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Question 1
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: Obturator nerve
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 2
Correct
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Atrial natriuretic peptide (ANP) acts to cause all of the following effects EXCEPT for:
Your Answer: Vasoconstricts the afferent arteriole
Explanation:ANP acts to: Inhibit Na+ reabsorption in the distal nephron (through inhibition of ENaC in principal cells)Suppress the production of reninSuppress the production of aldosteroneSuppress the production of ADHCause renal vasodilation, increasing the glomerular filtration rate
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This question is part of the following fields:
- Physiology
- Renal
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Question 3
Correct
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A clinical audit cycle comprises of 5 steps. Each of these processes are listed below:Which is the correct order that these should occur?1. Observation of practice and collection of data2. Identification of the problem3. Implementation of change4. Definition of criteria and setting of standards5. Analysis of data and comparison of performance with the criteria and standards
Your Answer: 2,4,1,5,3
Explanation:An audit assesses if a certain aspect of health care is attaining a recognized standard. This lets care providers and patients know where their service is doing well, and where there could be improvements. The aim is to achieve quality improvement and improve outcomes for patients.Audits are a quality improvement measure and one of the 7 pillars of clinical governance. It allows organizations to continually work toward improving quality of care by showing them where they are falling short, allows them to implement improvements, and reaudit or close the audit cycle to see if beneficial change has taken place.Clinical audits are a cycle with several steps:1. Identification of the problem2. Definition of criteria and setting of standards3. Observation of practice and collection of data4. Analysis of data and comparison of performance with the criteria and standards5. Implementation of change
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This question is part of the following fields:
- Evidence Based Medicine
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Question 4
Incorrect
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Which of the following is NOT a feature characteristic of intravascular haemolysis:
Your Answer: Methaemalbuminaemia
Correct Answer: Bilirubinuria
Explanation:Features of intravascular haemolysis include:haemoglobinaemia, methaemalbuminaemia, haemoglobinuria (dark urine) and haemosiderinuria
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This question is part of the following fields:
- Haematology
- Pathology
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Question 5
Correct
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Which of the following immunoglobulins is most important for mast cell degranulation:
Your Answer: IgE
Explanation:IgA is the major Ig in secretions, particularly from the gastrointestinal tract (but also in saliva, tears, sweat and breast milk).IgE is important for mast cell degranulation in allergic and antiparasitic response. In the allergic response, the plasma cell produces IgE-antibodies, which, like antibodies of other immunoglobulin isotypes, are capable of binding a specific allergen via its Fab portion.IgG is the most abundant in plasma (comprising 80% of normal serum immunoglobulin) and the main circulatory Ig for the secondary immune response.
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This question is part of the following fields:
- Immune Responses
- Pathology
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Question 6
Incorrect
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A 60-year-old patient with a history of hypertension and chronic kidney disease (CKD) walks into the clinic to discuss her most recent blood results indicating an accelerated progression of CKD.Which of the following is the correct definition for accelerated progression of CKD?
Your Answer: Glomerular filtration rate <30 ml/minute per 1.73 m² for three months or more
Correct Answer: A sustained decrease in GFR of 15 ml/minute/1.73 m 2 per year
Explanation:Chronic kidney disease (CKD) is a disorder in which kidney function gradually deteriorates over time. It’s fairly prevalent, and it typically remains unnoticed for years, with only advanced stages of the disease being recognized. There is evidence that medication can slow or stop the progression of CKD, as well as lessen or prevent consequences and the risk of cardiovascular disease (CVD).CKD is defined as kidney damage (albuminuria) and/or impaired renal function (GFR 60 ml/minute per 1.73 m2) for three months or longer, regardless of clinical diagnosis.A prolonged decline in GFR of 25% or more with a change in GFR category within 12 months, or a sustained drop in GFR of 15 ml/minute/1.73 m² per year, is considered accelerated CKD progression.End-stage renal disease (ESRD) is defined as severe irreversible kidney impairment with a GFR of less than 15 ml/minute per 1.73 m² and a GFR of less than 15 ml/minute per 1.73 m².
