JC1 formative exams 0809 Questions and answers

CPB
1. A 52 year old man attends his GP. The patient is an alcoholic and suffers from malnutrition. He tells the doctor that he has noticed that his eyes are feeling very dry and that he has recently started to have difficulty seeing at night. The doctor sends his patient to an ophthalmic consultant who confirms that the patient has xerophthalmia, due to a vitamin deficiency. Which vitamin deficiency results in this eye condition? A) Vitamin C B) Thiamine C) Folic acid D) Vitamin A E)Vitamin D Answer: D

2. A parent brings her 11 month old daughter into hospital for investigations into the reasons for mental and skeletal problems. The infant has hepatosplenomegally and is diagnosed as suffering from one of the mucopolysaccharidoses. This group of diseases is characterized by the intracellular storage of partially degraded: A) mucins B) glycosaminoglycans C) glycogen D) gangliosides E) collagen Answer B

3. The alpha-helical structure in proteins is maintained by a number of factors, including hydrogen bonding between backbone polar groups and interactions between amino-acid sidechains. Which amino acid may disrupt the regularity of an alpha helix due to the small size of its sidechain? A) Aspartate B) Cysteine C) Glycine D) Proline E) Tryptophan Answer: C

4. Activation of receptor operated channels (ROCs)allows for fast transmission of signals, based on ion movement. The channels form a pore complex, which opens on binding of ligand to the receptor. In relation to ligand binding to ROCs, which of the following statements is an accurate reflection of this process? A) One molecule of ligand is sufficient to open the channel. B) The channel is gated by the second transmembrane domain of each subunit. C) Movement of ions with all ROCs is from outside-to-in only. D) ROCs always cause depolarization of excitable membranes E) The rate of signal transmission by ROCs is in the order of minutes Answer: B

5. A 55-year-old woman with atrial fibrillation is to be treated with digoxin. Careful monitoring of the blood concentration of digoxin is required, as doubling the effective concentration may be enough to produce harmful effects of the medication. The degree of safety of a drug is described by the: A) therapeutic index B) dissociation constant (Kd) C) dose that causes toxicity in half a population (TD50) D) dose that causes a half-maximal effect (ED50) E) maximal effective concentration Answer: A

AS
Questions 1 and 2: A 30-year- old man presented with a 3 day history of severe diarrhea, vomiting and headache. He was severely dehydrated and the diagnosis of cholera was made. 1. The condition of the patient was complicated by an acid-base disturbance, which is most likely to be: A) respiratory acidosis B) metabolic alkalosis C) metabolic acidosis D) respiratory alkalosis E) compensated respiratory acidosis ANSWER: C

2. The patient was given oral rehydration therapy with a solution of glucose and salt. The lowest luminal concentration achievable for NaCl in the small intestine is approximately: A) 130 mMoles/L B) 30 mMoles/L C) 30 mEq/L D) 260 mMoles/L E) 260 mEq/L ANSWER: A

3. A 4-week-old infant is referred with projectile vomiting of recent origin, which on investigation is shown to be the result of which developmental abnormality? A) an omphalocoele B) a para-oesophageal hernia C) pyloric stenosis D) a congenitally short oesophagus E) gastroschisis Answer: C

4. A 43-year-old university professor presents with steathorrea visible fat in the faeces. During history taking he admits to a high intake of alcohol due to work stress. Physical examination reveals a mild jaundice. You suspect alcoholic liver disease which has caused impaired fat digestion. During normal digestion, dietary triglyceride will pass into the enterocytes as A) chylomicrons B) diacylglycerols C) unfragmented triglyceride D) monoacylglycerol and free fatty acids E) monoacylglycerols and glycerol ANSWER: D

5. The advantage of Nuseal aspirin is the formulation of a coating that prevents dissolution of the tablet in the stomach. This results in protection of the gastric mucosa by increasing absorption in the intestinal tract. Which of the following mechanisms is most likely to prevent absorption in the intestinal tract? A) Facilitated diffusion B) P-glycoprotein mediated transport C) Carrier-mediated transport D) Pinocytosis E) Passive diffusion Answer = B

NM
1. All living cells develop a potential across their cell membranes. What is the approximate equilibrium potential of Na+ using Nernst equation? A) -90 mV B) -20 mV C) +70 mV D) -110 mV E) +35 mV ANSWER: C 2. The femoral artery A) is a continuation of the internal iliac artery B) enters the thigh by passing superficial to the inguinal ligament C) is the main arterial supply to the lower limb D) lies lateral to the femoral nerve E) has branches, all of which lie deep to the deep fascia of the thigh ANSWER: C 3. The common peroneal nerve is at risk of injury in fractures of the neck of the fibula. That nerve is a branch of the A) sciatic nerve B) lumbosacral trunk C) femoral nerve D) sural nerve E) obturator nerve ANSWER: A 4. The vascular system in a 43-year-old accountant with long-standing diabetes mellitus is being assessed. There are no palpable pulses below his right knee. The dorsalis pedis pulse is normally felt A) medial to the extensor hallucis longus tendon B) distal to the flexor retinaculum of the ankle C) behind the lateral malleolus D) in the cleft between the first and second toes E) by gently pressing the artery against the lateral cuneiform bone ANSWER: B

