Formative

Question 1

Which of the following antibiotics inhibits purine synthesis?

a) ciprofloxacin
b) erythromycin
c) gentamicin
d) trimethoprim
e) vancomycin

Answer 1

d) trimethoprim

Trimethoprim is the only purine synthesis inhibitor amongst these options. Erythromycin and gentamycin are protein synthesis inhibitors. Vancomycin is a cell wall synthesis inhibitor. Ciprofloxacin is a topoisomerase inhibitor.

Question 2

Which of the following is used in human immunodeficiency virus (HIV) therapy:

a) aciclovir
b) gentamicin
c) nitrofurantoin
d) nystatin
e) saquinavir

Answer 2

e) saquinavir

Saquinavir is a protease inhibitor used in combination with 2-3 anti-HIV-1 drugs targeting other stages of the HIV-1 replication cycle. Acyclovir is used for treatment of severe HSV and recurrent VZV (Shingles) infection. The other three agents are not antivirals.

Question 3

Which of the following is used only in the treatment of urinary tract infection (UTI):

a) flucloxacillin
b) gentamicin
c) nitrofurantoin
d) nystatin
e) vancomycin

Answer 3

c) nitrofurantoin

Nitrofurantoin is used for uncomplicated UTIs. It has low tissue penetration and low bioavailability.

Question 4

Serious infections with methicillin-resistant Staphylococcus aureus (MRSA) require treatment with intravenous:

a) benzylpenicillin
b) flucloxacillin
c) gentamicin
d) nystatin
e) vancomycin

Answer 4

e) vancomycin

Vancomycin is the first line treatment. Note that culture and sensitivity may reveal resistance to vancomycin - the prevalence of which has risen over the years. MRSA is resistant to benzylpenicllin and flucloxacillin.

Question 5

Serious infection with gram negative organisms such as Escherichia coli should be treated with intravenous:

a) amoxycillin
b) amphotericin B
c) gentamicin
d) nitrofurantoin
e) nystatin

Answer 5

c) gentamicin

Gentamicin is the only antibiotic on this list suitable for treatment of serious infection. Amoxycillin and nitrofurantoin are generally used to treat local infections.

Question 6

Serious systemic fungal infections require treatment with intravenous:

a) aciclovir
b) amphotericin B
c) benzylpenicillin
d) gentamicin
e) vancomycin

Answer 6

b) amphotericin B

Amphotericin B is currently marketed in the UK for intravenous use only. Topical amphotericin B treatment is available outside the UK. Other polyenes (nystatin) and azoles are used for treatment of muco-cutaneous infections. note that amphotericin B is the only antifungal on this list.

Question 7

The pathogenisis of systemic Type III hypersensitivity requires:

a) gamma-interferon production
b) immune complex formation
c) immunoglobulin E (IgE) production
d) interleukin-4 (IL-4) production
e) local IgG production

Answer 7

b) immune complex formation

Question 8

Neutrophil polymorphs:

a) have antioxidant properties
b) are responsible for pain felt in acute inflammation
c) are a major component of the acute inflammatory response
d) are usually a major component of granulomatous inflammation
e) produce vasoconstriction in inflammation

Answer 8

c) are a major component of the acute inflammatory response

Question 9

Fibroblasts:

a) are usually a major component of granulomatous inflammation
b) produce collagens
c) produce vasoconstriction in inflammation
d) promote continuation of acute inflammation
e) relax vascular smooth muscle in acute inflammation

Answer 9

b) produce collagens

Question 10

Histamine:

a) has antioxidant properties
b) is responsible for pain felt in acute inflammation
c) produces vasoconstriction in inflammation
d) promotes continuation of acute inflammation
e) relaxes vascular smooth muscle in acute inflammation

Answer 10

e) relaxes vascular smooth muscle in acute inflammation

Question 11

Hypoxia:

a) impedes tissue healing
b) is a response to antigen
c) is a systemic response to injury
d) is antibody mediated
e) is promoted by poor nutrition

Answer 11

a) impedes tissue healing

Question 12

Glyceryl trinitrate (GTN) is administered by the sublingual route to avoid:

a) first pass metabolism
b) the blood brain barrier
c) phase I metabolism
d) phase II metabolism
e) recirculation

Answer 12

a) first pass metabolism

Question 13

A drug trial in which neither patient nor doctor is aware what treatment the patient is taking is called a:

a) controlled trial
b) cross-over trial
c) double blind trial
d) prospective trial
e) randomised trial

Answer 13

c) double blind trial

Question 14

A drug trial in which data is collected from case records after treatment is given is called a:

a) controlled trial
b) double blind trial
c) prospective trial
d) randomised trial
e) retrospective trial

Answer 14

e) retrospective trial

Question 15

A drug trial in which patients take both treatments being tested one after the other is called a:

a) controlled trial
b) cross-over trial
c) double blind trial
d) double label trial
e) randomised trial

Answer 15

b) cross-over trial

Question 16

A drug trial in which patients are allotted to treatment groups using random number generation is called a:

a) controlled trial
b) cross-over trial
c) double blind trial
d) prospective trial
e) randomised trial

Answer 16

e) randomised trial

Question 17

Mitosis:

a) does not involve recombination
b) produces diploid cells from diploid cells
c) produces diploid cells from haploid cells
d) produces haploid cells from diploid cells
e) produces haploid cells from haploid cells

Answer 17

b) produces diploid cells from diploid cells

Mitosis can involve recombination, although not always, so A is wrong, making B the only correct answer.

