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Question 1
Incorrect
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What function does vitamin E serve in the body?
Your Answer: Vision
Correct Answer: Antioxidant
Explanation:Vitamin E and its Functions
Several substances are classified as vitamin E, with alpha-tocopherol being the most common, accounting for 90% of human vitamin E. Alpha-tocopherol is composed of two carbon rings and a long saturated hydrocarbon chain, making it hydrophobic. It has an aromatic ring with an OH- group attached to it. Other substances with vitamin E activity include other tocopherols and tocotrienols, all of which act as antioxidants. Alpha-tocopherol is particularly important in cell membranes, preventing the peroxidation of unsaturated fatty acids by free radicals. It also has other functions, such as regulating gene transcription, inhibiting clotting formation, reducing proliferation of vascular smooth muscle, and playing a role in immunity.
Despite claims that taking vitamin E can reduce the risk of heart disease, cancer, and enhance sexual performance, there is currently no strong evidence to support these claims.
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This question is part of the following fields:
- Basic Sciences
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Question 2
Correct
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What occurs in eukaryotic prometaphase?
Your 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.
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This question is part of the following fields:
- Basic Sciences
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Question 3
Incorrect
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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 fourth power 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, and they will collapse first. This phenomenon explains why, when two balloons are attached together by their ends, the smaller balloon will empty into the bigger balloon.
In the lungs, this same principle applies to lung units, causing atelectasis and collapse when 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. Therefore, surfactant plays a crucial role in maintaining the proper functioning of the lungs and preventing respiratory distress. the relationship between alveolar size and surface tension is essential in respiratory physiology and can help in the development of treatments for lung diseases.
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This question is part of the following fields:
- Basic Sciences
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Question 4
Correct
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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.
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This question is part of the following fields:
- Basic Sciences
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Question 5
Correct
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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: 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.
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This question is part of the following fields:
- Basic Sciences
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Question 6
Incorrect
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What is the composition of enzymes found in lysosomes?
Your Answer: Peroxidases
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.
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This question is part of the following fields:
- Basic Sciences
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Question 7
Incorrect
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What is the estimated percentage of oxygen in the blood that is attached to haemoglobin?
Your Answer: 80%
Correct Answer: 100%
Explanation:Calculation of Oxygen in Blood
The majority of oxygen in the blood is bound to haemoglobin, with the exact amount varying based on the oxygen saturation and haemoglobin level. To calculate the amount of oxygen per litre of blood, the formula (13.9 × Hb × sats/100) + (PaO2 × 0.03) can be used. For example, an average man with an Hb of 14, saturations of 98% on room air, and a PaO2 of 12 would have 191 ml of oxygen per litre of blood. It is important to note that only 0.36 ml of this oxygen is dissolved in the blood.
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This question is part of the following fields:
- Basic Sciences
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Question 8
Correct
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What type of molecule does haemoglobin belong to?
Your Answer: Quaternary protein structure
Explanation:The Structure and Functions of Proteins
Proteins are complex molecules that can vary in structure from single amino acids to large, folded molecules. Amino acids are joined together by peptide bonds to form dipeptides and polypeptides. More complex molecules can also have disulphide bonds and ionic bonds. The primary structure of a protein is a simple amino acid chain, while the secondary structure is a specific shape such as a helix or pleated sheet. The tertiary structure is a more globular shape, arranged by ionic, hydrogen, and disulphide bonds, and hydrophobic interactions. The quaternary structure is a complex protein containing several polypeptide chains held together by interactions.
Proteins have multiple roles within the human body, including as hormones, food substrates, enzymes, receptor molecules, muscles, cell membrane constituents, carrier molecules in blood, and determinants of oncotic/osmotic pressures. However, proteins can be easily damaged by denaturation, which is the loss of the specific three-dimensional shape of a molecule. Denaturation can be caused by heat, salts, heavy metals, solvents, detergents, and extremes of pH.
