Amk Practice Questions - Conception, Foetal, Infancy

Based on the given symptoms and examination findings, the most likely diagnosis is viral meningitis. The patient presents with a sudden onset of symptoms, including headache, vomiting, drowsiness, and fever. The clear cerebrospinal fluid (CSF) obtained from the lumbar puncture suggests a viral rather than bacterial infection. The absence of focal neurological signs and the reactive pupils also support the diagnosis of viral meningitis.

Muscle cell hyperplasia is not an anatomical or physiological change associated with pregnancy. During pregnancy, the body undergoes various changes to accommodate the growing fetus. Increased peripheral vasodilation occurs to meet the increased metabolic demands of the mother and fetus. Elevation and rotation of the heart happen due to the expanding uterus pushing against the diaphragm. Haemorrhoids can occur due to increased pressure on the veins in the rectal area. Increased cardiac output is necessary to supply oxygen and nutrients to the growing fetus. However, muscle cell hyperplasia, which refers to an increase in the number of muscle cells, is not a typical change observed during pregnancy.

Based on the results of the Rinne's and Weber's tests, Sonya perceives sound better through bone conduction than through air conduction in her left ear. This suggests that there is a problem with sound transmission in her left ear, indicating conductive hearing loss. Additionally, Sonya reports that she can hear better in her left ear than her right during the Weber's test, further supporting the presence of conductive hearing loss in her left ear. Therefore, the correct answer is conductive hearing loss in the left ear.

A low lymphocyte count could indicate immunosuppression, which means that the immune system is not functioning properly and is unable to protect the body from infections and diseases. Treatment with cortisol, a type of steroid hormone, can also lead to a low lymphocyte count as it suppresses the immune system.

The cells of the inner cell mass that are exposed to the cavity of the blastocyst are called primitive endoderm. The primitive endoderm is one of the two cell types that differentiate from the inner cell mass during early embryonic development. It plays a crucial role in the formation of the yolk sac and contributes to the development of extraembryonic tissues. These cells are responsible for providing nutrients to the developing embryo and are essential for proper embryonic development.

During puberty, a primary oocyte finishes meiosis 1 before being ovulated. Meiosis 1 is the first division of meiosis, which involves the separation of homologous chromosomes. In this stage, the primary oocyte divides into two cells, one being a secondary oocyte and the other a polar body. The secondary oocyte then enters into meiosis 2, but this division is only completed if fertilization occurs. Therefore, the correct answer is meiosis 1.

The most likely diagnosis in this case is an extradural hematoma. The patient's history of head trauma and loss of consciousness, followed by a period of lucidity and subsequent deterioration, are consistent with the classic presentation of an extradural hematoma. This type of hematoma occurs when there is bleeding between the dura mater and the skull, usually as a result of a skull fracture. The initial unconsciousness is due to the immediate impact, while the lucid interval occurs when the bleeding temporarily stops. However, as the hematoma expands, it puts pressure on the brain, leading to worsening symptoms such as confusion and inability to obey commands.

The correct answer is "in the right labia majora". In an indirect inguinal hernia, the hernia sac follows the path of the spermatic cord or round ligament of the uterus. In females, the round ligament passes through the inguinal canal and may protrude into the labia majora, causing swelling in that area. Therefore, in this case, the swelling would be present in the right labia majora.

A testicular tumor is likely to metastasize to the lateral aortic lymph nodes. The lymphatic drainage of the testicles follows a pathway that includes the para-aortic lymph nodes, which are located along the lateral aspect of the aorta. Therefore, if a testicular tumor spreads through the lymphatic system, it is likely to first involve the lateral aortic lymph nodes.

Bladder carcinoma is likely to metastasize to the external iliac lymph nodes. This is because the lymphatic drainage of the bladder primarily occurs through the external iliac lymph nodes, making them the most likely site for metastasis. The other lymph nodes listed, such as popliteal, lumbar, superficial inguinal, and deep inguinal, are not typically involved in the metastasis of bladder carcinoma.

The spinal cord terminates at the level of L3/L4 in infants. This means that the spinal cord ends at the space between the third and fourth lumbar vertebrae. The termination level may vary slightly among individuals, but L3/L4 is the most common level.

