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Question 1
Correct
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What is the body's mechanism for handling excess nitrogen?
Your Answer: It is metabolised via the urea cycle
Explanation:The Urea Cycle: Processing Excess Nitrogen
Excess nitrogen in the form of ammonia or ammonium is converted into urea through the urea cycle. This process occurs mainly in the liver and allows for the excretion of excess nitrogen in the urine.
The urea cycle begins in the mitochondria, where ammonia combines with carbon dioxide and ATP to form carbamoyl phosphate. This compound then combines with ornithine to form citrulline. The process continues in the cytoplasm of the cell, where a series of reactions eventually leads to the production of urea.
Overall, the urea cycle is an important process for maintaining nitrogen balance in the body. By converting excess nitrogen into urea, the body can safely excrete it and prevent harmful buildup.
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This question is part of the following fields:
- Clinical Sciences
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Question 2
Incorrect
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A study recruits a random sample of 5,000 individuals over the age of 50 and asks about their use of herbs and other health supplements. Participants are then followed-up for five years. The study aims to compare the incidence of colon cancer among participants to see if the use of herbs or health supplements has any effect.
What type of study is this?Your Answer: Case-control study
Correct Answer: Cohort study
Explanation:Different Types of Studies
When it comes to conducting research, it is important to understand the characteristics of different types of studies as they serve different purposes. For instance, a cohort study is typically used to investigate risk factors of diseases. On the other hand, a case-control study begins with identifying cases of a particular disease and controls who are not affected. Unlike a cohort study, a case-control study does not require waiting for the occurrence of the disease.
Qualitative studies, on the other hand, are used to explore variables that are not easily quantifiable, such as opinions and thoughts of patients. These studies are not suitable for studying the incidence and risk of diseases. Lastly, a randomized controlled trial involves researchers assigning treatment instead of participants choosing their own treatment.
In summary, the characteristics of different types of studies is crucial in selecting the appropriate research method for a particular research question.
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This question is part of the following fields:
- Clinical Sciences
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Question 3
Correct
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A neonatal hearing screening program screened 10,000 newborns using otoacoustic emissions (OAE), which has a sensitivity of 80%. Out of the screened subjects, 200 failed the test and were invited for a brainstem auditory evoked potential (BAEP) test, which is the gold standard for diagnosing hearing impairment in newborns. The BAEP test confirmed that 100 of the 200 subjects had hearing impairment. What is the correct statement regarding this scenario?
Your Answer: If the prevalence of hearing impairment increases, the positive predictive value of OAE will increase
Explanation:The Impact of Disease Prevalence on Screening Test Results
Screening tests are commonly used to detect the presence of a disease in a population. The accuracy of a screening test is typically measured by its sensitivity and specificity, which are not significantly affected by the prevalence of the disease. However, the positive predictive value (PPV) and negative predictive value (NPV) of a screening test can be influenced by disease prevalence.
When the prevalence of a disease increases, the PPV of a screening test will also increase. This means that a positive test result is more likely to be a true positive when the disease is more common in the population. On the other hand, the NPV of a screening test will decrease as disease prevalence increases. This means that a negative test result is less likely to be a true negative when the disease is more prevalent.
Therefore, it is important to consider disease prevalence when interpreting the results of a screening test. A high PPV indicates a greater likelihood of disease presence, while a low NPV suggests a higher risk of false negatives. Healthcare professionals should take into account the prevalence of the disease in the population being screened to accurately interpret the results of a screening test.
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This question is part of the following fields:
- Clinical Sciences
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Question 4
Incorrect
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What is the location of pancreatic beta-cells?
Your Answer: In acini
Correct Answer: At the centre of islets of Langerhans
Explanation:The Pancreas and its Beta-Cells
The pancreas is a gland with both exocrine and endocrine functions. The exocrine part of the pancreas is made up of acini and ducts that secrete digestive enzymes into the small intestine. The endocrine part of the pancreas is composed of the islets of Langerhans, which are clusters of cells scattered throughout the pancreas. These islets contain alpha-cells, beta-cells, and delta-cells.
Beta-cells are the most abundant cells in the islets of Langerhans and are located in the center of the islets. They are responsible for producing and secreting insulin, a hormone that regulates blood sugar levels. Alpha-cells, on the other hand, produce glucagon, which raises blood sugar levels. Delta-cells produce somatostatin, which inhibits the release of insulin and glucagon.
In summary, the pancreas is a gland with both exocrine and endocrine functions. The endocrine part of the pancreas is made up of the islets of Langerhans, which contain alpha-cells, beta-cells, and delta-cells. Beta-cells are the most numerous cells in the islets and are responsible for producing and secreting insulin.
