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  • Question 1 - A 40-year-old male complains of a painful and swollen right calf. The possibility...

    Incorrect

    • A 40-year-old male complains of a painful and swollen right calf. The possibility of deep vein thrombosis (DVT) is being considered. What tests should be conducted to confirm the diagnosis?

      Your Answer: CT of the leg veins

      Correct Answer: Dopplers of the leg veins

      Explanation:

      Diagnostic Methods for Deep Vein Thrombosis

      When it comes to diagnosing deep vein thrombosis (DVT), there are several methods available. The most common ones are Doppler studies and venography. Doppler studies use B mode ultrasonography to examine the venous system, while venography involves injecting a contrast dye into the veins and taking X-rays. CT scans are not typically used for DVT diagnosis because they require contrast and expose the patient to radiation. D-Dimer concentrations can help rule out DVT if they are negative, but they cannot diagnose it. MRI scans are useful for examining soft tissues and bones, but they are not the best option for visualizing the vasculature. Finally, oxygen saturation of the limbs is not a reliable diagnostic method because tissue perfusion can be the same even if there is arterial disease. Overall, Doppler studies and venography are the most effective methods for diagnosing DVT.

    • This question is part of the following fields:

      • Basic Sciences
      22.3
      Seconds
  • Question 2 - A 70-year-old male smoker complains of calf pain.

    The GP performs a clinical...

    Incorrect

    • A 70-year-old male smoker complains of calf pain.

      The GP performs a clinical test by raising the patient's legs and observing for the angle at which there is blanching. After one minute, the legs are lowered over the side of the couch so that they are fully dependent with feet on the floor. Reactive hyperaemia is observed.

      Which clinical test does this describe?

      Your Answer: Trendelenburg's test

      Correct Answer: Buerger's test

      Explanation:

      Tests for Assessing Arterial and Venous Circulation, Hip Dysfunction, and Meniscal Tear

      Buerger’s test is a method used to evaluate the arterial circulation of the lower limb. The test involves observing the angle at which blanching occurs, with a lower angle indicating a higher likelihood of arterial insufficiency. Additionally, the degree of reactive hyperaemia on dependency of the limb after one minute is another positive sign of arterial insufficiency during the test.

      Another test used to assess circulation is the Ankle-Brachial Pressure Index (ABPI), which involves using blood pressure cuffs to determine the degree of claudication. McMurray’s test, on the other hand, is used to evaluate for a meniscal tear within the knee joint.

      Perthe’s test is a method used to assess the patency of the deep femoral vein prior to varicose vein surgery. Lastly, Trendelenburg’s test is used to evaluate hip dysfunction. These tests are important in diagnosing and treating various conditions related to circulation and joint function.

    • This question is part of the following fields:

      • Basic Sciences
      16.3
      Seconds
  • Question 3 - A couple in their early 30s come to your clinic seeking advice. The...

    Incorrect

    • A couple in their early 30s come to your clinic seeking advice. The husband has a history of haemophilia B and they are worried about the possibility of passing it on to their children. Can you determine which of their offspring will be affected by the disease?

      Your Answer: None of the daughters will be affected; all of the sons will be carriers

      Correct Answer: All daughters will be carriers; no sons will be affected

      Explanation:

      The inheritance of Haemophilia A and B is crucial in identifying individuals who are at risk of developing the condition. Haemophilia A and B are genetic disorders that are inherited in an X-linked recessive manner. Haemophilia A is caused by a deficiency in clotting factor VIII, while haemophilia B is caused by a deficiency in clotting factor IX.

      On the other hand, haemophilia C, which is caused by a deficiency in clotting factor XI, is primarily inherited in an autosomal recessive manner. In X-linked recessive conditions like haemophilia B, males are more likely to be affected than females. This is because males only need one abnormal copy of the gene, which is carried on the X chromosome, to be affected.

      Females, on the other hand, can be carriers of the condition if they carry one normal and one abnormal copy of the gene. While carriers can have clotting abnormalities, these are usually milder than those seen in affected individuals. Men cannot pass the condition to their sons, but they will pass on the abnormal X chromosome to all their daughters, who will be carriers.

      Female carriers can pass on the condition to around half their sons, and half their daughters will be carriers. Females can only be affected if they are the offspring of an affected male and a carrier female. In summary, the inheritance of haemophilia A and B is crucial in identifying individuals who are at risk of developing the condition. It also helps in providing appropriate genetic counseling and management for affected individuals and their families.

    • This question is part of the following fields:

      • Basic Sciences
      27.7
      Seconds
  • Question 4 - What is the conversion of pyruvate before it enters the Krebs cycle? ...

    Correct

    • What is the conversion of pyruvate before it enters the Krebs cycle?