The lymphatic vessels from the vagina drain to the internal and external iliac lymph nodes. These lymph nodes are located in the pelvis and receive lymphatic drainage from the lower abdomen, pelvis, and lower limbs. The internal iliac lymph nodes are situated along the internal iliac artery, while the external iliac lymph nodes are found along the external iliac artery. The lymphatic drainage from the vagina to these lymph nodes is important for immune response and the removal of waste products and pathogens from the vaginal area.

The recommended treatment for HIV involves using a combination of antiretroviral drugs. In this case, the correct answer suggests using two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI). NRTIs work by blocking the reverse transcriptase enzyme, which is necessary for HIV replication, while NNRTIs bind to and inhibit the reverse transcriptase enzyme directly. Using a combination of these drugs helps to prevent the virus from replicating and reduces the viral load in the body, ultimately slowing down the progression of HIV and improving the immune system.

Gonorrhoea should be treated with amoxicillin, ciprofloxacin, or ofloxacin in areas with low prevalence of resistance. In areas where resistance is more common, treatment with ceixime or celfriaxone is recommended. This is because the bacteria that cause gonorrhoea have developed resistance to certain antibiotics over time. Therefore, the choice of treatment depends on the local prevalence of resistance and the effectiveness of the antibiotics in combating the infection.

Chlamydia is a sexually transmitted infection caused by bacteria. It can be treated effectively with antibiotics such as doxycycline, azithromycin, or erythromycin. These medications work by killing the bacteria and reducing the symptoms of the infection. The choice of antibiotic may vary depending on factors such as the severity of the infection, individual patient characteristics, and any potential allergies or contraindications. It is important to complete the full course of antibiotics as prescribed by a healthcare professional to ensure complete eradication of the infection.

Patients with open herpes ulcers should be treated with antiviral medications such as acyclovir, famciclovir, or valaciclovir. These medications are effective in reducing the severity and duration of herpes outbreaks by inhibiting the replication of the virus. They can also help alleviate symptoms and promote faster healing of the ulcers. The choice of medication may depend on various factors, including the patient's medical history, the severity of the ulcers, and the preference of the healthcare provider.

During foetal development, the mesoderm is one of the three primary germ layers that forms early in embryonic development. It gives rise to various structures in the body, including muscles, bones, and connective tissue. These tissues are essential for the development and functioning of the musculoskeletal system, providing support, movement, and protection to the growing foetus.

During fetal development, the endoderm is one of the three primary germ layers that forms the innermost layer of cells. It gives rise to various organs and structures, including the epithelial lining of the gastrointestinal (GI) and respiratory tracts. This means that the cells derived from the endoderm differentiate and form the protective and functional linings of these important systems in the body.

During foetal development, the ectoderm is one of the three primary germ layers that forms the outermost layer of the embryo. It gives rise to various structures including the epidermis of the skin and the nervous system. The epidermis is the outermost layer of the skin, providing protection and acting as a barrier against the external environment. The nervous system, on the other hand, includes the brain, spinal cord, and nerves, which are responsible for transmitting signals and coordinating bodily functions. Therefore, the correct answer is that the ectoderm gives rise to the epidermis of the skin and the nervous system.

During foetal development, the sclerotome is a group of cells that gives rise to the vertebrae and ribs. The sclerotome is responsible for the formation of the skeletal structures in the back, including the individual bones of the spine (vertebrae) and the curved bones that protect the chest (ribs). These structures are essential for providing support, protection, and flexibility to the developing foetus and later in life.

During foetal development, the dermatome is responsible for giving rise to connective tissue and the dermis of the skin. The dermatome is a specific region of the embryo that develops into the connective tissue, which provides support and structure to various organs and tissues. Additionally, it also forms the dermis of the skin, which is the inner layer responsible for providing strength, elasticity, and sensory perception to the skin.

During foetal development, the myotome is a group of cells that forms the skeletal muscles of the trunk, neck, and limbs. These cells differentiate and develop into the specific muscle fibers that make up these structures. The myotome plays a crucial role in the formation and growth of the musculoskeletal system in the developing foetus.

The ductus arteriosus is an additional artery that connects the pulmonary artery to the descending aorta. This artery is present in the fetal circulatory system and allows blood to bypass the lungs, as the lungs are not fully functional in the womb. After birth, the ductus arteriosus usually closes and becomes a ligament called the ligamentum arteriosum.