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This question is part of the following fields:
- Clinical Sciences
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Question 5
Incorrect
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A 35-year-old man arrives at the emergency department with chest pain. He confesses to using cocaine. Upon examination, his heart rate is 110 bpm and his blood pressure is 118/76 mmHg. An ECG reveals T wave inversion in leads V3-V6. What part of his heart has been impacted?
Your Answer: Anterior
Correct Answer: Anterolateral
Explanation:ECG Leads and Myocardial Infarction
The T wave inversion on an electrocardiogram (ECG) can indicate a non-ST elevation myocardial infarction (MI) caused by cocaine abuse. The ECG has different leads that correspond to different areas of the heart. The septal leads are V1-V2, the anterior leads are V3-V4, the lateral leads are V5-V6, I, and aVL, and the inferior leads are II, III, and aVF. However, detecting posterior infarcts on a 12-lead ECG can be challenging. Some medical centers use additional ECG leads V7-9 to help identify posterior infarcts.
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This question is part of the following fields:
- Clinical Sciences
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Question 6
Incorrect
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What is the name of the intercellular junctional mechanism that allows cells to be electrically connected?
Your Answer: Tight junction
Correct Answer: Gap junction
Explanation:Cell Junctions: Types and Functions
Gap junctions are found where two adjacent cell membranes meet, allowing for electrical communication between cells. Desmosomes are specialized proteins that help cells stick together, particularly in epithelial tissue. Tight junctions prevent water and solutes from leaking out of cells. Zonula adherens junctions are cell junctions that connect to the actin cytoskeleton. These different types of cell junctions play important roles in maintaining the structure and function of tissues in the body.
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This question is part of the following fields:
- Clinical Sciences
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Question 7
Correct
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What is a frequent reason for mortality in individuals with severe malnutrition?
Your Answer: Infection
Explanation:The Deadly Consequences of Severe Malnutrition
Severe malnutrition is a widespread problem that affects millions of people worldwide. It is responsible for approximately 50% of deaths in childhood and infancy. One of the most common causes of death in malnourished individuals is severe infection. Malnutrition weakens the immune system, making it more difficult for the body to fight off infections. This is especially true for those living in poverty, with poor access to food, and in areas affected by famine, war, or conflict. These conditions often lead to poor water sanitation, disrupted infrastructure for sewerage, and close living quarters, which increase the likelihood of infection.
In addition to infections, arrhythmias are also a significant cause of death in people with severe malnutrition. Malnutrition often leads to hypokalaemia, a condition where there is a low level of potassium in the blood. Refeeding a malnourished person can worsen this electrolyte disturbance, creating an arrhythmogenic environment that can be fatal.
In conclusion, severe malnutrition has deadly consequences, with severe infection and arrhythmias being the leading causes of death. Addressing the root causes of malnutrition, such as poverty and poor access to food, is crucial in preventing these tragic outcomes.
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This question is part of the following fields:
- Clinical Sciences
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Question 8
Incorrect
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Ms. Johnson is a 35-year-old asthmatic woman with severe community acquired pneumonia. She has been admitted to the intensive care unit for cardiovascular support. Currently, her blood pressure is 80/64 mmHg, heart rate is 128 bpm, and cardiac output is 3.2 L/min. Ms. Johnson is receiving 15 L/min of oxygen through a facemask and has oxygen saturations of 88% with a respiratory rate of 16. Her temperature is 39.6°C. What is the estimated stroke volume for Ms. Johnson?
Your Answer: 40 ml
Correct Answer: 25 ml
Explanation:Cardiac Output and its Relationship to Health Conditions
Cardiac output is the product of heart rate and stroke volume. Stroke volume can be calculated by dividing cardiac output by heart rate. The average cardiac output is 5 liters per minute, with a normal stroke volume ranging from 50-85 milliliters per beat, depending on heart rate.
When a person experiences poor oxygen saturation and a normal respiratory rate, it may indicate that they are becoming exhausted and unable to breathe rapidly. This, combined with low blood pressure, tachycardia, and a failure to maintain cardiac output, can be indicative of shock. Additionally, a high temperature may suggest severe sepsis secondary to pneumonia.
cardiac output and its relationship to various health conditions can help medical professionals diagnose and treat patients more effectively. By monitoring heart rate, stroke volume, and other vital signs, healthcare providers can identify potential issues and intervene before they become life-threatening. Proper management of cardiac output is crucial for maintaining overall health and preventing serious complications.
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This question is part of the following fields:
- Clinical Sciences
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Question 9
Incorrect
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What is the leading reason for hypoglycemia in adults?
