SBA

Question 1

A 40-year-old woman presents to the emergency department with sudden, crushing chest pain radiating down her left arm and jaw. She also reports feeling nauseous and sweating. Based on her symptoms, which of the following areas is LEAST likely to be another site of pain?

A)Lower back
B)Right shoulder blade
C)Left upper arm
D)Upper abdomen

Answer 1

A

Question 2

During a routine check-up, your patient, a 30-year-old healthy woman, asks about the different blood vessels supplying her vital organs. You explain that the aorta, the largest artery in the body, has branches that deliver blood to various regions. Which of the following branches of the aorta would NOT supply blood directly to the brain?

A)Brachiocephalic artery
B) Descending thoracic aorta
C) Left common carotid artery
D) Left subclavian artery

Answer 2

B

Question 3

During an embryology lecture, your professor discusses the development of the aortic arches. You recall that these early embryonic structures contribute to the formation of important arteries in adults. Which of the following pairs of arteries arises from the same embryonic aortic arch?

A)Brachiocephalic artery and left subclavian artery
B)Left common carotid artery and right common carotid artery
C)Left subclavian artery and descending aorta
D) Aorta and pulmonary artery

Answer 3

B

Question 4

You are monitoring a healthy 30-year-old patient during an exercise stress test. You notice their heart rate increases as the intensity of the exercise increases. Which of the following events occurs DURING systole, the contraction phase of the heart cycle?

A)Blood flows passively from the atria into the ventricles.
B) The atrioventricular valves (mitral and tricuspid) open.
C) The pressure in the ventricles is higher than the pressure in the arteries.
D) The semilunar valves (aortic and pulmonary) close.

Answer 4

C

Question 5

During a lecture on cardiovascular physiology, your professor discusses Starling’s Law of the Heart, which explains the relationship between ventricular filling and stroke volume. You recall that increased venous return leads to increased stroke volume, up to a certain point. Which of the following factors is LEAST likely to contribute to an increased stroke volume according to Starling’s Law?

A)Increased preload
B)Increased contractility of the heart muscle
C) Increased afterload
D)Increased heart rate

Answer 5

C

Question 6

Which cranial nerve monitors the carotid body and sinus chemo-
and baroreceptors?
a) Vagus
b) Accessory
c) Glossopharyngeal
d) Facial
e) Hypoglossal

Answer 6

C

Question 7

What do the 3rd aortic arches form?
a) Minor vessels in the head
b) Left and right subclavian arteries
c) Left - aorta. Right - Right subclavian artery.
d) Left - left pulmonary artery and ductus arteriosus. Right -
right pulmonary artery.
e) The common carotid arteries

Answer 7

E

Question 8

What does the T wave on ECG represent?
a) Ventricular depolarisation
b) Ventricular repolarisation
c) Atrial repolarisation
d) Atrial depolarisation

Answer 8

B

Question 9

Which of these is not a layer in the arterial wall?
a) Serosa
b) Tunica intima
c) Tunica media
d) Tunica externa/adventitia

Answer 9

A

Question 10

A 25-year-old male sustains a deep laceration on his arm during a fall. Bleeding
is brisk, so you apply direct pressure and activate emergency services. While waiting
for the ambulance, you consider the body’s clotting mechanisms.
Which of the following factors is NOT directly involved in the intrinsic pathway of the
coagulation cascade?

A) Factor VIII (FVIII)
B) Factor IX (FIX)
C) Tissue factor (TF)
D) Contact with subendothelium
E) Activated platelet phospholipids

Answer 10

C

Question 11

Mitosis is the process by which a parent cell produces two genetically identical daughter cells. In which phase of mitosis do chromosomes line up along the equatorial plane of the parent cell?
a) Interphase b) Prophase c) Metaphase d) Anaphase e) Telophase

Answer 11

C

Question 12

Cystic fibrosis is an autosomal recessive disorder which manifests in the homozygous state. If two carrier parents have a healthy offspring, what is the chance that this offspring is a carrier of the defective gene?
a) 0%
b) 25% c) 33.3% d) 50% e) 66.7%

Answer 12

E

Question 13

A protein is a large polypeptide. In which stage of structure does the amino acid chain fold to form α-helices and β-pleated sheets?

a) b) c) d) e)
Primary
Secondary
Tertiary
Quaternary
Quinary

Answer 13

B

Question 14

Duchenne’s muscular dystrophy is a disorder which occurs when a point mutation on a particular gene produces a premature stop codon, resulting in an incomplete and non-functional protein. What type of DNA mutation is this?
Out-of-frame deletion
In-frame deletion
Mis-sense mutation
Non-sense mutation
Splice-site mutation

