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  • Question 1 - Which of the following is NOT a nutritional factor involved in wound healing:...

    Incorrect

    • Which of the following is NOT a nutritional factor involved in wound healing:

      Your Answer: Zinc

      Correct Answer: Vitamin B3

      Explanation:

      Vitamin B6 is required for collagen cross-links.

      Vitamin A is required for epithelial cell proliferation.

      Zinc is required for RNA and DNA synthesis.

      Copper is required for cross-linking of collagen.

    • This question is part of the following fields:

      • Cell Injury & Wound Healing
      • Physiology
      14
      Seconds
  • Question 2 - Purkinje fibres in the heart conduct action potentials at the rate of: ...

    Incorrect

    • Purkinje fibres in the heart conduct action potentials at the rate of:

      Your Answer: 0.2–1.1 m/s

      Correct Answer: 1.5–4.0 m/s

      Explanation:

      Purkinje fibres control the heart rate along with the sinoatrial node (SA node) and the atrioventricular node (AV node). The QRS complex is associated with the impulse passing through the Purkinje fibres. These fibres conduct action potential about six times faster than the velocity in normal cardiac muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      14.3
      Seconds
  • Question 3 - Which of the following is a true statement regarding the pupil? ...

    Correct

    • Which of the following is a true statement regarding the pupil?

      Your Answer: Phentolamine causes pupil constriction

      Explanation:

      A balance between the sympathetic tone to the radial fibres of the iris and parasympathetic tone to the pupillary sphincter muscle determines the pupil size. Phentolamine (α-adrenergic receptor blocker) causes pupillary constriction. Dilatation of the pupil occurs with increased sympathetic activity, decreased parasympathetic activity during darkness or block of muscarinic receptors by atropine.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      16.6
      Seconds
  • Question 4 - Which antibiotic acts by inhibiting protein synthesis? ...

    Incorrect

    • Which antibiotic acts by inhibiting protein synthesis?

      Your Answer: Trimethoprim

      Correct Answer: Erythromycin

      Explanation:

      Penicillins and cephalosporins (e.g. cefuroxime, cefotaxime, ceftriaxone) inhibit bacterial cell wall synthesis through the inhibition of peptidoglycan cross-linking.

      Macrolides (e.g. erythromycin), tetracyclines, aminoglycosides and chloramphenicol act by interfering with bacterial protein synthesis.

      Sulphonamides (e.g. trimethoprim, co-trimoxazole) work by inhibiting the synthesis of nucleic acid

    • This question is part of the following fields:

      • Pharmacology; Microbiology
      • Physiology
      11.9
      Seconds
  • Question 5 - Atractyloside is an inhibitor of electron transport chain. It is expected to have...

    Incorrect

    • Atractyloside is an inhibitor of electron transport chain. It is expected to have little or no effect on the functioning of which of the following cell types?

      Your Answer: Cardiac muscle cells

      Correct Answer: Red blood cells

      Explanation:

      Electron transport chain is a series of electron carriers that are embedded in the mitochondrial membrane. It is the place where ATP is made. Inhibiting the electron transport chain will stop production of ATP. Red blood cells are the only cell in the given option which do not contain ATP.

    • This question is part of the following fields:

      • General
      • Physiology
      35.4
      Seconds
  • Question 6 - Which is the site of action of the drug omeprazole? ...

    Correct

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

      Your 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
      26.2
      Seconds
  • Question 7 - Most of the coagulation factors are serine proteases. Which of the following is...

    Correct

    • Most of the coagulation factors are serine proteases. Which of the following is not one of them?

      Your Answer: Factor XIII

      Explanation:

      Serine protease coagulation factors include: thrombin, plasmin, Factors X, XI and XII. Factor VIII and factor V are glycoproteins and factor XIII is a transglutaminase.

    • This question is part of the following fields:

      • General
      • Physiology
      15.3
      Seconds
  • Question 8 - 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
      12.3
      Seconds
  • Question 9 - If a 55-year old gentleman who has suffered a stroke, develops a tremor...

    Incorrect

    • If a 55-year old gentleman who has suffered a stroke, develops a tremor in his fingers that worsens on reaching for an object, what part of his brain is likely to be involved?

      Your Answer: Basal ganglia

      Correct Answer: Cerebellum

      Explanation:

      The cerebellum plays an important role in the integration of sensory perception and motor output. Multiple neural pathways link the cerebellum with the motor cortex and the spinocerebellar tract. The cerebellum uses the constant feedback on body position to fine-tune the movements and integrates these pathways. The patient described here has a characteristic cerebellar tremor that is a slow, broad tremor of the extremities and occurs at the end of a purposeful movement.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      31.4
      Seconds
  • Question 10 - A 25-year-old woman complains of generalised swelling and particularly puffiness around the eyes...

    Correct

    • A 25-year-old woman complains of generalised swelling and particularly puffiness around the eyes which is worst in the morning. Laboratory studies showed:

      Blood urea nitrogen (BUN) = 30 mg/dl

      Creatinine = 2. 8 mg/dl

      Albumin = 2. 0 mg/dl

      Alanine transaminase (ALT) = 25 U/l

      Bilirubin = 1 mg/dl

      Urine analysis shows 3+ albumin and no cells.

      Which of the following is the most likely diagnosis?

      Your Answer: Nephrotic syndrome

      Explanation:

      Nephrotic syndrome is a disorder in which the glomeruli have been damaged, characterized by:

      – Proteinuria (>3.5 g per 1.73 m2 body surface area per day, or > 40 mg per square meter body surface area per hour in children)

      – Hypoalbuminemia (< 2,5 g/dl) – Hyperlipidaemia, and oedema (generalized anasarca).

    • This question is part of the following fields:

      • Physiology
      • Renal
      15.7
      Seconds
  • Question 11 - A 50 year old man on warfarin therapy following insertion of a pacemaker...

    Incorrect

    • A 50 year old man on warfarin therapy following insertion of a pacemaker presented with epistaxis. Which of the following is true regarding blood coagulation?

      Your Answer: Disseminated intravascular coagulation (DIC) results in depletion of fibrin split products

      Correct Answer: Patients with haemophilia A usually have a normal bleeding time

      Explanation:

      A prolonged bleeding time is seen in platelet disorders like thrombocytopenia. Patients with haemophilia A or B have a prolonged PTT but not a prolonged bleeding time.

      Ca2+ is necessary for coagulation.

      von Willebrand factor is an important part of the factor VIII complex and promotes platelet adhesion and aggregation.

      DIC results in depleted coagulation factors and accumulation of fibrin.

    • This question is part of the following fields:

      • General
      • Physiology
      36.9
      Seconds
  • Question 12 - The most likely cause of a low p(O2) in arterial blood is: ...

    Incorrect

    • The most likely cause of a low p(O2) in arterial blood is:

      Your Answer: Histotoxic hypoxia

      Correct Answer: Hypoxic hypoxia

      Explanation:

      Hypoxia is when the whole body or a region is deprived of adequate oxygen supply. Different types of hypoxia include the following:

      – Hypoxic hypoxia, which occurs due to poor oxygen supply, as a result of low partial pressure of oxygen in arterial blood. This could be due to low partial pressure of atmospheric oxygen (e.g., at high altitude), sleep apnoea, poor ventilation because of chronic obstructive pulmonary disease or respiratory arrest, or shunts. The other types of hypoxia have a normal partial pressure of oxygen.

      – Anaemic hypoxia occurs due to low total oxygen content of the blood, with a normal arterial oxygen pressure.