      Your Answer: Acetyl-CoA

      Explanation:

      The Krebs cycle occurs in the mitochondrion and involves the conversion of acetyl-CoA to oxaloacetate. This cycle produces six NADH, two FADH, and two ATP for each molecule of glucose. Pyruvate is converted to acetyl-CoA before entering the Krebs cycle, and water and carbon dioxide are end products. Acetic acid itself has no role in the cycle, but its acetyl group is used to form acetyl-CoA. Some anaerobic bacteria can convert sugars to acetic acid directly.

    • This question is part of the following fields:

      • Basic Sciences
      11
      Seconds
  • Question 5 - What are the potential clinical consequences of a lack of vitamin E? ...

    Incorrect

    • What are the potential clinical consequences of a lack of vitamin E?

      Your Answer: Bleeding gums

      Correct Answer: Ataxia

      Explanation:

      Vitamin E Deficiency

      Vitamin E deficiency is a rare condition that is more likely to occur in individuals with problems affecting the absorption of dietary fats. This includes those with a history of bowel surgery, pancreatic insufficiency, and cystic fibrosis. Premature infants are also at a higher risk of developing this deficiency as vitamin E does not easily cross the placenta. However, supplementation with vitamin E can reverse the damage in some cases.

      The effects of vitamin E deficiency can be severe and can cause spinocerebellar degeneration, which includes limb ataxia, loss of joint position sense, loss of sensation of vibration, and loss of deep tendon reflexes. Additionally, it can cause degeneration of retinal pigments, leading to blindness. In premature infants, it can cause haemolytic anaemia, thrombocytosis, and oedema.

      Overall, vitamin E deficiency is crucial in preventing and treating its effects. It is important to identify individuals who are at a higher risk of developing this deficiency and provide them with appropriate supplementation to prevent any long-term damage.

    • This question is part of the following fields:

      • Basic Sciences
      7
      Seconds
  • Question 6 - What is a primary function of vitamin A? ...

    Correct

    • What is a primary function of vitamin A?

      Your Answer: Vision

      Explanation:

      Vitamin A: Forms, Sources, and Functions

      Vitamin A is a crucial nutrient that exists in various forms in nature. The primary dietary form of vitamin A is retinol, also known as pre-formed vitamin A, which is stored in animal liver tissue as retinyl esters. The body can also produce its own vitamin A from carotenoids, with beta-carotene being the most common precursor molecule.

      The richest sources of vitamin A include liver and fish liver oils, dark green leafy vegetables, carrots, and mangoes. Vitamin A can also be added to certain foods like cereals and margarines.

      Vitamin A plays several essential roles in the body, including supporting vision by being a component of rhodopsin, a pigment required by the rod cells of the retina. It also contributes to the growth and development of various types of tissue, regulates gene transcription, and aids in the synthesis of hydrophobic glycoproteins and parts of the protein kinase enzyme pathways.

      In summary, the different forms and sources of vitamin A and its vital functions in the body is crucial for maintaining optimal health.

    • This question is part of the following fields:

      • Basic Sciences
      3.5
      Seconds
  • Question 7 - What is the composition of enzymes found in lysosomes? ...

    Incorrect

    • What is the composition of enzymes found in lysosomes?

      Your Answer: ATPases

      Correct Answer: Acid hydrolases

      Explanation:

      Lysosomes: The Digestive System of the Cell

      Lysosomes are organelles that come from the Golgi apparatus and are enclosed by a membrane. They are responsible for breaking down various biological macromolecules such as proteins, nucleic acids, carbohydrates, and lipids. Lysosomes contain acid hydrolases, which are enzymes that cleave chemical bonds by adding water and function at an acidic pH of around 5. They are involved in digesting foreign agents that are internalized by the cell and breaking down other cellular organelles like mitochondria, allowing for their components to be recycled.

      The acidic pH within lysosomes is maintained by a proton pump in the lysosomal membrane, which imports protons from the cytosol coupled to ATP hydrolysis. This acidic environment is necessary for the activity of the acid hydrolases. D-amino acid oxidases and peroxidases are not found in lysosomes but in peroxisomes. Alcohol dehydrogenases and ATPases are not involved in digestion but in other cellular functions. Alcohol dehydrogenases catalyze the interconversion between alcohols and aldehydes or ketones with the reduction of NAD+ to NADH, while ATPases catalyze the breakdown of ATP into ADP and a phosphate ion, releasing energy for the cell’s functions.

    • This question is part of the following fields:

      • Basic Sciences
      11.5
      Seconds
  • Question 8 - What is the primary factor that increases the risk of thiamine (vitamin B1)...

    Correct

    • What is the primary factor that increases the risk of thiamine (vitamin B1) deficiency?