Answer 14

D

Question 15

To achieve homeostasis, cells must communicate with each other. Which type of communication involves chemical messengers between cells, which are released into the extracellular fluid and travel short distances, such as at neuromuscular junctions?
Autocrine
Paracrine
Endocrine
Exocrine
Immune

Answer 15

B

Question 16

Fluid compartments in the body are said to be in osmotic equilibrium. Which of the following definitions correctly describes osmotic pressure?

a) b) c)
d) e)

Measure of the number of dissolved particles per kilogram of fluid
Measure of the number of dissolved particles per litre of fluid
Pressure applied to a solution, by a pure solvent, required to prevent inward osmosis, through a semipermeable membrane
Pressure exerted by a protein, that tends to pull fluid into its solution, through a semipermeable membrane
Pressure difference between capillary blood and interstitial fluid

Answer 16

C

Question 17

In which of the following conversions, found in the Kreb’s cycle, is ATP produced?
a) Oxaloacetate to citrate
b) Citrate to isocitrate
c) Isocitrate to α-ketoglutarate
d) α-ketoglutarate to succinyl-CoA
e) Succinyl-CoA to succinate

Answer 17

E

Question 18

8. In theoretically optimal conditions, what is the total number of produced by the glycolysis, Kreb’s cycle and oxidative phosphorylation of a single glucose molecule?

a) 2
b) 19
c) 38
d) 76
e) 146

Answer 18

C

Question 19

9. Ketogenesis occurs in liver hepatocytes when high levels of acetyl-CoA are generated, which exceed the capacity of the Kreb’s cycle. Where in the hepatocytes does this process occur?

a) Cytosol
b) Mitochondrial matrix
c) Inner mitochondrial membrane
d) Ribosomes
e) All of the above

Answer 19

B

Question 20

10. Collagen is the most abundant protein in the body, it forms a scaffold to provide strength and structure. Which type is found in basement membranes?

a) Type I
b) Type II
c) Type III
d) Type IV
e) Type V

Answer 20

D

Question 21

11. A 23-year-old man presents to his GP complaining of acid reflux. Which of the following cell types is responsible for secreting hydrochloric acid in the stomach?

a) Mucous cell
b) Parietal cell
c) Chief cell
d) Enteroendocrine cell
e) Goblet cell

Answer 21

B

Question 22

12. A 31-year-old is diagnosed with Crohn’s disease. As part of her diagnosis, she undergoes a small bowel biopsy. What is the type of epithelium seen in a normal small intestine?

a) Simple columnar
b) Stratified squamous non-keratinising
c) Stratified squamous keratinising
d) Pseudostratified columnar
e) Simple cuboidal

Answer 22

A

Question 23

13. What is the main blood supply to the midgut?

a) Coeliac trunk
b) Superior mesenteric artery
c) Renal artery
d) Inferior mesenteric artery
e) Popliteal artery

Answer 23

B

Question 24

14. The small intestine is responsible for the absorption of many vitamins and minerals. Which of the following is not an example of a fat-soluble vitamin?

a) Vitamin A
b) Vitamin B
c) Vitamin D
d) Vitamin E
e) Vitamin K

Answer 24

B

Question 25

15. A patient complaining of heartburn undergoes an oesophago-gastro-duodenoscopy, a gastric ulcer is noted. Which of the following definitions best describes an ulcer? a) A painful collection of pus b) A communication between lumens c) A breach in a mucosal surface d) A new growth of tissue in which cell multiplication is uncontrolled and progressive e) A strand of fibrous connective tissue attaching muscle to bone

Answer 25

C

Question 26

16. Which of the following is not one of the body’s mechanisms to protect the gastric mucosa against the stomach acid? a) Alkaline mucous on luminal surface b) Tight junctions between epithelial cells c) Replacement of damaged cells d) Feedback loops that control gastric acid secretion e) Secretion of sodium alginate

Answer 26

E

Question 27

17. The gag reflex is the reflex elevation of the pharynx, triggered by irritation of the oropharynx. Which pair of cranial nerves make up the afferent and efferent limbs of this reflex? a) Trigeminal (V) and facial (VII) b) Vestibulocochlear (VIII) and facial (VII) c) Glossopharyngeal (IX) and vagus (X) d) Vagus (X) and accessory (XI) e) Accessory (XI) and hypoglossal (XII)

Answer 27

C

Question 28

18. A healthy adult requires 40-50g of protein a day to supply the body with essential amino acids. In which part of the gastrointestinal tract is the bulk of protein absorbed? a) Stomach b) Duodenum c) Ileum d) Ascending colon e) Transverse colon

Answer 28

B

Question 29

19. Which of the following is not secreted by the stomach? a) Amylase b) Pepsinogen c) Intrinsic factor d) Somatostatin e) Gastrin