      – Hyperaemic hypoxia occurs due to poor delivery of oxygen to target tissues, such as in carbon monoxide poisoning or methemoglobinemia.

      – Histotoxic hypoxia results due to inability of the cells to use the delivered oxygen due to disabled oxidative phosphorylation enzymes.

      – Ischaemic (or stagnant) hypoxia occurs due to local flow restriction of well-oxygenated blood, seen in cases like cerebral ischaemia, ischaemic heart disease and intrauterine hypoxia.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      36
      Seconds
  • Question 13 - When one is silently counting, what part of his brain will show increased...

    Incorrect

    • When one is silently counting, what part of his brain will show increased regional cerebral blood flow (rCBF)?

      Your Answer: Occipital cortex

      Correct Answer: Supplementary motor area

      Explanation:

      Regional cerebral blood flow (rCBF) increases in the superior speech cortex (supplementary motor area) during periods of silent counting, whereas speaking aloud will do so in the motor cortex and medial temporal lobe, along with the superior speech cortex.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      24.7
      Seconds
  • Question 14 - The Henderson–Hasselbalch equation describes the derivation of pH as a measure of acidity. According to this equation,...

    Incorrect

    • The Henderson–Hasselbalch equation describes the derivation of pH as a measure of acidity. According to this equation, the buffering capacity of the system is at maximum when the number of free anions compared with undissociated acid is:

      Your Answer: Two times more

      Correct Answer: Equal

      Explanation:

      In 1908, Lawrence Joseph Henderson wrote an equation describing the use of carbonic acid as a buffer solution. Later, Karl Albert Hasselbalch re-expressed that formula in logarithmic terms, resulting in the Henderson–Hasselbalch equation. The equation is also useful for estimating the pH of a buffer solution and finding the equilibrium pH in acid–base reactions. Two equivalent forms of the equation are: pH = pKa + log10 [A–]/[HA] or pH = pKa + log10 [base]/[acid]. Here, pKa is − log10(Ka) where Ka is the acid dissociation constant, that is: pKa = –log10(Ka) = –log10 ([H3 O+][A–]/[HA]) for the reaction: HA + H2 O ≈ A– + H3 O+ In these equations, A– denotes the ionic form of the relevant acid. Bracketed quantities such as [base] and [acid] denote the molar concentration of the quantity enclosed. Maximum buffering capacity is found when pH = pKa or when the number of free anions to undissociated acid is equal and buffer range is considered to be at a pH = pKa ± 1.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      106
      Seconds
  • Question 15 - There are several mechanisms involved in the transport of sodium ions from blood...

    Incorrect

    • There are several mechanisms involved in the transport of sodium ions from blood to interstitial fluid of the muscle cells. Which of the following mechanisms best describes this phenomenon?

      Your Answer: Active transport through endothelial cell membranes

      Correct Answer: Diffusion through channels between endothelial cells

      Explanation:

      Capillaries are the smallest of the body’s blood vessels, measuring 5–10 μm and they help to enable the exchange of water, oxygen, carbon dioxide, and many other nutrients and waste substances between the blood and the tissues surrounding them. The walls of capillaries are composed of only a single layer of cells, the endothelium. Ion channels are pore-forming proteins that help to establish and control the small voltage gradient that exists across the plasma membrane of all living cells by allowing the flow of ions down their electrochemical gradient. An ion channel is an integral membrane protein or more typically an assembly of several proteins. The archetypal channel pore is just one or two atoms wide at its narrowest point. It conducts a specific ion such as sodium or potassium and conveys them through the membrane in single file.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      25.4
      Seconds
  • Question 16 - 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: Carboxyhaemoglobin

      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
      15.8
      Seconds
  • Question 17 - what is the cause of a prolonged PT(prothrombin time)? ...

    Incorrect

    • what is the cause of a prolonged PT(prothrombin time)?

      Your Answer: von Willebrand factor deficiency

      Correct Answer: Liver disease

      Explanation:

      PT measure the intrinsic pathway of coagulation. It determines the measure of the warfarin dose regime, liver disease and vit K deficiency status along with the clotting tendency of blood. PT measured factors are II,V,VII,X and fibrinogen. It is used along with aPTT which measure the intrinsic pathway.

    • This question is part of the following fields:

      • General
      • Physiology
      16
      Seconds
  • Question 18 - A patient came into the emergency in a state of shock. His blood...

    Correct

    • A patient came into the emergency in a state of shock. His blood group is not known, but on testing it clotted when mixed with Type A antibodies. Which blood should be transfused?

      Your Answer: B +ve

      Explanation:

      There are two stages to determine the blood group, known as ABO typing. The first stage is called forward typing. In this method, RBCs are mixed with two separate solutions of type A or type B antibodies to see if they agglutinate. If this blood clumps, this indicates the presence of antigens within the blood sample. For example, a sample of type B blood will clump when tested with type A antibodies as it contains type B antigens. Group B – has only the B antigen on red cells (and A 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 Rh factor on the red blood cell’s surface. This is also an antigen and those who have it are called Rh+. Those who have not 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. The patient’s blood group is B positive as he has antigen B, antibody A and Rh antigens.

    • This question is part of the following fields:

      • General
      • Physiology
      12.4
      Seconds
  • Question 19 - Work of breathing (WOB) is the energy expended to inhale and exhale a breathing gas. Normally, maximal amount of work...

    Correct

    • Work of breathing (WOB) is the energy expended to inhale and exhale a breathing gas. Normally, maximal amount of work of breathing is required to overcome:

      Your Answer: Elastic lung compliance

      Explanation:

      The forces of elastance (compliance), frictional resistance and inertia have been identified as the forces that oppose lung inflation and deflation. The normal relaxed state of the lung and chest is partially empty. Further exhalation requires muscular work. Inhalation is an active process requiring work. About 60–66% of the total work performed by the respiratory muscles is used to overcome the elastic or compliance characteristics of the lung–chest cage, 30–35% is used to overcome frictional resistance and only 2–5% of the work is used for inertia.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      29.5
      Seconds
  • Question 20 - Which statement is correct regarding secretions from the adrenal glands? ...

    Incorrect

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

      Your Answer: Adrenaline is produced by the zona reticularis

      Correct 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
      37.6
      Seconds
  • Question 21 - 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: Compensated metabolic acidosis

      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
      52.9
      Seconds
  • Question 22 - 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: Touch

      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
      32.3
      Seconds
  • Question 23 - The bronchial circulation is a part of the circulatory system that supplies nutrients and oxygen to the pulmonary...

    Incorrect

    • The bronchial circulation is a part of the circulatory system that supplies nutrients and oxygen to the pulmonary parenchyma. What percentage of cardiac output is received by bronchial circulation?

      Your Answer: 7%

      Correct Answer: 2%

      Explanation:

      The bronchial circulation is part of the systemic circulation and receives about 2% of the cardiac output from the left heart. Bronchial arteries arise from branches of the aorta, intercostal, subclavian or internal mammary arteries. The bronchial arteries supply the tracheobronchial tree with both nutrients and O2. It is complementary to the pulmonary circulation that brings deoxygenated blood to the lungs and carries oxygenated blood away from them in order to oxygenate the rest of the body.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      29.4
      Seconds
  • Question 24 - A neurotransmitter of the nigrostriatal pathway is: ...

    Incorrect

    • A neurotransmitter of the nigrostriatal pathway is:

      Your Answer: Glycine

      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
      7.6
      Seconds
  • Question 25 - The neurotransmitters adrenaline, noradrenaline and dopamine are derived from which amino acid? ...

