Test Your Knowledge About Diseases And Conditions! Trivia Quiz

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Test Your Knowledge About Diseases And Conditions! Trivia Quiz - Quiz

Are you looking to Test Your Knowledge about Diseases and Conditions! Diseases can be caused by different things in and outside the body and it is up to the medical practitioner to carry out adequate tests to diagnose the problem based on the symptoms one exhibits and tests one. How about you give it a shot and see how knowledgeable you are?


Questions and Answers
  • 1. 

    A 55-year-old woman presents with com­plaints of chest pain. She states that the chest pain predictably occurs when she climbs 4 flights of stairs to reach her apartment or when she has been jogging for more than 10 minutes. she is particularly concerned because her mother died of a myocardial infarction at 50 years of age.Which of the following best describes this patient's state?

    • A.

      Arrhythmia

    • B.

      Myocardial infarction

    • C.

      Variable angina

    • D.

      Stable angina

    • E.

      Unstable angina

    Correct Answer
    D. Stable angina
    Explanation
    This is a classic case of stable angina, which is chest pain that is precipitated by exertion but relieved by rest. Stable angina is due to atherosclerosis of the coro­nary arteries. This patient has risk factors for ischemic heart disease (IHD) (e.g., cigarette smoking, hypertension, hyperlipidemia, diabetes, family history of IHD / coronary artery disease). Prinzmetal angina is intermittent chest pain at rest, and unstable angina is pro­longed chest pain at rest.

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  • 2. 

    A 32-year-old woman returns to her physician for a follow-up of hypertension that has been poorly controlled in spite of numerous antihypertensive medications. It is decided to evaluate the patient for possi­ble "secondary" hypertension. Which of the following is a well-known cause of second­ary hypertension?

    • A.

      Ethnicity

    • B.

      Obesity

    • C.

      Renal artery stenosis

    • D.

      Smoking

    • E.

      Stress

    Correct Answer
    C. Renal artery stenosis
    Explanation
    The great majority of cases of hypertension are classified as essential hypertension. Essential hypertension results from the interactions of predisposing deter­minants and exogenous factors, including family history, ethnicity, stress, obesity, sodium intake, smoking, and physical activity. A small minority of cases of hypertension are due to secondary causes. Unilateral renal artery stenosis is a secondary cause that is typically correctable by surgery.

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  • 3. 

    A 53-year-old woman presents with dys­pnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, edema in the legs and feet, and fatigue. She has no history of angina, other signs of coronary artery dis­ease, hypertension, or valvular disease. Echocardiography reveals cardiomegaly, with four-chamber hypertrophy and dila­tion. Which of the following is the most likely diagnosis?

    • A.

      Congestive or dilated cardiomyopathy

    • B.

      Hypertrophic cardiomyopathy

    • C.

      Myocarditis

    • D.

      Restrictive cardiomyopathy

    Correct Answer
    A. Congestive or dilated cardiomyopathy
    Explanation
    Congestive or dilated cardiomyopathy is the most common form of car­diomyopathy. It is characterized by four-chamber hypertrophy and dilation as well as right-and left-sided severe heart failure. In some cases, congestive (dilated) cardiomy­opathy may be associated with alcoholism, thiamine deficiency, or prior myocarditis.

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  • 4. 

    A 64-year-old woman presents with dependent peripheral edema in her ankles and feet. She has long-standing chronic obstructive lung disease and a long history of cigarette smoking. Further investigation reveals that she has cor pul­monale with right-sided heart failure. Which of the following is the most likely cause of the right-sided heart failure in this patient?

    • A.

      Constrictive pericarditis

    • B.

      Disease of the lungs or pulmonary vessels

    • C.

      Left sided heart failure

    • D.

