Block 2 Pace Quiz 2

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  • 1/26 Questions

    A patient presents to the emergency in shock with severe abdominal pain. Blood analyses show normal albumin levels and liver enzymes but his amylase is high. He most likely has:

    • A blockage of the bile duct
    • Acute hepatitis
    • Acute pancreatitis
    • Nephotic syndrome
    • Wilson’s disease
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Block 2 Pace Quiz 2 - Quiz
About This Quiz

BLOCK 2 PACE QUIZ 2 assesses key medical knowledge, focusing on conditions like vitamin K deficiency, organ effects of alpha 1-antitrypsin deficiency, diagnosis of acute pancreatitis, role of serotonin in vasopermeability, and structural components of cardiac muscle cells.

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  • 2. 

    Dr. LaVille Which of the following conditions favors a bleeding tendency?

    • Iron deficiency anemia

    • Chronic heart failure

    • Sickle cell disease

    • Vitamin K deficiency

    • Emphysema

    Correct Answer
    A. Vitamin K deficiency
    Explanation
    Vitamin K is essential for the production of clotting factors in the blood. A deficiency in vitamin K can lead to impaired blood clotting, resulting in a bleeding tendency. Iron deficiency anemia, chronic heart failure, sickle cell disease, and emphysema do not directly affect the clotting process and therefore do not favor a bleeding tendency.

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  • 3. 

    Dr. Sharma A 25 year old known patient with myasthenia gravis delivers a full term baby. Your first priority would be to advise her of which of the following?

    • That the baby should sleep with her

    • That the baby must receive medication

    • That the baby must be placed on a respirator immediately

    • That the baby may die of sudden infant death syndrome

    • That the baby needs to be monitored in hospital for at least a week

    Correct Answer
    A. That the baby needs to be monitored in hospital for at least a week
    Explanation
    Because of the presence of maternal antibodies in the infant’s blood, the baby could suffer transient myasthenia and should be monitored for any breathing difficulty. Avoid the answers with “MUST” With good monitoring of the infant, the prognosis is good so D is not a choice.

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  • 4. 

    Dr. Yin Thick filaments are anchored to Z disks by

    • Nebulin

    • C protein

    • Titin

    • ą-actinin

    • Myomesin

    Correct Answer
    A. Titin
    Explanation
    Titin is a protein that plays a crucial role in muscle contraction. It is the largest known protein and acts as a molecular spring, providing elasticity to the muscle. In addition to its role in muscle contraction, titin also functions as an anchor for the thick filaments of the muscle to the Z disks. This anchoring helps to maintain the structural integrity of the muscle and allows for efficient transmission of force during muscle contraction. Therefore, titin is responsible for anchoring the thick filaments to the Z disks.

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  • 5. 

    Dr. Vigh   As a patient with paralyzed gluteus medius and minimus muscles on the left side attempts to stand on the left limb only, the right side of the pelvis typically:

    • Drops

    • Elevates

    • Rotates laterally

    • Rotates medially

    • Thrusts forward

    Correct Answer
    A. Drops
    Explanation
    When a patient with paralyzed gluteus medius and minimus muscles on the left side attempts to stand on the left limb only, the right side of the pelvis typically drops. This is because the gluteus medius and minimus muscles play a crucial role in stabilizing the pelvis during single limb support. Without the support from these muscles, the pelvis on the opposite side (right side) is unable to maintain its normal level position and drops downwards. This compensatory movement helps to shift the center of gravity towards the left side and maintain balance during the stance phase of walking.

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  • 6. 

    Which of the following statements concerning cardiac muscle cells is true?

    • Each muscle fiber is syncytium.

    • Cardiac conducting system is made of neurons and glia cells.

    • They possess dense bodies.

    • They require an external stimulus to undergo contraction.

    • They have sarcomere and myofibrils.

    Correct Answer
    A. They have sarcomere and myofibrils.
    Explanation
    Cardiac muscle cells, also known as cardiomyocytes, are responsible for the contraction of the heart. They possess sarcomeres and myofibrils, which are the structural components responsible for muscle contraction. Sarcomeres are the basic units of muscle contraction and consist of overlapping actin and myosin filaments. Myofibrils are long, cylindrical structures within the muscle cells that contain the sarcomeres. These sarcomeres and myofibrils allow cardiac muscle cells to contract and pump blood throughout the body.

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  • 7. 

