BCS + CCS: WK9-10 Flashcards
the right and left ____ ascend to form the central tendon of the diaphragm. They are joined by the ____ ______ ligament.
crura, median arcuate ligament
the rectus abdominus begins at what two structures?
xiphoid process
costal cartilage of ribs 5-7
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
d
true or false: generally, hepatitis virus’ are not cytolytic. Tissue damage is caused by cell-mediated immune response.
true
which two cell types of the stomach are found in the base?
chief cells, enteroendocrine
true or false: HepC treatments prevent chronicity of disease which can lead to liver cirrhosis, failure or hepatocellular carcinoma
false: treatment is not given until patient is chronic. we see if they can clear it on their own
true or false: false: the conjoint ligament sits posterolaterally to the superficial inguinal ring.
true
what is the name of the glands in the duodenum which secrete alkaline mucus to neutralise chyme?
brunner glands
five structures of the mucosa are:
- glands
- epithelium
- lamina propria
- muscularis mucosa
- lymphoid nodules
why is it important that GLUT-2 receptors have a low affinity for glucose?
to ensure rate of entry of glucose into the liver is proprtional with extracellular concentration
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 _____
circular, longitudinal, myenteric plexus, stomach
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
d
true or false: goblet cells, crypts and villi are not found in the stomach
true: has rugae
true or false: the large intestines also contain a folded surface with mucosa and significantly smaller villi compared to the small intestines
false: no villi
true or false: the conjoint ligament sits medially and anterior to the inguinal canal
false: sits behind it. slightly lateral to the superficial inguinal ring.
true or false: both hep B and C can have persistent infections
true
there are _ complexes in the electron transport chain. electrons come from reduced carriers in the Krebs cycle, ____ and _____
5, 3NADH, FADH2
detection of surface antigen for Hep B in serology indicates:
a) acute infection
b) chronic infection
c) vaccination
d) past infection
c
what are the three types of specialised epithelium in the stomach?
parietal cells
chief cells
enterendocrine cells
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
c) observational prospective
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
a) its retrospective, they already have the condition
what bone, joint, and ligament make up the posterior region of the pelvic outlet?
bone: coccyx
joint: sacroccygeal
ligament: sacrotuberous (sacrum to ischial tuberosity)
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
b
true or false: the external and internal oblique attac to the iliac crest and lumbar fascia
true
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
b) even if you de-identify the patient’s name, likely they will know who it is.
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
a) its decreased
during gluconeogenesis, what enzyme is responsible for conversion of pyruvate to oxaloacetate?
pyruvate carboxylase
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
c) just prospective
HbsAg (-), anti-Hbc (-), anti-Hbs (-) indcates:
a) immune due to natural infection
b) susceptible
c) immune due to hep B vaccination
d) chronic infection
b
lymphoid nodules are found in what layer of the GIT?
a) mucosa
b) submucosa
c) muscularis
d) serosa/adventita
a
true or false: confidentiality is a legislated duty whilst privacy is a professional duty
false: opposite way around
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
a
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
c
true or false: gluconeogenesis and glycolysis inhibit each other
true
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
c
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
adventitia - C
serosa - A
fibrosa - B
at what age can you apply for your own Medicare card?
a) 14
b) 15
c) 16
d) 18
b
what type of tubular glands are found in the duodenum?
a) simple alveolar
b) compound tubular
c) simple branched tubular
d) simple tubular
b
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
d) Formed by folds of external abdominal oblique aponeurosis
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
a
glucagon –> via enzyme ______ –> glucose-1-phosphate
glucose-1-phosphate –> via enzyme _____ –> glucose-6-phosphate
glucose-6-phosphate –> via enzyme ______ –> glucose
glycogen phosphorylase
phosphoglucomutase
glucose-6-phosphatase
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
b
The stalk of the processus vaginalis normally degenerates, however, its distal saccular part forms the _____ ________
tunica vaginalis
glycolysis of phosphoenolpyruvate to pyruvate is a one step process. the reverse of this (gluconeogensis) is a two step process. what are the steps?
pyruvate –> oxaloacetate
oxaloacetate –> phosphoenolpyruvate
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
a
which of these abdominal organs would contain adventitia?
a) stomach
b) duodenum
c) liver
d) kidneys
d) retroperitoneal
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
c
GLUT-4 receptors are found in what three tissues?
adipose tissue, skeletal muscle, heart muscle
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
d
true or false: Both HBV and HCV have effective antiviral therapies available
true
true or false: Prevalence of HepC is minimal in childhood and progressively higher with increasing age.
true
motor supply of the diaphragm comes from what nerves and origin
phrenic, C3-C5 keeps the diaphragm alive
where does the diaphragm attach sternally?