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This question is part of the following fields:
- Physiology
- Renal Physiology
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Question 7
Incorrect
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Which of the following is NOT an advantage of a case-control study used to identify past exposure to a risk factor in patients with a disease:
Your Answer: Particularly suitable for studying association between an exposure and an outcome when the outcome is uncommon
Correct Answer: Can directly measure absolute and relative risk of a disease
Explanation:Advantages:relatively quickrelatively cheap and easy to performparticularly suitable for studying associations between an exposure and an outcome when the outcome is uncommon or if the outcome occurs decades after exposurea wide range of risk factors can be investigated in each studyDisadvantages:subject to recall biasunlike in a whole population study, absolute risk cannot be quantifiedtemporal relationship between exposure and outcome can be difficult to establishunsuitable for rare risk factorsprone to confounding
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This question is part of the following fields:
- Evidence Based Medicine
- Study Methodology
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Question 8
Incorrect
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Regarding airway resistance, which of the following statements is INCORRECT:
Your Answer: Sympathetic stimulation and adrenaline cause bronchodilation mediated by beta2-adrenoceptors.
Correct Answer: In the lower respiratory tract, airway resistance is mostly determined by the smallest bronchioles.
Explanation:Airway resistance is primarily determined by the airway radius according to Poiseuille’s law, and whether the flow is laminar or turbulent. The major site of airway resistance is the medium-sized bronchi. The smallest airways would seem to offer the highest resistance, but they do not because of their branching parallel arrangement.
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This question is part of the following fields:
- Physiology
- Respiratory
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Question 9
Correct
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Which among the following antibacterial regimens is considered the most appropriate to prescribe in a patient presenting with clinical signs and symptoms consistent with a diagnosis of pelvic inflammatory disease?
Your Answer: Ceftriaxone plus doxycycline plus metronidazole
Explanation:The endocervix is the most common site of Neisseria gonorrhoeae infection in women. Symptoms of infection, when present, include dysuria, cervical discharge, and lower abdominal pain. However, 50% of cases in women may be asymptomatic leading to complications such as pelvic inflammatory disease (PID), which may cause sterility, ectopic pregnancy, or perihepatitis.PID is also known as Fitz-Hugh-Curtis syndrome is defined as an inflammation of the upper genital tract due to an infection in women. The disease affects the uterus, fallopian tubes, and ovaries. It is typically an ascending infection, spreading from the lower genital tract. The recommended intramuscular or oral regimens for PID are as follows:Ceftriaxone at 500 mg IM in a single dose (for persons weighing ≥150 kg, administer 1 g of ceftriaxone); plus doxycycline at 100 mg PO BID for 14 days with metronidazole at 500 mg PO BID for 14 days.
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This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 10
Incorrect
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You are about to give an antimuscarinic agent to a 55 year-old male patient. Which of the following conditions will make you with stop the administration, since it is a contraindication to antimuscarinic agents?
Your Answer: Hypophosphatemia
Correct Answer: Prostatic enlargement
Explanation:Antimuscarinic medications may impair the contractility of bladder smooth muscle, resulting in acute urine retention in men with BPH, and should be avoided or used with caution.
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This question is part of the following fields:
- Gastrointestinal
- Pharmacology
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Question 11
Incorrect
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A 27-year-old man has been diagnosed with testicular cancer and has spread to the regional lymph nodes. The lymph from the testes will drain to which of the following nodes?
Your Answer: Superficial inguinal lymph nodes
Correct Answer: Para-aortic lymph nodes
Explanation:Testes are retroperitoneal organs and its lymphatic drainage is to the lumbar and para-aortic nodes along the lumbar vertebrae.The scrotum is the one which drains into the nearby superficial inguinal nodes.The glans penis and clitoris drains into the deep inguinal lymph nodes.