Your Answer: Indomethacin
Correct Answer: Treated diabetes mellitus
Explanation:Hypoglycaemia in Adults
Hypoglycaemia is a condition where the blood glucose level falls below the typical fasting level, which is around <4 mmol/L for an adult. This condition can cause various symptoms, including tremors, sweating, nausea, lightheadedness, hunger, and disorientation. Severe hypoglycaemia can even lead to confusion, aggressive behaviour, and reduced consciousness. Drug-treated diabetes mellitus is the most common cause of hypoglycaemia in adults, especially due to insulin or hypoglycaemia drugs like sulphonylureas. Type 1 diabetes patients are at a higher risk of hypoglycaemia due to hypoglycaemia unawareness and blunted glucagon response. However, mild hypoglycaemia is common during fasting, pregnancy, and minor illness. Apart from diabetes, other causes of hypoglycaemia in adults include non-diabetic drugs, alcohol, hepatic failure, critical illness, hormone deficiency, malignancy, insulinoma, non-insulinoma pancreatogenous hypoglycaemia syndrome (NIPHS), and bariatric surgery. It is essential to understand the causes and symptoms of hypoglycaemia to manage the condition effectively. Early diagnosis and treatment can prevent severe complications and improve the quality of life for individuals with hypoglycaemia.
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This question is part of the following fields:
- Clinical Sciences
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Question 10
Incorrect
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What respiratory disorder is identified by the existence of Curschmann's spirals and Charcot-Leyden crystals?
Your Answer: Pulmonary fibrosis
Correct Answer: Asthma
Explanation:Respiratory Pathologies and Their Pathological Features
Asthma is a respiratory pathology that is characterized by an excessive inflammatory response of the small bronchial airways to harmless stimuli. This response involves the infiltration of eosinophils, which can aggregate and form Charcot-Leyden crystals. The accumulation of mucus in the airways can lead to the formation of Curschmann spirals. Bronchiectasis is another respiratory pathology that involves the progressive dilation of the small airways. COPD shares similar features with chronic asthma, but with more marked smooth muscle hyperplasia. Cystic fibrosis has pathological features similar to bronchiectasis, but it predominantly affects the upper lobes. Pulmonary fibrosis is a pathological term for the deposition of excess connective and fibrous tissue in the pulmonary interstitial space. Although there are multiple causes, the underlying pathology is the same.
In summary, respiratory pathologies can have different pathological features, but they all involve some form of inflammation or structural damage to the airways. Asthma, bronchiectasis, COPD, cystic fibrosis, and pulmonary fibrosis are some of the most common respiratory pathologies. their underlying pathology is crucial for developing effective treatments and improving patient outcomes.
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This question is part of the following fields:
- Clinical Sciences
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Question 11
Incorrect
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A 67-year-old woman is scheduled for a total hip replacement on her right side. The surgeon plans to use the lateral approach to access the hip joint, which involves dividing the tensor fascia lata, as well as the gluteus medius and minimus muscles. However, this approach poses a risk to the nerve supply of these muscles. Can you identify the nerve that innervates the tensor fascia lata and gluteus medius muscles?
Your Answer: Lateral femoral cutaneous nerve of the thigh
Correct Answer: Superior gluteal nerve
Explanation:Nerves and Approaches to the Hip Joint
The superior gluteal nerve originates from L4-S1 and exits the pelvis through the greater sciatic foramen. It provides innervation to the gluteus medius, gluteus minimus, and tensor fascia lata muscles. However, the nerves in danger depend on the approach used to access the hip joint.
The posterior approach involves an incision through the deep fascia and gluteus maximus, followed by division of the external rotators. This approach puts the sciatic nerve at risk. On the other hand, the anterior approach involves the planes between tensor fascia lata and sartorius, and then rectus femoris and gluteus medius. This approach endangers the lateral femoral cutaneous nerve of the thigh.
In summary, the nerves at risk during hip joint access depend on the approach used. The posterior approach puts the sciatic nerve in danger, while the anterior approach endangers the lateral femoral cutaneous nerve of the thigh. It is important for medical professionals to be aware of these potential risks to minimize complications during hip joint procedures.
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This question is part of the following fields:
- Clinical Sciences
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Question 12
Correct
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What is the molecule produced at the end of glycolysis that connects to the Kreb cycle?
Your Answer: Acetyl CoA
Explanation:The Process of Energy Production from Glucose
The process of producing energy from glucose involves several steps. The first step is glycolysis, where glucose is converted into fructose 1,6 bisphosphate and split into two 3-carbon particles. These particles are then converted into acetyl CoA, which provides the link with the Kreb cycle. The Kreb cycle, also known as the tricarboxylic acid cycle, is a process where organic acids are modified in a series of steps to produce NADH. Succinate and oxaloacetate are intermediates in the Kreb cycle.
The final step in the process is the electron transfer chain, which occurs inside mitochondria. The NADH generated during the Kreb cycle is used to produce energy in the form of adenosine triphosphate (ATP) by a series of redox reactions. This process is essential for the production of energy in the body, as ATP is the primary source of energy for cellular processes. By the process of energy production from glucose, we can better understand the importance of maintaining a healthy diet and lifestyle to ensure optimal energy production in the body.