posterior surface xiphoid process
true or false: Enecavir and Tenofovir are oral treatments available in Australia to treat hepA
false: hepB
true or false: indirect hernias are usually acquired in adulthood due to weakening of the abdominal musculature
false: direct
indirect = usually congenital
true or false: all Australians receive a Hep A vaccination
false: only if high risk group or going to an endemic location
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
b
what type of gastric tubular glands are found in the stomach?
a) simple alveolar
b) compound tubular
c) simple branched tubular
d) simple tubular
c
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
d
true or false: acute hepatitis C is less common than A and B
true
vireremia is:
presence of virus particles in the blood
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
a
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
true
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
d) 15-45 days (2-6 weeks)
true or false: the jejunum has fewer and shorter villi compared to the duodenum
true
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?
neutropenic pyrexia/neutropenic fever of unknown origin
true or false: lactate dehydrogenase causes pyruvate + 2NADH –> lactate + 2NAD+ in muscles in the absence of oxygen. This is an irreversible reaction.
fales: reversible. rest is true
true or false: majority of energy for the liver is from fatty acid oxidation
true
what connects the mucosa and submucosa?
a) connective tissue
b) lamina propria
c) muscularis mucosa
d) inner longitudinal muscle layer
c) this is also smooth muscle
HbsAg (-), anti-Hbc (+), anti-Hbs (-) indicates:
a) resolved infection
b) acute infection
c) immune due to hep B vaccination
d) chronic infection
a
true or false: mucous cells and parietal stomach cells are found in the pit and isthmus respectively
true
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
a
hexokinase and phosphofructokinase perform irreversible reactions in the prepatory phase of glycolysis. complete the reactions
Glucose –> ATP + hexokinase –> __________
fructose-6-phosphate –> ATP + phosphofructokinase –> __________
Glucose –> ATP + hexokinase –> glucose-6-phosphate
fructose-6-phosphate –> ATP + phosphofructokinase –> fructose-1,6-biphosphate
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
d
a preventative measure that limits the physical and social consequences of symptomatic disease is:
a) primary
b) secondary
c) tertiary
c
villi in the small intestines are formed by ___ ______ and microvilli
plicae circularis
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
b
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
b
true or false: the inguinal ligament lies inferior to the inguinal canal and is thickened medially by the lacunar ligament
true
the best prevention for HepA is:
a) cooking, peeling, and boiling fruit and veg
b) hand hygiene
c) immunisation
d) avoid sharing needles
c
portal tract contains:
vein, artery, 1 branch of bile duct, lymphatic vessel
ketogenesis is upregulated by prolonged starvation and glucagon. it involves the conversion of acetyl-CoA to ________ via _____________
malonyl-CoA, aceyyl-CoA carboxylase
true or false: direct inguinal hernias rarely enter the scrotum
true
disability-adjusted life years is:
years of healthy life lost + years of healthly life lost to disability
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
c) systemic error
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:
allocation concealment
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
a
true or false: Compared with non-indigenous Australians, indigenous Australians are almost 2.5x more likely to have HAV diagnosed.
false: 3x
sphincters contain a thickened layer of:
a) lumen
b) muscularis mucosa
c) submucosa
d) muscularis externa
d
what receptor on beta cells detects blood glucose?
GLUT-2
where can the femoral pulse be palpated?
a) mid-inguinal point
b) midpoint of inguinal ligament
c) femoral triangle
d) none of the above
a
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
b
the four parts of the gastric tubular glands are:
pit, isthmus, neck, base
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
c
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?
observation, retrospective case-control study
what is reduced during the electron transport chain?
a) ADP
b) oxygen
c) FADH
d) NAD+
b
what nerve travels through the superficial ring of the inguinal canal?
a) iliohypogastric
b) obturator
c) genitofemoral
d) ilioinguinal
d
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
primary: c
secondary: b
tertiary: a
for one molecule of glucose, how much ATP is produced in the krebs cycle?
2
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
b
glycogen phosphorylase is involved in:
breakdown of stored glycogen
what two nerves supply innervation to genitals?
ilioinguinal and gentiofemoral
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
a) people with a condition will be more motivated to recall risk factors
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
d
the rectus sheath supports the rectus abdominus. what makes up the anterior and psoterior compartment?
anterior - aponeurosis of external oblique and anterior aponeurosis of internal oblique
posterior - posterior aponeurosis of internal oblique and aponeurosis of transversus abdominus
true or false: Hepatitis C is usually an acute infection with subclinical illness and self-limiting.
false: Hep A
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.
false: superficial inguinal ring
acetyl-CoA is regulated by:
a) availability of pyruvate
b) oxygen
c) pyruvate dehydrogenase
d) acetyl-CoA carboxylase
d
what are the four types of fever?
