstitial hydrostatic pressure, Πc = capillary colloid osmotic pressure, Πi = interstitial colloid osmotic pressure. Therefore: 1 × [capillary hydrostatic pressure (17) – interstitial fluid hydrostatic pressure (–3)] – [plasma colloid osmotic pressure (28) – interstitial fluid colloid osmotic pressure (8)] = 0 mmHg

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 32 - In which of the following conditions will the oxygen-haemoglobin dissociation curve shift to...

    Incorrect

    • In which of the following conditions will the oxygen-haemoglobin dissociation curve shift to the right?

      Your Answer:

      Correct Answer: Exercise

      Explanation:

      The oxygen-haemoglobin dissociation curve plots saturated haemoglobin against the oxygen tension and is usually a sigmoid plot. Each molecule of haemoglobin can bind to four molecules of oxygen reversibly. Factors that can influence the binding include: pH, concentration of 2,3-diphosphoglycerate (2,3-DPG), temperature, type of haemoglobin molecules, and presence of toxins, especially carbon monoxide. Shape of the curve is due to interaction of bound oxygen molecules with the incoming molecules. The binding of first molecule is difficult, with easier binding of the second and third molecule and increase in difficulty with the fourth molecule – partly as a result of crowding and partly as a natural tendency of oxygen to dissociate.

      Left shift of curve indicates haemoglobin’s increased affinity for oxygen (seen at lungs). Right shift indicates decreased affinity and is seen with an increase in body temperature, hydrogen ions, 2,3-diphosphoglycerate (DPG), carbon dioxide concentration and exercise. Under normal resting conditions in a healthy individual, the normal position of the curve is at a pH of 7.4. A shift in the position of the curve with a change in pH is called the Bohr effect. Left shift occurs in acute alkalosis, decrease in p(CO2), decrease in temperature and decrease in 2,3-DPG. The fetal haemoglobin curve is to the left of the adult haemoglobin to allow for oxygen diffusion across the placenta. The curve for myoglobin is even further to the left. Carbon monoxide has a much higher affinity for haemoglobin than oxygen does. Thus, carbon monoxide poisoning leads to hypoxia.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 33 - The mechanism of action of streptokinase involves: ...

    Incorrect

    • The mechanism of action of streptokinase involves:

      Your Answer:

      Correct Answer: Direct conversion of plasminogen to plasmin

      Explanation:

      Streptokinase is an enzyme that is produced by group A beta haemolytic streptococcus and is an effective and cost efficient method for the dissolution of a clot used in cases of MI and pulmonary embolism. It works by directly converting plasminogen to plasmin which breaks down the blood components in the clot and fibrin, dissolving the clot. Streptokinase is a bacterial product and thus the body will develop immunity against it.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 34 - What is the basic chemical reaction that takes place in the breakdown of...

    Incorrect

    • What is the basic chemical reaction that takes place in the breakdown of complex foodstuffs?

      Your Answer:

      Correct Answer: Hydrolysis

      Explanation:

      Breakdown of complex food into simpler compounds is achieved by hydrolysis, with the help of different enzymes specific for different compounds.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 35 - Severe abdominal pain radiating to the back, along with increased serum amylase levels,...

    Incorrect

    • Severe abdominal pain radiating to the back, along with increased serum amylase levels, is seen in which of the following conditions?

      Your Answer:

      Correct Answer: Pancreatitis

      Explanation:

      The primary test for diagnosis and monitoring of pancreatitis is amylase. Increased plasma levels of amylase can be found in: salivary trauma (including anaesthetic intubation), mumps, pancreatitis and renal failure. However, a rise in the total amylase levels over 10 times the upper limit of normal (ULN) is suggestive of pancreatitis; 5–10 times the ULN may indicate ileus or duodenal disease or renal failure. Lower levels are commonly found in salivary gland disease.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 36 - A neurotransmitter of the nigrostriatal pathway is: ...

    Incorrect

    • A neurotransmitter of the nigrostriatal pathway is:

      Your Answer:

      Correct Answer: Dopamine

      Explanation:

      Dopamine acts as a neurotransmitter in the brain, activating dopamine receptors. It is also a neurohormone released from the hypothalamus. It plays an important role in the reward system. It is believed that dopamine provides a teaching signal to parts of the brain responsible for acquiring new motor sequences (behaviours), by activation of dopamine neurons when an unexpected reward is presented. Loss of dopamine neurones in the nigrostriatal pathway causes Parkinson’s disease. In the frontal lobes, dopamine controls the flow of information from other areas of the brain, and thus, dopamine disorders in this region can cause a decline in neurocognitive functions, especially memory, attention and problem solving. Reduced dopamine concentrations in the prefrontal cortex are thought to contribute to attention-deficit disorder and some symptoms of schizophrenia. Dopamine is also the primary neuroendocrine regulator of the secretion of prolactin from the anterior pituitary gland. Dopamine is also commonly associated with the pleasure system of the brain. This plays a key role in understanding the mechanism of action of drugs (such as cocaine and the amphetamines), which seem to be directly or indirectly related to the increase of dopamine.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 37 - Which of the following will be affected by a lesion in the posterior...

    Incorrect

    • Which of the following will be affected by a lesion in the posterior column-medial lemniscus system?

      Your Answer:

      Correct Answer: Fine touch

      Explanation:

      The posterior column–medial lemniscus (PCML) pathway is a sensory pathway that transmits fine touch and conscious proprioceptive information from the body to the brain. As the posterior columns are also known as dorsal columns, the pathway is also called the dorsal column–medial lemniscus system or DCML.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 38 - Myoglobin is released as a result of rhabdomyolysis from damaged skeletal muscles. What...

    Incorrect

    • Myoglobin is released as a result of rhabdomyolysis from damaged skeletal muscles. What function do they perform in the muscle?

      Your Answer:

      Correct Answer: Acts like haemoglobin and binds with O2

      Explanation:

      Myoglobin is a pigmented globular protein made up of 153 amino acids with a prosthetic group containing haem around which the apoprotein folds. It is the primary oxygen carrying protein of the muscles. The binding of oxygen to myoglobin is unaffected by the oxygen pressure as it has an instant tendency to bind given its hyperbolic oxygen curve. It releases oxygen at very low pO2 levels.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 39 - After having donated a unit of blood. The blood bank will prefer to...

    Incorrect

    • After having donated a unit of blood. The blood bank will prefer to use which of the following anticoagulants to store the blood?