The ductus venosus is a blood vessel that connects the umbilical vein to the inferior vena cava (IVC). During fetal development, the umbilical vein carries oxygenated blood from the placenta to the fetus. The ductus venosus acts as a shunt, allowing a portion of this oxygenated blood to bypass the liver and flow directly into the IVC. This helps to supply the developing fetus with oxygen-rich blood. After birth, the ductus venosus closes and becomes a ligament known as the ligamentum venosum.

Progesterone plays a crucial role during labor by promoting the formation of a mucus plug that seals the uterus from the cervix. This mucus plug acts as a protective barrier, preventing the entry of bacteria into the uterus and reducing the risk of infection. Additionally, progesterone also suppresses uterine contractions, allowing the cervix to remain closed and the baby to stay in the womb until the appropriate time for delivery. These effects of progesterone contribute to the smooth progression of labor and the overall well-being of both the mother and the baby.

Oestrogen plays a crucial role in preparing the uterus for labor by stimulating the growth of uterine muscle cells and increasing their contractility. It also promotes the softening and dilation of the cervix, allowing for the passage of the baby during childbirth. Additionally, oestrogen promotes the development of ducts in the mammary glands, which are responsible for producing and transporting milk after childbirth. These effects of oestrogen are essential for a successful labor and breastfeeding experience.

Natural killer (NK) cells play a crucial role in the immune system by identifying and attacking cells that display abnormal plasma membrane proteins. These proteins can be a result of viral infections, cancerous mutations, or other abnormalities. NK cells have the ability to recognize these abnormal cells and release cytotoxic granules, leading to the destruction of the target cells. This immune response helps in preventing the spread of infections and controlling the growth of cancer cells.

Lymphocytes are a type of white blood cell that play a crucial role in the immune response. They differentiate into three main types: T cells, B cells, and natural killer cells. T cells are responsible for cell-mediated immunity, recognizing and destroying infected cells. B cells produce antibodies to neutralize pathogens. Natural killer cells are able to directly kill infected or cancerous cells. These three types of lymphocytes work together to provide a coordinated immune response against various threats to the body.

Once T cells have been activated, they undergo clonal selection. This process involves the proliferation of the activated T cell into a large number of identical cells, known as clones. These clones are specific to the antigen that initially activated the T cell. Clonal selection ensures that there is a sufficient number of T cells that can recognize and respond to the specific antigen, enhancing the immune response against the pathogen or foreign substance.

Active helper T cells play a crucial role in the immune response by secreting interleukin 2. Interleukin 2 is a cytokine that acts as a growth factor for other immune cells, such as cytotoxic T cells and B cells. It stimulates the proliferation and differentiation of these cells, enhancing the immune response against pathogens. By secreting interleukin 2, active helper T cells help to coordinate and regulate the immune system, ensuring an effective and targeted immune response.

Memory helper T cells play a crucial role in the immune response. Upon re-infection, they can proliferate and differentiate into either active helper T cells or memory helper T cells. Active helper T cells help coordinate the immune response by activating other immune cells and releasing cytokines. Memory helper T cells, on the other hand, provide long-term immunity by "remembering" the previous encounter with the pathogen. They can quickly respond to re-infection, leading to a faster and more effective immune response. This dual ability of memory helper T cells to differentiate into either active or memory cells allows for a robust and adaptable immune response.

Cytotoxic T cells play a crucial role in the immune system by binding to microbes and triggering apoptosis. Apoptosis is a process of programmed cell death, which helps to eliminate infected or abnormal cells. By binding to microbes, cytotoxic T cells can identify and target these harmful invaders, leading to their destruction through apoptosis. This mechanism is essential for the body to defend against infections and maintain overall health.

IgM antibodies are the first antibodies to be secreted by plasma cells after the initial exposure to an antigen. They play a crucial role in the primary immune response. Additionally, IgM antibodies have the ability to activate the complement system, which is an important part of the immune response that helps to destroy pathogens.

IgA antibodies play a vital role in providing localized protection to the mucus membranes. They are found in high concentrations in areas such as the respiratory and gastrointestinal tracts, where they help prevent the entry of harmful pathogens. During times of stress, the levels of IgA antibodies decrease, which can potentially compromise the body's ability to defend against infections in these specific areas.