Question 18

Meiosis:

a) does not involve recombination
b) produces diploid cells from diploid cells
c) produces diploid cells from haploid cells
d) produces haploid cells from diploid cells
e) produces haploid cells from haploid cells

Answer 18

d) produces haploid cells from diploid cells

Question 19

Fertilisation:

a) does not involve recombination
b) produces diploid cells from diploid cells
c) produces diploid cells from haploid cells
d) produces haploid cells from diploid cells
e) produces haploid cells from haploid cells

Answer 19

c) produces diploid cells from haploid cells

Question 20

The X chromosome:

a) is transmitted by fathers to daughters but not sons
b) is transmitted by mothers to daughters but not sons
c) is transmitted by mothers to sons but not daughters
d) is transmitted only by fathers
e) is transmitted only by mothers

Answer 20

a) is transmitted by fathers to daughters but not sons

Question 21

The Y chromosome:

a) is transmitted by fathers to daughters but not sons
b) is transmitted by mothers to daughters but not sons
c) is transmitted by mothers to sons but not daughters
d) is transmitted only by fathers
e) is transmitted only by mothers

Answer 21

d) is transmitted only by fathers

Question 22

Retinoblastoma:

a) is a benign tumour
b) is caused by the loss of a tumour suppressor gene
c) is due to reversible genetic changes
d) represents precursors of cancer
e) require the presence of a specific cell surface receptor

Answer 22

b) is caused by the loss of a tumour suppressor gene

Retinoblastoma is a malignant tumour (cancer) of the retina and the primary genetic cause of this tumour is loss of the retinoblastoma tumour suppressor gene so B is the single best answer. While the development of the tumour is a multistep process, A would not be regarded as the single best answer as this is true for all tumours.

Question 23

Leukaemia is:

a) a malignant tumour of bone
b) a malignant tumour of connective tissue
c) a malignant tumour of fatty tissue
d) a malignant tumour of glandular epithelium
e) a malignant tumour of white blood cells

Answer 23

e) a malignant tumour fo white blood cells

Question 24

A liposarcoma is a:

a) benign tumour of fatty tissue
b) benign tumour of glandular epithelium
c) benign tumour of squamous epithelium
d) malignant tumour of fatty tissue
e) malignant tumour of glandular epithelium

Answer 24

d) malignant tumour of fatty tissue

Question 25

An adenocarcinoma is a:

a) benign tumour of connective tissue
b) benign tumour of fatty tissue
c) benign tumour of glandular epithelium
d) malignant tumour of connective tissu
e) malignant tumour of glandular epithelium

Answer 25

e) malignant tumour of glandular epithelium

Question 26

An astrocytoma is the following type of tumour:

a) a tumour of the central nervous system
b) a tumour of the liver
c) a tumour of the lung
d) a tumour of the peripheral nervous system
e) a tumour of the skin

Answer 26

a) a tumour of the central nervous system

Question 27

A seminoma is a:

a) malignant tumour of bone
b) malignant tumour of connective tissue
c) malignant tumour of fatty tissue
d) malignant tumour of glandular epithelium
e) malignant tumour of germ cells

Answer 27

e) malignant tumour of germ cells

Question 28

The omentum is a common site of metastasis in:

a) colorectal cancer
b) lung cancer
c) ovarian cancer
d) renal cancer
e) testicular cancer

Answer 28

c) ovarian cancer

Question 29

What is the commonest type of carcinoma in men in the United Kingdom?

a) bowel
b) lung
c) myeloma
d) non-hodgkin’s lymphoma
e) prostate

Answer 29

e) prostate

Question 30

Two medical students are in a patient’s cubicle on a hospital ward. Student X examines the patient’s cervical lymph nodes while student Y documents the examination findings and does not touch the patient. Before moving on to examine another patient, which of the following hand hygiene options is appropriate?

a) only student X uses alcohol gel to clean hands
b) only student X washes hands with plain soap and water
c) only student Y uses alcohol gel to clean hands
d) only student Y washes hands with plain soap and water
e) student X and student Y wash hands with plain soap and water

Answer 30

e) student X and student Y wash hands with plain soap and water

Option E is the correct response as it is a general protocol that hands and stethoscopes should be cleansed appropriately between patient contact.
In this scenario, although only student X examined the patient, student Y was also present in the cubicle. The definition of patient contact doesn’t only include the individual who has done active examination, but also the individual present at patient site.