- continued
- intermittent
- remittent
- relapsing
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
a
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
a) true
b) true
what are the three layers of muscularis externa in the stomach?
inner oblique
middle circular
outer longitudinal
the glucose-alanine cycle is involved in:
a) ketone formation
b) proteolysis
c) aerobic metabolism
d) anaerobic metabolism
b) urea formation is by-product
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
b
glycolysis produces __ of ATP
krebs cycle produces __ of ATP
electron transport chain produces up to __ of ATP
2, 2, 34
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
d
which organs require glucose as the primary carbon source? list at least 3
brain/CNS
muscles
kidneys
testes
erythrocytes
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
b) high levels increase pyruvate carboxylase. this increases ketone production
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.
false: its hepA not C
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
b
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
a
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
b) first 1/3
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
b) deep fundic glands
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:
intention to treat
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
b
what are the three muscles that make up the posterior abdominal wall regarding the abdominopelvic cavity?
psoas major, quadratus lumborum, diaphragm
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
c
the midpoint of the inguinal ligament is:
halfway between ASIS and pubic tubercle
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 ____
pit, isthmus, neck, base
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
d
peyer’s patches are large lymphoid nodule aggregates found where?
a) appendix
b) jejunum
c) caecum
d) ileum
d
coenzyme Av(CoA-SH) is regulated by _______ __________. This is stimulated by ____ and inhibited by _____ and adrenalin
acetyl-CoA carboxylase, insulin, glucagon
what are the three main steps of the electron transport chain?
- generating a proton motive force
- ATP synthesis via chemiosmosis
- reduction of oxygen
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
c
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
d
true or false: the majority of epithelium in the GIT is columnar
true
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
c
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+
acetylaldehyde, CO2, acetylaldehyde
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
b) part of spermatic cord
the inguinal ligament goes from ASIS to pubic tubercle. What forms it?
aponeurosis of external oblique, internal oblique, and transversus abdominus
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 _______.
processus vaginalis, scrotum
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
d) its 2x
which of these is true regarding hep A?
a) calicivirus
b) flavivirus
c) hepadnavirus
d) picornavirus
d
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
c
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
c) needs to be high
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
true
true or false: both Hep A and B are likely to be acute, subclinical and self-limiting
true
removal of a phosphate on glycogen phosphorylase occurs via _____. This upregulates/downregulates glycogen breakdown
insulin, downregulates
Lactate can be used as a fuel as it acts as a substrate for glucose production in the liver via the _____ _____.
cori cycle
true or false: retroperitoneal organs are covered in serosa which attaches them to the abdominal wall
false: this is adventitia
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
a
true or false: the veriform appendix still contains crypts of Leiberkuhn
true
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
D
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
b) pale stool, dark brown urine
femoral hernias occur in:
a) deep inguinal ring
b) Hesselbach’s triangle
c) femoral canal
d) femoral triangle
c
mucous glands of the salivary glands produce:
mucin (must be spelt correctly!!)
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:
allocation concealment
blinding/masking
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
d
true or false: peripheral parts of the diaphragm have sensory innervation from intercostal nerves and subcostal nerves
true
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%
c) 100:1 insulin to amylin
true or false: bright, yellow urine is a common sign of Hep A
true
the internal oblique originates from the costal margins of ribs 7-10 and connects to what two structures?
lumbar fascia + anterior 2/3 of iliac crest
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
b) not all patients progress to icteric phase
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
b
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
c
true or false: randomisation is a good way to avoid bias, but not confounding factors such as age
false: good for both
which of the following indicates hep B immunity from past infection?
a) anti-HbcAg
b) anti-HbsAg
c) anti-HbeAg
d) A and B
D
what act encompasses laws regarding privacy?
commonwealth privacy act 1998
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)
zymogen, high rough endoplasmic reticulum
the inguinal canal is sandwiched superiorly and posteriorly by what two structures?
superiorly: aponeurosis of external oblique (and internal oblique laterally)
posteriroly: transversalis fascia
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
b
true or false: cross-sectional studies tell us information about prevalence of disease and potential causation due to exposure
false: just prevalence
the junction beteen the greater and lesser pelvis is:
pelvic brim
glycogen synthase is involved in ______ ______ and glycogen phosphorylase is involved in _____ _____
glycogen production
glycogen breadkown
viruses that replicate in the blood are a form of:
a) active viremia
b) passive viremia
c) primary viremia
d) secondary viremia
a
the best prevention for HepC is:
a) hand hygiene
b) vaccination
c) education for male to male sex
d) availability of clean needles
d
Hepatitis D requires which other strain of Hepatitis to replicate?
a) A
b) B
c) C
d) E
b
what three features make up the anterolateral portion of the pelvic outlet?