      Systemic hypertension

    Correct Answer
    B. Disease of the lungs or pulmonary vessels
    Explanation
    The term cor pulmonale refers to right ventricular hypertrophy caused by pulmonary hypertension secondary to disorders of the lungs or pulmonary vessels. Other causes of right ventricular hypertrophy and failure, such as valvular disease, con­genital defects, and left-sided heart failure, are precluded by this definition. Therefore, although in general, the most common cause of right-sided heart failure is left-sided heart failure, cor pulmonale with right-sided heart failure is due to an intrinsic disease originating in the lungs. Constrictive pericarditis can clinically mimic right-sided heart failure but is entirely unrelated to cor pulmonale.

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  • 5. 

    What affects in general does valvular stenosis cause?

    • A.

      Pressure overload cardiac hypertrophy

    • B.

      Volume overload hypertrophy

    • C.

      No affect

    • D.

      Restrictive cardomyopathy

    Correct Answer
    A. Pressure overload cardiac hypertrophy
    Explanation
    In general valvular stenosis leads to pressure overload cardiac hypertrophy whereas mitral or aortic valve insufficiency tends to cause volume overload.

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  • 6. 

    The patient presents with approx 70% fixed obstruction of a blood vessel. She feels pain on exertion such as when climbing a hill or walking her dog. The pain is relieved by rest. Likely cause?

    • A.

      Stable angina

    • B.

      Unstable angina

    • C.

      Variant angina

    • D.

      MI

    Correct Answer
    A. Stable angina
    Explanation
    70% fixed occlusion and relieved by rest is indicative of stable angina.

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  • 7. 

    What type of ECG change may a Transmural infarct cause?

    • A.

      ST segment elevation

    • B.

      Non- ST segment elevation

    • C.

      Wide QRS complex

    • D.

      Presence of a J wave

    Correct Answer
    A. ST segment elevation
    Explanation
    Transmural infarct causes ST segment elevation.

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  • 8. 

    When a person moves from a supine position to a standing position, which of the following compensatory changes occurs?

    • A.

      Decreased heart rate

    • B.

      Increased contractility

    • C.

      Decreased total peripheral resistance

    • D.

      Decreased cardiac output

    Correct Answer
    B. Increased contractility
    Explanation
    When a person moves to a standing position, blood pools in the leg veins, causing a decreased venous return to the heart, decreased cardiac output and decreased arterial pressure. The baroreceptors detect the decrease in arterial pressure, and the vasomotor center is activated to increase sympathetic outflow and decrease parasympathetic outflow. There is an increase in heart rate (resulting in a decreased PR interval), contractility, and total peripheral resistance (TPR). Because both heart rate and contractility are increased, cardiac output will increase toward normal.

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  • 9. 

    A person’s electrocardiogram (ECG) has no P wave but has a normal QRS complex and a normal T wave. Therefore, his pacemaker is located in the

    • A.

      SA node

    • B.

      AV node

    • C.

      Bundle of His

    • D.

      Purkinje fibers

    Correct Answer
    B. AV node
    Explanation
    The absent P wave indicates that the atrium is not depolarizing and, therefore, the pacemaker cannot be in the sinoatrial (SA) node. Because the QRS and T waves are normal, depolarization and repolarization of the ventricle must be proceeding in the normal sequence. This situation can occur if the pacemaker is located in the atrioventricular (AV) node. If the pacemaker were located in the bundle of His or in the Purkinje system, the ventricles would activate in an abnormal sequence (depending on the exact location of the pacemaker) and the QRS wave would have an abnormal configuration. Ventricular muscle does not have pacemaker properties.

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  • 10. 

    If the ejection fraction increases, there will be a decrease in

    • A.

      Cardiac output

    • B.

      End systolic volume

    • C.

      Heart rate

    • D.

      Stroke volume

    • E.

      Systolic pressure

    Correct Answer
    B. End systolic volume
    Explanation
    An increase in ejection fraction means that a higher fraction of the end-diastolic volume is ejected in the stroke volume (e.g., because of the administration of a positive inotropic agent). When this situation occurs, the volume remaining in the ventricle after systole, the end-systolic volume, will be reduced. Cardiac output, pulse pressure, stroke volume, and systolic pressure will be increased.