    Correct

    • The neurotransmitters adrenaline, noradrenaline and dopamine are derived from which amino acid?

      Your Answer: Tyrosine

      Explanation:

      Tyrosine is the precursor to adrenaline, noradrenaline and dopamine. Tyrosine hydroxylase converts tyrosine to DOPA, which is in turn converted to dopamine, then to noradrenaline and finally adrenaline.

    • This question is part of the following fields:

      • Endocrine
      • Physiology
      11
      Seconds
  • Question 26 - What is the most likely cause of prolonged bleeding time in a 40...

    Incorrect

    • What is the most likely cause of prolonged bleeding time in a 40 year old women admitted for a laparoscopic cholecystectomy?

      Your Answer: Haemophilia

      Correct Answer: Thrombocytopaenia

      Explanation:

      Bleeding time is related to platelet function, thus a decrease in platelet function, as seen in thrombocytopenia, DIC and von Willebrand disease in which platelet aggregation is defective, leads to an increase in bleeding time. It is not affected by a decrease or deficiency of any other clotting factors. Aspirin and other COX inhibitors prolong bleeding time along with warfarin and heparin.

    • This question is part of the following fields:

      • General
      • Physiology
      18.1
      Seconds
  • Question 27 - Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal...

    Incorrect

    • Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal volume of 550 ml and an effective anatomical dead space of 250 ml. What is his alveolar ventilation?

      Your Answer: 2000 ml/min

      Correct Answer: 3000 ml/min

      Explanation:

      Alveolar ventilation is the amount of air reaching the alveoli per minute. Alveolar ventilation = respiratory rate × (tidal volume – anatomical dead space volume). Thus, alveolar ventilation = 10 × (550 − 250) = 3000 ml/min.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      55.6
      Seconds
  • Question 28 - What causes a reduction in pulmonary functional residual capacity? ...

    Incorrect

    • What causes a reduction in pulmonary functional residual capacity?

      Your Answer: Pneumonia

      Correct Answer: Pulmonary fibrosis

      Explanation:

      Pulmonary functional residual capacity (FRC) is = volume of air present in the lungs at the end of passive expiration.

      Obstructive diseases (e.g. emphysema, chronic bronchitis, asthma) = an increase in FRC due to an increase in lung compliance and air trapping.

      Restrictive diseases (e.g. pulmonary fibrosis) result in stiffer, less compliant lungs and a reduction in FRC.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      26.8
      Seconds
  • Question 29 - A 7-year-old girl is given cephalexin to treat an infection and develops hives,...

    Correct

    • 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: 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
      35.9
      Seconds
  • Question 30 - A TRUE statement regarding abolition of the cephalic phase of pancreatic secretion is...

    Incorrect

    • A TRUE statement regarding abolition of the cephalic phase of pancreatic secretion is that it:

      Your Answer: Will mainly affect HCO3 – secretion

      Correct Answer: Will result after vagotomy

      Explanation:

      Recognition and integration of the sight, smell and taste of food triggers the cephalic phase of pancreatic secretion, causing an increase in pancreatic HCO3- and enzyme secretion. The degree of enzyme secretion in this phase is about 50% of the maximal response seen with exogenous CCK and secretin. The vagus nerve regulates the secretion through the cholinergic fibres innervating the acinar cells of the pancreas, and through peptidergic nerve fibres, which innervate ductal cells.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      33
      Seconds
  • Question 31 - In what form are fats primarily transported in the body? ...

    Correct

    • In what form are fats primarily transported in the body?

      Your Answer: Free fatty acids

      Explanation:

      Fat is mainly transported in the body as free fatty acids. Once out of the adipose cell, the free fatty acids get ionized and combine with albumin.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      22.2
      Seconds
  • Question 32 - What is the normal duration of the ST segment? ...

    Incorrect

    • What is the normal duration of the ST segment?

      Your Answer: 0.2 s

      Correct Answer: 0.08 s

      Explanation:

      The ST segment lies between the QRS complex and the T-wave. The normal duration of the ST segment is 0.08 s. ST-segment elevation or depression may indicate myocardial ischaemia or infarction.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      11
      Seconds
  • Question 33 - A 65-year-old man complains of headaches, weakness, cramps, and confusion; blood tests reveal...

    Correct

    • A 65-year-old man complains of headaches, weakness, cramps, and confusion; blood tests reveal he has severe hyponatremia. The most likely cause is:

      Your Answer: Severe diarrhoea or vomiting

      Explanation:

      Hyponatraemia occurs when the sodium level in the plasma falls below 135 mmol/l. Hyponatraemia is an abnormality that can occur in isolation or, more commonly as a complication of other medical illnesses. Severe hyponatraemia may cause osmotic shift of water from the plasma into the brain cells. Typical symptoms include nausea, vomiting, headache and malaise. As the hyponatraemia worsens, confusion, diminished reflexes, convulsions, stupor or coma may occur. The cause of hyponatremia is typically classified by a person’s fluid status into low volume, normal volume, and high volume. Low volume hyponatremia can occur from diarrhoea, vomiting, diuretics, and sweating.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      18.7
      Seconds
  • Question 34 - The transmembrane proteins responsible for resting membrane potential of vascular smooth muscle cells...

    Incorrect

    • The transmembrane proteins responsible for resting membrane potential of vascular smooth muscle cells was blocked by a drug. Which of the following transmembrane proteins were blocked by this drug?

      Your Answer: Na+/K+ pump

      Correct Answer: K+ channels

      Explanation:

      The resting membrane potential is due to selective permeability of the membrane to potassium ions. The Na/K pump is responsible for the generation of a gradient across the membrane and it is due to the inherent ability of the K channels to allow diffusion back into the nerve at rest which charges the cells. In reality, the resting membrane potential is more positive because of small contributions by Na+ channels, Cl− channels and non-selective cation channels.

    • This question is part of the following fields:

      • General
      • Physiology
      58.4
      Seconds
  • Question 35 - 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: High serum concentration of glucose

      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
      25.8
      Seconds
  • Question 36 - Different substances have different renal clearance rates. Which of the following substances should...

    Correct

    • 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: 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
      10.7
      Seconds
  • Question 37 - Under normal conditions, what is the major source of energy of cardiac muscles?...

    Correct

    • Under normal conditions, what is the major source of energy of cardiac muscles?

      Your Answer: Fatty acids

      Explanation:

      Under basal conditions, most of the energy needed by cardiac muscle for metabolism is derived from fats (60%), 35% by carbohydrates, and 5% by ketones and amino acids. However, after intake of large amounts of glucose, lactate and pyruvate are mainly used. During prolonged starvation, fat acts as the primary source. 50% of the used lipids are sourced from circulating fatty acids.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      12.1
      Seconds
  • Question 38 - A medical student is told a substance is freely filtered but is not...

    Incorrect

    • A medical student is told a substance is freely filtered but is not metabolised, secreted, or stored in the kidney. It has a plasma concentration of 1000 mg/l and its urine excretion rate is 25 mg/min, and the inulin clearance is 100 ml/min. What is the rate of tubular reabsorption of the substance?

      Your Answer: 250 mg/min

      Correct Answer: 75 mg/min

      Explanation:

      Reabsorption or tubular reabsorption is the process by which the nephron removes water and solutes from the tubular fluid (pre-urine) and returns them to the circulating blood. To calculate the reabsorption rate of substance Z we use the following equation: excretion = (filtration + secretion) – reabsorption. As this substance is freely filtered, its filtration rate is equal to that of inulin. So 25 = (100 + 0) – reabsorption. Reabsorption = 100 – 25 therefore reabsorption = 75 mg/min.

