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  • Question 1 - What causes a reduction in pulmonary functional residual capacity? ...

    Incorrect

    • What causes a reduction in pulmonary functional residual capacity?

      Your Answer: Emphysema

      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
      18.4
      Seconds
  • Question 2 - Electrophoresis is used to detect antibodies (immunoglobulins) in a blood sample from the...

    Incorrect

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

      Your Answer: IgM

      Correct Answer: IgG

      Explanation:

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

    • This question is part of the following fields:

      • General
      • Physiology
      15.6
      Seconds
  • Question 3 - A TRUE statement regarding abolition of the cephalic phase of pancreatic secretion is...

    Correct

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

      Your 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
      29
      Seconds
  • Question 4 - Which of the following is the cause of flattened (notched) T waves on...

    Correct

    • Which of the following is the cause of flattened (notched) T waves on electrocardiogram (ECG)?

      Your Answer: Hypokalaemia

      Explanation:

      The T-wave is formed due to ventricular repolarisation. Normally, it is seen as a positive wave. It can be normally inverted (negative) in V1 (occasionally in V2-3 in African-Americans/Afro-Caribbeans). Hyperacute T-waves are the earliest ECG change of acute myocardial infarction. ECG findings of hyperkalaemia include high, tent-shaped T-waves, a small P-wave and a wide QRS complex. Hypokalaemia results in flattened (notched) T-waves, U-waves, ST-segment depression and prolonged QT interval.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      7.2
      Seconds
  • Question 5 - Renal function is an indication of the state of the kidney, measured by glomerular...

    Correct

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

      Your Answer: Substantial increases in renal blood flow

      Explanation:

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

    • This question is part of the following fields:

      • Physiology
      • Renal
      37.3
      Seconds
  • Question 6 - A 49-year-old woman with acute renal failure has a total plasma [Ca2+] =...

    Correct

    • A 49-year-old woman with acute renal failure has a total plasma [Ca2+] = 2. 5 mmol/l and a glomerular filtration rate of 160 l/day. What is the estimated daily filtered load of calcium?

      Your Answer: 240 mmol/day

      Explanation:

      Calcium is the most abundant mineral in the human body. The average adult body contains in total approximately 1 kg of calcium of which 99% is in the skeleton in the form of calcium phosphate salts. The extracellular fluid (ECF) contains approximately 22 mmol, of which about 9 mmol is in the plasma. About 40% of total plasma Ca2+ is bound to proteins and not filtered at the glomerular basement membrane. Therefore, the estimated daily filtered load is 1.5 mmol/l × 160 l/day = 240 mmol/day. The exact amount of free versus total Ca2+ depends on the blood pH: free Ca2+ increases during acidosis and decreases during alkalosis.

    • This question is part of the following fields:

      • Physiology
      • Renal
      29.8
      Seconds
  • Question 7 - After a prolonged coronary artery bypass surgery, a 60-year old gentleman was transfused...

    Correct

    • After a prolonged coronary artery bypass surgery, a 60-year old gentleman was transfused 3 units of fresh-frozen plasma and 2 units of packed red cells. Two days later, the nurse noticed that he was tachypnoeic and chest X-ray showed signs consistent with adult respiratory distress syndrome. Which of the following variables will be low in this patient?

      Your Answer: Compliance of the lung

      Explanation:

      Acute or adult respiratory distress syndrome (ARDS) is a reaction to several forms of lung injuries and is commonly associated with sepsis and SIRS (systemic inflammatory response syndrome), severe traumatic injury, severe head injury, narcotics overdose, drowning, pulmonary contusion, and multiple blood transfusions. There is an increase in risk due to pre-existing liver disease or coagulation abnormalities. It results due to indirect toxic effects of neutrophil-derived inflammatory mediators in the lungs. ARDS is defined by the 1994 American–European Consensus Committee as the acute onset of bilateral infiltrates on chest X-ray, a partial pressure of arterial oxygen (pa(O2)) to fraction of inspired oxygen Fi(O2) ratio of less than 200 mmHg and a pulmonary artery occlusion pressure of less than 18 or the absence of clinical evidence of left arterial hypertension. ARDS is basically pulmonary oedema in the absence of volume overload or poor left ventricular function. This is different from acute lung injury, which shows a pa(O2)/Fi(O2) ratio of less than 300 mmHg. Pathogenesis of ARDS starts from damage to alveolar epithelium and vascular endothelium, causing increased permeability. Damage to surfactant-producing type II cells disrupts the production and function of pulmonary surfactant, causing micro atelectasis and poor gas exchange. There is a decrease in lung compliance and increase in work of breathing. Eventually, there is resorption of alveolar oedema, regeneration of epithelial cells, proliferation and differentiation of type II alveolar cells and alveolar remodelling. Some show resolution and some progress to fibrosing alveolitis, which involves the deposition of collagen in alveolar, vascular and interstitial spaces.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      25.9
      Seconds
  • Question 8 - What is the normal glomerular filtration rate? ...

    Correct

    • What is the normal glomerular filtration rate?

