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  • Question 1 - The most resistant area in the brain to hypoxia is: ...

    Correct

    • The most resistant area in the brain to hypoxia is:

      Your Answer: Brain stem

      Explanation:

      The structures in the brainstem are more resistant to hypoxia than the cerebral cortex and the rest of the brain structures.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      30.5
      Seconds
  • Question 2 - Which of the following diseases have antibodies available for treatment of the condition....

    Correct

    • Which of the following diseases have antibodies available for treatment of the condition.

      Your Answer: None of these

      Explanation:

      There is no specific treatment for hepatitis A. Recovery from symptoms following infection may be slow and may take several weeks or months. The hepatitis A vaccine is effective for prevention and appears to be effective for life.Acute hepatitis B infection does not usually require treatment and most adults clear the infection spontaneously. Early antiviral treatment may be required in fewer than 1% of people, whose infection takes a very aggressive course (fulminant hepatitis) or who are immunocompromised. Although none of the available drugs can clear the infection, they can stop the virus from replicating, thus minimizing liver damage.There is no specific treatment for measles. Most people with uncomplicated measles will recover with rest and supportive treatment. In developed countries, children are immunized against measles at 12 months, generally as part of a three-part MMR vaccine (measles, mumps, and rubella). The vaccination is generally not given before this age because such infants respond inadequately to the vaccine due to an immature immune system. Treatment after rabies exposure can prevent the disease if administered promptly, generally within 10 days of infection. The Centres for Disease Control and Prevention recommends people receive one dose of human rabies immunoglobulin (HRIG) and four doses of rabies vaccine over a 14-day period.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      7.6
      Seconds
  • Question 3 - Presence of which of the following indicates a worse prognosis in rheumatoid arthritis?...

    Correct

    • Presence of which of the following indicates a worse prognosis in rheumatoid arthritis?

      Your Answer: Anti-CCP antibodies

      Explanation:

      Rheumatoid arthritis is both common and chronic, with significant consequences for multiple organ systems. Anti-cyclic citrullinated peptide (anti-CCP) antibody testing is particularly useful in the diagnosis of rheumatoid arthritis, with high specificity, presence early in the disease process, and ability to identify patients who are likely to have severe disease and irreversible damage. However, its sensitivity is low, and a negative result does not exclude disease. Anti-CCP antibodies have not been found at a significant frequency in other diseases to date, and are more specific than rheumatoid factor for detecting rheumatoid arthritis. The other factors that are mentioned do not play a key prognostic role.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      19.4
      Seconds
  • Question 4 - When the heart rate is increased (to pathological levels) which of the following...

    Correct

    • When the heart rate is increased (to pathological levels) which of the following is correct when comparing the duration of diastole to systole?

      Your Answer: It is shortened to a greater degree

      Explanation:

      The duration of systole is more fixed than the duration of diastole. When the heart rate increases the timing of the systole remains more or less the same however diastole decreases.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      66.6
      Seconds
  • Question 5 - A 28 year old female presents to the rheumatology clinic for review. She...

    Correct

    • A 28 year old female presents to the rheumatology clinic for review. She has a history of adult onset Still's disease and complains of joint pains and persistent skin rash despite undergoing treatment with methotrexate and etanercept. On examination, an erythematous macular rash and active synovitis is noted. CRP is high (95 mg/dl). Which of the following interventions would be most appropriate?

      Your Answer: Anakinra

      Explanation:

      Adult onset Still’s disease (AOSD) is an uncommon systemic inflammatory disease on the clinical spectrum of autoinflammatory disorders. Its presentation and clinical course may result in several well-differentiated phenotypes: from a systemic and highly symptomatic pattern to a chronic articular pattern. Overproduction of numerous pro-inflammatory cytokines is observed in AOSD. Anakinra, a human interleukin (IL)-1R antagonist, has recently been approved in the treatment of AOSD. Denosumab is a RANK ligand inhibitor used in the treatment of osteoporosis. Mepolizumab is used in the treatment of severe asthma with elevated eosinophils. There is some evidence to support the use of tocilizumab, an anti-IL6 monoclonal antibody in adult onset Still’s, but there is stronger data favouring the use of tocilizumab in the treatment of rheumatoid arthritis. Rituximab is usually reserved for patients who are unresponsive to anakinra.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      33.7
      Seconds
  • Question 6 - Which ventral (motor) root is responsible for triceps? ...

