Met SAQs Flashcards

Question 1

Q

Which of the following is a glycogenolytic enzyme?

A.ACC

B.Phosphorylase kinase

C.PFK-1

D.PDH phosphatase

Answer

A

Which of the following is a glycogenolytic enzyme?

A.ACC

B.Phosphorylase kinase

C.PFK-1

D.PDH phosphatase

Question 2

Q

how do high levels of acetyl co-a influence gluconeogenesis? [2]

Answer

A

high levels of Acetyl Co-A:

activates pyruvate carboxylase (used in step 1 of malate cycle: drives gluconeogenesis from pyruuvate -> PEP & eventually glucose)

inhibits: pyruvate dehydrogenase complex (prevents pyruvate being turned into acteyl co A & sparing it, leaving for gluconeogenesis)

Question 3

Q

insulin causes glucose to be taken up by which GLUT receptor?

GLUT1
GLUT2
GLUT3
GLUT4
GLUT5

Answer

A

insulin causes glucose to be taken up by which GLUT receptor?

GLUT1
GLUT2
GLUT3
GLUT4
GLUT5

Question 4

Q

alcohol metabolism produces increased what? (2)

Answer

A

NADH & Acetyl coA

Question 5

Q

which of the following lipoproteins has apo protein B48?

chylomicron
very low density lipo
intermediate DL
LDL
HDL

Answer

A

which of the following lipoproteins has apo protein B48?

chylomicron
very low density lipo
intermediate DL
LDL
HDL

Question 6

Q

During the course of a radical gastrectomy the surgeons detach the omentum and ligate the right gastro-epiploic artery. From which vessel does it originate?

SMA
IMA
Coeliac axis
Common hepatic artery
Gastroduodenal artery

Answer

A

During the course of a radical gastrectomy the surgeons detach the omentum and ligate the right gastro-epiploic artery. From which vessel does it originate?

SMA
IMA
Coeliac axis
Common hepatic artery
Gastroduodenal artery

Question 7

Q

which of the following cover cover lymphoid nodules

enterocytes
goblet cells
paneth cells
enteroendocrine cells
m cells

Answer

A

which of the following cover cover lymphoid nodules

enterocytes
goblet cells
paneth cells
enteroendocrine cells
*- m cells**

Question 8

Q

Which one of the peritoneal ligaments contains the right and left gastric artery?

Splenorenal ligament

Falciform ligament

Hepatogastric ligament

Hepatoduodenal ligament

Gastrosplenic ligament

Gastrocolic ligament

Answer

A

Which one of the peritoneal ligaments contains the right and left gastric artery?

Splenorenal ligament

Falciform ligament

Hepatogastric ligament

Hepatoduodenal ligament

Gastrosplenic ligament

Gastrocolic ligament

Question 9

Q

While on placement on a gastro ward one of your patients develops profuse diarrhoea. Where in the gastrointestinal tract is the majority of water absorbed?

Jejunum
Colon
Ileum
Duodenum
Rectum

Answer

A

While on placement on a gastro ward one of your patients develops profuse diarrhoea. Where in the gastrointestinal tract is the majority of water absorbed?

Jejunum
Colon
Ileum
Duodenum
Rectum

Question 10

Q

where is the endocrine function of pancreas located? [1]

Answer

A

islet of langerhans

Question 11

Q

Where is the majority of norepinephrine secreted from?

D cells in the pancreas & stomach

Parafollicular cells of the thyroid

Zona reticularis of adrenal cortex

Posterior pituitary

Adrenal medulla

Zona glomerulosa of adrenal cortex

Answer

A

Where is the majority of norepinephrine secreted from?

D cells in the pancreas & stomach

Parafollicular cells of the thyroid

Zona reticularis of adrenal cortex

Posterior pituitary

Adrenal medulla

Zona glomerulosa of adrenal cortex

Question 12

Q

Why does excessive alcohol consumption impair the TCA cycle?

A.Depletes ATP stores

B.Depletes NADH stores

C.Leads to an NADH excess

D.Leads to the inhibition of ACC

Answer

A

Why does excessive alcohol consumption impair the TCA cycle?

A.Depletes ATP stores

B.Depletes NADH stores

C.Leads to an NADH excess

D.Leads to the inhibition of ACC

Question 13

Q

Increases gluconeogenesis:

1,25-dihydroxycholecalciferol

Leptin

Cortisol

Renin

CCK

Antidiuretic hormone

Answer

A

Increases gluconeogenesis:

1,25-dihydroxycholecalciferol

Leptin

Cortisol

Renin

CCK

Antidiuretic hormone

Question 14

Q

which of the cells of the immune system recognise gluten and cause CD?

Answer

A

CD4 T cells (Th1)

Question 15

Q

glutamine –> glutamate –> a-ketoglutarate generates lots of:

a) ATP
b) NH3
c) NH4
d) NADH
e) NAD

Answer

A

glutamine –> glutamate –> a-ketoglutarate generates lots of:

a) ATP
b) NH3
* *c) NH4**
d) NADH
e) NAD

Question 16

Q

palatoglossus muscle is innervated by?

a) glossopharnygeal
b) trigeminal
c) vagus nerve
d) hypoglossal
e) facial nerve

Answer

A

palatoglossus muscle is innervated by?

a) glossopharnygeal
b) trigeminal
* *c) vagus nerve**
d) hypoglossal
e) facial nerve

Question 17

Q

A 35-year-old man presents to the emergency department with hypotension following a road traffic accident. How does angiotensin II act to increase the filtration fraction in the kidney?

Vasoconstriction of the efferent glomerular arteriole
Vasoconstriction of the afferent glomerular arteriole
Vasodilationo of the efferent glomerular arteriole
Vasodilation of the afferent glomerular arteriole
Vasoconstriction of the renal artery

Answer

A

A 35-year-old man presents to the emergency department with hypotension following a road traffic accident. How does angiotensin II act to increase the filtration fraction in the kidney?

Vasoconstriction of the efferent glomerular arteriole
Vasoconstriction of the afferent glomerular arteriole
Vasodilationo of the efferent glomerular arteriole
Vasodilation of the afferent glomerular arteriole
Vasoconstriction of the renal artery

Question 18

Q

sublingual gland recieves parasympathetic innervation from which nerve?

a) glossopharnygeal
b) trigeminal
c) vagus nerve
d) hypoglossal
e) facial nerve

Answer

A

sublingual gland recieves parasympathetic innervation from which nerve?

a) glossopharnygeal
b) trigeminal
c) vagus nerve
d) hypoglossal
* *e) facial nerve**

Question 19

Q

A 61-year-old man is brought to the Emergency Department with confusion, nystagmus, and ataxia. Blood tests show a thiamine deficiency, confirming the suspected diagnosis of Wernicke’s encephalopathy.

What enzyme’s synthesis is dependent on this vitamin?

Amylase
Lysyl hydroxylase
Pyruvate dehydrogenase
Retinoic acid
Transaminase

Answer

A

A 61-year-old man is brought to the Emergency Department with confusion, nystagmus, and ataxia. Blood tests show a thiamine deficiency, confirming the suspected diagnosis of Wernicke’s encephalopathy.

What enzyme’s synthesis is dependent on this vitamin?

Amylase
Lysyl hydroxylase
Pyruvate dehydrogenase
Retinoic acid
Transaminase

Question 20

Q

which vitamins are normally excreted in urine and which vitamins can be stored by the body in the liver? [5]

Answer

A

excreteed in urine = vitamin B & K
stored in liver = vitamin ADEK

Question 21

Q

A 47-year-old lady is diagnosed as suffering from a phaeochromocytoma. From which of the following amino acids are catecholamines primarily derived?

aspatime
glutamine
arginine
tyrosine
alanine

Answer

A

A 47-year-old lady is diagnosed as suffering from a phaeochromocytoma. From which of the following amino acids are catecholamines primarily derived?

aspatime
glutamine
arginine
tyrosine
alanine

Question 22

Q

acetyl co-A is the input for TCA. acetyl co-A can be produced by three ways. What are they? [3]

Answer

A

1.Glycolysis of glucose to pyruvate
•Converted to acetyl-CoA using pyruvate dehydrogenase complex (PDC)
•Produces 2 reduced NAD molecules per glucose
•1 reduced NAD per pyruvate

2.Transamination of glucogenic amino acids to pyruvate
• Converted to acetyl-CoA using pyruvate dehydrogenase complex (PDC)

3.Beta-oxidation of fatty acids directly to acetyl-CoA
•Produces 1 NADH and 1 FADH2 per acetyl-CoA

Question 23

Q

Question 24

Q

During vigorous exercise, the body cannot intake enough oxygen to maintain the respiratory needs of all its muscles in an aerobic state. At this point, anaerobic metabolism begins and this relies on glycolysis for the production of energy.

Which of the following enzymes is responsible for catalysing the rate limiting step in this process?

Hexokinase
PFK-1
Pyruvate kinase
PDH
Glucose phosphorylase

Answer

A

During vigorous exercise, the body cannot intake enough oxygen to maintain the respiratory needs of all its muscles in an aerobic state. At this point, anaerobic metabolism begins and this relies on glycolysis for the production of energy.

Which of the following enzymes is responsible for catalysing the rate limiting step in this process?

Hexokinase
PFK-1
Pyruvate kinase
PDH
Glucose phosphorylase

Question 25

Q

The afferent limb of the gag reflex is supplied by which nerve?

a) facial nerve
b) trigeminal nerve
c) glossopharyngeal nerve
d) hypoglossal nerve
e) vagus nerve

Answer

A

The afferent limb of the gag reflex is supplied by which nerve?

a) facial nerve
b) trigeminal nerve
c) glossopharyngeal nerve
d) hypoglossal nerve
e) vagus nerve

Question 26

Q

Where is the majority of secretin secreted from?

S cells in upper small intestine

Zona glomerulosa of adrenal cortex

I cells in upper small intestine

D cells in the pancreas & stomach

Sertoli cells

G cells in antrum of the stomach

Answer

A

Where is the majority of secretin secreted from?

S cells in upper small intestine

Zona glomerulosa of adrenal cortex

I cells in upper small intestine

D cells in the pancreas & stomach

Sertoli cells

G cells in antrum of the stomach

Question 27

Q

which of the following would cause cardiomyopathy if a patient had a deficiency?

phosphorous
iron
selenium
zinc
copper

Answer

A

which of the following would cause cardiomyopathy if a patient had a deficiency?

phosphorous
iron
selenium
zinc
copper

Question 28

Q

Name two symptoms of PKU (2 marks)

Answer

A

Symptoms can be split based on their causes for example individuals with PKU have fair skin, blonde hair –> due to reduction in the production of melanin.

CNS abnormalities –> due to reduced neurotransmitter production and can lead to jerking, tremors, seizures

Question 29

Q

Which vitamin is involved in the formation of collagen?

Vit A
Vit B
Vit C
Vit D
Vit E

Answer

A

Which vitamin is involved in the formation of collagen?