lower margin of pubic symphysis, ischiopubic rabus, ischotuberosity
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
c
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
d) no parietal cells
true or false: the inferior epigastric vessels lie posteriorly to the deep inguinal ring and transversalis fascia
true
lamina propria and muscularis mucosa are found in what layer of the GIT?
a) mucosa
b) submucosa
c) muscularis
d) serosa/adventita
a
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
b
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
malate, malate dehydrogenase
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
b
list the following types of studies from highest strength of evidence to lowest
- cohort studies
- case series and reports
- case-control studies
- randomised controlled trials
- randomised controlled trials
- cohort studies
- case-control studies
- case series and reports
glucose is a _ molecule carbon
pyruvate is a _ molecule carbon
acetyl-CoA is a _ molecule carbon
6, 3, 2
how much ATP is produced for 1 molecule of acetyl-CoA entering the krebs cycle?
1
which of these is true regarding hep C?
a) calicivirus
b) flavivirus
c) hepadnavirus
d) picornavirus
b
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 _______
2x 1,3-biphosphoglycerate –> phosphoglycerate kinase –> 2x ATP + 2x 3-phosphoglycerate
2x phosphoenolpyruvate –> pyruvate kinase –> 2x ATP + 2x pyruvate
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:
blinding or masking
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
c) most financially feasible and necessary. you aren’t lying
b is probably most next acceptable
true or false: femoral hernias account for 20% of groin hernias in males, and less than 1% of groin hernias in females
false: 20% females, 1% males
what are the percentages of direct and indirect inguinal hernias?
direct = 20%
indirect = 80%
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
all
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
b) its lateral
in exogenous transportation of lipids, lipis are encompassed in _______ where they are converted to _____ _____ ____ that enable them to enter muscle and adipose tissue
chylomicrons, free fatty acids
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
a
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
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
postprandial, coenzyme A will be:
a) upregulated
b) downregulated
c) no effect
d) cannot tell
a
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
b
list the following types of studies from most feasible to least feasible:
- cohort studies
- case series and reports
- case-control studies
- randomised controlled trials
- case series and reports
- case-control studies
- cohort studies
- randomised controlled trials
label the week that the following events occur regarding testicular descent:
- testes pass through inguinal canal
- testes lie close to developing deep inguinal ring
- testes are in the pelvic region
- testes enter the scrotum
- 28th week
- 28th week
- 12th week
- 32nd week
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
b
the rest are on confidentiality
true or false: veriform appendix contains villi
false
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?
hexokinase IV
true or false: There is a mandatory duty in NSW for healthcare professionals to report a child at risk of significant harm.
true
true or false: inferior epigastric arteries lie medial to the midpoint of the inguinal ligament
true
electron transport chain occurs in:
a) cytoplasm
b) mitochondrial matrix
c) inner membrane of mitochondria
d) endoplasmic reticulum
c
the use of placebos is a means of:
a) blinding
b) allocation concealment
c) randomisation
d) all of the above
a
during glycolysis, 1 molecule of glucose produces _ molecules of pyruvate to enter the Krebs cycle
2
which hepatitis virus is double stranded DNA?
a) A
b) B
c) C
d) E
B
myenteric plexus is found in what layer of the GIT?
a) mucosa
b) submucosa
c) muscularis
d) serosa/adventita
c
five types of bias are:
selection
performance
detection
attrition
reporting
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
c
Failure of degeneration of processus vaginalis causes an _____ inguinal hernia and is called “______”. This interferes with the descent of the testes.
indirect, hydrocele
list three factors that can reduce bias and confounders in a clinical trial
randomisation
allocation concealment
blinding/masking
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
b
in a fasted state, glucagon will stimulate the breakdown of _____ in the liver to the intermediate _______-__-________ which is converted to glucose via glycolysis.
glycogen, glucose-6-phosphate
what is aponeurosis?
a flat, tendon-like structure that connects muscle to another structure
external validity explores:
a) statistical significance of results
b) confounding factors
c) generalisability of results
d) potential for bias
c
true or false: Postprandial, insulin is active. Processes are always about “genesis” of glycogen, lipids, proteins storages
true
what two types of hepatitis have a faecal-oral route?
hep a & e
what are the two attachment points of the tranversus abdominus that are above the umbilicus?
