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Question 1
Correct
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Question 2
Correct
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One function of the liver is synthesis and storage of protein. Which of the following will result in hypoalbuminemia?
Your Answer: All of the above
Explanation:Both trauma and sepsis cause an acute inflammatory response causing plasma leakage of albumin. Nephropathy causes leakage of albumin from glomeruli and excretion of albumin in urine known as albuminuria. A hypercatabolic state is characterized by increased circulating catabolic hormones and increase break down of proteins.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 3
Correct
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A 55 year old cardiac patient is comfortable at rest but heavy housework results in fatigue, palpitations or dyspnoea. What New York Heart Association class best describes the severity of their disease?
Your Answer: NYHA Class II
Explanation:New York Heart Association functional classification:
Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities.
Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion.
Class III: marked limitation of any activity; the patient is comfortable only at rest.
Class IV: any physical activity brings on discomfort and symptoms occur at rest.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 4
Correct
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Question 5
Correct
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What is the isolated effect of B2 stimulation on the coronaries?
Your Answer: Vasodilatation
Explanation:Norepinephrine and epinephrine are agonists for all adrenergic receptor subtypes, although with varying affinities. Based on their physiology and pharmacology, adrenergic receptors have been divided into two principal types: alpha and beta. These types have been further differentiated into alpha-1, alpha-2, b1, and b2 receptors.
Alpha-1 Receptors are located on postsynaptic cells in smooth muscle and elicit vasoconstriction.
Alpha-2 receptors are localized on presynaptic membranes of postganglionic nerve terminals that synthesize norepinephrine. When activated by catecholamines, alpha-2 receptors act as negative feedback controllers, inhibiting further norepinephrine release.
Activation of myocardial b1 receptors stimulates the rate and strength of cardiac contraction, and consequently increases cardiac output. b1 Receptor activation also stimulates renin release from the kidney. Another class of antihypertensive agents acts by inhibiting b1 receptors.
Activation of b2 receptors by epinephrine relaxes vascular smooth muscle and results in vasodilation.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 6
Correct
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Which of the following is a precursor to the tissue macrophage?
Your Answer: Monocyte
Explanation:Monocytes are a type of white blood cell, or leukocyte. They are the largest type of leukocyte and can differentiate into macrophages or dendritic cells.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 7
Correct
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Select the correct statement regarding cholecystokinin (CCK):
Your Answer: It causes gallbladder contraction and pancreatic enzyme secretion.
Explanation:CCK has a primary action of increasing the motility of the gallbladder by contracting the muscles in the mucosa of the gall bladder. Apart from this, it augments the action of secretin, resulting in the production of an alkaline pancreatic juice. It increases the synthesis of enterokinase, inhibits gastric emptying and may also enhance the motility of the small intestine and colon. It is released (secreted) by your small intestine during the digestive process. It’s sometimes called pancreozymin.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 8
Correct
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The free radical most abundantly formed by the immune system is:
Your Answer: Hydroxyl radical
Explanation:Neutrophil and macrophage phagocytosis stimulates various cellular processes including the respiratory burst whereby increased cellular oxygen uptake results in the production of the potent oxidant bactericidal agents, hypochlorous acid and hydroxyl radical.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 9
Correct
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Where does the pituitary gland lie?
Your Answer: In a pocket of the sphenoid bone at the base of the brain
Explanation:The pituitary lies in a small depression in the sphenoid bone, known as the sella turcica or Turkish saddle.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 10
Incorrect
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Which of the following normally has a slow depolarizing “prepotential”?
Your Answer: Bundle of his
Correct Answer: Sinoatrial node
Explanation:There are 2 main types of action potentials (AP) in the heart, the slow response and the fast response:The slow response is initiated by the slow calcium-sodium channels, found in the SA node (which is the natural pacemaker of the heart) and the conduction fibers of the AV node.The fast response occurs in the atrial and ventricles muscle cells and the purkinje fibers.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 11
Correct
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The channel that coalesces the small pancreatic duct radicles before joining the common bile duct is known as the:
Your Answer: Duct of Wirsung
Explanation:The small ducts from the pancreas coalesce into a single duct known as the pancreatic duct or the duct of Wirsung. It usually joins the bile duct at the ampulla of Vater before entering the duodenum.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 12
Incorrect
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Coronary vasoconstriction can be caused by:
Your Answer: Hypoxia
Correct Answer: Beta blockage
Explanation:Coronary arteries contain alpha and beta receptors. The alpha receptor stimulates vasoconstriction and beta receptors stimulate vasodilation. When the chronotropic and inotropic effects of noradrenergic receptors are blocked by a B blocking drug, stimulation of the noradrenergic nerves will cause coronary vasoconstriction.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 13
Correct
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A 35-year-old woman under treatment for long-term epilepsy with valproate presented with complaints of excessive weight gain. She is consuming oral contraceptive pills.Which among the following is the best alternative to valproate for treating long-term epilepsy?