    Correct

    • Which ventral (motor) root is responsible for triceps?

      Your Answer: C7

      Explanation:

      Of the nerve fibers that make up the brachial plexus, C7 mainly forms the radial nerve to innervate the triceps muscle, thus innervating the shoulders, elbow, wrist and hand. C7 is responsible for the triceps reflex.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      9.5
      Seconds
  • Question 7 - The production of bile is increased by: Stimulation of the ____ nerve and...

    Correct

    • The production of bile is increased by: Stimulation of the ____ nerve and the hormone ____.

      Your Answer: Vagus, CCK

      Explanation:

      Cholecystokinin is synthesized and secreted by enteroendocrine cells in the duodenum, the first segment of the small intestine, and causes the release of digestive enzymes and bile from the pancreas and gallbladder, respectively. It also acts as a hunger suppressant. Release of CCK is stimulated by monitor peptide released by pancreatic acinar cells as well as CCK-releasing protein, a paracrine factor secreted by enterocytes in the gastrointestinal mucosa. In addition, release of acetylcholine by the parasympathetic nerve fibers of the vagus nerve also stimulate its secretion.

    • This question is part of the following fields:

      • Hepatobiliary
      • Medicine
      17.9
      Seconds
  • Question 8 - Inhibition of cell division at the end of G1 occurs through: ...

    Incorrect

    • Inhibition of cell division at the end of G1 occurs through:

      Your Answer: p53

      Correct Answer: Unphosphorolated retinoblastoma protein (uRb)

      Explanation:

      A cell’s decision to enter, or re-enter, the cell cycle is made before S-phase in G1 at what is known as the restriction point, and is determined by the combination of promotional and inhibitory extracellular signals that are received and processed. Ultimately unphosphorylated Rb acts as an inhibitor of G1.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      18.2
      Seconds
  • Question 9 - Which mechanism of action do Quinolones use? ...

    Incorrect

    • Which mechanism of action do Quinolones use?

      Your Answer: Inhibit Protein synthesis

      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.

    • This question is part of the following fields:

      • Infectious Diseases
      • Medicine
      14.7
      Seconds
  • Question 10 - In a normal heart rate at rest, the left ventricular end-diastolic volume is...

    Incorrect

    • In a normal heart rate at rest, the left ventricular end-diastolic volume is ….

      Your Answer: 50-70 ml

      Correct Answer: 100-130 ml

      Explanation:

      In cardiovascular physiology, end-diastolic volume (EDV) is the volume of blood in the right and/or left ventricle at end load or filling in (diastole) or the amount of blood in the ventricles just before systole. Because greater EDVs cause greater distention of the ventricle, EDV is often used synonymously with preload, which refers to the length of the sarcomeres in cardiac muscle prior to contraction (systole). End-diastolic volume: Right = 144 mL(± 23mL) & Left = 142 mL (± 21 mL).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      22.3
      Seconds
  • Question 11 - When 2 nucleotide chains of DNA bind together, thymine is bound to: ...

    Correct

    • When 2 nucleotide chains of DNA bind together, thymine is bound to:

      Your Answer: Adenine

      Explanation:

      As a general rule in the structure of DNA, thymine always binds to adenine with two hydrogen bonds, cytosine always binds to guanine with three hydrogen bonds and vice versa. However In the structure of RNA the only difference is that adenine binds to uracil instead of thymine. But thymine will always bind to adenine.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      19.6
      Seconds
  • Question 12 - What is the main function of vitamin E? ...

    Correct

    • What is the main function of vitamin E?

      Your Answer: It is an antioxidant

      Explanation:

      Vitamin E has many biological functions, the antioxidant function being the best known. Other functions include enzymatic activities, gene expression, and neurological function(s).

    • This question is part of the following fields:

      • Haematology
      • Medicine
      14.8
      Seconds
  • Question 13 - One of the cells of the bone marrow that are responsible for forming...

    Correct

    • One of the cells of the bone marrow that are responsible for forming the various forms of differentiated blood cells are called?

      Your Answer: Hematopoietic stem cell

      Explanation:

      Hematopoietic stem cells (HSCs) or hemocytoblasts are the stem cells that give rise to all the other blood cells through the process of haematopoiesis. They are derived from mesoderm and located in the red bone marrow, which is contained in the core of most bones.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      39
      Seconds
  • Question 14 - Which of the following vitamin deficiencies is associated with xerophthalmia? ...