- internal surface of costal cartilage of ribs 7-10
- xiphoid process
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
c
what epithelial cells in teh duodenum secrete defensins against bacteria and parasites?
a) paneth cells
b) brunner cells
c) lieberkuhn cells
d) macrophages
a
Which hep virus has the highest morality rate amongst the general population?
a) A
b) B
c) C
d) E
c
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
b
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
c
electrons in the electron transport chain move from ____ to ______
matrix to inner membrane space
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 ____
psoas major,
quadratus lumborum,
crus/crura, aorta
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
b
true or false: the superficial ring and inguinal canal are formed only by the external oblique aponeuorsis
true
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%
c
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
d
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
b
recovery for HepA is:
a) 3-6 weeks
b) 6-10 weeks
c) 10-14 weeks
d) 12-16 weeks
a
true or false: direct hernias usually protrude medially to the inferior epigastric vessels and through the superficial inguinal ring
true
true or false: glycogen phosphorylase is activated when glucagon binds to receptors on the liver cell surfaces
true
true or false: there are vaccines available for HepA, B, and C
false: only C
A is only for travel, at risk groups
B is for all aus people
Hepatitis E has a faecal oral route transmission and behaves similar to:
hep A
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?
direct hernia, obstruction
detection of anti-HBcAg IgM, anti-Hbe indicates:
a) acute infection
b) chronic infection
c) vaccination
d) past infection
a
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
e
urea is a by-product of:
a) krebs cycle
b) cori cycle
c) glucose-alanine cycle
d) beta-oxidation
c - protein breakdown
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
c
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
a
pyruvate is a:
a) 2 carbon molecule
b) 3 carbon molecule
c) 4 carbon molecule
d) 6 carbon molecule
b
how many portal tracts per lobule in the liver?
3
which of these is NOT a product of glycolysis?
a) 2x H+
b) 2x FADH2
c) 2x ATP
d) 2x H20
b) 2x NADH
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
a) only duodenum
true or false: cohort studies calculate relative risk between exposed and non-exposed groups
true
which of these is true regarding hep E?
a) calicivirus
b) flavivirus
c) hepadnavirus
d) picornavirus
a
which hepatitis is most dangerous for pregnant women?
a) B
b) C
c) D
d) E
d
glucagon binds to ____ on cell surfaces causing a series of downstream effects. It activates _____ ______ which enables glycogen breakdown
GPCRs, phosphorylase kinase
what is a major issue with retrospective studies?
recall bias - relies on memory and people with a condition will be more motivation to recall risk factors
true or false: the right to consent to a treatment is equivalent to the right to refuse
false
large intestines mostly produce mucus via:
a) paneth cells
b) goblet cells
c) myoepithelial acinar tubules
d) brunner cells
b
randomised controlled trials are a type of _______ study
experimental
Meissner’s plexus is found the ______ GIT layer and Myenteric plexus is found in the ______ GIT layer
submucosa
muscularis propria/muscularis
cohort studies, case-control studies, and cross-sectional studies are all types of _______ studies. They all contain a ______ group.
observational, comparison
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.
true
GALT stands for
Gut Associated Lymphoid Tissue
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
b
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
d
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
a) 10-12 weeks
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
a) we don’t know if its from past infection or vaccination. so A is most correct
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
c
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
a) lessening or preventing a serious threat to life, health or safety.
what lies posterior to the femoral canal?
a) lacunar ligament
b) inguinal ligament
c) femoral vein
d) pectineal ligament and pectineus muscle
d
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
true
true or false: Up to 20% of cases, cause of fever will not be identified despite thorough workup.
true
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
c
krebs cycle produces regeneration of?
oxaloacetate
true or false: most causes of hepatitis are viral, but they can be bacterial, parasitic, drug-induced and autoimmune in origin
true
true or false: the longer the duration of the fever, the less likely it is of an infectious nature
true
true or false: goblet cells are only found in the large intestines
false: small too
true or false: indirect hernias arise from incomplete closure of the processus vaginalis which is involved in testicular descent
true
the four main principles of a good study design are:
- minimise bias
- optimise generalisability
- feasible (data, resources, time)
- ethically sound
serous glands of the salivary glands produce:
enzymes/proteins
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
d) exposure and outcome are assessed at a specific time point, simultaneously
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
a
true or false: the inguinal ligament lies just above the inguinal canal
false: forms the base of the inguinal canal
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
d
what week do the testes descend into the scrotum?
a) 12th
b) 16th
c) 28th
d) 32nd
d
what two antigens would you see in serology of someone with hep B?
Anti-HBe (e antigen), anti-HBc (core antigen)
at what age in australia can you have access to your own My Health Records?
a) 14
b) 15
c) 16
d) 18
a
if the invetsigator assigns exposure, it is a type of _______ study. if exposure is not assigned, it is a type of ________ study.
experimental, observational
true or false: HepC rates were high in both indigenous and non-indigenous groups. risk factors were the same
true
true or false: non-randomised studies have potential for bias at each level
true
ganglion cells in the intestines are found in what layer?
submucosa, meissner’s plexus
the majority of inguinal hernias (80%) are:
indirect
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
d
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.
mucosa, smooth muscle
peyers patch appears ____ and is found in the ____
dark purple/purple, ileum
what four processes does prolonged fasdting and carbohydrate restriction lead to?