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This question is part of the following fields:
- Abdomen And Pelvis
- Anatomy
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Question 12
Correct
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A tumour is discovered behind the pectinate line during an examination of a 72-year-old patient with rectal bleeding. Which of the following is the lymphatic drainage of the pectinate line?
Your Answer: Superficial inguinal nodes
Explanation:The pectinate line is known as the watershed line because it divides the anal canal into two sections. Below the pectinate line, lymphatic drainage drains to the superficial inguinal lymph nodes.
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This question is part of the following fields:
- Abdomen
- Anatomy
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Question 13
Correct
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Regarding inhaled corticosteroids, which of the following statements is INCORRECT:
Your Answer: Lower doses of inhaled corticosteroids may be required in smokers.
Explanation:Current and previous smoking reduces the effectiveness of inhaled corticosteroids and higher doses may be necessary.
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This question is part of the following fields:
- Pharmacology
- Respiratory
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Question 14
Incorrect
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A 66-year-old male presents to his family physician with the complaint of increasing fatigue and lethargy, along with itching, especially after a hot bath. He also complains of increased sweating and dizziness. On examination, he has a plethoric appearance. Abdominal examination shows the presence of splenomegaly. A basic panel of blood tests is ordered in which her Hb comes out to be 17 g/dL. Which one of the following treatment options will be most suitable in this case?
Your Answer: Desferrioxamine
Correct Answer: Venesection
Explanation:The clinical and laboratory findings, in this case, support a diagnosis of polycythaemia vera. A plethoric appearance, lethargy, splenomegaly and itching are common in this disease. Patients may also have gouty arthritis, Budd-Chiari syndrome, erythromelalgia, stroke, myocardial infarction or DVT. The average age for diagnosis of Polycythaemia Vera is 65-74 years. It is a haematological malignancy in which there is overproduction of all three cell lines. Venesection is the treatment of choice as it would cause a decrease in the number of red blood cells within the body.Erythropoietin is given in patients with chronic renal failure as they lack this hormone. Administration of erythropoietin in such patients causes stimulation of the bone marrow to produce red blood cells. Desferrioxamine is a chelating agent for iron and is given to patients with iron overload due to repeated blood transfusions, e.g. in thalassemia patients.Penicillamine is a chelating agent for Copper, given as treatment in Wilson’s disease.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 15
Incorrect
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Which of the following statements is correct regarding gentamicin?
Your Answer: Gentamicin is effective against pneumococci.
Correct Answer: Gentamicin is ineffective against anaerobic bacteria.
Explanation:Gentamicin is the aminoglycoside of choice in the UK and is a parenterally administered, broad spectrum antibiotic typically used for moderate to severe gram negative infections. However, it is inactive against anaerobes. There is poor activity against haemolytic streptococci and pneumococci. It is usually given in conjunction with a penicillin or metronidazole (or both) when used for the blind treatment of undiagnosed serious infections. Nephrotoxicity and ototoxicity are the main toxic effects due to damage to the vestibulocochlear nerve (CN VIII).It is contraindicated in myasthenia gravis and should be used with great care in renal disease as it may result in accumulation and a higher risk of toxic side effects.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 16
Incorrect
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Amoxicillin is used first line for all of the following infections EXCEPT for:
Your Answer: Dental abscess
Correct Answer: Cellulitis
Explanation:Amoxicillin is used first line for low to moderate severity community acquired pneumonia, exacerbations of chronic bronchitis, for acute otitis media, for acute sinusitis, for oral infections/dental abscess, for Listeria meningitis (in combination with another antibiotic), for infective endocarditis (in combination with another antibiotic) and for H. Pylori eradication (in combination with metronidazole/clarithromycin and a PPI). Flucloxacillin is used first line for acute cellulitis.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 17
Correct
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You review a 46-year-old woman who has recently been prescribed antibiotics for a urinary tract infection. She suffers from COPD and is currently prescribed salbutamol and Seretide inhalers, and Phyllocontin continus. Since starting the antibiotics, she has been experiencing nausea, vomiting and abdominal pain.Which of the following antibiotics is she MOST LIKELY to have been prescribed for her UTI? Select ONE answer only .