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This question is part of the following fields:
- Clinical Sciences
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Question 13
Incorrect
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A 45-year-old man presents with erectile dysfunction and a history of poorly controlled type 2 diabetes mellitus. What is the percentage of men over the age of 45 with erectile dysfunction who have an underlying organic cause?
Your Answer: 20%
Correct Answer: 50%
Explanation:Erectile Dysfunction
Erectile dysfunction, also known as impotence, is a condition where a man is unable to maintain an erection long enough for satisfactory sexual intercourse. This condition is more common in older men, but it can also affect younger men due to psychological factors such as depression, stress, and performance anxiety.
However, around 50% of men over the age of 40 who suffer from erectile dysfunction have an underlying organic cause. This is often due to vascular and neuropathic consequences of diabetes, but it can also be caused by neurological pathology such as spinal cord trauma and multiple sclerosis, as well as hyperprolactinaemia.
It’s important to note that certain prescription drugs can also cause erectile dysfunction, particularly anti-hypertensives and diuretics.
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This question is part of the following fields:
- Clinical Sciences
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Question 14
Correct
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You are invited to witness a lumbar puncture on a 32-year-old male.
At what level of the vertebrae does the spinal cord typically terminate?Your Answer: L2
Explanation:The Importance of Knowing the Termination of the Spinal Cord
In most adults, the spinal cord ends at the level of L1/L2, while the cauda equina continues downwards within the vertebral column. However, there is some variation in adults, and in children, the spinal cord may extend as far as L3. It is crucial to be aware of this variation because trauma to the spinal cord during lumbar puncture can result in significant paralysis.
Moreover, identifying the interspace L3/4 using Tuffier’s line, which is drawn between both iliac crests, is highly inaccurate. This inaccuracy can lead to an inadvertent high lumbar puncture, which can cause complications. Therefore, it is essential to have a clear of the termination of the spinal cord to avoid any potential harm during medical procedures.
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This question is part of the following fields:
- Clinical Sciences
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Question 15
Incorrect
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Which tumour suppressor gene experiences loss of function as a late event in the multistep development model of colorectal carcinogenesis?
Your Answer: Bcl-2
Correct Answer: p53
Explanation:The Role of Tumor Suppressor Genes and Oncogenes in Colorectal Cancer
Colorectal cancer is a type of cancer that develops through a series of changes in the epithelium, known as the adenoma-carcinoma sequence. This process involves the accumulation of mutations in tumor suppressor genes and oncogenes. One of the most important tumor suppressor genes is p53, which is activated by cellular damage and oncogene activation. When activated, p53 inhibits cell growth and induces senescence or apoptosis. However, loss of functional p53 is a late event in colorectal carcinogenesis.
Another important tumor suppressor gene involved in the beta-catenin pathway is APC. It is mutated relatively early in the formation of colorectal cancers and is involved in regulating cell growth. On the other hand, Bcl-2 is an oncogene that promotes cell survival by inhibiting apoptosis. It is expressed in almost all cells as a constitutive survival factor.
c-Myc is another oncogene that plays a role in the production of pro-growth genes. It is the end product of the beta-catenin pathway. Finally, kRAS is a tyrosine kinase oncogene that signals downstream from a number of growth-factor receptors, such as EGFR. It is mutated or somewhere in its pathway in almost all tumors.
In summary, the development of colorectal cancer involves the accumulation of mutations in tumor suppressor genes and oncogenes. While p53 is the most important tumor suppressor gene, loss of its function is a late event in colorectal carcinogenesis. APC, Bcl-2, c-Myc, and kRAS are other important genes involved in regulating cell growth and survival in colorectal cancer.
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This question is part of the following fields:
- Clinical Sciences
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Question 16
Incorrect
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A 20-year-old medical student comes to you with complaints of shoulder pain and limited mobility after a rough tackle during a rugby match. Upon examination, you observe that his shoulder is visibly dislocated, leading you to suspect an anterior shoulder dislocation. Can you identify which nerve is most vulnerable to injury in this case?
Your Answer: Radial nerve
Correct Answer: Axillary nerve
Explanation:Nerve Injuries in the Upper Arm
When the proximal humerus moves downward, it can cause damage to the nerves of the brachial plexus, particularly the axillary nerve. Signs of axillary nerve damage include sensory loss on the lateral side of the upper arm, inability to raise the arm (deltoid), and weakened lateral rotation (teres minor).
Other nerve injuries in the upper arm include median nerve damage, which can cause tingling in the thumb and first two and a half digits, as well as loss of function in the thenar muscles. Musculocutaneous nerve damage can lead to tingling in the lateral forearm and inability to flex the elbow. Radial nerve damage can cause tingling in the posterior compartment of the forearm and dorsum of the hand, as well as wrist drop. Ulnar nerve damage can result in tingling in the little finger and medial half of the ring finger, as well as loss of grip strength.
