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Question 1
Incorrect
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The Auerbach's plexus is a set of ganglia that controls peristalsis and is located in the gut wall.Auerbach's plexus is located in which layer of the gut wall?
Your Answer: Mucosa
Correct Answer: Muscular layer
Explanation:The Auerbach’s plexus, also known as the myenteric plexus, is a collection of ganglia that controls peristalsis and is located in the gut wall.In the muscular layer of the wall, it is located between the circular and longitudinal muscle layers. It is a linear network of linked neurons that runs the length of the gastrointestinal system. The myenteric plexus generates an increase in gut wall tone and the strength of rhythmical contractions when stimulated.
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This question is part of the following fields:
- Gastrointestinal Physiology
- Physiology
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Question 2
Correct
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For which of the following infections is phenoxymethylpenicillin (penicillin V) primarily used?
Your Answer: Streptococcal tonsillitis
Explanation:Phenoxymethylpenicillin (penicillin V) is less active than benzylpenicillin but both have similar antibacterial spectrum. Because penicillin V is gastric-acid stable, it is suitable for oral administration, but should not be used for serious infections as absorption can be unpredictable and plasma concentrations can be variable. Its uses are:1. mainly for respiratory tract infections in children2. for streptococcal tonsillitis 3. for continuing treatment after one or more injections of benzylpenicillin when clinical response has begun. 4. for prophylaxis against streptococcal infections following rheumatic fever and against pneumococcal infections following splenectomy or in sickle-cell disease. It should not be used for meningococcal or gonococcal infections.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 3
Incorrect
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C-reactive protein (CRP) synthesis is predominantly stimulated by which of the following cytokines:
Your Answer: IL-5
Correct Answer: IL-6
Explanation:Activated leukocytes, adipocytes, and endothelial cells all release interleukin 6 (IL-6), a significant proinflammatory cytokine. The main downstream mediator of the acute phase response is C-reactive protein, which is predominantly produced by IL-6–dependent hepatic biosynthesis.
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This question is part of the following fields:
- Inflammatory Responses
- Pathology
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Question 4
Incorrect
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What is the mechanism of action of captopril:
Your Answer: Inhibition of the conversion of angiotensinogen to angiotensin
Correct Answer: Inhibition of the conversion of angiotensin I to angiotensin II
Explanation:Angiotensin-converting enzyme inhibitors (ACE inhibitors) e.g. captopril inhibit the conversion of angiotensin I to angiotensin II, and thus have a vasodilatory effect, lowering both arterial and venous resistance. The cardiac output increases and, because the renovascular resistance falls, there is an increase in renal blood flow. This latter effect, together with reduced aldosterone release, increases Na+ and H2O excretion, contracting the blood volume and reducing venous return to the heart.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 5
Incorrect
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In inserting a nasogastric tube, which area is least likely to be a site of resistance when the tube goes from the nose to the stomach?
Your Answer:
Correct Answer: In the posterior mediastinum where the oesophagus is crossed by the pulmonary trunk
Explanation:In the posterior mediastinum where the oesophagus is crossed by the pulmonary trunk offers the least resistance when nasogastric tube is inserted from the nose to the stomach.
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This question is part of the following fields:
- Anatomy
- Thorax
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Question 6
Incorrect
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A man presents to the emergency department with a hand laceration that has damaged the opponens digiti minimi muscle.All of the following statements regarding the opponens digiti minimi muscle is considered correct, except:
Your Answer:
Correct Answer: It is innervated by the superficial branch of the ulnar nerve
Explanation:Opponens digiti minimi (ODM) is an intrinsic muscle of the hand. It’s a triangular muscle that extends between the hamate bone (carpal bone) and the 5th metacarpal bone. It forms the hypothenar muscle group together with the abductor digiti minimi and flexor digiti minimi brevis, based on the medial side of the palm (hypothenar eminence). These muscles act together in moving the little finger. The opponens digiti minimi is responsible for flexion, lateral rotation and opposition of the little finger.Its origin is the hook of hamate and flexor retinaculum. It inserts into the medial border of 5th metacarpal bone. It is innervated by the deep branch of the ulnar nerve, which stems from the brachial plexus (C8, T1 spinal nerves).Its blood supply is by the deep palmar branch of ulnar artery and deep palmar arch, which is the terminal branch of the radial artery.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 7
Incorrect
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Which of the following is NOT one of insulin's actions:
Your Answer:
Correct Answer: Increased gluconeogenesis
Explanation:Insulin has a number of effects on glucose metabolism, including:Inhibition of glycogenolysis and gluconeogenesisIncreased glucose transport into fat and muscleIncreased glycolysis in fat and muscleStimulation of glycogen synthesisBy inhibiting gluconeogenesis, insulin maintains the availability of amino acids as substrates for protein synthesis. Thus, insulin supports protein synthesis through direct and indirect mechanisms.