    • This question is part of the following fields:

      • Physiology
      • Renal
      33.7
      Seconds
  • Question 39 - A 70-year-old male who has smoked since his teens complains of progressive shortness...

    Incorrect

    • A 70-year-old male who has smoked since his teens complains of progressive shortness of breath and a persistent cough. He is diagnosed with COPD. Which of the following abnormalities is most likely to be present in his pulmonary function tests?

      Your Answer: Increased FEV1/FVC

      Correct Answer: Increased residual volume

      Explanation:

      Chronic obstructive pulmonary disease (COPD) is a type of obstructive lung disease characterized by long-term poor airflow. The main symptoms include shortness of breath and cough with sputum production. The best diagnostic test for evaluating patients with suspected chronic obstructive pulmonary disease (COPD) is lung function measured with spirometry. Key spirometrical measures may be obtained with a portable office spirometer and should include forced vital capacity (FVC) and the normal forced expiratory volume in the first second of expiration (FEV1). The ratio of FEV1 to forced vital capacity (FEV1/FVC) normally exceeds 0.75. Patients with COPD typically present with obstructive airflow. Complete pulmonary function testing may show increased total lung capacity, functional residual capacity and residual volume. A substantial loss of lung surface area available for effective oxygen exchange causes diminished carbon monoxide diffusion in the lung (DLco) in patients with emphysema. Tobacco smoking is the most common cause of COPD, with factors such as air pollution and genetics playing a smaller role.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      34.1
      Seconds
  • Question 40 - An ECG of a 30 year old woman revealed low voltage QRS complexes....

    Correct

    • An ECG of a 30 year old woman revealed low voltage QRS complexes. This patient is most probably suffering from?

      Your Answer: Pericardial effusion

      Explanation:

      The QRS complex is associated with current that results in the contraction of both the ventricles. As ventricles have more muscle mass than the atria, they result in a greater deflection on the ECG. The normal duration of a QRS complex is 10s. A wide and deep Q wave depicts myocardial infarction. Abnormalities in the QRS complex maybe indicative of a bundle block, ventricular tachycardia or hypertrophy of the ventricles. Low voltage QRS complexes are characteristic of pericarditis or a pericardial effusion.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      22.8
      Seconds
  • Question 41 - Mechanical distortion, and not K+ channels are responsible for distortion of which of...

    Incorrect

    • Mechanical distortion, and not K+ channels are responsible for distortion of which of the following structures?

      Your Answer: Sinoatrial (SA) node

      Correct Answer: Pacinian corpuscle

      Explanation:

      Pacinian corpuscles are a type of mechanoreceptor, sensitive to deep pressure, touch and high-frequency vibration. The Pacinian corpuscles are ovoid and about 1 mm long. In the centre of the corpuscle is the inner bulb, which is a fluid-filled cavity with a single afferent unmyelinated nerve ending. Any deformation in the corpuscle causes the generation of action potentials by opening of pressure-sensitive sodium ion channels in the axon membrane. This allows influx of sodium ions, creating a receptor potential (independent of potassium channels).

    • This question is part of the following fields:

      • Neurology
      • Physiology
      31.6
      Seconds
  • Question 42 - The proximal tubule is the portion of the ductal system of the nephron of the kidney which leads from Bowman's capsule to the loop...

    Correct

    • The proximal tubule is the portion of the ductal system of the nephron of the kidney which leads from Bowman's capsule to the loop of Henle. Which of the following is most likely to be seen in a sample of fluid leaving the proximal tubule?

      Your Answer: It will have no amino acids

      Explanation:

      The proximal tubule is the portion of the duct system of the nephron leading from Bowman’s capsule to the loop of Henlé. The most distinctive characteristic of the proximal tubule is its brush border (or ‘striated border’). The luminal surface of the epithelial cells of this segment of the nephron is covered with densely packed microvilli forming a border which greatly increases the luminal surface area of the cells, presumably facilitating their reabsorptive function. Glucose, amino acids, inorganic phosphate, and some other solutes are100% reabsorbed via secondary active transport through co-transporters driven by the sodium gradient out of the nephron.

    • This question is part of the following fields:

      • Physiology
      • Renal
      53.9
      Seconds
  • Question 43 - The most likely cause of prominent U waves on the electrocardiogram (ECG) of...

    Correct

    • The most likely cause of prominent U waves on the electrocardiogram (ECG) of a patient is:

      Your Answer: Hypokalaemia

      Explanation:

      The U-wave, not always visible in ECGs, is thought to represent repolarisation of papillary muscles or Purkinje fibres. When seen, it is very small and occurs after the T-wave. Inverted U-waves indicate myocardial ischaemia or left ventricular volume overload. Prominent U-waves are most commonly seen in hypokalaemia. Other causes include hypercalcaemia, thyrotoxicosis, digitalis exposure, adrenaline and class 1A and 3 anti-arrhythmic agents. It can also be seen in congenital long-QT syndrome and in intracranial haemorrhage.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      25
      Seconds
  • Question 44 - When the pitch of a sound increases, what is the physiological response seen...

    Incorrect

    • When the pitch of a sound increases, what is the physiological response seen in the listener?

      Your Answer: A greater number of hair cells become activated

      Correct Answer: The location of maximal basilar membrane displacement moves toward the base of the cochlea

      Explanation:

      An increase in the frequency of sound waves results in a change in the position of maximal displacement of the basilar membrane in the cochlea. Low pitch sound produces maximal displacement towards the cochlear apex and greatest activation of hair cells there. With an increasing pitch, the site of greatest displacement moves towards the cochlear base. However, increased amplitude of displacement, increase in the number of activated hair cells, increased frequency of discharge of units in the auditory nerve and increase in the range of frequencies to which such units respond, are all seen in increases in the intensity or a sound stimulus.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      37.7
      Seconds
  • Question 45 - Which of the following organs is most likely to have dendritic cells? ...

    Correct

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

      Your 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
      14.1
      Seconds
  • Question 46 - Which of the following enzymes is secreted by the small intestinal mucosa? ...

    Incorrect

    • Which of the following enzymes is secreted by the small intestinal mucosa?

      Your Answer: Secretin

      Correct Answer: Lactase

      Explanation:

      Lactase, an enzyme belonging to β-galactosidase family of enzymes, brings about the hydrolysis of the disaccharide lactose into galactose and glucose. In humans, it is present along the brush border membrane of the cells lining the small intestinal villi. Deficiency of lactase causes lactose intolerance.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      8.1
      Seconds
  • Question 47 - A 35-year-old ultra marathon runner becomes severely dehydrated and collapses. This patient most...

    Incorrect

    • A 35-year-old ultra marathon runner becomes severely dehydrated and collapses. This patient most likely has:

      Your Answer:

      Correct Answer: Decreased baroreceptor firing rate

      Explanation:

      Baroreceptors are sensors located in the blood vessels of all vertebrate animals. They sense the blood pressure and relay the information to the brain, so that a proper blood pressure can be maintained. Acute dehydration results in decreased plasma volume and increased plasma osmolarity, since more water than salt is lost in sweat. The decrease in plasma volume leads to an inhibition of the baroreceptors and a lower firing rate. The increase in plasma osmolarity leads to increased ADH secretion and high plasma ADH levels, which increases water permeability of collecting duct cells. Therefore more water is reabsorbed by the kidneys and renal water excretion is low.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 48 - 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 49 - Normally, the O2 transfer in the lungs from alveolar to capillary is perfusion-limited....

    Incorrect

    • Normally, the O2 transfer in the lungs from alveolar to capillary is perfusion-limited. In which of the following situations does it become a diffusion-limited process?