      Your Answer:

      Correct Answer: Citrate

      Explanation:

      Calcium is necessary for coagulation to occur. Citrate being a chelator and combining with calcium ions to form un-ionised compound will prevent coagulation. Following transfusion the citrate is removed by the liver with in a few minutes. Oxalate also works on the same principle but it is toxic to the body.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 40 - What is the normal duration of PR interval on an electrocardiogram of a...

    Incorrect

    • What is the normal duration of PR interval on an electrocardiogram of a healthy individual?

      Your Answer:

      Correct Answer: 0.12–0.20 s

      Explanation:

      PR interval extends from the beginning of the P-wave until the beginning of the QRS complex. The normal duration of the PR interval is 0.12-0.20 s. It can be prolonged in first degree heart block, and reduced in Wolff-Parkinson-White syndrome.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 41 - A 7-year-old boy is diagnosed with metabolic acidosis as a result of severe...

    Incorrect

    • A 7-year-old boy is diagnosed with metabolic acidosis as a result of severe dehydration. Which of the following conditions is most likely to cause severe dehydration and metabolic acidosis?

      Your Answer:

      Correct Answer: Severe diarrhoea

      Explanation:

      Diarrhoea is defined as having three or more loose or liquid stools per day, or as having more stools than is normal for that person. Severe diarrhoea, causing fluid loss and loss of bicarbonate, will result in marked dehydration and metabolic acidosis.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 42 - Which of the following is responsible for the maximum increase in total peripheral...

    Incorrect

    • Which of the following is responsible for the maximum increase in total peripheral resistance on sympathetic stimulation?

      Your Answer:

      Correct Answer: Arterioles

      Explanation:

      Arterioles are also known as the resistance vessels as they are responsible for approximately half the resistance of the entire systemic circulation. They are richly innervated by the autonomic nervous system and hence, will bring about the maximum increase in peripheral resistance on sympathetic stimulation.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 43 - When at rest, which of the following will be higher in a marathon...

    Incorrect

    • When at rest, which of the following will be higher in a marathon runner compared to an untrained individual?

      Your Answer:

      Correct Answer: Cardiac stroke volume

      Explanation:

      Cardiac muscle hypertrophy is seen in trained athletes as compared to the normal population. This hypertrophy results in higher stroke volume at rest and increased cardiac reserve (maximum cardiac output during exercise). However, the cardiac output at rest is almost the same in both trained and untrained people. This is because in trained athletes, the heart rate is slower, even up to 40-50 beats/min. There is minimal affect of athletic training on oxygen consumption and respiratory rate.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 44 - Intravenous diazepam was administered to a man who was brought to the emergency...

    Incorrect

    • Intravenous diazepam was administered to a man who was brought to the emergency department with status epilepticus. He was administered 15 l/min oxygen via a reservoir bag mask. Blood investigations showed sodium = 140 mmol/l, potassium = 4 mmol/l and chloride = 98 mmol/l. His arterial blood gas analysis revealed pH 7.08, p(CO2)= 61.5 mmHg, p(O2) = 111 mmHg and standard bicarbonate = 17 mmol/l. This patient had:

      Your Answer:

      Correct Answer: Mixed acidosis

      Explanation:

      Acidosis with high p(CO2) and low standard bicarbonate indicates mixed acidosis. Lower p(O2) is due to breathing of 70% oxygen. The prolonged seizures lead to lactic acidosis and the intravenous diazepam is responsible for the respiratory acidosis. Treatment includes airway manoeuvres and oxygen, assisted ventilation if needed, and treatment with fluids.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 45 - A lesion involving the lateral geniculate nucleus of the thalamus is likely to...

    Incorrect

    • A lesion involving the lateral geniculate nucleus of the thalamus is likely to affect:

      Your Answer:

      Correct Answer: Vision

      Explanation:

      The lateral geniculate nucleus (LGN) of the thalamus is the primary processor of visual information in the central nervous system. The LGN receives information directly from the retina and sends projections directly to the primary visual cortex. The LGN likely helps the visual system focus its attention on the most important information.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 46 - Which is a feature of the action of insulin? ...

    Incorrect

    • Which is a feature of the action of insulin?

      Your Answer:

      Correct Answer: Promotes protein synthesis

      Explanation:

      Insulin is produced by the beta-cells of the islets of Langerhans in the pancreas. Its actions include:

      – promoting uptake of glucose into cells

      – glycogen synthesis (glycogenesis)

      – protein synthesis

      – stimulation of lipogenesis (fat formation).

      – driving potassium into cells – used to treat hyperkaelamia.

      Parathyroid hormone and activated vitamin D are the principal hormones involved in calcium/phosphate metabolism, rather than insulin.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      0
      Seconds
  • Question 47 - Which of the following can lead to haemolytic anaemia? ...

    Incorrect

    • Which of the following can lead to haemolytic anaemia?

      Your Answer:

      Correct Answer: Presence of haemoglobin S

      Explanation:

      Haemoglobin S is an abnormal type of haemoglobin seen in sickle cell anaemia. This allows for the haemoglobin to crystalize within the RBC upon exposure to low partial pressures of oxygen. This results in rupture of the RBCs as they pass through microcirculation, especially in the spleen. This can cause blockage of the vessel down stream and ischaemic death of tissues, accompanied by severe pain.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 48 - Chronic obstructive pulmonary disease (COPD) is likely to result in: ...

    Incorrect

    • Chronic obstructive pulmonary disease (COPD) is likely to result in:

      Your Answer:

      Correct Answer: Respiratory acidosis

      Explanation:

      COPD leads to respiratory acidosis (chronic). This occurs due to hypoventilation which involves multiple causes, such as poor responsiveness to hypoxia and hypercapnia, increased ventilation/perfusion mismatch leading to increased dead space ventilation and decreased diaphragm function.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 49 - What is the result of maltase deficiency in the brush border of the...

    Incorrect

    • What is the result of maltase deficiency in the brush border of the small intestine?

      Your Answer:

      Correct Answer: Results in increased passage of maltose in stool

      Explanation:

      Maltase is an enzyme produced from the surface cells of the villi, lining the small intestine and aids in hydrolysing the disaccharide maltose, which splits into two molecules of α-glucose. It is done by breaking the glycosidic bond between the ‘first’ carbon of one glucose and the ‘fourth’ carbon of the other (a 1–4 bond). Hence, a deficiency of enzyme maltase will result in the increased passage of maltose in the stool.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 50 - How are amino acids transported across the luminal surface of the small intestinal...

    Incorrect

    • How are amino acids transported across the luminal surface of the small intestinal epithelium?