Your Answer: Ciprofloxacin
Explanation:Phyllocontin continus contains aminophylline (a mixture of theophylline and ethylenediamine), a bronchodilator used in the management of COPD and asthma.This patient is exhibiting symptoms of theophylline toxicity, which may have been triggered by the prescription of the antibiotic. Quinolone antibiotics, such as ciprofloxacin and levofloxacin, and macrolide antibiotics, such as erythromycin, increase the plasma concentration of theophyllines and can lead to toxicity.The drugs that commonly affect the half-life and the plasma concentration of theophylline are summarised in the table below:Drugs increasing plasma concentration of theophyllineDrugs decreasing plasma concentration of theophyllineCalcium channel blockers, e.g. VerapamilCimetidineFluconazoleMacrolides, e.g. erythromycinQuinolones, e.g. ciprofloxacinMethotrexateBarbituratesCarbamazepinePhenobarbitolPhenytoin (and fosphenytoin)RifampicinSt. John’s wort
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This question is part of the following fields:
- Pharmacology
- Respiratory Pharmacology
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Question 18
Incorrect
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Which of the following statements is true about anterior cord syndrome?
Your Answer: It has the best prognosis of the incomplete spinal cord injuries
Correct Answer: There is preservation of proprioception
Explanation:Anterior cord syndrome is an incomplete cord syndrome that predominantly affects the anterior 2/3 of the spinal cord, characteristically resulting in motor paralysis below the level of the lesion as well as the loss of pain and temperature at and below the level of the lesion. The patient presentation typically includes these two findings; however, there is variability depending on the portion of the spinal cord affected. Other findings include back pain, or autonomic dysfunction such as hypotension, neurogenic bowel or bladder, and sexual dysfunction. The severity of motor dysfunction can vary, typically resulting in paraplegia or quadriplegia.Proprioception, vibratory sense, two-point discrimination, and fine touch are not affected in anterior cord syndrome. These sensations are under the control of the dorsal column of the spinal cord, which is supplied by two posterior spinal arteries running in the posterior lateral sulci.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 19
Incorrect
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A 32-year-old woman with a history of bipolar disorder exhibits lithium toxicity symptoms.Which of the following is the MOST LIKELY feature to be present?
Your Answer: Xanthopsia
Correct Answer: Clonus
Explanation:Lithium toxicity manifests itself in the following ways:AtaxiaClonusComaConfusionConvulsionsDiarrhoeaIncreased muscle toneNausea and vomitingNephrogenic diabetes insipidusRenal failureTremor
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This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
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Question 20
Correct
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You are attending to a patient that has presented with a severe headache in the Emergency Department. The patient has signs of cerebral oedema and raised intracranial pressure. You discuss the case with the on-call neurology registrar and decide to prescribe Mannitol. The nurse assisting you asks you to reconsider this management plan as she suspects the patient has a contraindication to Mannitol.Out of the following, what is a contraindication to mannitol?