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This question is part of the following fields:
- Endocrine
- Pharmacology
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Question 8
Incorrect
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Which of the following is NOT a heritable risk factor for venous thrombosis:
Your Answer:
Correct Answer: Von Willebrand disease
Explanation:Approximately one-third of patients who suffer DVT or PE have an identifiable heritable risk factor, although additional risk factors are usually present when they develop the thrombosis. The history of a spontaneous DVT in a close relative increases an individual’s risk of DVT even if no known genetic predisposition can be identified.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 9
Incorrect
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The correct statement about the glomerular filtration barrier is which of the following?
Your Answer:
Correct Answer: The basement membrane is negatively charged, restricting filtration of negatively charged molecules.
Explanation:The main factor in determining whether a substance is filtered or not is molecular weight. Molecules < 7 kDa in molecular weight e.g. glucose, amino acids, urea, ions are filtered freely, but larger molecules are increasingly restricted up to 70 kDa, and there is very little filtration for anything above this. There is further restriction of negatively charged molecules because they are repelled by negative charges, particularly in the basement membrane. Albumin, which has a molecular weight of 69 kDa and is negatively charged, is filtered but only in very small amounts. All of the filtered albumin is reabsorbed in the proximal tubule. Small molecules such as ions, glucose, amino acids and urea pass the filter without hindrance. Other than the ultrafiltrate being essentially protein free, it has an otherwise identical composition of plasma. Bowman's capsule consists of:- an epithelial lining which consists of a single layer of cells called podocytes- endothelium which is perforated by pores or fenestrations – this allows plasma components with a molecular weight of < 70 kDa to pass freely.
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This question is part of the following fields:
- Physiology
- Renal
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Question 10
Incorrect
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An increased anion gap metabolic acidosis is typically caused by which of the following?
Your Answer:
Correct Answer: Propylene glycol overdose
Explanation:Causes of a raised anion gap acidosis can be remember using the mnemonic MUDPILES:-Methanol-Uraemia (in renal failure)-Diabetic ketoacidosis-Propylene glycol overdose-Infection/Iron overdose/Isoniazid/Inborn errors of metabolism-Lactic acidosis-Ethylene glycol overdose-Salicylate overdose
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This question is part of the following fields:
- Physiology
- Renal
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Question 11
Incorrect
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Regarding benzylpenicillin, which of the following statements is CORRECT:
Your Answer:
Correct Answer: If meningococcal disease is suspected, benzylpenicillin should be given before transfer to hospital.
Explanation:Benzylpenicillin (although inactivated by bacterial beta-lactamases) is effective for many streptococcal (including pneumococcal), gonococcal, and meningococcal infections and also for anthrax, diphtheria, gas gangrene, leptospirosis, and treatment of Lyme disease. If meningococcal disease (meningitis with non-blanching rash or meningococcal septicaemia) is suspected, benzylpenicillin should be given before transfer to hospital, so long as this does not delay the transfer; benzylpenicillin is no longer the drug of first choice for pneumococcal meningitis. Although benzylpenicillin is effective in the treatment of tetanus, metronidazole is preferred. Benzylpenicillin is inactivated by gastric acid and absorption from the gastrointestinal tract is poor and therefore it must be given by injection.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 12
Incorrect
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Which of the following is the correct sequential order of the phases of healing:
Your Answer:
Correct Answer: Haemostasis, inflammation, proliferation, remodelling
Explanation:Acute wound healing has four main stages: haemostasis, inflammation, proliferation and remodelling.