      Your Answer: Chronic alcohol excess

      Explanation:

      Thiamine: Its Roles, Sources, Deficiency States, and Manifestations

      Thiamine is a vital nutrient that plays several roles in the body. It acts as a cofactor to enzymes involved in energy production, metabolism of branched chain amino acids, and regulation of nerve and muscle action potentials. It is found in many foods, including wheat, oats, and yeast-containing products. However, deficiency states can occur in chronic alcohol dependence, renal dialysis, and cultures that mainly consume white rice. The deficiency can manifest as ‘dry’ beriberi, which causes peripheral neuropathy, muscle weakness, fatigue, and reduced concentration, or ‘wet’ beriberi, which also involves heart failure and edema. In severe cases, Wernicke-Korsakoff syndrome can develop, which is an emergency requiring urgent IV replacement of thiamine. If left untreated, it can lead to irreversible amnesia, confabulation, and dementia. Therefore, all patients with alcohol-related admissions should be considered for Pabrinex, a B vitamin infusion.

    • This question is part of the following fields:

      • Basic Sciences
      10
      Seconds
  • Question 9 - What is the primary function of riboflavin in the B vitamin group? ...

    Incorrect

    • What is the primary function of riboflavin in the B vitamin group?

      Your Answer: Nervous transmission

      Correct Answer: Mopping up free radicals

      Explanation:

      The Role of Riboflavin in the Body

      Riboflavin, also known as vitamin B2, is a B-vitamin that plays a crucial role in the body. One of its functions is to act as an antioxidant, mopping up free radicals that can cause damage to cells. However, if the metabolites formed during this process are not excreted promptly, the free radicals can be generated again. Riboflavin is also involved in the production of blue-light sensitive pigments in the eye, which help establish the circadian rhythm. This function is not related to visual acuity.

      Riboflavin is found in a variety of foods, including milk and offal. Deficiency of this vitamin is rare, but when it does occur, it can cause non-specific effects on the skin and mucous membranes. There is no evidence of clear long-lasting damage from riboflavin deficiency. Overall, riboflavin is an important nutrient that plays a vital role in maintaining good health.

    • This question is part of the following fields:

      • Basic Sciences
      11.1
      Seconds
  • Question 10 - What controls the specific stages of the cell cycle? ...

    Incorrect

    • What controls the specific stages of the cell cycle?

      Your Answer: The on/off activity of cyclases and cyclase-dependent kinases

      Correct Answer: Cyclins and cyclin-dependent kinases

      Explanation:

      Regulation of the Cell Cycle by Cyclins and Cyclin-Dependent Kinases

      The cell cycle is controlled by the activity of proteins known as cyclins and phosphorylating enzymes called cyclin-dependent kinases (CDKs). Cyclins and CDKs combine to form an activated heterodimer, where cyclins act as the regulatory subunits and CDKs act as the catalytic subunits. Neither of these molecules is active on their own. When a cyclin binds to a CDK, the CDK phosphorylates other target proteins, either activating or deactivating them. This coordination leads to the entry into the next phase of the cell cycle. The specific proteins that are activated depend on the different combinations of cyclin-CDK. Additionally, CDKs are always present in cells, while cyclins are produced at specific points in the cell cycle in response to other signaling pathways.

      In summary, the cell cycle is regulated by the interaction between cyclins and CDKs. This interaction leads to the phosphorylation of target proteins, which ultimately controls the progression of the cell cycle.

    • This question is part of the following fields:

      • Basic Sciences
      13.8
      Seconds
  • Question 11 - What significance do linoleic and alpha-linolenic acids hold? ...

    Incorrect

    • What significance do linoleic and alpha-linolenic acids hold?

      Your Answer: They are omega-3 fatty acids

      Correct Answer: They are essential fatty acids

      Explanation:

      The Importance of Essential Fatty Acids in the Diet

      Essential fatty acids, such as linoleic and alpha-linolenic acids, are crucial components of a healthy diet. Although they are only required in small amounts, they play several important roles in the body. These fatty acids are necessary for the synthesis of phospholipids, which are essential components of cell membranes. They also help regulate cholesterol transport and synthesis, and serve as precursors for omega-3 fatty acids and arachidonic acid. Additionally, essential fatty acids are important for the synthesis of prostaglandins, leukotrienes, and thromboxanes.

      A lack of adequate essential fatty acids in the diet can have negative consequences, particularly for brain growth in infancy. It can also lead to alopecia, dermatitis, and fatty liver. Therefore, it is important to ensure that the diet includes sources of these essential fatty acids, such as certain types of fish, nuts, and seeds. By doing so, individuals can support their overall health and well-being.

    • This question is part of the following fields:

      • Basic Sciences
      5.2
      Seconds
  • Question 12 - What could be a potential cause of metabolic acidosis? ...

    Incorrect

    • What could be a potential cause of metabolic acidosis?

      Your Answer: Chronic obstructive pulmonary disease (COPD)

      Correct Answer: Poorly controlled diabetes

      Explanation:

      Acid-Base Imbalances in Different Medical Conditions

      Poorly controlled diabetes can cause the breakdown of fatty acids, leading to the production of ketones as an alternative energy source. However, an excess of ketones can result in metabolic acidosis due to their acidic nature. On the other hand, chronic obstructive pulmonary disease (COPD) and suffocation can cause the retention of carbon dioxide, leading to respiratory acidosis. In COPD, there may be a compensatory metabolic alkalosis. Voluntary hyperventilation can cause respiratory alkalosis due to the reduction of carbon dioxide. Vomiting can also lead to metabolic alkalosis. Diabetic ketoacidosis is a complication of type 1 diabetes that results in high blood sugar levels, ketone production, and acidosis.