      Your 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
      3.7
      Seconds
  • Question 9 - A lesion involving the suprachiasmatic nucleus of hypothalamus is likely to affect: ...

    Correct

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

      Your Answer: Regulation of circadian rhythm

      Explanation:

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

    • This question is part of the following fields:

      • Neurology
      • Physiology
      15.3
      Seconds
  • Question 10 - Which of the following proteins prevents red blood cells (RBCs) from bursting when...

    Incorrect

    • Which of the following proteins prevents red blood cells (RBCs) from bursting when they pass through capillaries?

      Your Answer: Myosin

      Correct Answer: Spectrin

      Explanation:

      Spectrin is a structural protein found in the cytoskeleton that lines the intercellular side of the membrane of cells which include RBCs. They maintain the integrity and structure of the cell. It is arranged into a hexagonal arrangement formed from tetramers of spectrin and associated with short actin filaments that form junctions allowing the RBC to distort its shape.

    • This question is part of the following fields:

      • General
      • Physiology
      21.3
      Seconds
  • Question 11 - A 50 year old man on warfarin therapy following insertion of a pacemaker...

    Correct

    • 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: 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
      11.2
      Seconds
  • Question 12 - Which of the following is an anion? ...

    Correct

    • Which of the following is an anion?

      Your Answer: Phosphate

      Explanation:

      Cations: sodium, magnesium, calcium and potassium

      Anions: chloride, phosphate, bicarbonate, lactate, sulphate and albumin

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      6.7
      Seconds
  • Question 13 - 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
      6.2
      Seconds
  • Question 14 - Which of the following compensatory parameters is responsible for causing an increase in...

    Correct

    • Which of the following compensatory parameters is responsible for causing an increase in the blood pressure in a 30 year old patient with a BP of 40 mmHg?

      Your Answer: Baroreceptor reflex

      Explanation:

      The baroreflex or baroreceptor reflex is one of the body’s homeostatic mechanisms for regulating blood pressure. It provides a negative feedback response in which an elevated blood pressure will causes blood pressure to decrease; similarly, decreased blood pressure depresses the baroreflex, causing blood pressure to rise. The system relies on specialised neurones (baroreceptors) in the aortic arch, carotid sinuses and elsewhere to monitor changes in blood pressure and relay them to the brainstem. Subsequent changes in blood pressure are mediated by the autonomic nervous system. Baroreceptors include those in the auricles of the heart and vena cava, but the most sensitive baroreceptors are in the carotid sinuses and aortic arch. The carotid sinus baroreceptors are innervated by the glossopharyngeal nerve (CN IX); the aortic arch baroreceptors are innervated by the vagus nerve (CN X).

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      8
      Seconds
  • Question 15 - A 70-year-old male who has smoked since his teens complains of progressive shortness...

    Correct

    • 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 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
      7.1
      Seconds
  • Question 16 - A neurotransmitter of the nigrostriatal pathway is: ...

    Correct

    • A neurotransmitter of the nigrostriatal pathway is:

      Your 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
      2.3
      Seconds
  • Question 17 - A teenage Somalian boy presents with a complaint of an enlarged lower jaw....

    Correct

    • A teenage Somalian boy presents with a complaint of an enlarged lower jaw. His blood film shows blast cells and macrophages. Which virus is responsible for this?

      Your Answer: Epstein–Barr virus

      Explanation:

      Burkitt’s lymphoma is a type of non-Hodgkin’s lymphoma. Histologically it is characterised by a starry sky appearance due to numerous neoplastic macrophages which are required to clear the rapidly dividing tumour cells/blast cells. Burkitt’s lymphoma commonly affects the jaw bone, forming a huge tumour mass. It is associated with translocation of c-myc gene and has three types: 1) endemic/African type, 2)sporadic and 3)immunodeficiency-associated. The first type is strongly associated with EBV.

    • This question is part of the following fields:

      • General
      • Physiology
      1.8
      Seconds
  • Question 18 - Which part of the nephron would have to be damaged to stop the...

    Incorrect

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

      Your Answer: Collecting duct

      Correct Answer: Proximal tubule

      Explanation:

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

    • This question is part of the following fields:

      • Physiology
      • Renal
      24.7
      Seconds
  • Question 19 - 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: Polycythaemia vera

      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
      19.7
      Seconds
  • Question 20 - Which of the following is true regarding factor XI? ...

    Correct

    • Which of the following is true regarding factor XI?

      Your Answer: Deficiency causes haemophilia C

      Explanation:

      Factor XI is also known as plasma thromboplastin and is one of the enzymes of the coagulation cascade. It is produced in the liver and is a serine protease. It is activated by factor XIIa, thrombin and by itself. Deficiency of factor XI causes the rare type of haemophilia C. Low levels of factor XI also occur in other disease states, including Noonan syndrome. High levels of factor XI have been seen in thrombosis.

    • This question is part of the following fields:

      • General
      • Physiology
      24.4
      Seconds
  • Question 21 - A 47 year-old woman was admitted for elective cholecystectomy, with a past...