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This question is part of the following fields:
- Pathology
- Wound Healing
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Question 13
Incorrect
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Which of the following is NOT a function of bile:
Your Answer:
Correct Answer: Digestion of fats into monoglycerides and fatty acids.
Explanation:Bile functions to eliminate endogenous and exogenous substances from the liver (including bilirubin), to neutralise gastric acid in the small intestine, and to emulsify fats in the small intestine and facilitate their digestion and absorption. Bile salts also act as bactericides, destroying many of the microbes that may be present in the food. Bile doesn’t contain digestive enzymes for digestion of lipids into monoglycerides and fatty acids; this is performed mainly by pancreatic lipase.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 14
Incorrect
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An analytical study is conducted to compare the risk of stroke between Ticagrelor therapy and Warfarin therapy among patients with atrial fibrillation. The following is obtained from the study:No. of patients who took Ticagrelor: 300No. of patients who took Ticagrelor and suffered a stroke: 30No. of patients who took Warfarin: 500No. of patients who took Warfarin and suffered a stroke: 20Compute for the absolute risk in the Ticagrelor group.
Your Answer:
Correct Answer: 0.1
Explanation:The absolute risk (AR) is the probability or chance of an event. It is computed as the number of events in treated or control groups, divided by the number of people in that group.AR = 30/300 = 0.1
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This question is part of the following fields:
- Evidence Based Medicine
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Question 15
Incorrect
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Which of these is an example of ordinal data?
Your Answer:
Correct Answer: Disease staging system
Explanation:Categorical data or data that is ordered is Ordinal data e.g. disease staging system, pain scoring system.Disease staging system is the correct answer
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This question is part of the following fields:
- Evidence Based Medicine
- Statistics
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Question 16
Incorrect
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What is the most common application of Nitrates?
Your Answer:
Correct Answer: Angina
Explanation:In patients with exertional stable angina, nitrates improve exercise tolerance, time to onset of angina, and ST-segment depression during exercise testing. In combination with beta-blockers or calcium channel blockers, nitrates produce greater anti-anginal and anti-ischemic effects.While they act as vasodilators, coronary vasodilators, and modest arteriolar dilators, the primary anti ischemic effect of nitrates is to decrease myocardial oxygen demand by producing systemic vasodilation more than coronary vasodilation. This systemic vasodilation reduces left ventricular systolic wall stress.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 17
Incorrect
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You evaluate a 80-year-old man who has a history of persistent heart failure and discover that he has generalised oedema.Which of the following claims regarding capillary hydrostatic pressure (P c) is false?
Your Answer:
Correct Answer: P c increases along the length of the capillary, from arteriole to venule
Explanation:The capillary hydrostatic pressure (Pc) is normally between 15 and 30 millimetres of mercury. Pc Decreases along the capillary’s length, mirroring the arteriolar and venule pressures proximally and distally.Pc is determined by the ratio of arteriolar resistance (RA) to venular resistance (RV).When the RA/RV ratio is high, the pressure drop across the capillary is modest, and Pcis is close to venule pressure.When the ratio of RA/RV is low, the pressure drop across the capillary is considerable, and Pcis is close to arteriolar pressure.Pcis closer to the venule pressure and thus more responsive to changes in venous pressure than arteriolar pressure when RA/RV is high.Pcis the major force behind fluid pushing out of the capillary bed and into the interstitium.It is also the most variable of the forces affecting fluid transport at the capillary, partly because sympathetic-mediated arteriolar vasoconstriction varies.
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This question is part of the following fields:
- Cardiovascular Physiology
- Physiology
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Question 18
Incorrect
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A 71-year-old patient has been diagnosed with a dopamine-secreting neuroendocrine tumour.Which of the following statements about dopamine is correct?