      Your Answer:

      Correct Answer: Co-transport with sodium ions

      Explanation:

      Once complex peptides are broken down into amino acids by the peptidases present in the brush border of small intestine, they are ready for absorption by at least four sodium-dependent amino acid co-transporters – one each for acidic, basic, neutral and amino acids, present on the luminal plasma membrane. These transporters first bind sodium and can then bind the amino acids. Thus, amino acid absorption is totally dependent on the electrochemical gradient of sodium across the epithelium. The basolateral membrane in contrast, possesses additional transporters to carry amino acids from the cell into the blood, but these are sodium-independent.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 51 - Which of the following organs is most likely to have dendritic cells? ...

    Incorrect

    • Which of the following organs is most likely to have dendritic cells?

      Your Answer:

      Correct Answer: Skin

      Explanation:

      Dendritic cells are part of the immune system and they function mainly as antigen presenting cells. They are present in small quantities in tissues which are in contact in the external environment. Mainly in the skin and to a lesser extent in the lining of the nose, lungs, stomach and intestines. In the skin they are known as Langerhans cells.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 52 - Action potentials are used extensively by the nervous system to communicate between neurones...

    Incorrect

    • Action potentials are used extensively by the nervous system to communicate between neurones and muscles or glands. What happens during the activation of a nerve cell membrane?

      Your Answer:

      Correct Answer: Sodium ions flow inward

      Explanation:

      During the generation of an action potential, the membrane gets depolarized which cause the voltage gated sodium channels to open and sodium diffuses inside the neuron, resulting in the membrane potential moving towards a positive value. This positive potential will then open the voltage gated potassium channels and cause more K+ to move out decreasing the membrane potential and restoring the membrane potential to its resting value.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 53 - The renal tubule is the portion of the nephron that contains the fluid...

    Incorrect

    • The renal tubule is the portion of the nephron that contains the fluid that has been filtered by the glomerulus. Which of the following substances is actively secreted into the renal tubules?

      Your Answer:

      Correct Answer: Potassium

      Explanation:

      The renal corpuscle filters out solutes from the blood, delivering water and small solutes to the renal tubule for modification. In normal circumstances more than 90% of the filtered load of K is reabsorbed by the proximal tubules and loops of Henlé and almost all K appearing in the urine has been secreted by the late distal tubules and collecting tubules. So the rate of excretion is usually independent of the rate of filtration, but is closely tied to the rate of secretion and control of K excretion, largely accomplished by control of the secretion rate. Around 65–70% of the filtered potassium is reabsorbed along with water in the proximal tubule and the concentration of potassium in the tubular fluid varies little from that of the plasma.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 54 - Calculate the resistance of the artery if the pressure at one end is...

    Incorrect

    • Calculate the resistance of the artery if the pressure at one end is 60 mmHg, pressure at the other end is 20 mm Hg and the flow rate in the artery is 200 ml/min.

      Your Answer:

      Correct Answer: 0.2

      Explanation:

      Flow in any vessel = Effective perfusion pressure divided by resistance, where effective perfusion pressure is the mean intraluminal pressure at the arterial end minus the mean pressure at the venous end. Thus, in the given problem, resistance = (60 − 20)/200 = 0.2 mmHg/ml per min.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 55 - During strenuous exercise, what else occurs besides tachycardia? ...

    Incorrect

    • During strenuous exercise, what else occurs besides tachycardia?

      Your Answer:

      Correct Answer: Increased stroke volume

      Explanation:

      During strenuous exercise there is an increase in:

      – Heart rate, stroke volume and therefore cardiac output. (CO = HR x SV)

      – Respiratory rate (hyperventilation) which will lead to a reduction in Paco2.

      – Oxygen demand of skeletal muscle, therefore leading to a reduction in mixed venous blood oxygen concentration.

      Renal blood flow is autoregulated, so renal blood flow is preserved and will tend to remain the same. Mean arterial blood pressure is a function of cardiac output and total peripheral resistance and will increase with exercise, mainly as a result of the increase in cardiac output that occurs.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 56 - A 7-year-old girl is given cephalexin to treat an infection and develops hives,...

    Incorrect

    • A 7-year-old girl is given cephalexin to treat an infection and develops hives, with localised facial oedema. Which of the following conditions will cause localised oedema?

      Your Answer:

      Correct Answer: Angio-oedema

      Explanation:

      Angio-oedema, is the rapid swelling of the skin, mucosa and submucosal tissues. The underlying mechanism typically involves histamine or bradykinin. The version related to histamine is to due an allergic reaction to agents such as insect bites, food, or medications. The version related to bradykinin may occur due to an inherited C1 esterase inhibitor deficiency, medications e.g. angiotensin converting enzyme inhibitors, or a lymphoproliferative disorder.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 57 - Which of the following is a likely consequence of severe diarrhoea? ...

    Incorrect

    • Which of the following is a likely consequence of severe diarrhoea?

      Your Answer:

      Correct Answer: A decrease in the sodium content of the body

      Explanation:

      Diarrhoea can occur due to any of the numerous aetiologies, which include infectious, drug-induced, food related, surgical, inflammatory, transit-related or malabsorption. Four mechanisms have been implicated in diarrhoea: increased osmotic load, increased secretion, inflammation and decreased absorption time. Diarrhoea can result in fluid loss with consequent dehydration, electrolyte loss (Na+, K+, Mg2+, Cl–) and even vascular collapse. Loss of bicarbonate ions can lead to a metabolic acidosis.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 58 - A 54-year-old woman with amyotrophic lateral sclerosis is diagnosed with respiratory acidosis. The...

    Incorrect

    • A 54-year-old woman with amyotrophic lateral sclerosis is diagnosed with respiratory acidosis. The patient’s renal excretion of potassium would be expected to:

      Your Answer:

      Correct Answer: Fall, since tubular secretion of potassium is inversely coupled to acid secretion

      Explanation:

      Respiratory acidosis is a medical emergency in which decreased ventilation (hypoventilation) increases the concentration of carbon dioxide in the blood and decreases the blood’s pH (a condition generally called acidosis). Secretion of acid and potassium by the renal tubule are inversely related. So, increased excretion of H+ during renal compensation for respiratory acidosis will result in decreased secretion (or increased retention) of potassium ions, with the result that the body’s potassium store rises. An increase in K+ excretion would be associated with renal compensation for respiratory alkalosis. The filtered load of K+depends only on K+ plasma concentration and glomerular filtration rate, not on plasma pH.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 59 - Glucose is not secreted by the kidneys, and is filtered without a limit....