Vit A
Vit B
Vit C
Vit D
Vit E

Question 30

Q

which vitamin causes production of CCR9 & a4b9 in gut honing T cells?

vitamin A
vitamin B
vitamin C
vitamin D
vitamin E

Answer

A

which vitamin causes production of CCR9 & a4b9 in gut honing T cells?

vitamin A
vitamin B
vitamin C
vitamin D
vitamin E

Question 31

Q

which nerve innervates sensation to the face?

a) trigeminal nerve
b) facial nerve
c) glossopharnyngeal
d) vagus nerve
e) hypoglossal

Answer

A

which nerve innervates sensation to the face?

*a) trigeminal nerve**
b) facial nerve
c) glossopharnyngeal
d) vagus nerve
e) hypoglossal

Question 32

Q

Question 33

Q

which vagus nerve (left or right), innervates the

i) anterior stomach wall? [1]
ii) posterior stomach wall? [2]

Answer

A

Left vagus innervates anterior wall [1]
Right vagus innervates posterior wall []1

Question 34

Q

Which one of the following actions is directly caused by gastrin?

Increases pancreatic secretions rich in digestive enzymes
Increases pepsinogen secretion
Decreases gastric emptying
Stimulates aldosterone release
Increases plasma phosphate
Increases proximal tubule Na+/H+ activity

Answer

A

Which one of the following actions is directly caused by gastrin?

Increases pancreatic secretions rich in digestive enzymes
Increases pepsinogen secretion
Decreases gastric emptying
Stimulates aldosterone release
Increases plasma phosphate
Increases proximal tubule Na+/H+ activity

Question 35

Q

Which one of the peritoneal ligaments contains the hepatic artery, hepatic portal vein and common bile duct?

Gastrocolic ligament

Hepatoduodenal ligament

Splenorenal ligament

Hepatogastric ligament

Gastrosplenic ligament

Falciform ligament

Answer

A

Which one of the peritoneal ligaments contains the hepatic artery, hepatic portal vein and common bile duct?

Gastrocolic ligament

Hepatoduodenal ligament

Splenorenal ligament

Hepatogastric ligament

Gastrosplenic ligament

Falciform ligament

Question 36

Q

which intermediary is needed for transamination to occur? [1]
which enzyme is needed for transamination to occur? [1]

Answer

A

intermediary= **pyridoxal phosphate (from vitamin B6)**
enzyme = **transaminase**

Question 37

Q

Von Gierkes disease is caused by a mutation in which gene?

a) PYGT
b) PYGL
c) G6PC
d) HGD
e) G1PC

Answer

A

Von Gierkes disease is caused by a mutation in which gene?

a) PYGT
b) PYGL
* *c) G6PC**
d) HGD
e) G1PC

Question 38

Q

which nerve innervates the muscles of facial expression?

a) trigeminal nerve
b) facial nerve
c) glossopharnyngeal
d) vagus nerve
e) hypoglossal

Answer

A

which nerve innervates the muscles of facial expression?

a) trigeminal nerve
* *b) facial nerve**
c) glossopharnyngeal
d) vagus nerve
e) hypoglossal

Question 39

Q

what is role of paneth cells? [1]
where located? [1]

Answer

A

paneth cells: secrete antimicrobe substances; H&E= pink

Question 40

Q

Which layer of the gastrointestinal tract contains Meissners plexus?

Muscularis externa
Submucosa
Serosa
Mucosa

Answer

A

Which layer of the gastrointestinal tract contains Meissners plexus?

Muscularis externa
Submucosa
Serosa
Mucosa

Question 41

Q

A 39-year-old lady has recurrent attacks of biliary colic. What is the approximate volume of bile to enter the duodenum per 24 hours?

500 mL
50 mL
100 mL
2000 mL
150 mL

Answer

A

A 39-year-old lady has recurrent attacks of biliary colic. What is the approximate volume of bile to enter the duodenum per 24 hours?

500 mL
50 mL
100 mL
2000 mL
150 mL

Question 42

Q

Which one of the following inhibits gastric acid secretion?

Histamine
Nausea
Calcium
Parasympathetic vagal stimulation
Gastrin

Answer

A

Which one of the following inhibits gastric acid secretion?

Histamine
Nausea
Calcium
Parasympathetic vagal stimulation
Gastrin

Question 43

Q

which metabolic disease is caused by mutation in glycogen phosphorylase in liver?

a) McArdles Disease
b) Hers Disease
c) von Gierkes
d) Maple syrup disease

Answer

A

which metabolic disease is caused by mutation in glycogen phosphorylase in liver?

a) McArdles Disease
* *b) Hers Disease**
c) von Gierkes
d) Maple syrup disease

Question 44

Q

where do u find hormone receptors (3)

Answer

A

nucleus (typically steroid hormones)
cytoplasm
plasma membrane

Question 45

Q

which metabolic disorder means that the following reaction cant occur?

pyruvate –> glucose-6-P –> glucose

a) von Gierkes
b) Hers
c) McArdles
d) Galactosaemia
e) hereditary fructose intolerance

Answer

A

which metabolic disorder means that the following reaction cant occur?

pyruvate –> glucose-6-P –> glucose

*a) von Gierkes**
b) Hers
c) McArdles
d) Galactosaemia
e) hereditary fructose intolerance

Question 46

Q

A 17-year-old lady presents with right iliac fossa pain and diagnosed as having acute appendicitis. You take her to theatre to perform a laparoscopic appendicectomy. During the procedure the scrub nurse distracts you and you inadvertently avulse the appendicular artery. The ensuing haemorrhage is likely to be supplied directly from which vessel?

IMA
SMA
Ileo-colic artery
Internal iliac artery
None of the above

Answer

A

A 17-year-old lady presents with right iliac fossa pain and diagnosed as having acute appendicitis. You take her to theatre to perform a laparoscopic appendicectomy. During the procedure the scrub nurse distracts you and you inadvertently avulse the appendicular artery. The ensuing haemorrhage is likely to be supplied directly from which vessel?

IMA
SMA
Ileo-colic artery
Internal iliac artery
None of the above

Question 47

Q

the coeliac trunk arises from the abdominal aorta at which vertebral level?

T12
L1
L2
L3
L4

Answer

A

the coeliac trunk arises from the abdominal aorta at which vertebral level?

T12
L1
L2
L3
L4

Question 48

Q

Which one of the following actions is directly caused by renin?

Stimulates ADH release

Stimulates thirst

Converts angiotensinogen to angiotensin I

Inhibits glucagon secretion

Decreases appetite

Vasoconstriction of vascular smooth muscle

Answer

A

Which one of the following actions is directly caused by renin?

Stimulates ADH release

Stimulates thirst

Converts angiotensinogen to angiotensin I

Inhibits glucagon secretion

Decreases appetite

Vasoconstriction of vascular smooth muscle

Question 49

Q

A 22-year-old male presents to his general practitioner with a 4-month history of headaches, palpitations, and heavy sweating. He also reports some non-intentional weight loss. On examination, the patient is sweating heavily and is tachycardic. It is suspected that the man may have a malignancy affecting the tissue responsible for the secretion of adrenaline.

Where is the most likely site of the malignancy?

Adrenal cortex
Adrenal medulla
Medulla oblongata
Parathyroid gland
Thyroid

Answer

A

A 22-year-old male presents to his general practitioner with a 4-month history of headaches, palpitations, and heavy sweating. He also reports some non-intentional weight loss. On examination, the patient is sweating heavily and is tachycardic. It is suspected that the man may have a malignancy affecting the tissue responsible for the secretion of adrenaline.

Where is the most likely site of the malignancy?

Adrenal cortex
Adrenal medulla
Medulla oblongata
Parathyroid gland
Thyroid

Question 50

Q

which gastric cell produces histamine in to activate stomach acid creation?

a) parietal cells
b) G cells
c) chief cells
d) ECL likes
e) mucous secreting cells

Answer

A

which gastric cell produces histamine in to activate stomach acid creation?

a) parietal cells
b) G cells
c) chief cells
d) ECL cells
e) mucous secreting cells

Question 51

Q

which vitamin deficiency is associated with beri beri?

vit. A
vit B1
vit. B2
vit. B3
vit. B4

Answer

A

which vitamin deficiency is associated with beri beri?

vit. A
*- vit B1**
vit. B2
vit. B3
vit. B4

Question 52

Q

what is the equation for converting pyruvate to acetyl co A?

Answer

A

pyruvate + CoA + NAD+ –> acetyl Co-A + Co2 + NADH

Question 53

Q

An 18-year-old male is admitted with confusion and myoclonus. A blood test reveals a high ammonium level. He has a family history of a urea cycle disorder.

What enzyme deficiency is present?

Carbomyl phosphate synthetase I
Glycogen phosphorylase
Isocitrate dehydrogenase
PFK-1
Glyocgen synthase

Answer

A

An 18-year-old male is admitted with confusion and myoclonus. A blood test reveals a high ammonium level. He has a family history of a urea cycle disorder.

What enzyme deficiency is present?

Carbomyl phosphate synthetase I
Glycogen phosphorylase
Isocitrate dehydrogenase
PFK-1
Glyocgen synthase

Question 54

Q

A 6-year-old male patient presents with signs and symptoms of severe fasting hypoglycaemia. On examination, he has hepatomegaly. His blood lactate levels, uric acid and triglycerides are raised. After extensive investigations, he is diagnosed with glycogen storage disease I (Von Gierke disease).

Which enzyme is deficient in this condition?

Glucose-6-phosphatase
Glucose-6-phosphatase dehydrogenase
a-1,6 glucosidase
Myophosphorylase
Glucocerebrosidase

Answer

A

A 6-year-old male patient presents with signs and symptoms of severe fasting hypoglycaemia. On examination, he has hepatomegaly. His blood lactate levels, uric acid and triglycerides are raised. After extensive investigations, he is diagnosed with glycogen storage disease I (Von Gierke disease).

Which enzyme is deficient in this condition?

Glucose-6-phosphatase
Glucose-6-phosphatase dehydrogenase
a-1,6 glucosidase
Myophosphorylase
Glucocerebrosidase

Question 55

Q

what are two seperate roles of aldosterone? [2]

Answer

A

restores BP, reabsorbed salt & water lvls (not excrete as much) [1]
restores K loss [1]

(two totally differnet systems! )

Question 56

Q

which are the only two hormones that are released frm posterior pituitary gland? [2]

Answer

A

ADH
Oxytocin

Question 57

Q

the hepatoduodenal ligament is found which of the following:

a) greater omentum
b) lesser omentum
c) mesocolon
d) mesentary

Answer

A

the hepatoduodenal ligament is found which of the following:

a) greater omentum
b) lesser omentum
c) mesocolon
d) mesentary

Question 58

Q

does the spleen develop in the dorsal or ventral mesogastrium?

Answer

A

does the spleen develop in the dorsal or ventral mesogastrium?

: dorsal mesogastrium

Question 59

Q

what do the suprahyoid muscles do to the hyoid bone when swallowing?

what do the infrahyoid muscles do to the hyoid bone when swallowing?