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  • 11. 

    An increase in contractility is demonstrated on a Frank–Starling diagram by

    • A.

      Increased cardiac output for a given end-diastolic volume

    • B.

      Increased cardiac output for a given end-systolic volume

    • C.

      Decreased cardiac output for a given end-diastolic volume

    • D.

      Decreased cardiac output for a given end-systolic volume

    Correct Answer
    A. Increased cardiac output for a given end-diastolic volume
    Explanation
    An increase in contractility produces an increase in cardiac output for a given end-diastolic volume or pressure. The Frank-Starling relationship demonstrates the matching of cardiac output (what leaves the heart) with venous return (what returns to the heart). An increase in contractility (positive inotropic effect) will shift the curve upward

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  • 12. 

    The first heart sound corresponds to point 

    • A.

      1

    • B.

      2

    • C.

      3

    • D.

      4

    Correct Answer
    A. 1
    Explanation
    The first heart sound corresponds to closure of the atrial–ventricular valves. Before this closure occurs, the ventricle fills (phase 4 → 1). After the valves close, isovolumetric contraction begins and ventricular pressure increases (phase 1 → 2)

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  • 13. 

    If the heart rate is 70 beats/min, then the cardiac output of this ventricle is closest to 

    • A.

      3.45 L/min

    • B.

      4.55 L/min

    • C.

      5.25 L/min

    • D.

      8.00 L/min

    Correct Answer
    C. 5.25 L/min
    Explanation
    Stroke volume is the volume ejected from the ventricle and is represented on the pressure-volume loop as phase 2 → 3; the end-diastolic volume is about 140 mL and the end-systolic volume is about 65 mL; the difference, or stroke volume, is 75 mL. Cardiac output is calculated as stroke volume × heart rate or 75 mL × 70 beats/min = 5250 mL/min or 5.25 L/min.

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  • 14. 

    In which of the following situations is pulmonary blood flow greater than aortic blood flow?

    • A.

      Normal adult

    • B.

      Fetus

    • C.

      Left-to-right ventricular shunt

    • D.

      Right-to-left ventricular shunt

    • E.

      Administration of a positive inotropic agen

    Correct Answer
    C. Left-to-right ventricular shunt
    Explanation
    In a left-to-right ventricular shunt, a defect in the ventricular septum allows blood to flow from the left ventricle to the right ventricle instead of being ejected into the aorta. The “shunted” fraction of the left ventricular output is therefore added to the output of the right ventricle, making pulmonary blood flow (the cardiac output of the right ventricle) higher than systemic blood flow (the cardiac output of the left ventricle). In normal adults, the outputs of both ventricles are equal in the steady-state. In the fetus, pulmonary blood flow is near zero. Right ventricular failure results in decreased pulmonary blood flow. The administration of a positive inotropic agent should have the same effect on contractility and cardiac output in both ventricles.

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  • 15. 

    Where is the thoracic aorta located

    • A.

      Superior mediastinum

    • B.

      Anterior mediastinum

    • C.

      Posterior mediastinum

    • D.

      Middle mediastinum

    Correct Answer
    C. Posterior mediastinum
    Explanation
    The thoracic aorta is located in the posterior mediastinum. The mediastinum is the central compartment of the thoracic cavity, and it is divided into four regions: superior, anterior, middle, and posterior. The thoracic aorta is the largest artery in the body and it originates from the left ventricle of the heart. It descends through the thoracic cavity, passing behind the heart and through the diaphragm. Therefore, it is situated in the posterior mediastinum.

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  • 16. 

    Where does the aorta become the descending aorta

    • A.

      Sternal angle 

    • B.

      T1/T2

    • C.

      T3/T4

    • D.