- lipolysis
- gluconeogenesis
- proteolysis
- ketosis
two main sites of gluconeogenesis are:
liver and renal cortex
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
a) fever =>3 weeks
true or false: Compared with non-indigenous Australians, indigenous Australians are twice as more likely to be hospitalised due to HepA infection
true
secretory product of pancreatic exocrine glands are called:
zymogen
what goes between the anterior abdominal muscles and extraperitoneal fat?
a) transversalis fascia
b) deep fascia
c) visceral peritoneum
d) parietal peritoneum
a
The male ________ is a fibrous tract connecting the primordial testes to the anterolateral abdominal wall at the site of the future ___ inguinal ring.
gubernaculum, deep
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
d
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
a) anabolic
what lies medially to the femoral canal?
a) lacunar ligament
b) inguinal ligament
c) femoral vein
d) pectineal ligament and pectineus muscle
a
true or false: there are vaccines for hep A, B and C
false: only A & B
hesselbach’s triangle is a common site of direct inguinal hernia. what makes up the medial, lateral, and inferior boarders?
medial: lateral boarder of rectus abdominus muscle
lateral: inferior epigastric arteries
inferior: inguinal ligament
what are the names of the two enzymes in the prepatory phase of glycolysis that perform irreversible reactions (with the use of ATP)?
hexokinase
phosphofructokinase
initially during starvation, ______ in the liver is the primary source of glucose for skeletal muscle. As starvation continues, ________ in the liver becomes more important.
glycogenolysis
gluconeogenesis
what are the three main times that a breach of confidentiality is permitted?
- when the patient gives consent
- when required by law
- when there is a public interest in disclosure
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
b
with oxygen, pyruvate will form _____ to enter the krebs cycle. This is done by the _______ ________ _____
acetyl-CoA, pyruvate dehydrogenase complex
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
d
a preventative measure that eliminates causes of disease or increases resistance to disease is:
a) primary
b) secondary
c) tertiary
a
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
d
what two ions are involved in the release of insulin from beta cells?
potassium, calcium
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
b - pyruvate has a carboxyl group removed, releasing carbon dioxide
c - NAD+ is reduced to NADH
a - acetyl group is transferred to coenzyme A
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
d
true or false: the lamina propria layers of the oesophagus and duodenum will contain glands
true
list the structures (excluding the perineal muscles) that make up the pelvic outlet from anterior to posterior
lower margin of pubic symphysis, ischiopubic ramus, ischial tuberosity, sacrotuberous ligament, coccyx, coccygeal joint
most hepatitis virus’ are ss+RNA, except:
a) A
b) B
c) C
d) E
b) dsDNA
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
c
during starvation, glucagon is _____ and pyruvate kinase is ______
upregulated, downregulated
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
b
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
a
the first step of the Krebs cycle involves acetyl-CoA (2C) + ______ (4C) = ________ (6C)
oxaloacetate, citrate
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
d
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
c
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
a
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
d
________ is a legislated concept and pertains to a person’s need to control the access of others to their personal information.
privacy
acetyl-CoA is a 2 molecule carbon. What are the other products during the conversion of 1x pyruvate to acetyl-CoA?
1x CO2, 1x NADH, 1x acetyl-CoA
remember two molecules of pyruvate enter the krebs cycle, this is for one molecule.
addition of a phosphate on glycogen phosphorylase occurs via _____. This upregulates/downregulates glycogen breakdown
glucagon, uprgulates
what are the aponeurotic arches that attach the diaphragm to lumbar vertebrae L1-L3?
medial and lateral arcuate ligaments
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
b
true or false: the left and right crura of the diaphragm originate fibres from L2-L4
true
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
a
true or false: HepC is often symtpomatic when acute
true
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
true:
- similar characteristics between cohorts
- masking is difficult
- no randomization
true or false: the colon mucosa exclusively contains crypts, but no villi
true
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
c) just external oblique aponeurosis
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
b) this is hepD. HepE behaves like Hep A
removal of a phosphate on glycogen synthase occurs via ______. this upregulates/downregulates production of glycogen
insulin, upregulates
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
a
the anterior abdominal wall has two layers of superficial fascia. Camper’s fascia is the _______ ____ ______ and Scarpa’s fascia is the ______ ______ _____
superficial fatty layer, deep membranous layer
true or false: indirect hernias usually protrude medially to the inferior epigastric vessels and through the deep inguinal ring
false: protrude laterally
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
b
the linea terminalis of the pelvic inlet consists of:
pubic crest + pecten pubis + arcuate line
the mid inguinal point is:
halfway between pubic symphysis and ASIS
intention to treat minimises:
a) attrition bias
b) reporting bias
c) detection bias
d) all of the above
d
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?
you cannot conceal a serious indictable offence. must report
Pyruvate is translocated via _______ ________ from the cytoplasm to the mitochondrial matrix. In the mitochondrial matrix, pyruvate is converted to acetyl-CoA via ________ _________.
pyruvate translocase, pyruvate dehydrogenase.
what are the three major causes for classic fever with unknown origin?