    Incorrect

    • Glucose is not secreted by the kidneys, and is filtered without a limit. What is the transport maximum for glucose?

      Your Answer:

      Correct Answer: 300 mg/dl

      Explanation:

      Transport maximum (or Tm) refers to the point at which increases in concentration do not result in an increase in movement of a substance across a membrane. Glucose is not secreted, thus excretion = filtration – reabsorption. Both filtration and reabsorption are directly proportional to the concentration of glucose in the plasma. However, reabsorption has a transport maximum of about 300 mg/dl in healthy nephrons, while filtration has effectively no limit (within reasonable physiological ranges). So, if the concentration rises above 300 mg/dl, the body cannot retain all the glucose, leading to glucosuria. Glucosuria is nearly always caused by elevated blood glucose levels, most commonly due to untreated diabetes mellitus.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 60 - Which of the following is likely to induce secretion of glucagon? ...

    Incorrect

    • Which of the following is likely to induce secretion of glucagon?

      Your Answer:

      Correct Answer: Low serum concentration of glucose

      Explanation:

      The most potent stimulus for secretion of glucagon is hypoglycaemia whereas hyperglycaemia is a stimulus for insulin release. Glucagon secretion also occurs in response to high levels of amino acids. Somatostatin inhibits glucagon secretion. Parasympathetic stimulation increases pancreatic acinar secretion, but not of α-cells.

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      0
      Seconds
  • Question 61 - Skeletal muscle fibres are divided into two basic types, type I (slow-twitch fibres)...

    Incorrect

    • Skeletal muscle fibres are divided into two basic types, type I (slow-twitch fibres) and type II (fast-twitch fibres). Fast muscle fibres do which of the following:

      Your Answer:

      Correct Answer: Use anaerobic metabolism

      Explanation:

      Skeletal muscles are divided into two types:

      1) type I also known as the slow twitch fibres. They use oxygen for their metabolism and as a result they have a high endurance potential. To support this they have abundant mitochondria and myoglobin, so they appear red/dark.

      2) type II fibres also called fast twitch fibres, are low endurance fibres used during anaerobic metabolism. They are required for short bursts of strength and cannot sustain contractions for long periods of time.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 62 - QT interval in the electrocardiogram of a healthy individual is normally: ...

    Incorrect

    • QT interval in the electrocardiogram of a healthy individual is normally:

      Your Answer:

      Correct Answer: 0.40 s

      Explanation:

      QT interval extends from beginning of the QRS complex till the end of he T-wave and normally lasts for 0.40 s. It is important in the diagnosis of long-QT and short-QT syndrome. The QT interval varies on the basis of heart rate and may need to be corrected.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 63 - After a severe asthma attack, a 26-year-old woman is left in a markedly...

    Incorrect

    • After a severe asthma attack, a 26-year-old woman is left in a markedly hypoxic state. In which of the following organs are the arterial beds most likely to be vasoconstricted due to the hypoxia?

      Your Answer:

      Correct Answer: Lungs

      Explanation:

      Hypoxic pulmonary vasoconstriction is a local response to hypoxia resulting primarily from constriction of small muscular pulmonary arteries in response to reduced alveolar oxygen tension. This unique response of pulmonary arterioles results in a local adjustment of perfusion to ventilation. This means that if a bronchiole is obstructed, the lack of oxygen causes contraction of the pulmonary vascular smooth muscle in the corresponding area, shunting blood away from the hypoxic region to better-ventilated regions. The purpose of hypoxic pulmonary vasoconstriction is to distribute blood flow regionally to increase the overall efficiency of gas exchange between air and blood.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 64 - One sensitive indicator of heavy alcohol dependence is: ...

    Incorrect

    • One sensitive indicator of heavy alcohol dependence is:

      Your Answer:

      Correct Answer: Elevated serum gamma-glutamyl transpeptidase

      Explanation:

      Elevated serum gamma-glutamyl transpeptidase (GGT) may be the only laboratory abnormality in patients who are dependent on alcohol. Heavy drinkers may also have an increased MCV.

    • This question is part of the following fields:

      • Hepatobiliary
      • Physiology
      0
      Seconds
  • Question 65 - Different substances have different renal clearance rates. Which of the following substances should...

    Incorrect

    • Different substances have different renal clearance rates. Which of the following substances should have the lowest renal clearance rate in a healthy patient?

      Your Answer:

      Correct Answer: Glucose

      Explanation:

      Under normal conditions the renal clearance of glucose is zero, since glucose is completely reabsorbed in the renal tubules and not excreted. Glycosuria – the excretion of glucose into the urine- is nearly always caused by elevated blood glucose levels, most commonly due to untreated diabetes mellitus.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 66 - The primary area involved in the pathology of Parkinson's disease is: ...

    Incorrect

    • The primary area involved in the pathology of Parkinson's disease is:

      Your Answer:

      Correct Answer: Substantia nigra

      Explanation:

      Parkinson’s disease is a degenerative, movement disorder of the central nervous system, and is typically characterized by muscle rigidity, tremor and bradykinesia (in extreme cases, akinesia). Secondary symptoms include high-level cognitive dysfunction and subtle language problems.

      Parkinson’s disease is also called ‘primary Parkinsonism’ or ‘idiopathic Parkinson’s disease and is the most common cause of Parkinsonism, a group of similar symptoms. The disorder is caused due to loss of pigmented dopaminergic cells in the pars compacta region of the substantia nigra.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 67 - Which is the site of action of the drug omeprazole? ...

    Incorrect

    • Which is the site of action of the drug omeprazole?

      Your Answer:

      Correct Answer: H+/K+ ATPase

      Explanation:

      H+/K+-ATPase or ‘proton pump’ located in the canalicular membrane plays a major role in acid secretion. The ATPase here is magnesium-dependent. Omeprazole is a proton pump inhibitor and blocks H+/K+- ATPase.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 68 - What is the mostly likely cause of prolonged activated partial thromboplastin time (aPPT)...

    Incorrect

    • What is the mostly likely cause of prolonged activated partial thromboplastin time (aPPT) ?

      Your Answer:

      Correct Answer: Heparin therapy

      Explanation:

      The partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT) is an indicator for measuring the efficacy of both the intrinsic and common coagulation pathway. Prolonged aPTT may indicate: use of heparin, antiphospholipid antibody and coagulation factor deficiency (e.g., haemophilia). Deficiencies of factors VIII, IX, XI and XII and rarely von Willebrand factor (if causing a low factor VIII level) may lead to a prolonged aPTT correcting on mixing studies.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 69 - During a normal respiratory exhalation, what is the recoil alveolar pressure? ...