Your Answer: Severe cardiac failure
Explanation:Mannitol is the most widely used osmotic diuretic that is most commonly used to reduce cerebral oedema and intracranial pressure. It is recommended to use mannitol for the reduction of CSF pressure/cerebral oedema in a dose of 0.25-2 g/kg as an intravenous infusion over 30-60 minutes. This can be repeated 1-2 times after 4-8 hours if needed.Mannitol has several contraindications and some of them are listed below:1. Anuria due to renal disease2. Acute intracranial bleeding (except during craniotomy)3. Severe cardiac failure4. Severe dehydration5. Severe pulmonary oedema or congestion6. Known hypersensitivity to mannitol
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 21
Incorrect
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The big toe of a 59-year-old female is red, hot, and swollen. The patient is diagnosed with acute gout. You intend to start her on a nonsteroidal anti-inflammatory medicine (NSAID). Her husband was diagnosed with a peptic ulcer, and she is apprehensive about the potential adverse effects of NSAIDs.Which of the following NSAIDs has the lowest chance of causing side effects?Â
Your Answer: Naproxen
Correct Answer: Ibuprofen
Explanation:Non-steroidal anti-inflammatory medications (NSAIDs) have slight differences in anti-inflammatory activity, but there is a lot of diversity in individual response and tolerance to these treatments. Approximately 60% of patients will respond to any NSAID; those who do not respond to one may well respond to another. Pain relief begins soon after the first dose, and a full analgesic effect should be achieved within a week, whereas an anti-inflammatory effect may take up to three weeks to achieve (or to be clinically assessable). If the desired results are not reached within these time frames, another NSAID should be attempted.By inhibiting the enzyme cyclo-oxygenase, NSAIDs limit the generation of prostaglandins. They differ in their selectivity for inhibiting various types of cyclo-oxygenase; selective inhibition of cyclo-oxygenase-2 is linked to reduced gastrointestinal discomfort. Susceptibility to gastrointestinal effects is influenced by a number of different parameters, and an NSAID should be chosen based on the frequency of side effects.Ibuprofen is an anti-inflammatory, analgesic, and antipyretic propionic acid derivative. Although it has fewer side effects than other non-selective NSAIDs, its anti-inflammatory properties are less effective. For rheumatoid arthritis, daily doses of 1.6 to 2.4 g are required, and it is contraindicated for illnesses characterized by inflammation, such as acute gout.Because it combines strong efficacy with a low incidence of adverse effects, Naproxen is one of the top choices. It is more likely to cause negative effects than ibuprofen.Similar to ibuprofen, ketoprofen and diclofenac have anti-inflammatory characteristics, however they have additional negative effects.Indomethacin has a similar or better effect to naproxen, however it comes with a lot of side effects, such as headaches, dizziness, and gastrointestinal problems.
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This question is part of the following fields:
- Musculoskeletal Pharmacology
- Pharmacology
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Question 22
Correct
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The average BP reading on ambulatory blood pressure monitoring for a 59-year-old Caucasian man is 152/96 mmHg (ABPM).The first-line drug treatment for this patient would be which of the following? Please only choose ONE answer.
Your Answer: Amlodipine
Explanation:An ambulatory blood pressure reading of >150/95 is classified as stage 2 hypertension, according to the NICE care pathway for hypertension, and the patient should be treated with an antihypertensive drug.A calcium-channel blocker, such as amlodipine, would be the most appropriate medication for a 59-year-old Caucasian man.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 23
Incorrect
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Which of the following statements is correct regarding flow through the cardiovascular system?
Your Answer: Laminar blood flow may be heard as a carotid bruit or heart murmur.
Correct Answer: Turbulent blood flow may be caused by increased cardiac output.
Explanation:Frictional forces at the sides of a vessel cause a drag force on the fluid touching them in laminar blood flow, which creates a velocity gradient where the flow is greatest at the centre. Laminar blood flow may become disrupted and flow may become turbulent at high velocities, especially in large arteries or where the velocity increases sharply at points of sudden narrowing in the vessels, or across valves. There is increased tendency for thrombi formation when there is turbulent blood flow. Clinically, turbulence may be heard as a murmur or a bruit. As a result of elevated cardiac output, there may be turbulent blood flow, even when the cardiac valves are anatomically normal, and as a result, a physiological murmur can be heard. One such example is pregnancy.
