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Question 1
Incorrect
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The action of progesterone on different organs/systems includes:
Your Answer: Brain: stimulation of LH secretion thus triggering ovulation
Correct Answer: Breasts: stimulation of lobular and alveolar development
Explanation:Progesterone is a sex hormone which affects mainly the reproductive system. In the breasts, it mediates the lobuloalveolar maturation to allow for milk production; this is done in conjunction with prolactin. It acts to maintain female reproductive and sex characteristics.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 2
Incorrect
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A 32 year old female is diagnosed with SLE based on her complaints of polyarthralgia, mouth ulcers and ANA positivity. Labs reveal normal urinalysis, urea and electrolytes. ESR is 90mm in the first hour. How will you manage this patient?
Your Answer: Prednisolone 30 mg/day
Correct Answer: Hydroxychloroquine 200 mg/day
Explanation:Hydroxychloroquine is used in the management of SLE as it prevents disease progression and has relatively mild side effects, for instance headache, nausea etc. Its use reduces the usage of corticosteroids. It is particularly effective when the disease is less severe and there is no organ involvement. Cyclophosphamide and prednisolone are indicated in cases of renal, neurological and lung involvement.
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This question is part of the following fields:
- Connective Tissue
- Medicine
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Question 3
Incorrect
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Periodic fevers occur in humans with mutations in the gene for pyrin. Pyrin is a protein found in which one of the following cells?
Your Answer: B lymphocytes
Correct Answer: Neutrophils
Explanation:Pyrin, also known as marenostrin or TRIM20, is a protein encoded by the Mediterranean fever (MEFV) gene, causing the autoinflammatory disease familial Mediterranean fever (FMF). Pyrin produces an increased sensitivity to intracellular signals. It is produced mainly in neutrophils, which display an increased ratio of cells entering apoptosis when exposed to pyrin.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 4
Incorrect
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Which enzyme is responsible for the removal of acetylcholine from the synapse?
Your Answer: Pseudocholinesterase
Correct Answer: Acetylcholinesterase
Explanation:Acetylcholinesterase is the enzyme that is responsible for breaking down acetylcholine into choline and acetate. Both of these molecules are transported back to the presynaptic neuron to be synthesized again. This enzyme is attached to the collagen fibers of the basement membrane in the synaptic cleft.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 5
Incorrect
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A cohort study is being designed to look at the relationship between smoking and prostate cancer. What is the usual outcome measure in a cohort study?
Your Answer: Numbers needed to harm
Correct Answer: Relative risk
Explanation:A cohort study is a particular form of longitudinal study that samples a cohort (a group of people who share a defining characteristic, typically those who experienced a common event in a selected period, such as birth or graduation), performing a cross-section at intervals through time. The relative risk (RR) or risk ratio is the ratio of the probability of an outcome in an exposed group to the probability of an outcome in an unexposed group. Relative risk is used in the statistical analysis of the data of experimental, cohort and cross-sectional studies, to estimate the strength of the association between treatments or risk factors, and outcomes.
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This question is part of the following fields:
- Medicine
- Research Skills
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Question 6
Correct
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Question 7
Incorrect
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If both the noradrenergic and the cholinergic systems are blocked in the heart, the rate will be approximately:
Your Answer: 70/min
Correct Answer: 100/min
Explanation:The normal heart beat is about 70/min. This is due to a predominant parasympathetic activity. If sympathetic activity was unopposed the heart rate would have been 150/min. When both the noradrenergic and cholinergic systems are blocked the heart rate is 100/min. This is the normal firing rate of the SA node.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 8
Incorrect
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The role of the hemidesmosome is?
Your Answer: Holding cells together
Correct Answer: Attaches cells to underlying basal lamina
Explanation:Hemidesmosomes connect the basal surface of epithelial cells via intermediate filaments to the underlying basal lamina. The transmembrane proteins of hemidesmosomes are not cadherins, but another type of protein called integrin.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 9
Incorrect
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Which of the following is a precursor to the tissue macrophage?
Your Answer: Normoblast
Correct 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 10
Incorrect
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Which cell secretes parathyroid hormone?
Your Answer: Oxyphil cells
Correct Answer: Chief cells
Explanation:Parathyroid chief cells, also known as parathyroid principal cells or parathyroid cells, are the most prevalent type of cell in the parathyroid gland and the only ones present at birth. They secrete parathyroid hormone (PTH).
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 11
Incorrect
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What is the effect of oxytocin on the breast?
Your Answer: Inhibits milk ejection
Correct Answer: Milk ejection
Explanation:Oxytocin is a peptide hormone and neuropeptide, produced by the hypothalamus and released by the posterior pituitary. It causes the milk ejection or let-down reflex, causing the milk to be transported to the subareolar sinuses, allowing it to be released through the nipple. This response is initiated by the act of suckling by the baby, but it can be conditioned to be triggered by different stimuli.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 12
Correct
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Question 13
Incorrect
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Translation usually begins at which codon?
Your Answer: UGA
Correct Answer: AUG
Explanation:The start codon is the first codon of a messenger RNA (mRNA) transcript translated by a ribosome. The start codon always codes for methionine in eukaryotes and the most common start codon is AUG.