      Your Answer:

      Correct Answer: Pulmonary oedema

      Explanation:

      Normally, the transfer of oxygen from air spaces to blood takes place across the alveolar-capillary membrane by simple diffusion and depends entirely on the amount of blood flow (perfusion-limited process). Diseases that affect this diffusion will transform the normal process to a diffusion limited process. Thus, the diseases which cause a thickened barrier (such as pulmonary oedema due to increased extravascular lung water or asbestosis) will limit the diffusion of oxygen. Chronic obstructive lung diseases will have little effect on diffusion. Inhaling hyperbaric gas mixtures might overcome the diffusion limitation in patients with mild asbestosis or interstitial oedema, by increasing the driving force. Strenuous (not mild) exercise might also favour diffusion limitation and decrease passage time. Increasing the rate of ventilation will not have this affect but will only maintain a high oxygen gradient from air to blood.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 50 - 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 51 - The pleural cavity is the space between the two pulmonary pleurae which cover...

    Incorrect

    • The pleural cavity is the space between the two pulmonary pleurae which cover the lungs. What is the normal amount of pleural fluid?

      Your Answer:

      Correct Answer: 10 ml

      Explanation:

      Pleural fluid is a serous fluid produced by the serous membrane covering normal pleurae. Most fluid is produced by the parietal circulation (intercostal arteries) via bulk flow and reabsorbed by the lymphatic system. The total volume of fluid present in the intrapleural space is estimated to be only 2–10 ml. A small amount of protein is present in intrapleural fluid. Normally, the rate of reabsorption increases as a physiological response to accumulating fluid.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 52 - Extracellular body fluid as compared with intracellular body fluid: ...

    Incorrect

    • Extracellular body fluid as compared with intracellular body fluid:

      Your Answer:

      Correct Answer: Is relatively rich in glucose

      Explanation:

      The percentages of body water contained in various fluid compartments add up to total body water (TBW). This water makes up a significant fraction of the human body, both by weight and by volume. Ensuring the right amount of body water is part of fluid balance, an aspect of homeostasis. The extracellular fluid (ECF) includes all fluids outside the cells. This fluid can be divided into three fluid departments: interstitial (in the tissue spaces) fluid, blood plasma and lymph, and specialised compartments called transcellular fluid. The extracellular fluid surrounds all the cells in the body and is in equilibrium with the intracellular fluid. So, its composition must remain fairly constant even though substances are passing into and out of the cells. The interstitial fluid, though called a fluid, is in a reality a gel-like composition made up of: water, proteoglycan molecules and collagen. The extracellular fluid constitutes 40% of total body water, with intracellular fluid making up the remaining 60%. It is relatively rich in glucose.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 53 - Which of the following substances is most likely to cause pulmonary vasodilatation? ...

    Incorrect

    • Which of the following substances is most likely to cause pulmonary vasodilatation?

      Your Answer:

      Correct Answer: Nitric oxide

      Explanation:

      In the body, nitric oxide is synthesised from arginine and oxygen by various nitric oxide synthase (NOS) enzymes and by sequential reduction of inorganic nitrate. The endothelium of blood vessels uses nitric oxide to signal the surrounding smooth muscle to relax, so dilating the artery and increasing blood flow. Nitric oxide/oxygen blends are used in critical care to promote capillary and pulmonary dilation to treat primary pulmonary hypertension in neonatal patients post-meconium aspiration and related to birth defects.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 54 - Which of the following can occur even in the absence of brainstem co-ordination?...

    Incorrect

    • Which of the following can occur even in the absence of brainstem co-ordination?

      Your Answer:

      Correct Answer: Gastric emptying

      Explanation:

      Although gastric emptying is under both neural and hormonal control, it does not require brainstem co-ordination. Increased motility of the orad stomach (decreased distensibility) or of the distal stomach (increased peristalsis), decreased pyloric tone, decreased duodenal motility or a combination of these, all increase the rate of gastric emptying. The major control mechanism for gastric emptying is through duodenal gastric feedback. The duodenum has receptors for the presence of acid, carbohydrate, fat and protein digestion products, osmolarity different from that of plasma, and distension. Activating these receptors decreases the rate of gastric emptying. Neural mechanisms involve both enteric and vagal pathways and a vagotomy impairs the gastric emptying regulation. CCK (cholecystokinin) slows gastric emptying at physiological levels of the hormone. Gastrin, secretin and glucose-1-phosphate also slow gastric emptying, but require higher doses.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 55 - Some substances, such as Chromium-51 and Technetium-99, are freely filtered but not secreted...

    Incorrect

    • Some substances, such as Chromium-51 and Technetium-99, are freely filtered but not secreted or absorbed by the kidney. In these cases, their clearance rate is equal to:

      Your Answer:

      Correct Answer: Glomerular filtration rate

      Explanation:

      If a substance passes through the glomerular membrane with perfect ease, the glomerular filtrate contains virtually the same concentration of the substance as does the plasma and if the substance is neither secreted nor reabsorbed by the tubules, all of the filtered substance continues on into the urine. Glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidney.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 56 - 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 57 - A 40-year old gentleman, known with a history of peptic ulcer disease, was...

    Incorrect

    • A 40-year old gentleman, known with a history of peptic ulcer disease, was brought to the clinic in a dehydrated state with persistent vomiting. His blood investigations revealed:
      • sodium = 142 mmol/l
      • potassium = 2.6 mmol/l
      • chloride = 85 mmol/l
      • pH = 7.55
      • p(CO2) = 50 mmHg
      • p(O2) = 107 mmHg
      • standard bicarbonate = 40 mmol/l
      This patient has a:

      Your Answer:

      Correct Answer: Metabolic alkalosis

      Explanation:

      High pH with high standard bicarbonate indicates metabolic alkalosis. The pa(CO2) was appropriately low in compensation. This is hypokalaemic hypochloraemic metabolic acidosis due to prolonged vomiting. Treatment includes treating the cause and intravenous sodium chloride with potassium.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 58 - A 50-year-old woman goes to the doctor complaining of myalgia, muscle cramps, and...

    Incorrect

    • A 50-year-old woman goes to the doctor complaining of myalgia, muscle cramps, and weakness; she is diagnosed with severe hypokalaemia. Which of the following is the most common cause of hypokalaemia?

      Your Answer:

      Correct Answer: Prolonged vomiting

      Explanation:

      Potassium is one of the body’s major ions. Nearly 98% of the body’s potassium is intracellular. The ratio of intracellular to extracellular potassium is important in determining the cellular membrane potential. Small changes in the extracellular potassium level can have profound effects on the function of the cardiovascular and neuromuscular systems. Hypokalaemia may result from conditions as varied as renal or gastrointestinal (GI) losses, inadequate diet, transcellular shift (movement of potassium from serum into cells) and medications. The important causes of hypokalaemia are:

      Renal losses: renal tubular acidosis, hyperaldosteronism, magnesium depletion, leukaemia (mechanism uncertain).

      GI losses: vomiting or nasogastric suctioning, diarrhoea, enemas or laxative use, ileal loop.

      Medication effects: diuretics (most common cause), β-adrenergic agonists, steroids, theophylline, aminoglycosides.

      Transcellular shift: insulin, alkalosis.

      Severe hypokalaemia, with serum potassium concentrations of 2.5–3 meq/l, may cause muscle weakness, myalgia, tremor, muscle cramps and constipation.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 59 - Rapid Eye Movement (REM) sleep is typically associated with: ...