      T4/T5

    Correct Answer
    D. T4/T5
    Explanation
    The aorta becomes the descending aorta at the level of T4/T5. The sternal angle is not the location where the aorta changes into the descending aorta.

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  • 17. 

    Does the vagus nerve carry pain sensations?

    • A.

      Yes

    • B.

      No

    Correct Answer
    B. No
    Explanation
    The vagus nerve does not carry pain sensations. It is primarily responsible for controlling involuntary bodily functions such as heart rate, digestion, and breathing. While it does play a role in transmitting sensory information from internal organs, it does not specifically transmit pain signals. Pain sensations are typically carried by other nerves in the body.

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  • 18. 

    The opening of the oesophageal hiatus in the diaphragm is at 

    • A.

      T8

    • B.

      T10

    • C.

      T12

    • D.

      T7

    Correct Answer
    B. T10
    Explanation
    The opening of the oesophageal hiatus in the diaphragm is at T10. This is because the oesophagus passes through the diaphragm at this level, allowing it to connect the throat to the stomach. The diaphragm is a muscle that separates the chest cavity from the abdominal cavity, and the oesophageal hiatus is the hole in the diaphragm through which the oesophagus passes.

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  • 19. 

    Superior meatus receives the opening of

    • A.

      Anterior ethmoid air cells

    • B.

      Frontal sinus

    • C.

      Maxillary sinus

    • D.

      Posterior ethmoid air cells

    Correct Answer
    D. Posterior ethmoid air cells
    Explanation
    The superior meatus receives the opening of the posterior ethmoid air cells. The ethmoid air cells are located within the ethmoid bone, which is located between the eyes and forms part of the nasal cavity. The posterior ethmoid air cells are specifically located towards the back of the ethmoid bone. When these cells are open, they drain into the superior meatus, which is a passage in the nasal cavity. This allows for proper ventilation and drainage of the posterior ethmoid air cells. The other options, anterior ethmoid air cells, frontal sinus, and maxillary sinus, do not directly open into the superior meatus.

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  • 20. 

    The olfactory epithelium in the roof of the nasal cavity is innervated by the olfactory nerve. what is the roman numeral associated with this nerve

    • A.

      CN I

    • B.

      CN V2

    • C.

      CN V

    • D.

      CN II

    Correct Answer
    A. CN I
    Explanation
    The olfactory epithelium in the roof of the nasal cavity is innervated by the olfactory nerve, which is also known as cranial nerve I (CN I). This nerve is responsible for the sense of smell and carries sensory information from the nasal cavity to the brain.

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  • 21. 

    What is a Colles' fracture?

    • A.

      Fracture of the distal radius

    • B.

      Fracture of the proximal radius

    • C.

      Fracture of the distal ulna

    • D.

      Fracture of the proximal ulna

    Correct Answer
    A. Fracture of the distal radius
    Explanation
    A Colles' fracture refers to a fracture of the distal radius, which is the bone in the forearm located near the wrist. This type of fracture typically occurs when there is a break in the bone near the wrist joint, causing the end of the radius to become displaced. It is a common injury that often results from a fall onto an outstretched hand.

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  • 22. 

    What nerve is being assessed with the trapezius movement?

    • A.

      Accessory nerve

    • B.

      3rd and 4th cervical nerves

    • C.

      Suprascapular nerve

    • D.

      Axillary nerve

    Correct Answer
    A. Accessory nerve
    Explanation
    The correct answer is the accessory nerve. The trapezius muscle is innervated by the accessory nerve, also known as cranial nerve XI. This nerve controls the movement of the trapezius muscle, which is responsible for various movements of the shoulder and neck, such as shrugging the shoulders and rotating the head. The other options mentioned, such as the 3rd and 4th cervical nerves, suprascapular nerve, and axillary nerve, are not directly involved in the innervation of the trapezius muscle.

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  • 23. 

    Median nerve injury affects what the most?

    • A.

      Elbow flexion

    • B.

