FunMed Qs Flashcards

Question

A 72-year-old retired biochemist presents to a haemato-oncology clinic for a review of his recent blood tests. The haematologist explains that glycoproteins on the cell surface membrane of follicular lymphoma cells facilitate the transduction of pro-survival signals from the tumour microenvironment. Proteins are processed in several stages before their expression on the cell surface membrane. Given this information, would be the last organelle involved in processing folded glycoproteins before their expression on the cell surface membrane? Cytoplasmic ribosomes Golgi apparatus Lysosome RER SER

Answer 1

A 72-year-old retired biochemist presents to a haemato-oncology clinic for a review of his recent blood tests. The haematologist explains that glycoproteins on the cell surface membrane of follicular lymphoma cells facilitate the transduction of pro-survival signals from the tumour microenvironment. Proteins are processed in several stages before their expression on the cell surface membrane. Given this information, would be the last organelle involved in processing folded glycoproteins before their expression on the cell surface membrane? Cytoplasmic ribosomes **Golgi apparatus** Lysosome RER SER

Answer 2

Which cell organelle is involved in the breakdown of oligopeptides? GA RER Peroxisome **Lysosome** SER

Answer 3

which of the following are specifically involved in bacterial infection? eosinophils basophils dendritic cells monocytes **neutrophils**

Answer 4

The development of cancer involves mutations to genes involved in progression through the cell cycle. Which of the following sections of the cell cycle takes the least amount of time? G1 Mitosis S phase **Anaphase** G2

Answer 5

A saturation curve is plotted to show the effect of cyanide on the activity of cytochrome oxidase. Cyanide is a non-competitive inhibitor of cytochrome oxidase. What effect will cyanide have on the Km of cytochrome oxidase? Dcrease Km Decrease Km if Vmax changes Increase KM Increase Km if Vmax changes **No effect on Km - Km is the substrate concentration at 50% of the enzyme's maximum reaction rate (Vmax) and is, therefore, a surrogate measure of an enzyme's affinity for its substrate.** ## Footnote **Non-competitive enzyme inhibitors have no effect on Km value**

Answer 6

Which of the following is not a tumour suppressor gene? p53 APC NF-1 Rb **myc** myc is an oncogene which encodes a transcription factor:

Answer 7

Mr Green is admitted via the emergency department and found to have a large liver abscess. He undergoes CT guided aspiration and the fluid is sent off for analysis. Initial microscopy demonstrates a large population of neutrophils. Which of the following cytokines is likely to have been responsible for this cell infiltration? IL-2 IL-4 IL-5 **IL-8** IL-10 **IL-8 - main functions include: neutrophil chemotaxis**

Answer 8

memory cells plasma cells

Answer 9

which cells target cellular cytoplasms? CD4 cells **CD8 cells** dendritic cells t cell depedent macrophages plasma cells **and NK cells !**

Answer 10

p53 stops cells entering which phase of the cell cycle? G1 G2 **S1** M1 M2

Answer 11

GI tract [1] blood vessels [1]

Answer 12

_Which one of the following functions/properties is most associated with CD4?_ Found on thymocytes, T cells, and some natural killer cells that acts as a ligand for CD58 and CD59 and is involved in signal transduction and cell adhesion **Co-receptor for MHC class II** The signalling component of the T cell receptor complex Unique marker for natural killer cells MHC molecule that presents lipid molecules Co-receptor for MHC class I

Answer 13

_Which one of the following functions/properties is most associated with mast cells?_ Involved in the cell-mediated immune response Recognises antigens presented by MHC class II molecules Kidney shaped nucleus Primary phagocytic cell in acute inflammation Recognises antigens presented by MHC class I molecules **Releases histamine during allergic response**

Answer 14

which of the following best describes edwards syndrome? trisomy 21 **trisomy 18** trisomy 13 trisomy 11 trisomy 10

Answer 15

**crossing over** in prophase or metaphase

Answer 16

A neonate presents with hypotonia and seizures and, after a series of investigations, is diagnosed with Zellweger syndrome, a peroxisomal disorder. What function do these organelles primarily perform? Breakdown of large molecules such as proteins and polysaccahrides **Catabolism of long chain fatty acids** Degradation of protein molecules that have been tagged wtih ubiquitin Lipid synthesis Production of lysosomal enzymes

Answer 17

_Enterococci are:_ Gram-negative rod Gram-positive rod **Gram-positive cocci** Gram-negative cocci

Answer 18

which type of transport protein is heterozygous in structure? [1] **enyzme** which type of transport proteins are in homologous structure? [2] **GPCR, nicotinic**

Answer 19

A 45-year-old primigravida enters the clinic. The triple screen blood test revealed an increased risk of Down's syndrome. Further investigations are performed including amniocentesis where a prenatal diagnosis of Down's syndrome is made. Which genetic abnormalities most commonly causes this condition? Deletion Insertion Mosiacism **Nondisjunction** Robertsonian translocation

Answer 20

A 38-year-old female is seen in clinic regarding her treatment options following recently been diagnosed with Huntington's disease. The doctor explains that Huntington's disease is caused by excess triplets of DNA units called nucleotides. What is the biochemical composition of these DNA units? **One sugar, one amine and one phosphate molecule** Two sugars, one amine and one phosphate molecule One sugar, two amines, one phosphate molecule One sugar, two amines, two phosphate molecules Two sugards, two amines, three phosphate molecules **A nucleotide is made up of one sugar, one amine and one phosphate**

Answer 21

You are a junior doctor working in orthopaedics. Whilst on a ward round, you see a patient who underwent a hemiarthroplasty 3 days ago for a broken hip. Unfortunately, they have now developed a bacterial infection of the surgical site. You consider the patient's immune response to the bacteria which are causing this infection. Which of the following immune-mediated processes would be occurring to help the patient fight this infection? Eosinophuls would destroy the bacteria **IgG would enhance the phagocytosis of bacteria and viruses** IgM would dimerise to form a hexamer and activate complement system Macrophages would produce antibodies Neutrophils would coordinate the destruction of any parasites which may be present ## Footnote **Enhance phagocytosis of bacteria and viruses - IgG**