- infectious
- malignancies
- connective tissue disease
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
true
glycolysis is:
conversion of glucose to pyruvate
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
d
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
d
true or false: all hydroceles are indirect hernias
false: not always protrusion of bowel present. hydrocele = peritoneal fluid
endoplasmic reticulum rich area of pancreatic glands are ___/_____ in colour and secretory product zymogen regions are ____ in colour
blue/purple, pink
HbsAg (-), anti-Hbc (+), anti-Hbs (+) indcates:
a) immune due to natural infection
b) susceptible
c) immune due to hep B vaccination
d) chronic infection
a
true or false: the aponeuroses of all three abdominal muscles contribute to formation of linea alba
true
true or false: insulin causes reactions that remove phosphates whereas glucagon causes reactions that add phosphates
true
what are the two major aspects of consent?
- capacity/competence
- voluntary
when blood glucose is low, ____ cells in the pancreas secrete _____
when blood glucose is high, ____ cells in the pancreas secrete _____
alpha, glucagon
beta, insulin
which of the following indicates hep B immunity from vaccination?
a) anti-HbcAg
b) anti-HbsAg
c) anti-HbeAg
d) A and B
a
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
d
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
d
true or false: intraperitoneal organs are covered in serosa, which is a layer of “slippery” mesothelium
true
true or false: postprandial, coenzyme A is downregulated and thus less acetyl-CoA will be entering the krebs cycle
false: its upregulated, more enters krebs cycle
which aponeursis forms the inguinal ligament and superficial inguinal ring?
external oblique aponeurosis
true or false: In Australia, most HepC outbreaks have been linked to consumption of uncooked shellfish.
false: hepA
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
b) hepC only blood
a persistent processus vaginalis is found in a two day old male. what is the name of this congenital condition?
congenital hydrocele
true or false: in routine staining you cannot differentiate between different endocrine cells in the Islet of Langerhans
true
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
d) specific time point, hence only prevalence and not incidence
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
b
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
c) appear pale
the rectus abdominus muscle is two parallel muscles that are medially defined by the _____ ____ and laterally defined by the ______ _________
linea alba, semilunaris
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
canaliculi, portal tracts
what lies lateral to the femoral canal?
a) lacunar ligament
b) inguinal ligament
c) femoral vein
d) pectineal ligament and pectineus muscle
c
true or false: during starvation, coenzyme A is downregulated and thus less acetyl-CoA is entering the Krebs cycle
true
oxidising agents will _____ electrons, reducing agents will ______ electrons
accept, release
true or false: hesselbach’s triangle is boarded inferiorly by the inguinal canal
false: inguinal ligament
the site of direct inguinal hernias is called:
hesselbachs triangle
HbsAg (-), anti-Hbc (-), anti-Hbs (+) indcates:
a) immune due to natural infection
b) susceptible
c) immune due to hep B vaccination
d) chronic infection
c
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
b) this is an indirect hernia - not always the case
ue or false: the midpoint of the inguinal ligament is slightly more medial compared to the mid-inguinal point
false: opposite way around
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
b) this makes up the inferior boundary
*transversalis fascia also amkes up posterior wall*
true or false: indirect inguinal hernias are covered by transversalis fascia and peritoneum
false: this is indirect
a study that is not applicable to other broad populations under real-world conditions is an example of a lack of _________
generalisability
What are the two parts of lymphoid nodules in the GIT?
pale germinal centre
dark outer mantle
5 layers of the GIT from deep to superficial are:
lumen –> mucosa –> submucosa –> external muscle –> serosa/adventitia/peritoneum
the cori cycle is involved in:
a) ketone formation
b) proteolysis
c) aerobic metabolism
d) anaerobic metabolism
c
what muscle’s aponeurosis forms the linea semilunaris?
a) rectus abdominus
b) external oblique
c) internal oblique
d) transversus abdominus
A
true or false: the inguinal ligament is formed an outpouching of the transversalis fascia
false: this is the deep inguinal ring
inguinal ligament = all 3 aponeuroses
_______ is the assurance that certain information revealed in a professional relationship will not be disclosed without the consent of the subject.