    Correct

    • Which of the following vitamin deficiencies is associated with xerophthalmia?

      Your Answer: Vitamin A

      Explanation:

      Xerophthalmia caused by a severe vitamin A deficiency is described by pathologic dryness of the conjunctiva and cornea. The conjunctiva becomes dry, thick and wrinkled. If untreated, it can lead to corneal ulceration and ultimately to blindness as a result of corneal damage.

    • This question is part of the following fields:

      • Haematology
      • Medicine
      11.9
      Seconds
  • Question 15 - The brainstem reticular formation, consists of which important control system responsible for consciousness...

    Correct

    • The brainstem reticular formation, consists of which important control system responsible for consciousness and sleep?

      Your Answer: RAS reticular activating system

      Explanation:

      The reticular formation is a set of interconnected nuclei that are located along the brainstem. Reticular activating system (RAS) is a set of connected nuclei in the brain that is responsible for regulating wakefulness and sleep wake transitions and is the most influential component in the reticular formation.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      17.9
      Seconds
  • Question 16 - With regard to the spleen which of the following has the correct match?...

    Correct

    • With regard to the spleen which of the following has the correct match?

      Your Answer: Periarteriolar lymphoid sheets - T lymphocytes

      Explanation:

      The spleen consists of:Red pulp – responsible for mechanical filtration of red blood cells. Red pulp contains sinusoids, which are filled with blood, splenic cords of reticular fibers and a marginal zoneWhite pulp – responsible for active immune response through humoral and cell-mediated pathways. Composed of nodules, called Malpighian corpuscles. These are composed of: lymphoid follicles, rich in B-lymphocytes and periarteriolar lymphoid sheaths, rich in T-lymphocytes

    • This question is part of the following fields:

      • Haematology
      • Medicine
      15.4
      Seconds
  • Question 17 - The net effect of active Vitamin D on calcium and phosphate homeostasis is?...

    Incorrect

    • The net effect of active Vitamin D on calcium and phosphate homeostasis is?

      Your Answer: Increase in Ca, decrease in phosphate

      Correct Answer: Increase in Ca, increase in phosphate

      Explanation:

      Bone and its metabolism are regulated by several hormones, amongst which is vitamin D. It is heavily involved in the metabolism and homeostasis of calcium and phosphate through several processes. Vitamin D works in the intestine, kidney, bone and parathyroid glands to maintain levels of calcium and phosphate, promoting its absorption, bone resorption, and proper functioning of the parathyroid to maintain adequate serum calcium levels.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      31.2
      Seconds
  • Question 18 - Which of the following correctly describes stages in the formation of CSF? ...

    Correct

    • Which of the following correctly describes stages in the formation of CSF?

      Your Answer: All of the above

      Explanation:

      All the above are true for the formation of CSF

    • This question is part of the following fields:

      • Medicine
      • Neurology
      10.5
      Seconds
  • Question 19 - Within the hypothalamus, the dopamine-secreting neurones of the intrahypothalamic system have their cell...

    Incorrect

    • Within the hypothalamus, the dopamine-secreting neurones of the intrahypothalamic system have their cell bodies in which nuclei?

      Your Answer: Paraventricular

      Correct Answer: Arcuate

      Explanation:

      Arcuate nucleus dopaminergic neurons consist of a single group of neurons that project to the median eminence where they release dopamine into the hypophyseal portal circulation to inhibit pituitary prolactin secretion.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      41.6
      Seconds
  • Question 20 - A 28 year old man was rushed to the hospital after experiencing sudden...

    Incorrect

    • A 28 year old man was rushed to the hospital after experiencing sudden onset chest pain while playing football. He has never felt such pain in the past. However, one of his uncles had a similar sudden discomfort at a young age and he passed away following a heart problem. The following vitals are recorded on examination:BP: 101/74 mmHgRR: 22 breaths/minPR: 87 beats/min Physical examination reveals abnormally long fingers and on asking the man to hold the opposite wrist, the thumb and little finger overlap each other. He is not taking any medication regularly and past medical/surgical history is not significant. He admits to smoking half pack of cigarettes/day for the last 10 years but denies abusing any illicit drugs. Which of the following explanation most likely explains the disease process in this man?