Answer

A

what do the suprahyoid muscles do to the hyoid bone when swallowing?
elevate hyoid

what do the infrahyoid muscles do to the hyoid bone when swallowing?
depress hyoid

Question 60

Q

Which of the following is true during exercise?

A.Glycogenesis and lipogenesis are favoured

B.Glycogenolysis and lipolysis are inhibited

C.ATP is the primary driver of increased glycolysis

D.Ca2+ and AMP promote glycolysis

Answer

A

Which of the following is true during exercise?

A.Glycogenesis and lipogenesis are favoured

B.Glycogenolysis and lipolysis are inhibited

C.ATP is the primary driver of increased glycolysis

D.Ca2+ and AMP promote glycolysis: Drop in pH due to lactic acid accumulation inhibits glycolysis + oxidative phosphorylation

Question 61

Q

which Ig is the only antibody capable of crossing the placenta to give passive immunity to the fetus?

a) IgG
b) IgM
c) IgA
d) IgE
e) IgD

Answer

A

which Ig is the only antibody capable of crossing the placenta to give passive immunity to the fetus?

*a) IgG**
b) IgM
c) IgA
d) IgE
e) IgD

Question 62

Q

growth hormone is released from anterior pituitary gland after stimulation by growth hormone releasing hormone. which hormone does it indirectly cause the release of to increase bone and muscle mass?

AMP
cAMP
IP3
IGF-1
DAG

Answer

A

growth hormone is released from anterior pituitary gland after stimulation by growth hormone releasing hormone. which hormone does it indirectly cause the release of to increase bone and muscle mass?

AMP
cAMP
IP3
*- IGF-1**
DAG

Question 63

Q

which one of the followings statements is true of glucagon?

produced in response to hyperglycaemia
released by beta cells
inhibits gluconeogenesis
produced in response to an increase in amino acids
composed of 2 alpha polypeptide chains linked by H bonds

Answer

A

which one of the followings statements is true of glucagon?

produced in response to hyperglycaemia
released by beta cells
inhibits gluconeogenesis
*- produced in response to an increase in amino acids**
composed of 2 alpha polypeptide chains linked by H bonds

Question 64

Q

What is the gene responsible for the mutation of which can induce osmotic diarrhea to the patient?
SLC5A1
SLC5A2
SLC5A3
SLC5A4

Answer

A

•What is the gene responsible for the mutation of which can induce osmotic diarrhea to the patient?

•SLC5A1

SLC5A2
SLC5A3
SLC5A4

Answer 63

A

Latency on a nerve conduction study describes:

a) distance between 2 different stimulation sites
b) height of electrical activity
c) distance betwen stimulation site and muscle sensor
* *d) time from stimulation to start of electrical activity**

Answer 64

A

Which cycle is used in gluconeogenesis to ger pyruvate –> phosphoenolpyruvate (PEP) ?

a) Krebs Cycle
b) Cori Cycle
* *c) Malate Cycle**
d) Glyoxylate cycle
e) Carnitine shuttle

Answer 65

A

gliadin binds to which antibody in the gut with a patient with CD?

*- IgA**
IgD
IgG
IgM
IgE

•IN COELIAC DISEASED PATIENTS, the IgA along with gliadin do not get broken down and are transferred from the apical membrane of the enterocytes down to the basolateral membrane

Answer 66

A

A 52-year-old male is brought to the emergency department with frank haematemesis by the ambulance. Urgent resuscitation measures are taken and an urgent oesophagogastroduodenoscopy (OGD) is performed. An active bleed is seen in the distal part of the lesser curvature of the stomach and is controlled with endoclips and adrenaline. He has a past medical history of gastric ulcers.

Which artery is the most likely cause of the bleed

Left gastric artery
Right gastric artery
Left gastroepiploic artery
Right gastroepiploic artery
Short gastric artery

Answer 67

A

cholesterol

Answer 68

A

What forms the the borders of Hesselbach’s triangle?

Inguinal ligament laterally, inferior epigastric vessels laterally, pubic tubercle medially
Inguinal ligament laterally, inferior epigastric vessels laterally, umibilicus medially
Inguinal ligament laterally, ASIS laterally, pubic tubercle medially
*- Inguinal ligament laterally, inferior epigastric vessels laterally, lateral border of the rectus sheath medially**
Inguinal ligament laterally, ASIS laterally, lateral border of the rectus sheath medially

Answer 69

A

which of the following is not a role of micronutrients

co-factors
co-enzymes
antioxidants
control of gene expression
* *5 oxidants**

Answer 70

A

Where is the majority of aldosterone secreted from?

Posterior pituitary

Zona glomerulosa of adrenal cortex

Zona fasciculata of adrenal cortex

Zona reticularis of adrenal cortex

Juxtaglomerular cells

Adrenal medulla

Answer 71

A

growth hormone is released from anterior pituitary gland after stimulation by growth hormone releasing hormone. which hormone works to inhibit this reaction? [1]

somatostatin

Answer 72

A

bile salts are secreted by:

a) parietal cells
b) enterocytes
c) goblet cells
d) chief cells
e) hepatocytes

Answer 73

A

polygenic – more than one type of both class I and class II ( 1 mark)

polymorphic – multiple alleles in population means most individuals are heterozygous ( 1 mark)

Answer 74

A

Lymphatic infiltration
Crypt hyperplasia
Flattened villi

Answer 75

A

what does this describe: ‘directly anterior to the sulcus terminalis and extend in a V-shaped line across the root of the tongue’

foliate papillae
lingual tonsil
palatine tonsil
- vallate papillae
- foramen cecum of tongue

Answer 76

A

Which one of the following actions is directly caused by gastrin?

Stimulates aldosterone release

Increases pancreatic secretions rich in digestive enzymes

Increases gastric H+ secretion

Decreases gastric emptying

Increases pancreatic bicarbonate secretion

Increases gut absorption of calcium

Answer 77

A

•Simple columnar epithelial cells (enterocytes)

Answer 78

A

which metabolism disorder causes a second wind of exercise?

a) von Gierkes
b) Hers
* *c) McArdles**
d) Galactosaemia
e) hereditary fructose intolerance

Answer 79

A

ADH:

regulates osmolality of blood serum (increases reabsorbtion & causes dilution of blood serum)
vasoconstriction of arterial BP

Answer 80

A

which cells do you find lining peyers patches?

a) G cells
b) D cells
c) T cells
* *d) M cells**
e) B cell

Answer 81

A

where is Fe absorbed in the body?

*a) duodenum**
b) jejenum
c) ileum
d) ascending colon
e) transverse colon

Answer 82

A

Type I Slow Oxidative

High mitochondrial content -> good TCA cycle capabilities therefore lots of ATP produced aerobically
High myoglobin content -> good oxygen delivery
Good for frequent and prolonged contraction, suitable for a marathon run.

Answer 83

A

A 55-year-old man is admitted with a brisk haematemesis. He is taken to the endoscopy department and an upper GI endoscopy is performed by the gastroenterologist. He identifies an ulcer on the posterior duodenal wall and spends an eternity trying to control the bleeding with all the latest haemostatic techniques. He eventually asks the surgeons for help. A laparotomy and anterior duodenotomy are performed, as the surgeon opens the duodenum a vessel is spurting blood into the duodenal lumen. From which of the following does this vessel arise?

Left gastric artery
Common hepatic artery
Right hepatic artery
SMA
Splenic artery

Answer 84

A

what type of disease if famial hypercholeserolemia?

a) X linked recessive
* *b) autosomal dom**
c) autosomal rec
d) Y-linked
e) X-linked dom

Answer 85

A

•Elimination of gluten-containing food (e.g. wheat, rye, barley) from the diet

Answer 86

A

Filtration fraction:

Can be estimated using creatinine clearance

GFR * plasma concentration

Plasmacreatinine / urinarycreatinine

Glomerular filtration rate / renal blood flow

Renal plasma flow / (1 - Haematocrit)

Is typically around 0.20

Answer 87

A

ubiqunione

Answer 88

A

which nerve is being tested here?

*a) median**
b) ulnar
c) radius
d) axillary

Answer 89

A

What is the rate limiting enzyme of glycolysis?

PFK1
Glycogen synthase
Glyocgen phosphorylase
Glucose-6-phosphate dehydrogenase
Isocitrate dehydrogenase

Answer 90

A

in nucleus - alter gene expression

Answer 91

A

what type of bacteria is H. pylori?

gram-postive
gram-negative

Answer 92

A

Hers disease result in more mild hypoglycemia (1)

Hers disease PYGL gene is defected, so defect in glycogen phoshporylase means can break down liver glycogen (1)

But can still undergo gluconeogensis (1)

von Gierkes disease is defect in glucose-6-phosphatase, so cant break down glycogen –> glucose at all. (1)

Answer 93

A

Which one of the following actions is directly caused by CCK?

Decreases gastric emptying

Decreases pepsinogen secretion

Decreases gallbladder contraction

Increases gastric motility

Decreases appetite

Decreases gastric H+ secretion

Answer 94

A

which type of cells are bile salts secreted from?

- goblet cells

paneth cells
enteroendocrine cells
*- hepatocytes**
parietal cells

Answer 95

A

Glomerular filtration rate:

Urine flow rate * urine concentration

Is typically around 100 ml/min

UPAH * V / PPAH

GFR * plasma concentration

Is typically around 0.20

Renal plasma flow / (1 - Haematocrit)

Answer 96

A

how is fructose absorbed in the mucousal phase of digestion?

a) primary active transport
b) secondary active transport
c) simple diffusion
* *d) faciliated diffusion**
e) paracellular transport

glucose and galactose go via 2 AT through SGLT but fructose does fac d.

Answer 97

A

hypothalamus !

Answer 98

A

What is the best way to describe a silent mutation

A single base mutation that changes the amino acid, but there is no obvious clinical effect
A single base mutation that changes the amino acid, but there is no obvious clinical effect at birth
A single base mutation that changes the amino acid, causing changes in 2 & 3 structure of protein
A single base mutation that does not change the amino acid and does not affect the phenotype or transcription of that gene
A single base mutation that does not change the AA but may affect transcription or translation of the gene

Answer 99

A

which type of receptor is insulin receptor?

a) enzyme-linked
b) GPCR
c) ion channel
* *d) tyrosine-kinase**

Answer 100

A

which cells found in the small intestine that are modified enterocytes that cover lymphoid nodules

parietal cells
goblet cells
paneth cells
enteroendocrine cells
*- m cells**

Answer 101

A

Which ligament is at risk in this boy?

radial collateral ligament
ulnar collateral ligament
*- annular ligament**
deltoid ligament

Answer 102

A

A 64-year-old man is admitted with a COPD exacerbation. He is hypoxic on admission with an SpO2 of 72%. He has a lactic acidosis on blood analysis.

What is the rate limiting enzyme of the process which has resulted in the lactic acidosis?

HMG-CoA reductase
Fructose-1,6 biphosphatase
PFK1 - The rate limiting enzyme for glycoloysis is phosphofructokinase (PFK1)
Glycgen synthase
Glucose 6 P deH

Answer 103

A

Which substance can be used to achieve the most accurate measurement of the glomerular filtration rate?