In summary, proteins are essential molecules with a diverse range of structures and functions within the human body. their structure and potential for denaturation is crucial for maintaining their proper function.
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This question is part of the following fields:
- Basic Sciences
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Question 9
Correct
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The arrangement of amphipathic phospholipids in the mammalian cell membrane, what is it like?
Your Answer: A lipid bilayer with hydrophilic heads facing out and hydrophobic tails facing in
Explanation:The Function and Structure of the Mammalian Cell Membrane
The mammalian cell membrane serves as a protective barrier that separates the cytoplasm from the extracellular environment. It also acts as a filter for molecules that move across it. Unlike plant and prokaryotic cells, mammalian cells do not have a cell wall. The main component of the cell membrane is a bilayer of amphipathic lipids, which have a hydrophilic head and a hydrophobic tail. The phospholipids in the bilayer are oriented with their hydrophilic heads facing outward and their hydrophobic tails facing inward. This arrangement allows for the separation of the watery extracellular environment from the watery intracellular compartment.
It is important to note that the cell membrane is not a monolayer and the phospholipids are not linked head-to-tail. This is in contrast to DNA, which has a helical chain formation. Overall, the structure and function of the mammalian cell membrane are crucial for maintaining the integrity and proper functioning of the cell.
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This question is part of the following fields:
- Basic Sciences
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Question 10
Incorrect
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A man in his forties comes in with chest pain resembling a heart attack and is diagnosed with a myocardial infarction. During his hospitalization, it is discovered that he has familial hypercholesterolemia but his triglyceride levels are normal. What is the underlying biochemical abnormality?
Your Answer: Hepatic overproduction of VLDL
Correct Answer: Defective LDL receptors
Explanation:Lipid Metabolism and Transport in the Body
The breakdown of triglycerides in the small intestine is facilitated by pancreatic lipase. These triglycerides are then transported to the liver and other parts of the body through chylomicrons.
Very low-density lipoprotein (VLDL) is responsible for carrying triglycerides from the liver to peripheral tissues. When there is an overproduction of VLDL in the liver, it can lead to high levels of triglycerides in the body.
Pure hypercholesterolaemia is a condition that arises due to a defect in the process of cholesterol uptake into cells. This process relies on apolipoprotein B-100 binding to LDL receptors and facilitating endocytosis. When this process is disrupted, it can lead to high levels of cholesterol in the body.
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This question is part of the following fields:
- Basic Sciences
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Question 11
Incorrect
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Of which cellular structure is the fibrillar centre a component?
Your Answer: The chromosomes
Correct Answer: The nucleolus
Explanation:The Fibrillar Centre in the Nucleolus
The fibrillar centre is a crucial component of the nucleolus, which is found in most metazoan nucleoli, particularly in higher eukaryotes. Along with the dense fibrillar components and the granular component, it forms the three major components of the nucleolus. During the end of mitosis, the fibrillar centre serves as a storage point for nucleolar ribosomal chromatin and associated ribonucleoprotein transcripts. As the nucleolus becomes active, the ribosomal chromatin and ribonucleoprotein transcripts begin to form the dense fibrillar components, which are more peripherally located and surround the fibrillar centres. The transcription zone for multiple copies of the pre-rRNA genes is the border between these two structures. It is important to note that the fibrillar centre is not a component of any of the cell structures mentioned in the incorrect answer options.
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This question is part of the following fields:
- Basic Sciences
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Question 12
Correct
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What occurs during metaphase II of meiosis?
Your Answer: The cell's chromosomes attach to the meiotic spindle to divide into chromatids
Explanation:The Process of Meiosis
Meiosis is a complex process that involves two major cycles. The first cycle, meiosis I, condenses the reproductive cell’s DNA into chromosomes that are then replicated, creating two pairs of each original chromosome. These pairs are then separated, and the cell divides with one chromosome in each daughter cell. The second cycle, meiosis II, splits the chromosomes into individual chromatids, which are then separated as in meiosis I. This separation is facilitated by a spindle, a set of parallel fibers that attach to the center of each chromosome and split into two, making the chromatids travel on the polar opposite sides of the cell. The cell then divides again, giving rise to four haploid daughter cells.