IgD antibodies play a crucial role in the activation of B cells. They are present on the surface of mature B cells and help in the recognition of antigens. When an antigen binds to the IgD antibody, it triggers the activation of the B cell, leading to the production of specific antibodies against the antigen. This activation process is essential for the immune response as it allows B cells to differentiate into plasma cells and produce large amounts of antibodies to combat the invading pathogens. Therefore, IgD antibodies are directly involved in the activation of B cells.

IgG antibodies are the most abundant type of antibodies in the human body. They play a crucial role in the secondary immune response, which occurs upon re-exposure to a previously encountered antigen. During a secondary response, IgG antibodies are produced in large quantities and quickly bind to the antigen, neutralizing it and promoting its elimination from the body. This rapid and efficient response is possible due to the memory cells that are formed during the primary immune response. These memory cells "remember" the antigen and can quickly produce IgG antibodies upon re-infection, providing a faster and stronger defense against the pathogen.

IgE antibodies play a crucial role in allergic and hypersensitivity reactions. When a person is exposed to an allergen, such as pollen or pet dander, the immune system produces IgE antibodies specific to that allergen. These antibodies bind to mast cells and basophils, which are immune cells in the body. Upon re-exposure to the allergen, the allergen binds to the IgE antibodies on these cells, triggering the release of inflammatory mediators like histamine. This leads to the symptoms of an allergic reaction, such as itching, sneezing, and swelling. Therefore, IgE antibodies are responsible for initiating and amplifying allergic and hypersensitivity reactions.

Clonal selection is a process in which B cells that recognize a specific antigen are selected and activated. This process gives rise to two types of cells: memory B cells and plasma cells. Memory B cells are responsible for storing information about the antigen and are used for future immune responses. On the other hand, plasma cells are specialized cells that secrete antibodies, which are proteins that bind to and neutralize antigens. Therefore, memory B cells play a crucial role in long-term immunity, while plasma cells are involved in the immediate immune response by producing antibodies.

Trophectoderm cells are the outer cells of the blastocyst that play a crucial role in the formation of the placenta. These cells attach to the uterine wall and develop into the placenta, providing vital nutrients and oxygen to the developing embryo. They also facilitate the exchange of waste products between the mother and the fetus. Trophectoderm cells are specialized and essential for the successful implantation and development of the embryo.

FSH, or follicle-stimulating hormone, plays a crucial role in the reproductive system. It is responsible for stimulating the development of ovarian follicles in females, which contain the eggs. This hormone helps in the maturation of the follicles, leading to the release of a mature egg during ovulation. FSH also stimulates the production of estrogen, which is important for the growth and development of the reproductive organs. Overall, FSH plays a vital role in the menstrual cycle and fertility in females.

During the menstrual cycle, oestrogen levels gradually increase. As oestrogen levels rise, it eventually reaches a point where it inhibits the production of FSH (follicle-stimulating hormone) and LH (luteinizing hormone). Once oestrogen inhibits FSH and LH, these hormones are no longer suppressed, and their production resumes. This allows for the development and release of an egg during ovulation.

The corpus luteum produces progesterone and estrogen hormones. These hormones play a crucial role in the menstrual cycle and reproductive system. Progesterone helps prepare the uterus for pregnancy and maintains the uterine lining, while estrogen helps regulate the menstrual cycle and promote the development of secondary sexual characteristics. Both hormones work together to inhibit the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are responsible for the maturation and release of eggs from the ovaries. By inhibiting FSH and LH, progesterone and estrogen help regulate the menstrual cycle and prevent ovulation during pregnancy.

The HIV virus enters a host CD4 cell through a process involving the interaction between GP120 and CD4. GP120 recognizes CD4 and binds to it, leading to a structural change in the virus that exposes GP41. GP41 then binds to CCR5, a co-receptor on the surface of the CD4 cell, which allows the fusion of the virus with the cell membrane. This fusion enables the virus to enter the CD4 cell and initiate the infection process.