Glucose
Protein
Inulin
Creatitine
PAH acid

Answer 104

A

which antibody protects agaisnt parasitic worms?

a) IgG
b) IgM
c) IgA
* *d) IgE**
e) IgD

Answer 105

A

glutamate is an amino acid that also acts as an important …

a) steroid hormone

b) neurotransmitter

c) secondary messenger
d) source of metabolic energy

Answer 106

A

TAG transport is mediated by:

a) chylomicrons & IDLs
* *b) chylomicrons & VLDLs**
c) chylomicrons & LDLs
d) chylomicrons & HDLs
e) VLDLs and LDLs

Answer 107

A

which of the following messengers are use paracrine siginalling in to control stomach acid secretions?

a) histamine only
b) acetylcholine only
c) gastrin & histamine
d) somatostatin & gastrin
* *e) somatostain & histamine**

Answer 108

A

You are developing a new drug for diabetes which acts to decrease synthesis of glucose in the liver from non-carbohydrate carbon substrates. You want to develop a drug which targets the the rate limiting enzyme.

What enzyme will you target?

Fructose 1,6 biphosphatase The rate limiting enzyme for gluconeogenesis is fructose 1,6 bisphosphatase
HMG-CoA synthase
HMG-CoA reductase
Glutamine-PRPP amidotransferase
Acetyl-CoA carboxylase

Answer 109

A

Which one of the following actions is directly caused by somatostatin?

Increases pancreatic bicarbonate secretion

Decreases pancreatic secretions

Stimulates release of insulin-like growth factors

Increases glycogenolysis

Increases gut absorption of calcium

Stimulates thirst

Answer 110

A

which dietary molecule is essential for transmination to occur?

vitamin B6

vitamin B12

vitamin C

vitamin B3

Answer 111

A

statins block the activity of HMG-Co A reductase. so less cholesterol is made from acetly co-A (acetyl co-A –> cholesterol) (1)
causes more LDL receptors to be made & take in MORE LDLs -> reducing blood LDLs

Answer 112

A

which is the sensory nerve innervation for gagging?

a) trigeminal nerve
b) facial nerve
c) glossopharnyngeal
d) vagus nerve
e) hypoglossal

Answer 113

A

which of the following is correct?

glucagon works on the liver and muscles to build up glycogen stores

insulin works on liver to build glycogen stores

insulin works on the muscle and liver to build glycogen stores

glucagon works on the liver and muscles to break down glycogen stores

insulin works on the muscle and liver to break down glycogen stores

1. insulin: muscle and liver - builds glycogen stores

2. glucagon: only liver - breaks down glyocgen stores to release glucose

3. adrenaline: muscles via a & b adrergic receptors - release glucose

4 calcium: muscles via a & b adrergic receptors - release glucose

Answer 114

A

Increases pepsinogen secretion:

VIP

Renin

CCK

Gastrin

Secretin

Ghrelin

Answer 115

A

Which one of the following actions is directly caused by antidiuretic hormone?

Increases Na+ reabsorption in the renal distal tubule

Stimulates aldosterone release

Up-regulates alpha-1 receptors on arterioles

Increases plasma calcium

Vasoconstriction of vascular smooth muscle

Promotes water reabsorption in the collecting ducts of the kidneys by the insertion of aquaporin-2 channels

Answer 116

A

Which one of the following stimulates gastric acid secretion?

CCK
Gastric inhibitory peptide
Secretin
Histamine
Somatostatin

Answer 117

A

if you bang your elbow and get pins & needles running down you hand, which nerve is most likely affected?

a) median
b) radial
* *c) ulnar**
d) musculocutaneous

Answer 118

A

Which one of the following is the main inhibitory neurotransmitter in the spinal cord?

Adrenaline
Glutamate
Serotonin
Dopamine
Glycine

Glycine is the principal inhibitory neurotransmitter of the spinal cord

Answer 119

A

A 52-year-old male presents to his general practitioner with a two-month history of abdominal pain, occasional haematemesis and significant weight loss. He is sent for a gastroscopy, which identifies multiple gastric ulcers and thickened gastric folds. It is therefore suspected that the patient may have a gastrinoma and is sent for a secretin stimulation test (involves exogenous secretin administration) to confirm the diagnosis.

What is the mechanism of action of this exogenous hormone?

Carbohydrate digestion
Decreases gastric acid secretion
Stimulates gallbladder contractin
Stimulates gastric acid secretion
Stimulates pancreatic enzyme secretion

Answer 120

A

A patient has pins and needles in this distribution, which nerve is compressed?

a) ulnar
* *b) median**
c) radius
d) musculocutanous

Answer 121

A

which enzyme is not present in skeletal muscle?

a) debranching enzyme
b) phosphoglucomutase
* *c) glucose-6-phosphatase**
d) glycogen phosphorylase
e) pyruvate dehydrogenase

Answer 122

A

insulin

*- activates phosphodiesterase**
*- activates protein phosphastase**

Answer 123

A

which nerve innervates the muscles that causes gagging?

a) trigeminal nerve
b) facial nerve
c) glossopharnyngeal
d) vagus nerve
e) hypoglossal

Answer 124

A

meissner plexus: submucosal tissue
auerbach’s plexus: myenteric - betweeen circ and long. muscle layer

Answer 125

A

during the mechanism of T cell gut honing, what do gut dendritic cells secrete?

a) CCR9
b) retinoic acid - activates T cells to make a4B7 & CCR9
c) a4B7
d) MADCAM
e) IgA

Answer 126

A

which nerve provides special sensory innervation to anterior portion of tongue?

a) glossopharnygeal
b) trigeminal
c) vagus nerve
d) hypoglossal
* *e) facial nerve**

Answer 127

A

Hers disease: glycogen phosphorylase in liver [1]
McArdles caused by: deficiency in glycogen phosophorylase gene: PYGM. cant breakdown glycogen in the muscle = muscle weakness [1]

Answer 128

A

Which of the following best describes the mechanism of the body’s response to a decrease in blood pressure?

Decreased HR and vasoconstriction
Decreased epithelial sodium channels in DCT
Increased bradykinin
Insertion of AQP-2 channels in CD
Insertion of AQP-2 channels in thick ascending loop of Henle

Answer 129

A

intermediate density lipoproteins cause left over chylomicrons to become:

a) HDLs & LDLs
b) VLDL & HDLs
c) VLDL & LDLs
d) HDLs
e) LDLs

Answer 130

A

the receptive reflex in the proximal part of the stomach causes what to be released?

a) Ach
* *b) CCK - vagal-vagal interaction that causes proximal stomach stretch so not immediatly full**
c) NO
d) Ca2+
e) cAMP

Answer 131

A

fats (& cholesterol) absorbed from GI tract, turn into chylomicrons and go into lymphatic system:

here they interact with HDLs

- ApoC2 added: allows chylomicrons to give its triglycerides to peripheral cells

- ApoE added: allows chylomicron remenant to be taken up by the liver to deliver FA & cholesterol

Answer 132

A

preproinsulin

gets turned into proinsulin, then at GA = insulin

Answer 133

A

A 6-day-old child is referred to a community paediatrician by a general physician for poor feeding, vomiting and increasing lethargy. The child was born at term via spontaneous vaginal delivery, and his antenatal scans report no complications.

On examination, the baby looks floppy and tired. His nappy is wet and has a characteristic maple syrup odour.

Given the most likely diagnosis, which of the following is a known complication if left untreated?

Metabolic and resp acidosis
Metabolic alkalosis
Resp alkalosis
Metabolic acidosis
Resp acidosis

If left untreated, alpha-ketoacids build up in the blood resulting in metabolic acidosis (ketoacidosis).

Answer 134

A

what type of transport do proteins undergo during mucosal phase of digestion?

facilitated diffusion
primary active transport
*- secondary active transport**
endocytosis

Answer 135

A

A 60-year-old male patient experiences uncontrolled hepatic bleeding during liver resection surgery. The ‘Pringle manoeuvre’ is performed whereby the hepatic artery, portal vein and common bile duct are clamped, thus interrupting the blood flow. The structures mentioned form the anterior boundary of the epiploic foramen.

Which other vessel forms a boundary to this region?

Abdominal aorta
IVC
Thoracic aorta
Common hepatic artery
Right renal artery

Answer 136

A

You are designing a research project looking at the effects of prolonged fasting on lipid stores. You want to study the effects of diet on breakdown of fats. You decide to monitor the concentrations of the rate limiting enzyme of this process in response to a high glucose load.

What enzyme will you measure?

Glycogen phosphorylase
Isocitrate dehydrogenase
PFK-1
Glycogen synthase
Cartinine-palmitoyl transferase -

The rate limiting enzyme for lipolysis is carnitine-palmitoyl transferase I

Answer 137

A

Commonest HLA in people with celiac disease is..
HLA-DQ1

•HLA-DQ2

HLA-DQ3
HLA-DQ4

Answer 138

A

Simple diffusion
Active transport e.g. Na+/K+ATPase for absorption of glucose
Facilitated diffusion (a carrier-mediated transport system to allow faster absorption compared with simple diffusion e.g. proteins)

Answer 139

A

Which one of the following actions is directly caused by growth hormone?

Inhibits glucagon secretion

Increases gluconeogenesis

Increases glycogenolysis

Inhibits insulin secretion

Decreases gastric H+ secretion

Increases renal reabsorption of calcium

Answer 140

A

pyroxidal phosphate
derived from vitamin B6

Answer 141

A

With regards to the gastrointestinal tract, submucosa:

Contains the lamina propria

Contains Auerbach’s (myenteric) plexus

Contains Meissner’s plexus

Contains the muscularis mucosae

Answer 142

A

•A change in the composition of gut flora (e.g. due to infection, stress, hormones etc.) can trigger the activation of the genes for coeliac disease

Answer 143

A

which enzyme breaks alpha 1-4 glycosidic bonds?

a) debranching enzyme
b) phosphoglucomutase
c) glucose-6-phosphatase
* *d) glycogen phosphorylase**
e) pyruvate dehydrogenase

Answer 144

A

Which one of the following actions is directly caused by somatostatin?

Increases gastric motility

Increases growth hormone secretion

Increases appetite

Promotes water reabsorption in the collecting ducts of the kidneys by the insertion of aquaporin-2 channels

Increases renal conversion of 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol

Decreases gallbladder contraction

Answer 145

A

where in the GI tract are bile acids mostly absorbed?

a) duodenum
b) jejunum
c) ileum
d) ascending colon
e) transverse colon

(also absorbed in colon, but less so)

Answer 146

A

movement of water in gut crypt cells is controlled by which transporters?

a) aquaporins
b) ENAC
c) ROMK
* *d) CFTR**
e) Na/K/Cl2

Answer 147

A

A patient becomes dehydrated which leads to increased absorption of water in the collecting duct. If you were to measure the concentration of his urine you would find that it is near to 1200mOsm/L

Where in the nephron would you expect a similar osmolarity to be found?