    Incorrect

    • During a normal respiratory exhalation, what is the recoil alveolar pressure?

      Your Answer:

      Correct Answer: +10 cmH2O

      Explanation:

      To determine compliance of the respiratory system, changes in transmural pressures (in and out) immediately across the lung or chest cage (or both) are measured simultaneously with changes in lung or thoracic cavity volume. Changes in lung or thoracic cage volume are determined using a spirometer with transmural pressures measured by pressure transducers. For the lung alone, transmural pressure is calculated as the difference between alveolar (pA; inside) and intrapleural (ppl; outside) pressure. To calculate chest cage compliance, transmural pressure is ppl (inside) minus atmospheric pressure (pB; outside). For the combined lung–chest cage, transmural pressure or transpulmonary pressure is computed as pA – pB. pA pressure is determined by having the subject deeply inhale a measured volume of air from a spirometer. Under physiological conditions the transpulmonary or recoil pressure is always positive; intrapleural pressure is always negative and relatively large, while alveolar pressure moves from slightly negative to slightly positive as a person breathes.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
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  • Question 70 - Which of the following conditions is characterized by generalised oedema due to effusion...

    Incorrect

    • Which of the following conditions is characterized by generalised oedema due to effusion of fluid into the extracellular space?

      Your Answer:

      Correct Answer: Anasarca

      Explanation:

      Anasarca (or ‘generalised oedema’) is a condition characterised by widespread swelling of the skin due to effusion of fluid into the extracellular space. It is usually caused by liver failure (cirrhosis of the liver), renal failure/disease, right-sided heart failure, as well as severe malnutrition/protein deficiency.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 71 - Which of the following is responsible for the activation of pepsinogen released in...

    Incorrect

    • Which of the following is responsible for the activation of pepsinogen released in the stomach?

      Your Answer:

      Correct Answer: Acid pH and pepsin

      Explanation:

      Pepsinogen is the inactive precursor of pepsin. Once secreted, it comes in contact with hydrochloric acid and pepsin, previously formed, and undergoes cleavage to form active pepsin.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 72 - Chest X-ray of a 45-year old gentleman with a week history of pleurisy...

    Incorrect

    • Chest X-ray of a 45-year old gentleman with a week history of pleurisy showed a small pneumothorax with moderate-sized pleural effusion. Arterial blood gas analysis showed p(CO2) = 23 mmHg, p(O2) = 234.5 mmHg, standard bicarbonate = 16 mmol/l. What are we most likely dealing with?

      Your Answer:

      Correct Answer: Compensated respiratory alkalosis

      Explanation:

      Normal pH with low p(CO2) and low standard bicarbonate could indicate either compensated respiratory alkalosis or a compensated metabolic acidosis. However, the history of hyperventilation for 5 days (pleurisy) favours compensated respiratory alkalosis. Compensated metabolic acidosis would have been likely in a diabetic patient with fever, vomiting and high glucose (diabetic ketoacidosis).

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 73 - A 32-year old gentleman came to the emergency department, complaining of progressively increasing...

    Incorrect

    • A 32-year old gentleman came to the emergency department, complaining of progressively increasing weakness in his arms and legs over 5 days. On examination, there is symmetrical weakness on both sides of his face, along with weakness of the proximal and distal muscles of all four limbs. No loss of sensation noted. Deep tendon reflexes could not be elicited and plantar responses were downward. On enquiry, it was revealed that he had an upper respiratory tract infection 10 days ago. The likely diagnosis is:

      Your Answer:

      Correct Answer: Guillain–Barré syndrome

      Explanation:

      Guillain–Barré syndrome (GBS) is an acute, autoimmune polyradiculoneuropathy which affects the peripheral nervous system and is usually triggered by an acute infectious process. 75% patients have a history of acute infection within the past 1–4 weeks, usually respiratory or gastrointestinal. immunisations have also been implicated. The most common form is acute inflammatory demyelinating polyneuropathy. It results in an ascending paralysis with complete loss of deep tendon reflexes. Treatment includes immunoglobulins and supportive care. However, the disease may be fatal due to severe pulmonary complications and dysautonomia.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
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  • Question 74 - Production of pain is most likely associated with: ...

    Incorrect

    • Production of pain is most likely associated with:

      Your Answer:

      Correct Answer: Substance P

      Explanation:

      Substance P is a short-chain polypeptide that functions as a neurotransmitter and as a neuromodulator, and is thus, a neuropeptide. It has been linked with pain regulation, mood disorders, stress, reinforcement, neurogenesis, respiratory rhythm, neurotoxicity, nausea and emesis. It is also a potent vasodilator as it brings about release of nitric oxide from the endothelium. Its release can also cause hypotension.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 75 - Which of the following brings about a reduction in gastric blood flow? ...

    Incorrect

    • Which of the following brings about a reduction in gastric blood flow?

      Your Answer:

      Correct Answer: Vasopressin

      Explanation:

      Gastric blood flow is increased by vagal stimulation, gastrin, histamine and acetylcholine as they stimulate gastric section and the production of vasodilator metabolites. Acetylcholine and histamine also have a direct action on the gastric arterioles. Similarly, gastric blood flow is reduced by inhibitors of secretion – catecholamines, secretin and vasopressin.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 76 - Abnormal breathing is noticed in a of victim of a road traffic accident,...

    Incorrect

    • Abnormal breathing is noticed in a of victim of a road traffic accident, who sustained a head injury. The breathing pattern is characterised by alternate periods of waxing and waning tidal volumes with interspersed periods of apnoea. This breathing pattern is known as:

      Your Answer:

      Correct Answer: Cheyne–Stokes breathing

      Explanation:

      Cheyne-Stokes breathing is an abnormal breathing pattern with breathing periods of gradually waxing and waning tidal volumes, with apnoeic periods interspersed. It is usually the first breathing pattern to be seen with a rise in intracranial pressure and is caused by failure of the respiratory centre in the brain to compensate quickly enough to changes in serum partial pressure of oxygen and carbon dioxide. The aetiology includes strokes, head injuries, brain tumours and congestive heart failure. It is also a sign of altitude sickness in normal people, a symptom of carbon monoxide poisoning or post-morphine administration. Biot’s respiration (cluster breathing) is characterized by cluster of quick, shallow inspirations followed by regular or irregular periods of apnoea. It is different from ataxic respiration, which has completely irregular breaths and pauses. It results due to damage to the medulla oblongata by any reason (stroke, uncal herniation, trauma) and is a poor prognostic indicator. Kussmaul breathing, also known as ‘air hunger’, is basically respiratory compensation for metabolic acidosis and is characterized by quick, deep and laboured breathing. It is most often seen in in diabetic ketoacidosis. Due to forced inspiratory rate, the patients will show a low p(CO2). Ondine’s curse is congenital central hypoventilation syndrome or primary alveolar hypoventilation, which can be fatal and leads to sleep apnoea. It involves an inborn failure to control breathing autonomically during sleep and in severe cases, can affect patients even while awake. It is known to occur in 1 in 200000 liveborn children. Treatment includes tracheostomies and life long mechanical ventilator support.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
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  • Question 77 - Nephrotic syndrome is a condition that causes proteinuria, hypoalbuminemia and oedema. Which of...