Your Answer: Lamotrigine
Explanation:Among the given anti-epileptics the best drug that can be given in this patient is lamotrigine.Topiramate, carbamazepine, phenytoin, and phenobarbital are all hepatic enzyme inducers and are associated with decreased effectiveness of the oral contraceptive (OCP) due to acceleration of the metabolism of oestrogens and progestogens.If she is planning on pregnancy then registry studies suggest that lamotrigine would also be the best choice.Other hepatic enzyme inducers include rifampicin, spironolactone, griseofulvin, etc.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 14
Incorrect
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A 30-year-old male with a history of premature cardiovascular disease in the family has come for review of his lab investigations. His fasting cholesterol is 8.4 mmol/l with high-density lipoprotein (HDL) of 1.6 mmol/l. You elect to commence him on atorvastatin 20 mg PO daily.Which of the following best describes the mechanism of action of the statins?
Your Answer: They stimulate HMG CoA reductase
Correct Answer: They inhibit HMG CoA reductase
Explanation:Statins are a selective, competitive inhibitor of hydroxymethylglutaryl-CoA (HMG-CoA) reductase, which is the enzyme responsible for the conversion of HMG-CoA to mevalonate in the cholesterol synthesis pathway.Statins are usually well tolerated with myopathy, rhabdomyolysis, hepatotoxicity, and diabetes mellitus being the most common adverse reactions. This is the rate-limiting step in cholesterol synthesis, that leads to increased hepatic low-density lipoprotein (LDL) receptors and reduced hepatic VLDL synthesis coupled with increased very-low-density lipoprotein (VLDL) clearance.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 15
Correct
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Question 16
Correct
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Choose the correct statement about Aminoglycosides and Chloramphenicol
Your Answer: Chloramphenicol works on Ribosome 50 S peptidyl transferase
Explanation:Aminoglycoside is a category of traditional Gram-negative antibacterial therapeutic agents that inhibit protein synthesis. Aminoglycoside antibiotics display bactericidal activity against gram-negative aerobes and some anaerobic bacilli where resistance has not yet arisen, but generally not against Gram-positive and anaerobic Gram-negative bacteria.Chloramphenicol is a bacteriostatic by inhibiting protein synthesis. It prevents protein chain elongation by inhibiting the peptidyl transferase activity of the bacterial ribosome. It specifically binds to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit, preventing peptide bond formation.
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 17
Incorrect
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Which of the following drugs would be the safest to prescribe in a 22 year old man with seropositive rheumatoid arthritis who is planning to start a family?
Your Answer: Methotrexate
Correct Answer: Prednisolone
Explanation:Prednisolone although has many undesirable side effects it may be considered relatively safe compared to the drugs that are provided here. Prolonged treatment with sulphasalazine may depress semen quality and cause irreversible infertility. Methotrexate and leflunomide both inhibit purine/pyrimidine synthesis (the former by inhibiting folate metabolism) and are contraindicated in pregnancy or while trying to conceive. In males, a temporary or permanent decrease in sperm count may occur with cyclophosphamide. Because the recovery of fertility after cyclophosphamide therapy is variable, sperm banking should be considered before treatment is begun.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 18
Correct
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Which glucose transporter is responsible for the uptake of dietary glucose from the gut?
Your Answer: SGLT1
Explanation:SGLT 1 is responsible for the uptake of glucose via secondary active transport from the small intestine and the renal tubules.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 19
Correct
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Where are the cell bodies of preganglionic neurons located?
Your Answer: Lateral column
Explanation:The cell bodies of the preganglionic neurons are located in the lateral grey column of the spinal cord and in the motor nuclei of the 3rd, 7th, 9th and 10th cranial nerves.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 20
Correct
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Which one of the following neurotransmitters is considered a monoamine?
Your Answer: Dopamine
Explanation:Monoamines are a class of neurotransmitters that include:
- Dopamine: A neurotransmitter involved in reward, motivation, and motor control.
- Norepinephrine: A neurotransmitter involved in arousal, attention, and stress responses.
- Serotonin: Although not listed in the options, it is another key monoamine involved in mood regulation.
The other neurotransmitters listed are not monoamines:
- Acetylcholine: This is a different type of neurotransmitter involved in muscle activation and various brain functions.
- GABA (gamma-aminobutyric acid): This is the main inhibitory neurotransmitter in the central nervous system.
- Glutamate: This is the main excitatory neurotransmitter in the central nervous system.