    Incorrect

    • A 47 year-old woman was admitted for elective cholecystectomy, with a past history of easy bruising and heavy menstrual periods. The patient was also diagnosed with Willebrand's disease. Willebrand's disease is:

      Your Answer: Y-linked

      Correct Answer: Autosomal dominant

      Explanation:

      von Willebrand disease is an autosomal dominant disorder marked by the deficiency of vWF, a large protein synthesized by the endothelial cells and megakaryocytes. It mediates adhesion of platelets to the subendothelium at site of vascular injury. Disease characteristics include impaired platelet adhesion, prolonged bleeding time and a functional deficiency of factor VIII (vWF is its carrier protein).

    • This question is part of the following fields:

      • General
      • Physiology
      31.3
      Seconds
  • Question 22 - Which type of contractions are responsible for the propulsion of chyme along the...

    Correct

    • Which type of contractions are responsible for the propulsion of chyme along the small intestine?

      Your Answer: Segmentation

      Explanation:

      Two major types of intestinal contractions are segmentation and peristalsis:

      Segmentation occurs most frequently and primarily involves circular muscle. It is essentially a contraction of 2- or 3-cm long intestinal segments while the muscle on either side of it relaxes. Chyme in the segment is displaced in both directions. As the contracted segment relaxes, the previously relaxed segments on either side may contract. This efficiently mixes the chyme with the digestive secretions and exposes the mucosal absorptive surface to the luminal contents. It also serves a propulsive function and contributes to the movement of chyme.

      Peristalsis is a propulsive wave of contraction that is initiated by intestinal distension. It is short lived and travels only a few centimetres before dying out. The combined effects of intestinal peristalsis and segmentation provide for both adequate mixing of the intestinal contents and slow, steady movement of chyme.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      7.9
      Seconds
  • Question 23 - 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: Pulmonary embolus

      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
      28.3
      Seconds
  • Question 24 - 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
      17.1
      Seconds
  • Question 25 - Decreased velocity of impulse conduction through the atrioventricular node (AV node) in the...

    Correct

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

      Your Answer: Increased PR interval

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      64.5
      Seconds
  • Question 26 - 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
      26.4
      Seconds
  • Question 27 - A 15-day old male baby was brought to the emergency department with sweating...

    Correct

    • A 15-day old male baby was brought to the emergency department with sweating and his lips turning blue while feeding. He was born full term. On examination, his temperature was 37.9°C, blood pressure 75/45 mmHg, pulse was 175/min, and respiratory rate was 42/min. A harsh systolic ejection murmur could be heard at the left upper sternal border. X-ray chest showed small, boot-shaped heart with decreased pulmonary vascular markings. He most likely has:

      Your Answer: Tetralogy of Fallot

      Explanation:

      The most common congenital cyanotic heart disease and the most common cause of blue baby syndrome, Tetralogy of Fallot shows four cardiac malformations occurring together. These are ventricular septal defect (VSD), pulmonary stenosis (right ventricular outflow obstruction), overriding aorta (degree of which is variable), and right ventricular hypertrophy. The primary determinant of severity of disease is the degree of pulmonary stenosis. Tetralogy of Fallot is seen in 3-6 per 10,000 births and is responsible for 5-7% congenital heart defects, with slightly higher incidence in males. It has also been associated with chromosome 22 deletions and DiGeorge syndrome. It gives rise to right-to-left shunt leading to poor oxygenation of blood. Primary symptom is low oxygen saturation in the blood with or without cyanosis at birth of within first year of life. Affected children ay develop acute severe cyanosis or ‘tet spells’ (sudden, marked increase in cyanosis, with syncope, and may result in hypoxic brain injury and death). Other symptoms include heart murmur, failure to gain weight, poor development, clubbing, dyspnoea on exertion and polycythaemia. Chest X-ray reveals characteristic coeur-en-sabot (boot-shaped) appearance of the heart. Treatment consists of immediate care for cyanotic spells and Blalock–Taussig shunt (BT shunt) followed by corrective surgery.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      33.9
      Seconds
  • Question 28 - what is the cause of a prolonged PT(prothrombin time)? ...

    Incorrect

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

      Your Answer: Heparin therapy

      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
      8
      Seconds
  • Question 29 - A 56-year-old woman weighs 75 kg. In this patient, total body water, intracellular...

    Incorrect

    • A 56-year-old woman weighs 75 kg. In this patient, total body water, intracellular fluid and extracellular fluid are respectively:

      Your Answer: 40 l, 30 l, 10 l

      Correct Answer: 45 l, 30 l, 15 l

      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. The total body water (TBW) content of humans is approximately 60% of body weight. Two-thirds is located in the intracellular and one-third in the extracellular compartment. So, in a 75-kg individual, TBW = 60 × 75/100 = 45 l. Intracellular content = 2/3 × 45 = 30 l and extracellular content = 1/3 × 45 = 15 l.

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      17.3
      Seconds
  • Question 30 - Calculate the total peripheral resistance for a patient with a blood pressure of...