    Incorrect

    • Nephrotic syndrome is a condition that causes proteinuria, hypoalbuminemia and oedema. Which of the following is the cause of the oedema in these patients?

      Your Answer:

      Correct Answer: Decreased oncotic pressure

      Explanation:

      The glomeruli of the kidneys are the parts that normally filter the blood. They consist of capillaries that are fenestrated and allow fluid, salts and other small solutes to flow through, but normally not proteins. In nephrotic syndrome, the glomeruli become damaged allowing small proteins, such as albumin to pass through the kidneys into urine. Oedema usually occurs due to salt and water retention by the diseased kidneys as well as due to the reduced colloid oncotic pressure (because of reduced albumin in the plasma). Lower serum oncotic pressure causes fluid to accumulate in the interstitial tissues.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
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  • Question 78 - A 26-year-old female patient had the following blood report: RBC count =...

    Incorrect

    • A 26-year-old female patient had the following blood report: RBC count = 4. 0 × 106/μl, haematocrit = 27% and haemoglobin = 11 g/dl, mean corpuscular volume (MCV) = 90 fl, mean corpuscular haemoglobin concentration (MCHC) = 41 g/dl. Further examination of blood sample revealed increased osmotic fragility of the erythrocytes. Which of the following is the most likely cause of this patient’s findings?

      Your Answer:

      Correct Answer: Spherocytosis

      Explanation:

      Spherocytes are small rounded RBCs. It is due to an inherited defect of the RBC cytoskeleton membrane tethering proteins. Membrane blebs form that are lost over time and cells become round instead of biconcave. As it is a normochromic anaemia, the MCV is normal. it is diagnosed by osmotic fragility test which reveals increased fragility in a hypotonic solution.

    • This question is part of the following fields:

      • General
      • Physiology
      0
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  • Question 79 - A 45-year-old pregnant woman develops high blood pressure at 20 weeks. She complains...

    Incorrect

    • A 45-year-old pregnant woman develops high blood pressure at 20 weeks. She complains of headaches and swollen feet, and a test reveals proteinuria (350 mg/day). Which of the following is the most likely diagnosis?

      Your Answer:

      Correct Answer: Pre-eclampsia

      Explanation:

      Pre-eclampsia (PE) is a disorder of pregnancy characterized by the onset of high blood pressure (two separate readings taken at least 6 h apart of 140/90 or more) and often a significant amount of protein in the urine (>300 mg of protein in a 24-h urine sample). While blood pressure elevation is the most visible sign of the disease, it involves generalised damage to the maternal endothelium of the kidneys and liver, with the release of vasopressive factors only secondary to the original damage. Pre-eclampsia may develop at varying times within pregnancy and its progress differs among patients; most cases present pre-term. It has no known cure apart from ending the pregnancy (induction of labour or abortion). It may also present up to 6 weeks post partum. Risk factors for pre-eclampsia include obesity, prior hypertension, older age, and diabetes mellitus.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 80 - A 77-year-old woman's renal function is tested. The following results were obtained during...

    Incorrect

    • A 77-year-old woman's renal function is tested. The following results were obtained during a 24-h period:

      Urine flow rate: 2. 0 ml/min

      Urine inulin: 0.5 mg/ml

      Plasma inulin: 0.02 mg/ml

      Urine urea: 220 mmol/l

      Plasma urea: 5 mmol/l.

      What is the urea clearance?

      Your Answer:

      Correct Answer: 88 ml/min

      Explanation:

      Urea is reabsorbed in the inner medullary collecting ducts of the nephrons. The clearance (C) of any substance can be calculated as follows: C = (U × V)/P, where U and P are the urine and plasma concentrations of the substance, respectively and V is the urine flow rate. So, glomerular filtration rate = (0.220 × 2. 0)/0.005 = 88 ml/min.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 81 - Arterial blood gas analysis of a man admitted with acute exacerbation of chronic...

    Incorrect

    • Arterial blood gas analysis of a man admitted with acute exacerbation of chronic obstructive pulmonary disease (COPD) showed the following: pH = 7.28, p(CO2) = 65.5 mmHg, p(O2)= 60 mmHg and standard bicarbonate = 30.5 mmol/l. This patient had:

      Your Answer:

      Correct Answer: Respiratory acidosis

      Explanation:

      Acidosis with high p(CO2) and normal standard bicarbonate indicates respiratory acidosis, commonly seen in acute worsening of COPD patients. Respiratory acidosis occurs due to alveolar hypoventilation which leads to increased arterial carbon dioxide concentration (p(CO2)). This in turn decreases the HCO3 –/p(CO2) and decreases pH. In acute respiratory acidosis, the p(CO2) is raised above the upper limit of normal (over 45 mm Hg) with a low pH. However, in chronic cases, the raised p(CO2) is accompanied with a normal or near-normal pH due to renal compensation and an increased serum bicarbonate (HCO3 – > 30 mmHg).

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
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  • Question 82 - A blood sample of a 58 year old male patient, who underwent an...

    Incorrect

    • A blood sample of a 58 year old male patient, who underwent an abdominal aortic aneurysm repair, was sent to the laboratory. The laboratory technician said that the patient’s blood agglutinates with antisera anti-A and anti-D, while the patient’s serum agglutinates cells of blood group B. What is the blood group of this patient?