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This question is part of the following fields:
- Clinical Sciences
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Question 17
Correct
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A study was conducted to investigate the relationship between television watching and lung cancer. The results showed that individuals who watched television for over five hours per day had a 30% higher risk of developing lung cancer (p=0.01). Additionally, these individuals were more likely to be smokers (p=0.02). What is the correct statement regarding these findings?
Your Answer: The risk of lung cancer for patients who watched television for more than five hours a day will reduce if smokers are excluded from analysis
Explanation:The Relationship between Television Watching and Lung Cancer
The relationship between television watching and lung cancer is not straightforward. While it may appear that watching television for more than five hours a day increases the risk of lung cancer, there are confounding factors that need to be considered. Smoking, for example, is a significant confounder since it is associated with both television watching and lung cancer.
To determine the true relationship between television watching and lung cancer, further analyses of results are needed. It is insufficient to simply exclude smokers from the study since the information given in the question is not enough to make such a conclusion. While previous studies have shown that smoking is associated with lung cancer, we cannot assume that this is the only factor at play.
In summary, while it may seem that watching television for extended periods of time increases the risk of lung cancer, significant confounding by smoking is present. Therefore, we cannot conclude that watching television is a significant risk factor for lung cancer without further analysis.
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This question is part of the following fields:
- Clinical Sciences
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Question 18
Incorrect
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A 25-year-old male is brought in after a possible heroin overdose. His friend discovered him on the floor of his apartment, where he may have been for a full day. The patient is groggy but responsive and reports experiencing muscle soreness. The medical team suspects rhabdomyolysis and wants to conduct a blood test to assess muscle damage. What specific blood test would be helpful in this evaluation?
Your Answer: Protein C
Correct Answer: Creatine kinase
Explanation:Rhabdomyolysis: Causes and Consequences
Rhabdomyolysis is a serious medical condition that occurs when muscle cells break down and release their contents into the interstitial space. This can lead to a range of symptoms, including muscle pain and weakness, hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia, and brown discoloration of the urine. In severe cases, rhabdomyolysis can cause cardiac arrhythmias, renal failure, and disseminated intravascular coagulation (DIC).
There are many different factors that can trigger rhabdomyolysis, including crush injuries, toxic damage, drugs and medications, severe electrolyte disturbances, reduced blood supply, ischemia, electric shock, heat stroke, and burns. One of the key diagnostic markers for rhabdomyolysis is elevated levels of creatine kinase in the blood.
Treatment may involve addressing the underlying cause of the muscle breakdown, managing electrolyte imbalances, and providing supportive care to prevent complications. By the causes and consequences of rhabdomyolysis, individuals can take steps to protect their health and seek prompt medical attention if necessary.
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This question is part of the following fields:
- Clinical Sciences
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Question 19
Incorrect
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What is the hormone that can be synthesized from cholesterol in the adrenal glands?
Your Answer: Oxytocin
Correct Answer: Cortisol
Explanation:The Role of Cholesterol in Hormone Production
Cholesterol plays a crucial role in the production of steroid hormones, which are essential for various bodily functions. These hormones are produced in the adrenal glands and include progesterone, cortisol, aldosterone, oestrogens, and androgens. Progesterone is important in pregnancy, while cortisol and other glucocorticoids are required by all body cells and play a role in the fight-or-flight response and glucose homeostasis. Aldosterone regulates salt and water balance, while oestrogens and androgens are required for the development of female and male characteristics, respectively.
The production of steroid hormones is a complex process that involves multiple pathways and is influenced by various factors such as the body’s metabolic needs and the abundance of hormones already present in the cell. Enzyme mutations or deficiencies in this pathway can lead to disorders that affect salt and water balance and reproductive function, such as congenital adrenal hyperplasia.
In addition to steroid hormones, other hormones such as antidiuretic hormone and oxytocin are produced in the posterior pituitary gland, while thyroid hormone is made in the thyroid gland in the neck and parathyroid hormone is made in the parathyroid glands located behind the thyroid gland. the role of cholesterol in hormone production is crucial for maintaining overall health and preventing hormonal imbalances.
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This question is part of the following fields:
- Clinical Sciences
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Question 20
Correct
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You are participating in a seminar about eating disorders. What renal alteration is common in individuals with extreme malnourishment?
Your Answer: Reduced glomerular filtration rate
Explanation:Renal Physiology Changes in Severe Malnutrition
Patients with severe malnutrition experience changes in their renal physiology due to reduced food intake. These changes include an increased secretion of aldosterone and a reduced glomerular filtration rate (GFR), which alters the excretion patterns of many solutes, electrolytes, and drugs. As a result, there is an increased urinary excretion of potassium, calcium, magnesium, and phosphate, leading to a tendency for hypokalaemia, hypocalcaemia, hypomagnesaemia, and hypophosphataemia over time.