      Your Answer: Overactive elastase enzyme leading to an excessive breakdown of collagen

      Correct Answer: A defect of the glycoprotein structure which usually wraps around elastin

      Explanation:

      Aortic dissection is defined as separation of the layers within the aortic wall. Tears in the intimal layer result in the propagation of dissection (proximally or distally) secondary to blood entering the intima-media space. This can be caused as a result of both congenital or acquired factors like chronic uncontrolled hypertension. This patient shows no sign of hypertension but his physical examination hints towards Marfan Syndrome. Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder affecting the microfibrils and elastin in connective tissue throughout the body. MFS is associated with pathological manifestations in the cardiovascular system (e.g., mitral valve prolapse, aortic aneurysm, and dissection), the musculoskeletal system (e.g., tall stature with disproportionately long extremities, joint hypermobility), and the eyes (e.g., subluxation of the lens of the eye). Decreased collagen production occurs in ageing, hydroxylation defects are present in vitamin C deficiency, copper deficiency affecting lysyl oxidase enzyme occurs in Menke’s disease.

    • This question is part of the following fields:

      • Connective Tissue
      • Medicine
      67.7
      Seconds
  • Question 21 - The oligosaccharidases responsible for further digestion of starch after breakdown by the above...

    Correct

    • The oligosaccharidases responsible for further digestion of starch after breakdown by the above mentioned enzymes is located where?

      Your Answer: Brush border of small intestine

      Explanation:

      The final step in digestion of carbohydrates, which is conversion of disaccharides to absorbable monosaccharides occurs on the small intestinal epithelial cells. The enzymes responsible for this final stage of digestion are not freely found in the intestinal lumen, but they are found as integral membrane proteins in the plasma membrane of the epithelial cell. The apical plasma membrane of the intestinal epithelial cell has numerous microvilli known as the brush border. Thus, the enzymes embedded in those microvilli are referred to as brush border enzymes.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      24.1
      Seconds
  • Question 22 - To which protein is T3 mostly bound in the serum? ...

    Correct

    • To which protein is T3 mostly bound in the serum?

      Your Answer: Thyroxin-binding globulin

      Explanation:

      In a normal person, approximately 0.03 per cent of the total serum T4, and 0.3 per cent of the total serum T3 are present in free or unbound form. The major serum thyroid hormone-binding proteins are: 1) thyroxine-binding globulin [TBG or thyropexin], 2) transthyretin [TTR or thyroxine-binding prealbumin (TBPA)], and 3) albumin (HAS, human serum albumin). TBG has highest affinity for T4, which is 50-fold higher than that of TTR and 7,000-fold higher that of HSA. As a result TBG binds 75% of serum T4, while TTR and HSA binds only 20% and Albumin 5%, respectively.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      13.7
      Seconds
  • Question 23 - Regarding CSF: ...

    Correct

    • Regarding CSF:

      Your Answer: Disruption of arachnoid villi function results in a communicating hydrocephalus

      Explanation:

      In normal adults CSF volume is around 125ml to 150ml. Turnover of the entire volume of cerebrospinal fluid is about 3 to 4 times a day. Composition of CSF is similar to that of plasma except that CSF is nearly protein-free compared with plasma and has different electrolyte levels. Blockage of the foramina causes an obstructive or non-communicating hydrocephalus. Communicating hydrocephalus or non-obstructive hydrocephalus is caused by impaired CSF reabsorption in the absence of any CSF flow obstruction.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      4.1
      Seconds
  • Question 24 - Where is the carotid sinus located? ...

    Incorrect

    • Where is the carotid sinus located?

      Your Answer: Before the bifurcation of the carotid artery

      Correct Answer: After the bifurcation of the carotid artery, on the internal carotid

      Explanation:

      The carotid sinus is a small dilation in the internal carotid artery just above its bifurcation into the external and internal carotid branch. Baroreceptors are present at this dilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      52.7
      Seconds
  • Question 25 - Which heart sounds are matched correctly? ...

    Correct

    • Which heart sounds are matched correctly?

      Your Answer: All of the above

      Explanation:

      In healthy adults, there are two normal heart sounds often described as a lub and a dub (or dup), that occur in sequence with each heartbeat. These are the first heart sound (S1) and second heart sound (S2), produced by the closing of the atrioventricular valves and semilunar valves, respectively. In addition to these normal sounds, a variety of other sounds may be present including heart murmurs, adventitious sounds, and gallop rhythms S3 and S4. 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. S4 when audible in an adult is called a presystolic gallop or atrial gallop. This gallop is produced by the sound of blood being forced into a stiff or hypertrophic ventricle.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      23.4
      Seconds
  • Question 26 - The thalamic main input from the cortex is via which tracts? ...