    A deficiency of alpha 1-antitrypsin will affect most one of the following organs?

    • Liver

    • Lung

    • Spleen

    • Kidney

    • Pancrease

    Correct Answer
    A. Lung
    Explanation
    A deficiency of alpha 1-antitrypsin primarily affects the lungs. Alpha 1-antitrypsin is a protein that helps protect the lungs from damage caused by enzymes released by white blood cells. Without enough alpha 1-antitrypsin, these enzymes can cause inflammation and destruction of lung tissue, leading to conditions such as emphysema. While alpha 1-antitrypsin is also produced in the liver, a deficiency does not typically cause significant liver problems. Therefore, the correct answer is lung.

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  • 8. 

    (this is last question pertaining to mini 2 ) Which of the following may be the presenting symptom of a patient suffering from myasthenia crisis?

    • Sweating

    • Breathing difficulty

    • Palpitations

    • Cardiac arrest

    • Diarrhea

    Correct Answer
    A. Breathing difficulty
    Explanation
    Respiratory distress is the key feature of the myasthenic crisis

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  • 9. 

    Failure of closure of the cranial neuropore causes this serious congenital malformation.

    • Meroanencephaly

    • Rachischisis

    • Myelocele

    • Spina bifida occulta

    • Spina bifida cystica

    Correct Answer
    A. Meroanencephaly
    Explanation
    Meroanencephaly is a serious congenital malformation that occurs when the cranial neuropore fails to close properly. This leads to incomplete development of the brain and skull. Unlike other conditions listed, such as rachischisis, myelocele, spina bifida occulta, and spina bifida cystica, meroanencephaly specifically refers to the failure of closure of the cranial neuropore.

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  • 10. 

    Which of the following structures can be found in smooth muscle?

    • Triads

    • Sarcomeres

    • Intercalated discs

    • Myofilaments

    • Troponin

    Correct Answer
    A. Myofilaments
    Explanation
    Smooth muscle is a type of muscle tissue found in various organs of the body. Unlike skeletal muscle, it lacks the organized sarcomeres and striations. However, smooth muscle does contain myofilaments, which are responsible for muscle contraction. These myofilaments are composed of actin and myosin proteins, which slide past each other during contraction. Therefore, myofilaments can be found in smooth muscle.

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  • 11. 

    Extrafusal fibers are innervated by

    • Sensory fibers

    • Somatic motor fibers

    • Sympathetic nerve fibers

    • Parasympathetic nerve fibers

    • Both sensory and somatic motor fibers

    Correct Answer
    A. Somatic motor fibers
    Explanation
    The correct answer is somatic motor fibers. Somatic motor fibers are responsible for innervating the extrafusal fibers, which are the main contractile fibers in skeletal muscles. These fibers are responsible for generating force and movement. Sensory fibers transmit sensory information from the muscles to the central nervous system, while sympathetic and parasympathetic nerve fibers are involved in the autonomic control of smooth muscles and glands, not skeletal muscles. Therefore, the correct answer is somatic motor fibers.

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  • 12. 

    Dr. Boaz  DiGeorge Syndrome is a suite of congenital craniofacial malformations associated with immunological defects due to failure of the thymus gland to differentiate and calcium metabolic defects related to failed parathyroid gland development. A primary embryological cause is

    • Failure of development of Rathke’s pouch

    • Lack of migration of ectoderm through the primitive streak

    • Lack of normal development and migration of neural crest cells

    • Failure of descent of the thyroid gland primordium

    • Lack of normal closure of the cervical sinus

    Correct Answer
    A. Lack of normal development and migration of neural crest cells
    Explanation
    DiGeorge Syndrome is a congenital disorder that is caused by the lack of normal development and migration of neural crest cells. These cells play a crucial role in the development of various structures in the body, including the thymus gland, parathyroid gland, and craniofacial structures. The failure of neural crest cells to develop and migrate properly leads to the characteristic features of DiGeorge Syndrome, such as craniofacial malformations, immunological defects, and calcium metabolic defects. Therefore, the correct answer is lack of normal development and migration of neural crest cells.

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  • 13. 