Furthermore, the reduced muscle bulk in individuals with severe malnutrition causes low levels of production of urea and creatinine. However, reduced excretion causes plasma levels to remain normal or only slightly reduced. As muscle is broken down to provide substrates for gluconeogenesis, a negative nitrogen balance ensues. Additionally, urate excretion is reduced, causing a relative hyperuricaemia.
In summary, severe malnutrition affects renal physiology, leading to altered excretion patterns of various solutes, electrolytes, and drugs. These changes can result in imbalances in potassium, calcium, magnesium, and phosphate levels. Furthermore, the breakdown of muscle tissue can cause a negative nitrogen balance, while reduced urate excretion can lead to hyperuricaemia.
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This question is part of the following fields:
- Clinical Sciences
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Question 21
Correct
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What is the usual initiator of the complement system cascade in the absence of specific antibodies?
Your Answer: C3b
Explanation:The Complement Cascade and its Three Pathways
The complement cascade is a series of pro-enzymes found in the serum and tissue space that are activated by generic pathogenic markers. There are three pathways to activation: alternative, mannose-binding lectin, and classical. The classical pathway requires the presence of antigen-specific antibody or C-RP. This pathway predominates in response to re-challenge of a bacterium. However, when faced with a new bacterium, C3b binds to foreign surfaces and activates the alternative pathway.
C1 is an early component of the classical pathway, while C3a is the other part formed from hydrolysis of C3 and causes mast cell degranulation. C5 acts as a neutrophil chemoattractant, while C6-9b form the membrane-attack complex, which causes bacterial lysis. the complement cascade and its pathways is crucial in developing effective treatments for infections and other diseases.
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This question is part of the following fields:
- Clinical Sciences
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Question 22
Incorrect
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What antenatal biomarker is linked to the inability to form vertebral arches?
Your Answer: Reduced amniotic fluid inhibin-A
Correct Answer: Raised maternal serum alpha-feto protein (AFP)
Explanation:Vertebral Arch Development and Neural Tube Defects
The vertebral arches are formed from the paravertebral somites and grow posteriorly to encase the dorsal aspect of the spinal cord. Failure of development or fusion of the vertebral arches can lead to neural tube defects, which range from anencephaly to meningomyelocele and myelocele. These defects are associated with a significantly raised maternal serum alpha-feto protein and can be detected on antenatal ultrasound scans.
Biomarkers for Down Syndrome Risk Stratification
Several biomarkers are used in the risk-stratification screening for Down syndrome. These tests, performed on maternal serum, include PAPP-A, beta-HCG, AFP, uE3, and inhibin-A. Increased risk for Down syndrome occurs when PAPP-A and AFP are reduced, beta-HCG and inhibin-A are raised, and uE3 is reduced. These tests are used in combination with nuchal fold thickness to provide risk stratification for trisomy 21. Mothers of high-risk fetuses are offered diagnostic testing, such as amniocentesis or chorionic villus sampling.
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This question is part of the following fields:
- Clinical Sciences
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Question 23
Incorrect
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A 42-year-old male patient is experiencing acute renal failure, fever, weight loss, and livedo reticularis. Upon renal biopsy, there is evidence of neutrophilic and eosinophilic infiltration in artery walls with fibrinoid necrosis. What is the most probable circulating antibody present in this patient?
Your Answer: AMA
Correct Answer: ANCA
Explanation:Polyarteritis Nodosa and Associated Antibodies
Polyarteritis nodosa (PAN) is a type of vasculitis that affects medium-sized arteries, particularly those in the renal vasculature. Patients with PAN may experience vague symptoms such as malaise, weight loss, anemia, fever, and non-specific pains. However, more specific features of PAN include acute renal failure with beading of the renal vessel on angiography, livedo reticularis, the presence of pANCA in the blood, and granulomas with eosinophilic infiltrate on biopsy. While the majority of PAN cases are idiopathic, it can also be associated with hepatitis B virus infection.
In addition to PAN, there are other autoimmune or inflammatory conditions that may be associated with specific antibodies. For example, anti-mitochondrial antibody (AMA) is strongly associated with primary biliary cirrhosis, while Antinuclear antibodies (ANA) are non-specific and may be present in conditions such as SLE, autoimmune hepatitis, post-infection, and inflammatory bowel disease. Therefore, the presence of certain antibodies can aid in the diagnosis and management of these conditions.
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This question is part of the following fields:
- Clinical Sciences
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Question 24
Correct
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What is responsible for the depolarization phase of the cardiac action potential?