    Correct

    • The thalamic main input from the cortex is via which tracts?

      Your Answer: Thalamocortical pathway

      Explanation:

      The thalamus is connected to cerebral cortex via the thalamocortical radiation.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      17.7
      Seconds
  • Question 27 - Physiological effects of T3 on the heart include all the following except: ...

    Incorrect

    • Physiological effects of T3 on the heart include all the following except:

      Your Answer: Increased expression of serca pump gene

      Correct Answer: Increased expression of β-myosin heavy chain gene

      Explanation:

      Tri-iodothyronine, also known as T3, is a hormone which can affect almost every system in the human body. In the heart, it increases the number of β1-adrenergic receptors, enhances the response to circulating catecholamines, increases the proportion of α-myosin heavy chains in the atria, and increases the expression of serca pump gene.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      37.3
      Seconds
  • Question 28 - Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms ...

    Incorrect

    • Adrenergic stimulation will lead to myocyte relaxation via the following mechanisms

      Your Answer: Decreased the number of sarcomeres

      Correct Answer: Increased phosphorylation of phosholamban

      Explanation:

      Phosphorylation of phospholamban, which increases calcium ATPase activity and sequestration of calcium in the sarcoplasmic reticulum. An increased rate of relaxation is explained because cAMP also activates the protein phospholamban, situated on the membrane of the SR, that controls the rate of uptake of calcium into the SR. The latter effect explains enhanced relaxation (lusitropic effect).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      38.3
      Seconds
  • Question 29 - What is the most appropriate management of a DVT during pregnancy? ...

    Correct

    • 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.

    • This question is part of the following fields:

      • Medicine
      • Respiratory
      6.3
      Seconds
  • Question 30 - What is the most important source of heat production in the body? ...

    Incorrect

    • What is the most important source of heat production in the body?

      Your Answer: Ingestion of food

      Correct Answer: Skeletal muscle contraction

      Explanation:

      Thermogenesis is the process by which organisms produce heat. Through skeletal muscle contraction, or shivering, ATP is converted into kinetic energy, some of which converts into heat. These muscle contractions produce about 70% of total body heat.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      26.8
      Seconds
  • Question 31 - The interventricular septum is supplied anteriorly by the? ...

    Correct

    • The interventricular septum is supplied anteriorly by the?

      Your Answer: Left anterior descending artery

      Explanation:

      The anterior interventricular artery or left anterior descending artery supplies the anterior 2/3rds of the interventricular septum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      13.9
      Seconds
  • Question 32 - In terms of relative steroid potency, how much prednisone is equivalent to 100mg...

    Incorrect

    • In terms of relative steroid potency, how much prednisone is equivalent to 100mg hydrocortisone?

      Your Answer: 10mg

      Correct Answer: 25mg

      Explanation:

      Different corticosteroids have varying degrees of potency. 1 mg of prednisone is equivalent to 4 mg of hydrocortisone. Therefore, 25 mg of prednisone are equivalent to 100 mg of hydrocortisone.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      23
      Seconds
  • Question 33 - The enzyme that catalyses the final step in glycogen synthesis is: ...

    Correct

    • The enzyme that catalyses the final step in glycogen synthesis is:

      Your Answer: Glycogen synthase

      Explanation:

      Glycogen synthase is a key enzyme in glycogenesis, the conversion of glucose into glycogen. This enzyme combines excess glucose residues one by one into a polymeric chain for storage as glycogen.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      8.1
      Seconds
  • Question 34 - If O2 makes up 21% of air, then at one atmosphere (760mmHg) it...

    Correct

    • If O2 makes up 21% of air, then at one atmosphere (760mmHg) it would be expected that the PO2 of inspired air should be 0,21 x 760 = 160mmHg. In the alveoli the actual measure is 149mmHg because…

      Your Answer: Water is equilibrated with air

      Explanation:

      There are several factors that determine the value of alveolar partial oxygen pressure including: the pressure of outside air, the partial pressure of inspired oxygen and carbon dioxide, the rates of total body oxygen consumption and carbon dioxide production, the rates of alveolar ventilation and perfusion. The alveolar partial pressure is lower than the atmospheric oxygen partial pressure. One reason is, as the air enters the lungs, it is humidified by the upper airway and thus the partial pressure of water vapour reduces the oxygen partial pressure as water is equilibrated with air.