Answer 29

A

Question 30

20. The majority of saliva is produced by the parotid, submandibular and sublingual salivary glands. Which of the following is not a function of saliva? a) Lubrication for mastication b) Maintaining the oral pH c) Starch digestion d) Production of ghrelin e) Anti-bacterial properties

Answer 30

D

Question 31

21. A 53-year-old man presents to A&E via ambulance, he complains of chest pain. Occlusion of which coronary artery is most likely to result in a fatal heart attack? a) Left anterior descending artery b) Circumflex artery c) Left main coronary artery d) Right main coronary artery e) Posterior descending artery

Answer 31

C

Question 32

22. A radiologist is reviewing a patient’s CT scan. What is/are the first branch(es) of the normal Aorta? a) Left subclavian artery b) Brachiocephalic trunk c) Right subclavian artery d) Coronary arteries e) Left common carotid artery

Answer 32

D

Question 33

23. Joseph is a 63-year-old man who has recently been diagnosed with hypertension. His doctor explains that his average blood pressure is determined by multiple body processes, including action by the heart, nervous system and blood vessels. In the clinic today, Joseph’s blood pressure is 150/95. Given these figures, what is Joseph’s mean arterial pressure (MAP)? a) 76.7 mmHg b) 113.3 mmHg c) 55 mmHg d) 122.5 mmHg e) 102.5 mmHg

Answer 33

B

Question 34

24. Which one of the following structures does not lie within the right atrium? a) Trabeculae carnae b) Musculi pectinati c) Fossa ovalis d) Tricuspid valve e) Crista terminalis

Answer 34

A

Question 35

25. You are working in A&E and are asked to see a 31-year-old man in resus. During your initial assessment, you notice that he is bleeding profusely. A crossmatch shows that his blood type is A- Which of the following blood types could he safely receive by transfusion? a) Only O- b) A+ and A- c) A-, AB- and O- d) A- and O- e) All types

Answer 35

D

Question 36

26. Which of the following options correctly shows the normal pathway of conduction through the heart? SAN = Sinoatrial node AVN = Atrioventricular node a) SAN -> atrial contraction -> AVN -> Purkinje fibres -> bundle of His -> ventricular contraction b) SAN -> Purkinje fibres -> atrial contraction -> AVN -> bundle of His -> ventricular contraction c) SAN -> atrial contraction -> AVN -> bundle of His -> Purkinje fibres -> ventricular contraction d) AVN -> atrial contraction -> SAN -> Purkinje fibres -> ventricular contraction -> bundle of His e) SAN -> bundle of His -> AVN -> Purkinje fibres -> ventricular contraction

Answer 36

C

Question 37

27. During phase 3 of ventricular cardiomyocyte action potential, the cells repolarise. Which of the following best describes how repolarisation occurs? a) Influx of K+ ions b) Efflux of K+ ions c) Influx of Na+ ions d) Influx of Ca2+ ions e) Efflux of Na+ ions

Answer 37

B

Question 38

28. The movement of which ion is responsible for the upstroke of the sino-atrial node action potential? a) Ca2+ influx b) Na+ influx c) K+ efflux d) Cl- efflux e) Na+ efflux

Answer 38

A

Question 39

29. You are observing an ECHO scan in clinic, the cardiologist shows you the four chambers of the heart and asks you about the cardiac cycle. During which phase does most ventricular filling occur? a) Atrial systole b) Isovolumetric relaxation of the ventricles c) Isovolumetric contraction of the ventricles d) Diastole e) Ventricular systole

Answer 39

D

Question 40

30. A pathologist is examining a section of a blood vessel. Which of these is found in the tunica media of a blood vessel? a) Vase vasorum b) Collagen c) Smooth muscle d) Endothelium e) Elastic lamina

Answer 40

C

Question 41

31. A 38-year-old man is diagnosed with alcoholic liver disease. Which of the following is not a function of the liver? a) Detoxification of substances b) Drug metabolism c) Production of bile d) Excretion of urea e) Storage of iron

Answer 41

D

Question 42

32. A 48-year-old man is diagnosed with acute cholecystitis (inflammation of the gallbladder). What is the main function of bile? a) Eliminates excess paracetamol in the intestine b) Eliminates bacteria in the small intestine c) Emulsification of fats d) Cleavage of disaccharides to form monosaccharides e) Digestion of proteins

Answer 42

C

Question 43

33. The functional unit of the liver is the hepatic lobule. Hepatic lobules have a hexagonal shape with a portal triad at each of its corners. What does a portal triad consist of? a) Hepatic portal vein, bile duct, lymphatic vessel b) Hepatic portal vein, hepatic artery, hepatic nerve c) Hepatic nerve, bile duct, lymphatic vessel d) Hepatic portal vein, hepatic artery, lymphatic vessel e) Hepatic portal vein, hepatic artery, bile duct