    Incorrect

    • Rapid Eye Movement (REM) sleep is typically associated with:

      Your Answer:

      Correct Answer: Penile erections

      Explanation:

      Normal sleep comprises of alternate cycles between slow-wave sleep (non-REM sleep) and REM sleep. REM sleep is characterized by increased metabolic brain activity and EEG desynchronization. Somnambulism (sleepwalking), enuresis (bedwetting) and night terrors all occur during slow-wave sleep or during arousal from slow-wave sleep. In comparison, REM sleep is characterized by hypotonia of major muscle groups (excluding ocular muscles), dreams, nightmares and penile erection.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 60 - A 35-year-old woman in her 37th week of pregnancy complains of urinary incontinence....

    Incorrect

    • A 35-year-old woman in her 37th week of pregnancy complains of urinary incontinence. She is most likely to have:

      Your Answer:

      Correct Answer: Stress incontinence

      Explanation:

      Urinary incontinence is the involuntary excretion of urine from one’s body. It is often temporary and it almost always results from an underlying medical condition. Several types include:

      – Stress incontinence is the voiding of urine following increased abdominal pressure e.g. laughing, coughing, pregnancy etc. It is the most common form of incontinence in women, most commonly due to pelvic floor muscle weakness, physical changes from pregnancy, childbirth and menopause. In men it is a common problem following a prostatectomy. Most lab results such as urine analysis, cystometry and postvoid residual volume are normal.

      – Urge incontinence is involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urinate. The most common cause of urge incontinence are involuntary and inappropriate detrusor muscle contractions.

      – Functional incontinence – occurs when a person does not recognise the need to go to the toilet, recognise where the toilet is or get to the toilet in time. The urine loss may be large. Causes of functional incontinence include confusion, dementia, poor eyesight, poor mobility, poor dexterity or unwillingness. t

      – Overflow incontinence – sometimes people find that they cannot stop their bladders from constantly dribbling or continuing to dribble for some time after they have passed urine.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 61 - Calculate the stroke volume in a patient admitted for coronary bypass surgery, with...

    Incorrect

    • Calculate the stroke volume in a patient admitted for coronary bypass surgery, with the following parameters pre-operatively:

      Oxygen consumption = 300 ml/min

      Arterial oxygen content = 20 ml/100 ml blood

      Pulmonary arterial oxygen content = 15 ml/100 ml blood and Heart rate = 100 beats/min.

      Your Answer:

      Correct Answer: 60 ml

      Explanation:

      By Fick’s principle, cardiac output can be calculated as follows: VO2 = CO × (CAO2– CVO2) where VO2= oxygen consumption, CO = cardiac output, CAO2 = arterial oxygen content and CvO2 = mixed venous oxygen content. Thus, in the given problem, 300 ml/min = CO × (20 – 15) ml/100 ml CO = 300 × 100/5 ml/min CO = 6000 ml/min. Also, cardiac output = stroke volume × heart rate. Thus, 6000 ml/min = stroke volume × 100 beats/min. Hence, stroke volume = 6000/100 ml/min which is 60 ml/min.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 62 - 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 63 - A 55 year old lady underwent an uneventful appendicectomy. Two hours later, her...

    Incorrect

    • A 55 year old lady underwent an uneventful appendicectomy. Two hours later, her arterial blood gas analysis on room revealed pH: 7.30, p(CO2): 53 mmHg and p(O2): 79 mmHg. What is the most likely cause of these findings?

      Your Answer:

      Correct Answer: Alveolar hypoventilation

      Explanation:

      In the given problem, there is respiratory acidosis due to hypercapnia from a low respiratory rate and/or volume (hypoventilation). Causes of hypoventilation include conditions impairing the central nervous system (CNS) respiratory drive, impaired neuromuscular transmission and other causes of muscular weakness (drugs and sedatives), along with obstructive, restrictive and parenchymal pulmonary disorders. Hypoventilation leads to hypoxia and hypercapnia reduces the arterial pH. Severe acidosis leads to pulmonary arteriolar vasoconstriction, systemic vascular dilatation, reduced myocardial contractility, hyperkalaemia, hypotension and cardiac irritability resulting in arrhythmias. Raised carbon dioxide concentration also causes cerebral vasodilatation and raised intracranial pressure. Over time, buffering and renal compensation occurs. However, this might not be seen in acute scenarios where the rise in p(CO2) occurs rapidly.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 64 - A 30 year old female suffered from mismatched transfusion induced haemolysis. Which substance...

    Incorrect

    • A 30 year old female suffered from mismatched transfusion induced haemolysis. Which substance will be raised in the plasma of this patient?

      Your Answer:

      Correct Answer: Bilirubin

      Explanation:

      Bilirubin is a yellow pigment that is formed due to the break down of RBCs. Haemolysis results in haemoglobin that is broken down into a haem portion and globin which is converted into amino acids and used again. Haem is converted into unconjugated bilirubin in the macrophages and shunted to the liver. In the liver it is conjugated with glucuronic acid making it water soluble and thus excreted in the urine. Its normal levels are from 0.2-1 mg/dl. Increased bilirubin causes jaundice and yellowish discoloration of the skin.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 65 - 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 66 - 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 67 - 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 68 - A 34-year old gentleman presented with acute pancreatitis to the emergency department. On...

    Incorrect

    • A 34-year old gentleman presented with acute pancreatitis to the emergency department. On enquiry, there was found to be a history of recurrent pancreatitis, eruptive xanthomas and raised plasma triglyceride levels associated with chylomicrons. Which of the following will be found deficient in this patient?

      Your Answer:

      Correct Answer: Lipoprotein lipase

      Explanation:

      The clinical features mentioned here suggest the diagnosis of hypertriglyceridemia due to lipoprotein lipase (LPL) deficiency. LPL aids in hydrolysing the lipids in lipoproteins into free fatty acids and glycerol. Apo-CII acts as a co-factor. Deficiency of this enzyme leads to hypertriglyceridemia.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 69 - If the blood flow is constant, oxygen extraction by tissues will show the...

    Incorrect

    • If the blood flow is constant, oxygen extraction by tissues will show the greatest decrease due to which of the following interventions?

      Your Answer:

      Correct Answer: Tissue cooling

      Explanation:

      With a constant blood flow to a given tissue bed, there will be an increase in oxygen extraction by the tissue with the following; an increase in tissue metabolism and oxygen requirements: warming (or fever), exercise, catecholamines and thyroxine. With cooling, the demand for oxygen decreases, leading to decreased oxygen extraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 70 - Calculate the cardiac output in an adult male with the following parameters:

    Heart...

    Incorrect

    • Calculate the cardiac output 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:

      Correct Answer: 6.25 l/min

      Explanation:

      As per Fick’s principle, 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.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 71 - Which of the following has the highest content of triglycerides? ...

    Incorrect

    • Which of the following has the highest content of triglycerides?

      Your Answer:

      Correct Answer: Chylomicron

      Explanation:

      Created by the small intestinal cells, chylomicrons are large lipoprotein molecules which transport lipids to the liver, adipose, cardiac and skeletal tissue. Chylomicrons are mainly composed of triglycerides (,85%) along with some cholesterol and cholesteryl esters. Apo B-48 is the main apolipoprotein content.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 72 - 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 73 - 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 74 - A suspected recreational drug user was brought to the Emergency department in an...

    Incorrect

    • A suspected recreational drug user was brought to the Emergency department in an unconscious state, and was found to be hypoventilating. Which of the following set of arterial blood gas analysis report is most consistent with hypoventilation as the primary cause? pH, pa(CO2) (mmHg), pa(O2) (mmHg).