      Your Answer:

      Correct Answer: A positive

      Explanation:

      Group A – has only the A antigen on red cells (and B antibody in the plasma)

      Group B – has only the B antigen on red cells (and A antibody in the plasma)

      Group AB – has both A and B antigens on red cells (but neither A nor B antibody in the plasma)

      Group O – has neither A nor B antigens on red cells (but both A and B antibody are in the plasma). Many people also have a so-called Rh factor on the red blood cell’s surface. This is also an antigen and those who have it are called Rh+. A person with Rh– blood does not have Rh antibodies naturally in the blood plasma (as one can have A or B antibodies, for instance) but they can develop Rh antibodies in the blood plasma if they receive blood from a person with Rh+ blood, whose Rh antigens can trigger the production of Rh antibodies. A person with Rh+ blood can receive blood from a person with Rh– blood without any problems. In this scenario the person has blood group A+ as he has A antigen, anti B antibody and Rh antigen

    • This question is part of the following fields:

      • General
      • Physiology
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  • Question 83 - Which of the following will increase blood pressure and cause hypokalaemia? ...

    Incorrect

    • Which of the following will increase blood pressure and cause hypokalaemia?

      Your Answer:

      Correct Answer: Angiotensin II

      Explanation:

      Angiotensin is a peptide that is released in response to a decrease in blood volume and blood pressure. It has multiple functions but mainly acts to cause vasoconstriction, increase BP and release aldosterone from the adrenal cortex. It is a powerful vasoconstrictor and release of aldosterone causes increased retention of sodium and excretion of potassium.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 84 - Acute respiratory distress syndrome (ARDS) is a medical condition that occurs in critically...

    Incorrect

    • Acute respiratory distress syndrome (ARDS) is a medical condition that occurs in critically ill patients, and can be triggered by events such as trauma and sepsis. Which of the following variables is most likely to be lower than normal in a patient with ARDS?

      Your Answer:

      Correct Answer: Lung compliance

      Explanation:

      Acute (or Adult) respiratory distress syndrome (ARDS) is a medical condition occurring in critically ill patients characterized by widespread inflammation in the lungs. The development of acute respiratory distress syndrome (ARDS) starts with damage to the alveolar epithelium and vascular endothelium, resulting in increased permeability to plasma and inflammatory cells. These cells pass into the interstitium and alveolar space, resulting in pulmonary oedema. Damage to the surfactant-producing type II cells and the presence of protein-rich fluid in the alveolar space disrupt the production and function of pulmonary surfactant, leading to micro atelectasis and impaired gas exchange. The pathophysiological consequences of lung oedema in ARDS include a decrease in lung volumes, compliance and large intrapulmonary shunts. ARDS may be seen in the setting of pneumonia, sepsis, following trauma, multiple blood transfusions, severe burns, severe pancreatitis, near-drowning, drug reactions, or inhalation injuries.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
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  • Question 85 - In a cardiac cycle, what event does the opening of the atrioventricular (AV)...

    Incorrect

    • In a cardiac cycle, what event does the opening of the atrioventricular (AV) valves coincide with?

      Your Answer:

      Correct Answer: Beginning of diastole

      Explanation:

      Cardiac diastole refers to the time period when the heart is relaxed after contraction and is preparing to refill with blood. Both ventricular and atrial diastole are together known as complete cardiac diastole. At its beginning, the ventricles relax, causing a drop in the ventricular pressure. As soon as the left ventricular pressure drops below that in left atrium, the mitral valve opens and there is ventricular filling of blood. Similarly, the tricuspid valve opens filling the right atrium.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 86 - A lesion involving the suprachiasmatic nucleus of hypothalamus is likely to affect: ...

    Incorrect

    • A lesion involving the suprachiasmatic nucleus of hypothalamus is likely to affect:

      Your Answer:

      Correct Answer: Regulation of circadian rhythm

      Explanation:

      The suprachiasmatic nucleus (SCN) in the hypothalamus is responsible for controlling endogenous circadian rhythms and destruction of the SCN leads to a loss of circadian rhythm.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 87 - Which of the following organelles have the capacity to regenerate and spontaneously replicate?...

    Incorrect

    • Which of the following organelles have the capacity to regenerate and spontaneously replicate?

      Your Answer:

      Correct Answer: Mitochondrion

      Explanation:

      A mitochondria is a membrane bound organelle found in eukaryotic cells. They are called the powerhouse of the cell and are the place where ATP is formed from energy generated through metabolism. They are capable of replication as well as repair and regeneration.

    • This question is part of the following fields:

      • General
      • Physiology
      0
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  • Question 88 - Bile salt reuptake principally occurs where? ...

    Incorrect

    • Bile salt reuptake principally occurs where?

      Your Answer:

      Correct Answer: In the ileum

      Explanation:

      90 – 95% of the bile salts are absorbed from the small intestine (mostly terminal ileum and then excreted again from the liver. This is known as the enterohepatic circulation. The entire pool recycles twice per meal and approximately 6 to 8 times per day.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 89 - Which organ is responsible for the secretion of enzymes that aid in digestion...

    Incorrect

    • Which organ is responsible for the secretion of enzymes that aid in digestion of complex starches?

      Your Answer:

      Correct Answer: Pancreas

      Explanation:

      α-amylase is secreted by the pancreas, which is responsible for hydrolysis of starch, glycogen and other carbohydrates into simpler compounds.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 90 - If your EEG shows waves with a frequency range of 8-12 Hz, the...

    Incorrect

    • If your EEG shows waves with a frequency range of 8-12 Hz, the waves most likely to be seen are:

      Your Answer:

      Correct Answer: Alpha

      Explanation:

      Electroencephalography (EEG) is the neurophysiological measurement of the electrical activity of the brain. It is done by placing electrodes on the scalp or subdurally. In reality, the electrical currents are not measured, but rather the voltage differences between different parts of the brain. Four major types of EEG activity are recognized, which are alpha, beta, delta and theta.

      Alpha waves, also known as Berger’s waves ranges in frequency from 8-12 Hz. Best detected with eyes closed, alpha waves are characteristic of a relaxed, alert state of consciousness. An alpha-like normal variant called mu is sometimes seen over the motor cortex (central scalp) and attenuates with movement or, rather, with the intention to move.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 91 - Which statement is correct regarding coagulation? ...

    Incorrect

    • Which statement is correct regarding coagulation?

      Your Answer:

      Correct Answer: Thrombin converts fibrinogen to fibrin

      Explanation:

      Coagulation of blood is a complex process and an important part of haemostasis. There are two main pathways related to coagulation: the contact activation pathway/intrinsic pathway and tissue factor/extrinsic pathway. The extrinsic pathway is activated by external trauma that causes blood to escape from the vascular system. This pathway is quicker than the intrinsic pathway and involves factor VII. The intrinsic pathway is activated by trauma inside the vascular system, and initiated by platelets, exposed endothelium, chemicals, or collagen. This pathway is slower than the extrinsic pathway, but more important. It involves factors XII, XI, IX, VIII. Both pathways meet to finish the formation of a clot in what is known as the common pathway. The common pathway involves factors I, II, V, and X. They converge on the common pathway in which activation of prothrombin to thrombin leads to conversion of fibrinogen to fibrin and clot formation.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 92 - A recognised side-effect of prefrontal leukotomy is: ...