      Loss of abduction and adduction of the 2-5th finger digits.

    • C.

      Ability to effectively use thumb, index and middle fingers

    • D.

      Elbow extension

    Correct Answer
    A. Elbow flexion
    Explanation
    Median nerve injury affects the ability to effectively use the thumb, index, and middle fingers. The median nerve innervates the muscles that control these fingers, so when it is injured, the individual may experience weakness or loss of function in these digits. The other options, such as elbow flexion, loss of abduction and adduction of the 2-5th finger digits, and elbow extension, are not directly affected by median nerve injury.

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  • 24. 

    Which is the most common fractures tarsal bone?

    • A.

      Talus

    • B.

      Navicular

    • C.

      Cuboid

    • D.

      Calcaneus

    Correct Answer
    D. Calcaneus
    Explanation
    The calcaneus is the most common fractured tarsal bone. This bone is located in the heel and is responsible for supporting the weight of the body during walking and running. Fractures of the calcaneus often occur due to high-energy injuries such as falls from a height or car accidents. These fractures can cause severe pain, swelling, and difficulty walking. Treatment may involve immobilization, pain management, and in some cases, surgery to realign the bone fragments.

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  • 25. 

    How do you assess psoas major muscle?

    • A.

      Ask patient to dorsiflex

    • B.

      Ask patient to plantarflex

    • C.

      Ask patient to flex thigh at hip joint with leg flexed at the knee

    • D.

      Ask patient to extend thigh at hip joint with leg also flexed at knee

    Correct Answer
    C. Ask patient to flex thigh at hip joint with leg flexed at the knee
    Explanation
    To assess the psoas major muscle, the examiner should ask the patient to flex the thigh at the hip joint while keeping the leg flexed at the knee. This movement specifically targets the psoas major muscle, which is responsible for flexing the hip joint. By asking the patient to perform this action, the examiner can assess the strength, range of motion, and any potential pain or discomfort associated with the psoas major muscle.

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  • 26. 

    The most common cause of infective endocarditis.

    • A.

      S. aureus

    • B.

      S. epidermidis

    • C.

      S. pyogenes

    • D.

      S. hemolyticus

    Correct Answer
    A. S. aureus
    Explanation
    S. aureus is the most common cause of infective endocarditis. This bacterium is a common inhabitant of the skin and nasal passages and can enter the bloodstream through breaks in the skin or during medical procedures. It has the ability to adhere to damaged heart valves and form vegetations, leading to the development of infective endocarditis. S. aureus is known for its virulence and ability to cause severe infections, making it a significant pathogen in this context.

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  • 27. 

    Which bacterial strain is the most common cause of intravenous catheter colonization?

    • A.

      S. epidermidis

    • B.

      Streptococcus mutans

    • C.

      E. coli

    • D.

      Strp. pyogenes

    Correct Answer
    A. S. epidermidis
    Explanation
    S. epidermidis is the most common cause of intravenous catheter colonization. This bacterium is a normal inhabitant of the skin and can easily colonize catheters, leading to infections. It produces a biofilm that allows it to adhere to the catheter surface and form a protective barrier against the immune system and antibiotics. This makes S. epidermidis a significant threat in healthcare settings, as catheter-related infections can lead to serious complications.

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  • 28. 

    Vasodilator drugs inhibit/ reduce

    • A.

      Tissue perfusion

    • B.

      Preload

    • C.

      RAA system

    • D.

      Cardiac output

    Correct Answer
    B. Preload
    Explanation
    Vasodilator drugs reduce preload. Preload refers to the amount of blood that fills the ventricles of the heart during diastole. By dilating the blood vessels, vasodilator drugs decrease the resistance to blood flow and allow more blood to return to the heart. This increased blood volume leads to increased stretch of the ventricles, which in turn increases preload. Therefore, by reducing preload, vasodilator drugs help to decrease the workload on the heart and improve cardiac function.

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  • 29. 

    A 62-year-old man presents with pallor, fatigue, and dyspnoea on exertion. Occult blood noted in stools and his blood smear showed hypochromic, microcytic red cells. The most common cause?

    • A.

      Lower GI bleed

    • B.

      Upper GI bleed

    • C.

      Coeliac disease

    • D.

      Iron deficiency anaemia

    Correct Answer
    B. Upper GI bleed
    Explanation
    The correct answer is Upper GI bleed. This is because the patient's symptoms, such as pallor, fatigue, and dyspnea on exertion, along with the presence of occult blood in stools and hypochromic, microcytic red cells on blood smear, are consistent with iron deficiency anemia. Iron deficiency anemia is commonly caused by chronic blood loss, and the most common source of chronic blood loss is an upper gastrointestinal bleed.

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  • 30. 

    What does digoxin do?

    • A.

      Activate Na+K- ATPase

    • B.

      Decrease Nai

    • C.

      Inhibit  Na+K- ATPase

    • D.

      Decrease Cai

    Correct Answer
    C. Inhibit  Na+K- ATPase
    Explanation
    Digoxin inhibits Na+K+-ATPase. Na+K+-ATPase is an enzyme responsible for maintaining the balance of sodium and potassium ions inside and outside of cells. By inhibiting this enzyme, digoxin disrupts the normal flow of ions, leading to an increase in intracellular sodium levels. This increase in sodium concentration can then indirectly affect the exchange of calcium ions, ultimately leading to an increase in intracellular calcium levels. Overall, digoxin's inhibition of Na+K+-ATPase affects the balance of ions and can have various effects on cardiac function.

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  • 31. 

    Antidysrhytmic drugs are classified by the Vaughan Williams classification - What is an example of a  class 4 drug

    • A.

      Lidocaine

    • B.

      Amiodarone

    • C.

      Propranolol

    • D.

      Verampil

    Correct Answer
    D. Verampil
    Explanation
    Verapamil is an example of a class 4 drug in the Vaughan Williams classification of antidysrhythmic drugs. Class 4 drugs are calcium channel blockers, which work by blocking calcium channels in the heart, leading to a decrease in heart rate and contractility. Verapamil specifically acts on the L-type calcium channels in the heart, resulting in a decrease in heart rate and the force of contraction. This class of drugs is commonly used to treat conditions such as hypertension, angina, and certain cardiac arrhythmias.

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  • 32. 

    The right ventricle of the heart

    • A.

      Forms most of the inferior surface of the heart and the anterior surface

    • B.

      Is normally oval in cross-section

    • C.

      Has the bicuspid valve in its inflow tract

    • D.

      Has 3 papillary muscles for it’s cups

    Correct Answer
    A. Forms most of the inferior surface of the heart and the anterior surface
    Explanation
    The right ventricle of the heart forms most of the inferior surface of the heart and the anterior surface. This means that it is located at the bottom and front of the heart. This is anatomically correct as the right ventricle pumps blood to the lungs to be oxygenated, and it is positioned in a way that allows for efficient blood flow in this direction.

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  • 33. 

    Which one is not true regarding the coronary arteries?

    • A.

      Arises from the inferior aspect of the aortic arch

    • B.

      Each gives atrial and ventricle branches

    • C.

      Anastomoses extensively with each other

    • D.

      Supply the papillary muscles of the mitral and tricuspid valve

    Correct Answer
    A. Arises from the inferior aspect of the aortic arch
    Explanation
    The right coronary artery arises from the anterior aortic sinus and the left from the left posterior sinus immediately. Next to the aortic valve.

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  • 34. 

    A patient is admitted into the emergency room and manifests ventricular tachycardia following an acute myocardial infarction. This arrhythmia is life-threatening and needs to be controlled immediately. Which drug would be best to quickly control the condition?

    • A.

      Dobutamine 

    • B.

      Quinidine

    • C.