      Your Answer:

      Correct Answer: 7.28, 55, 81

      Explanation:

      Hypoventilation (or respiratory depression) causes an increase in carbon dioxide (hypercapnia) and respiratory acidosis. It can result due to drugs such as alcohol, benzodiazepines, barbiturates, opiates, mechanical conditions or holding ones breath. Strong opioids such as heroin and fentanyl are commonly implicated and can lead to respiratory arrest. In recreational drug overdose, acute respiratory acidosis occurs with an increase in p(CO2) over 45 mm Hg and acidaemia (pH < 7.35)

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 75 - Which of the following will show decreased hearing when tested by air conduction...

    Incorrect

    • Which of the following will show decreased hearing when tested by air conduction but normal hearing when tested by bone conduction?

      Your Answer:

      Correct Answer: Fibrosis causing fixation of the ossicles

      Explanation:

      As the cochlea is embedded into bone, the vibrations from the bone are transmitted directly to the fluid in the cochlea. Hence, any damage to the ossicles or tympanic membrane will not show an abnormal result on bone conduction test.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 76 - 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 77 - A 65-year old patient with altered bowl movement experienced the worsening of...

    Incorrect

    • A 65-year old patient with altered bowl movement experienced the worsening of shortness of breath and exertional chest pains over the course of 8 weeks. Examination shows pallor and jugular venous distension. Furthermore, a test of the stool for occult blood is positive. Laboratory studies show:

      Haemoglobin 7.4 g/dl

      Mean corpuscular volume 70 fl Leukocyte count 5400/mm3

      Platelet count 580 000/mm3 Erythrocyte sedimentation 33 mm/h

      A blood smear shows hypochromic, microcytic RBCs with moderate poikilocytosis. Which of the following is the most likely diagnosis?

      Your Answer:

      Correct Answer: Iron deficiency anaemia

      Explanation:

      Iron deficiency anaemia is the most common type of anaemia. It can occur due to deficiency of iron due to decreased intake or due to faulty absorption. An MCV less than 80 will indicated iron deficiency anaemia. On the smear the RBC will be microcytic hypochromic and will also show piokilocytosis. iron profiles tests are important to make a diagnosis. Clinically the patient will be pale and lethargic.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 78 - 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 79 - Pain in the right upper quadrant of the abdomen on ingestion of a...

    Incorrect

    • Pain in the right upper quadrant of the abdomen on ingestion of a fatty meal is seen in a condition which involves which of the following substances?

      Your Answer:

      Correct Answer: Cholecystokinin

      Explanation:

      The clinical scenario described here favours the presence of gallstones. During food ingestion, vagal discharges stimulate gallbladder contraction. Moreover, presence of fat and amino acids in the intestinal lumen stimulates the release of cholecystokinin (CCK) in the duodenum. This causes sustained gallbladder contraction and relaxation of the sphincter of Oddi. If gallstones are present, there will be inflammation in the gallbladder and CCK will aggravate it due to contractions.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 80 - Regarding the coagulation cascade, Factor VII: ...

    Incorrect

    • Regarding the coagulation cascade, Factor VII:

      Your Answer:

      Correct Answer: Is a serine protease

      Explanation:

      Factor VII (FVII) is a zymogen for a vitamin K-dependent serine protease essential for the initiation of blood coagulation. It is synthesized primarily in the liver and circulates in plasma. Within the liver, hepatocytes are involved in the synthesis of most blood coagulation factors, such as fibrinogen, prothrombin, factor V, VII, IX, X, XI, XII, as well as protein C and S, and antithrombin, whereas liver sinusoidal endothelial cells produce factor VIII and von Willebrand factor.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 81 - A 79-year-old has been bedridden for 2 months after suffering from a stroke....

    Incorrect

    • A 79-year-old has been bedridden for 2 months after suffering from a stroke. She suddenly developed shortness of breath and chest pain, and was diagnosed with a pulmonary embolism. Which of the following is most likely to increase in this case?

      Your Answer:

      Correct Answer: Ventilation/perfusion ratio

      Explanation:

      Pulmonary embolism (PE) is a blockage of an artery in the lungs by an embolus that has travelled from elsewhere in the body through the bloodstream. The change in cardiopulmonary function is proportional to the extent of the obstruction, which varies with the size and number of emboli obstructing the pulmonary arteries. The resulting physiological changes may include pulmonary hypertension with right ventricular failure and shock, dyspnoea with tachypnoea and hyperventilation, arterial hypoxaemia and pulmonary infarction. Consequent alveolar hyperventilation is manifested by a lowered pa(CO2). After occlusion of the pulmonary artery, areas of the lung are ventilated but not perfused, resulting in wasted ventilation with an increased ventilation/perfusion ratio – the physiological hallmark of PE – contributing to a further hyperventilatory state. The risk of blood clots is increased by cancer, prolonged bed rest, smoking, stroke, certain genetic conditions, oestrogen-based medication, pregnancy, obesity, and post surgery.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 82 - A 26-year-old female patient had the following blood report: RBC count = 4....

    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) = 80–100 fl, mean corpuscular haemoglobin concentration (MCHC) = 31–37 g/dl. Which of the following is correct regarding this patient’s erythrocytes:

      Your Answer:

      Correct Answer: Normal MCV

      Explanation:

      MCV is the mean corpuscular volume and it is calculated from the haematocrit and the RBC count. It is normally 90 fl. Mean corpuscular haemoglobin concentration (MCHC) [g/dl] = haemoglobin [g/dl]/haematocrit = 11/0.27 = 41 g/dl and is higher than normal range (32 to 36 g/dL).

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 83 - With respect to far accommodation, which of the following is a TRUE statement?...

    Incorrect

    • With respect to far accommodation, which of the following is a TRUE statement?

      Your Answer:

      Correct Answer: The ciliary muscles are relaxed

      Explanation:

      Myopia or near-sightedness is a disease due to elongated eyeballs or too strong a lens. For far accommodation (focus of a distant object onto the retina), the lens needs to decrease its refractive power, or in other words, increase its focal length. This is done by relaxation of ciliary muscles which tightens the zonular fibres and flattening of the lens. Relaxation of the zonular fibres, rounding of the lens, shortening of the focal length and constriction of the pupil occurs during near accommodation.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 84 - 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 85 - A 43-year-old diabetic man complains of headaches, palpitations, anxiety, abdominal pain and weakness....

    Incorrect

    • A 43-year-old diabetic man complains of headaches, palpitations, anxiety, abdominal pain and weakness. He is administered sodium bicarbonate used to treat:

      Your Answer:

      Correct Answer: Metabolic acidosis

      Explanation:

      Sodium bicarbonate is indicated in the management of metabolic acidosis, which may occur in severe renal disease, uncontrolled diabetes, circulatory insufficiency due to shock or severe dehydration, extracorporeal circulation of blood, cardiac arrest and severe primary lactic acidosis. Bicarbonate is given at 50-100 mmol at a time under scrupulous monitoring of the arterial blood gas readings. This intervention, however, has some serious complications including lactic acidosis, and in those cases, should be used with great care.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 86 - 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 87 - 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 88 - 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 89 - A 25 year old man presented with a history of headache and peripheral...

    Incorrect

    • A 25 year old man presented with a history of headache and peripheral cyanosis. He had been living in the Himalayas for 6 months prior to this. What is the reason for his condition?

