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Question 1
Correct
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The predominant receptors in the hearts conduction system are?
Your Answer: Î’1
Explanation:All of the components of the intrinsic conduction system contain autorhythmic cells that spontaneously depolarize. In the absence of extrinsic neural or hormonal influences, the SA node pacing rate would be about 100 beats per minute (bpm). The heart rate and cardiac output, however, must vary in response to the needs of the body’s cells for oxygen and nutrients under varying conditions. In order to respond rapidly to changing requirements of the body’s tissues, the heart rate and contractility are regulated by the autonomic nervous system (ANS), hormones, and other factors. The ANS has two interacting systems: the sympathetic and parasympathetic systems.
Sympathetic receptors: There are two types of adrenergic receptors: β and α. In the cardiovascular system there are β1, β2, α1, and α2 adrenergic receptors. β1 adrenergic receptors are expressed in the heart conduction system (in the SA node, AV node, and on atrial and ventricular cardiomyocytes). The activation of β1 receptors increases heart rate (via the SA node), and contractility.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 2
Correct
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The intestine is lined by:
Your Answer: Simple columnar epithelium
Explanation:In the small intestine, epithelium is simple columnar and specialised for absorption. The epithelium is arranged into villi, creating a brush border and increasing the area for absorption. The epithelium is simple columnar with microvilli.In the colon, epithelium is simple columnar and without villi. Goblet cells, which secrete mucous, are also present.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 3
Incorrect
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Where is the lower border of the liver usually found?
Your Answer: 10th rib midclavicular line on right
Correct Answer: 10th rib anterior axillary line on right
Explanation:Assessment of liver margins is important clinically to determine the size of the liver and is done via percussion during the physical examination. The liver typically extends from the fifth intercostal space or 6th rib to the right costal margin in the midclavicular line and the 10th rib on anterior axillary line.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 4
Correct
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What is the most appropriate management of a DVT during pregnancy?
Your Answer: Heparin
Explanation:Low molecular weight heparin (LMWH) is safe in pregnancy and is therefore the first line management. Warfarin is teratogenic and must be avoided whilst the other options have no role to play.
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This question is part of the following fields:
- Medicine
- Respiratory
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Question 5
Incorrect
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A 82-year-old woman admitted following a fractured neck of femur has been discharged. On review, she is making good progress but consideration is given to secondary prevention of further fractures. What is the most appropriate step in the prevention of further fractures?
Your Answer: Arrange DEXA scan + start oral bisphosphonate if T-score < -1.5 SD
Correct Answer: Start oral bisphosphonate
Explanation:In such a clinical scenario, NICE guidelines support initiating treatment with bisphosphonates without waiting for a DEXA scan.Osteoporosis is defined as low bone mineral density caused by altered bone microstructure ultimately predisposing patients to low-impact, fragility fractures.Management:Vitamin D and calcium supplementation should be offered to all women unless the clinician is confident they have adequate calcium intake and are vitamin D repleteAlendronate is the first-line treatment. Around 25% of patients cannot tolerate alendronate, usually due to upper gastrointestinal problems. These patients should be offered risedronate or etidronate.Strontium ranelate and raloxifene are recommended if patients cannot tolerate bisphosphonates.Other medications that are useful in the treatment of osteoporosis are denosumab, teriparatide, raloxifene, etc.
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This question is part of the following fields:
- Medicine
- Pharmacology
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Question 6
Correct
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Where in the course of the gastrointestinal tract does the first significant digestion of fat begin in a normal human being?
Your Answer: Duodenum
Explanation:The enzyme lipase which is responsible for digestion of fat is secreted by the exocrine pancreas in the 2nd part of the duodenum at the point where the pancreatic duct opens. It opens together with the common bile duct which contains bile that emulsify fat aiding in digestion. The oesophagus, stomach and mouth do not contain enzymes related to fat digestion.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 7
Correct
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In both innate and humoral immunity, receptors involved recognize:
Your Answer: The shape of the antigen
Explanation:Antigen receptors recognize the shape of the antigen. They identify specific epitopes and are found on T cells.
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This question is part of the following fields:
- Immunology
- Medicine
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Question 8
Correct
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Question 9
Incorrect
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Which mechanism of action do Quinolones use?
Your Answer: Inhibit Folic Acid metabolism
Correct Answer: Inhibit DNA gyrase
Explanation:The quinolones are a family of synthetic broad-spectrum antibiotic drugs. Quinolones exert their antibacterial effect by preventing bacterial DNA from unwinding and duplicating.
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This question is part of the following fields:
- Infectious Diseases
- Medicine
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Question 10
Correct
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After exercise, O2 debt repay may take up to:
Your Answer: 90 min
Explanation:Physical activity or exercise requires oxygen for production of ATP or energy via aerobic pathways of energy production. When the amount of oxygen that reaches muscles depletes, cells start producing energy anaerobically by partial breakdown of glucose resulting in lactic acid. Lactic acid should be removed from cells as it causes muscle fatigue. Oxygen is needed to oxidize lactic acid in to carbon dioxide and water and this need is known as oxygen debt. The existence of an oxygen debt explains why we continue to breathe deeply and quickly for a while after exercise. This may take up from 60 – 90 mins.
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This question is part of the following fields:
- Medicine
- Respiratory
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SESSION STATS - PERFORMANCE PER SPECIALTY