    • This question is part of the following fields:

      • Medicine
      • Respiratory
      20.4
      Seconds
  • Question 35 - A 50-year-old male was brought to the ER after the accidental consumption of...

    Correct

    • A 50-year-old male was brought to the ER after the accidental consumption of 300 ml of diethylene glycol. Blood investigations were suggestive of metabolic acidosis and renal failure. What is the appropriate management in this patient?

      Your Answer: Haemodialysis and oral ethanol

      Explanation:

      Among the given options the most appropriate management in this patient would be ethanol and haemodialysis.Ethanol competes with ethylene glycol for alcohol dehydrogenase and thus, helps manage a patient with ethylene glycol toxicity.Ethylene glycol is a type of alcohol used as a coolant or antifreezeFeatures of toxicity are divided into 3 stages:Stage 1: (30 min to 12 hours after exposure) Symptoms similar to alcohol intoxication: confusion, slurred speech, dizziness (CNS depression)Stage 2: (12 – 48 hours after exposure) Metabolic acidosis with a high anion gap and high osmolar gap. Also tachycardia, hypertensionStage 3: (24 – 72 hours after exposure) Acute renal failureManagement has changed in recent times:Fomepizole, an inhibitor of alcohol dehydrogenase, is now used first-line in preference to ethanol.Ethanol has been used for many years works by competing with ethylene glycol for the enzyme alcohol dehydrogenase this limits the formation of toxic metabolites (e.g. glycolaldehyde and glycolic acid) which are responsible for the hemodynamic/metabolic features of poisoning.Haemodialysis has a role in refractory cases.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      16.8
      Seconds
  • Question 36 - A 40-year-old man is admitted to the Emergency Department in a confused state....

    Correct

    • A 40-year-old man is admitted to the Emergency Department in a confused state. He tells you that he consumed two bottles of antifreeze. On examination, his pulse is 120 bpm and blood pressure is 140/90 mmHg. An arterial blood gas analysis shows uncompensated metabolic acidosis. He is transferred to the high dependency unit and ethanol is given via a nasogastric tube. How does ethanol help this patient?

      Your Answer: Competes with ethylene glycol for alcohol dehydrogenase

      Explanation:

      Ethanol competes with ethylene glycol for alcohol dehydrogenase and thus, helps manage a patient with ethylene glycol toxicity.Ethylene glycol is a type of alcohol used as a coolant or antifreezeFeatures of toxicity are divided into 3 stages:Stage 1: (30 min to 12 hours after exposure) Symptoms similar to alcohol intoxication: confusion, slurred speech, dizziness (CNS depression)Stage 2: (12 – 48 hours after exposure) Metabolic acidosis with a high anion gap and high osmolar gap. Also tachycardia, hypertensionStage 3: (24 – 72 hours after exposure) Acute renal failureManagement has changed in recent times:Fomepizole, an inhibitor of alcohol dehydrogenase, is now used first-line in preference to ethanol.Ethanol has been used for many years works by competing with ethylene glycol for the enzyme alcohol dehydrogenase this limits the formation of toxic metabolites (e.g. glycolaldehyde and glycolic acid) which are responsible for the hemodynamic/metabolic features of poisoning.Haemodialysis has a role in refractory cases.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      46.7
      Seconds
  • Question 37 - Phosphorylation of glucose once it enters the cell is catalysed by which enzyme?...

    Correct

    • Phosphorylation of glucose once it enters the cell is catalysed by which enzyme?

      Your Answer: Hexokinase

      Explanation:

      Glucose 6-phosphate is produced by phosphorylation of glucose on the sixth carbon. This is catalysed by the enzyme hexokinase in most cells. One molecule of ATP is consumed in this reaction.

    • This question is part of the following fields:

      • Medicine
      • Metabolism
      6.7
      Seconds
  • Question 38 - Which of the following forms one of the characteristic and functional cells making...

    Correct

    • Which of the following forms one of the characteristic and functional cells making up the anterior pituitary gland?

      Your Answer: Corticotrope

      Explanation:

      The anterior pituitary, also known as adenohypophysis or pars anterior contains the following types of cells: – acidophil cells: somatotroph cells, which produce growth hormone; and lactotrophs, which produce prolactin- basophil cells: corticotropes, which produce adrenocorticotropic hormone; thyrotropes, which produce thyroid stimulating hormone; and – gonadotrophs, which produce luteinizing hormone and follicle stimulating hormone.