Your Answer: Sodium channels opening
Explanation:The Phases of Cardiac Action Potential
The cardiac action potential is a complex process that involves several phases. The first phase, known as phase 0 or the depolarisation phase, is initiated by the opening of fast Na channels, which allows an influx of Na ions into the cell. This influx of ions causes the membrane potential to become more positive, leading to the contraction of the heart muscle.
Following phase 0, the second phase, known as phase 1 or initial repolarisation, occurs when the Na channels close. This closure causes a brief period of repolarisation, where the membrane potential becomes more negative.
The third phase, known as phase 2 or the plateau phase, is characterised by the opening of K and Ca channels. The influx of calcium ions into the cell is balanced by the efflux of potassium ions, leading to a stable membrane potential. This phase is important for maintaining the contraction of the heart muscle.
Finally, phase 3 or repolarisation occurs when the Ca channels close, causing a net negative current as K+ ions continue to leave the cell. This phase allows the membrane potential to return to its resting state, ready for the next cardiac action potential.
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This question is part of the following fields:
- Clinical Sciences
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Question 25
Correct
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What is the enzyme responsible for catalyzing the rate limiting step in glycolysis?
Your Answer: Phosphofructokinase
Explanation:The Rate Limiting Step of Glycolysis
The conversion of fructose 6 phosphate to fructose 1,6,bisphosphate is the main rate limiting step of the glycolysis pathway. This conversion is catalysed by the enzyme phosphofructokinase in the presence of ATP. However, excessive cellular concentrations of ATP can inhibit the activity of phosphofructokinase. This inhibition encourages the storage of excess glucose as glycogen instead of making excessive ATP in times of abundance. On the other hand, when there is cellular abundance of ATP but it is undergoing rapid degradation to AMP, the rising levels of AMP reduce the effect of high concentrations of ATP on the inhibition of the enzyme. Although several other steps in the glycolysis pathway are under control or inhibition in times of cellular ATP abundance or due to an accumulation of the products of glycolysis, phosphofructokinase is considered the main rate limiting step of glycolysis.
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This question is part of the following fields:
- Clinical Sciences
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Question 26
Incorrect
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What is the daily recommended amount of carbohydrates to consume?
Your Answer: 200 g
Correct Answer: 50 g
Explanation:The Importance of Carbohydrates in the Diet
Carbohydrates are essential for the body as they provide fuel for the brain, red blood cells, and the renal medulla. Although the average daily intake of carbohydrates is around 180 g/day, the body can function on a much lower intake of 30-50 g/day. During pregnancy or lactation, the recommended minimum daily requirement of carbohydrates increases to around 100 g/day.
When carbohydrate intake is restricted, the body can produce glucose through gluconeogenesis, which is the process of making glucose from other fuel sources such as protein and fat. However, when carbohydrate intake is inadequate, the body produces ketones during the oxidation of fats. While ketones can be used by the brain as an alternative fuel source to glucose, prolonged or excessive reliance on ketones can lead to undesirable side effects. Ketones are acidic and can cause systemic acidosis.
It is important to note that most people consume 200-400 g/day of carbohydrates, which is much higher than the recommended minimum daily requirement. Therefore, it is essential to maintain a balanced diet that includes carbohydrates in the appropriate amount to ensure optimal health.
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This question is part of the following fields:
- Clinical Sciences
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Question 27
Incorrect
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Which type of lipoprotein is involved in the development of atherosclerosis observed in coronary artery disease?
Your Answer: High density lipoprotein (HDL)
Correct Answer: Low density lipoprotein (LDL)
Explanation:Atherosclerosis: The Gradual Narrowing of Arteries
Atherosclerosis is a gradual process that involves the narrowing of arteries due to the accumulation of lipid-rich deposits within artery walls. This condition can take many years to develop and is the primary cause of coronary heart disease, peripheral vascular disease, and ischemic stroke. When a clot forms over an atherosclerotic plaque, it can lead to a heart attack by blocking blood flow to the cardiac muscle.
Monocytes from the blood absorb oxidized LDL particles to form lipid-laden foam cells, which accumulate in the vessel walls and eventually form fatty streaks and atherosclerotic plaques. These foam cells secrete cytokines and chemokines that promote smooth muscle cell proliferation, contributing to the development of the atherosclerotic plaque. Any damage to the plaque can result in the release of tissue factor, which promotes clot formation.
LDL can easily form oxidized LDL, especially in the presence of haem, which is released from damaged red blood cells in areas of turbulent blood flow. Inflammation, obesity, diabetes, and impaired glucose tolerance can also contribute to the formation of oxidized LDL. the causes and mechanisms of atherosclerosis is crucial in preventing and treating this condition.
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This question is part of the following fields:
- Clinical Sciences
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Question 28
Incorrect
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A 79-year-old man comes in with red, velvety lesions in his mouth. Upon biopsy, it is revealed that there is epithelial atrophy and moderate dysplasia. What is the name of this condition?