    While on a semester break vacation in Dominica following her final exams, a scuba diving Ross medical student is accidentally speared by her diving partner. The end of the spear passes medial to lateral, posterior to the medial malleolus. It severs an artery there, which is the:

    • Anterior tibial

    • Dorsalis pedis

    • Fibular

    • Medial plantar

    • Posterior tibial

    Correct Answer
    A. Posterior tibial
    Explanation
    The correct answer is the posterior tibial artery. The question describes a scenario where a spear passes through the leg, severing an artery. The location of the injury is described as medial to lateral and posterior to the medial malleolus, which corresponds to the location of the posterior tibial artery. Therefore, the posterior tibial artery is the artery that is severed in this scenario.

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  • 14. 

    Which vasopermeability factor is secreted by activated platelets?

    • Bradykinin

    • Histamine

    • Thrombin

    • Thromboxane

    • Serotonin

    Correct Answer
    A. Serotonin
    Explanation
    Activated platelets secrete serotonin, which is a vasopermeability factor. Serotonin is released from platelets during the clotting process and acts as a vasoconstrictor, causing the blood vessels to constrict and increase permeability. This allows for the recruitment of immune cells and the delivery of nutrients and oxygen to the site of injury or inflammation. Serotonin also plays a role in platelet aggregation and clot formation.

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  • 15. 
    Dr. Wright A person on an exercise regimen decides to lift barbells using his biceps brachii.  He did his reps twice.  The first time he started at his Lo, the optimum length.  The second time he extended his forearms and started with his biceps at their maximum normal length.  For the second rep, how would the skeletal muscles’ active tension, passive tension, and total tension vary from that of the first rep? - ProProfs

    Dr. Wright A person on an exercise regimen decides to lift barbells using his biceps brachii.  He did his reps twice.  The first time he started at his Lo, the optimum length.  The second time he extended his forearms and started with his biceps at their maximum normal length.  For the second rep, how would the skeletal muscles’ active tension, passive tension, and total tension vary from that of the first rep?

    • 1

    • 2

    • 3

    • 4

    • 5

    • 6

    Correct Answer
    A. 5
    Explanation
    When the person starts the second rep with his biceps at their maximum normal length, the active tension of the skeletal muscles would decrease because the muscle fibers are not as optimally positioned to generate force. The passive tension would increase because the muscle fibers are stretched beyond their optimum length, causing passive resistance. The total tension would decrease compared to the first rep because the decrease in active tension outweighs the increase in passive tension.

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  • 16. 

    Dr. Averill  Substituted organophosphate compounds were originally developed as insecticides (malathion and parathion) and then as very potent “nerve gases” (e.g. sarin).  As a class of substances organophosphates inhibit the activity of acetylcholine esterase.  What would be the expected effect if an organophosphate compound were applied topically to the eye?

    • Droopy eyelid

    • Miosis

    • Mydriasis

    • Unsusual sensitivity to light

    Correct Answer
    A. Miosis
    Explanation
    When an organophosphate compound is applied topically to the eye, the expected effect would be miosis. Miosis refers to the constriction of the pupil, which is caused by the inhibition of acetylcholine esterase activity by organophosphates. This inhibition leads to an accumulation of acetylcholine, resulting in the constricted pupil.

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  • 17. 

    A six year old child is brought to the clinic following an episode of diarrhea.  She is treated with a solution which corrects her electrolyte imbalance due to the diarrhea.  After treatment, which statement concerning her electrolytes is most likely to be correct?

    • The Nernst equation would express her nerve equilibrium potential for multiple ions.

    • The GHK equation would express her nerve equilibrium potential for a single ion.

    • The Nernst potential for her Na+ can be determined substituting in equation log [Na+] outside x log [Na+] inside.

    • The Goldman constant field equation can be expressed as ln [Na+] + ln [K+]

    • The Nernst potential would give the potential that would prevent the net diffusion of an ion across her nerve membrane at equilibrium

    Correct Answer
    A. The Nernst potential would give the potential that would prevent the net diffusion of an ion across her nerve membrane at equilibrium
    Explanation
    The Nernst potential is the membrane potential at which the net diffusion of an ion across the nerve membrane is zero, meaning there is no movement of the ion in either direction. This occurs at equilibrium, where the concentration gradient of the ion is balanced by the electrical gradient. In the given scenario, the child's electrolyte imbalance due to diarrhea is corrected using a solution. Therefore, after treatment, the statement that the Nernst potential would give the potential that would prevent the net diffusion of an ion across her nerve membrane at equilibrium is most likely to be correct.

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  • 18. 