Answer 22

_Q1) What is the most abundant cell in scar tissue?_ a. Adipocytes b. Endothelial cells **c.Fibroblasts** d. Macrophages e. Neutrophils

Answer 23

_In a cell, what is the function of the nucleus?_ Ribosome production Site of N-linked glycosylation Catabolism of very long chain fatty acids and amino acids Degradation of protein molecules that have been tagged with ubiquitin Translation of RNA into proteins **DNA maintenance and RNA transcription**

Answer 24

Which of the following is responsible for activating macrophages? **Interferon-y (IFN-y)** Histamine TNF-a IL-1 IL-6

Answer 25

Antibodies are critical for defence against pathogens, especially extracellular bacteria: * Bind to them to increase their uptake by phagocytes (for example, macrophages or neutrophils), * or to induce their killing by complement activation * or by cellular components of the immune system (antibody dependent cellular cytotoxicity, ADCC). * Block infection by preventing the binding of pathogens to critical receptors on host cells and can neutralise the activity of toxins that cause disease.

Answer 26

_Expresses CD4 cells & a major source IL-2_ Mast cells **Helper T cells** Neutrophils Monocytes B cells Cytotoxic T cells

Answer 27

Triple helical structure formed by 3 peptide chains : ▪every 3rd amino acid is glycine ▪Gly-X-Y (proline-hydroxyproline)

Answer 28

which of the following best describes patau syndrome? trisomy 21 trisomy 18 **trisomy 13** trisomy 11 trisomy 10

Answer 29

_Which one of the following functions/properties is most associated with macrophages?_ Most common type of white blood cell **Involved in phagocytosis of cellular debris and pathogens** Recognises antigens presented by MHC class I molecules Recognises antigens presented by MHC class II molecules Defends against protozoan and helminthic infections Granules contain myeloperoxidase and lysozyme

Answer 30

A 2-year-old child attends the GP surgery with chicken pox. The mother is concerned as her eldest daughter, who had chicken pox when she was 3, is about to sit the 11+ exam and she is worried she may become ill. The GP reassures the mother that she is unlikely to become infected in this case. Which of the following cells is a constituent of 'adaptive immunity' and will have a role in preventing a second episode of chicken pox? NK cells **B cells** Neutrophils Hepatocytes Goblet cells

Answer 31

A 16-year-old boy presents with learning disabilities and obesity. He is diagnosed with Prader-Willi syndrome. His mother has read on-line that the disease is closely linked to Angelman syndrome. What is the major genetic determinant which separates the two conditions? Pleiotropy Heteroplasmy Mosaicism Robertsonian translocation **Genetic imprinting** ## Footnote **Genetic imprinting is defined as a difference in phenotype dependent on whether the mutation is maternal or paternal origin**

Answer 32

_Which one of the following functions/properties is most associated with neutrophils?_ Present in tissues and are similar in function to basophils Diffferentiates into macrophages Defends against protozoan and helminthic infections Acts as an antigen presenting cell **Granules contain myeloperoxidase and lysozyme** Major source of IL-2

Answer 33

**point mutation:** causes **GTP to be permentely bound to it and allows pathway to be perm switched on**

Answer 34

_Which one of the following functions/properties is most associated with macrophages?_ Kidney shaped nucleus **Acts as an antigen presenting cell** Primary phagocytic cell in acute inflammation Recognises antigens presented by MHC class II molecules Major source of IL-2 Defends against protozoan and helminthic infections

Answer 35

An 8-month-old baby girl is brought into the GP surgery with her mother. They both recently moved to the UK and her mother is concerned that her daughter’s appearance seems different from some of the other children in her daycare centre. On examination, her daughter appears well. Although, it is noted that she has a shortened neck and a protruding tongue. There are a number of white spots visible in her iris. What is the most common cytogenetic cause of this patient’s diagnosis? Autosomal recessive Mitochondrial inheritance Mosiacism **Nondisjunction:** **Nondisjunction is the commonest cause of Down's syndrome** Robertsonian translocation ## Footnote **5% of cases of Down's syndrome are secondary to a Robertsonian translocation and 1% of cases are secondary to mosaicism. Down's syndrome is not inherited via autosomal recession or mitochondrial inheritance.**

Answer 36

A 64-year-old woman is admitted to the hospital following a 6-week history of feeling generally unwell and shortness of breath. She has also lost a stone in weight over this period. On examination, you note cervical lymphadenopathy and splenomegaly. She undergoes a lymph node biopsy and is subsequently diagnosed with diffuse large B cell lymphoma. Which of the following cytokines would normally be responsible for the proliferation of this cell type? IL-1 IL-2 IL-5 **IL-6** IL8 **IL-6 - main functions include: stimulates proliferation and differentiation of B cells**

Answer 37

A 6-year-old boy presents to the GP with recurrent chest infections and poor growth and weight gain. The patient is referred by the GP to a paediatric clinic, who order further tests including a genetic test for mutations in the CFTR gene to screen for cystic fibrosis. This confirms a single nucleotide mutation in the CFTR gene resulting in a stop codon in place of arginine. What is the name of this type of mutation? Frameshift Missense **Nonsense: results in stop codon** Silent Synonymous

Answer 38

_Effect on Vmax of uncompetitive inhibitors:_ No change **Decreased** Increased

Answer 39

**GABA Glycine**

Answer 40

Which cytokine is responsible for differentiating Th0 cells to Th1 cells? TNF-A IFN-y **IL-12** IL-4 IL-5

Answer 41

fibrocartilage

Answer 42

Which part of an antibody do immune cells bind to? Disulfide bridge Heavy chain of antigen binding site Light chain of antigen binding site **Fc region** Light chain hypervariable region