    Incorrect

    • Calculate the total peripheral resistance for a patient with a blood pressure of 130/70 mm HG and cardiac output of 5 litres / min?

      Your Answer: 22 mmHg × min/l

      Correct Answer: 18 mmHg × min/l

      Explanation:

      Total peripheral resistance = Mean arterial pressure/Cardiac output. And the mean arterial pressure = Diastolic pressure + 1/3 (Systolic pressure – Diastolic pressure), i.e., 70 + 1/3 (130-70) = 90 mmHg. Therefore, total peripheral resistance = 90 mmHg/5 l per min = 18 mmHg × min/l.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      6.1
      Seconds
  • Question 31 - A 40 year old man suffered severe trauma following an MVA. His BP...

    Incorrect

    • A 40 year old man suffered severe trauma following an MVA. His BP is 70/33 mmhg, heart rate of 140 beats/mins and very feeble pulse. He was transfused 3 units of blood resulting in his BP returning to 100/70 and his heart rate to 90 beats/min. What decreased following transfusion?

      Your Answer: Stroke volume

      Correct Answer: Total peripheral resistance

      Explanation:

      The patient is in hypovolemic shock, he is transfused with blood to replace the volume lost. It is important not only to replace fluids but stop active bleeding in resuscitation. Fluid replacement will result in a decreased sympathetic discharge and adequate ventricular filling thus reducing total peripheral resistance and increasing cardiac output and cardiac filling pressures.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      3.7
      Seconds
  • Question 32 - Glucose is not secreted by the kidneys, and is filtered without a limit....

    Correct

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

      Your Answer: 300 mg/dl

      Explanation:

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

    • This question is part of the following fields:

      • Physiology
      • Renal
      2.1
      Seconds
  • Question 33 - Which of the following is responsible for the maximum increase in total peripheral...

    Incorrect

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

      Your Answer: Arteries

      Correct Answer: Arterioles

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      1.7
      Seconds
  • Question 34 - A 42-year old woman presents to the doctor with jaundice. Her investigations show...

    Incorrect

    • A 42-year old woman presents to the doctor with jaundice. Her investigations show conjugated hyperbilirubinemia, raised urine bilirubin levels and low urine urobilinogen levels. What is the likely cause of her jaundice?

      Your Answer: Haemolytic anaemia

      Correct Answer: Blockage of the common bile duct

      Explanation:

      The description of the patient here fits the diagnosis of obstructive jaundice or cholestasis, which results in conjugated hyperbilirubinemia. Cholestasis occurs due to impairment of bile flow, which can be anywhere from the liver cell canaliculus to the ampulla of Vater. Causes can be divided into intrahepatic and extrahepatic.

      – Intrahepatic causes include hepatitis, drug toxicity, alcoholic liver disease, primary biliary cirrhosis, cholestasis of pregnancy and metastatic cancer.

      – Extrahepatic causes include common duct stone, pancreatic cancer, benign stricture of the common duct, ductal carcinoma, pancreatitis and sclerosing cholangitis.

      There is absence of bile constituents in the intestine, which causes spillage in the systemic circulation. Symptoms include pale stools, dark urine, pruritus, malabsorption leading to steatorrhea and deficiency of fat-soluble vitamins. Chronic cases can result in osteoporosis or osteomalacia due to vitamin D deficiency and Ca2+ malabsorption. Cholesterol and phospholipid retention produces hyperlipidaemia despite fat malabsorption (although increased liver synthesis and decreased plasma esterification of cholesterol also contribute); triglyceride levels are largely unaffected. The lipids circulate as a unique, low-density lipoprotein called lipoprotein X.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      8.1
      Seconds
  • Question 35 - Which of the following has the highest content of triglycerides? ...

    Correct

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

      Your 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
      1.4
      Seconds
  • Question 36 - Nephrotic syndrome is a condition that causes proteinuria, hypoalbuminemia and oedema. Which of...

    Incorrect

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

      Your Answer:

      Correct Answer: Decreased oncotic pressure

      Explanation:

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

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 37 - If your EEG shows waves with a frequency range of 8-12 Hz, the...

    Incorrect

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

      Your Answer:

      Correct Answer: Alpha

      Explanation:

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

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

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 38 - A 20-year old gentleman was brought to the emergency department with headache and...

    Incorrect

    • A 20-year old gentleman was brought to the emergency department with headache and nausea for 2 days. He also complained of intolerance to bright light and loud sounds. Lumbar puncture showed glucose < 45 mg/dl, protein > 5 mg/dl and neutrophil leucocytosis. The likely diagnosis is:

      Your Answer:

      Correct Answer: Meningitis

      Explanation:

      Diagnosis of meningitis can be carried out with examination of cerebrospinal fluid (CSF) with a lumbar puncture (LP). In a case of bacterial meningitis, the CSF analysis will show:

      – Opening pressure: > 180 mmH2O

      – White blood cell count: 10–10 000/μl with neutrophil predominance

      – Glucose: < 40 mg/dl – CSF glucose to serum glucose ratio: < 0.4 – Protein: > 4.5 mg/dl

      – Gram stain: positive in > 60%

      – Culture: positive in > 80%

      – Latex agglutination: may be positive in meningitis due to Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Escherichia coli and group B streptococci

      – Limulus, lysates: positive in Gram-negative meningitis

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 39 - What is the result of maltase deficiency in the brush border of the...