    • This question is part of the following fields:

      • Endocrinology
      • Medicine
      22.4
      Seconds
  • Question 39 - Which membrane bound protein in the sarcoplasmic reticulum regulates calcium return from the...

    Incorrect

    • Which membrane bound protein in the sarcoplasmic reticulum regulates calcium return from the cytosol to the sarcoplasmic reticulum?

      Your Answer: Calmodulin

      Correct Answer: Phospholamban

      Explanation:

      Phosphorylation of phospholamban increases calcium ATPase activity and sequestration of calcium in the sarcoplasmic reticulum. An increased rate of relaxation is explained because cAMP also activates the protein phospholamban, situated on the membrane of the sarcoplasmic reticulum (SR), that controls the rate of uptake of calcium into the SR. The latter effect explains enhanced relaxation (lusitropic effect).

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      12.5
      Seconds
  • Question 40 - The immunoglobulin found in the highest concentration in humans is ...

    Correct

    • The immunoglobulin found in the highest concentration in humans is

      Your Answer: IgG

      Explanation:

      Representing approximately 75% of serum antibodies in humans, IgG is the most common type of antibody found in the circulation. IgG molecules are created and released by plasma B cells.

    • This question is part of the following fields:

      • Immunology
      • Medicine
      8.6
      Seconds
  • Question 41 - Which of the following substances inhibits pancreatic secretion? ...

    Incorrect

    • Which of the following substances inhibits pancreatic secretion?

      Your Answer: Vasoactive intestinal polypeptide

      Correct Answer: Pancreatic polypeptide

      Explanation:

      Number of hormones and neurotransmitters can stimulate and inhibit pancreatic exocrine secretion. Cholecystokinin, secretin, vasoactive intestinal peptide and substance P stimulate pancreatic secretion. Pancreatic polypeptide, somatostatin inhibit pancreatic secretion.

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      19.8
      Seconds
  • Question 42 - The end product of trehalase action on oligosaccharides is ...

    Correct

    • The end product of trehalase action on oligosaccharides is

      Your Answer: Two glucose molecules

      Explanation:

      Disaccharides are glycoside hydrolases, enzymes that break down certain types of sugars called disaccharides into simpler sugars called monosaccharides.Examples of disaccharides:Lactase (breaks down lactose into glucose and galactose)Maltase (breaks down maltose into 2 glucoses)Sucrase (breaks down sucrose into glucose and fructose)Trehalase (breaks down trehalose into 2 glucoses)

    • This question is part of the following fields:

      • Gastrointestinal
      • Medicine
      8.7
      Seconds
  • Question 43 - Afferent A δ fibers from nociceptors terminate primarily on neurons in which lamina:...

    Correct

    • Afferent A δ fibers from nociceptors terminate primarily on neurons in which lamina:

      Your Answer: I and V

      Explanation:

      Nociceptors are receptors of pain sensation. There are 2 primary afferent/sensory pain fibers which transmit impulses from the receptor to the CNS, specifically to the dorsal horn of the spinal cord. The two fibers are A δ and C fibers. The dorsal horn of the spinal cord is the relay centre for sensory information converging from the periphery. Grey matter of the dorsal horn is subdivided in to laminae based on cytoarchitecture. C fibers terminate in lamina II the substantia gelatinosa. A δ fibers terminate primarily in lamina I but some project more deeply to terminate in lamina V.

    • This question is part of the following fields:

      • Medicine
      • Neurology
      9.9
      Seconds
  • Question 44 - A 60-year-old male is under treatment with azathioprine after a renal transplant. During...

    Incorrect

    • A 60-year-old male is under treatment with azathioprine after a renal transplant. During his review, he complains of pain and swelling over his left great toe. Investigations reveal hyperuricemia. Suspecting gout, he was started on allopurinol. Subsequently, he develops aplastic anaemia. Which of the following is the most appropriate reason for his bone marrow failure?

      Your Answer: Azathioprine toxicity

      Correct Answer: Mercaptopurine toxicity

      Explanation:

      The cause for bone marrow suppression in this patient is most probably mercaptopurine toxicity.Azathioprine is metabolized to 6-mercaptopurine (6-MP), which itself is metabolized by xanthine oxidase. Xanthine oxidase inhibition by allopurinol leads to the accumulation of 6-MP which then precipitates bone marrow failure. This may be potentially fatal if unrecognized.Clinical presentation:Toxicity symptoms include gastrointestinal symptoms, bradycardia, hepatotoxicity, myelosuppression.