Answer 43

You are studying enzyme-kinetics before an important exam and come across the Line-Weaver Burk plot of the Michaelis-Menten model. You need to be familiar with the all the abbreviations and their meanings. What is represented by 'Km' on the Line-Weaver Burk plot? Maximum rate of the catalysed-reaction Half maximum rate of the catalysed-reaction **Concentration of substrate that leads to half maximal velocity** Concentration of substrate that leads to half maximal velocity Contratrion of substrate that leads to maximal velocity

Answer 44

_Which one of the following cell types is the main source of tumour necrosis factor-alpha?_ Th1 cells Dendritic cells Th2 cells Activated T helper cells B cells **Macrophages**

Answer 45

what type of receptor is adrenergic? ion gated enzyme linked intracellular **GPCR**

Answer 46

which of the following triggers humoral immunity? NK cells CD4+ TH1 dendritic cells **CD4+ TH2** CD4+ Th0

Answer 47

The oxygen-haemoglobin dissociation curve is shifted to the left in: **With decreased 2,3 DPG in transfused rbc** Resp. acidosis High altitude Pyrexia Haemolytic anaemia

Answer 48

which of the following is the step of cytokines making blood vessels more sticky when inflammation initially occurs? rolling & activation **tethering** diapedesis & migraton arrest expansion

Answer 49

A 19-year-old male presents to general practice with a sore throat and fatigue. On examination the GP remarks cervical lymphadenopathy and splenomegaly. The GP suspects a diagnosis of mononucleosis. Which of the following malignancies is most associated with Epstein- Barr Virus? Heptacellular carinoma **Burkitts lymphoma** Oesphageal cancer Acute lymphoblastic leukameia Kaposi sarcoma

Answer 50

_Least abundant isotype in blood serum:_ IgA **IgE** IgG IgD IgM

Answer 51

which of the following link cells to underlying basement membrane? tight junction desmosome **hemidesmosome** gap junction adherens / zonula adherens

Answer 52

which of the following activates macrophages? NK cells **CD4+ TH1** dendritic cells CD4+ TH2 CD4+ Th0

Answer 53

A baby girl is diagnosed with cystic fibrosis following her heel prick test. This disease is caused by a faulty membrane protein called the cystic fibrosis transmembrane conductance regulator. Which one of the following determines the tertiary structure of the aforementioned protein? AA sequence **Interactions between R groups of amino acids** Local H bonds Peptide bonds Presecne or abscence of a-helices

Answer 54

A 10-year-old male is referred to an oncologist for suspected lymphoma. His symptoms include fever, night sweats, weight loss and lymphadenopathy is present on examination. Molecular testing and histological analysis of a lymph node biopsy suggest a diagnosis of Burkitt's lymphoma. Which oncogene is associated with Burkitt's lymphoma ABL p53 n-MYC **c-MYC** HER2

Answer 55

_Which one of the following functions/properties is most associated with monocytes?_ Mediates acute and chronic organ rejection Are responsible for hyperacute organ rejection Present in tissues and are similar in function to basophils Involved in the cell-mediated immune response Involved in phagocytosis of cellular debris and pathogens **Diffferentiates into macrophages**

Answer 56

A 37-year-old male presents to his general practitioner with a 3-month history of altered bowel habit, with occasional blood in his stool. After a series of investigations, he is discovered to have bowel cancer, which is successfully treated with a semi-colectomy. As part of his care, it is decided to screen the patient for mutated oncogenes. What testing method would be used to screen this patient? Centrifugation Electron microscopy Enzyme linked immunosorbent assay **PCR: Polymerase chain reactions are used to detect mutated oncogenes** Western blot

Answer 57

During cell division, at what stage do sister chromatids move to opposite ends of the cell? Prometaphase Metaphase **Anaphase** Telophase Cytokinesis

Answer 58

which of the following are contain cadherins? tight junction **desmosome** hemidesmosome gap junction

Answer 59

which is the most potent APC? neutrophil plasma cell **dendritic cell** macrophages monocytes

Answer 60

The complement cascade can be activated via antibody-antigen complex formation via the classical pathway. Which of the following antibody serotypes is most effective in performing this function? IgA IgD IgE IgG **IgM** ## Footnote **IgM is a pentamer which has the highest complement activation capacity**

Answer 61

which of the following is purely involved in adaptive immunity? natural T killer cell **B cell** basophil neutrophil monocyte

Answer 62

which of the following binds to bacteria cell wall, changes the charge of the cell wall and causes it to rupture? **polymyxins** glycopeptide antiobiotics penicillin

Answer 63

**cyclins A & E**

Answer 64

Which of the following cells is a constituent of 'innate immunity?' Hepatocytes **NK cells** B cells Goblet cells T cells **NK cells promote the destruction of cells harboring pathogens and are a component of the innate response.** **B cells are responsible for antibody production and are a component of the adaptive response. T helper cells 'help' B cells by encouraging the production of specific antibodies.**

Answer 65

what plane of section is this image? **coronal** transverse sagitall oblique para-sagittal

Answer 66

_Which type of membrane receptor is activated by muscarinic acetylcholine?_ **G protein-coupled receptor** Guanylate cyclase receptor Ligand-gated ion channel receptor Non-receptor tyrosine kinase Receptor tyrosine kinase

Answer 67

A middle-aged man goes to see his GP about a recent high cholesterol reading. The GP knows he could help reduce this man's cholesterol by giving him a class of drug called a statin. Which of the following enzymes is the target of these drugs? Cartinine-palmitoyl transferase I Cartinine-palmitoyl transferase II Acetyl-CoA carboxoylase HMG-CoA synthase **HMG-CoA reductase**

Answer 68

A 10-year-old boy presents with an itchy rash on his elbows. The rash is red and there are excoriation marks. He has a past history of hay fever and has generally dry skin. The GP diagnoses him with eczema and he is prescribed hydrocortisone. The GP also explains that there are certain triggers which the boy may be hypersensitive to, including dust. Which antibody is responsible for mediating type 1 hypersensitivity? IgG IgA IgD **IgE** IgM

Answer 69

_Which one of the following functions/properties is most associated with basophils?_ Are responsible for hyperacute organ rejection Defends against protozoan and helminthic infections Involved in the cell-mediated immune response Multi-lobed nucleus **Releases histamine during allergic response** Kidney shaped nucleus