confidentiality
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
a) tyrosine kinase receptor
true or false: indirect hernias project through the inguinal ring, whereas direct hernias projet thrugh the abdominal wall
true
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
d
true or false: the femoral sheath is found in teh subinguinal space, just below the inguinal canal
true
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
d
explain the orientation of the three layers of abdominal muscle
- external oblique - waist coat/front pocket
- internal oblique - fan shaped
- transversus abdominal - transverse fibres
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
false: sensory is these AND the phrenic nerves
the prepatory phase of glycolysis requires ____. The payoff phase generates ___ and _____
2x ATP,
4x ATP + 2NADH
what nerve is most at risk during inguinal hernia repair?
a) iliohypogastric
b) obturator
c) genitofemoral
d) ilioinguinal
d
what lies anterior to the femoral canal?
a) lacunar ligament
b) inguinal ligament
c) femoral vein
d) pectineal ligament and pectineus muscle
b
true or false: external obliques are the most superficial abdominal muscle
false: rectus abdominus
oxidation occurs in which three complexes of the electron transport chain?
I, III, IV
what is ecological fallacy?
risk-associations apparent between different groups of people may not accurately reflect the true association between individuals within those groups
true or false: all australians receive at least 4 doses of HepB vaccination
true
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
c
which of these is true regarding hep B?
a) calicivirus
b) flavivirus
c) hepadnavirus
d) picornavirus
c
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
a
true or false: the diaphragm attaches to L1, L2, and L3
TRUE
true or false: In Starvation, glucagon is active. The processes are always about “lysis” of protein, lipids, and glycogen storage & reducing energy output
true
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
a
pyruvate carboxylase is involved in the conversion of _____ to ______
pyruvate to oxaloacetate
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
b
glycolysis has __ steps. the first half is the prepatory phase (investment) and the latter half is the payoff phase
10
1-5 and 6-10
what are the four major parts that make up the pelvic inlet?
- linea terminalis which contains pubic crest, pecten pubis, arcuate line
- iliopectineal line
- margin of ala
- promontory of sacrum
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
c
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?
direct inguinal, strangulated
during a fasted state, fatty acids will be converted to ________ to be used by muscle and converted to _______ to be used by the brain
triacylglycerols, ketones
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
a, b, c
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
c
the rectus abdominus goes to which structure?
a) pubic tubercle
b) superior region of pubic symphysis
c) pubic crest
d) linea teriminalis
c
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
d
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
c
true or false: during starvation, gluconeogenesis and glycogenolysis aim to increase blood glucose levels for organs that require glucose as a primary energy source
true
what two major features enable glucose to enter cells?
- insulin receptor substrate protein
- GLUT-4 receptor
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
d) it will add phosphate
true or false: when designing a cohort study, cohorts need to be chosen from similar groups with distinct characteristics within their populations
false: Cohorts need to be chosen from separate, but similar, populations.
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
d) its columnar not cuboidal
phosphorylation of glycogen synthase occurs via ______. this upregulates/downregulates production of glycogen
glucagon, downregulates
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
b
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
c) its retrospective - outcome then exposure
true or false: ecological studies are good to measure assocation between a population who has exposure to a something and the disease incidence/prevalence
true
alcohol fermentation of pyruvate occurs without oxygen and is a two-step process. what are the two enzymes involved?
pyruvate decarboxylase, alcohol dehydrogenase
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
a
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
a
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
mitochondrial matrix, glycerol, acetyl-CoA
true or false: GLUT-1 is ubiquitously expressed
true
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
a
list the six structures that compose the anterior abdominal wall, starting at skin:
- skin
- superficial fascia (campers fascia + scarpas fascia)
- abdominal muscle
- transversalis fascia
- extraperiotneal fat
- parietal peritoneum
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.
very low density lipoprotein
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
b) insulin is upregulated, causing glyconeogenesis (glucose –> glycogen)
during starvation, coenzyme A will be:
a) upregulated
b) downregulated
c) no effect
d) cannot tell
b
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:
ecological study
portal tracts are supported by a fine connective tissue of _____
reticulin
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
false: its a higher negative charge
internal validity explores:
a) statistical significance of results
b) generalisability of results
c) confounding factors
d) potential for bias
d
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
T7
T10
L1
what connects the peritoneum and transverus abdominus?
transversalis fascia
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
c
true or false: the three muscular layers of the stomach are
inner circular
middle oblique
outer longitudinal
false:
inner oblique
middle circular
outer longitudinal
where does the krebs cycle occur?
mitochondrial matrix
the inguinal ligament connects which two structures?
anterior superior iliac spine to pubic tubercle
true or false: The muscles of the anterior abdominal wall are separated by fascia planes (connective tissue).
true
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
d
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.
protein, pyruvate, pyruvate, urea
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
c
true or false: indirect inguinal hernias are covered by peritoneum, processus vaginalis, and fascial coverings and commonly enter the scrotum
true
true or false: jaundice is less commonly seen in HepA compared to other types of Hepatitis
true