Your Answer:
Correct Answer: It inhibits prolactin release from the anterior pituitary
Explanation:Dopamine is a neurotransmitter and amine hormone that is derived from the amino acid tyrosine. It is made in a number of places throughout the human body, both inside and outside the central nervous system. The adrenal medulla, dopamine neurons in the arcuate nucleus of the hypothalamus, the substantia nigra, and other areas of the brain produce dopamine.The tuberoinfundibular pathway refers to the dopamine neurons in the arcuate nucleus of the hypothalamus’ tubeal region. Dopamine is discharged into the hypothalamo-hypophyseal portal system from these neurons’ neurosecretory terminals at the median eminence.The major function of dopamine produced from the hypothalamus is to suppress prolactin production from the anterior pituitary, and it is released in reaction to excessive levels of prolactin secretion. Modulation of motor-control centres and activation of reward centres are two more crucial activities of the brain.Dopamine-secreting cells can also be found in other areas of the body, where they perform mostly paracrine functions (acting on nearby cells).
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This question is part of the following fields:
- Endocrine Physiology
- Physiology
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Question 19
Incorrect
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Where does angiotensin II directly act on the renal nephron:
Your Answer:
Correct Answer: Proximal tubule
Explanation:Angiotensin II acts to directly increase Na+reabsorption from the proximal tubule (by activating Na+/H+antiporters).
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This question is part of the following fields:
- Physiology
- Renal
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Question 20
Incorrect
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A 29 year old woman is unable to invert her foot after sustaining an injury to her leg playing water-polo. Which of the following nerves are most likely damaged:
Your Answer:
Correct Answer: Tibial and deep fibular nerve
Explanation:Inversion of the foot is primarily produced by the tibialis anterior and the tibialis posterior muscles, innervated by the deep fibular nerve and the tibial nerve respectively.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 21
Incorrect
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You're evaluating a male patient who's having a lung function test done. In calculating the patient’s functional residual capacity, what parameters should you add to derive the functional residual capacity volume?
Your Answer:
Correct Answer: Expiratory reserve volume + residual volume
Explanation:The volume of air that remains in the lungs after a single breath is known as functional residual capacity (FRC). It is calculated by combining the expiratory reserve volume and residual volume.
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This question is part of the following fields:
- Physiology
- Respiratory Physiology
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Question 22
Incorrect
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Which of the following is caused by an alpha-1 antitrypsin deficiency?
Your Answer:
Correct Answer: Early onset emphysema
Explanation:Mucus contains chemicals such as alpha-1-antitrypsin, lysozyme, and IgA that protect the airway from pathogens and damaging proteases released from dead bacteria and immune cells. Early-onset emphysema results from a genetic deficit of alpha-1-antitrypsin, which is caused by unregulated protease activity in the lungs, which results in the degradation of elastin in the alveoli.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 23
Incorrect
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Langhans giant cells, seen in granulomatous inflammation. are:
Your Answer:
Correct Answer: Multinucleated cells formed from fusion of epithelioid cells
Explanation:A granuloma is a collection of five or more epithelioid macrophages, with or without attendant lymphocytes and fibroblasts; epithelioid macrophages are altered macrophages which have turned themselves over to becoming giant phagocytosing and killing machines, they often fuse to become multinucleate (Langhans) giant cells.
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This question is part of the following fields:
- Inflammatory Responses
- Pathology
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Question 24
Incorrect
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Pancreatic acinar digestive enzyme secretion is mainly stimulated by which of the following hormones:
Your Answer:
Correct Answer: Cholecystokinin
Explanation:Exocrine pancreatic secretion is controlled by:Parasympathetic stimulation which enhances secretion of both the enzyme and aqueous componentsSympathetic stimulation which inhibits pancreatic secretionSecretin which stimulates secretion of the alkaline-rich fluid from ductal cellsCholecystokinin which stimulates secretion of the enzyme-rich fluid from acinar cellsSomatostatin which inhibits secretion from both acinar and ductal cellsGastrin which stimulates pancreatic acinar cells to secrete digestive enzymes
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 25
Incorrect
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A patient suffers from an injury and as a consequence, the nerve that was damaged innervates the obturator internus muscle.In which of the following nerves is the obturator internus muscle innervated by?
Your Answer:
Correct Answer: Nerve to obturator internus
Explanation:The obturator internus is innervated by the obturator internus nerve (L5–S2), a branch of sacral plexus.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 26
Incorrect
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Question 27
Incorrect
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Regarding the resting membrane potential, which of the following statements is CORRECT:
Your Answer:
Correct Answer: The resting cell membrane is more permeable to K + ions than to Na + ions.