      In summary, different medical conditions can cause acid-base imbalances in the body. It is important to identify the underlying cause of the imbalance to provide appropriate treatment.

    • This question is part of the following fields:

      • Basic Sciences
      8
      Seconds
  • Question 13 - Which form of vitamin D is the most active in the human body?...

    Correct

    • Which form of vitamin D is the most active in the human body?

      Your Answer: 1, 25 (OH) 2 vitamin D

      Explanation:

      The Process of Vitamin D Production and Activation

      Vitamin D comes in two forms, D2 and D3. D3 can be produced in the skin through a reaction that requires UV light, while D2 cannot. Both forms can also be obtained through diet, with some foods now being supplemented with Vitamin D. However, the production of Vitamin D3 in the skin can be affected by various factors such as seasons, latitude, clothing, sun block, and skin tone, making it difficult for individuals to get adequate levels of Vitamin D through sunlight alone, especially in the UK during winter.

      Once absorbed into the lymph, Vitamin D2 and D3 circulate in the bloodstream and reach the liver. Here, the liver enzyme 25-hydroxylase adds an OH group to the Vitamin D molecule, resulting in 25(OH) Vitamin D. The compound then travels to the kidney, where the enzyme 1-alpha hydroxylase adds another OH group, creating the active form of Vitamin D, 1,25 (OH)2Vitamin D. When there is enough of this active form, an inactive metabolite called 24,25 (OH)2Vitamin D is produced instead. this process is important in ensuring adequate Vitamin D levels for overall health and well-being.

    • This question is part of the following fields:

      • Basic Sciences
      5.5
      Seconds
  • Question 14 - While taking a patient's medical history, you discover that their family has a...

    Correct

    • While taking a patient's medical history, you discover that their family has a strong history of a certain disease. Autosomal dominant diseases are often caused by defects in structural genes and typically present in early adulthood, affecting both males and females equally. Which of the following diseases does not follow an autosomal dominant pattern of inheritance?

      Your Answer: Haemochromatosis

      Explanation:

      Abnormal Binding Proteins and Iron Deposition: A Genetic Disorder

      Abnormal binding proteins can lead to the deposition of iron in the body, resulting in various health complications. This genetic disorder is inherited in an autosomal recessive manner. The deposition of iron can cause cardiomyopathy, cirrhosis, pancreatic failure due to fibrosis, and skin pigmentation.

      In general, disorders that affect metabolism or DNA replication on a cellular or genetic level tend to be autosomal recessive. On the other hand, genetic disorders that affect the structure of the body on a larger level are usually autosomal dominant. While there may be exceptions to these rules, they can serve as a helpful guide for exam preparation. Proper of this genetic disorder can aid in its diagnosis and management.

    • This question is part of the following fields:

      • Basic Sciences
      25.9
      Seconds
  • Question 15 - What occurs in eukaryotic prometaphase? ...

    Incorrect

    • What occurs in eukaryotic prometaphase?

      Your Answer: The sister chromatids move to opposite ends of the cell

      Correct Answer: The nuclear membrane and the nucleoli disintegrate and kinetochores appear

      Explanation:

      The Significance of Prometaphase in Cell Division

      Prometaphase is a crucial phase in cell division that marks the transition from prophase to metaphase. Although it is often considered as a part of these two phases, it has distinct events that make it an individual phase. During prometaphase, the nuclear membrane disintegrates, and the nucleoli are no longer visible. Additionally, each chromosome forms two kinetochores near the centromere, which serve as attachment points for spindle fibers. These fibers connect to the opposite poles of the cell, forming travelling lines that will separate the sister chromatids during anaphase.

      Prophase is characterized by chromatin condensation, while DNA and centrosome duplication occur during interphase. Chromosome alignment takes place during metaphase, and the sister chromatids separate during anaphase. Prometaphase, therefore, plays a crucial role in preparing the chromosomes for separation during anaphase. Its distinct events make it an essential phase in cell division, and its proper execution is necessary for successful cell division.

    • This question is part of the following fields:

      • Basic Sciences
      16
      Seconds
  • Question 16 - A premature baby is born and the anaesthetists are struggling to ventilate the...

    Incorrect

    • A premature baby is born and the anaesthetists are struggling to ventilate the lungs because of insufficient surfactant. How does Laplace's law explain the force pushing inwards on the walls of the alveolus caused by surface tension between two static fluids, such as air and water in the alveolus?