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This question is part of the following fields:
- Medicine
- Metabolism
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Question 14
Incorrect
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The reticular formation occupies which area of the brain?
Your Answer: Thalamic nuclei
Correct Answer: Medulla and midbrain
Explanation:The reticular formation is a set of interconnected nuclei that are located along the brainstem.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 15
Correct
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Which of the following has the shortest duration:
Your Answer: Atrial systole
Explanation:Atrial systole: 0.1s
Atrial diastole: around 0.4s
Ventricular diastole: 0.4-0.53s
Ventricular systole: 0.27s
PR interval: 0.12-0.2 s
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 16
Incorrect
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Efferent innervation of the muscle spindle is supplied by which type of motor neuron?
Your Answer: Delta – motor neuron
Correct Answer: Gama – motor neuron
Explanation:The muscle spindle is supplied by both sensory and motor nerves. Sensory supply is via Type Ia fibers whereas the motor supply is via gamma motor neurons.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 17
Incorrect
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Concerning S3, which of the following statements is INCORRECT?
Your Answer: AV valves are open
Correct Answer: Coincide with atrial contraction
Explanation:A third heart sound also called a ventricular gallop occurs at the beginning of diastole after S2 and is lower in pitch than S1 or S2 as it is not of valvular origin. The third heart sound is benign in youth, some trained athletes, and sometimes in pregnancy but if it re-emerges later in life it may signal cardiac problems, such as a failing left ventricle as in dilated congestive heart failure (CHF). S3 is thought to be caused by the oscillation of blood back and forth between the walls of the ventricles initiated by blood rushing in from the atria. The reason the third heart sound does not occur until the middle third of diastole is probably that during the early part of diastole, the ventricles are not filled sufficiently to create enough tension for reverberation. It may also be a result of tensing of the chordae tendineae during rapid filling and expansion of the ventricle. In other words, an S3 heart sound indicates increased volume of blood within the ventricle. An S3 heart sound is best heard with the bell-side of the stethoscope (used for lower frequency sounds). A left-sided S3 is best heard in the left lateral decubitus position and at the apex of the heart, which is normally located in the 5th left intercostal space at the midclavicular line. A right-sided S3 is best heard at the lower-left sternal border. The way to distinguish between a left and right-sided S3 is to observe whether it increases in intensity with inhalation or exhalation. A right-sided S3 will increase on inhalation, while a left-sided S3 will increase on exhalation.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 18
Correct
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The AV Node:
Your Answer: It decelerates impulses passing to the ventricles
Explanation:The action potentials in the sinoatrial (SA) and atrioventricular (AV) nodes are largely due to Ca2+, with no contribution by Na+ influx. The depolarization continues to conduct slowly through the atrioventricular (AV) node. The AV node is located in the right posterior portion of the interatrial septum. This is small and bean-shaped. The atrial conductive system is organized so that the cardiac impulse does not travel from the atria into the ventricles too rapidly; this delay allows the atria to empty before ventricular contraction begins. It is the AV node and its adjacent conductive fibers that delay this transmission into the ventricles. Conduction through the AV Node is represented on the ECG by the PR interval.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 19
Incorrect
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In blistering dermatological disorders e.g.. Pemphigus, which junctions are attacked by autoantibodies?
Your Answer: Hemidesmosomes
Correct Answer: Desmosomes
Explanation:Pemphigus is an autoimmune disease caused by antibodies directed against both desmoglein 1 and desmoglein 3 present in desmosomes. Loss of desmosomes results in loss of cohesion between keratinocytes in the epidermis, and a disruption of the barrier function served by intact skin. The process is classified as a type II hypersensitivity reaction
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 20
Incorrect
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Mitosis is the process of cell division which culminates in cell chromosomes which are:
Your Answer: Subsequently used in fertilisation
Correct Answer: Diploid
Explanation:Mitosis is a part of the cell cycle when replicated chromosomes are separated into two new diploid nuclei.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 21
Correct
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Which ion channel does not contribute to the myocardial action potential?
Your Answer: Chloride channel
Explanation:The upstroke in the cardiac action potential is due to opening of the sodium channels and an influx of sodium into the cell. The initial repolarization phase is due to transient opening of the potassium channels along with calcium channels. Influx of calcium causes the prolonged plateau phase of the action potential. Delayed opening of the rectifier potassium channel and delayed closure of the calcium channel leads to the repolarization phase of cardiac action potential.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 22
Incorrect
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Select a factor which stimulates glucagon secretion.
Your Answer: Somatostatin
Correct Answer: Protein meal
Explanation:Several studies have shown that glucagon levels are increased in individuals with a high protein diet. It is still debated, however, whether this type of diet affects insulin levels as well.
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This question is part of the following fields:
- Endocrinology
- Medicine
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Question 23
Incorrect
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Which of the following causes an increase in venous return?