    Incorrect

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

      Your Answer:

      Correct Answer: Results in increased passage of maltose in stool

      Explanation:

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

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 40 - 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:

      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
      0
      Seconds
  • Question 41 - 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 42 - Signals pass through neuromuscular junctions via the neurotransmitter acetylcholine. After release from the...

    Incorrect

    • Signals pass through neuromuscular junctions via the neurotransmitter acetylcholine. After release from the skeletal neuromuscular junction, acetylcholine:

      Your Answer:

      Correct Answer: Causes postsynaptic depolarisation

      Explanation:

      Acetylcholine is released from the presynaptic membrane into the cleft where it binds to the ion gated channels on the post synaptic membrane, causing them to open. This results in sodium entering into the fibre and further depolarizing it, creating an action potential.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 43 - 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 44 - 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 45 - 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 46 - 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:

      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
      0
      Seconds
  • Question 47 - 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 48 - In a cardiac cycle, what event does the closing of atrioventricular (AV) valves...

    Incorrect

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

      Your Answer:

      Correct Answer: First heart sound

      Explanation:

      In the cardiac cycle, the closing of the atrioventricular (AV) valves coincides with the onset of ventricular systole. This event marks the beginning of the isovolumetric contraction phase, where the ventricles begin to contract, but the volume of blood in the ventricles remains the same because both the AV valves and the semilunar valves (aortic and pulmonary valves) are closed. The closing of the AV valves produces the first heart sound, known as “S1” or “lub.”

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 49 - 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:

      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
      0
      Seconds
  • Question 50 - 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 51 - A neonate with failure to pass meconium is being evaluated. His abdomen is...

    Incorrect

    • A neonate with failure to pass meconium is being evaluated. His abdomen is distended and X-ray films of the abdomen show markedly dilated small bowel and colon loops. The likely diagnosis is:

      Your Answer:

      Correct Answer: Aganglionosis in the rectum

      Explanation:

      Hirschsprung’s disease (also known as aganglionic megacolon) leads to colon enlargement due to bowel obstruction by an aganglionic section of bowel that starts at the anus. A blockage is created by a lack of ganglion cells needed for peristalsis that move the stool. 1 in 5000 children suffer from this disease, with boys affected four times more commonly than girls. It develops in the fetus in early stages of pregnancy. Symptoms include not having a first bowel movement (meconium) within 48 hours of birth, repeated vomiting and a swollen abdomen. Two-third of cases are diagnosed within 3 months of birth. Some children may present with delayed toilet training and some might not show symptoms till early childhood. Diagnosis is by barium enema and rectal biopsy (showing lack of ganglion cells).

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 52 - Which of the following is a true statement regarding secretion of gastric acid?...

    Incorrect

    • Which of the following is a true statement regarding secretion of gastric acid?

      Your Answer:

      Correct Answer: Acetylcholine increases gastric acid secretion

      Explanation:

      Gastric acid secretion is increased by acetylcholine, histamine and gastrin, with the help of cAMP as a secondary messenger. They increase H+ and Cl- secretion by increasing the number of H+/K+ ATPase molecules and Cl- channels. In contrast, gastric acid secretion is decreased by somatostatin, epidermal growth factor and prostaglandins.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 53 - 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 54 - What will the destruction of endoplasmic reticulum stop? ...

    Incorrect

    • What will the destruction of endoplasmic reticulum stop?

      Your Answer:

      Correct Answer: Synthesis of proteins

      Explanation:

      The rough endoplasmic reticulum is the factory for the manufacturing of proteins. It contains ribosomes attached to it and transports proteins that are destined for membranes and secretions. The rough ER is connected to the nuclear envelope and to the cisternae of the Golgi apparatus by vesicles that shuttle between the two compartments.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 55 - Which antibiotic acts by inhibiting protein synthesis? ...

    Incorrect

    • Which antibiotic acts by inhibiting protein synthesis?

      Your Answer:

      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
      0
      Seconds
  • Question 56 - A patient presents with loss of pain and temperature sensation in the left...

    Incorrect

    • A patient presents with loss of pain and temperature sensation in the left leg. He is likely to have a lesion involving:

      Your Answer:

      Correct Answer: Right lateral spinothalamic tract

      Explanation:

      The spinothalamic tract is a sensory pathway originating in the spinal cord that transmits information to the thalamus. There are two main parts of the spinothalamic tract: the lateral spinothalamic tract transmits pain and temperature and the anterior spinothalamic tract transmits touch (crude touch). The decussation of this pathway occurs at the level of the spinal cord. Hence, a unilateral lesion of the lateral spinothalamic tract causes contralateral loss of pain and temperature.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 57 - Ventricular filling follows a delay caused by? ...