      Your Answer: Proportional to the square root of the radius of the alveolus

      Correct Answer: Inversely proportional to the radius of the alveolus

      Explanation:

      The Relationship between Alveolar Size and Surface Tension in Respiratory Physiology

      In respiratory physiology, the alveolus is often represented as a perfect sphere to apply Laplace’s law. According to this law, there is an inverse relationship between the size of the alveolus and the surface tension. This means that smaller alveoli experience greater force than larger alveoli for a given surface tension, causing them to collapse first. This phenomenon is similar to what happens when two balloons of different sizes are attached together, with the smaller balloon emptying into the larger one.

      In the lungs, this collapse of smaller alveoli can lead to atelectasis and collapse if surfactant is not present. Surfactant is a substance that reduces surface tension, making it easier to expand the alveoli and preventing smaller alveoli from collapsing. this relationship between alveolar size and surface tension is crucial in respiratory physiology, as it helps explain the importance of surfactant in maintaining proper lung function.

    • This question is part of the following fields:

      • Basic Sciences
      26.7
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  • Question 17 - A 50-year-old male comes to the clinic complaining of abdominal swelling, nausea, and...

    Incorrect

    • A 50-year-old male comes to the clinic complaining of abdominal swelling, nausea, and mild jaundice. He has a history of regular alcohol consumption, drinking two 330ml bottles of lager per day (3% ABV) and a 75cl bottle of 12% ABV wine per week.

      What is the approximate number of units of alcohol this man consumes per week? Round to the nearest unit.

      Your Answer: 13 units

      Correct Answer: 23 units

      Explanation:

      Calculating Units of Alcohol

      To calculate the number of units of alcohol in a drink, you need to multiply the percentage of alcohol (ABV) by the volume in millilitres and then divide by 1000. However, there are potential pitfalls to watch out for when answering questions about units of alcohol. For example, if the consumption is presented as a daily amount, you need to multiply by 7 to get the weekly amount. Additionally, if the volume is presented in centilitres, you need to convert it to millilitres before performing the calculation.

      For instance, let’s say you want to calculate the units of alcohol in a bottle of lager. If the ABV is 3% and the volume is 330ml, the calculation would be 3% x 330ml divided by 1000, which equals 0.99 units rounded up to 1 unit. If the person drinks two bottles a day, that’s 2 units per day or 14 units per week. Similarly, if the person drinks one bottle of wine per week, and the ABV is 12% and the volume is 750ml, the calculation would be 12% x 750ml divided by 1000, which equals 9 units per bottle.

      It’s important to be aware of potential pitfalls when calculating units of alcohol, such as checking the units of volume and adjusting for duration. By this simple calculation, you can be prepared for any question that may come up in an exam setting. The UK recommendations for alcohol consumption are no more than 14 units per week for both sexes. While calculating units of alcohol may seem daunting, with practice and preparation, you can confidently tackle any question that comes your way.

    • This question is part of the following fields:

      • Basic Sciences
      22
      Seconds
  • Question 18 - What is a good dietary source of vitamin A? ...

    Incorrect

    • What is a good dietary source of vitamin A?

      Your Answer: Citrus fruit

      Correct Answer: Liver

      Explanation:

      The Importance of Vitamin A in Our Body

      Vitamin A is an essential nutrient that can be found in various sources such as liver, fish liver oils, dark green leafy vegetables, carrots, and mangoes. It can also be added to certain foods like cereals and margarines. This nutrient plays a crucial role in our body as it is required for vision, growth and development of tissues, regulation of gene transcription, and synthesis of hydrophobic glycoproteins and parts of the protein kinase enzyme pathways.

      One of the primary functions of vitamin A is to support our vision. It is a component of rhodopsin, a pigment that is necessary for the rod cells of the retina. Without vitamin A, our eyesight can be compromised, leading to various eye problems. Additionally, vitamin A is also essential for the growth and development of many types of tissues in our body. It helps in maintaining healthy skin, teeth, and bones.

      Moreover, vitamin A is involved in regulating gene transcription, which is the process of converting DNA into RNA. This nutrient also plays a role in the synthesis of hydrophobic glycoproteins and parts of the protein kinase enzyme pathways. These processes are essential for the proper functioning of our body.

      In conclusion, vitamin A is a vital nutrient that our body needs to function correctly. It is essential for our vision, growth and development of tissues, regulation of gene transcription, and synthesis of hydrophobic glycoproteins and parts of the protein kinase enzyme pathways. Therefore, it is crucial to include vitamin A-rich foods in our diet or take supplements if necessary.

    • This question is part of the following fields:

      • Basic Sciences
      5.6
      Seconds
  • Question 19 - What are the defining features of an amino acid? ...

    Incorrect

    • What are the defining features of an amino acid?

      Your Answer: It contains amino and carboxyl groups

      Correct Answer: It has the formula H2N - CHR - COOH where R is the variable group

      Explanation:

      The Versatility of Amino Acids and its Applications in Electrophoresis

      Amino acids are the building blocks of proteins and are composed of a basic structure of H2N – CHR – COOH, where R represents the variable group that distinguishes one amino acid from another. The simplest amino acid is glycine, where the R group is just H. Amino acids are capable of forming complex and useful molecules due to their dipolar or amphoteric nature, which makes them simultaneously acidic and basic. In solution, they form zwitterions, which can act as either an acid or a base depending on the pH of the solution. This versatility of amino acids is what allows for the process of electrophoresis, which separates proteins based on their charge in a solution. By using solutions of different pH, different proteins can be assessed, making it a useful tool in the diagnosis of bone marrow malignancies like myeloma.