Your Answer: Patterson-Brown-Kelly syndrome
Correct Answer: Erythroplakia
Explanation:Pre-Malignant Conditions and Tongue Abnormalities
Erythropakia and leukoplakia are two pre-malignant conditions that affect the mouth. They are characterized by the presence of dysplastic epithelial cells that can develop into squamous cell carcinoma if left untreated. Leukoplakia is more common than erythroplakia and appears as white patches that do not move with physical rubbing. On the other hand, erythroplakia appears as red, velvety patches. Both conditions are more common in older individuals and are associated with alcohol consumption and smoking.
Glossitis is a condition that involves inflammation of the tongue. It can occur in response to various factors such as vitamin B12 deficiency, Sjögren’s syndrome, and Crohn’s disease. Macroglossia, on the other hand, is an enlargement of the tongue that can be either congenital or acquired. Congenital causes include Down syndrome and Beckwith-Weideman syndrome, while acquired causes include vascular malformations, hypothyroidism, acromegaly, and amyloidosis.
Patterson-Brown-Kelly syndrome is a rare condition that causes dysphagia. It occurs when chronic, severe iron deficiency anemia stimulates the formation of an upper esophageal web. This web can cause difficulty swallowing and may require treatment such as dilation or surgery. Overall, it is important to be aware of these various conditions and seek medical attention if any symptoms arise.
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This question is part of the following fields:
- Clinical Sciences
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Question 29
Correct
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In response to cigarette smoke, does the respiratory epithelium undergo metaplasia and if so, what type of epithelial cell does it form?
Your Answer: Stratified squamous
Explanation:Epithelial Tissue and its Metaplasia
Epithelial tissue is a type of tissue that lines the surfaces of organs and structures in the body. Respiratory epithelium, which is made up of pseudostratified, ciliated columnar cells, can undergo a process called metaplasia. This is when the tissue transforms into a different type of tissue. In the case of respiratory epithelium, it can transform into stratified squamous epithelium. This transformation occurs when the cilia on the columnar cells are lost, and the cells become squamous in shape.
This transformation can be problematic, as the squamous cells can become dysplastic and lead to the development of squamous cell carcinoma in the lungs. Small cell carcinoma is another type of cancer that affects epithelial tissue, but its exact origin is not clear.
Different types of epithelial tissue can be found in various parts of the body. Simple columnar epithelium, for example, is commonly found in the stomach. Simple cuboidal epithelium lines the reproductive organs, such as the ovaries and testes. Small cell epithelium lines the large and small intestines, while transitional epithelium can be found in the bladder.
the different types of epithelial tissue and their potential for metaplasia can help in the diagnosis and treatment of various diseases and conditions.
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This question is part of the following fields:
- Clinical Sciences
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Question 30
Incorrect
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A 28-year-old individual is currently undergoing tuberculosis treatment and is being administered vitamin B6 (pyridoxine). What is the primary function of vitamin B6 in the human body?
Vitamin B6, also known as pyridoxine, plays a crucial role in various bodily functions. It is essential for the metabolism of amino acids, which are the building blocks of proteins. Vitamin B6 also aids in the production of neurotransmitters, such as serotonin and dopamine, which are responsible for regulating mood and behavior. Additionally, it is involved in the synthesis of hemoglobin, which is the protein in red blood cells that carries oxygen throughout the body. Therefore, the administration of vitamin B6 as part of tuberculosis treatment may help support the body's immune system and aid in the recovery process.Your Answer: Antioxidant function
Correct Answer: Production of serotonin
Explanation:The Importance of Vitamin B6 in the Human Body
Vitamin B6, also known as pyridoxine, plays a crucial role in various functions of the human body. One of its primary functions is the production of neurotransmitters such as serotonin, dopamine, and norepinephrine, which are essential for regulating mood, behavior, and cognitive processes. Additionally, vitamin B6 acts as a cofactor in cellular reactions required for collagen synthesis, lipid metabolism, and red blood cell function.
The body’s requirement for vitamin B6 increases during periods of growth, pregnancy, and lactation. Consumption of coffee and alcohol, smoking, and certain chronic diseases can also increase the body’s need for this vitamin. Moreover, a high protein diet and administration of certain medications, including azathioprine, corticosteroids, chloramphenicol, oestrogens, levo dopa, isoniazid, penicillamine, and phenytoin, can also increase the body’s demand for vitamin B6.
In some cases, pyridoxine supplementation is necessary, especially for individuals taking isoniazid for tuberculosis. The long treatment regimen required to eliminate tuberculosis increases the risk of vitamin B6 deficiency. Therefore, it is essential to ensure adequate intake of vitamin B6 through a balanced diet or supplementation to maintain optimal health.
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This question is part of the following fields:
- Clinical Sciences
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