    Incorrect

    • Ventricular filling follows a delay caused by?

      Your Answer:

      Correct Answer: AV node

      Explanation:

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

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 58 - A patient with a long standing lower motor neuron lesion will have: ...

    Incorrect

    • A patient with a long standing lower motor neuron lesion will have:

      Your Answer:

      Correct Answer: Muscle wasting

      Explanation:

      Lower motor neurons (LMNs) connect the brainstem and spinal cord to muscle fibres. Damage to lower motor neurons is indicated by abnormal electromyographic potentials, fasciculations, paralysis, weakening and wasting of skeletal muscles.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 59 - Calculate the cardiac stroke volume of a patient whose oxygen consumption (measured by...

    Incorrect

    • Calculate the cardiac stroke volume of a patient whose oxygen consumption (measured by analysis of mixed expired gas) is 300 ml/min, arterial O2 content is 20 ml/100 ml blood, pulmonary arterial O2 content is 15 ml/100 ml blood and heart rate is 60/min.

      Your Answer:

      Correct Answer: 100 ml

      Explanation:

      By Fick’s principle, VO2 = Q × (CA (O2) − CV (O2)) where VO2 = O2 consumption, Q = cardiac output and CA(O2) and CV(O2) are arterial and mixed venous O2 content respectively. Thus, in the given problem, 300 ml O2/min = Q × (20−15) ml O2/100 ml. Thus, Q = 6000 ml blood/min. Then, we can calculate stroke volume by dividing the cardiac output with heart rate. Thus, stroke volume = 6000 ml/min divided by 60/min stroke volume = 100 ml.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 60 - A 26-year-old female patient had the following blood report: RBC count =...

    Incorrect

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

      Your Answer:

      Correct Answer: Spherocytosis

      Explanation:

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

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 61 - Multiple cells were labelled using a fluorescent dye that doesn’t cross the cell...

    Incorrect

    • Multiple cells were labelled using a fluorescent dye that doesn’t cross the cell membrane. One cell in the middle was bleached with a light that destroys the dye, but the cell soon recovers its stain. The presence of which structures best explains this?

      Your Answer:

      Correct Answer: Gap junctions

      Explanation:

      Gap junctions are attachments between cells that permit intercellular communication e.g. they permit current flow and electrical coupling between myocardial cells. They allow direct electrical transmission among cells and also permit certain substance to pass through as well. They are either homotypic, formed by two identical hemichannels or heterotypic, formed by different hemichannels.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 62 - Which of the following associations is correctly matched with the body's defence mechanism...

    Incorrect

    • Which of the following associations is correctly matched with the body's defence mechanism in fighting infection?

      Your Answer:

      Correct Answer: Specific cellular mechanism → cytotoxic T cells

      Explanation:

      The immune system has certain levels of defence against pathogens. First line includes simple barriers such as skin, mucosa and stomach acid that prevent the pathogen from entering into the body. If this barrier is breached then the innate immune system is activated which includes leukocytes (macrophages, neutrophils, mast cells, eosinophils, basophils, natural killer cells). If the pathogens invade the second layer of defence then the third layer, adaptive immunity is activated, which includes B and T lymphocytes. B cells provide a humoral response whereas cytotoxic T cells have specific cellular mechanisms. They maintain a memory of past infections and are activated faster following a recurrence.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 63 - A 65-year-old man complains of headaches, weakness, cramps, and confusion; blood tests reveal...

    Incorrect

    • 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:

      Correct 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
      0
      Seconds
  • Question 64 - Different substances have different renal clearance rates. Which of the following substances should...

    Incorrect

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

      Your Answer:

      Correct Answer: Glucose

      Explanation:

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

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 65 - The neurotransmitters adrenaline, noradrenaline and dopamine are derived from which amino acid? ...

    Incorrect

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

      Your Answer:

      Correct 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
      0
      Seconds
  • Question 66 - 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:

      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
      0
      Seconds
  • Question 67 - 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:

      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
      0
      Seconds
  • Question 68 - A blood sample of a 58 year old male patient, who underwent an...

    Incorrect

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

      Your Answer:

      Correct Answer: A positive

      Explanation:

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

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

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

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

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 69 - Which of the following will be a likely sequelae of complete ileal resection?...

    Incorrect

    • Which of the following will be a likely sequelae of complete ileal resection?

      Your Answer:

      Correct Answer: Vitamin B12 deficiency

      Explanation:

      The ileum is a part of the small intestine and has a pH of around 7-8 (neutral or slightly alkaline). Its main function is absorption of products of digestion. The ileal wall has multiple villi, which in turn have numerous microvilli. This increases the surface area available for absorption significantly. The cells lining the ileum contain multiple enzymes such as protease and carbohydrase, which aid in the final stages of digestion. Villi contain lacteals which absorb the products of fat digestion, fatty acids and glycerol. Thus, ileal resection will lead to their decreased absorption and increased fat content in the stool. The ileum is also responsible for absorption of vitamin B12.