Answer 70

_Which one of the following functions/properties is most associated with helper T cells?_ Involved in phagocytosis of cellular debris and pathogens Kidney shaped nucleus Induce apoptosis in virally infected and tumour cells **Major source of IL-2** Major cell of the humoral immune response Differentiated from B cells

Answer 71

- single nucleotide exchange **GGC** TO **GTC** in bladder cancers (glycine -\> valine)

Answer 72

which of the following do you find immediately deep to tight junction? desmosome hemidesmosome gap junction **adherens / zonula adherens**

Answer 73

which leukocyte's granules contain histamine and heparin? eosinophils **basophils** dendritic cells monocytes neutrophils

Answer 74

* Memory T-cells do not require costimulatory signals from APCs to become activated in response to an infection and * respond more quickly to antigenic stimulation (proliferate faster and reach higher numbers than naïve T-cells following antigenic stimulation).

Answer 75

_Which one of the following functions/properties is most associated with cytotoxic T cells?_ Are responsible for hyperacute organ rejection Granules contain myeloperoxidase and lysozyme Recognises antigens presented by MHC class II molecules **Recognises antigens presented by MHC class I molecules** Major source of IL-2 Differentiated from B cells

Answer 76

- steroid hormones - sex hormones - vitamin D - bile salts

Answer 77

which of the following detects vibration of skin? meissner ruffini merkel **pancinian**

Answer 78

A 25-year-old woman who immigrated from Papua New Guinea with her parents as a child is coming for preconception counselling. Both her parents are known to be sickle cell trait carriers, and she is worried about her future child as she has seen sickle cell disease in others as a child. Her partner is known to also be a sickle cell trait carrier. Sickle cell disease is inherited in an autosomal recessive manner. What is the chance that the woman is a carrier of the sickle cell trait? 0% 12.5% 25% **50%** 75% **For autosomal recessive conditions, if both parents are carriers (heterozygote) there is a 50% chance of having a carrier (heterozygote) child**

Answer 79

_Which one of the following functions/properties is most associated with plasma cells?_ Recognises antigens presented by MHC class I molecules Present in tissues and are similar in function to basophils Are responsible for hyperacute organ rejection **Differentiated from B cells** Major cell of the humoral immune response Diffferentiates into macrophages

Answer 80

**Turner syndrome -(45, X)** Loss of X chr: 1/5000 females. 99% lost spon. in preg. short. abscence of menstruation (amenorrhea). congenital heart d: 20%. webbed neck

Answer 81

type 1 (think bones !)

Answer 82

which of the following allow the passage of ions and small molecules between cells? tight junction desmosome hemidesmosome **gap junction** adhering belt / zonula adherens

Answer 83

_In terms of DNA mutations, missense:_ A mutation that results in a stop codon A mutation that does not change the amino acid, often base change in 3rd position of codon **A point mutation that changes the amino acid sequence, which in turn may make the protein non-functional** Caused by insertion or deletion of a number of nucleotides which results in the subsequent reading of the DNA 'downstream' being completely wrong

Answer 84

_Which one of the following functions/properties is most associated with CD8?_ Receptor for Epstein-Barr virus **Found on cytotoxic T cells** Interacts with B7 on antigen presenting cell as costimulation signal Found on thymocytes, T cells, and some natural killer cells that acts as a ligand for CD58 and CD59 and is involved in signal transduction and cell adhesion Found on helper T cells Co-receptor for MHC class II

Answer 85

_Which one of the following is associated with the G2 phase of the cell cycle?_ Under influence of p53 Synthesis of DNA, RNA and histones Determines length of cell cycle Quiescence Centrosome duplication **Cells increase in size**

Answer 86

During a rotation in the colorectal surgical department, you spend a morning observing a colonoscopy list. Many of the patients who come during the morning are sufferers of the genetic condition Hereditary Non-Polyposis Colorectal Cancer (HNPCC) who are being screened to try to catch any development of colorectal cancer early in the presentation. You know that a high percentage of those who express this genetic mutation will develop colorectal cancer, although this is not the same with all genetic mutations. What is the genetics term used to describes the above? Heterogenicity Inheritance **Penetrance** Prevalence Punnet Diagram

Answer 87

which of the following is a hemidesmosome? A B C D **E**

Answer 88

Midbrain [1]

Answer 89

which of the following best describes: 'portion of antigen that is recognised and bound by a receptor on an immune cell" immunogen **epitope** immunoglobin antibody IL-2

Answer 90

What type of receptor does this adrenaline act on? Enzyme linked receptor **GPRC** Internal receptor Ion channel-linked receptor Voltage-sensitve ion channel

Answer 91

A 66-year-old woman undergoes surgery for ovarian cancer and subsequently starts adjuvant chemotherapy including paclitaxel. The mechanism of action of this drug is to disrupt tubulin, a protein which forms microtubules. What is the best description of the normal function of these structures? Biosynthesis of the lipid membrane Faciliating vesicle docking with other organelles **Guide movement during intracellular transport and help bind internal organelles** Maintain the cells shape and help with DNA translation Transport of substances across the cell membrane

Answer 92

_Fixes complement but does not pass to the fetal circulation:_ IgE IgA IgD **IgM** IgG

Answer 93

_IgE:_ Transported across the interior of the cell via transcytosis **Least abundant isotype in blood serum** Fixes complement but does not pass to the fetal circulation First immunoglobulins to be secreted in response to an infection Fixes complement and passes to the fetal circulation Pentamer when secreted

Answer 94

Which one of the following best describes the function of the p53 gene? Inhibits angiogenesis Oncogene **Encodes proteins which regulate cell cycle** Encodes proteins which activate of NK cells Encodes proteins which directly repair damaged DNA ## Footnote **p53 - plays a crucial role in the cell cycle, preventing entry into the S phase until DNA has been checked and repaired**