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This question is part of the following fields:
- Basic Cellular
- Physiology
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Question 24
Correct
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A 18 year old with known asthma presents himself to ED with acute breathlessness and wheeze for the past 20 minutes. On examination he is tachypneic and tachycardic. His oxygen saturations are 96% on air. What is the first line treatment for acute asthma:
Your Answer: Salbutamol
Explanation:High-dose inhaled short-acting beta2-agonists are the first line treatment for acute asthma(salbutamol or terbutaline). Oxygen should only been given to hypoxaemic patients (to maintain oxygen saturations of 94 – 98%). A pressurised metered dose inhaler with spacer device is preferred in patients with moderate to severe asthma (4 puffs initially, followed by 2 puffs every 2 minutes according to response, up to 10 puffs, whole process repeated every 10 – 20 minutes if necessary). The oxygen-driven nebuliser route is recommended for patients with life-threatening features or poorly responsive severe asthma (salbutamol 5 mg at 15 – 30 minute intervals). Continuous nebulisation should be considered in patients with severe acute asthma that is poorly responsive to initial bolus dose (salbutamol at 5 – 10 mg/hour) The intravenous route should be reserved for those in whom inhaled therapy cannot be used reliably.
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This question is part of the following fields:
- Pharmacology
- Respiratory
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Question 25
Correct
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What is the most common application of Nitrates?
Your 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 26
Incorrect
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Aplastic crises in sickle cell anaemia is classically precipitated by which of the following infections:
Your Answer: E. coli O157:H7
Correct Answer: Parvovirus B19
Explanation:A serious complication in sickle cell disease (SCD) is the aplastic crisis. This may be caused by infection with Parvovirus B-19 (B19V). This virus causes fifth disease, a normally benign childhood disorder associated with fever, malaise, and a mild rash. This virus infects RBC progenitors in bone marrow, resulting in impaired cell division for a few days. Healthy people experience, at most, a slight drop in hematocrit, since the half-life of normal erythrocytes in the circulation is 40-60 days. In people with SCD, however, the RBC lifespan is greatly shortened (usually 10-20 days), and a very rapid drop in Hb occurs. The condition is self-limited, with bone marrow recovery occurring in 7-10 days, followed by brisk reticulocytosis.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 27
Incorrect
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A patient has an elevated potassium level of 6.7 mmol/L. All of the following conditions may cause elevated potassium levels, except for which one?
Your Answer: Beta-blockers
Correct Answer: Bartter’s syndrome
Explanation:Bartter’s syndrome is an autosomal recessive renal tubular disorder characterized by hypokalaemia, hypochloraemia, metabolic alkalosis, and hyperreninemia with normal blood pressure. The underlying kidney abnormality results in excessive urinary losses of sodium, chloride, and potassium. Bartter’s syndrome does not cause an elevated potassium level, but instead causes a decrease in its concentration (hypokalaemia). The other choices are causes of hyperkalaemia or elevated potassium levels. Renal failure, Addison’s disease (adrenal insufficiency), congenital adrenal hyperplasia, renal tubular acidosis (type 4), rhabdomyolysis, burns and trauma, tumour syndrome, and acidosis are non-drug causes of hyperkalaemia. On the other hand, drugs that can cause hyperkalaemia include ACE inhibitors, angiotensin receptor blockers, NSAIDs, beta-blockers, digoxin, and suxamethonium.
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This question is part of the following fields:
- Physiology
- Renal Physiology
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Question 28
Incorrect
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A 74-year-old woman with a history of ischaemic heart disease and heart failure is complaining of worsening oedema, bloating, and a loss of appetite. She has ascites and peripheral oedema on examination. Her oedema is being controlled by an oral diuretic, but it appears that this is no longer enough. You discuss her care with the on-call cardiology registrar, who believes she is very likely to have significant gut oedema that is interfering with her diuretic absorption and that she will need to change her medication.Which of the following oral diuretics is most likely to help you overcome this problem?