Your Answer: Peripheral vasodilatation
Correct Answer: An increase in the negative intra-thoracic pressure
Explanation:During inspiration, intrathoracic pressure becomes more negative and intra-abdominal pressure more positive. This increases the venous pressure gradient from abdomen to thorax and promotes filling of the central veins.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 24
Correct
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The following are examples of the functions of the vascular endothelium except:
Your Answer: Tumour suppression
Explanation:Vascular endothelium has many important functions including regulation of vascular tone, molecular exchange between blood and tissue compartments, hemostasis and signaling for the immune regulation and inflammation. Depending on specific tissue needs and local stresses, endothelial cells are capable of evoking either antithrombotic or prothrombotic events. Tumor suppression is related to genes, or anti-oncogenes, that regulate a cell during cell division and replication.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 25
Incorrect
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Coronary arteries fill up during
Your Answer: Ventricular ejection
Correct Answer: Diastole
Explanation:During contraction of the ventricular myocardium (systole), the subendocardial coronary vessels (the vessels that enter the myocardium) are compressed due to the high ventricular pressures. This compression results in momentary retrograde blood flow (i.e., blood flows backward toward the aorta) which further inhibits perfusion of myocardium during systole. However, the epicardial coronary vessels (the vessels that run along the outer surface of the heart) remain open. Because of this, blood flow in the sub endocardium stops during ventricular contraction. As a result, most myocardial perfusion occurs during heart relaxation (diastole) when the subendocardial coronary vessels are open and under lower pressure.
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This question is part of the following fields:
- Cardiovascular
- Medicine
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Question 26
Correct
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Absorption of protein antigens i.e. bacterial and viral proteins takes place in the:
Your Answer: Microfold cells (m cells) of the intestine
Explanation:M cells are specialized epithelial cells. They have a high capacity of transcytosis of microorganisms and macromolecules. They rapidly uptake antigens and present them to immune cells associated with the gut. In contrast to absorptive enterocytes, M cells do not exert direct defence mechanisms to antigens and pathogens in the intestinal cavity. Crypts of Lieberkühn are located mainly in the small intestine and large intestine and the main function is to replenish epithelial cells and to secrete intestinal enzymatic juice as well as mucous. Brunner’s glands empty into intestinal glands and their main function is to secrete mucin and to form a protective mucus layer on the duodenal epithelial cells to protect it from acidic chyme coming from the stomach. Islets of Langerhans are located in the pancreas and secrets insulin mainly. Mucosa associated lymphoid tissue plays a role in inducing immune response after presentation of antigens.
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This question is part of the following fields:
- Gastrointestinal
- Medicine
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Question 27
Incorrect
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The interior of lysosomes is kept at a pH of around 5 by the action of:
Your Answer:
Correct Answer: H+ ATPase
Explanation:The lysosome maintains its pH differential by pumping in protons (H+ ions) from the cytosol across the membrane via proton pumps and chloride ion channels. Vacuolar H+-ATPases are responsible for transport of protons, while the counter transport of chloride ions is performed by ClC-7 Cl−/H+ antiporter.
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This question is part of the following fields:
- Cell Biology
- Medicine
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Question 28
Incorrect
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The endothelium of the sinusoids has the following important function:
Your Answer:
Correct Answer: Highly fenestrated, large subendothelial spaces, many macrophages
Explanation:Substances absorbed in the intestines reach the liver via the portal vein and contain toxic substances that needs to be detoxified in hepatocytes. Thus, hepatic sinusoids are fenestrated and contain large spaces which allows passage of substances freely. These fenestrations are rich in Kupffer cells which are macrophages.
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This question is part of the following fields:
- Hepatobiliary
- Medicine
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Question 29
Incorrect
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Salty taste is triggered by:
Your Answer:
Correct Answer: Amiloride-sensitive sodium channel
Explanation:Amiloride-sensitive sodium channels also known as epithelial Na channels is a membrane bound ion channel that is selectively permeable to Na+ ions. These channels are located throughout different epithelial membranes in the body. It is found in taste receptor cells, where it plays an important role in salt taste perception. They are also located in the kidney, the lung and the colon. Hyperpolarization-activated, cyclic nucleotide-gated (HCN) voltage-gated ion channels are widely seen in the cortex, hippocampus, thalamus and brain regions that underlie the generation of both focal and generalized-onset seizures. The metabotropic glutamate receptor (mGluRs) perform a variety of functions in the central and peripheral nervous systems. They are involved in learning, memory, anxiety, and the perception of pain. Gustducin is a G protein associated with taste and gustatory system. It plays a major role in sensation of bitter, sweet and umami stimuli.
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This question is part of the following fields:
- Medicine
- Neurology
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Question 30
Incorrect
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A 71-year-old woman residing in a nursing home for a couple of years complains of drooling of saliva and sudden difficulty in swallowing while eating. She is a known hypertensive on treatment. What would be your next step?
Your Answer:
Correct Answer: Endoscopy
Explanation:Dysphagia or difficulty in swallowing. Endoscopy allows for visual examination of the oesophagus and is indicated in patients with dysphagia to determine the underlying aetiology, exclude malignant and premalignant conditions, assess the need for therapy, and perform therapy including dilation.
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This question is part of the following fields:
- Geriatrics
- Medicine
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