Answer 95

Collagen is the major component of connective tissues that make up several body parts, including tendons, ligaments, skin and muscles. Its protein structure is primarily due to interactions between the R groups of the amino acids that make up the protein. What level of protein structure does this refer to? Primary structure Secondary strucutre **Tertairy structure** Quaternary structure Quinary structure

Answer 96

_Which one of the following functions/properties is most associated with monocytes?_ Major cell of the humoral immune response Involved in phagocytosis of cellular debris and pathogens **Kidney shaped nucleus** Most common type of white blood cell Granules contain myeloperoxidase and lysozyme Recognises antigens presented by MHC class I molecules

Answer 97

which of the following detects pressure & texture of skin? meissner ruffini **merkel** pancinian

Answer 98

when does cyclin B work? G1 Interphase **G2** S1 S2

Answer 99

A 3-year-old girl is seen in a clinic by a family doctor. She has just returned from South Africa and has presented with severe sunburn on her face and arms. She has always had freckles on face, arms and legs. The parents describe that her skin becomes worse when she goes out in the sun. On examination, she has dry and scaly skin and has irregular dark spots on the skin. Keeping in mind the most likely diagnosis, what is the underlying cause of her condition? Defect in mismatch repair Defect in excision repair **Defect in nucleotide excision repair -** **A defect in nucleotide excision repair is found in xeroderma pigmentosum** Vitamin C deficiency Vitamin B7 deficiency

Answer 100

Ehlers Danlos syndrome is classically caused by defects in collagen type V. What is the most common type of collagen? **Collagen Type I** Collagen Type II Collagen Type III Collagen Type IV Collagen Type V

Answer 101

_Which one of the following is one of the main functions of tumour necrosis factor-alpha?_ **Neutrophil chemotaxis** Acute inflammation Stimulates differentiation of naive T cells into Th1 cells Activates macrophages Stimulates growth and differentiation of T cell response Activates NK cells

Answer 102

Which of the following best describes mitosis? Longest phase of cell cycle Resting phase of the cycle Determines the length of the cycle Centrosome duplication **Shortest phase of cell cycle**

Answer 103

_Mediates type 1 hypersensitivity reactions:_ IgM **IgE** IgD IgG IgA

Answer 104

_Which one of the following functions/properties is most associated with mast cells?_ Acts as an antigen presenting cell Are responsible for hyperacute organ rejection Differentiated from B cells **Granules contain histamine and heparin** Most common type of white blood cell Recognises antigens presented by MHC class II molecules

Answer 105

diaphragm attaches to the spine at: T10 T11 **T12** L1 L2

Answer 106

_Acts as an antigen presenting cell:_ Plasma cells **B cells** Helper T cells Natural killer cells Monocytes Neutrophils

Answer 107

which of the following link cytoskeletons of adjacent cells to form strong cohesive epithelium? tight junction **desmosome** hemidesmosome gap junction **adhering belt / zonula adherens**

Answer 108

which of the following muscarinic receptor is located in eye / lungs / gut? M1 M2 **M3** M4 m5

Answer 109

what cell type is this? eosinophils basophils **lymphocyte** monocytes neutrophils

Answer 110

which of the following contain integrins? tight junction desmosome **hemidesmosome** gap junction

Answer 111

Two male patients with Marfan syndrome are reviewed in clinic. Both have confirmed mutations in the same gene, FBN1, on chromosome 15. While the patients are closely matched in age, one is noted to have severe skeletal abnormalities, including marked thoracic lordosis and pectus excavatum, while the other has a near-normal skeletal examination. Which genetic term best accounts for the differences in phenotype between these two individuals? Aneuploidy Anticipation **Expressivity** Penetrance X-inactivation ## Footnote **In genetics, expressivity describes the extent to which a genotype shows its phenotypic expression in an individual**

Answer 112

_Which one of the following functions/properties is most associated with plasma cells?_ Are responsible for hyperacute organ rejection **Produces large amounts of antibody specific to a particular antigen** Major source of IL-1 Expresses CD8 Multi-lobed nucleus Recognises antigens presented by MHC class II molecules

Answer 113

1/Ro Ro = av. number of new transmissions per case over infectious period in sus or non vaccinated pop

Answer 114

Which cell is responsible for the production of IL-1? Neutrophils Basophils Eosinophils T cells **Macrophages**

Answer 115

_In a cell, what is the function of the nucleolus?_ DNA maintenance and RNA transcription Breakdown of large molecules such as proteins and polysaccharides **Ribosome production** Translation and folding of new proteins Aerobic respiration. Contains mitochondrial genome as circular DNA Translation of RNA into proteins

Answer 116

which of the following is a desmosome? A B **C** D E

Answer 117

which of the following best describes Klinefelter syndrome 45X- **47 XXY** 47 XYY 45Y-

Answer 118

What usually stimulates platelet production? **Thrombopoetin** IL-5 EPO Granulocyte-colony stimulating factor IL-4

Answer 119

which of the following is a gap junction? A B C **D** E

Answer 120

which of the following are moves into tissue and becomes a macrophage? eosinophils basophils dendritic cells **monocytes** neutrophils

Answer 121

bacteria **cell wall synthesis**

Answer 122

core protein attached to glycosaminoglycans (GAGs) [1]

Answer 123

what is the arrow pointing to in the lamina propria of the gastric mucosa? smooth muscle cells endothelial cells plasma cells **lymphocytes** fibroblasts

Answer 124

A 16-year-old patient is brought into GP by her mother with concerns that she has not yet entered puberty. The patient states that she experiences bullying amongst her peers as a result of her appearance, short height and the weight she has recently put on despite eating very little. She reports low mood and no longer experiencing joy from the activities she used to like. She informs you that she is the only girl in her class to not have experienced periods. She is also concerned that her breasts have not developed, and her nipples are widely spaced apart. On examination, the patient has a webbed neck. Examination of the oropharynx reveals a high-arched palate. The patient is referred to a paediatrician, who subsequently refers the patient to the genetics team. As part of their assessment, the genetics team order a karyotype. Given the likely diagnosis, what results would be expected from the karyotype? Trisomy 13 Trisomy 18 Trisomy 21 **45, XO - Turner syndrome - 45,XO** 47, XX7