Your Answer: Furosemide
Correct Answer: Bumetanide
Explanation:Bumetanide is primarily used in patients with heart failure who have failed to respond to high doses of furosemide. Bumetanide and furosemide differ primarily in terms of bioavailability and pharmacodynamic potency. In the intestine, furosemide is only partially absorbed, with a bioavailability of 40-50 percent. Bumetanide, on the other hand, is almost completely absorbed in the intestine and has a bioavailability of about 80%. As a result, when it has a better bioavailability than furosemide, it is commonly used in patients with gut oedema.When taken alone, Bendroflumethiazide is a moderately potent diuretic that is unlikely to control her oedema.Mannitol is a type of osmotic diuretic used to treat cerebral oedema and high intracranial pressure.Acetazolamide is a weak diuretic that inhibits carbonic anhydrase. It’s a rare occurrence.
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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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Which of the following statements is false regarding the biceps brachii muscle?
Your Answer: It weakly assists with flexion of the arm at the shoulder
Correct Answer: It pronates the radioulnar joint in the forearm
Explanation:The biceps brachii muscle is one of the chief muscles of the arm. The origin at the scapula and the insertion into the radius of the biceps brachii means it can act on both the shoulder joint and the elbow joint, which is why this muscle participates in a few movements of the arm. It derives its name from its two heads which merge in one unique distal body, defining the unusual structure of the muscle.The biceps brachii muscle is supplied by the musculocutaneous nerve (C5-C6), a branch of the brachial plexus.Arterial supply to the biceps brachii muscle varies considerably, coming from up to eight vessels originating from the brachial artery in the middle third of the arm.In the shoulder joint both muscle heads partially enforce opposite movements. The long head pulls the arm away from the trunk (abduction) and turns it inwards (inward rotation) whereas the short head pulls the arm back towards the trunk (adduction). When both heads contract simultaneously it leads to an arm bend (flexion). In the elbow joint the muscle bends the forearm (flexion) and rotates it outwards (supination). The supination is most powerful in a flexed elbow. In addition to the movement functions, the biceps has the important task to support the humeral head within the shoulder joint. Its antagonist is the triceps brachii in the posterior compartment of the arm.
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This question is part of the following fields:
- Anatomy
- Upper Limb
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Question 30
Incorrect
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Excessive gastric acid output is detected in a patient with a history of recurrent stomach ulcers. It's possible that the patient has Zollinger-Ellison syndrome.Which of the following statements about stomach acid is correct?
Your Answer: It is secreted by chief cells
Correct Answer: The proton pump located in the canalicular membrane is vital to its secretion
Explanation:The stomach produces gastric acid, which is a digesting fluid. The stomach secretes about 2-3 litres every day. It is involved in tissue breakdown, the conversion of pepsinogen to active pepsin, and the creation of soluble salts with calcium and iron, and has a pH range of 1.5-3.5. It also serves as an immune system by destroying microbes.The following substances are found in gastric acid:WaterAcid hydrochloridePepsinogenmucous Intrinsic factorThe parietal cells in the proximal 2/3 (body) of the stomach release gastric acid. The concentration of hydrogen ions in parietal cell secretions is 1-2 million times that of blood. Chloride is released against both a concentration and an electric gradient, and active transport is required for the parietal cell to produce acid.The following is how stomach acid is secreted:1. Gastric acid secretion is dependent on the H+/K+ ATPase (proton pump) situated in the canalicular membrane. The breakdown of water produces hydrogen ions within the parietal cell. The hydroxyl ions produced in this reaction mix quickly with carbon dioxide to generate bicarbonate ions. Carbonic anhydrase is the enzyme that catalyses this process.2. In return for chloride, bicarbonate is carried out of the basolateral membrane. The ‘alkaline tide’ occurs when bicarbonate is released into the bloodstream, resulting in a modest rise in blood pH. The parietal cell’s intracellular pH is maintained by this procedure. Conductance channels carry chloride and potassium ions into the lumen of canaliculi.3. Through the action of the proton pump, hydrogen ions are pushed out of the cell and into the lumen in exchange for potassium; potassium is thus efficiently recycled.4. The canaliculi accumulate osmotically active hydrogen ions, which creates an osmotic gradient across the membrane, allowing water to diffuse outward.
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This question is part of the following fields:
- Gastrointestinal Physiology
- Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