- Glycine: An inhibitory neurotransmitter in the central nervous system.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 21
Correct
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On a mountain the atmospheric pressure is 700 mmHg and the humidity close to zero, the partial pressure of oxygen is:
Your Answer: 147 mmHg
Explanation:Natural air includes approximately 21% of oxygen. If humidity is zero, the partial pressure of oxygen is 700 × 21% = 147 mmHg
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This question is part of the following fields:
- Medicine
- Respiratory
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Question 22
Correct
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Where is retinol mainly stored?
Your Answer: Liver
Explanation:Vitamin A is a group of unsaturated nutritional organic compounds that includes retinol, retinal, retinoic acid, and several provitamin A carotenoids (most notably beta-carotene). The liver stores a multitude of substances, including glucose (in the form of glycogen), vitamin A (1–2 years’ supply), vitamin D (1–4 months’ supply), vitamin B12 (3–5 years’ supply), vitamin K, iron, and copper.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 23
Correct
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With regards to environmental temperature, for each degree Celsius of elevation, the metabolic rate rises?
Your Answer: 0.14
Explanation:An increase in body temperature is associated with a higher metabolic rate. Evidence suggests that an increase of 1°C in your body temperature increases your metabolism by 10 to 14%.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 24
Correct
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The breakdown of superoxide is catalysed by which enzyme?
Your Answer: Superoxide dismutase
Explanation:As superoxide is toxic, nearly all organisms living in the presence of oxygen contain isoforms of the superoxide-scavenging enzyme superoxide dismutase, or SOD. SOD is an extremely efficient enzyme; it catalyses the neutralization of superoxide nearly as quickly as the two can diffuse together spontaneously in solution.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 25
Correct
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Café-au-lait spots are seen in each of the following, except:
Your Answer: Friedreich's ataxia
Explanation:Café-au-lait spots are hyperpigmented lesions that vary in colour from light brown to dark brown, with borders that may be smooth or irregular.
Causes include:
- Neurofibromatosis type I
- McCune–Albright syndrome
- Legius syndrome
- Tuberous sclerosis
- Fanconi anaemia
- Idiopathic
- Ataxia-telangiectasia
- Basal cell nevus syndrome
- Benign congenital skin lesion
- Bloom syndrome
- Chediak-Higashi syndrome
- Congenital nevus
- Gaucher disease
- Hunter syndrome
- Maffucci syndrome
- Multiple mucosal neuroma syndrome
- Noonan syndrome
- Pulmonary Stenosis
- Silver–Russell syndrome
- Watson syndrome
- Wiskott–Aldrich syndrome
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 26
Correct
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In the presence of oxygen , lactate that was produced under anaerobic conditions is converted to:
Your Answer: Pyruvate
Explanation:Lactate can be used in two ways:Oxidation back to pyruvate by well-oxygenated muscle cells, heart cells, and brain cells. Pyruvate is then directly used to fuel the Krebs cycle orConversion to glucose via gluconeogenesis in the liver and release back into circulation.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 27
Correct
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What is the protective hexametric sequence at the ends of chromosomes called?
Your Answer: Telomere
Explanation:Telomeres are non coding DNA plus proteins that are found at the end of the linear chromosomes. They maintain the integrity of the chromosomes and prevent their shortening.
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This question is part of the following fields:
- Genetics
- Medicine
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Question 28
Correct
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Question 29
Correct
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According to the Vaughan William's classification of antiarrhythmic agents, lidocaine is a:
Your Answer: Class Ib agent
Explanation:Lidocaine is an example of class IB antiarrhythmics.The Vaughan-Williams classification of antiarrhythmicsI: Membrane stabilizing agentsIA: Quinidine, Procainamide, DisopyramideIB: Lidocaine, MexiletineIC: Propafenone, Flecainide II: β blockers – Propranolol, EsmololIII: Agents widening AP – Amiodarone, Dronedarone, Dofetilide, Ibutilide, SotalolIV: Calcium channel blockers – Verapamil, DiltiazemV: Miscellaneous – Digoxin, adenosine, magnesium
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 30
Incorrect
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An elderly man presents with fever of 38°C and a very severe headache. His BP is 85/50 mm Hg. He has neck stiffness and photophobia. What is the most appropriate management?
Your Answer: IV fluid and CT head
Correct Answer: CT head
Explanation:In elderly patients, symptoms suggestive of meningitis could be due to an intracranial mass lesion (such as abscess, tumour or an intracerebral haematoma). Therefore elderly patients are increased risk of cerebral herniation from an LP. A CT head should be done before an LP to exclude a mass lesion.
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This question is part of the following fields:
- Geriatrics
- Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY
