BCS + CCS: WK9-10

Question 1

the right and left ____ ascend to form the central tendon of the diaphragm. They are joined by the ____ ______ ligament.

Answer 1

crura, median arcuate ligament

Question 2

the rectus abdominus begins at what two structures?

Answer 2

xiphoid process

costal cartilage of ribs 5-7

Question 3

Darryl is a 72yo, otherwise healthy male, who has presented with a fever of unknown origin. He has had no recent overseas travel, but has fought in the Vietnam war and this has been his only experience overseas. He mentioned that they travelled extensively via boat through much of South East Asia, but he cannot recall where exactly. What would you consider first to determine his classic pyrexia of unknown origin?

a) temporal arteritis
b) occult abscess
c) osteomyelitis
d) tuberculosis

Answer 3

d

Question 4

true or false: generally, hepatitis virus’ are not cytolytic. Tissue damage is caused by cell-mediated immune response.

Answer 4

true

Question 5

which two cell types of the stomach are found in the base?

Answer 5

chief cells, enteroendocrine

Question 6

true or false: HepC treatments prevent chronicity of disease which can lead to liver cirrhosis, failure or hepatocellular carcinoma

Answer 6

false: treatment is not given until patient is chronic. we see if they can clear it on their own

Question 7

true or false: false: the conjoint ligament sits posterolaterally to the superficial inguinal ring.

Answer 7

true

Question 8

what is the name of the glands in the duodenum which secrete alkaline mucus to neutralise chyme?

Answer 8

brunner glands

Question 9

five structures of the mucosa are:

Answer 9

1. glands
2. epithelium
3. lamina propria
4. muscularis mucosa
5. lymphoid nodules

Question 10

why is it important that GLUT-2 receptors have a low affinity for glucose?

Answer 10

to ensure rate of entry of glucose into the liver is proprtional with extracellular concentration

Question 11

the muscularis externa is smooth muscle composed of two layers, inner ____ and outer ________ layers. The ______ ______ is found between the two layers. The only GIT structure that has three layers is the _____

Answer 11

circular, longitudinal, myenteric plexus, stomach

Question 12

where are duodenal brunner glands found?

a) in the muscularis externa layer
b) in the luminal region of the mucosal layer
c) between the submucosa and mucosa in connective tissue
d) above and below the muscularis mucosa in connective tissue

Answer 12

d

Question 13

true or false: goblet cells, crypts and villi are not found in the stomach

Answer 13

true: has rugae

Question 14

true or false: the large intestines also contain a folded surface with mucosa and significantly smaller villi compared to the small intestines

Answer 14

false: no villi

Question 15

true or false: the conjoint ligament sits medially and anterior to the inguinal canal

Answer 15

false: sits behind it. slightly lateral to the superficial inguinal ring.

Question 16

true or false: both hep B and C can have persistent infections

Answer 16

true

Question 17

there are _ complexes in the electron transport chain. electrons come from reduced carriers in the Krebs cycle, ____ and _____

Answer 17

5, 3NADH, FADH2

Question 18

detection of surface antigen for Hep B in serology indicates:

a) acute infection
b) chronic infection
c) vaccination
d) past infection

Answer 18

c

Question 19

what are the three types of specialised epithelium in the stomach?

Answer 19

parietal cells

chief cells

enterendocrine cells

Question 20

which of the following is false regarding cohort studies?

a) a set time frame between exposure and outcome needs to be established to determine incidence
b) participants are selected base on exposure status and thus exposure characteristics (risk factors) need to be known
c) it is an experimental prospective study
d) confirms association between exposure and disease

Answer 20

c) observational prospective

Question 21

when would a case-control study be LESS preferable?

a) evaluation of diagnostic interventions and tests
b) to establish associations between outcome and exposure(s)
c) studying rare conditions
d) assessing multiple risk factors of a condition

Answer 21

a) its retrospective, they already have the condition

Question 22

what bone, joint, and ligament make up the posterior region of the pelvic outlet?

Answer 22

bone: coccyx
joint: sacroccygeal
ligament: sacrotuberous (sacrum to ischial tuberosity)

Question 23

a preventative measure that is focused on early detection and interruption of disease process before it becomes symptomatic is:

a) primary
b) secondary
c) tertiary

Answer 23

b

Question 24

true or false: the external and internal oblique attac to the iliac crest and lumbar fascia

Answer 24

true

Question 25

you are working in a small remote hospital and a man comes in with a dildo far up his ass as seen on his xray. it is your first rotation and you require help as you think surgical intervention is necessary. you approach the GIT surgical reigstrar on duty with the xrays in your hand. does this breach any issues of confidentiality?

a) yes in all respects
b) yes, as it is a small hospital the patient is likely identifiable, but it is medically necessary
c) no, but only if you de-identify patient information on the xray
d) none whatsoever, medically neccessary

Answer 25

b) even if you de-identify the patient’s name, likely they will know who it is.

Question 26

which of these would not occur during starvation?

a) increase synthesis of fatty acids and triacylglyceroles in liver and adipose tissue
b) increase glucose and bile acid production in the liver
c) activation of glycogen phosphorylase
d) reduced brain signals for food intake and appetite, but increased satiety

Answer 26

a) its decreased

Question 27

during gluconeogenesis, what enzyme is responsible for conversion of pyruvate to oxaloacetate?

Answer 27

pyruvate carboxylase

Question 28

which of these is false regarding a randomised controlled clinical trial study?

a) individuals are assigned at random in order to reduce bias
b) compares the effect and/or value of an intervention against a control
c) can be retrospective or prospective
d) ideal design for a cause and effect question

Answer 28

c) just prospective

Question 29

HbsAg (-), anti-Hbc (-), anti-Hbs (-) indcates:

a) immune due to natural infection
b) susceptible
c) immune due to hep B vaccination
d) chronic infection

Answer 29

b

Question 30

lymphoid nodules are found in what layer of the GIT?

a) mucosa
b) submucosa
c) muscularis
d) serosa/adventita

Answer 30

a

Question 31

true or false: confidentiality is a legislated duty whilst privacy is a professional duty

Answer 31

false: opposite way around

Question 32

when evaluating a study, we ask “are the results true for the subjects in the study?” this is:

a) internal validity
b) external validity
c) assessment of confounding factors
d) critical appraisal

Answer 32

a

Question 33

glyceraldehyde-3-phosphate is a triose phosphate produced at the end of the investment stage of glycolysis. which enzyme produces it?

a) phosphofructokinase-1
b) hexokinase
c) aldolase
d) triose phosphate isomerase

Answer 33

c

Question 34

true or false: gluconeogenesis and glycolysis inhibit each other

Answer 34

true

Question 35

systematic differences between groups in how outcomes are determined is an example of:

a) selection bias
b) performance bias
c) detection bias
d) attrition bias
e) reporting bias

Answer 35

c

Question 36

match the words and definitions. adventitia, serosa, fibrosa

a) smooth membrane of a thin layer of mesothelial cells which excrete serous fluid to reduce friction from muscle movement. Serous membranes line and enclose body cavities
b) connective tissue capsule
c) connective tissue layer binds together or attaches structures to abdominal wall

Answer 36

adventitia - C

serosa - A

fibrosa - B

Question 37

at what age can you apply for your own Medicare card?

a) 14
b) 15
c) 16
d) 18

Answer 37

b

Question 38

what type of tubular glands are found in the duodenum?

a) simple alveolar
b) compound tubular
c) simple branched tubular
d) simple tubular

Answer 38

b

Question 39

which of these is false regarding the inguinal canal?

a) tunnel extending from deep to superficial inguinal rings
b) parallels the inguinal ligament
c) transmid spermatid cord or round ligament of uterus
d) composed of folds of all three layers of the abdominal muscle aponeuroses

Answer 39

d) Formed by folds of external abdominal oblique aponeurosis

Question 40

phosphorylase kinase is involved in the breakdown of glycogen. which statement is true

a) upregulated by glucagon, downregulated by insulin
b) upregulated by insulin, downregulated by glucagon
c) upregulated by insulin and glucagon
d) downregulated by insulin and glucagon

Answer 40

a

Question 41

glucagon –> via enzyme ______ –> glucose-1-phosphate

glucose-1-phosphate –> via enzyme _____ –> glucose-6-phosphate

glucose-6-phosphate –> via enzyme ______ –> glucose

Answer 41

glycogen phosphorylase

phosphoglucomutase

glucose-6-phosphatase

Question 42

the main role of the submucosa is:

a) production of immune cells
b) anchor mucosa to muscularis externa
c) provide smooth muscle support to the mucosa
d) provide secretory products to the mucosa

Answer 42

b

Question 43

The stalk of the processus vaginalis normally degenerates, however, its distal saccular part forms the _____ ________

Answer 43

tunica vaginalis

Question 44

glycolysis of phosphoenolpyruvate to pyruvate is a one step process. the reverse of this (gluconeogensis) is a two step process. what are the steps?

Answer 44

pyruvate –> oxaloacetate

oxaloacetate –> phosphoenolpyruvate

Question 45

what is the major morphological change below the arcuate line?

a) the aponeurosis of all three abdominal layers fuse to form the anterior rectus sheath only
b) the tranversus abdominus is in direct contact with the extraperitoneal fat
c) coeliac plexus branches, less risk of surgical injury
d) inferior epigastric arteries branch, less risk of surgical injury

Answer 45

a

Question 46

which of these abdominal organs would contain adventitia?

a) stomach
b) duodenum
c) liver
d) kidneys

Answer 46

d) retroperitoneal

Question 47

In 2018, NSW reported 6 cases of meningococcal A. In 2019, there were 26 reported new cases. This is a:

a) outbreak
b) endemic
c) epidemic
d) pandemic

Answer 47

c

Question 48

GLUT-4 receptors are found in what three tissues?

Answer 48

adipose tissue, skeletal muscle, heart muscle

Question 49

regarding release of insulin from beta cells, a high ATP:ADP ratio occurs. this leads to a build up of what ion to depolarise the cell membrane?

a) sodium
b) calcium
c) chloride
d) potassium

Answer 49

d

Question 50

true or false: Both HBV and HCV have effective antiviral therapies available

Answer 50

true

Question 51

true or false: Prevalence of HepC is minimal in childhood and progressively higher with increasing age.

Answer 51

true

Question 52

motor supply of the diaphragm comes from what nerves and origin

Answer 52

phrenic, C3-C5 keeps the diaphragm alive

Question 53

where does the diaphragm attach sternally?

Answer 53

posterior surface xiphoid process

Question 54

true or false: Enecavir and Tenofovir are oral treatments available in Australia to treat hepA

Answer 54

false: hepB

Question 55

true or false: indirect hernias are usually acquired in adulthood due to weakening of the abdominal musculature

Answer 55

false: direct

indirect = usually congenital

Question 56

true or false: all Australians receive a Hep A vaccination

Answer 56

false: only if high risk group or going to an endemic location

Question 57

HbsAg (+), anti-Hbc (+), IgM anti-Hbc (+) anti-Hbs (-) indcates:

a) immune due to natural infection
b) acute infection
c) immune due to hep B vaccination
d) chronic infection

Answer 57

b

Question 58

what type of gastric tubular glands are found in the stomach?

a) simple alveolar
b) compound tubular
c) simple branched tubular
d) simple tubular

Answer 58

c

Question 59

which of the following is an example of tertiary prevention regarding HepC?

a) education for all food handlers
b) professional barber services in prisons
c) needle exchange programmes
d) abstinence from alcohol

Answer 59

d

Question 60

true or false: acute hepatitis C is less common than A and B

Answer 60

true

Question 61

vireremia is:

Answer 61

presence of virus particles in the blood

Question 62

in salivary glands, serous glands appear pink. why?

a) dense amount of RNA due to protein production
b) myoepithelial cells makes them appear pink
c) swollen lumen makes them appear pink
d) enlarged cytoplasm appears more pink

Answer 62

a

Question 63

true or false: the external oblique aponeurosis contributes the most to the inguinal ligament, the internal oblique aponeurosis contributes to the lateral 2/3rds, and the transversus abdominus contributes to the lateral 1/3rd

Answer 63

true

Question 64

which of these is false regarding HepA?

a) usually acute, subclinical and self-limiting
b) replicates exclusively in hepatocytes
c) adults are more likely to develop signs and symptoms
d) incubation period is 3-6 months

Answer 64

d) 15-45 days (2-6 weeks)

Question 65

true or false: the jejunum has fewer and shorter villi compared to the duodenum

Answer 65

true

Question 66

Jane is receiving chemotherapy and is neutropenic. She was had a fever of 39 degrees for the last 3 weeks. What is the diagnostic name of this?

Answer 66

neutropenic pyrexia/neutropenic fever of unknown origin

Question 67

true or false: lactate dehydrogenase causes pyruvate + 2NADH –> lactate + 2NAD+ in muscles in the absence of oxygen. This is an irreversible reaction.

Answer 67

fales: reversible. rest is true

Question 68

true or false: majority of energy for the liver is from fatty acid oxidation

Answer 68

true

Question 69

what connects the mucosa and submucosa?

a) connective tissue
b) lamina propria
c) muscularis mucosa
d) inner longitudinal muscle layer

Answer 69

c) this is also smooth muscle

Question 70

HbsAg (-), anti-Hbc (+), anti-Hbs (-) indicates:

a) resolved infection
b) acute infection
c) immune due to hep B vaccination
d) chronic infection

Answer 70

a

Question 71

true or false: mucous cells and parietal stomach cells are found in the pit and isthmus respectively

Answer 71

true

Question 72

Recent reports of 6 new covid cases linked to a backpacker in quarantine is likely to be:

a) outbreak
b) endemic
c) epidemic
d) pandemic

Answer 72

a

Question 73

hexokinase and phosphofructokinase perform irreversible reactions in the prepatory phase of glycolysis. complete the reactions

Glucose –> ATP + hexokinase –> __________

fructose-6-phosphate –> ATP + phosphofructokinase –> __________

Answer 73

Glucose –> ATP + hexokinase –> glucose-6-phosphate

fructose-6-phosphate –> ATP + phosphofructokinase –> fructose-1,6-biphosphate

Question 74

620,000 people died worldwide from HBV-related causes in 2000. This was due to:

a) 6% chronic, 94% acute
b) 52% chronic, 48% acute
c) 48% chronic, 52% acute
d) 94% chronic, 6% acute

Answer 74

d

Question 75

a preventative measure that limits the physical and social consequences of symptomatic disease is:

a) primary
b) secondary
c) tertiary

Answer 75

c

Question 76

villi in the small intestines are formed by ___ ______ and microvilli

Answer 76

plicae circularis

Question 77

Hexokinase has a broad specificity for hexose sugars and a high Km for liver hexokinase. This means:

a) high affinity for substrate and thus requires a greater concentration of substrate to reach Vmax
b) low affinity for substrate and thus requires a greater concentration of substrate to reach Vmax
c) high affinity for substrate and thus requires a smaller concentration of substrate to reach Vmax
d) low affinity for substrate and thus requires a smaller concentration of substrate to reach Vmax

Answer 77

b

Question 78

connective tissue, Meissner’s plexus, vessels and nerves are found in what layer of the GIT?

a) mucosa
b) submucosa
c) muscularis
d) serosa/adventita

Answer 78

b

Question 79

true or false: the inguinal ligament lies inferior to the inguinal canal and is thickened medially by the lacunar ligament

Answer 79

true

Question 80

the best prevention for HepA is:

a) cooking, peeling, and boiling fruit and veg
b) hand hygiene
c) immunisation
d) avoid sharing needles

Answer 80

c

Question 81

portal tract contains:

Answer 81

vein, artery, 1 branch of bile duct, lymphatic vessel

Question 82

ketogenesis is upregulated by prolonged starvation and glucagon. it involves the conversion of acetyl-CoA to ________ via _____________

Answer 82

malonyl-CoA, aceyyl-CoA carboxylase

Question 83

true or false: direct inguinal hernias rarely enter the scrotum

Answer 83

true

Question 84

disability-adjusted life years is:

Answer 84

years of healthy life lost + years of healthly life lost to disability

Question 85

which of these is false regarding bias?

a) differences between groups is not due to the intervention
b) creates difference in outcomes between the intervention and comparator group
c) an external error
d) can be a result of experimental design

Answer 85

c) systemic error

Question 86

a double-blind study is when neither patient nor the doctor know in advance which therapy will be assigned e.g. before treatment allocation is made. another name for this is:

Answer 86

allocation concealment

Question 87

the femoral sheath makes up the femoral canal. What forms the anterior portion of this canal?

a) transversalis fascia
b) iliopsoas fascia
c) external oblique fascia
d) all of the above

Answer 87

a

Question 88

true or false: Compared with non-indigenous Australians, indigenous Australians are almost 2.5x more likely to have HAV diagnosed.

Answer 88

false: 3x

Question 89

sphincters contain a thickened layer of:

a) lumen
b) muscularis mucosa
c) submucosa
d) muscularis externa

Answer 89

d

Question 90

what receptor on beta cells detects blood glucose?

Answer 90

GLUT-2

Question 91

where can the femoral pulse be palpated?

a) mid-inguinal point
b) midpoint of inguinal ligament
c) femoral triangle
d) none of the above

Answer 91

a

Question 92

when evaluating a study, we ask “are the results true for other populations?” this is:

a) internal validity
b) external validity
c) assessment of confounding factors
d) critical appraisal

Answer 92

b

Question 93

the four parts of the gastric tubular glands are:

Answer 93

pit, isthmus, neck, base

Question 94

HepA prevention should be focused on:

a) improvements in sharps education and sharing of equipment
b) improvements in vaccination programs
c) improvements in water and sanitation supply
d) improvement in education about blood-borne contacts

Answer 94

c

Question 95

There is a suspicion that zinc oxide, the white non-absorbent sunscreen traditionally worn by lifeguards is more effective at preventing sunburns that lead to skin cancer than absorbent sunscreen lotions. A case-control study was conducted to investigate if exposure to zinc oxide is a more effective skin cancer prevention measure. The study involved comparing a group of former lifeguards that had developed cancer on their cheeks and noses (cases) to a group of lifeguards without this type of cancer (controls) and assess their prior exposure to zinc oxide or absorbent sunscreen lotions.

This is an example of what kind of study?

Answer 95

observation, retrospective case-control study

Question 96

what is reduced during the electron transport chain?

a) ADP
b) oxygen
c) FADH
d) NAD+

Answer 96

b

Question 97

what nerve travels through the superficial ring of the inguinal canal?

a) iliohypogastric
b) obturator
c) genitofemoral
d) ilioinguinal

Answer 97

d

Question 98

Match the definitions and words: primary prevention, secondary prevention, tertiary prevention

a) limits the physical and social consequences of symptomatic disease
b) early detection and interruption of the disease process before it becomes symptomatic
c) keeps the disease process from becoming established by eliminating causes of disease or by increasing resistance to disease

Answer 98

primary: c
secondary: b
tertiary: a

Question 99

for one molecule of glucose, how much ATP is produced in the krebs cycle?

Answer 99

2

Question 100

In 2018, there were 10 recorded cases of influenza A in NSW. In 2019, there were 9 recorded cases in NSW. In 2020, there were 10 recorded cases in NSW. this is a:

a) outbreak
b) endemic
c) epidemic
d) pandemic

Answer 100

b

Question 101

glycogen phosphorylase is involved in:

Answer 101

breakdown of stored glycogen

Question 102

what two nerves supply innervation to genitals?

Answer 102

ilioinguinal and gentiofemoral

Question 103

recall bias is likely to:

a) increase reporting of risk factors in a retrospective study
b) decrease reporting of risk factors in a retrospective study
c) decrease reporting of risk factors in a prospective study
d) all of the above are possible

Answer 103

a) people with a condition will be more motivated to recall risk factors

Question 104

somatostatin comes from:

a) Grehlin cells in the exocrine portion of the pancreas
b) Grehlin cells in the endocrine portion of the pancreas
c) D cells in the exocrine portion of the pancreas
d) D cells in the endocrine portion of the pancreas

Answer 104

d

Question 105

the rectus sheath supports the rectus abdominus. what makes up the anterior and psoterior compartment?

Answer 105

anterior - aponeurosis of external oblique and anterior aponeurosis of internal oblique

posterior - posterior aponeurosis of internal oblique and aponeurosis of transversus abdominus

Question 106

true or false: Hepatitis C is usually an acute infection with subclinical illness and self-limiting. ​

Answer 106

false: Hep A

Question 107

true or false: direct hernias involve bowel herniating through a weakness in hesselbach’s triangle. bowel enters the inguinal canal can exit via the deep inguinal ring where it forms a lumb in the scrotum or labia majora.

Answer 107

false: superficial inguinal ring

Question 108

acetyl-CoA is regulated by:

a) availability of pyruvate
b) oxygen
c) pyruvate dehydrogenase
d) acetyl-CoA carboxylase

Answer 108

d

Question 109

what are the four types of fever?

Answer 109

1. continued
2. intermittent
3. remittent
4. relapsing

Question 110

systematic differences between baseline characteristics of the groups that are compared due to sampling of subjects and/or allocation to groups is an example of:

a) selection bias
b) performance bias
c) detection bias
d) attrition bias
e) reporting bias

Answer 110

a

Question 111

State whether the following statements are true or false:

a) Viruses can enter hepatocytes (parenchymal cells) via being transcytosed across Kupffer and epithelial cells without undergoing replication to reach hepatocytes.
b) Viruses can multiply within Kupffer cells and endothelial cells and infect hepatocytes

Answer 111

a) true
b) true

Question 112

what are the three layers of muscularis externa in the stomach?

Answer 112

inner oblique

middle circular

outer longitudinal

Question 113

the glucose-alanine cycle is involved in:

a) ketone formation
b) proteolysis
c) aerobic metabolism
d) anaerobic metabolism

Answer 113

b) urea formation is by-product

Question 114

assessing past exposure to cigarette smoking of a group that have lung cancer vs a group that doesnt is a type of:

a) interventional, prospective case-control study
b) observational, retrospective case-control study
c) interventional, retrospective case-control study
d) observational, prospective case-control study

Answer 114

b

Question 115

glycolysis produces __ of ATP

krebs cycle produces __ of ATP

electron transport chain produces up to __ of ATP

Answer 115

2, 2, 34

Question 116

in the electron transport chain, 1x NADH and 1x FADH2 will generate how much ATP respectively?

a) 1 and 2
b) 1.5 and 2.5
c) 2 and 1
d) 2.5 and 1.5

Answer 116

d

Question 117

which organs require glucose as the primary carbon source? list at least 3

Answer 117

brain/CNS

muscles

kidneys

testes

erythrocytes

Question 118

which of the following is false regarding acetyl-CoA?

a) high levels of acetyl-CoA will inhibit pyruvate dehydrogenase
b) high levels of acetyl-CoA will inhibit pyruvate carboxylase
c) high levels of acetyl-CoA will prevent glucose entering the electron transport chain
d) high levels of acetyl-CoA will lower insulin

Answer 118

b) high levels increase pyruvate carboxylase. this increases ketone production

Question 119

true or false: Since late 2005, indigenous children in QLD, NT, SA and WA have had two doses of Hep C vaccine added to the routine vaccination schedule between 12 and 24 months old.

Answer 119

false: its hepA not C

Question 120

the right and left domes of the diaphragm form the costal surface. where do they attach?

a) costal margin
b) internal surfaces of the inferior six costal cartilages and ribs
c) posterior surface of xiphoid process
d) external surfaces of the inferior six costal cartilages and ribs

Answer 120

b

Question 121

glycolysis occurs:

a) in the cytoplasm
b) in the endoplasmic reticulum
c) in the outer membrane of the mitocondria
d) in the inner membrane of the mitocondria

Answer 121

a

Question 122

which of these is false regarding the oesophagus?

a) middle region of the oesophagus contains both skeletal and smooth muscle
b) first 2/3 of the oesophagus is skeletal muscle and under voluntary control
c) stratified squamous epithelium
d) the submucosa contains tubulo/alveolar mucous glands

Answer 122

b) first 1/3

Question 123

which of these is false regarding the stomach fundus?

a) shallow gastric pits
b) shallow fundic glands
c) glands contain parietal cells
d) glands contain chief cells

Answer 123

b) deep fundic glands

Question 124

when we retain all randomised subjects in the final analysis, even those with missing data OR to retain all randomised subjects in the treatment group they were originally assigned to, even those who never received the assigned treatment. This is known as:

Answer 124

intention to treat

Question 125

a low ATP:ADP ratio will have what effect on endocrine function of the pancreas?

a) release insulin
b) release glucagon
c) release both
d) release none

Answer 125

b

Question 126

what are the three muscles that make up the posterior abdominal wall regarding the abdominopelvic cavity?

Answer 126

psoas major, quadratus lumborum, diaphragm

Question 127

you want to design a study to look at the relationship between alcohol and fatty liver disease over a 1 year period. Cohort A are people between the ages of 50-70 who drink at least 3 standard drinks per day, and cohort B are people who drink 1 or less standard drinks per week who are also aged 50-70. what type of study is this?

a) cross-sectional study
b) case-study
c) cohort study
d) randomized controlled trial

Answer 127

c

Question 128

the midpoint of the inguinal ligament is:

Answer 128

halfway between ASIS and pubic tubercle

Question 129

surface mucous cells are found in the ___ of the stomach. parietal cells are found in the ____, mucous neck cells are found in the ___, chief and enteroendocrine cells are found in the ____

Answer 129

pit, isthmus, neck, base

Question 130

which abdominal muscle attaches to the anterior 2/3 of the iliac crest, lumbar fascia, and pubic symphysis?

a) rectus abdominus
b) external oblique
c) internal oblique
d) transversus abdominus

Answer 130

d

Question 131

peyer’s patches are large lymphoid nodule aggregates found where?

a) appendix
b) jejunum
c) caecum
d) ileum

Answer 131

d

Question 132

coenzyme Av(CoA-SH) is regulated by _______ __________. This is stimulated by ____ and inhibited by _____ and adrenalin

Answer 132

acetyl-CoA carboxylase, insulin, glucagon

Question 133

what are the three main steps of the electron transport chain?

Answer 133

1. generating a proton motive force
2. ATP synthesis via chemiosmosis
3. reduction of oxygen

Question 134

if you want to look at the association between drug X and liver cancer at a population level, the best study design is:

a) randomized controlled trial
b) cohort study
c) ecological study
d) cross-sectional study

Answer 134

c

Question 135

which of the following is false after a meal:

a) insulin will phosphorylase glycogen synthase, increasing glycogen production
b) insulin will phosphorylase glycogen phosphorylase, turning off glycogen breakdown
c) insulin will act via tyrosine kinase receptor
d) all of the above are true

Answer 135

d

Question 136

true or false: the majority of epithelium in the GIT is columnar

Answer 136

true

Question 137

the origin of the transversus abdominus muscle is:

a) costal margin ribs 7-10
b) external surface of lower 8 ribs
c) internal surface of costal cartilages ribs 5-7
d) external surface of lower ribs 7-10

Answer 137

c

Question 138

alcohol fermentation is a two step reation. pyruvate decarboxylase converts pyruvate to ________ and releases ____. alcohol dehydrogenase converts _______ to ethanol via reduction of NADH to NAD+

Answer 138

acetylaldehyde, CO2, acetylaldehyde

Question 139

what structure descends with the testes through the deep inguinal ring and inguinal canal?

a) urethra
b) ductus deferens
c) cremasteric muscle
d) tunica vaginalis

Answer 139

b) part of spermatic cord

Question 140

the inguinal ligament goes from ASIS to pubic tubercle. What forms it?

Answer 140

aponeurosis of external oblique, internal oblique, and transversus abdominus

Question 141

A peritoneal diverticulum, the ________ _________, transverses the developing inguinal canal, carrying muscular and fascial layers of the anterolateral abdominal wall before it as it enters the primordial _______.

Answer 141

processus vaginalis, scrotum

Question 142

which of these is not a result of 1x acetyl-CoA entering the krebs cycle?

a) 3NAD+ –> 3NADH
b) FAD –> FADH2
c) 1x ATP
d) 4x CO2

Answer 142

d) its 2x

Question 143

which of these is true regarding hep A?

a) calicivirus
b) flavivirus
c) hepadnavirus
d) picornavirus

Answer 143

d

Question 144

the sacrotuberous ligament goes between what two regions of the pelvis?

a) ischial body and all regions of sacrum
b) ischial spine and middle of sacrum
c) ischial tuberosity and bottom of sacrum
d) ischial tuberosity to top of sacrum

Answer 144

c

Question 145

which of these would NOT result in release of insulin from beta cells?

a) presence of GLUT-2 receptors
b) parasympathetic release of acetylcholine
c) low ATP:ADP ratio
d) lack of calcium ions

Answer 145

c) needs to be high

Question 146

true or false: as electrons are transferred in the electron transport chain, some energy is lost with each transfer. this energy is used to pump proton ions across the membrane from the matrix to the inner membrane space

Answer 146

true

Question 147

true or false: both Hep A and B are likely to be acute, subclinical and self-limiting

Answer 147

true

Question 148

removal of a phosphate on glycogen phosphorylase occurs via _____. This upregulates/downregulates glycogen breakdown

Answer 148

insulin, downregulates

Question 149

Lactate can be used as a fuel as it acts as a substrate for glucose production in the liver via the _____ _____.

Answer 149

cori cycle

Question 150

true or false: retroperitoneal organs are covered in serosa which attaches them to the abdominal wall

Answer 150

false: this is adventitia

Question 151

a hernia that occurs medially to the inferior epigastric vessles is likely:

a) direct hernia through hesselbach’s triangle
b) indirect hernia through hesselbach’s triangle
c) direct hernia through the deep inguinal ring
d) indirect hernia through the deep inguinal ring

Answer 151

a

Question 152

true or false: the veriform appendix still contains crypts of Leiberkuhn

Answer 152

true

Question 153

which of the following is an example of secondary prevention in relation to hepB?

a) improving sanitation and prevent contact with raw sewage
b) vaccination
c) promote abstinence, monogomy, and safer sexual practice
d) screening of at risk populations for asymptomatic chronic infection

Answer 153

D

Question 154

which of these would NOT be found during acute hep A infection?

a) AST and ALT >500U/L
b) dark brown stool
c) IgM anti-HAV
d) fatigue

Answer 154

b) pale stool, dark brown urine

Question 155

femoral hernias occur in:

a) deep inguinal ring
b) Hesselbach’s triangle
c) femoral canal
d) femoral triangle

Answer 155

c

Question 156

mucous glands of the salivary glands produce:

Answer 156

mucin (must be spelt correctly!!)

Question 157

when the patient nor doctor are aware of which therapy will be assigned before treatment allocation is made, this is called:

when the patient nor doctor are aware of assigned treatment after randomisation has occurred and until study is completed, this is called:

Answer 157

allocation concealment

blinding/masking

Question 158

An acute disease which primarily effects children is likely to have:

a) a high number of deaths and a low DALY
b) a high number of deaths and a high DALY
c) a low number of deaths and a low DALY
d) a low number of deaths and a high DALY

Answer 158

d

Question 159

true or false: peripheral parts of the diaphragm have sensory innervation from intercostal nerves and subcostal nerves

Answer 159

true

Question 160

the islet of langerhans contains the endocrine component of the pancreas. which of the following facts are false:

a) pale purple/pink in colour
b) beta cells make up about 70%
c) beta cells have insulin and amylin in a 1:100 ratio
d) alpha cells make up about 20%

Answer 160

c) 100:1 insulin to amylin

Question 161

true or false: bright, yellow urine is a common sign of Hep A

Answer 161

true

Question 162

the internal oblique originates from the costal margins of ribs 7-10 and connects to what two structures?

Answer 162

lumbar fascia + anterior 2/3 of iliac crest

Question 163

which of these is false regarding HepA?

a) transmitted via faecal-oral route
b) all patients will progress to an icteric phase, but chronic illness is very rare
c) investigations in recent overseas travel is an important determinant
d) patients often present as feeling unwell and afebrile

Answer 163

b) not all patients progress to icteric phase

Question 164

what causes the blueish tinge of the liver on H&E slides?

a) presence of hepatocytes
b) large amounts of cytoplasm and high rough ER content
c) portal tracts
d) lots of lymphoid nodules

Answer 164

b

Question 165

why does the veriform appendix appear quite purple on H&E slides?

a) abundance of macrophages
b) thick muscularis externa
c) abundance of lymphoid nodules
d) large protein and RNA production

Answer 165

c

Question 166

true or false: randomisation is a good way to avoid bias, but not confounding factors such as age

Answer 166

false: good for both

Question 167

which of the following indicates hep B immunity from past infection?

a) anti-HbcAg
b) anti-HbsAg
c) anti-HbeAg
d) A and B

Answer 167

D

Question 168

what act encompasses laws regarding privacy?

Answer 168

commonwealth privacy act 1998

Question 169

exocrine pancreatic glands contain intracellular _____ granules. These are distinctly two-tone pink/blue due to high _____ ________ ______ content (blue colour) and high content of enzymes (pink colour)

Answer 169

zymogen, high rough endoplasmic reticulum

Question 170

the inguinal canal is sandwiched superiorly and posteriorly by what two structures?

Answer 170

superiorly: aponeurosis of external oblique (and internal oblique laterally)
posteriroly: transversalis fascia

Question 171

in what layer of the anterior abdominal wall can we see the inferior epigastric vessels?

a) reflecting the rectus abdominus and rectus sheaths
b) reflecting the external obliques
c) reflecting the external and internal obliques
d) between transversus abdominus and transversalis fascia

Answer 171

b

Question 172

true or false: cross-sectional studies tell us information about prevalence of disease and potential causation due to exposure

Answer 172

false: just prevalence

Question 173

the junction beteen the greater and lesser pelvis is:

Answer 173

pelvic brim

Question 174

glycogen synthase is involved in ______ ______ and glycogen phosphorylase is involved in _____ _____

Answer 174

glycogen production

glycogen breadkown

Question 175

viruses that replicate in the blood are a form of:

a) active viremia
b) passive viremia
c) primary viremia
d) secondary viremia

Answer 175

a

Question 176

the best prevention for HepC is:

a) hand hygiene
b) vaccination
c) education for male to male sex
d) availability of clean needles

Answer 176

d

Question 177

Hepatitis D requires which other strain of Hepatitis to replicate?

a) A
b) B
c) C
d) E

Answer 177

b

Question 178

what three features make up the anterolateral portion of the pelvic outlet?

Answer 178

lower margin of pubic symphysis, ischiopubic rabus, ischotuberosity

Question 179

activation of phosphorylase kinase converts glycogen phosphorylase B (inactive form) to its active form, glycogen phosphorylase A. what does this ezyme do?

a) convert glycogen to glucose-6-phosphate
b) convert glucose to glucose-6-phosphate
c) convert glycogen to glucose-1-phosphate
d) convert glucose-6-phosphate to glucose

Answer 179

c

Question 180

which of these is false regarding the pylorus of the stomach?

a) low pyloric glands
b) deep gastric pits
c) no chief cells
d) abdunance of parietal cells

Answer 180

d) no parietal cells

Question 181

true or false: the inferior epigastric vessels lie posteriorly to the deep inguinal ring and transversalis fascia

Answer 181

true

Question 182

lamina propria and muscularis mucosa are found in what layer of the GIT?

a) mucosa
b) submucosa
c) muscularis
d) serosa/adventita

Answer 182

a

Question 183

adding a phosphate to phosphorylase kinase will:

a) activate it and begin process of glycogen formation
b) activate it and begin process of glycogen breakdown
c) deactivate it and begin process of glycogen formation
d) deactivate it and begin process of glycogen breakdown

Answer 183

b

Question 184

oxaloacetate can enter the krebs cycle. in order to the leave the mitochondria it is converted to ______ via _____ ______. once in the cytosol, it is converted back to oxaloacetate

Answer 184

malate, malate dehydrogenase

Question 185

a good way to minimise internal bias it to:

a) have a non-randomised controlled trial
b) have a randomised controlled trial
c) prospective study
d) retrospective study

Answer 185

b

Question 186

list the following types of studies from highest strength of evidence to lowest

1. cohort studies
2. case series and reports
3. case-control studies
4. randomised controlled trials

Answer 186

4. randomised controlled trials
5. cohort studies
6. case-control studies
7. case series and reports

Question 187

glucose is a _ molecule carbon

pyruvate is a _ molecule carbon

acetyl-CoA is a _ molecule carbon

Answer 187

6, 3, 2

Question 188

how much ATP is produced for 1 molecule of acetyl-CoA entering the krebs cycle?

Answer 188

1

Question 189

which of these is true regarding hep C?

a) calicivirus
b) flavivirus
c) hepadnavirus
d) picornavirus

Answer 189

b

Question 190

phosphoglycerate kinase and pyruvate kinase produce 2x ATP each during the payoff phase of glycolysis. Complete the reactions

2x 1,3-biphosphoglycerate –> phosphoglycerate kinase –> 2x ATP + 2x ________

2x phosphoenolpyruvate –> pyruvate kinase –> 2x ATP + 2x _______

Answer 190

2x 1,3-biphosphoglycerate –> phosphoglycerate kinase –> 2x ATP + 2x 3-phosphoglycerate

2x phosphoenolpyruvate –> pyruvate kinase –> 2x ATP + 2x pyruvate

Question 191

being unaware of assigned treatment after randomisation has occurred until study completion. This it to reduce differential care and assessment of outcomes. This is called:

Answer 191

blinding or masking

Question 192

Mary and Simon have a son together called Alex and you are the family GP. Mary confided in you that Simon is not the father of Alex and she wishes to keep this a secret from the family. Simon dies of a rare heart condition that is genetically heritable at the age of 40. You provide this information to his wife, and Alex, who is now 15. Alex demands to get a genetic test to see if he also has the gene, but his mother insists “thats now how genetics works” and asks you to explain, insinuating to lie to Alex about it so he doesn’t discover the truth. What do you do?

a) lie for Mary and tell Alex that although its genetic, it can only go from fathers to daughters
b) Lie for Mary, but organise the genetic test anyway for Alex.
c) Tell Alex to discuss this with his mother further and you can decide in a few weeks whether you want to do the testing as its expensive and takes a while to organise, thus giving an opportunity for him to find out the truth.
d) tell Alex that he can’t have the condition because his father is not really his father

Answer 192

c) most financially feasible and necessary. you aren’t lying

b is probably most next acceptable

Question 193

true or false: femoral hernias account for 20% of groin hernias in males, and less than 1% of groin hernias in females

Answer 193

false: 20% females, 1% males

Question 194

what are the percentages of direct and indirect inguinal hernias?

Answer 194

direct = 20%

indirect = 80%

Question 195

when would a cohort study not be appropriate? (multiple answers)

a) studying a rare condition
b) when confounding factors are not established
c) when the condition diagnosis criteria is unclear
d) when the condition is genetically inherited

Answer 195

all

Question 196

which of these is false regarding the deep inguinal ring?

a) lateral endpoint of the canal
b) medial to inferior epigastric arteries
c) outpouching of transversalis fascia
d) found above the midpoint of the inguinal ligament

Answer 196

b) its lateral

Question 197

in exogenous transportation of lipids, lipis are encompassed in _______ where they are converted to _____ _____ ____ that enable them to enter muscle and adipose tissue

Answer 197

chylomicrons, free fatty acids

Question 198

glycogen synthase is involved in glycogen formation. addition of a phosphate will:

a) activate it and encourage glycogen production
b) inactivate it and encourage glycogen production
c) activate it and inhibit glycogen production
d) inactivate it and inhibit glycogen production

Answer 198

a

Question 199

name the enzyme pairs for both ways of reactions and state whether its involved in glycolysis or gluconeogenesis:

a) glucose glucose-6-phosphate
b) fructose-6-phosphate fructose 1,6-biphosphate

Answer 199

glucose –> glucose-6-phosphate (glycolysis) via hexokinase

glucose-6-phosphate –> glucose (gluconeogenesis) via glucose-6-phosphatase

fructose-6-phosphate –> fructose 1,6-biphosphate (glycolysis) via phosphofructokinase

fructose 1,6-biphosphate –> fructose-6-phosphate (gluconeogenesis) via fructose 1,6-biphosphatase

Question 200

postprandial, coenzyme A will be:

a) upregulated
b) downregulated
c) no effect
d) cannot tell

Answer 200

a

Question 201

systematic differences between groups in the care that is provided, or in the exposure to factors other than the interventions of interest is an example of:

a) selection bias
b) performance bias
c) detection bias
d) attrition bias
e) reporting bias

Answer 201

b

Question 202

list the following types of studies from most feasible to least feasible:

1. cohort studies
2. case series and reports
3. case-control studies
4. randomised controlled trials

Answer 202

2. case series and reports
3. case-control studies
4. cohort studies
5. randomised controlled trials

Question 203

label the week that the following events occur regarding testicular descent:

1. testes pass through inguinal canal
2. testes lie close to developing deep inguinal ring
3. testes are in the pelvic region
4. testes enter the scrotum

Answer 203

1. 28th week
2. 28th week
3. 12th week
4. 32nd week

Question 204

which of these is true regarding privacy?

a) origins in ethical duty
b) regulats the broader control of information, some of which might not be confidential
c) forms the basis of the therapeutic relationship
d) ensures professional relationship will not be disclosed without consent of the subject

Answer 204

b

the rest are on confidentiality

Question 205

true or false: veriform appendix contains villi

Answer 205

false

Question 206

during insulin release, beta cells convert glucose to glucose-6-phosphate where it undergoes glycolysis, krebs cycle, and oxidative phosphorylation to increase the ATP:ADP ratio. the enzyme involved in thsi conversion is?

Answer 206

hexokinase IV

Question 207

true or false: There is a mandatory duty in NSW for healthcare professionals to report a child at risk of significant harm.

Answer 207

true

Question 208

true or false: inferior epigastric arteries lie medial to the midpoint of the inguinal ligament

Answer 208

true

Question 209

electron transport chain occurs in:

a) cytoplasm
b) mitochondrial matrix
c) inner membrane of mitochondria
d) endoplasmic reticulum

Answer 209

c

Question 210

the use of placebos is a means of:

a) blinding
b) allocation concealment
c) randomisation
d) all of the above

Answer 210

a

Question 211

during glycolysis, 1 molecule of glucose produces _ molecules of pyruvate to enter the Krebs cycle

Answer 211

2

Question 212

which hepatitis virus is double stranded DNA?

a) A
b) B
c) C
d) E

Answer 212

B

Question 213

myenteric plexus is found in what layer of the GIT?

a) mucosa
b) submucosa
c) muscularis
d) serosa/adventita

Answer 213

c

Question 214

five types of bias are:

Answer 214

selection

performance

detection

attrition

reporting

Question 215

most epithelium of the GIT is columnar epithelium except:

a) oesophagus is stratified pseudocolumnar
b) stomach is cuboidal
c) oesophagus is stratified squamous
d) stomach is stratified pseudocolumnar

Answer 215

c

Question 216

Failure of degeneration of processus vaginalis causes an _____ inguinal hernia and is called “______”. This interferes with the descent of the testes.

Answer 216

indirect, hydrocele

Question 217

list three factors that can reduce bias and confounders in a clinical trial

Answer 217

randomisation

allocation concealment

blinding/masking

Question 218

the femoral sheath makes up the femoral canal. What forms the posterior portion of this canal?

a) transversalis fascia
b) iliopsoas fascia
c) external oblique fascia
d) all of the above

Answer 218

b

Question 219

in a fasted state, glucagon will stimulate the breakdown of _____ in the liver to the intermediate _______-__-________ which is converted to glucose via glycolysis.

Answer 219

glycogen, glucose-6-phosphate

Question 220

what is aponeurosis?

Answer 220

a flat, tendon-like structure that connects muscle to another structure

Question 221

external validity explores:

a) statistical significance of results
b) confounding factors
c) generalisability of results
d) potential for bias

Answer 221

c

Question 222

true or false: Postprandial, insulin is active. Processes are always about “genesis” of glycogen, lipids, proteins storages

Answer 222

true

Question 223

what two types of hepatitis have a faecal-oral route?

Answer 223

hep a & e

Question 224

what are the two attachment points of the tranversus abdominus that are above the umbilicus?

Answer 224

1. internal surface of costal cartilage of ribs 7-10
2. xiphoid process

Question 226

a 2 day old male has a scan that shows that coils of small intestines have persisted in the processus vaginalis next to his testes. What is this called?

a) omphalocele
b) hydrocele
c) preformed hernial sac (indirect hernia)
d) direct hernia into the scrotum

Answer 226

c

Question 227

what epithelial cells in teh duodenum secrete defensins against bacteria and parasites?

a) paneth cells
b) brunner cells
c) lieberkuhn cells
d) macrophages

Answer 227

a

Question 228

Which hep virus has the highest morality rate amongst the general population?

a) A
b) B
c) C
d) E

Answer 228

c

Question 229

digestive and absorptive cells of the small intestines are found:

a) luminal region of microvilli
b) base of microvilli in the crypts
c) neck of the crypts
d) in the submucosa

Answer 229

b

Question 230

removing a phosphate on phosphorylase kinase will:

a) activate it and inhibit to the process of glycogen breakdown
b) activate it and begin process of glycogen breakdown
c) deactivate it and inhibit to the process of glycogen breakdown
d) deactivate it and begin process of glycogen breakdown

Answer 230

c

Question 231

electrons in the electron transport chain move from ____ to ______

Answer 231

matrix to inner membrane space

Question 232

the medial arcuate ligament goes over the ____ _____.

the lateral arcuate ligament goes over the ____ _____

the median arcuate ligament is composed of fibres from the left and right ___ and goes over the ____

Answer 232

psoas major,

quadratus lumborum,

crus/crura, aorta

Question 233

the origin of the external oblique muscle is:

a) costal margin ribs 7-10
b) external surface of lower 8 ribs
c) internal surface of costal cartilages ribs 5-7
d) external surface of lower ribs 7-10

Answer 233

b

Question 234

true or false: the superficial ring and inguinal canal are formed only by the external oblique aponeuorsis

Answer 234

true

Question 235

HepB is one of the most common global infectious diseases. What percent of those infected will develop cirrhosis, liver failure or hepatocellular carcinoma?

a) 5-10%
b) 10-25%
c) 15-40%
d) 20-35%

Answer 235

c

Question 236

A chronic disease is likely to have:

a) a high number of deaths and a low DALY
b) a high number of deaths and a high DALY
c) a low number of deaths and a low DALY
d) a low number of deaths and a high DALY

Answer 236

d

Question 237

first two ATPs are produced in what reaction of glycolysis?

a) glucose to glucose-6-phosphate
b) glyceraldehyde-3-phosphate to 1,3-biphosphoglycerate
c) phosphoenolpyruvate to pyruvate
d) fructose-6-phosphate to fructose 1,6-biphosphate

Answer 237

b

Question 238

recovery for HepA is:

a) 3-6 weeks
b) 6-10 weeks
c) 10-14 weeks
d) 12-16 weeks

Answer 238

a

Question 239

true or false: direct hernias usually protrude medially to the inferior epigastric vessels and through the superficial inguinal ring

Answer 239

true

Question 240

true or false: glycogen phosphorylase is activated when glucagon binds to receptors on the liver cell surfaces

Answer 240

true

Question 241

true or false: there are vaccines available for HepA, B, and C

Answer 241

false: only C

A is only for travel, at risk groups

B is for all aus people

Question 242

Hepatitis E has a faecal oral route transmission and behaves similar to:

Answer 242

hep A

Question 243

darren, 57yo male comes into the emergency room with abdominal pain and says he has not passed stool in 8 days. Upon examination and CT scan, he has a hernia that contains part of his bowel. What kind of hernia is this?

Answer 243

direct hernia, obstruction

Question 244

detection of anti-HBcAg IgM, anti-Hbe indicates:

a) acute infection
b) chronic infection
c) vaccination
d) past infection

Answer 244

a

Question 245

systematic differences between reported and unreported findings is an example of:

a) selection bias
b) performance bias
c) detection bias
d) attrition bias
e) reporting bias

Answer 245

e

Question 246

urea is a by-product of:

a) krebs cycle
b) cori cycle
c) glucose-alanine cycle
d) beta-oxidation

Answer 246

c - protein breakdown

Question 247

what week do the testes lie close to the developing deep inguinal ring and pass through the inguinal canal?

a) 12th
b) 16th
c) 28th
d) 32nd

Answer 247

c

Question 248

cross-sectional studies are looking at:

a) prevalence of a condition
b) incidence of a condition
c) association between exposure then outcome
d) association between outcome then exposure

Answer 248

a

Question 249

pyruvate is a:

a) 2 carbon molecule
b) 3 carbon molecule
c) 4 carbon molecule
d) 6 carbon molecule

Answer 249

b

Question 250

how many portal tracts per lobule in the liver?

Answer 250

3

Question 251

which of these is NOT a product of glycolysis?

a) 2x H+
b) 2x FADH2
c) 2x ATP
d) 2x H20

Answer 251

b) 2x NADH

Question 252

which of these statements is false regarding brunner glands?

a) found in small intestines
b) appear large and pale
c) secrete alkaline mucus to neutralise chyme
d) found in mucosa layer

Answer 252

a) only duodenum

Question 253

true or false: cohort studies calculate relative risk between exposed and non-exposed groups

Answer 253

true

Question 254

which of these is true regarding hep E?

a) calicivirus
b) flavivirus
c) hepadnavirus
d) picornavirus

Answer 254

a

Question 255

which hepatitis is most dangerous for pregnant women?

a) B
b) C
c) D
d) E

Answer 255

d

Question 256

glucagon binds to ____ on cell surfaces causing a series of downstream effects. It activates _____ ______ which enables glycogen breakdown

Answer 256

GPCRs, phosphorylase kinase

Question 257

what is a major issue with retrospective studies?

Answer 257

recall bias - relies on memory and people with a condition will be more motivation to recall risk factors

Question 258

true or false: the right to consent to a treatment is equivalent to the right to refuse

Answer 258

false

Question 259

large intestines mostly produce mucus via:

a) paneth cells
b) goblet cells
c) myoepithelial acinar tubules
d) brunner cells

Answer 259

b

Question 260

randomised controlled trials are a type of _______ study

Answer 260

experimental

Question 261

Meissner’s plexus is found the ______ GIT layer and Myenteric plexus is found in the ______ GIT layer

Answer 261

submucosa

muscularis propria/muscularis

Question 262

cohort studies, case-control studies, and cross-sectional studies are all types of _______ studies. They all contain a ______ group.

Answer 262

observational, comparison

Question 263

true or false: During starvation, high levels of acetyl-CoA from fatty acid metabolism will inhibit the pyruvate dehydrogenase (pyruvate –> acetyl-CoA) to prevent glucose entering the electron transport chain. This means glucose can be recycled by other pathways to be used for betters means.

Answer 263

true

Question 264

GALT stands for

Answer 264

Gut Associated Lymphoid Tissue

Question 265

which of the following groups are not a priority for HepA vaccination?

a) men who have sex wth men
b) all Australian children
c) aboriginal and torres strait islander children
d) childcare workers

Answer 265

b

Question 266

serology results show: HepBsAg, HBV IgM and no HBVAb

this indicates:

a) Patient has had HepB vaccination
b) Patient has had HepB in the past, but no persistent infection
c) Patient has a chronic HepB infection
d) Patient has an acute HepB infection

Answer 266

d

Question 267

which of these is false regarding HepB?

a) incubation 3-6 weeks
b) transmission is by blood, sexual contact or bodily fluid
c) 5% become chronic carriers, but infection is usually acute
d) chronic liver disease is more common in children than adults

Answer 267

a) 10-12 weeks

Question 268

serology results show: HAV IgG. this indicates:

a) IgG antibodies against HepA, indicating immunity
b) IgG anitbodies against HepA, indicating vaccination
c) IgG antibodies against HepA, indicating chronic infecetion
d) IgG antibodies against HepA, indicating acute infection

Answer 268

a) we don’t know if its from past infection or vaccination. so A is most correct

Question 269

the principle route of HCV infection in childhood is by:

a) use of syringes and sharp objects
b) poor santitation and waste disposal
c) mother to child transmission
d) poor sanitation regarding food handlers

Answer 269

c

Question 270

Amy’s dad, a seemingly fit and healthly 40yo, has suddenly died. You are her dad’s GP and know that he liked to be very private about his health and life. Autopsy results show that he had a rare, hereditary genetic condition that could’ve be surgically repaired if caught earlier. You are also aware that Amy and her dad have not spoken in 3 years. What do you do?

a) tell Amy about her father’s condition as it is medically necessary due to genetic factors
b) suggest to Amy that she might want genetic testing, without telling her what for
c) provide the information to Amy’s mother, who was very close with her father and let her decide if she wants to tell their children.
d) do nothing, Amy is not your patient and she did not have a close relationship with her father

Answer 270

a) lessening or preventing a serious threat to life, health or safety.

Question 271

what lies posterior to the femoral canal?

a) lacunar ligament
b) inguinal ligament
c) femoral vein
d) pectineal ligament and pectineus muscle

Answer 271

d

Question 272

true or false: free fatty acids from lipolysis are released into the bloodstream and undergo beta-oxidation in the liver, forming ketone bodies which are a source of energy for myocytes and neurons

Answer 272

true

Question 273

true or false: Up to 20% of cases, cause of fever will not be identified despite thorough workup.

Answer 273

true

Question 274

processus vaginalis and testicular descent goes through which portion of the inguinal canal?

a) conjoint ligament
b) superficial inguinal ring
c) deep inguinal ring
d) both rings

Answer 274

c

Question 275

krebs cycle produces regeneration of?

Answer 275

oxaloacetate

Question 276

true or false: most causes of hepatitis are viral, but they can be bacterial, parasitic, drug-induced and autoimmune in origin

Answer 276

true

Question 277

true or false: the longer the duration of the fever, the less likely it is of an infectious nature

Answer 277

true

Question 278

true or false: goblet cells are only found in the large intestines

Answer 278

false: small too

Question 279

true or false: indirect hernias arise from incomplete closure of the processus vaginalis which is involved in testicular descent

Answer 279

true

Question 280

the four main principles of a good study design are:

Answer 280

1. minimise bias
2. optimise generalisability
3. feasible (data, resources, time)
4. ethically sound

Question 281

serous glands of the salivary glands produce:

Answer 281

enzymes/proteins

Question 282

a cross-sectional study:

a) exposure across multiple cohorts over a set period of time to determine risk
b) retrospectively looks at exposure factors across mutliple cohorts that have a condition
c) establishes an association between risk and outcome
d) none of the above

Answer 282

d) exposure and outcome are assessed at a specific time point, simultaneously

Question 283

without oxygen, pyruvate will:

a) form lactate via reduction of NADH to NAD+
b) form lactate via oxidation of NAD+ to NADH
c) enter the muscle to be recycled
d) enter the krebs cycle as oxaloacetate

Answer 283

a

Question 284

true or false: the inguinal ligament lies just above the inguinal canal

Answer 284

false: forms the base of the inguinal canal

Question 285

a study which looks at the outcome then works back to a common exposure is a type of:

a) controlled trial
b) cross-sectional study
c) cohort study
d) case-control study

Answer 285

d

Question 286

what week do the testes descend into the scrotum?

a) 12th
b) 16th
c) 28th
d) 32nd

Answer 286

d

Question 287

what two antigens would you see in serology of someone with hep B?

Answer 287

Anti-HBe (e antigen), anti-HBc (core antigen)

Question 288

at what age in australia can you have access to your own My Health Records?

a) 14
b) 15
c) 16
d) 18

Answer 288

a

Question 289

if the invetsigator assigns exposure, it is a type of _______ study. if exposure is not assigned, it is a type of ________ study.

Answer 289

experimental, observational

Question 290

true or false: HepC rates were high in both indigenous and non-indigenous groups. risk factors were the same

Answer 290

true

Question 291

true or false: non-randomised studies have potential for bias at each level

Answer 291

true

Question 292

ganglion cells in the intestines are found in what layer?

Answer 292

submucosa, meissner’s plexus

Question 293

the majority of inguinal hernias (80%) are:

Answer 293

indirect

Question 294

which of the following is false during starvation:

a) glucagon will add a phosphate to glycogen synthase, turning off glycogen production
b) glucagon will add a phosphate to glycogen phosphorylase, turning off glycogen breakdown
c) glucagon will act via a G-protein coupled receptor
d) all of the above are true

Answer 294

d

Question 295

the muscularis mucosa is found in the _____ layer and is two fine bands of ____ ___. it forms a continous layer down the whole length of the GIT.

Answer 295

mucosa, smooth muscle

Question 296

peyers patch appears ____ and is found in the ____

Answer 296

dark purple/purple, ileum

Question 297

what four processes does prolonged fasdting and carbohydrate restriction lead to?

Answer 297

1. lipolysis
2. gluconeogenesis
3. proteolysis
4. ketosis

Question 298

two main sites of gluconeogenesis are:

Answer 298

liver and renal cortex

Question 299

which of these is false regarding pyrexia of unknown origin?

a) fever =>2 weeks
b) failure to reach diagnosis despite three outpatient visits
c) failure to reach diagnosis wth 3 days in hospital without elucidation of a cause
d) failure to reach diagnosis with 1 week of intelligent and invasive investigation

Answer 299

a) fever =>3 weeks

Question 300

true or false: Compared with non-indigenous Australians, indigenous Australians are twice as more likely to be hospitalised due to HepA infection

Answer 300

true

Question 301

secretory product of pancreatic exocrine glands are called:

Answer 301

zymogen

Question 302

what goes between the anterior abdominal muscles and extraperitoneal fat?

a) transversalis fascia
b) deep fascia
c) visceral peritoneum
d) parietal peritoneum

Answer 302

a

Question 303

The male ________ is a fibrous tract connecting the primordial testes to the anterolateral abdominal wall at the site of the future ___ inguinal ring.

Answer 303

gubernaculum, deep

Question 304

which of the following is an example of tertiary prevention regarding HepC?

a) education for all food handlers
b) professional barber services in prisons
c) needle exchange programmes
d) hepatitis A and B vaccination

Answer 304

d

Question 305

which of these is false regarding proteolysis:

a) catabolic process
b) stimulated by starvation and glucagon
c) only occurs in the liver cytoplasm
d) amino acids are involved in gluconeogenesis

Answer 305

a) anabolic

Question 306

what lies medially to the femoral canal?

a) lacunar ligament
b) inguinal ligament
c) femoral vein
d) pectineal ligament and pectineus muscle

Answer 306

a

Question 307

true or false: there are vaccines for hep A, B and C

Answer 307

false: only A & B

Question 308

hesselbach’s triangle is a common site of direct inguinal hernia. what makes up the medial, lateral, and inferior boarders?

Answer 308

medial: lateral boarder of rectus abdominus muscle
lateral: inferior epigastric arteries
inferior: inguinal ligament

Question 309

what are the names of the two enzymes in the prepatory phase of glycolysis that perform irreversible reactions (with the use of ATP)?

Answer 309

hexokinase

phosphofructokinase

Question 310

initially during starvation, ______ in the liver is the primary source of glucose for skeletal muscle. As starvation continues, ________ in the liver becomes more important.

Answer 310

glycogenolysis

gluconeogenesis

Question 311

what are the three main times that a breach of confidentiality is permitted?

Answer 311

1. when the patient gives consent
2. when required by law
3. when there is a public interest in disclosure

Question 312

universal infant immunisation is the most effective way to reduce global burden of disease for which hepatitis?

a) HepA
b) HepB
c) HepC
d) HepD

Answer 312

b

Question 313

with oxygen, pyruvate will form _____ to enter the krebs cycle. This is done by the _______ ________ _____

Answer 313

acetyl-CoA, pyruvate dehydrogenase complex

Question 314

a femoral hernia will pass ____ and ____ to the pubic tubercle:

a) superior and medial
b) superior and lateral
c) inferior and medial
d) inferior and lateral

Answer 314

d

Question 315

a preventative measure that eliminates causes of disease or increases resistance to disease is:

a) primary
b) secondary
c) tertiary

Answer 315

a

Question 316

HbsAg (+), anti-Hbc (+), IgM anti-Hbc (-), anti-Hbs (-) indcates:

a) immune due to natural infection
b) resolved infection
c) immune due to hep B vaccination
d) chronic infection

Answer 316

d

Question 317

what two ions are involved in the release of insulin from beta cells?

Answer 317

potassium, calcium

Question 318

list the steps of pyruvate dehydrogenase complex in order

a) acetyl group is transferred to coenzyme A
b) pyruvate has a carboxyl group removed, releasing carbon dioxide
c) NAD+ is reduced to NADH

Answer 318

b - pyruvate has a carboxyl group removed, releasing carbon dioxide

c - NAD+ is reduced to NADH

a - acetyl group is transferred to coenzyme A

Question 319

an observational study is a type of:

a) retrospective case study
b) clinical trial
c) prospective cohort study
d) A & C
e) none of the above

Answer 319

d

Question 320

true or false: the lamina propria layers of the oesophagus and duodenum will contain glands

Answer 320

true

Question 321

list the structures (excluding the perineal muscles) that make up the pelvic outlet from anterior to posterior

Answer 321

lower margin of pubic symphysis, ischiopubic ramus, ischial tuberosity, sacrotuberous ligament, coccyx, coccygeal joint

Question 322

most hepatitis virus’ are ss+RNA, except:

a) A
b) B
c) C
d) E

Answer 322

b) dsDNA

Question 323

serology showing: HAV IgG, HepBsAg, HCVAb indicates:

a) patient has immunity against hepA, patient has immunity with HepB, patient has infection with HepC
b) patient has chronic infection with HepA, patient has immunity against HepB, patient has immunity with HepC
c) patient has immunity against HepA, patient has HepB, patient is vaccination against HepC
d) patient has immunity against all three conditions

Answer 323

c

Question 324

during starvation, glucagon is _____ and pyruvate kinase is ______

Answer 324

upregulated, downregulated

Question 325

HAV IgM is:

a) IgM antibodies to HepA and indicates immunity via past infection
b) IgM antibody to HepA and indicates acute infection
c) IgM antibodies to HepA and indicates immunity via vaccination
d) IgM antibody to HepA and indicates chronic infection

Answer 325

b

Question 326

if i want to look at the annual incidence of stroke in australia, the best study design is:

a) prospective population-based cohort study
b) randomised controlled clinical trial
c) a double-blind randomised controlled clinical trial
d) a retrospective case-study

Answer 326

a

Question 327

the first step of the Krebs cycle involves acetyl-CoA (2C) + ______ (4C) = ________ (6C)

Answer 327

oxaloacetate, citrate

Question 328

a hernia that occurs laterally to the inferior epigastric vessles is likely:

a) direct hernia through hesselbach’s triangle
b) indirect hernia through hesselbach’s triangle
c) direct hernia through the deep inguinal ring
d) indirect hernia through the deep inguinal ring

Answer 328

d

Question 329

a temperature of ≥38.3°C develops on several occasions in a hospitalized patient who is receiving acute care and in whom infection was not manifest or incubating on admission is what type of fever of unknown origin?

a) neutropenic
b) classic
c) nosocomial
d) hospital-acquired

Answer 329

c

Question 330

the origin of the internal oblique muscle is:

a) costal margin ribs 7-10
b) external surface of lower 8 ribs
c) internal surface of costal cartilages ribs 5-7
d) external surface of lower ribs 7-10

Answer 330

a

Question 331

which of these is FALSE regarding below the arcuate line?

a) anterior lamina is composed of all three abdominal muscle rectus sheaths
b) transveralis fascia is in direct contact with rectus abdominus
c) no posterior rectus sheath
d) none of the above. all are true

Answer 331

d

Question 332

________ is a legislated concept and pertains to a person’s need to control the access of others to their personal information.

Answer 332

privacy

Question 333

acetyl-CoA is a 2 molecule carbon. What are the other products during the conversion of 1x pyruvate to acetyl-CoA?

Answer 333

1x CO2, 1x NADH, 1x acetyl-CoA

remember two molecules of pyruvate enter the krebs cycle, this is for one molecule.

Question 334

addition of a phosphate on glycogen phosphorylase occurs via _____. This upregulates/downregulates glycogen breakdown

Answer 334

glucagon, uprgulates

Question 335

what are the aponeurotic arches that attach the diaphragm to lumbar vertebrae L1-L3?

Answer 335

medial and lateral arcuate ligaments

Question 336

A study was designed to assess the impact of sun exposure on skin damage in beach volleyball players. During a weekend tournament, players from one team wore waterproof, SPF 35 sunscreen, while players from the other team did not wear any sunscreen. At the end of the volleyball tournament players’ skin from both teams was analysed for texture, sun damage, and burns. Comparisons of skin damage were then made based on the use of sunscreen. The analysis showed a significant difference between the the teams in terms of the skin damage.

This is an example of?

a) case-control study
b) cohort study
c) cross-sectional study
d) controlled trial

Answer 336

b

Question 337

true or false: the left and right crura of the diaphragm originate fibres from L2-L4

Answer 337

true

Question 338

if i want to compare the incidence of stroke for people exposed to smoking vs. not exposed, the best study design is:

a) prospective population-based cohort study
b) randomised controlled clinical trial
c) a double-blind randomised controlled clinical trial
d) a retrospective case-study

Answer 338

a

Question 339

true or false: HepC is often symtpomatic when acute

Answer 339

true

Question 340

true or false: whilst cohort studies may convey a relationship between exposure and outcome in a prospective study, confounding issues are more of a problem

Answer 340

true:

• similar characteristics between cohorts
• masking is difficult
• no randomization

Question 341

true or false: the colon mucosa exclusively contains crypts, but no villi

Answer 341

true

Question 342

which of these is false regarding the superficial inguinal ring?

a) medial endpoint of the inguinal canal
b) lies superior to the pubic tubercle
c) composed of aponeurosis from all three abdominal muscles
d) triangle-shaped opening

Answer 342

c) just external oblique aponeurosis

Question 343

which of these is false regarding HepE?

a) faecal-oral route transmission
b) requires HepB for infection
c) high fatality amongst pregnant women
d) no progression to chronicity

Answer 343

b) this is hepD. HepE behaves like Hep A

Question 344

removal of a phosphate on glycogen synthase occurs via ______. this upregulates/downregulates production of glycogen

Answer 344

insulin, upregulates

Question 345

the conjoint ligament:

a) joins the internal oblique and transversus abdominal muscles to the pelvis
b) joins the transversalis fascia to the inguinal canal
c) attaches the inguinal canal and inguinal ligament
d) attaches the inguinal canal to the external oblique muscle

Answer 345

a

Question 346

the anterior abdominal wall has two layers of superficial fascia. Camper’s fascia is the _______ ____ ______ and Scarpa’s fascia is the ______ ______ _____

Answer 346

superficial fatty layer, deep membranous layer

Question 347

true or false: indirect hernias usually protrude medially to the inferior epigastric vessels and through the deep inguinal ring

Answer 347

false: protrude laterally

Question 348

viruses that are present in the blood, but do not replicate in the blood is:

a) active viremia
b) passive viremia
c) primary viremia
d) secondary viremia

Answer 348

b

Question 349

the linea terminalis of the pelvic inlet consists of:

Answer 349

pubic crest + pecten pubis + arcuate line

Question 350

the mid inguinal point is:

Answer 350

halfway between pubic symphysis and ASIS

Question 351

intention to treat minimises:

a) attrition bias
b) reporting bias
c) detection bias
d) all of the above

Answer 351

d

Question 352

you are on your first psych rotation at a rural hospital. A man comes in, threatening to cut his wrists and kill himself as he has done “unspeakable things”. He admits he has molested his 13yo daughter whilst she was sleeping as he was high on methamphetamine. He begs you that he wants to go clean and to keep him in-patient at the hospital so he can detox and seek counselling for him and his family. He says that you can’t tell anyone because of “patient-doctor confidentiality” and that he will never do it again. What do you do?

Answer 352

you cannot conceal a serious indictable offence. must report

Question 353

Pyruvate is translocated via _______ ________ from the cytoplasm to the mitochondrial matrix. In the mitochondrial matrix, pyruvate is converted to acetyl-CoA via ________ _________.

Answer 353

pyruvate translocase, pyruvate dehydrogenase.

Question 354

what are the three major causes for classic fever with unknown origin?

Answer 354

1. infectious
2. malignancies
3. connective tissue disease

Question 355

true or false: during starvation, muscles wont get signals to breakdown their glycogen storage (as in, if the muscle is not in use) because they lack glucose-6-phosphatase

Answer 355

true

Question 356

glycolysis is:

Answer 356

conversion of glucose to pyruvate

Question 357

the Cori Cycle is involved in:

a) formation of ketone bodies
b) glycerol backbone conversion to pyruvate as part of gluconeogenesis
c) renewal of amino acids to enter the Krebs cycle
d) conversion of lactate to pyruvate as part of gluconeogenesis

Answer 357

d

Question 358

glycogen synthase is involved in glycogen formation. removal of a phosphate will:

a) activate it and encourage glycogen production
b) inactivate it and encourage glycogen production
c) activate it and inhibit glycogen production
d) inactivate it and inhibit glycogen production

Answer 358

d

Question 359

true or false: all hydroceles are indirect hernias

Answer 359

false: not always protrusion of bowel present. hydrocele = peritoneal fluid

Question 360

endoplasmic reticulum rich area of pancreatic glands are ___/_____ in colour and secretory product zymogen regions are ____ in colour

Answer 360

blue/purple, pink

Question 361

HbsAg (-), anti-Hbc (+), anti-Hbs (+) indcates:

a) immune due to natural infection
b) susceptible
c) immune due to hep B vaccination
d) chronic infection

Answer 361

a

Question 362

true or false: the aponeuroses of all three abdominal muscles contribute to formation of linea alba

Answer 362

true

Question 363

true or false: insulin causes reactions that remove phosphates whereas glucagon causes reactions that add phosphates

Answer 363

true

Question 364

what are the two major aspects of consent?

Answer 364

1. capacity/competence
2. voluntary

Question 365

when blood glucose is low, ____ cells in the pancreas secrete _____

when blood glucose is high, ____ cells in the pancreas secrete _____

Answer 365

alpha, glucagon

beta, insulin

Question 366

which of the following indicates hep B immunity from vaccination?

a) anti-HbcAg
b) anti-HbsAg
c) anti-HbeAg
d) A and B

Answer 366

a

Question 367

which of these is not an advantage of intention to treat?

a) pragmatic estimation of real-world effects
b) maintains randomisation and sample size
c) avoid selection bias and preserves generlisability
d) enables ease of data analysis

Answer 367

d

Question 368

which of the following is an example of primary prevention of HepA?

a) routine suveillance
b) prompt diagnosis and treatment of infected food handlers
c) statutory notification
d) vaccination

Answer 368

d

Question 369

true or false: intraperitoneal organs are covered in serosa, which is a layer of “slippery” mesothelium

Answer 369

true

Question 370

true or false: postprandial, coenzyme A is downregulated and thus less acetyl-CoA will be entering the krebs cycle

Answer 370

false: its upregulated, more enters krebs cycle

Question 371

which aponeursis forms the inguinal ligament and superficial inguinal ring?

Answer 371

external oblique aponeurosis

Question 372

true or false: In Australia, most HepC outbreaks have been linked to consumption of uncooked shellfish.

Answer 372

false: hepA

Question 373

which of these statements is false?

a) most common symptoms of HepB and C are fatigue
b) HepB and C are spread by blood, sexual contact, and sharing of needles
c) 70% of individuals with HepC will progress to chronic infection
d) hepC incubation is about 7 weeks

Answer 373

b) hepC only blood

Question 374

a persistent processus vaginalis is found in a two day old male. what is the name of this congenital condition?

Answer 374

congenital hydrocele

Question 375

true or false: in routine staining you cannot differentiate between different endocrine cells in the Islet of Langerhans

Answer 375

true

Question 376

which of the following is false regarding cross-sectional studies?

a) involves calculation of odds ratio between exposed vs. non-exposed groups
b) looks at prevalence of an illness
c) participants are selected based on the inclusion and exclusion criteria
d) taken over a period of several time points

Answer 376

d) specific time point, hence only prevalence and not incidence

Question 377

when evaluating a fever of unknown origin, what is the protocol for obtaining blood cultures?
a) three sets of blood drawn from the same site every 12 hours

b) three sets of blood drawn from different sites with an interval of at least several hours
c) three sets of blood drawn from the same site every 4-6 hours
d) three sets of blood drawn from different sites with an interval of at least 24 hours

Answer 377

b

Question 378

which of these is false regarding mucous glands of the salivary gland?

a) swollen lumen makes them difficult to see
b) appear pale and lighter than serous glands
c) appear pink and darker than serous glands
d) nucleus pushed to periphery due to cytoplasm full of secretion

Answer 378

c) appear pale

Question 379

the rectus abdominus muscle is two parallel muscles that are medially defined by the _____ ____ and laterally defined by the ______ _________

Answer 379

linea alba, semilunaris

Question 380

Bile is secreted into ________ between hepatocytes, shunted by bile ducts in the ____ ______. Duct epithelium secrete a bicarbonate rich fluid, which is added to the bile

Answer 380

canaliculi, portal tracts

Question 381

what lies lateral to the femoral canal?

a) lacunar ligament
b) inguinal ligament
c) femoral vein
d) pectineal ligament and pectineus muscle

Answer 381

c

Question 382

true or false: during starvation, coenzyme A is downregulated and thus less acetyl-CoA is entering the Krebs cycle

Answer 382

true

Question 383

oxidising agents will _____ electrons, reducing agents will ______ electrons

Answer 383

accept, release

Question 384

true or false: hesselbach’s triangle is boarded inferiorly by the inguinal canal

Answer 384

false: inguinal ligament

Question 385

the site of direct inguinal hernias is called:

Answer 385

hesselbachs triangle

Question 386

HbsAg (-), anti-Hbc (-), anti-Hbs (+) indcates:

a) immune due to natural infection
b) susceptible
c) immune due to hep B vaccination
d) chronic infection

Answer 386

c

Question 387

which of these is not a feature of a congenital hydrocele?

a) persistent processus vaginalis
b) always presents with coiled bowel
c) peritoneal fluid around the testes
d) peritoneal cavity/lining in the testes

Answer 387

b) this is an indirect hernia - not always the case

Question 388

ue or false: the midpoint of the inguinal ligament is slightly more medial compared to the mid-inguinal point

Answer 388

false: opposite way around

Question 389

which of these is NOT a feature that makes up the superior boundary of the inguinal canal?

a) transversalis fascia
b) inguinal ligament
c) internal oblique
d) transversus abdominus

Answer 389

b) this makes up the inferior boundary

*transversalis fascia also amkes up posterior wall*

Question 390

true or false: indirect inguinal hernias are covered by transversalis fascia and peritoneum

Answer 390

false: this is indirect

Question 391

a study that is not applicable to other broad populations under real-world conditions is an example of a lack of _________

Answer 391

generalisability

Question 392

What are the two parts of lymphoid nodules in the GIT?

Answer 392

pale germinal centre

dark outer mantle

Question 393

5 layers of the GIT from deep to superficial are:

Answer 393

lumen –> mucosa –> submucosa –> external muscle –> serosa/adventitia/peritoneum

Question 394

the cori cycle is involved in:

a) ketone formation
b) proteolysis
c) aerobic metabolism
d) anaerobic metabolism

Answer 394

c

Question 395

what muscle’s aponeurosis forms the linea semilunaris?

a) rectus abdominus
b) external oblique
c) internal oblique
d) transversus abdominus

Answer 395

A

Question 396

true or false: the inguinal ligament is formed an outpouching of the transversalis fascia

Answer 396

false: this is the deep inguinal ring

inguinal ligament = all 3 aponeuroses

Question 397

_______ is the assurance that certain information revealed in a professional relationship will not be disclosed without the consent of the subject.

Answer 397

confidentiality

Question 398

which of these is false regarding insulin receptor substrate proteins?

a) GPCR
b) signalling adaptor protein
c) only activated by insulin
d) all of the above are true

Answer 398

a) tyrosine kinase receptor

Question 399

true or false: indirect hernias project through the inguinal ring, whereas direct hernias projet thrugh the abdominal wall

Answer 399

true

Question 400

systematic differences between groups in withdrawals from a study is an example of:

a) selection bias
b) performance bias
c) detection bias
d) attrition bias
e) reporting bias

Answer 400

d

Question 401

true or false: the femoral sheath is found in teh subinguinal space, just below the inguinal canal

Answer 401

true

Question 402

a retrospective study that is based on the outcome status and aims to determine the relationship between risk factor and disease is a:

a) controlled trial
b) cross-sectional study
c) cohort study
d) case-control study

Answer 402

d

Question 403

explain the orientation of the three layers of abdominal muscle

Answer 403

1. external oblique - waist coat/front pocket
2. internal oblique - fan shaped
3. transversus abdominal - transverse fibres

Question 404

true or false: motor innervation of the diaphragm is by phrenic nerves, but sensory innervation is from the lower 6-7 intercostal nerves and subcostal nerves

Answer 404

false: sensory is these AND the phrenic nerves

Question 405

the prepatory phase of glycolysis requires ____. The payoff phase generates ___ and _____

Answer 405

2x ATP,

4x ATP + 2NADH

Question 406

what nerve is most at risk during inguinal hernia repair?

a) iliohypogastric
b) obturator
c) genitofemoral
d) ilioinguinal

Answer 406

d

Question 407

what lies anterior to the femoral canal?

a) lacunar ligament
b) inguinal ligament
c) femoral vein
d) pectineal ligament and pectineus muscle

Answer 407

b

Question 408

true or false: external obliques are the most superficial abdominal muscle

Answer 408

false: rectus abdominus

Question 409

oxidation occurs in which three complexes of the electron transport chain?

Answer 409

I, III, IV

Question 410

what is ecological fallacy?

Answer 410

risk-associations apparent between different groups of people may not accurately reflect the true association between individuals within those groups

Question 411

true or false: all australians receive at least 4 doses of HepB vaccination

Answer 411

true

Question 412

viruses that are first released int the blood from the site of entry. concentration of virus is often low

a) active viremia
b) passive viremia
c) primary viremia
d) secondary viremia

Answer 412

c

Question 413

which of these is true regarding hep B?

a) calicivirus
b) flavivirus
c) hepadnavirus
d) picornavirus

Answer 413

c

Question 414

If a patient’s serology results show HCVAb only, this indicates:

a) antibodies against HepC due to vaccination
b) immunity to HepC via past exposure
c) current acute infection with HepC
d) current chronic infection with HepC

Answer 414

a

Question 415

true or false: the diaphragm attaches to L1, L2, and L3

Answer 415

TRUE

Question 416

true or false: In Starvation, glucagon is active. The processes are always about “lysis” of protein, lipids, and glycogen storage & reducing energy output

Answer 416

true

Question 417

the midpoint of the inguinal ligament is halfway between the ASIS and pubic tubercle. what lies just superiorly to this?

a) opening of inguinal canal
b) femoral pulse
c) arcuate line
d) conjoint ligament

Answer 417

a

Question 418

pyruvate carboxylase is involved in the conversion of _____ to ______

Answer 418

pyruvate to oxaloacetate

Question 419

the central tendon of the diaphragm attaches to:

a) posterior surface of xiphoid process
b) base of pericardial sac
c) L1
d) none of the above

Answer 419

b

Question 420

glycolysis has __ steps. the first half is the prepatory phase (investment) and the latter half is the payoff phase

Answer 420

10

1-5 and 6-10

Question 421

what are the four major parts that make up the pelvic inlet?

Answer 421

1. linea terminalis which contains pubic crest, pecten pubis, arcuate line
2. iliopectineal line
3. margin of ala
4. promontory of sacrum

Question 422

the femoral canal lies:

a) anterior to the inguinal canal
b) superior to the inguinal canal
c) inferior to the inguinal canal
d) posterior to the inguinal canal

Answer 422

c

Question 423

darren, 57yo male comes into the emergency room with abdominal pain. Upon examination and CT scan, he has a hernia that contains ischemic bowel. What kind of hernia is this?

Answer 423

direct inguinal, strangulated

Question 424

during a fasted state, fatty acids will be converted to ________ to be used by muscle and converted to _______ to be used by the brain

Answer 424

triacylglycerols, ketones

Question 425

a poor study could have (multiple answers):

a) optimised bias and optimised generalisability
b) optmised bias and minised generalisability
c) minised bias and minised generalisability
d) minised bias and optimised generalisability

Answer 425

a, b, c

Question 426

a study that looks at the exposure then the outcome prospectively is a type of:

a) case-study
b) randomised controlled clinical trial study
c) cohort study
d) cross-sectional study

Answer 426

c

Question 427

the rectus abdominus goes to which structure?

a) pubic tubercle
b) superior region of pubic symphysis
c) pubic crest
d) linea teriminalis

Answer 427

c

Question 428

what nerves pass through the left and right cruca of the diaphragm?

a) phrenic nerves
b) abdominal portion of vagal plexus
c) coeliac plexus
d) splanchnic nerves

Answer 428

d

Question 429

the krebs cycle (per 1 acetyl-CoA entering) will:

a) regenerate citrate
b) reduce 2NAD+ to 2NADH
c) release 2 molecules of CO2
d) produce 4 ATP

Answer 429

c

Question 430

true or false: during starvation, gluconeogenesis and glycogenolysis aim to increase blood glucose levels for organs that require glucose as a primary energy source

Answer 430

true

Question 431

what two major features enable glucose to enter cells?

Answer 431

1. insulin receptor substrate protein
2. GLUT-4 receptor

Question 432

which of these is false regarding pyruvate dehydrogenase?

a) involved in converted pyruvate to acetyl-CoA
b) its inhibited by high levels of ATP
c) high levels of acetyl-CoA will inhibit it
d) insulin will remove a phosphate group and activate it

Answer 432

d) it will add phosphate

Question 433

true or false: when designing a cohort study, cohorts need to be chosen from similar groups with distinct characteristics within their populations

Answer 433

false: Cohorts need to be chosen from separate, but similar, populations.

Question 434

which of these is false regarding salivary glands?

a) mucous glands appear pale on H&E slide
b) serous glands appear pink on H&E slide
c) they are both acinar and compound glands
d) mucin is secreted through cudoidal cell ducts that are surrounded by myoepithelial cells, which allows for squeezing

Answer 434

d) its columnar not cuboidal

Question 435

phosphorylation of glycogen synthase occurs via ______. this upregulates/downregulates production of glycogen

Answer 435

glucagon, downregulates

Question 436

regarding release of insulin from beta cells, what ion rapidly enters the cell after depolarisation, causing teh release of vesicles that contain pre-synthesised insulin?

a) sodium
b) calcium
c) chloride
d) potassium

Answer 436

b

Question 437

which of these is false for case-control studies?

a) participants are selected based on their outcome status
b) observational study
c) looking at exposure then outcome
d) retrospective study

Answer 437

c) its retrospective - outcome then exposure

Question 438

true or false: ecological studies are good to measure assocation between a population who has exposure to a something and the disease incidence/prevalence

Answer 438

true

Question 439

alcohol fermentation of pyruvate occurs without oxygen and is a two-step process. what are the two enzymes involved?

Answer 439

pyruvate decarboxylase, alcohol dehydrogenase

Question 440

which of these is the greatest risk factor in NSW for HepA?

a) travel to highly endemic areas
b) contact with another notified case
c) household member travel to endemic area
d) male to male sexual contact

Answer 440

a

Question 441

a high ATP:ADP ratio will have what effect on endocrine function of the pancreas?

a) release insulin
b) release glucagon
c) release both
d) release none

Answer 441

a

Question 442

Beta-oxidation occurs in the _________ _____. Fats are broken down to _____ + fatty acids and the fatty acids are converted to ______ where they then enter the Krebs cycle

Answer 442

mitochondrial matrix, glycerol, acetyl-CoA

Question 443

true or false: GLUT-1 is ubiquitously expressed

Answer 443

true

Question 444

in the last intestines, the mucularis externa is:

a) proportional to the mucosa
b) proportional to the submucosa
c) 2x thicker than mucosa
d) 2x thicker than submucosa

Answer 444

a

Question 445

list the six structures that compose the anterior abdominal wall, starting at skin:

Answer 445

1. skin
2. superficial fascia (campers fascia + scarpas fascia)
3. abdominal muscle
4. transversalis fascia
5. extraperiotneal fat
6. parietal peritoneum

Question 446

in endogenous transportation of lipids, lipids leave the liver as ____ ____ _____ ______ where they are absorbed into muscle or fat from the blood stream as free fatty acids.

Answer 446

very low density lipoprotein

Question 447

which of these is false postprandial:

a) fats are converted to triacylglycerol to be utilised by muscle as fatty acid or converted to acetyl-CoA for krebs cycme
b) glucagon is downregulated and insulin is upregulated, causing gluconeogenesis and storage of excess blood glucose
c) proteins will be converted to amino acids to form ketones or be excreted as urea
d) all of the above are true

Answer 447

b) insulin is upregulated, causing glyconeogenesis (glucose –> glycogen)

Question 448

during starvation, coenzyme A will be:

a) upregulated
b) downregulated
c) no effect
d) cannot tell

Answer 448

b

Question 449

an observational study defined by the level at which data are analysed at the population or group level, rather than the individual level is called:

Answer 449

ecological study

Question 450

portal tracts are supported by a fine connective tissue of _____

Answer 450

reticulin

Question 451

true or false: The higher positive charge in the matrix attracts the protons H+ back from the intermembrane space to the matrix. This enables ATP synthase to work

Answer 451

false: its a higher negative charge

Question 452

internal validity explores:

a) statistical significance of results
b) generalisability of results
c) confounding factors
d) potential for bias

Answer 452

d

Question 453

list the relative vertebral level that matches the following structures for skin dermatomes:

a) over epigastrium and xyphoid process
b) umbilicus
c) above inguinal ligament and pubic symphysis

Answer 453

T7

T10

L1

Question 454

what connects the peritoneum and transverus abdominus?

Answer 454

transversalis fascia

Question 455

second two ATPs are produced in what reaction of glycolysis?

a) glucose to glucose-6-phosphate
b) glyceraldehyde-3-phosphate to 1,3-biphosphoglycerate
c) phosphoenolpyruvate to pyruvate
d) fructose-6-phosphate to fructose 1,6-biphosphate

Answer 455

c

Question 456

true or false: the three muscular layers of the stomach are

inner circular

middle oblique

outer longitudinal

Answer 456

false:

inner oblique

middle circular

outer longitudinal

Question 457

where does the krebs cycle occur?

Answer 457

mitochondrial matrix

Question 458

the inguinal ligament connects which two structures?

Answer 458

anterior superior iliac spine to pubic tubercle

Question 459

true or false: The muscles of the anterior abdominal wall are separated by fascia planes (connective tissue).

Answer 459

true

Question 460

occutrs during subsequent dissemination of infection and after replication at seoncdary ites of infection, releasing more progeny.

a) active viremia
b) passive viremia
c) primary viremia
d) secondary viremia

Answer 460

d

Question 461

The glucose-alanine cycles involves glutamate (from ______ breakdown) + ______ from glycolysis is converted to alanine. This enters the blood system and goes to the liver where _______ is regenerated, and glucose is formed via gluconeogenesis. ____ is a by-product.

Answer 461

protein, pyruvate, pyruvate, urea

Question 462

is the arcuate line or semicircular line of douglas is located:

a) roughly 2 vertebral spaces above the inguinal ligament
b) roughly a vertebral space above the inguinal ligament
c) roughly 1/3 of the distance from pubic crest to umbilicus
d) roughly 2/3 of the distance from pubic crest to umbilicus

Answer 462

c

Question 463

true or false: indirect inguinal hernias are covered by peritoneum, processus vaginalis, and fascial coverings and commonly enter the scrotum

Answer 463

true

Question 464

true or false: jaundice is less commonly seen in HepA compared to other types of Hepatitis

Answer 464

true