Answer 125

which of the following is located presynaptically? - alpha 1 * *- alpha 2** - beta 1 - beta 2 - beta 3

Answer 126

_Acetylcholine:_ Principal excitatory neurotransmitter of the cortex **Major neurotransmitter in preganglionic sympathetic neurons** Made in the substantia nigra pars reticulata Causes renal vasodilation Levels are elevated in anxiety Increased in patients with schizophrenia

Answer 127

which of the following contain claudlins? **tight junction** desmosome hemidesmosome gap junction

Answer 128

A 28-year-old female is pregnant and attends her 20-week anomaly scan. During her appointment, she is informed that her baby is a boy. What is his chromosomal arrangement? 23 pairs of autosomes and one pair of sex chromosomes (XY) 22 pairs of autosomes and one pair of sex chromosomes (XX) 24 pairs of autosomes and one pair of sex chromosomes (XY) **22 pairs of autosomes and one pair of sex chromosomes (XY)** 23 pairs of autosomes and one pair of sex chromosomes (XX)

Answer 129

_DNA ligase:_ Unwinds the DNA at the replication fork Removes RNA primers and replaces them with DNA **Seals up the fragments** Fluoroquinolones inhibit this enzyme Elongates the leading strand of DNA in a 5'-3' direction Prevents supercoiling during replication

Answer 130

**- preoptic area (POA) monitors** core temperature: recieves input from warm receptors from skin and and internal receptors - **paraventricular (PVN)** and **dorsomedial hypothalamic (DMH) nuclei:** recieve input from cold

Answer 131

_Which one of the following functions/properties is most associated with B cells?_ Defends against protozoan and helminthic infections Recognises antigens presented by MHC class I molecules Expresses CD28 Major source of IL-2 **Acts as an antigen presenting cell** Produces large amounts of antibody specific to a particular antigen

Answer 132

A 4-year-old girl is brought to the GP by her mother with a sore throat. She has a rare immunodeficiency syndrome where she has low levels of CD4 T cells, which is caused by a deficiency in the molecule that stimulates their proliferation by presenting bacterial antigens. What is most likely to be deficient? Antibodies MHC Class I **MHC Class II** Interferon ILs

Answer 133

which vertebral levels are the paravertebral ganglia found? **T1-T4** T1-L2 T5-T10 T5-T12 T5-L2

Answer 134

_Which one of the following functions/properties is most associated with helper T cells?_ Granules contain myeloperoxidase and lysozyme **Mediates acute and chronic organ rejection** Multi-lobed nucleus Produces large amounts of antibody specific to a particular antigen Bi-lobed nucleus Expresses CD8

Answer 135

_In terms of DNA mutations, frameshift:_ A point mutation that changes the amino acid sequence, which in turn may make the protein non-functional A mutation that results in a stop codon **Caused by insertion or deletion of a number of nucleotides which results in the subsequent reading of the DNA 'downstream' being completely wrong** A mutation that does not change the amino acid, often base change in 3rd position of codon

Answer 136

**Turner syndrome -(45, X)** Loss of X chr: 1/5000 females. 99% lost spon. in preg. short. abscence of menstruation (amenorrhea). congenital heart d: 20%. webbed neck

Answer 137

which of the following control paracellular diffusion & prevents exchange of intrinsic proteins and lipids between apical and basolateral plasma membrane? **tight junction** desmosome hemidesmosome gap junction adhering belt / zonula adherens

Answer 138

**chaperone proteins**

Answer 139

which cyclin allows cell cycle to continue to mitosis? cyclin A **cyclin B** cyclin D cyclin E cyclin F

Answer 140

_Which one of the following functions/properties is most associated with eosinophils?_ Releases histamine during allergic response Multi-lobed nucleus Major source of IL-1 Are responsible for hyperacute organ rejection **Defends against protozoan and helminthic infections** Kidney shaped nucleus

Answer 141

**2 used** **4 produced**

Answer 142

_Which one of the following functions/properties is most associated with neutrophils?_ Produces large amounts of antibody specific to a particular antigen Induce apoptosis in virally infected and tumour cells **Are responsible for hyperacute organ rejection** Defends against protozoan and helminthic infections Kidney shaped nucleus Primary phagocytic cell in acute inflammation

Answer 143

A newly born baby is diagnosed with Down syndrome. The geneticist confirms that there is the presence of two genetically different populations of cells in the body 46,XY and 47,XY,+21. What process has resulted in the development of Down syndrome in this child? Non-disjunction Robertsonian translocation **Mosiacism** Non-penetrance Haploidy

Answer 144

which of the following is a tight junction? **A** B C D E

Answer 145

A 54-year-old female presents to see her GP as she has just been diagnosed with breast cancer. The underlying pathology of malignancy involves a failure of apoptosis. Where do the receptors which induce apoptosis occur within cells? Nucleus SER RER Rb **Membrane**

Answer 146

_Which of the following structures is/are derived from the neural crest?_ **Facial and skull bones** Kidneys, ureters, gonads Anterior pituitary Spinal cord Bones (except facial and skull) Thyroid, parathyroid, thymus

Answer 147

which of the following blocks D-Ala binding in bacterial cell wall and therefore stops it forming cross links by forming H-bonds between the D-ala polymyxins **glycopeptide antiobiotics** penicillin

Answer 148

Most of the signals carried within the brain are excitatory, with a neurotransmitter causing activation of the post-synaptic neurone. Glutamate is the most important excitatory neurotransmitter within the brain. Activation of which of the following receptors by glutamate causes immediate activation of the post-synaptic neurone? Nicotinic receptor Alpha-2 receptor Beta-3 receptor **AMPA receptor** NMDA receptor

Answer 149

what plane of section is this image? **coronal** transverse sagitall oblique para-sagittal

Answer 150

which part of antibody dictates its function after binding to antigen? FAB region **Fc region: determines if its IgE / M etc**