    • This question is part of the following fields:

      • Medicine
      • Pharmacology
      51.5
      Seconds
  • Question 45 - Concerning surface anatomy, where is the mitral valve found? ...

    Correct

    • Concerning surface anatomy, where is the mitral valve found?

      Your Answer: Situated in the 4th intercostal space to the left of the sternum

      Explanation:

      The mitral valve is situated in the left 4th intercostal space just beneath the sternum.

    • This question is part of the following fields:

      • Cardiovascular
      • Medicine
      54.6
      Seconds
  • Question 46 - The process whereby DNA fragments are separated by size and charge is called:...

    Correct

    • The process whereby DNA fragments are separated by size and charge is called:

      Your Answer: Gel electrophoresis

      Explanation:

      Fragments of DNA of varying length can be separated on the basis of their charge and their size by a process called gel electrophoresis. Because DNA contains negatively charged phosphate groups, it will migrate in an electric field toward the positive electrode. Shorter chains migrate more rapidly through the pores of the gel, and thus separation depends on length. DNA bands in the gel can be visualized by various techniques including staining with dyes and autoradiography.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      21.9
      Seconds
  • Question 47 - An important enzyme in renal tissue responsible for the conversion of glutamine to...

    Correct

    • An important enzyme in renal tissue responsible for the conversion of glutamine to glutamate and the subsequent production of NH4 is called?

      Your Answer: Glutaminase

      Explanation:

      Glutaminase catalyses the following reaction:Glutamine + H2O → Glutamate + NH3

    • This question is part of the following fields:

      • Medicine
      • Renal
      34.3
      Seconds
  • Question 48 - Which of the following is a physiological effect of pregnancy on the kidney?...

    Incorrect

    • Which of the following is a physiological effect of pregnancy on the kidney?

      Your Answer: Decreased GFR

      Correct Answer: Decreased creatinine

      Explanation:

      A pregnant woman may experience an increase in kidney and ureter size. The glomerular filtration rate (GFR) commonly increases by 50%, returning to normal around 20 weeks postpartum. Plasma sodium does not change because this is offset by the increase in GFR. There is decreased blood urea nitrogen (BUN) and creatinine and potentially glucosuria (due to saturated tubular reabsorption).

    • This question is part of the following fields:

      • Medicine
      • Renal
      21.1
      Seconds
  • Question 49 - During which phase of meiosis does exchange of genetic material occur accounting for...

    Incorrect

    • During which phase of meiosis does exchange of genetic material occur accounting for genetic diversity between individuals:

      Your Answer: Anaphase 1

      Correct Answer: Prophase 1

      Explanation:

      Prophase 1 has been divided into five different stages ( laptotene, zygotene, pachytene, diplotene ans diakinesis). In prophase 1 chromosomes are going to condense to become visible, each chromosome will contain two chromatids that are joined at the centromere. the nucleolus and nuclear envelope are going to disintegrate. the homologous chromosomes will form tetrad and crossing over will occur between the chromosomes (random exchange of genes), the point of exchange is known as the chiasmata, this increases genetic diversity.

    • This question is part of the following fields:

      • Genetics
      • Medicine
      65.3
      Seconds
  • Question 50 - Which one of the following is able to move across cell membranes by...

    Correct

    • Which one of the following is able to move across cell membranes by passive diffusion?

      Your Answer: CO2

      Explanation:

      The cell membrane is permeable to water molecules and a few other small, uncharged, molecules like oxygen (O2) and carbon dioxide (CO2). Larger molecules like glucose or charged ions are unable to cross passively.

    • This question is part of the following fields:

      • Cell Biology
      • Medicine
      7.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (5/9) 56%
Medicine (34/50) 68%
Infectious Diseases (1/2) 50%
Connective Tissue (2/3) 67%
Neurology (6/6) 100%
Hepatobiliary (1/1) 100%
Cell Biology (1/2) 50%
Genetics (2/3) 67%
Haematology (4/4) 100%
Endocrinology (2/7) 29%
Gastrointestinal (2/3) 67%
Respiratory (2/2) 100%
Metabolism (2/2) 100%
Pharmacology (2/3) 67%
Immunology (1/1) 100%
Renal (1/2) 50%
Passmed