      Lidocaine 

    • D.

      Atropine

    Correct Answer
    C. Lidocaine 
    Explanation
    Lidocaine is best for the management of VT associated with acute MI. The rest will induce tachyarrythmias.

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  • 35. 

    Person defective with Factor VIII is said to have:

    • A.

      Rosethal syndrome

    • B.

      Haemophilia A

    • C.

      Haemophilia B

    • D.

      Option 4

    Correct Answer
    B. Haemophilia A
    Explanation
    Haemophilia A is the correct answer because it is a genetic disorder caused by a deficiency or defect in Factor VIII, a blood clotting protein. People with Haemophilia A have prolonged bleeding and are at risk for excessive bleeding even from minor injuries. This condition is inherited in an X-linked recessive manner, meaning it primarily affects males. Haemophilia B, on the other hand, is caused by a deficiency or defect in Factor IX, another blood clotting protein. Rosenthal syndrome is not related to the deficiency of Factor VIII or any other clotting factor.

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  • 36. 

    The heart is derived from the:

    • A.

      Somatic mesoderm

    • B.

      Splanchnic mesoderm

    • C.

      Intermediate mesoderm

    • D.

      Parasail mesoderm

    Correct Answer
    B. Splanchnic mesoderm
    Explanation
    The heart is derived from the splanchnic mesoderm. During embryonic development, the splanchnic mesoderm gives rise to the cardiovascular system, including the heart. This layer of mesoderm forms the cardiac mesoderm, which eventually differentiates into the primitive heart tube. As development progresses, the heart tube undergoes further morphological changes to form the four-chambered heart. Therefore, the splanchnic mesoderm is responsible for the development and formation of the heart.

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  • 37. 

    The most superior part of the inferior vena cava is derived from

    • A.

      Left vitelline vein

    • B.

      Right vitelline vein

    • C.

      Left umbilical vein

    • D.

      Right umbilical vein

    Correct Answer
    B. Right vitelline vein
    Explanation
    The most superior part of the inferior vena cava is derived from the right vitelline vein. The vitelline veins are responsible for draining blood from the yolk sac during embryonic development. The right vitelline vein specifically gives rise to the hepatic segment of the inferior vena cava. This segment connects the liver to the heart, allowing deoxygenated blood from the lower body to be returned to the heart for oxygenation. Therefore, the correct answer is the right vitelline vein.

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  • 38. 

    45-year-old presents with marked splenomegaly. Her blood differential shows the presence of small numbers of myeloblasts and promyelocytes with a predominance of myelocytes, band, and segmented neutrophils. On examination, a Philadelphia chromosome was noticed. What is the most likely cause

    • A.

      AML

    • B.

      Expansion of mature B lymphocytes within multiple lymph nodes

    • C.

      9;22 translocation

    • D.

      CLL

    Correct Answer
    C. 9;22 translocation
    Explanation
    The presence of a Philadelphia chromosome, which refers to the 9;22 translocation, is strongly associated with chronic myeloid leukemia (CML). In CML, there is an abnormal fusion of the BCR and ABL genes, resulting in the production of a hybrid protein with increased tyrosine kinase activity. This leads to uncontrolled proliferation of myeloid cells, including myeloblasts, promyelocytes, myelocytes, and neutrophils. The other options, AML and CLL, are not typically associated with the 9;22 translocation.

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  • 39. 

    A patient with severe anemia has a peripheral blood smear with oval macrocytes, hypersegmented neutrophils, and decreased platelets. The most likely cause of the anaemia is

    • A.

      Anaemia of chronic disease

    • B.

      Iron deficiency anaemia

    • C.

      Aplastic anaemia

    • D.