Explanation:A membrane potential is a property of all cell membranes, but the ability to generate an action potential is only a property of excitable tissues. The resting membrane is more permeable to K+and Cl-than to other ions (and relatively impermeable to Na+); therefore the resting membrane potential is primarily determined by the K+equilibrium potential. At rest the inside of the cell is negative relative to the outside. In most neurones the resting potential has a value of approximately -70 mV.
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This question is part of the following fields:
- Basic Cellular
- Physiology
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Question 28
Incorrect
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You're a member of the cardiac arrest team, and you're helping to resuscitate an elderly gentleman who had collapsed at home. The team leader requests that you administer an adrenaline shot.Which of the following statements about adrenaline is FALSE?
Your Answer:
Correct Answer: The IM dose in anaphylaxis is 1 ml of 1:1000
Explanation:Adrenaline (epinephrine) is a sympathomimetic amine that binds to alpha- and beta-adrenergic receptors and acts as an agonist. It is active at both alpha and beta receptors in roughly equal amounts.When taken orally, it becomes inactive. Subcutaneous absorption is slower than intramuscular absorption. In cardiac arrest, it is well absorbed from the tracheal mucosa and can be given through an endotracheal tube.At the adrenergic synapse, catechol-O-methyltransferase (COMT) and monoamine oxidase (MAO) metabolise it primarily. The inactive products are then passed through the kidneys and excreted in the urine.In adult cardiac arrest, the IV dose is 1 mg, which is equal to 10 ml of 1:10000 or 1 ml of 1:1000. In anaphylaxis, the IM dose is 0.5 ml of 1:1000. (500 mcg).In open-angle glaucoma, adrenaline causes mydriasis and lowers pressure.Adrenaline is used in cardiopulmonary resuscitation, the treatment of severe croup, and the emergency management of acute allergic and anaphylactic reactions (as a nebuliser solution).
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 29
Incorrect
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Compliance is greater in all but which one of the following:
Your Answer:
Correct Answer: Pulmonary oedema
Explanation:Compliance changes at different lung volumes. Initially at lower lung volumes the compliance of the lung is poor and greater pressure change is required to cause a change in volume. This occurs if the lungs become collapsed for a period of time. At functional residual capacity (FRC) compliance is optimal since the elastic recoil of the lung tending towards collapse is balanced by the tendency of the chest wall to spring outwards. At higher lung volumes the compliance of the lung again becomes less as the lung becomes stiffer. At all volumes, the base of the lung has a greater compliance than the apex. Patients with emphysema have increased compliance. Compliance is affected by a person’s age, sex and height.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 30
Incorrect
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A 42-year-old man presented to the emergency room with complains of a dry cough and fever that has been going on for the past few days. Upon history taking and observation, it was established that he works as a Jacuzzi and whirlpool installer and smokes 15 cigarettes per day. The presence of a non-productive cough, several episodes of diarrhoea, developed bilateral pleuritic chest pain, and shortness of breath most notably on exertion were also noted.Which of the following is most likely the causative agent of the case presented above?
Your Answer:
Correct Answer: Legionella pneumophila
Explanation:Legionella species are ubiquitous, Gram-negative bacilli acquired primarily through inhalation. Infections caused by Legionella spp. produce a spectrum of symptoms ranging from mild upper respiratory tract infections to pneumonia. Legionella spp. are responsible for 2% to 15% of community-acquired pneumonia.Clinical manifestations of Legionella infections include febrile disease with pneumonia (legionnaires’ disease), febrile disease without pulmonary involvement (Pontiac fever), and asymptomatic infection.The mode of transmission and the number of infecting organisms in the inoculum play a role in the clinical features of the infection. In addition, host factors, such as a suppressed immune system, chronic lung disease, alcoholism, and heavy smoking, predispose individuals to legionnaires’ disease.Legionella spp. can tolerate chlorine concentrations of 3 mg/L, they resist water treatment and subsequently gain entry into and colonize human-made water supplies and distribution systems. Hot water systems, cooling towers, and evaporative condensers are major reservoirs. Other sources include cold water systems, ornamental fountains, whirlpool spas, humidifiers, respiratorytherapy equipment, and industrial process waters.
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This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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SESSION STATS - PERFORMANCE PER SPECIALTY