During meiosis II, the chromosomes align on the spindle in metaphase II. Tetrads separate during anaphase I and line up during metaphase I. Sister chromatids separate on the meiotic spindle during anaphase II. Finally, chromosomes uncoil and lengthen at the end of meiosis, in telophase II. This process is essential for the production of gametes and the continuation of sexual reproduction in many organisms.
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This question is part of the following fields:
- Basic Sciences
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Question 13
Incorrect
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A 32-year-old snowboarder presents to the Emergency department complaining of pain and swelling around the first metacarpophalangeal joint (MCP joint) following a fall during practice.
Upon examination, there is significant swelling and bruising on the ulnar side of the joint.
What is the most probable injury that the patient has sustained?Your Answer: Accessory collateral ligament
Correct Answer: Ulnar collateral ligament
Explanation:Skier’s Thumb: A Common Injury in Winter Sports
Skier’s thumb, also known as gamekeeper’s thumb, is a common injury that occurs in winter sports. It is caused by damage or rupture of the ulnar collateral ligament, which is located at the base of the thumb. This injury can result in acute swelling and gross instability of the thumb. In severe cases where a complete tear of the ligament is suspected, an MRI may be necessary to confirm the diagnosis, and surgical repair may be required.
Once the acute swelling has subsided, treatment for skier’s thumb typically involves immobilization in a thumb spica. This is the standard therapy for cases of partial rupture.
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This question is part of the following fields:
- Basic Sciences
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Question 14
Correct
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The diabetes prevention program has been running for the last 5 years. At baseline, a well conducted study with a sample size of 500 showed that the prevalence of diabetes among adults aged 40 and above was 15%.
Five years later another survey (of 400 responders) showed that the prevalence of diabetes was 10%.
In the above example, which definition of prevalence is correct?Your Answer: Prevalence is the number of new and old smokers in a year
Explanation:Prevalence and Incidence in Smoking
Prevalence and incidence are two important concepts in the smoking habits of a population. Prevalence refers to the number of people who smoke at a particular time point, such as at the beginning or end of a study period. This is calculated by dividing the number of smokers by the total population.
On the other hand, incidence refers to the number of new cases of smoking at a particular time point. For example, this could be at the beginning of a study period for the whole year or at the 10th year. This is calculated by dividing the number of new smokers by the number of smoke-free individuals who are potentially at risk of taking up smoking.
prevalence and incidence is important in evaluating the effectiveness of smoking cessation programs and policies. By tracking changes in prevalence and incidence over time, researchers and policymakers can determine whether their efforts are making a difference in reducing smoking rates. Additionally, these concepts can help identify populations that are at higher risk of taking up smoking, allowing for targeted interventions to prevent smoking initiation.
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This question is part of the following fields:
- Basic Sciences
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Question 15
Incorrect
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What is the primary function of riboflavin in the B vitamin group?
Your Answer: Visual acuity
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.
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This question is part of the following fields:
- Basic Sciences
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Question 16
Correct
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During which stage of the cell cycle does the replication of DNA occur?
Your Answer: S phase
Explanation:The Five Phases of the Cell Cycle
The cell cycle is a complex process that is divided into five main phases, each with its unique cellular events. The first phase is the G0 phase, which is a resting phase where the cell has stopped dividing and is out of the cell cycle. The second phase is the G1 phase, also known as interphase Gap 1, where cells increase in size, and a checkpoint control mechanism prepares the cell for DNA synthesis.
The third phase is the S phase, where DNA replication occurs. The fourth phase is the G2 phase, also known as Gap 2, which is a gap between DNA synthesis and the onset of mitosis. During this phase, the cell continues to grow until it is ready to enter mitosis. Finally, the fifth phase is the M phase, also known as mitosis, where cell growth stops, and the cell focuses its energy to divide into two daughter cells.