Answer 151

_Which one of the following functions/properties is most associated with helper T cells?_ Granules contain histamine and heparin Major cell of the humoral immune response **Expresses CD4** Expresses CD8 Kidney shaped nucleus Releases histamine during allergic response

Answer 152

Which cell organelle is involved in the synthesis of lipids? GA **SER** Ribosome RER Nucleolus

Answer 153

_Mediates acute and chronic organ rejection:_ Mast cells Natural killer cells Neutrophils Monocytes B cells **Cytotoxic T cells**

Answer 154

which of the following is the step of where leukocytes move through BV wall to site of inflammation? rolling & activation tethering **diapedesis & migraton** arrest expansion

Answer 155

which of the following is an inhibatory adrenergic receptor? - alpha 1 * *- alpha 2** - beta 1 - beta 2 - beta 3

Answer 156

Which of the following acts by stimulating CD4 and CD8 T-cell proliferation and differentiation into effector T cells and memory T cells? IL-1 **IL-2** IL-4 IL-5 IL-6

Answer 157

which of the following is a gap junction? A B C D E

Answer 158

what plane of section is this image? coronal transverse **sagittal** oblique para-sagittal

Answer 159

which of the following does integrin belong to? collagen **glycoprotein** elastin proteoglycan

Answer 160

**Lance field antigen**

Answer 161

You are a foundation year 2 doctor who has been asked to have blood testing to assess for antibodies to the novel coronavirus (COVID-19) as part of a hospital-wide screening programme. You ask the phlebotomist which antibody is being assessed for, and he informs you that it is an IgG antibody test. Which of the following best describes the role of this antibody? **Enhances phagocytosis of the novel coroanvirus** First immunglobin released upon contraction of the novel coranvirus Provides immunity to parasites secreteted in urogeneital tract in response of the novel covid transferred through breast milk to provide neonatal protection from the novel covid

Answer 162

which of the following detects light touch of skin? **meissner** ruffini merkel pancinian

Answer 163

Q2) There are two types of MHC proteins, which are important for T-cell activation. Class I and Class II. Class I proteins are expressed and displayed by all nucleated cells in the body. Class II are less widely distributed and are only found on the surfaces of cells that present antigens to CD4 cells. Which of the following cell types would not display MHC type I on its surface? A B-cells B Dendritic cell C Endothelia cell **D Erythrocyte** E Macrophages

Answer 164

which of the following acts a substatrate for transpeptidase & blocks it working? polymyxins glycopeptide antiobiotics **penicillin**

Answer 165

Which of the following cells are responsible for secreting Il-6? B-cells Basophils **Macrophages** NK cells Neutrophils

Answer 166

Which cells, derived from pluripotent haematopoietic stem cells, are responsible for mediating the production of antigen-specific immunoglobulins T cells Mast cells Dendritic cells **B cells** Goblet cells **B cells are responsible for antibody production. When the body is invaded by a previously unknown pathogen, T helper cells 'help' B cells by encouraging the production of specific antibodies.**

Answer 167

_Which one of the following functions/properties is most associated with macrophages?_ **Major source of IL-1** Expresses CD4 Expresses CD28 Granules contain myeloperoxidase and lysozyme Present in tissues and are similar in function to basophils Most common type of white blood cell

Answer 168

A 30-year-old male presents to his GP with a painless, swollen lymph node. Bloods are taken, which show a raised white cell count, and he is referred to oncology. On further testing, he is diagnosed with follicular lymphoma. What is gene is most likely to be mutated in this type of cancer? C-MYC RET Rb MTS-1 **BCL-2**

Answer 169

what are the vertebral levels for: greater splanchnic nerves: **T5-9** lesser spachnic nerves: **T10-12**

Answer 170

A 6-month old boy is diagnosed with phenylketonuria. He has started to develop mental retardation and reduced hair and skin pigmentation. What is the term used to describe the presence of the variety of phenotypic traits in this patient? **Pleitropy = a condition where a single mutation causes more than one observable phenotypic effect. A well known example is PKU** Heteroplasmy Mosaicism Non-disjunction Robertsonian translocation

Answer 171

_Which one of the following functions/properties is most associated with natural killer cells?_ Present in tissues and are similar in function to basophils **Induce apoptosis in virally infected and tumour cells** Major cell of the humoral immune response Defends against protozoan and helminthic infections Granules contain myeloperoxidase and lysozyme Involved in phagocytosis of cellular debris and pathogens

Answer 172

Which one of the following amino acids is present in all types of collagen? Alanine Aspartime **Glycine** Tyrosine Cysteine

Answer 173

_In a cell, what is the function of the lysosome?_ Steroid, lipid synthesis **Breakdown of large molecules such as proteins and polysaccharides** Translation of RNA into proteins Modifies, sorts, and packages these molecules that are destined for cell secretion Catabolism of very long chain fatty acids and amino acids Manufacture of lysosomal enzymes

Answer 174

DNA sequence Amino Acid Sequence Original AAA GCC AAA lys, ala, lys Mutation AAA ACC ATT lys, thr, lys, What mutation has occurred? Deletion Insertion Inversion **Missense - a point mutation that changes the amino acid sequence, which in turn may make the protein non-functional** Nonsense

Answer 175

A 17-year-old man attends the GP complaining of intermittent shortness of breath, associated with dusty environments and exercise. He adds that his symptoms are worse at night and that he has a past medical history of eczema. Given the likely diagnosis, which of the following cells is most likely to be responsible for mediating the immune reaction causing his symptoms? Macrophages NK cells Neutrophils Th1 helper cells **Th2 helper cells**

Answer 176

asthma is driven by the overproduction of: IL-1 IL-2 **IL-4** IL-6 1L-12

Answer 177

Which of these cells express IgE receptors on their cell surface? T cells Neutrophils Eosinophils **Mast cells** Macrophages

Answer 178

which of the following contain connexins? tight junction desmosome hemidesmosome **gap junction**

Answer 179

which of the following triggers cell mediated immunity? NK cells **CD4+ TH1: produces TNF-a and IFN-y which triggers cell mediated immunity** dendritic cells CD4+ TH2 CD4+ Th0