    Systemic exposure to the organophosphate insecticide, parathion, is accompanied by bradycardia (decreased heart rate), low blood pressure, and increased peristalsis of the colon.  What drug could be administered to counteract the bradycardia induced by parathion?

    • Nicotine

    • Atropine

    • Phenylephrine

    • Acetylcholine

    • Propranolol

    Correct Answer
    A. Atropine
    Explanation
    Atropine is the correct answer because it is an anticholinergic drug that blocks the action of acetylcholine on the heart, leading to an increase in heart rate. Since parathion causes bradycardia, which is a decreased heart rate, administering atropine can counteract this effect and restore a normal heart rate.

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  • 19. 

    Following surgical opening of the adductor canal, a patient experienced a loss of cutaneous sensation of the medial side of the leg. Which nerve was cut?

    • Ilioinguinal

    • Tibial

    • Obturator

    • Medial sural cutaneous

    • Saphenous

    Correct Answer
    A. Saphenous
    Explanation
    The loss of cutaneous sensation on the medial side of the leg suggests damage to the nerve responsible for innervating that area. The saphenous nerve is the main sensory nerve of the medial side of the leg, so if it was cut during the surgical opening of the adductor canal, it would explain the loss of sensation in that area.

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  • 20. 

    A 45 year old patient is diagnosed with hypertension.  One of the drugs administered is a beta blocker, which affects cardiac myocytes to decrease contractile force.  What would be the effect of a beta receptor blocker on cardiac muscle stimulation-contraction coupling?

    • Decrease in both cAMP and L-type calcium channel activation

    • Increase in Na+/K+ pump activity and secondary active transport of Ca++

    • Decrease in troponin-C affinity for Ca++

    • Increase in activity of myosin light chain phosphatase

    • Increase in SERCA activity and Ca++ transport into SR

    Correct Answer
    A. Decrease in both cAMP and L-type calcium channel activation
    Explanation
    A beta receptor blocker decreases the levels of cAMP, which is an important signaling molecule in cardiac muscle cells. This decrease in cAMP leads to a decrease in the activation of L-type calcium channels, which are responsible for allowing calcium ions into the cardiac myocytes. Therefore, the overall effect of a beta receptor blocker on cardiac muscle stimulation-contraction coupling is a decrease in both cAMP and L-type calcium channel activation.

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  • 21. 

    Dr. Benjamin A 46 year old male hunter accidentally stuck himself while preparing his arrows for hunting.  History revealed that curare (d-tubocurarine) was present in his arrows.  A significant finding on examination was paralysis in the arm that he stuck himself.   Which of the following best explains the mechanism of the paralysis seen?

    • Increased anti-acetylcholinesterase activity

    • Blockage of Na+ channels and subsequent repolarization

    • Blockage of K++ gated channels and subsequent depolarization

    • Competitive inhibition of binding to nicotinic cholinergic receptors

    • Competitive inhibition of binding to muscarinic cholinergic receptors

    Correct Answer
    A. Competitive inhibition of binding to nicotinic cholinergic receptors
    Explanation
    The paralysis seen in the patient is most likely due to the competitive inhibition of binding to nicotinic cholinergic receptors. Curare is a neuromuscular blocking agent that acts by competitively inhibiting the binding of acetylcholine to nicotinic cholinergic receptors at the neuromuscular junction. This prevents the normal transmission of nerve impulses to the muscles, leading to paralysis. The other options listed do not explain the mechanism of action of curare.

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  • 22. 

    A 37-year-old women in the fourth month of pregnancy is diagnosed with aggressive ovarian cancer. Her physician advises immediate surgery to remove her ovaries. The woman wants to deliver her baby and has read on the internet that she will have an abortion if her ovaries are removed. She comes to your office for a second opinion. You recommend that  

    • She postpone the surgery until after the birth of her child

    • She postpone the surgery until the third trimester of her pregnancy

    • She immediately have the surgery with post-operative progesterone supplements

    • She immediately have the surgery with estrogen supplements

    • She immediately have the surgery with no hormonal steroid supplements

    Correct Answer
    A. She immediately have the surgery with no hormonal steroid supplements
    Explanation
    The correct answer is to immediately have the surgery with no hormonal steroid supplements. This is because aggressive ovarian cancer is a life-threatening condition that requires immediate treatment. Removing the ovaries does not result in an abortion, as the fetus is not dependent on the ovaries for survival. Hormonal steroid supplements are not necessary in this case, as they are not directly related to the treatment of ovarian cancer.