    • This question is part of the following fields:

      • Basic Sciences
      6
      Seconds
  • Question 20 - What are the clinical effects that can occur due to acute or chronic...

    Incorrect

    • What are the clinical effects that can occur due to acute or chronic over-administration of multivitamins leading to Vitamin A toxicity?

      Your Answer: Bone overgrowth with deformity

      Correct Answer: Nausea, vomiting and headaches

      Explanation:

      The Importance and Risks of Vitamin A

      Vitamin A is an essential nutrient that plays a crucial role in various bodily functions such as growth and development, vision, enzyme signalling pathways, and the maintenance of epithelial membranes. However, excessive intake of vitamin A can lead to toxicity, which can cause several adverse effects. These include raised intracranial pressure resulting in headaches, nausea, vomiting, and visual loss, increased bone resorption leading to osteoporosis and hypercalcaemia, liver damage, hair loss, and skin changes. Moreover, there is a possible increased risk of malignancy, particularly among smokers. Pregnant women are also advised to avoid foods rich in vitamin A, such as liver and fish oils, due to the teratogenicity of vitamin A-derived drugs. Therefore, it is crucial to maintain a balanced intake of vitamin A to avoid the risks associated with its toxicity.

    • This question is part of the following fields:

      • Basic Sciences
      14.8
      Seconds
  • Question 21 - What is the most common method of assessing nutritional status in adults? ...

    Incorrect

    • What is the most common method of assessing nutritional status in adults?

      Your Answer: Ponderal index

      Correct Answer: Body mass index

      Explanation:

      The Body Mass Index as a Measure of Nutritional Status

      The measurement and assessment of nutritional status can be challenging, and there is no single test that can provide a complete picture. However, the body mass index (BMI) is a commonly used measurement in clinical practice. The BMI is calculated by dividing a person’s weight in kilograms by their height in meters squared. This measure is used to assess adiposity and nutritional status, and it is simple and quick to calculate and interpret.

      Although the BMI is a convenient measure, it has limitations for assessing obesity in individual patients. It is best used to track trends in an individual patient’s BMI over time. In some cases, the BMI may overestimate fat mass in patients who are very tall or have a high proportion of lean tissue due to an active lifestyle. Additionally, the BMI may not be accurate for athletes and children.

      Other measurements, such as skin fold thickness and weight, can also be useful, but the BMI is generally considered the better option. The ponderal index is used specifically for children. It is important to note that albumin is not a reliable marker of nutritional status, as it can also be affected by inflammation.

      Overall, the BMI is a widely used measure of nutritional status and is recommended by the World Health Organization. However, it is important to consider its limitations and use it in conjunction with other measurements to obtain a more complete picture of a patient’s nutritional status.

    • This question is part of the following fields:

      • Basic Sciences
      8.3
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  • Question 22 - The Krebs or TCA cycle is a series of metabolic processes beginning with...

    Correct

    • The Krebs or TCA cycle is a series of metabolic processes beginning with the synthesis of citrate from acetyl-CoA which results in a number of important metabolic products. Where in the cell does this cycle occur?

      Your Answer: Mitochondria

      Explanation:

      Cellular Processes and Organelles

      Metabolic processes in the cell occur in specific locations. Acetyl-CoA production and the Krebs cycle take place in the mitochondrium, while glycolysis occurs in the cytoplasm. The nucleus is the central structure of the cell that contains DNA and is double membrane-bound. The rough endoplasmic reticulum is responsible for packaging and transporting proteins, while the smooth endoplasmic reticulum performs a similar function but lacks ribosomes.

      It is important to understand where these processes occur in the cell to better understand their functions and how they contribute to the overall functioning of the cell. The mitochondrium is responsible for producing energy in the form of ATP, while the cytoplasm is where glucose is broken down during glycolysis. The nucleus is where genetic information is stored and replicated, and the endoplasmic reticulum is involved in protein synthesis and transport.

      In summary, the cell is a complex system with various organelles that perform specific functions. where these processes occur in the cell is crucial to how they contribute to the overall functioning of the cell.

    • This question is part of the following fields:

      • Basic Sciences
      16.7
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  • Question 23 - A 65-year-old patient with suspected spinal cord compression has been admitted to the...

    Correct

    • A 65-year-old patient with suspected spinal cord compression has been admitted to the neurosurgical team for an urgent MRI of the spine. The MRI technique primarily relies on the magnetic properties of which particle?