      Maximum water absorption occurs in the colon followed by the jejunum. Hence, ileal resection is less likely to lead to fluid volume deficiency. Also, most minerals (like calcium, iron etc.) are absorbed in the duodenum, and thus will not be affected by ileal resection.

    • This question is part of the following fields:

      • Gastroenterology
      • Physiology
      0
      Seconds
  • Question 70 - Arterial blood gas analysis of a man admitted with acute exacerbation of chronic...

    Incorrect

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

      Your Answer:

      Correct Answer: Respiratory acidosis

      Explanation:

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

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 71 - Which of the following organelles have the capacity to regenerate and spontaneously replicate?...

    Incorrect

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

      Your Answer:

      Correct Answer: Mitochondrion

      Explanation:

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

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 72 - 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 73 - The anatomical dead space in a patient with low oxygen saturation, is 125...

    Incorrect

    • The anatomical dead space in a patient with low oxygen saturation, is 125 ml, with a tidal volume of 500 ml and pa(CO2) of 40 mm Hg. The dead space was determined by Fowler's method. If we assume that the patient's lungs are healthy, what will his mixed expired CO2 tension [pE(CO2)] be?

      Your Answer:

      Correct Answer: 30 mmHg

      Explanation:

      According to Bohr’s equation, VD/VT = (pA(CO2) − pE(CO2))/pA(CO2), where pE(CO2) is mixed expired CO2 and pA(CO2) is alveolar CO2pressure. Normally, the pa(CO2) is virtually identical to pA(CO2). Thus, VD/VT = (pa(CO2)) − pE(CO2)/pa(CO2). By Fowler’s method, VD/VT= 0.25. In the given problem, (pa(CO2) − pE(CO2)/pa(CO2) = (40 − pE(CO2)/40 = 0.25. Thus, pE(CO2) = 30 mmHg. If there is a great perfusion/ventilation inequality, pE(CO2) could be significantly lower than 30 mm Hg, and the patient’s physiological dead space would exceed the anatomical dead space.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 74 - 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 75 - A 23 year old woman is Rh -ve and she delivered a baby...

    Incorrect

    • A 23 year old woman is Rh -ve and she delivered a baby with a Rh+ blood group. What measure can be performed to prevent Rh incompatibility in the next pregnancy?

      Your Answer:

      Correct Answer: Immunoglobulin D

      Explanation:

      Rh disease is also known as erythroblastosis fetalis and is a disease of the new-born. In mild states it can cause anaemia with reticulocytosis and in severe forms causes severe anaemia, morbus hemolytcus new-born and hydrops fetalis. RBCs of the Rh+ baby can cross the placenta and enter into the maternal blood. As she is Rh- her body will form antibodies against the D antigen which will pass through the placenta in subsequent pregnancies.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 76 - Depression of the normal coagulation system and excessive bleeding after surgery can occur...

    Incorrect

    • Depression of the normal coagulation system and excessive bleeding after surgery can occur in which of the following medical conditions?

      Your Answer:

      Correct Answer: Liver disease

      Explanation:

      As most of the coagulation factors are synthesized in the liver, liver diseases like hepatitis or cirrhosis will depress the coagulation system. Vitamin K deficiency can also decrease the production of vitamin K dependent coagulation factors VII, XI, X and prothrombin.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 77 - 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 78 - Myoglobin is released as a result of rhabdomyolysis from damaged skeletal muscles. What...

    Incorrect

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

      Your Answer:

      Correct Answer: Acts like haemoglobin and binds with O2

      Explanation:

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

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 79 - A patient admitted for esophagectomy showed low levels of the lightest plasma protein...

    Incorrect

    • A patient admitted for esophagectomy showed low levels of the lightest plasma protein in terms of weight. Which of the following is the lightest plasma protein:

      Your Answer:

      Correct Answer: Albumin

      Explanation:

      Albumin is the most abundant and the lightest of all the plasma proteins. It maintains osmotic pressure, transports unconjugated bilirubin, thyroid hormones, fatty acids, drugs and acts as a buffer for pH.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 80 - 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 81 - In which situation is a stretch reflex such as knee jerk likely to...

    Incorrect

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

      Your Answer:

      Correct 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
      0
      Seconds
  • Question 82 - A blood sample from a patient with polycythaemia vera will show which of...

    Incorrect

    • A blood sample from a patient with polycythaemia vera will show which of the following abnormalities?

      Your Answer:

      Correct Answer: High platelet count

      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 a myeloproliferative syndrome, 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 increased 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 83 - 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:

      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
      0
      Seconds
  • Question 84 - What is the mostly likely cause of prolonged activated partial thromboplastin time (aPPT)...

    Incorrect

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

      Your Answer:

      Correct Answer: Heparin therapy

      Explanation:

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

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 85 - Which statement is correct regarding coagulation? ...

    Incorrect

    • Which statement is correct regarding coagulation?

      Your Answer:

      Correct Answer: Thrombin converts fibrinogen to fibrin

      Explanation:

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

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 86 - What is the role of factor VII in coagulation? ...

    Incorrect

    • What is the role of factor VII in coagulation?