A checkpoint in the middle of mitosis, known as the metaphase checkpoint, ensures that the cell is prepared to complete division. the five phases of the cell cycle is crucial in how cells divide and grow.
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This question is part of the following fields:
- Basic Sciences
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Question 17
Correct
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A couple in their late 30s come to the clinic seeking information about the risk of their three children inheriting Huntington's disease. The husband has recently been diagnosed with the disease, while the wife is not affected. What is the likelihood, expressed as a percentage, that their children will inherit the disease?
Your Answer: 50%
Explanation:Huntington’s Disease
Huntington’s disease is a genetic disorder that typically appears later in life and is characterized by symptoms such as chorea, cognitive decline, and personality changes. It is an autosomal dominant disease, meaning that there is a 50% chance of passing it on to offspring. If the gene is inherited from an unaffected parent, the child will not be affected. This is different from autosomal recessive inheritance, where both parents must pass on the gene for it to affect their children.
The disease is caused by an increase in the length of a repeating trinucleotide sequence (CAG) in the Huntington protein. This sequence can change in length through generations, and longer sequences are associated with earlier onset of symptoms (genetic anticipation). Since Huntington’s disease usually presents itself after people have already started their families, there are many issues associated with genetic testing.
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This question is part of the following fields:
- Basic Sciences
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Question 18
Correct
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What is the most common method of assessing nutritional status in adults?
Your 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.
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This question is part of the following fields:
- Basic Sciences
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Question 19
Incorrect
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What is the conversion of pyruvate before it enters the Krebs cycle?
Your Answer: Oxaloacetate
Correct 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.
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This question is part of the following fields:
- Basic Sciences
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Question 20
Correct
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What is the primary role of the nucleus in a eukaryotic cell?
Your Answer: To regulate gene transcription and translation
Explanation:The Nucleus: Control Centre of the Cell
The nucleus is the control centre of the cell, responsible for regulating gene transcription from DNA into mRNA and from mRNA into peptide/protein synthesis. Eukaryotic cells have a membrane-enclosed organised nucleus, while prokaryotic cells lack this structure. The nuclear structure consists of an outer and inner nuclear membrane that form the nuclear envelope, which has nuclear pores allowing the movement of water-soluble molecules. Inside the nucleus is the nucleoplasm containing the nuclear lamina, a dense fibrillar network that acts as a skeleton and regulates DNA replication and cell division. The nucleus also contains nucleoli, structures involved in the formation of ribosomes responsible for mRNA translation.
Although the incorrect answer options above describe processes in which the nucleus is involved, none of them constitutes its main function within the cell.
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This question is part of the following fields:
- Basic Sciences
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Question 21
Incorrect
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What role does the nucleolus play in eukaryotic cells?
Your Answer: To store the cells DNA during cell division
Correct Answer: To transcribe ribosomal RNA and assemble ribosomes
Explanation:The Nucleolus: Structure and Function
The nucleolus is a non-membrane-bound structure that takes up about a quarter of the nuclear volume. It is composed mainly of proteins and nucleic acids and is responsible for transcribing ribosomal RNA (rRNA) and assembling ribosomes in the cell. Nucleoli are formed in nucleolar organizing regions (NORs), which are also the regions of the genes for three of the four eukaryotic rRNAs.
During ribosome assembly, ribosomal proteins enter the nucleolus from the cytoplasm and begin to assemble on an rRNA precursor. As the pre-rRNA is cleaved to produce 5.8S, 18S, and 28S rRNAs, additional ribosomal proteins and the 5S rRNA (which is synthesized elsewhere in the nucleus) assemble to form preribosomal subunits. These subunits then exit the nucleolus into the cytoplasm and combine to produce the final 40S and 60S ribosomal subunits.
Overall, the nucleolus plays a crucial role in protein synthesis by producing the components necessary for ribosome assembly. Its unique structure and function make it an essential component of the cell’s machinery.