      Your Answer: Hydrogen ion (proton)

      Explanation:

      How MRI Scanners Use Hydrogen Ions to Create Images

      MRI scanners use the magnetic properties of hydrogen ions, also known as protons, to create images of the human body. These protons have nuclear spin, which means they have magnetic vectors that can be aligned in an electromagnet. The scanner bombards the protons with radiofrequency radiation, causing them to release energy when they return to their resting state. This energy release is recorded and used to construct the MRI image.

      While other nuclei, such as carbon 13, also have net nuclear spin and could be used in MRI imaging, hydrogen ions are much more abundant in human tissues. This makes them the preferred choice for creating images of the body. By using the magnetic properties of hydrogen ions, MRI scanners can create detailed images of internal structures without the use of harmful radiation.

    • This question is part of the following fields:

      • Basic Sciences
      4.9
      Seconds
  • Question 24 - What is the final product of glycolysis besides ATP? ...

    Correct

    • What is the final product of glycolysis besides ATP?

      Your Answer: Pyruvate

      Explanation:

      Glycolysis: The Energy-Producing Reaction

      Glycolysis is a crucial energy-producing reaction that converts glucose into pyruvate while releasing energy to create ATP and NADH+. It is one of the three major carbohydrate reactions, along with the citric acid cycle and the electron transport chain. The reaction involves ten enzymatic steps that provide entry points to glycolysis, allowing for a variety of starting points. The most common starting point is glucose or glycogen, which produces glucose-6-phosphate.

      Glycolysis occurs in two phases: the preparatory (or investment) phase and the pay-off phase. In the preparatory phase, ATP is consumed to start the reaction, while in the pay-off phase, ATP is produced. Glycolysis can be either aerobic or anaerobic, but it does not require nor consume oxygen.

      Although other molecules are involved in glycolysis at some stage, none of them form its end product. Lactic acid is associated with anaerobic glycolysis. glycolysis is essential for how the body produces energy from carbohydrates.

    • This question is part of the following fields:

      • Basic Sciences
      11.1
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  • Question 25 - A 50-year-old female patient presents to the vascular clinic for evaluation of varicose...

    Incorrect

    • A 50-year-old female patient presents to the vascular clinic for evaluation of varicose veins. During the assessment, a test is conducted to determine the site of incompetence. The patient is instructed to lie down, and her legs are raised to empty the veins. A constricting band is then placed below the sapheno-femoral junction, and the patient is asked to stand up to observe for varicose vein filling. What is the name of this test?

      Your Answer: Trendelenburg's test

      Correct Answer: Tourniquet test

      Explanation:

      Tests for Varicose Veins and Arterial Insufficiency

      The Trendelenburg and tourniquet tests are both used to evaluate the site of incompetence in varicose veins at the sapheno-femoral junction. During the Trendelenburg test, the examiner applies pressure with their fingers over the junction, while in the tourniquet test, a tourniquet is placed just below the junction. If the veins fill rapidly upon standing, it suggests that the sapheno-femoral junction is not the source of the incompetence.

      Buerger’s test is used to assess the arterial circulation of the lower limb. The lower the angle at which blanching occurs, the more likely there is arterial insufficiency. This test is important in diagnosing peripheral artery disease.

      The ankle-brachial pressure index (ABPI) is another test used to assess arterial insufficiency. Blood pressure cuffs are used to measure the systolic blood pressure in the ankle and arm. The ratio of the two pressures is calculated, and a lower ratio indicates a higher degree of claudication.

      Finally, Perthe’s test is used to assess the patency of the deep femoral vein before varicose vein surgery. This test involves compressing the vein and observing the filling of the superficial veins. If the superficial veins fill quickly, it suggests that the deep femoral vein is patent and can be used for surgery.

      In summary, these tests are important in diagnosing and evaluating varicose veins and arterial insufficiency. They help healthcare professionals determine the best course of treatment for their patients.

    • This question is part of the following fields:

      • Basic Sciences
      7
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  • Question 26 - A 10-year-old patient presents with recurrent skin cancer and is diagnosed with xeroderma...

    Incorrect

    • A 10-year-old patient presents with recurrent skin cancer and is diagnosed with xeroderma pigmentosum. What is the defective biochemical mechanism in this disease?

      Your Answer: mRNA splicing

      Correct Answer: DNA excision repair

      Explanation:

      Xeroderma Pigmentosum and DNA Repair

      Deoxyribonucleic acid (DNA) found in the skin cells can absorb ultraviolet (UV) light, which can cause the formation of pyrimidine dimers. These dimers are removed through a process called excision repair, where the damaged DNA is cut out and replaced with new DNA. However, if this process fails, it can lead to mutations in genes that suppress tumors or promote their growth, potentially leading to cancer.

      Xeroderma pigmentosum is a genetic disorder that is inherited in an autosomal recessive pattern. This means that an individual must inherit two copies of the mutated gene, one from each parent, to develop the disorder. Generally, disorders that affect metabolism or DNA replication on a cellular or genetic level are inherited in an autosomal recessive pattern. On the other hand, genetic disorders that affect larger structural components are usually inherited in an autosomal dominant pattern. While there are exceptions to these rules, they can serve as a helpful guide for exam preparation.