PCT
Descending loop of Henle
Tip of loop of Henle
Thin ascending Loop of Henle
Thick ascending Loop of Henle

Answer 148

A

Tetrahydrobiopterin

Answer 149

A

Which one of the following best accounts for the action of PTH in increasing serum calcium levels?

Activation of vit. D to increase absorption of calcium from the small intestine
Direct stimulation of osteoclasts to absorb bone with release of calcium
Stimulation of phosphate absorbtion at the DCT of the kidney
Decreased porosity of the vessels at the Bowmans capsule to calcium
Vasospasm of the afferent renal arteriole thereby reducing GFR and calcium urinary loss

PTH increases the activity of 1-α-hydroxylase enzyme, which converts 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol, the active form of vitamin D.
Osteoclasts do not have a PTH receptor and effects are mediated via osteoblasts.

Answer 150

A

In all steroid-producing human tissue, the conversion of cholesterol to pregnenolone is an essential step. Pregnenolone is the precursor for all steroid hormones, and its formation represents the rate-limiting step of steroid synthesis

Answer 151

A

ID the branch of the brachial plexus identified by the arrow

axillary
radial
median
ulnar

Answer 152

A

A 46-year-old gentleman presents to the general practice with a 2-week history of a tickly non-productive cough. There are no associated symptoms. The patient’s respiratory examination is normal. The gentleman started taking ACE inhibitors at around the same time as the symptom started. You decide the patient’s cough is likely due to the new medication, and prescribe an angiotensin receptor blocker in place of the ACE inhibitor. A lot of antihypertensive medication target elements of the renin-angiotensin-aldosterone-system. Angiotensin I is a hormone that is important in the renin-angiotensin-aldosterone-system. It is derived from the hydrolysis of angiotensinogen in a reaction catalysed by which enzyme?

Carbonic anhydrase
ACE
Cycoloxygenase-2
Renin
Amylase

Answer 153

A

**villus atrophy
crypt hyperplasia**

Answer 154

A

how are lipids absorbed in the mucosal phase of lipid digestion?

a) primary active transport
b) secondary active transport
* *c) simple diffusion**
d) faciliated diffusion
e) paracellular transport

Answer 155

A

iron helps to improve childrens learning ability and cognitive development: Fe helps Hb to carry oxygen to neurons in brain

Answer 156

A

Where in the body is angiotensinogen produced?

Adrenal cortex
Liver
Lungs
Kidneyss
Pancreas

Answer 157

A

ileal brake is caused be what entering the ileum?

a) proteins
b) carbs
* *c) fats**
d) minerals
e) vitamins

- fats reach the ileum (even tho theyre meant to have been absorbed in duodenum)
- causes release of peptide YY & glucagon-like peptide-1 (GLP-1) by enteroendocrine cells
= slows gastric emptying

Answer 158

A

A patient presents to their GP with dehydration due to diarrhoea and vomiting. This is detected by the kidneys as reduced renal perfusion causing the renin-angiotensin-aldosterone system to be activated.

Which part of the adrenal gland is needed as part of this system?

JXG cells
Pulmonary endothelium
Zona glomerulosa - aldosterone is secreted from the zona glom
Zona fasciculata
Zona reticularis

Answer 159

A

what colour does CLO test go if H. pylori is present?

a) blue
b) yellow
c) green
* *d) orange / red**
e) purple

Answer 160

A

What effect does angiotensin II have on common renal measurements?

Decreased GFR, decreased renal plasma flow, no change in filtration fraction

Increased GFR, no change in renal plasma flow, increase in filtration fraction

Decreased GFR, no change in renal plasma flow, decrease in filtration fraction

Decreased GFR, increased renal plasma flow, decrease in filtration fraction

Increased GFR, decreased renal plasma flow, increase in filtration fraction

Increased GFR, increased renal plasma flow, no change in filtration fraction

Answer 161

A

metabolism of glutamine releases a lot of what?

urea
NH3
NH4+
uric acid
NADH

a-keto glutarate glutamate glutamine: generates free ammonia (as NH4+)
a-ketoglutarate is needed for TCA cycle for energy.*
- Glutamine has 2 amino groups, glutmate has 1, a-keto glutarate has 0 - so each step removes/adds an amino group so the metabolism of glutamine releases a lot of ammonium.*

Answer 162

A

what do chief cells secrete in children? [1]
chymosin / rennin

function? [1]
coagulate milk allowing it to be retained longer in the stomach

Answer 163

A

Where is the majority of somatostatin secreted from?

P/D1 cells lining the fundus of the stomach and epsilon cells of the pancreas

S cells in upper small intestine

Sertoli cells

D cells in the pancreas & stomach

I cells in upper small intestine

Zona glomerulosa of adrenal cortex

Answer 164

A

Which one of the following hormonal agents will increase secretions of water and electrolytes in pancreatic juice?

- secretin
- aldosterone
- somatostatin
- cholecystokinin
- adrenaline

Answer 165

A

The thoracic duct of the lymphatic system empties in the..

•Left subclavian vein

Left internal jugular vein
Left brachiocephalic vein
Left hemiazygos vein

Answer 166

A

cells can make which vitamin from tryptophan if they are deficient in it?

vitamin B1
vitamin B2
vitamin B3
vitamin B4
vitamin B5

Answer 167

A

A 6-month-old boy presents to the genetics clinic with a one-month history of swallowing and movement difficulties.

A genetic test is done for rare diseases which demonstrates a four base-pair insertion on chromosome 15, causing defects in the enzyme hexosaminidase A.

What type of genetic mutation is this?

Frameshift
Missense
Nonsense
Silent
Synonymous

Answer 168

A

Class I: HLA-A, B and C

Class II: HLA-DR, DP and DQ

Answer 169

A

A 16-year-old boy presents to the Emergency Department with acute onset pain in the right iliac fossa, nausea, vomiting, and fever. He has no significant past medical or surgical history. On examination, you find rebound tenderness at McBurney’s point, guarding, and a positive Rovsing’s sign. You strongly suspect appendicitis and the patient is later taken for surgery.

Which of these is most likely to be a physiological response in this scenario?

Increased glucagon secretion: physiological stresses increase secretion of glucagon !!
Increased insulin secretion
Reducde cortisol secretion
Increased T4 secretion
Reduced ACTH secretion

Answer 170

A

You are designing a research project looking at the pathophysiology of abetalipoproteinemia. You decide that a suitable target would be the rate limiting enzyme of lipogenesis.

What enzyme will you target?

Carbomyl phosphate synthestase I
Acetly CoA carboxylase
Glycogen phosphorylase
Isocitratre dehydrogenase
PFK-1

Lipogenesis is the process by which acetyl-CoA is converted to fatty acids. The rate limiting enzyme for lipogenesis is acetyl CoA carboxylase.

Answer 171

A

The most effective class of gastric anti-secretory drug

a.Proton pump inhibitors

b. Histamine (H2) receptor blocker
c. Aluminium hydroxide
d. Amoxycillin

Answer 172

A

Which one of the following actions is directly caused by somatostatin?

Decreases gastric emptying

Increases secretion of melanocyte-stimulating hormone (MSH) and corticotrophin-releasing hormone (CRH)

Increases renal reabsorption of calcium

Increases gastric H+ secretion

Increases glycogenolysis

Increases growth hormone secretion

Answer 173

A

which of the following have supranuclear granules?

goblet cells
*- paneth cells**
enteroendocrine cells
m cells
parietal cells

Answer 174

A

Which ligament in the knee is being tested here?

anterior cruciate ligament
*- posterior cruciate ligament**
medial collateral ligament
lateral collateral ligament

Answer 175

A

which of the following binds to basophils and mast cells and activates these cells to produce antimicrobial factors to participate in respiratory immune defense in humans?

IgA
IgM
IgE
*- IgD**
IgG

Answer 176

A

which micronutrient is important in imprinting home to the gut mucosa from peyers patches?

*a) Vitamin A**
b) Vitamin B
c) Vitamin C
d) Vitamin D
e) Vitamin E

makes retinoic acid !!

gut dendritic cells use retinoic acid to inform the niave T cells
causes niave T cells to change transcription to express CCR9 & a4B& to do gut honing

Answer 177

A

What effect does vasodilation of afferent arterioles have on common renal measurements?

Decreased GFR, increased renal plasma flow, decrease in filtration fraction

Decreased GFR, decreased renal plasma flow, no change in filtration fraction

Increased GFR, increased renal plasma flow, no change in filtration fraction

Increased GFR, decreased renal plasma flow, increase in filtration fraction

Decreased GFR, no change in renal plasma flow, decrease in filtration fraction

Increased GFR, no change in renal plasma flow, increase in filtration fraction

Answer 178

A

A 16-year-old boy presents with muscle pain during exercise, early fatigue, and dark urine. He is diagnosed with McArdle’s disease.

What is the rate-limiting enzyme for the defective pathway in this disease?

Isocitrate dehydrogenase
Phosphofructokinase-1
Glycogen synthase
Glyocgen phosphorylase
Glucose-6-phosphate dehydrogenase

Answer 179

A

B12 & vitamin D

Answer 180

A

Increases glycogenolysis:

Cortisol

Somatostatin

Gastrin

Glucagon

Growth hormone

Ghrelin

Answer 181

A

Which cell secretes hydrochloric acid?

a. Mast cell
b. Columnar cell

c.Parietal cell

d. Chief cell
e. Goblet cell

Answer 182

A

which apoprotein acts as recognition signal for LDL to be taken up by peripheral cells?

Apo B48
*- Apo B100**
Apo C2
Apo E
Apo B10

Answer 183

A

which cells found in the small intestine secrete antimicrobe substances?

enterocytes
goblet cells
*- paneth cells**
enteroendocrine cells
m cells

Answer 184

A

which lipoprotein carries fats from the liver to peripheral cells:

a) chylomicrons
* *b) VLDLs**
c) IDLs
d) LDLs
e) HDLs

Answer 185

A

A 63-year-old man attends the dialysis unit three times a week to receive haemofiltration. In normal functioning kidneys, what detects changes in salt concentrations (such as sodium chloride) and adapts the glomerular filtration rate accordingly?

Juxtaglomerular cells
Mesengial cells
Podocytes
Macula Densa
Prinicpal cells

Answer 186

A

lipoprotein lipase breaks down fats from inside lipoproteins and carries them into the cells. Which apoprotein is it activated by?

Apo B48
Apo B100
*- Apo C2**
Apo E
Apo B10

Answer 187

A

which of the following is correct?

glycogen synthase is activated by addition of P, glycogen phosphorylase is activated by removal of P
*- glycogen synthase is activated by removal of P, glycogen phosphorylase is activated by addition of P**
glycogen synthase is inhibited by addition of P, glycogen phosphorylase is inhibited by removal of P
glycogen synthase is inhibited by removal of P, glycogen phosphorylase is inhibited by addition of P

glycogen synthase is activated by removing P, inactivated by adding P
glycogen phosphorylase is activated by adding P, inactivated by removing P

Answer 188

A

the duodenal and jejunal breaks cause what to be released?

a) Ach
* *b) CCK**
c) NO
d) Ca2+
e) cAMP

release of CCK activates vagal efferents
as a result of vagal efferents:
- reduces opening of pyloric sphincter
- reductions contractions in corpus
- enhances relaxation of fundus

Answer 189

A

insulin inhibits gluconeogenesis

Answer 190

A

what is used to capture this image?

*a) CT**
b) MRI T1
c) MRI T2
d) plain radiograph

Answer 191

A

Tissue transglutaminase (tTG) or endomysium Gluten

Answer 192

A

1. A patient with suspected celiac disease has IgA anti-TTG test which comes back within normal range. What could contribute to the false negative nature of this investigation? (2)

IgA deficient patient (1)
Patient isn’t actively consuming gluten (1)

2. What could be done to verify the patient’s celiac disease?

Perform total IgA blood test to assess IgA status of pt (1)
IgG-anti-TTG (1)
Ask patient to consume gluten for some time before redoing the tests (1)
Duodenal biopsy (after patient consumes gluten!!) (1)

Answer 193

A

where is the largest microbial colony found in the GI tract?

a) stomach
b) duodenum
c) jejunum
d) ileum
* *e) colon**

not in small intestine bc: difficult env. for growth

Answer 194

A

The flat bones of the skull are formed by intramembranous ossification

True
False

Answer 195

A

immune cells have increased requirement for which co factor

- B6

*- NADPH - made via the pentose phosphate pathway**
NADH
FADH
B12

Answer 196

A

Which one of the peritoneal ligaments connects the liver to the anterior abdominal wall?

Falciform ligament

Gastrocolic ligament

Splenorenal ligament

Hepatogastric ligament

Gastrosplenic ligament

Hepatoduodenal ligament

Answer 197

A

Apo B100 causes LDLs to be taken up by cells (1)
because only taken up via receptor mediated endocytosis (1)

Answer 198

A

Which layer of the gastrointestinal tract contains Auerbach’s (myenteric) plexus?

Muscularis externa
Submucosa
Serosa
Mucosa

Answer 199

A

zollinger-ellison syndrome (ZES) causes innappropriate secretions from which cell?

a) parietal cells
* *b) G cells - causes increased gastrin productio n**
c) chief cells
d) ECL likes
e) mucous secreting cells

Answer 200

A

submanidublar gland recieves parasympathetic innervation from which nerve?

a) glossopharnygeal
b) trigeminal
c) vagus nerve
d) hypoglossal
* *e) facial nerve**

Answer 201

A

Which one of the following actions is directly caused by secretin?

Vasoconstriction of vascular smooth muscle

Decreases pepsinogen secretion

Stimulates parietal cell maturation

Increases pancreatic bicarbonate secretion

Increases pancreatic secretions rich in digestive enzymes

Stimulates release of insulin-like growth factors

Answer 202

A

parotid gland recieves parasympathetic innervation from which nerve?

*a) glossopharnygeal**
b) trigeminal
c) vagus nerve
d) hypoglossal
e) facial nerve

Answer 203

A

hypocalcemia causes the release of which hormone to regulate Ca2+ levels?

TSH
*- PTH**
FH
GHRH
ADH

Answer 204

A

With respect to the phosphorylation of glucose, which one of the following is most associated with glucokinase?

High affinity for glucose (low Km)

Induced by insulin

Low capacity (low Vmax)

Not affected by insulin

When glucose levels are low helps sequester glucose in the tissues

Located in most tissues

Answer 205

A

Where is the majority of CCK secreted from?

P/D1 cells lining the fundus of the stomach and epsilon cells of the pancreas

S cells in upper small intestine

Sertoli cells

D cells in the pancreas & stomach

I cells in upper small intestine

Zona glomerulosa of adrenal cortex

Answer 206

A

A 56-year-old man has chronic pancreatitis and is struggling to absorb fat-soluble components of his diet.

Which of the following is a fat-soluble vitamin which has a role as an anti-oxidant during processes such as immune function and protection of cell membranes?

Vit B
Vit E
Vit K
Vit C
Vit B

Answer 207

A

Which one of the peritoneal ligaments contains the short gastric vessels?

Splenorenal ligament

Gastrosplenic ligament

Hepatoduodenal ligament

Hepatogastric ligament

Falciform ligament

Gastrocolic ligament

Answer 208

A

which vitamin deficiency is associated with pellegra?

vit. A
vit B1
vit. B2
*- vit. B3**
vit. B4

Answer 209

A

foam cells (where macrophages engulf LDL and become foam cells) stick to BV walls and make atheroma plaque

Answer 210

A

which vitamin is used in the as a cofactor in the Krebs Cycle and glycolysis?

- vitamin B1
- vitamin B2
- vitamin B3
- vitamin B6
- vitamin B12

Answer 211

A

where are CD4 T cells usually found in the gut?

epithelium
submucosa
*- lamina propria**
muscularis mucosa

Answer 212

A

which apoprotein do chylomicrons have on them:

a) B100
b) B49
c) B101
* *d) B48**
e) B102

Answer 213

A

Which one of the following actions is directly caused by VIP?

Increases proximal tubule Na+/H+ activity

Increases gallbladder contraction

Increases pancreatic bicarbonate secretion

Decreases pancreatic secretions

Increases secretion of water from pancreas and intestines

Up-regulates alpha-1 receptors on arterioles

Answer 214

A

From which of the following does the epigastric artery originate?

Internal iliac artery
External iliac artery
Superior vesical artery
Inferior vesical artery
None of the above

Answer 215

A

The citric acid cycle is responsible for the major share of energy release and supply during aerobic respiration.

What is the rate limiting enzyme of the citric acid cycle?

PFK1
Glycogen synthase
Glyocgen phosphorylase
Glucose-6-phosphate dehydrogenase
Isocitrate dehydrogenase

Answer 216

A

Which one of the following is not an effect of cholecystokinin?

It causes gallbladder contraction
It increases the rate of gastric emptying
It relaxes the sphincter of oddi
It stimulates the pancreatic acinar cells
It has a trophoc effect on pancreatic acinar cells

Answer 217

A

The first antibodies to be produced in a humoral immune response are always:

a) IgG
* *b) IgM**
c) IgA
d) IgE
e) IgD

The first antibodies to be produced in a humoral immune response are always IgM, because IgM can be expressed without isotype switching (see Figs 4.20 and 9.8). These early IgM antibodies are produced before B cells have undergone somatic hypermutation and therefore tend to be of low affinity.

Answer 218

A

which lipoprotein carries fats from the liver to peripheral cells?

chylomicron
very low density lipo
intermediate DL
LDL
HDL

Answer 219

A

Which cell secretes pepsinogen?

a. Mast cell
b. Columnar cell
c. Parietal cell

d.Chief cell

e.Goblet cell

Answer 220

A

A: component of visual pigments; anitoxidnat; prevents damage to lipids of cell surface membranes(1)

D: Aids in the use of calcium and phosphorus (1)

E: antioxidant 1)

K; part of blood clotting cascade (1)

Answer 221

A

which vitamin is used for closure of neural tube during development and if deficient, causes spina bifida:

zinc
copper
B9 - folate !!
B12
selenium

Answer 222

A

pectinate line [1]

simple columnar –> stratified squamous nonk epithelium

Answer 223

A

chylomicrons pick up which two apoproteins from HDL?

*a) ApoCII and ApoE**
b) ApoCI and ApoB100
c) ApoCII and ApoB100
d) ApoC and ApoB48
e) ApoB48 and ApoB100

Answer 224

A

Prolactin is secreted from which part of the body?

Anterior pituitary
Hypothalamus
Parathyroid gland
Adrenal gland
Posterior pituitary

Answer 225

A

which of the following is autosomal dominant?

a) PKU
b) medium chain actly coenzyme dehydrogenase (MCAD)
c) von Gierkes disease
d) Maple Syrup Urine Disease
* *e) familal hypercholesterolemia**

Answer 226

A

Among all the masticatory muscles, X is the only one with horizontally arranged fibers.

X =?

a) medial pterygoid
b) lateral pterygoid
c) masseter
d) temporalis

Answer 227

A

NSAIDS block which receptor on parietal cells?

a) M3
b) CCK2
c) H2
d) somatostatin receptor
* *e) prostaglandin receptor - causes decresease in mucous and bicarbonate production :(**

Answer 228

A

Julie, a 54-year-old female, presents to her GP with a lump in her groin. It is not associated with pain but becomes more prominent when she coughs.

On examination, the GP notes the lump is inferior and lateral to the pubic tubercle, which aids his diagnosis of a femoral hernia. Therefore part of Julie’s bowel had entered the femoral canal which causes a bulge into the femoral triangle, an anatomical region in the upper thigh.

Laterally to medially, what contents can be found in this anatomical region?

Femoral nerve, femoral artery, femoral vein, empty space, lymphatics
Femoral artery, femoral vein, femoral nerve, empty space, lymphatics
Femoral nerve, femoral vein, femoral artery, empty space, lymphatics
Lymphatics, empty space, femoral nerve, femoral artery, femoral vein
Lymphatics, empty space, femoral vein, femoral artery, femoral nerve

Answer 229

A

Phenylalanine is an amino acid and is normally present in protein based foods, such having too much protein could lead to a build-up of phenylalanine. In this case as Nuria is pregnant, if she has excess phenylalanine can affect the development of the foetus.

Answer 230

A

which micronutrient helps to improve childrens learning ability and cognitive development

vitamin A
vitamin B12
zinc
*- iron: Fe helps Hb to carry oxygen to neurons in brain**
vitamin C

Answer 231

A

Which layer of the gastrointestinal tract contains the muscularis mucosae?

Submucosa

Mucosa

Serosa

Muscularis externa

Answer 232

A

What is measured to obtain renal plasma flow?

Creatinine
Para-amino hippuric acid (PAH)
Inulin
Glucose
Protein

Answer 233

A

paneth cells are found in right side of colon only

Answer 234

A

NAD & NADP
pellegra

Answer 235

A

The left colic artery supplies the upper and lower parts of the descending colon.

What artery does the left colic artery branch off?

SMA
Inferior gluteal artery
IMA
Inferior rectal artery
Inferior epigatric artery

Answer 236

A

Glomerular filtration rate:

Is typically around 0.20

Can be estimated using creatinine clearance

Glomerular filtration rate / renal blood flow

Plasmacreatinine / urinarycreatinine

UPAH * V / PPAH

Urine flow rate * urine concentration

Answer 237

A

during glucose metabolism, the if there is a little cAMP levels, which of the following occurs?

glucagon and adrenaline activated
insulin is activated
*- glucagon an adrenaline inhibited**
*less glucose is released**

Answer 238

A

A 28-year-old man with a long-term history of alcohol is rushed to the emergency department following a prolonged seizure. His work-up fails to reveal any sinister causes of seizures. He has no history of epilepsy. The consultant attending to him believes that the seizure may be caused by a vitamin deficiency secondary to his chronic alcohol intake.

Which one of the following vitamin deficiency may have caused the seizure?

Vitamin B7
Vitamin B2
Vitamin B3
Vitamin B5
Vitamin B6 - Vitamin B6 (pyridoxine) is required for the synthesis of GABA

Answer 239

A

gastrin is secreted by G cells. which receptor does it bind to on parietal cells?

a) M3
* *b) CCK₂**
c) H₂
d) somatostatin receptor
e) prostaglandin receptor

Answer 240

A

interstilial cells of cajal are associated with a major influx of what?

a) Na+
b) K+
* *c) Ca2+**
d) ACh

into SMC - contraction occurs (also Na)

Answer 241

A

which nerve innervates the muscle that elevates the pharnyx during swallowing ?

a) trigeminal nerve
b) facial nerve
* *c) glossopharnyngeal - stylopharnygeus muscle**
d) vagus nerve
e) hypoglossal

Answer 242

A

Duodenum: iron
Jejunum: main site of absorption
Ileum: terminal ileum site of vitamin B12 absorption

Answer 243

A

This patient has a congenital absence of a muscle. Which action at the shoulder would be significantly weakened?

*a) flexion**
b) extension
c) abduction
d) external rotation

Answer 244

A

blunt trauma to peritoneum can be tear away from the which artery and cause internal bleeding?

left gastric artery
right gastric artery
*- splenic artery - cuz spleen is intraperitoneal so moves lots**
common hepatic artery
gastroduodenal artery

Answer 245

A

what is the correct label for this strucutre?

a) rotundudm foramen
b) manibular foramen
* *c) mental foramen**
d) ovale foramen
e) hypoglossal foramen

Answer 246

A

An 8-year-old girl is brought to the physician due to developmental delay and seizure attacks since the age of 6. She presented with abnormal behaviour, ataxia, unusual laughing, intellectual disability, and mandibular prognathism. Genomic testing revealed a deletion in the 15q11-q13 chromosome. She was diagnosed with Angelman syndrome (AS). AS originates from the dysfunctional expression of the ubiquitin-protein ligase E3A gene on chromosome 15.

Which of the following cellular activities is most likely to be impaired?

Aerobic respiration
Catabolism of very long chain fatty acids and AAs
Folding of new proteins
Proteasomal degradation of proteins - Ubiquitin tagging destines proteins to proteasome for degradation
Translation of RNA into proteins

Answer 247

A

Which one of the peritoneal ligaments contains the tail of the pancreas?

Splenorenal ligament

Gastrosplenic ligament

Hepatoduodenal ligament

Hepatogastric ligament

Gastrocolic ligament

Falciform ligament

Answer 248

A

Which one of the following actions is directly caused by glucagon?

Vasoconstriction of vascular smooth muscle

Decreases osteoclastic activity

Inhibits insulin secretion

Decreases plasma phosphate

Increases glycogenolysis

Decreases renal reabsorption of phosphate

Answer 249

A

which of the following vitamins are antioxidants?

vitamin A & C
vitamin C only
vitamin A & E
vitamin A & C
*- vitamin A, C & E**

Answer 250

A

A 12-year-old boy is being investigated for coeliac disease and has recently had biopsies of both the small and large intestinal linings.

In a normal biopsy, which of the following can be found in the lining of the small intestine but not in that of the large intestine?

Muscularis mucosae
Myenteric nerve plexus
Villi
Columnar epithelium
Goblet cells

Answer 251

A

dorsal mesogastrium forms connections between:

stomach & spleen [1]
spleen and posterior ab. wall [1]

Answer 252

A

hormonal (RAAS)
CNS (osmorecptors)
kindeys

Answer 253

A

mitochondria [1]
ER [1]
peroxisome [1]

Answer 254

A

An 18-year-old man is referred to the acute medical team with nausea and vomiting. He is a type 1 diabetic and has recently been unwell. Blood tests confirm diabetic ketoacidosis, and he is started on an insulin infusion.

What type of receptor does this treatment bind to?

Beta-1 receptors
GPRC
Guanylate cylase receptors
Ligand-gated ion channel receptors
Tyrosine kinase receptors

Answer 255

A

Which of the following is not a catabolic pathway?

Glycolysis

TCA cycle

Glycogenolysis

Gluconeogenesis

Glycogenesis

Anabolic pathways build complex molecules from simpler ones and typically need an input of energy.

Catabolic pathways involve the degradation (or breakdown) of complex molecules into simpler ones. Molecular energy stored in the bonds of complex molecules is released in catabolic pathways and harvested in such a way that it can be used to produce ATP.

Answer 256

A

PKU is a condition which is caused a mutation on the enzyme phenylalanine hydroxylase (or insufficiency of tetrahydrobiopterin) [1]

therefore prevents conversion of phenylalanine into tyrosine. [1]

The condition is normally autosomal recessive, which means that two individuals need to be carriers in order to for their offspring to have PKU. [1]

Answer 257

A

what type of cells line stomach?

a. Squamous cell
b. Pseudostratified cell

c.Columnar cell - simple columnar cells

d.Cuboidal call

Answer 258

A

which part of the manible serves as the muscle attachment point and moves the mandible?

*a) coronoid process**
b) neck
c) head
d) ramus
e) body

Answer 259

A

Fructose-6-phosphate to Fructose-1,6-bisphosphate via the enzyme Phosphofructokinase-1.

Is regulated by:

ATP:AMP ratio
Citrate (decreases activity)
Fructose-2,6-bisphosphate (increased activity)

Answer 260

A

A 56-year-old lady is due to undergo a left hemicolectomy for carcinoma of the splenic flexure. The surgeons decide to perform a high ligation of the inferior mesenteric vein. Into which of the following does this structure usually drain

Portal vein
IVC
Left renal vein
Left iliac vein
Splenic vein

Answer 261

A

which of the following is found in the stomach body?

a) parietal and chief cells
* *b) parietal and D cells & chief cells**
c) mucous cells, D cells & chief cells
d) mucous cells and D cells & G cells
e) parietal cells, G cells & chief cells

Answer 262

A

which antibody activates basophils and mast cells to make antimicrobrial factors
a) IgG
b) IgM
c) IgA
d) IgE
e) IgD

Answer 263

A

during ox. phosph H+ are pumped across the inner mitochondrial matrix at which complexes?

complexes 1, 2 & 3
complexes 1, 2 & 4
*- complexes 1, 3, & 4**
complexes 2, 3 & 4

Answer 264

A

expression of VEGF - induces angiogenesis
reduces expression of mitochondria

Answer 265

A

Where in the body is most angiotensin-converting-enzyme located?

Adrenal cortex
Liver
Lungs
Kidneyss
Pancreas

Answer 266

A

this indicates weakenss of which muscle?

a) serratus anterior
b) deltoid
c) trapezuis
d) latissimus dorsi

Answer 267

A

insulin is present as what form when it is not used / stored?

a) monomer
b) dimer
c) pentameter
* *d) hexamer**

when active: monomer

Answer 268

A

Each villus has a central core composed of:
one artery
one vein,
a strand of muscle
centrally located lymphatic capillary (lacteal)

Answer 269

A

Which one of the following types of epithelium lines the lumenal surface of the normal oesophagus?

Non keratinsed stratified squamous epithelium
Ciliated columnar epithelium
Keratinsed stratified squamous epithelium
Non ciliated columnar epithelium
None of the above

Answer 270

A

The sprinter uses anaerobic respiration to produce the required amount of ATP for his race.
This involves the break down of glucose to pyruvate to produce a net of 2 ATP.
This is converted into lactic acid to prevent entry into the TCA cycle, which ultimately requires oxygen.
The lactic acid is sent to the liver via the blood, and hence, as an acid, lowers the pH.
The lactic acid is converted back into glucose, at the cost of 6 ATP and is delivered back to the muscle.

Answer 271

A

which molecule coming into B langerhan cells in pancreas causes the secretion of insulin?

a) Na+
b) K+
c) ACh
d) Ca2+
e) Cl-

Answer 272

A

which condition renders the body in a positive nitrogen balance?

endurance exercise

starvation

a car accident

pregnancy

Answer 273

A

Which one of the following structures will lie posterior to the epiploic foramen at this level?

hepatic artery
cystic duct
hepatic portal vein
greater omentum
SMA
IVC

The epiploic foramen has the following boundaries:
Anteriorly (in the free edge of the lesser omentum): Bile duct to the right, portal vein behind and hepatic artery to the left.
PosteriorlyInferior vena cava
Inferiorly1st part of the duodenum
SuperiorlyCaudate process of the liver

Answer 274

A

which of the following is found in the stomach antrum?

a) D cells and G cells
b) G cells and mucous cells
c) mucous cells, D cells & chief cells
* *d) mucous cells and D cells & G cells**
e) D cells & G cells & chief cells

Answer 275

A

which two hormones cause glycogen breakdown at the muscles?

insulin and adrenaline
adrenaline and glucagon
*- adrenaline and calcium**
calcium and glucagon
glucagon and insulin

glucagon only works in liver !!

Answer 276

A

muscles of mastication are supplied by which nerve?

a) hypoglossal
b) glossopharyngeal
c) facial nerve
* *d) trigeminal nerve - V3 mandibular branch**
e) vagus nerve

Answer 277

A

where in GI tract most likely to find payers patches?

a) stomach
b) duodenum
c) jejunum
* *d) ileum**
e) colon

Answer 278

A

the transverse mesocolon

Answer 279

A

which of the following would a clinical deficiency cause peripheral neuropathy?

vitamin A

vitamin D

vitamin E

vitamin K

Answer 280

A

which nerve is most as risk from this fracture

*a) median**
b) ulnar
c) radius
d) axillary

Answer 281

A

Which one of the following actions is directly caused by angiotensin II?

Promotes water reabsorption in the collecting ducts of the kidneys by the insertion of aquaporin-2 channels

Increases Na+ reabsorption in the renal distal tubule

Increases gut absorption of calcium

Increases gluconeogenesis

Vasoconstriction of vascular smooth muscle

Converts angiotensinogen to angiotensin I

Answer 282

A

the adaptive reflex in the proximal part of the stomach causes what to be released?

a) Ach
b) CCK
* *c) NO - causes relaxation of the stomach via ENS**
d) Ca2+
e) cAMP

Answer 283

A

A 73-year-old lady is admitted for a laparoscopic cholecystectomy. During her pre-operative assessment it is noted that she is receiving furosemide for the treatment of hypertension. Where is the site of action of this diuretic?

PCT
Descending loop of Henle
Ascending loop of Henle
DCT
CD

Answer 284

A

Rate controlling step:

o HCO3- + NH4+ –> carbamoyl phosphate (via enzyme carbamoyl phosphate synthase 1)
o Requires 2 ATP.
o Controlled allosterically by glutamate metabolite: N-acetyl glutamate - this is formed in an excess of glutamate, so drives urea cycle.

b) the two amino groups required from: aspartate (1) & ammonia (1)

essentially is a shuttle reaction of NH4 into from aspartate and ammonia into urea

Answer 285

A

hard palatine is made of which two bones?