The lymphatic vessels from the penis drain to the superficial inguinal nodes. The superficial inguinal nodes are located in the groin area and receive lymphatic drainage from the lower limbs, perineum, and external genitalia, including the penis. These nodes play a crucial role in filtering and trapping foreign substances, such as pathogens, in the lymph fluid before it is returned to the bloodstream. Therefore, the superficial inguinal nodes are the correct lymph nodes to which the lymphatic vessels from the penis drain.

Lymphatic vessels from the vulva drain to the superficial or deep inguinal lymph nodes. The inguinal lymph nodes are located in the groin area and play a crucial role in filtering and draining lymph fluid from the lower extremities, genitals, and lower abdomen. The lymphatic drainage pattern varies depending on the specific region of the body, and in the case of the vulva, the lymphatic vessels primarily drain to the inguinal lymph nodes. These nodes are responsible for filtering and removing any potential pathogens or waste products from the lymph fluid before it is returned to the bloodstream.

During pregnancy, progesterone and estrogen play crucial roles in maintaining the uterine lining and preparing the mammary glands for milk secretion. Progesterone helps to maintain the thickened uterine lining, ensuring a suitable environment for the developing fetus. It also helps to prevent contractions that could lead to premature labor. Estrogen, on the other hand, stimulates the growth of mammary glands and ducts in the breasts, preparing them for milk production and secretion after childbirth. Together, these hormones are essential for the successful progression of pregnancy and the ability to breastfeed.

Prolactin plays a crucial role in lactation by stimulating milk synthesis and secretion. It is a hormone produced by the pituitary gland in response to the suckling of the baby. Prolactin promotes the development of mammary glands and stimulates the production of milk. It also helps in maintaining lactation by ensuring the continuous production and release of milk. Therefore, the main role of prolactin in lactation is milk synthesis and secretion.

Oxytocin is a hormone that plays a crucial role in labor and childbirth. It is responsible for stimulating contractions of the uterus, which helps in the dilation of the cervix. As the cervix dilates, it opens up to allow the baby to pass through the birth canal. Therefore, the main effect of oxytocin during labor is the dilation of the cervix.

The complement system plays a crucial role in immunity by promoting phagocytosis, which is the process of engulfing and destroying pathogens by immune cells. Additionally, it contributes to inflammation, which is a protective response of the immune system to infection or injury. Inflammation helps to recruit immune cells to the site of infection, enhance the immune response, and ultimately eliminate the pathogen. Therefore, the complement system's promotion of phagocytosis and contribution to inflammation are important mechanisms in the immune system's defense against pathogens.

A high monocyte count could indicate viral/fungal infections or TB. Monocytes are a type of white blood cell that play a crucial role in the immune response against infections. An increase in their count suggests an ongoing immune response to combat viral or fungal infections. Additionally, tuberculosis (TB) is a bacterial infection that can also cause an elevation in monocyte levels as the immune system tries to fight off the infection. Therefore, a high monocyte count may be indicative of these particular infections.

A low monocyte count could indicate bone marrow suppression, which refers to a decrease in the production of monocytes by the bone marrow. This can be caused by various factors such as infections, certain medications, or diseases affecting the bone marrow. On the other hand, treatment with cortisol, a hormone that helps regulate the immune system, can also lead to a low monocyte count. Cortisol has immunosuppressive effects and can inhibit the production of monocytes. Therefore, both bone marrow suppression and treatment with cortisol can result in a low monocyte count.

The PCR test is the most suitable HIV test to be performed in neonates. This is because the PCR test can detect the presence of the HIV virus in the blood at an early stage, even before antibodies are produced. Neonates may have acquired HIV from their mothers during pregnancy, childbirth, or breastfeeding, so it is crucial to accurately diagnose HIV in newborns to ensure timely treatment and management. The PCR test is highly sensitive and specific, making it an effective diagnostic tool for detecting HIV in neonates.

The correct answer includes both drug combinations: efavirenz, zidovudine, and lamivudine; and efavirenz, tenofovir, and emtricitabine. These drug combinations are commonly used in the treatment of HIV. Efavirenz is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that helps to prevent the replication of the virus. Zidovudine and lamivudine are nucleoside reverse transcriptase inhibitors (NRTIs) that also inhibit the replication of the virus. Tenofovir and emtricitabine are also NRTIs that work in a similar way. Using a combination of these drugs helps to reduce the viral load and improve the immune system function in individuals with HIV.