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This question is part of the following fields:
- Basic Sciences
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Question 22
Incorrect
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To what type of cell can mesenchymal stem cells transform?
Your Answer: Skin cells
Correct Answer: Osteoblasts
Explanation:Mesenchymal Cells: The Stem Cells of the Human Skeleton
Mesenchymal cells are the primary stem cells of the human skeleton. These multipotent cells originate in the bone marrow and have the ability to differentiate into various cell types. Osteoblasts, responsible for bone formation, chondrocytes, which give rise to cartilage, and adipocytes, specialized in storing energy as fat, are some of the cells that mesenchymal cells can produce. Muscle cells, or myocytes, arise from muscle satellite cells, while skin cells come from epithelial stem cells. Neurons mostly arise from neural stem cells, although some may come from astrocytes. White blood cells, on the other hand, come from hematopoietic stem cells. Mesenchymal cells play a crucial role in the maintenance and repair of the human skeleton, making them an essential area of study in regenerative medicine.
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This question is part of the following fields:
- Basic Sciences
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Question 23
Correct
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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.
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This question is part of the following fields:
- Basic Sciences
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Question 24
Incorrect
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What is the primary factor that increases the risk of thiamine (vitamin B1) deficiency?
Your Answer: Vegetarians
Correct 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.
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This question is part of the following fields:
- Basic Sciences
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Question 25
Incorrect
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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.
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This question is part of the following fields:
- Basic Sciences
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Question 26
Correct
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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: 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.
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This question is part of the following fields:
- Basic Sciences
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Question 27
Correct
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Which food is a rich source of vitamin D in the diet?
Your Answer: Oily fish
Explanation:Sources of Vitamin D
Vitamin D is a type of fat-soluble vitamin that can be found in certain foods such as cheese, butter, eggs, and oily fish. However, vegetable sources of vitamin D are limited, although some foods are fortified with this vitamin. For instance, 100 grams of sundried shiitake mushrooms contain 1600 IU of vitamin D, while one egg contains 20 IU. Wild salmon is also a good source of vitamin D, with 100 grams containing 800 IU, while farmed salmon contains 200 IU.
Aside from food sources, sunlight is also a good source of vitamin D. Exposure of arms and legs to sunlight for 10-15 minutes can provide 3000 IU of vitamin D. However, it is difficult to obtain the daily requirement of 25-50 IU of vitamin D through sunlight alone, especially for people living in temperate climates. As a result, many people may have insufficient vitamin D levels. It is important to ensure that we get enough vitamin D through a combination of food sources and sunlight exposure.
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This question is part of the following fields:
- Basic Sciences
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Question 28
Correct
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A 50-year-old female patient with varicose veins presents to the vascular clinic for evaluation.
During the assessment, a test is conducted to determine the location of incompetence. The patient is instructed to lie down, and the veins are emptied by elevating her legs off the couch. The examiner then identifies the site of the sapheno-femoral junction and applies pressure with their fingers. The patient is then asked to stand up to evaluate vein filling.
What is the name of this test?Your Answer: Trendelenburg's test
Explanation:Assessing Varicose Vein Site of Incompetence
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 site, while in the tourniquet test, a tourniquet is placed just below the junction level.
If the veins fill quickly upon standing, it indicates that the sapheno-femoral junction is not the source of the incompetence. These tests are essential in determining the location of the varicose vein site of incompetence, which is crucial in planning the appropriate treatment. By identifying the site of incompetence, physicians can perform targeted interventions to improve venous function and alleviate symptoms. Therefore, the Trendelenburg and tourniquet tests are valuable tools in the diagnosis and management of varicose veins.
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This question is part of the following fields:
- Basic Sciences
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Question 29
Incorrect
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What are the potential clinical consequences of a lack of vitamin E?
Your Answer: Excessive bleeding
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.
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This question is part of the following fields:
- Basic Sciences
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Question 30
Correct
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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.
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This question is part of the following fields:
- Basic Sciences
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