    • This question is part of the following fields:

      • Basic Sciences
      10.5
      Seconds
  • Question 27 - What significance do leucine, lysine, and phenylalanine hold? ...

    Correct

    • What significance do leucine, lysine, and phenylalanine hold?

      Your Answer: They are essential amino acids

      Explanation:

      Essential Amino Acids and their Importance in the Diet

      There are approximately 20 essential amino acids that are crucial for human health. These amino acids are considered essential because the body cannot produce them on its own and they must be obtained through the diet. While some of these essential amino acids can be used to create other non-essential amino acids, they are still necessary for overall health and wellbeing.

      Some examples of essential amino acids include histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. However, the amount of these essential amino acids can vary depending on the type of dietary protein consumed. Additionally, cooking or preserving proteins can alter the amino acid composition, making them less effective for the body.

      In summary, essential amino acids play a vital role in maintaining human health and must be obtained through the diet. the importance of these amino acids and their sources can help individuals make informed decisions about their dietary choices.

    • This question is part of the following fields:

      • Basic Sciences
      8
      Seconds
  • Question 28 - What role does vitamin K play in the body? ...

    Incorrect

    • What role does vitamin K play in the body?

      Your Answer: Calcium homeostasis

      Correct Answer: Activation of clotting factors II, VII, IX, X

      Explanation:

      The Roles of Vitamin K in the Body

      Vitamin K plays several important roles in the body. One of its main functions is to modify clotting factors II, VII, IX, and X through a process called carboxylation. This modification allows calcium to bind to the factors, which is necessary for them to participate in the clotting pathway. This principle is used in full blood counts to prevent clotting by adding EDTA, which chelates the calcium. Vitamin K also modifies osteocalcin and matrix proteins in bone, as well as nephrocalcin in the kidney, in a similar way.

      In addition to its role in blood clotting and bone health, vitamin K is also important for nervous tissue development and growth. However, vitamin K antagonists such as warfarin are sometimes used as anticoagulants to prevent blood clots. It is important to follow guidelines and instructions carefully when using these medications. Overall, vitamin K plays a crucial role in maintaining the health and function of various systems in the body.

    • This question is part of the following fields:

      • Basic Sciences
      9.2
      Seconds
  • Question 29 - What factor causes a shift of the oxygen dissociation curve to the left?...

    Incorrect

    • What factor causes a shift of the oxygen dissociation curve to the left?

      Your Answer: Increased CO2

      Correct Answer: Increased pH

      Explanation:

      The Oxygen Dissociation Curve and its Effects on Oxygen Saturation

      The oxygen dissociation curve is a graph that compares the oxygen saturation of hemoglobin (Hb) at different partial pressures of oxygen. When more oxygen is needed by the tissues, the curve shifts to the right. This means that at the same partial pressure of oxygen, less oxygen is bound to Hb, allowing it to be released to the tissues. This effect is caused by increased levels of CO2 and temperature, which assist in the transfer of oxygen to more metabolically active tissues. Additionally, increased levels of 2,3-DPG also aid in this process.

      On the other hand, a left shift in the curve reflects conditions where there is less need for oxygen in the tissues, such as in the lungs. This allows for increased binding of oxygen to Hb, allowing it to be taken up before transport to the tissues that require it. Overall, the oxygen dissociation curve plays a crucial role in regulating oxygen saturation in the body and ensuring that oxygen is delivered to the tissues that need it most.

    • This question is part of the following fields:

      • Basic Sciences
      14.6
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  • Question 30 - You are evaluating a geriatric patient in the emergency department who has fallen...

    Incorrect

    • You are evaluating a geriatric patient in the emergency department who has fallen and needs a venous cannula for fluid resuscitation. To ensure maximum flow into the vein, you plan to apply the Hagen-Poiseuille equation to select an appropriate cannula size. Which of the following statements is true according to this law?

      Your Answer: Flow is proportional to the radius of the cannula squared

      Correct Answer: Flow will be faster through a shorter cannula

      Explanation:

      Poiseuille’s Equation and Fluid Flow in Cylinders

      Poiseuille’s equation is used to describe the flow of non-pulsatile laminar fluids through a cylinder. The equation states that the flow rate is directly proportional to the pressure driving the fluid and the fourth power of the radius. Additionally, it is inversely proportional to the viscosity of the fluid and the length of the tube. This means that a short, wide cannula with pressure on the bag will deliver fluids more rapidly than a long, narrow one.

      It is important to note that even small changes in the radius of a tube can greatly affect the flow rate. This is because the fourth power of the radius is used in the equation. Therefore, any changes in the radius will have a significant impact on the flow rate. Poiseuille’s equation is crucial in determining the optimal conditions for fluid delivery in medical settings.

    • This question is part of the following fields:

      • Basic Sciences
      13
      Seconds

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