      Vitamin B12 or folate deficiency 

    Correct Answer
    D. Vitamin B12 or folate deficiency 
    Explanation
    The correct answer is Vitamin B12 or folate deficiency. This is indicated by the presence of oval macrocytes, which are larger than normal red blood cells, and hypersegmented neutrophils, which have more than the usual number of lobes in their nucleus. These findings are characteristic of megaloblastic anemia, which is caused by a deficiency in either Vitamin B12 or folate. Additionally, the decreased platelet count suggests that the patient may also have thrombocytopenia, which can be seen in megaloblastic anemia. Anaemia of chronic disease, iron deficiency anaemia, and aplastic anaemia are less likely causes based on the given information.

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  • 40. 

    Insulin is an example of what type of hormone?

    • A.

      Catecholamine

    • B.

      Steroid 

    • C.

      Paracrine

    • D.

      Peptide

    Correct Answer
    D. Peptide
    Explanation
    Insulin is an example of a peptide hormone. Peptide hormones are made up of chains of amino acids and are typically water-soluble. Insulin is produced by the pancreas and plays a crucial role in regulating blood sugar levels. It acts by binding to specific receptors on target cells, triggering a cascade of cellular responses. Unlike steroid hormones, which are derived from cholesterol, insulin is not lipid-soluble and cannot pass through the cell membrane. Instead, it binds to receptors on the cell surface, initiating intracellular signaling pathways.

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  • 41. 

    In skeletal muscle

    • A.

      Amino acids are an essential fuel

    • B.

      Large quantities of triacylglycerols are stored as fuels

    • C.

      At rest, fatty acids are the preferred fuel

    • D.

      Stored muscle glycogen can be converted to glucose and released to replenish blood glucose

    Correct Answer
    C. At rest, fatty acids are the preferred fuel
    Explanation
    At rest, fatty acids are the preferred fuel in skeletal muscle because they can be broken down through beta-oxidation to produce ATP, which is the energy currency of cells. Fatty acids provide a long-lasting and sustained source of energy compared to other fuel sources like glucose. This preference for fatty acids during rest allows the preservation of glycogen stores in the muscle, which can be used during periods of high-intensity exercise or when glucose is needed to replenish blood glucose levels.

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  • 42. 

    Glycolysis in red blood cells produces pyruvate that is further metabolized to

    • A.

      Lactate

    • B.

      Ethanol

    • C.

      Haemoglobin

    • D.

      CO2

    Correct Answer
    A. Lactate
    Explanation
    During glycolysis in red blood cells, glucose is broken down to produce pyruvate. In the absence of oxygen, pyruvate is converted to lactate through the process of fermentation. This allows for the regeneration of NAD+ which is needed for glycolysis to continue. Lactate can then be transported to the liver where it can be converted back to pyruvate and further metabolized. Therefore, lactate is the correct answer as it is the end product of pyruvate metabolism in red blood cells.

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  • 43. 

    The co-enzyme involved in a transaminase reaction is 

    • A.

      Biotin phosphate

    • B.

      NADH

    • C.

      NADP+

    • D.

      Pyridoxak phosphate 

    Correct Answer
    D. Pyridoxak phosphate 
    Explanation
    Pyridoxak phosphate is the correct answer because it is a co-enzyme involved in transaminase reactions. Transaminase reactions involve the transfer of an amino group from an amino acid to a keto acid, and pyridoxak phosphate acts as a co-enzyme by accepting and donating amino groups during this process. Biotin phosphate, NADH, and NADP+ are not directly involved in transaminase reactions, so they are not the correct answers.

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  • 44. 

    When blood glucose is abnormal high, the pancreas releases

    • A.

      Insulin

    • B.

      Glucagon

    • C.

      Epinephrine

    • D.

      Trypsin

    Correct Answer
    A. Insulin
    Explanation
    When blood glucose levels are abnormally high, the pancreas releases insulin. Insulin is a hormone that helps regulate blood sugar levels by allowing glucose to enter cells, where it can be used for energy. Insulin also helps store excess glucose in the liver for later use. By releasing insulin, the pancreas helps lower blood glucose levels and maintain a stable balance in the body.

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