Answer 180

The oxygen-haemoglobin dissociation curve is shifted to the right in which of the following scenarios? Hypothermia Resp. alkolosis Low altitude Decreased 2,3 DPG in transfused red cells **Chonic iron deficiency anaemia Mnemonic to remember causes of right shift of the oxygen dissociation curve: CADET face RIGHT C O2 A cidosis 2,3-DPG E xercise T emperature**

Answer 181

Which interleukin is responsible for the proliferation of B cells? IL-1 IL-2 IL-3 **IL-4** IL-5

Answer 182

which of the following detects stretching of skin? meissner **ruffini** merkel pancinian

Answer 183

_Provides localized protection on mucous membranes:_ IgG IgD **IgA** IgE IgM

Answer 184

which are the largest type of wbc? eosinophils basophils lymphocyte **monocytes** neutrophils

Answer 185

what controls T cell clonal expansion ? IL-1 **IL-2** IL-3 IL-4 IL-5

Answer 186

A 64-year-old female attends a clinic for assessment after presenting to her GP with a lump in her right breast. A mammography and breast tissue biopsy confirm the presence of an invasive ductal carcinoma. Which of the following oncogenes is most associated with this condition? ABL1 N-MYC RET BCL-2 **HER2**

Answer 187

which of the following do laminin and fibronectin belong to? collagen **glycoprotein** elastin proteoglycan

Answer 188

_In a cell, what is the function of the rough endoplasmic reticulum?_ Ribosome production Translation of RNA into proteins Steroid, lipid synthesis **Translation and folding of new proteins** Breakdown of large molecules such as proteins and polysaccharides Modifies, sorts, and packages these molecules that are destined for cell secretion

Answer 189

_Which one of the following best describes the gross mechanism of action of quinolones?_ Inhibits cell wall formation Damages DNA **Inhibits DNA synthesis** Inhibits RNA synthesis Inhibits protein synthesis by acting on the 30S subunit of ribosomes Inhibits protein synthesis by acting on the 50S subunit of ribosomes

Answer 190

_Which one of the following is associated with the S phase of the cell cycle?_ Under influence of p53 **Synthesis of DNA, RNA and histones** Determines length of cell cycle Quiescence Centrosome duplication Cells increase in size

Answer 191

A new chemotherapeutic drug is being trialed which acts on the phase of the cell cycle which determines cell cycle length. At which stage of the cell cycle will this drug most likely act to achieve this effect? G0 phase **G1 phase** G2 phase M phaase S phase **The G1 phase is the initial growth phase of the cell. It is under the influence of p53. Through the action of several different regulatory proteins, it determines the overall length of the cell cycle. Different cells in different tissues have variable cell cycle lengths e.g. skin cells replicate more quickly than hepatocytes.**

Answer 192

_Binds to Fc receptors found on the surface of mast cells and basophils:_ **IgE** IgD IgG IgM IgA

Answer 193

Which one of the following genes protects against neoplasms? sis **p53** ras myc src

Answer 194

_Major cell of the humoral immune response:_ Neutrophils Helper T cells Macrophages **B cells** Natural killer cells Plasma cells

Answer 195

_Which one of the following functions/properties is most associated with neutrophils?_ **Most common type of white blood cell** Granules contain histamine and heparin Major source of IL-2 Defends against protozoan and helminthic infections Mediates acute and chronic organ rejection Acts as an antigen presenting cell

Answer 196

which molecule causes transcription to occur? DNA polymerase I RNA polymerase I DNA polymerase II **RNA polyermase II**

Answer 197

what is structure of aspirin like in i) stomach [1] **R-COOH. lipid soluble** ii) blood [1] **R-COO- water soluble**

Answer 198

**kidneys:** excrete more **hydrogen** and **retain** **bicarbonate** **respiratory system** compensates for metabolic acidosis by **expelling CO2 at a faster rate** (**breathing** **rate** increase).

Answer 199

By excreting more H+ in urine and retaining more HCO-3 By retaining more H+ and excreting more HCO-3 in urine.

Answer 200

They **rise** because more CO2 is being expelled from the blood, resulting in less H+ generation and thus higher pH levels. [1] They **fall** because more CO2 is being retained in the blood, resulting in more H+ generating and thus lower pH levels. [1]

Answer 201

decreased resting tone (tension) of the muscle and decreased resistance to passive movement

Answer 202

the absolute amount of drug given; the pharmaceutical preparation; the reversibility of drug action; the half-life of the drug; the slope of the concentration-response curve; the activity of metabolites, the influence of disease on drug elimination. or Method of Administration Dosage Body Weight Age Tolerance Type of Drug

Answer 203

- biotransformation: drug becomes smaller and more water soluble so the kidney can remove it - add a polar group: **oxidation (**and hydrolysis or reduction)

Answer 204

**synthesis** (stick a group onto drug to make it more soluble) liver takes big chem (e.g. glucose) adds it onto drug - is able to be excreted

Answer 205

A prodrug is a medication or compound that, after administration, is **metabolized** (i.e., converted within the body) into a **pharmacologically** **active drug**.

Answer 206

label A-D stages of cancer development: A: **hyperplasia** B: **metaplasia** C: **dysplasia** D: **anaplasia**

Answer 207

* *C-MYC overexpression:** breast / colon cancer * *C-MYC translocation**: burkitt lymphoma

Answer 208

k-ras mutation is a form of cancer occuring by which mechanism: growth factors growth factors receptors **signal transduction** transcription factors anti-apoptic factors

Answer 209

b-cell leukameia is a form of cancer that occurs by mutatations to: growth factors growth factors receptors signal transduction transcription factors **anti-apoptic factors: bcl2; 14 & 18 translocatio**

Answer 210

1. **Fluroquinolones**: taret topoisomerases in resp. and urinary tract infections 2. **Trimethoprim**: target nucleotide synthesis

Answer 211

what type of molecule is elastin? polypeptide **glycoprotein** proteoglycan oligosaccahride