*a) maxilla and palatine**
b) vomer and ethmoid
c) palatine and ethmoid
d) vomer and palatine
e) palatine and mandible

Answer 286

A

which of the following is not a primary retroperitoneal structure?

aorta
kidneys
*- pancreas**
ureter
anal canal

Answer 287

A

which apoprotein, added by HDL to a chylomicron, means the chylomicron remnant can be taken up by the liver to deliver FA & cholesterol?

Apo B48
Apo B100
Apo C2
*- Apo E**
Apo B10

Answer 288

A

Which one of the following inhibits the secretion of insulin?

Adrenaline
Lipids
Gastrin
Arginine
Vagal cholinergic activty

Answer 289

A

A 54-year-old woman is admitted with symptoms of a stroke, including difficulty speaking and vision changes. She was in a hair salon at the time and got a headache after having her hair washed.

Investigation shows a vertebral arterial dissection, which is thought to be caused by hyperextending her neck.

How does this blood vessel enter the cranial cavity?

carotid canal
foramen magnum
foramen ovale
foramane spinosum
jugular foramen

Answer 290

A

T3 inhibits pituitary release of TSH

Answer 291

A

which of the following is not a pancreatic enzyme?

*-Pepsin**
Trypsinogen
Chymotripsinogen
Amylase
Lipase

Answer 292

A

A 24-year-old woman presents to her general practitioner with a 7-month history of fatigue, abdominal cramping, and abdominal bloating. It is suspected that she may have coeliac disease and the following blood test result is obtained:

Tissue transglutaminase IgA+ve

Which of the following immune cells is responsible for the production of this result?

Eosinophils
Macrophages
Memory cells
Plasma cells
T cells

Answer 293

A

high vasculature (bc secrete into blood)
cells in the gland are very close to capillaries
interact with own organ first e.g. in adrenal gland: hormones from cortex can see tissues in the medulla first -> to influence own response of organ

Answer 294

A

which cells in the stomach secrete pepsinogen?

a) mucous secreting cells
b) chief cells
c) parietal cells
d) D cell
e) G cells

Answer 295

A

CCK
GIP - (gastric inhibitory protein)
Secretin

Answer 296

A

The soft palatine is supplied by which nerve?

a) facial nerve
b) trigeminal nerve
c) glossopharyngeal nerve
d) hypoglossal nerve
* *e) vagus nerve**

Answer 297

A

which of the following have subnuclear granules?

goblet cells
paneth cells
*- enteroendocrine cells**
m cells

Answer 298

A

HIF1: Hypoxia induced factor down regulates mitochondria, which require oxygen to produce ATP via the TCA cycle and are therefore less useful in hypoxic conditions. Promotes VEGF expression.
VEGF: Increased vasculature and therefore oxygen supply, countering hypoxic conditions.
EPO increases the number erythrocytes produced, causing a higher haematocrit and therefore higher oxygen binding capacity. This is necessary for the marathon runner who primarily uses the TCA cycle to produce ATP in aerobic conditions, which requires large amounts of oxygen.

Answer 299

A

•Intramuscular injections of hydroxocobalamin because patient cannot release IF.

Answer 300

A

•Chyme sits in intestinal lumen- has an osmotic effect and water is drawn out of epithelial cells into lumen à diarrhoea

Answer 301

A

A 61-year-old man undergoes a carotid endarterectomy after carotid artery stenosis was found in investigations following a TIA. When he wakes he has a hoarse voice, which is still present and has not improved after 72 hours. He has also been refusing food. On examination, his gag reflex is not present. A CT head is performed which shows no abnormalities.

What is the most likely cause of his symptoms?

Facial nerve injury
glossopharnygeal nerve injury
hypoglossal nerve injury
- vagus nerve injury
- stroke

All innervation for speech originates from the vagus (X) nerve so injuries to the vagus will cause speech problems

Answer 302

A

*internal thoracic artery** –> superior epigastric artery
*external iliac artery** –> inferior epigastric artery

Answer 303

A

A 13-year-old female presents with painful muscle cramp associated with early fatigue and ‘red urine’ with strenuous exercise. Blood glucose and lactate levels are normal. She is diagnosed with glycogen storage disease type V (McArdle disease).

Which of the following enzymes is deficient in this patient?

Glucose-6-phosphatase
Glucose-6-phosphate dehydrogenase
debranching enzyme
glycogen phosphorylase aka myophosphatase
GLucocerebroisdae

Answer 304

A

which is the active form of thyroid hormone?

T1
T2
- T3
T4
- T5

T4 = inactive
T3 = active

Answer 305

A

A 35-year-old woman goes to her general practitioner complaining of epigastric pain which is worse after eating a takeaway or drinking alcohol. Upon further questioning, a nocturnal cough is also reported. A diagnosis of gastro-oesophageal reflux disorder (GORD) is made. Symptoms of this disorder are due to irritation caused by stomach acid (H+), released from cells under gastrin stimulation.

Which cell type is stimulated by this hormone?

G cells
Gastric chief cells
Gastric mucousal cells
Gastric parietal cells
Intinsic cells

Answer 306

A

With respect to the phosphorylation of glucose, which one of the following is most associated with glucokinase?

Not affected by insulin

Low capacity (low Vmax)

High affinity for glucose (low Km)

Inhibited by glucose-6-phosphate

When glucose levels are low helps sequester glucose in the tissues

When glucose levels are high helps store excessive glucose in the liver

Answer 307

A

GLUT4 is located in which 3 locations? [3]

**adipose tissues
liver**
skeletal muscle

Answer 308

A

the motor supply to all of muscles of the tongue except the pataoglossus are innervated by?

a) glossopharnygeal
b) trigeminal
c) vagus nerve
* *d) hypoglossal**
e) facial nerve

Answer 309

A

cytochrome C transfers electrons to oxygen at which complex in oxidative phosphorlyation?

a) complex 1
b) complex 2
c) complex 3
* *d) complex 4**

Answer 310

A

the presence of which immune cell would signify significant oesphagitus?

macrophage
lymphocyte
plasma cell
neutrophil
eiosonophil

Answer 311

A

interstitial cells of cajal

Answer 312

A

pepsinogen is activated by secretions from which cell?

mucous lining
stem
parietal: pepsinogen –> pepsin by HCl of parietal
D cell
G cell

Answer 313

A

which inflammatory cytokines are associated with CD?

IFN-γ
TNF-a
IL-1
IL-6

Answer 314

A

what is the effect of increased citrate levels on the rate determing step of glycolysis? [1]
inhibits

what is the effect of increased ADP / AMP levels on the rate determing step of glycolysis? [1]
increases it

Answer 315

A

which of the following is the linear alba?

A
B
C
D
E
F

Answer 316

A

which of the following is the inguinal ligmanet?

A
B
C
D
E
F

Answer 317

A

which of the following is the external oblique?

A
B
C
D
E
F

Answer 318

A

which of the following is the rectus abdominus?

A
B
C
D
E
F

Answer 319

A

which of the following is the tendinous intersections?

A
B
C
D
E
F

Answer 320

A

which artery becomes the inferior epigastric artery?

internal iliac artery
SMA
IMA
external iliac artery
lower intercosal arteries

Answer 321

A

inability for cells to produce Acetyl CoA is produced by a deficiency in

vitamin B1
vitamin K
vitamin C
vitamin B2
vitamin B6

Answer 322

A

cricopharyngeus

Answer 323

A

upper oesophageal sphincter: produced by skeletal muscle cricopharyngeus. anatomical sphincter

*lower oesophageal sphincter:** looks the same as oesophagus. physiological sphincter. aided by:
a) acute angle of stomach enter
b) right curs of the diaphragm: pinch-cock effect

Answer 324

A

A = **rectus abdominis**
B = **linea alba**
C = **ASIS**
D = **inguinal ligament**
E = **tendinous intersection**

Answer 325

A

geniohyoid

Answer 326

A

which of the following is foramen cecum of tongue?

A
B
C
D
E

Answer 327

A

which of the following is foliate papillae?

A
B
C
D
E

Answer 328

A

which of the following is lingual tonsil?

A
B
C
D
E

Answer 329

A

which of the following is vallate papillae?

A
B
C
D
E

Answer 330

A

which of the following is the foramen cecum ?

A
B
C
D
E

Answer 331

A

which hormone acts to counter hypocalcemia?

LH
T3
TSH
GnRH
PTH (parathyroid hormone)

Answer 332

A

what is the overall net / gain or loss of ATP during glycolysis?

2 ATP gain
2 ATP loss
4 ATP gain
4 ATP loss
38 Gain

Answer 333

A

what is the overall net / gain or loss of ATP during cori cycle?

2 ATP gain
2 ATP loss
4 ATP gain
4 ATP loss
38 Gain

Answer 334

A

ligamentum teres: inferior aspect of the falciform ligament

Answer 335

A

sites of collection of inflammatory fluid (may go undiagnose). inflammatory fluid can spread via epiploic foramen: peritonitis

Answer 336

A

which of the following is not a suprahyoid muscle?

Stylohyoid
Digastric
Sternohyoid
Geniohyoid
Mylohyoid

Answer 337

A

which of the following is not an infrahyoid muscle?

Geniohyoid
Sternohyoid
Omohyoid
Sternothyroid
Thyrohyoid

Answer 338

A

during ox. phosph H+ are pumped across the inner mitochondrial matrix at which complexes?

- complexes 1, 2 & 3

complexes 1, 2 & 4
*- complexes 1, 3, & 4**
complexes 2, 3 & 4

Answer 339

A

jejunum: long vasa recta and fewer loops - A

ileum: larger arcades and vasa recta are shorter - B

Answer 340

A

jejunum: long vasa recta and fewer loops - A

ileum: larger arcades and vasa recta are shorter - B

Answer 341

A

which part of the gut is the appendix in?

foregut

midgut

hindgut

Answer 342

A

Which nerve provides parasympathetic innervation to the hindgut?

Vagus nerve

pelvic splachnic nerves

pudendal nerve

phrenic nerce

Answer 343

A

falicform ligament
greater omentum

Answer 344

A

cysteic artery

Answer 345

A

cysteic artery

Answer 346

A

lumbar splachnic nerve

Answer 347

A

absorption of amino acids through apical surface of intestinal cells occurs via?

faciliated diffusion
Na-linked secondary active transport
Ca-linked secondary active transport
Simple diffusion
Paracellular diffusion

Answer 348

A

absorption of amino acids through basolateral surface of intestinal cells occurs via?

faciliated diffusion
Na-linked secondary active transport
Ca-linked secondary active transport
Simple diffusion
Paracellular diffusion

Answer 349

A

which enzyme acts a sensor initiating production of insulin?

glucokinase
glycogen synthase
glycogen phosphorylase
PFK-1
PDH

Answer 350

A

Ach binds to which receptor on parietal cell to stimulate HCl production?

M1
M2
M3
H2
CCK2

Answer 351

A

Ca2+ binding to calmodulin in smooth muscle allows it to interact with and activate myosin light chain kinase which catalyzes the phosphorylation of myosin.

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