      Your Answer:

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

      Explanation:

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

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 87 - Which of the following is a potential cause of a positive D-dimer assay?...

    Incorrect

    • Which of the following is a potential cause of a positive D-dimer assay?

      Your Answer:

      Correct Answer: Deep venous thrombosis

      Explanation:

      A D-dimer test is performed to detect and diagnose thrombotic conditions and thrombosis. A negative result would rule out thrombosis and a positive result although not diagnostic, is highly suspicious of thrombotic conditions like a deep vein thrombosis, pulmonary embolism as well as DIC.

    • This question is part of the following fields:

      • General
      • Physiology
      0
      Seconds
  • Question 88 - 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:

      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
      0
      Seconds
  • Question 89 - A medical student is asked to calculate the net pressure difference in a...

    Incorrect

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

      Your Answer:

      Correct Answer: 0 mmHg

      Explanation:

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

    • This question is part of the following fields:

      • Fluids & Electrolytes
      • Physiology
      0
      Seconds
  • Question 90 - 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 91 - 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 92 - In the kidney, the macula densa is an area of closely packed specialized cells lining the wall of...

    Incorrect

    • In the kidney, the macula densa is an area of closely packed specialized cells lining the wall of the:

      Your Answer:

      Correct Answer: Distal convoluted tubule

      Explanation:

      In the kidney, the macula densa is an area of closely packed specialised cells lining the region of the distal convoluted tubule (DCT) lying next to the glomerular vascular pole. The cells of the macula densa are sensitive to the ionic content and water volume of the fluid in the DCT, producing signals that promote renin secretion by other cells of the juxtaglomerular apparatus.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 93 - Destruction of the ventromedial nucleus of the hypothalamus will result in: ...

    Incorrect

    • Destruction of the ventromedial nucleus of the hypothalamus will result in:

      Your Answer:

      Correct Answer: Loss of satiety

      Explanation:

      The ventromedial nucleus of the hypothalamus is divided into an anterior and a superior part. The anterior part controls the female sexual drive, whereas the superior part is responsible for satiety. Destruction of the superior part of the nucleus will result in overeating, as no signal tells the body that it is satisfied.

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 94 - Chest X-ray of a 45-year old gentleman with a week history of pleurisy...

    Incorrect

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

      Your Answer:

      Correct Answer: Compensated respiratory alkalosis

      Explanation:

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

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 95 - A 59-year-old woman with hyperaldosteronism is prescribed a diuretic. Which of the following...

    Incorrect

    • A 59-year-old woman with hyperaldosteronism is prescribed a diuretic. Which of the following diuretics promotes diuresis by opposing the action of aldosterone?

      Your Answer:

      Correct Answer: Potassium-sparing diuretic

      Explanation:

      The term potassium-sparing refers to an effect rather than a mechanism or location. Potassium-sparing diuretics act by either antagonising the action of aldosterone (spironolactone) or inhibiting Na+ reabsorption in the distal tubules (amiloride). This group of drugs is often used as adjunctive therapy, in combination with other drugs, for the management of chronic heart failure. Spironolactone, the first member of the class, is also used in the management of hyperaldosteronism (including Conn’s syndrome) and female hirsutism (due to additional antiandrogen actions).

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 96 - Chronic obstructive pulmonary disease (COPD) is likely to result in: ...

    Incorrect

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

      Your Answer:

      Correct Answer: Respiratory acidosis

      Explanation:

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

    • This question is part of the following fields:

      • Physiology
      • Respiratory
      0
      Seconds
  • Question 97 - Glucose is the most important source of energy for cellular respiration. The transport...

    Incorrect

    • Glucose is the most important source of energy for cellular respiration. The transport of glucose in the renal tubular cells occurs via:

      Your Answer:

      Correct Answer: Secondary active transport with sodium

      Explanation:

      In 1960, Robert K. Crane presented for the first time his discovery of the sodium-glucose cotransport as the mechanism for glucose absorption. Glucose transport through biological membranes requires specific transport proteins. Transport of glucose through the apical membrane of renal tubular as well as intestinal epithelial cells depends on the presence of secondary active Na+–glucose symporters, SGLT-1 and SGLT-2, which concentrate glucose inside the cells, using the energy provided by co-transport of Na+ ions down their electrochemical gradient.

    • This question is part of the following fields:

      • Physiology
      • Renal
      0
      Seconds
  • Question 98 - 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 99 - A lesion involving the lateral geniculate nucleus of the thalamus is likely to...

    Incorrect

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

      Your Answer:

      Correct Answer: Vision

      Explanation:

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

    • This question is part of the following fields:

      • Neurology
      • Physiology
      0
      Seconds
  • Question 100 - 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

SESSION STATS - PERFORMANCE PER SPECIALTY

Physiology (22/35) 63%
Respiratory (2/4) 50%
General (4/9) 44%
Gastroenterology (3/4) 75%
Cardiovascular (5/8) 63%
Renal (5/6) 83%
Neurology (2/2) 100%
Fluids & Electrolytes (1/2) 50%
Passmed