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  • 23. 

    The absence of a ventral double-fold of coelomic membrane connecting the heart to the ventral body wall (a ventral mesocardium) is a result of

    • Degeneration of this mesentery

    • Formation of the pericardiopleural canals

    • Formation of the pleuroperitoneal canals

    • Absence of a ventral mesentery on the ventral body wall below the ligamentum teres

    • A bilateral connection of the early intraembryonic coelom rostral to the developing heart

    Correct Answer
    A. A bilateral connection of the early intraembryonic coelom rostral to the developing heart
    Explanation
    The absence of a ventral mesocardium, which is a double-fold of coelomic membrane connecting the heart to the ventral body wall, is a result of a bilateral connection of the early intraembryonic coelom rostral to the developing heart. This connection prevents the formation of the ventral mesocardium, leading to its absence.

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  • 24. 

    After the twentieth week of gestation, a thinned vasculosyncytial placental membrane is formed consisting of the following three layers:

    • Syncytiotrophoblast – cytotrophoblast – fetal capillary endothelium

    • Maternal capillary endothelium - syncytiotrophoblast – fetal capillary epithelium

    • Syncytiotrophoblast – connective tissue of the villus – fetal capillary endothelium

    • Connective tissue of the villus – syncytiotrophoblast - maternal capillary endothelium

    • Maternal capillary endothelium – syncytiotrophoblast – cytotrophoblast

    Correct Answer
    A. Syncytiotrophoblast – connective tissue of the villus – fetal capillary endothelium
    Explanation
    After the twentieth week of gestation, the placental membrane consists of three layers: syncytiotrophoblast, connective tissue of the villus, and fetal capillary endothelium. The syncytiotrophoblast is the outermost layer of the placental membrane and is responsible for nutrient and gas exchange between the mother and the fetus. The connective tissue of the villus provides structural support to the placenta. The fetal capillary endothelium is the innermost layer and is responsible for transporting oxygen and nutrients to the fetus. Therefore, the correct answer is syncytiotrophoblast – connective tissue of the villus – fetal capillary endothelium.

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  • 25. 

    A person lost in the woods for two days is finally rescued.  He had access to water but no food or drink, and the temperature exceeded 35 degrees Celcius on both days.  When he is brought to the ER, his plasma sodium level is 129 mEq/L (normal 140).  What process associated with excitation-contraction coupling in smooth muscle is most directly compromised by this ionic imbalance?

    • Ligand-gated calcium entry from ECF

    • Primary active transport of calcium to ECF

    • Leak channel calcium entry from ECF

    • Calcium-induced calcium release from SR

    • Secondary active transport of calcium to ECF

    • Voltage-gated calcium entry from ECF

    • Primary active transport of calcium to SR

    Correct Answer
    A. Secondary active transport of calcium to ECF
    Explanation
    The person in the question was lost in the woods for two days with access to water but no food or drink, and the temperature exceeded 35 degrees Celsius on both days. This suggests that the person experienced dehydration and potentially electrolyte imbalances. The plasma sodium level of 129 mEq/L (normal 140) indicates hyponatremia, which is a lower than normal concentration of sodium in the blood. Secondary active transport is responsible for the movement of calcium ions across cell membranes, using the energy from the movement of another molecule, such as sodium. Therefore, the ionic imbalance in this person's plasma sodium level may compromise the secondary active transport of calcium to the extracellular fluid (ECF).

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  • 26. 

    A 46 year old male had surgery on his neck.   During routine postoperative examination, it was noticed that tapping the side of his face resulted in twitching of that side of his face (Chovstek’s sign).  Which of the following best explains the cause of the twitching?

    • Hyperkalemia

    • Hypokalemia

    • Hypercalcemia

    • Hypocalemia

    • Hypernatremia

    Correct Answer
    A. Hypocalemia
    Explanation
    Twitching of the face in response to tapping on the side of the face is known as Chovstek's sign and is commonly associated with hypocalcemia. Hypocalcemia is a condition characterized by low levels of calcium in the blood. Calcium is essential for proper nerve and muscle function, and low levels can lead to increased excitability of nerves and muscles, resulting in twitching. Therefore, hypocalcemia is the most likely cause of the twitching observed in this patient after neck surgery.

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  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Oct 20, 2011
    Quiz Created by
    Chachelly
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