      Your Answer:

      Correct Answer: Physiological polycythaemia

      Explanation:

      Polycythaemia is a condition that results in an increase in the total number of red blood cells (RBCs) in the blood. It can be due to myeloproliferative syndrome or due to chronically low oxygen levels or rarely malignancy. In primary polycythaemia/polycythaemia vera the increase is due to an abnormality in the bone marrow, resulting in increases RBCs, white blood cells (WBCs) and platelets. In secondary polycythaemia the increase occurs due to high levels of erythropoietin either artificially or naturally. The increase is about 6-8 million/cm3 of blood. A type of secondary polycythaemia is physiological polycythaemia where people living in high altitudes who are exposed to hypoxic conditions produce more erythropoietin as a compensatory mechanism for thin oxygen and low oxygen partial pressure.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 90 - 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: normal FEV1, 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. Which of the following is most accurate about his residual volume?

      Your Answer:

      Correct Answer: Cannot be measured directly with a spirometer

      Explanation:

      Residual volume is the air left in the lungs after maximal expiration is done. Thus, this is not a part of vital capacity and cannot be measured with a spirometer directly. It can be measured by the methods such as body plethysmography or inert gas dilution. Expiratory reserve volume is vital capacity minus inspiratory capacity. Resting volume of lungs is he sum of residual volume and expiratory reserve volume. Lungs recoil inward until the recoil pressure becomes zero, which corresponds to a volume significantly lower than residual volume.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 91 - The gradual depolarization in-between action potentials in pacemaker tissue is a result of?...

    Incorrect

    • The gradual depolarization in-between action potentials in pacemaker tissue is a result of?

      Your Answer:

      Correct Answer: A combination of gradual inactivation outward IK along with the presence of an inward ‘funny’ current (If) due to opening of channels permeable to both Na+ and K+ ions

      Explanation:

      One of the characteristic features of the pacemaker cell is the generation of a gradual diastolic depolarization also called the pacemaker potential. In phase 0, the upstroke of the action potential caused by an increase in the Ca2+ conductance, an influx of calcium occurs and a positive membrane potential is generated. The next is phase 3 which is repolarization caused by increased K+ conductance as a result of outwards K+ current. Phase 4 is a slow depolarization which accounts for the pacemaker activity, caused by increased conductance of Na+, inwards Na+ current called IF. it is turned on by repolarization.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 92 - Which of the following causes the maximum increase in the secretion of antidiuretic...

    Incorrect

    • Which of the following causes the maximum increase in the secretion of antidiuretic hormone (ADH)?

      Your Answer:

      Correct Answer: Increased plasma osmolarity

      Explanation:

      The most potent stimulus for ADH release is increased plasma osmolarity. Decreased plasma volume is a less potent stimulus in comparison. However, decrease blood volume and arterial pressure due to severe haemorrhage does lead to ADH secretion. Hypothalamic releasing factors do not control the release of posterior pituitary hormones ADH and oxytocin.

    • This question is part of the following fields:

      • Endocrinology
      • Physiology
      0
      Seconds
  • Question 93 - In the glomerulus of the kidney, the mesangium is a structure associated with the capillaries. It has extraglomerular mesangial...

    Incorrect

    • In the glomerulus of the kidney, the mesangium is a structure associated with the capillaries. It has extraglomerular mesangial cells that:

      Your Answer:

      Correct Answer: Form the juxtaglomerular apparatus in combination with the macula densa and juxtaglomerular cells

      Explanation:

      The mesangium is an inner layer of the glomerulus, within the basement membrane surrounding the glomerular capillaries. The mesangial cells are phagocytic and secrete the amorphous basement membrane-like material known as the mesangial matrix. They are typically separated from the lumen of the capillaries by endothelial cells. The other type of cells in the mesangium are the extraglomerular mesangial cells which form the juxtaglomerular apparatus in combination with two other types of cells: the macula densa of the distal convoluted tubule and juxtaglomerular cells of the afferent arteriole. This apparatus controls blood pressure through the renin–angiotensin–aldosterone system.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 94 - A 50-year old gentleman who suffered a stroke was brought to the emergency...

    Incorrect

    • A 50-year old gentleman who suffered a stroke was brought to the emergency department by his relatives. The patient however denied the presence of paralysis of his left upper and lower limbs. What is the most likely site of the lesion in this patient?

      Your Answer:

      Correct Answer: Right posterior parietal cortex

      Explanation:

      A large injury to the non-dominant parietal cortex can make the patient neglect or refuse to acknowledge the presence of paralysis on the contralateral side. This can also involve the perception of the external world. Smaller injuries in this area which involve the precentral gyrus (primary motor cortex) or postcentral gyrus (primary sensory cortex) cause contralateral spastic paralysis or contralateral loss of tactile sensation respectively. A lesion in posterior inferior gyrus of the dominant frontal lobe results in motor aphasia. Involvement of the posterior superior gyrus of the dominant frontal lobe produces sensory aphasia.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 95 - Causes of metabolic acidosis with a normal anion gap include: ...

    Incorrect

    • Causes of metabolic acidosis with a normal anion gap include:

      Your Answer:

      Correct Answer: Diarrhoea

      Explanation:

      Excess acid intake and excess bicarbonate loss as in diarrhoea, are causes of metabolic acidosis with a normal anion gap. The other conditions all result in an increased anion gap.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 96 - 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 97 - upon stroking the plantar surface of a patient's foot, extension of toes was...

    Incorrect

    • upon stroking the plantar surface of a patient's foot, extension of toes was noted. This is likely to be accompanied with:

      Your Answer:

      Correct Answer: Spasticity

      Explanation:

      An upper motor neuron lesion affects the neural pathway above the anterior horn cell or motor nuclei of the cranial nerves, whereas a lower motor neurone lesion affects nerve fibres travelling from the anterior horn of the spinal cord to the relevant muscles. An upper motor neurone lesions results in the following:

      – Spasticity in the extensor muscles (lower limbs) or flexor muscles (upper limbs).

      – ‘clasp-knife’ response where initial resistance to movement is followed by relaxation

      – Weakness in the flexors (lower limbs) or extensors (upper limbs) with no muscle wasting

      – Brisk tendon jerk reflexes

      – Positive Babinski sign (on stimulation of the sole of the foot, the big toe is raised rather than curled downwards)

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 98 - 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 99 - Lung compliance is increased by: ...

    Incorrect

    • Lung compliance is increased by:

      Your Answer:

      Correct Answer: Emphysema

      Explanation:

      Lung compliance is increased by emphysema, acute asthma and increasing age and decreased by alveolar oedema, pulmonary hypertension, atelectasis and pulmonary fibrosis.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 100 - During pregnancy the uterus enlarges however after delivery it regresses to its original...

    Incorrect

    • During pregnancy the uterus enlarges however after delivery it regresses to its original size. Which of the following organelles is responsible for this regression?

      Your Answer:

      Correct Answer: Lysosomes

      Explanation:

      Lysosomes are formed by budding of the Golgi apparatus and contain enzymes which digest macromolecules. They are found in both plants and animals and are active in autophagic cell death, digestion after phagocytosis and for the cells own recycling process. They fuse with the molecules and release their content resulting in digestion.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cell Injury & Wound Healing (0/1) 0%
Physiology (17/46) 37%
Cardiovascular (3/5) 60%
Neurology (2/8) 25%
Pharmacology; Microbiology (0/1) 0%
General (3/8) 38%
Gastroenterology (2/4) 50%
Renal (3/5) 60%
Respiratory (1/7) 14%
Fluids & Electrolytes (2/4) 50%
Respiratory; Cardiovascular (0/1) 0%
Endocrine (1/1) 100%
Endocrinology (0/1) 0%
Passmed