    Incorrect

    • A recognised side-effect of prefrontal leukotomy is:

      Your Answer:

      Correct Answer: Confusion

      Explanation:

      Used previously as a treatment for psychiatric disorders, prefrontal leucotomy severs the connection between the prefrontal cortical association area and the thalamus. This leads to functional isolation of the prefrontal and orbitofrontal association cortex. Thus, along with the desired reduction in anger and frustration, undesirable side effects included changes in mood and affect, as well as confusion.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 93 - Carbon dioxide is principally transported in the blood in which form? ...

    Incorrect

    • Carbon dioxide is principally transported in the blood in which form?

      Your Answer:

      Correct Answer: Bicarbonate

      Explanation:

      Carbon dioxide is transported in the blood in various forms:

      – Bicarbonate (80–90%)

      – Carbamino compounds (5–10%)

      – Physically dissolved in solution (5%).

      Carbon dioxide is carried on the haemoglobin molecule as carbamino-haemoglobin; carboxyhaemoglobin is the combination of haemoglobin with carbon monoxide.

    • This question is part of the following fields:

      • Physiology
      • Respiratory; Cardiovascular
      0
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  • Question 94 - A 45-year old gentleman presents with diarrhoea for two weeks. He has no...

    Incorrect

    • A 45-year old gentleman presents with diarrhoea for two weeks. He has no history of fever and the diarrhoea stops on fasting. Which is the most likely type of diarrhoea that he is suffering from?

      Your Answer:

      Correct Answer: Osmotic

      Explanation:

      The different types of diarrhoea are:

      1. Secretory diarrhoea – Due to increased secretion or decreased absorption. There is minimal to no structural damage in this type. The most common cause is cholera toxin which stimulates secretion of anions (especially chloride), with sodium and water.

      2. Osmotic diarrhoea – Due to increased osmotic load, there is water loss. This occurs in cases of maldigestion syndromes, such as coeliac or pancreatic disease.

      3. Motility-related diarrhoea – Occurs in cases of abnormal gastrointestinal motility. Due to increased motility, there is poor absorption and this leads to diarrhoea. This is seen post-vagotomy or in diabetic neuropathy.

      4. Inflammatory diarrhoea – Due to damage to the mucosa or brush border, there is a loss of protein-rich fluids and poor absorption. Features of all the above three types can be seen in this type. Aetiology includes bacterial, viral, parasitic infections or autoimmune problems including inflammatory bowel disease.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
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  • Question 95 - An experiment was conducted in which the skeletal muscle protein (not smooth muscle)...

    Incorrect

    • An experiment was conducted in which the skeletal muscle protein (not smooth muscle) involved in contraction was selectively inhibited. Which protein was inhibited?

      Your Answer:

      Correct Answer: Troponin

      Explanation:

      The mechanism of contraction of smooth muscles is different from that of skeletal muscles in which the contractile protein is troponin whilst in smooth muscle contraction is a protein called calmodulin. Calmodulin reacts with calcium ions and stimulates the formation of myosin crossbridges.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 96 - What is the normal glomerular filtration rate? ...

    Incorrect

    • What is the normal glomerular filtration rate?

      Your Answer:

      Correct Answer: 125 mL/min

      Explanation:

      The normal glomerular filtration rate (GFR) in humans is 125 mL/min. After the age of 40, GFR decreases progressively by about 0.4–1.2 mL/min per year.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 97 - A sudden loud sound is more likely to result in cochlear damage than...

    Incorrect

    • A sudden loud sound is more likely to result in cochlear damage than a slowly developing loud sound. This is because:

      Your Answer:

      Correct Answer: There is a latent period before the attenuation reflex can occur

      Explanation:

      On transmission of a loud sound into the central nervous system, an attenuation reflex occurs after a latent period of 40-80 ms. This reflex contracts the two muscles that pull malleus and stapes closer, developing a high degree of rigidity in the entire ossicular chain. This reduces the ossicular conduction of low frequency sounds to the cochlea by 30-40 decibels. In this way, the cochlea is protected from damage due to loud sounds (these are low frequency sounds) when they develop slowly.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 98 - For calculation of cardiac output by Fick's principle, which of the following vessels...

    Incorrect

    • For calculation of cardiac output by Fick's principle, which of the following vessels is the best source of venous blood to determine the arterial-to-venous oxygen tension difference?

      Your Answer:

      Correct Answer: Pulmonary artery

      Explanation:

      Fick’s principle states that the total uptake (or release) of a substance by peripheral tissues is equal to the product of the blood flow to the peripheral tissues and the arterial– venous concentration difference (gradient) of the substance. It is used to measure the cardiac output, and the formula is Cardiac output = oxygen consumption divided by arteriovenous oxygen difference. Assuming there are no shunts across the pulmonary system, the pulmonary blood flow equals the systemic blood flow. The arterial and venous blood oxygen content is measured by sampling from the pulmonary artery (low oxygen content) and pulmonary vein (high oxygen content). Peripheral arterial blood is used as a surrogate for the pulmonary vein.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 99 - Which of these substances is secreted by pericytes in the juxtaglomerular cells? ...

    Incorrect

    • Which of these substances is secreted by pericytes in the juxtaglomerular cells?

      Your Answer:

      Correct Answer: Renin

      Explanation:

      The juxtaglomerular cells synthesise, store and secrete the enzyme renin in the kidney. They are specialised smooth muscle cells in the wall of the afferent arteriole that delivers blood to the glomerulus and thus play a critical role in the renin– angiotensin system and so in renal autoregulation.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 100 - Which of the following substances brings about a dilatation of the gastrointestinal resistance...

    Incorrect

    • Which of the following substances brings about a dilatation of the gastrointestinal resistance vessels?

      Your Answer:

      Correct Answer: Vasoactive intestinal peptide

      Explanation:

      Gastric vasoconstrictors include catecholamines, angiotensin II and vasopressin. Vasodilators include vasoactive intestinal peptide and the hormones; gastrin, cholecystokinin and glucagon.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (2/3) 67%
Physiology (9/11) 82%
Renal (3/4) 75%
Neurology (2/2) 100%
General (1/1) 100%
Endocrine (1/1) 100%
Passmed