5. A 35 year old woman presents with skeletal muscle weakness. Neuromuscular transmission is abnormal and a diagnosis of myasthenia gravis is established. Her symptoms are improved by administration of pyridostigmine. The mechanism of action of pyridostigmine is that it: A) increases post-synaptic receptor density B) increases quantal release of acetylcholine C) enhances calcium availability D) is a non-depolarising neuromuscular blocker E) inhibits acetylcholinesterase Answer: E

HIS
1. Christine, a 70 year old woman presents to the Accident and Emergency department after falling down the stairs in her home and is suffering from significant blood loss. Upon examination it is decided a transfusion of three units of blood is required. Blood typing is performed and it is determined that Christine is Type B. In her plasma there are A) Anti-A agglutinins B) Anti-A and Anti-B agglutinin C) Anti-B agglutinins D) Anti-A and Anti-B agglutinogens E) Anti-A agglutinogens ANSWER: A

2. Mountain climbers involved in an attempt to climb Mount Everest (8,848 metres in height) will spend a period of weeks at a high-altitude base-camp (5,300 metres) to allow their bodies to adjust to the lower oxygen partial pressure. Under these conditions the body adapts physiologically by increasing respiratory and heart rates, by increasing erythrocyte numbers and by adjusting the allosteric control of oxygen binding by haemoglobin within the erythrocyte; these changes serve to maximise the delivery of oxygen to the tissues. The most important allosteric regulator of the oxygen binding behaviour of normal adult Haemoglobin (HbA) is: A) 1,3-bisphosphoglyceric-acid B) 2,3-bisphosphoglyceric-acid C) Carbon dioxide D) Carbon monoxide E) Protons ANSWER: B

3. A 54-year-old man presents with shortness of breath and pain in his left side. You suspect myocardial infarction. Elevated levels of which of the following enzymes in his bloodstream would be most diagnostic of myocardial infarction? A) Alkaline Phosphatase B) Creatine Kinase MB C) Creatine Kinase MM D) Lactate Dehydrogenase 5 E) Mitochondrial Alanine Transaminase ANSWER: B

4. Patients that have leukocyte adhesion deficiency have a short life expectancy unless they receive a bone marrow transplant. The disease is caused by a genetic deficiency in the integrin that binds to ICAM. Among other things, this integrin deficiency affects the immune response by causing defective neutrophil migration from the bloodstream to the site of infection. In what aspect of neutrophil migration does the interaction of ICAM and integrin play a role? A) chemokine signaling B) diapedesis C) proliferation D) rolling adhesion E) tight adhesion ANSWER E 5. Cooperation between components of the innate and the adaptive immune system is critical for successful immune response to pathogens. Which of the following interactions is an example of this type of cooperation ? A) Antibody-dependant cell mediated killing by NK cells B) Down-regulation of T-cell mediated immunity by T regulatory cells. C) Induction of apoptosis of tumor cells by cytotoxic T cells. D) Recognition of bacteria by pathogen recognition receptors on phagocytes. E) Secretion of chemokines by endothelial cells. Answer: A

HBS
1. In operant conditioning, __________increases the rate of a response and______________decreases the rate of a response. Pick the correct two words to fill the blanks A) learning and unlearning B) punishment and reinforcement C) reinforcement and punishment D) reinforcement and forgetting E) learning and forgetting ANSWER: C

2. Classicial conditioning is best defined as: A) A type of learning where the future rate of occurrence of a behavior is affected by the consequences following the occurrence of that behavior B) A type of learning in which a stimulus acquires the capacity to evoke a response that was originally evoked by another stimulus C) A type of learning involving new connections in the brain D) A type of learning where experience influences whether behavior occurs again E) A type of learning affected by primary and secondary reinforcers ANSWER: B

3. What three factors affect perception in people? A) Illusion, experience and selective attention B) Sensory, context, experience C) Context, deficits, experience D) Context, situation, selective attention E) Context, experience, selective attention ANSWER: E

4. When someone thinks they remember that one member of class spread a rumour when, in fact, it was someone else, this is referred to as what kind of problem in memory? A) A re-construction problem B) A recall problem C) A source monitoring error D) A mis-information effect E) A neurological problem ANSWER: C

5) Which is the correct definition of anterograde amnesia?

A) Inability to take in new factual information or remember day-to-day events B) A form of traumatic amnesia C) Inability to remember events that happened prior to onset of injury or disease D) A clinical disorder of short term memory affecting recall E) A clinical disorder involving damage to the lateral hippocampus ANSWER: A