Answer 43

E

Question 44

34. Following contraction of the gallbladder, what is the correct pathway taken by bile? a) Cystic duct -> ampulla of vater -> common hepatic duct -> duodenum b) Cystic duct -> common bile duct -> ampulla of vater -> duodenum c) Cystic duct -> common hepatic duct -> ampulla of vater -> duodenum d) Ampulla of vater -> cystic duct -> common hepatic duct -> duodenum e) Ampulla of vater -> common bile duct -> cystic duct -> duodenum

Answer 44

B

Question 45

35. Which of the following is not retroperitoneal? a) Head of the pancreas b) Ascending colon c) Descending colon d) Transverse colon e) Adrenal gland

Answer 45

D

Question 46

36. The endocrine pancreas produces a number of hormones via a number of different cell types in the islets of Langerhans. Which of the following cell types is responsible for the production of glucagon? a) Alpha cells b) Beta cells c) Gamma cells d) Delta cells e) Epsilon cells

Answer 46

A

Question 47

37. Which vessel makes up the majority of the blood supply to the liver? a) Hepatic artery b) Inferior vena cava c) Hepatic portal vein d) Cystic artery e) Common hepatic artery

Answer 47

C

Question 48

38. What type of epithelium is found in the gallbladder? a) Simple columnar b) Stratified squamous, keratinising c) Simple cuboidal d) Stratified squamous non-keratinising e) Pseudostratified columnar

Answer 48

A

Question 49

39. In the urea cycle, arginine is cleaved by arginase to generate urea and which other molecule? a) Citrulline b) Ornithine c) CO2 d) Ammonia e) Alanine

Answer 49

B

Question 50

40. Gluconeogenesis is the process of generating new molecules of glucose from noncarbohydrate precursors, such as amino acids and glycerol. How many molecules of ATP are consumed per molecule of glucose formed via gluconeogenesis? a) 2 b) 3 c) 6 d) 8 e) 12

Answer 50

C

Question 51

41. What are the largest and most numerous glial cells found in the central nervous system? a) Microglia b) Ependymal cells c) Schwann cells d) Oligodendrocytes e) Astrocytes

Answer 51

E

Question 52

42. A 32-year-old man presents with a hoarse voice after undergoing surgery on his oesophageal cancer. On investigation, his recurrent laryngeal nerve is found to be compressed. Which cranial nerve is the recurrent laryngeal nerve derived from? a) Vestibulocochlear (CN VIII) b) Glossopharyngeal (CN IX) c) Vagus (CN X) d) Accessory (CN XI) e) Hypoglossal (CN XII)

Answer 52

C

Question 53

43. The three primary brain vesicles found in the early embryo are the prosencephalon, mesencephalon and the rhombencephalon. By which week of embryonic development can these three vesicles be identified? a) 5th week b) 6th week c) 7th week d) 8th week e) 9th week

Answer 53

A

Question 54

44. A 55-year-old man presents to the emergency department with a suspected cerebellar stroke. Which of these is not one of the primary functions of the cerebellum? a) Maintenance of posture and balance b) Co-ordination of voluntary movement c) Maintenance of muscle tone d) Computation of motor error and adjustment e) Receiving and interpreting pressure sensations

Answer 54

E

Question 55

45. The inner eye is made up of three layers of tear film. What is the most posterior (outermost) layer and what type of cell or gland secretes this? a) Lipid layer, secreted by meibomian glands b) Aqueous layer, secreted by goblet cells c) Aqueous layer, secreted by lacrimal glands d) Mucous layer, secreted by goblet cells e) Mucous layer, secreted by lacrimal glands

Answer 55

D

Question 56

46. What does the resting membrane potential of a neuron typically sit between? a) 50 and 75 mV b) -50 and -75 mV c) -25 and -50 mV d) 25 and 50 mV e) 0 and 25 mV

Answer 56

B

Question 57

47. Nicotinic receptors are found in the somatic, sympathetic and parasympathetic nervous systems. Which neurotransmitter(s) primarily act(s) on nicotinic receptors? a) ACh b) Nicotine c) ACh and Nicotine d) Glutamate and Nicotine e) G proteins and ACh

Answer 57

C

Question 58

1. A 48-year-old woman presents to her GP with signs of hypothyroidism. The doctor tests her ankle jerk reflex using a tendon hammer. Which levels of the spinal cord are responsible for the ankle jerk reflex? a) C5/C6 b) T11/T12 c) L3/L4 d) S1/S2 e) S3/S4

Answer 58

D

Question 59

49. A 20-year-old man is being investigated for a suspected brain tumour. He describes a loss of vision in his temporal visual fields (bitemporal hemianopia). What is the most likely site of damage? a) Left optic nerve b) Optic tract c) Left Meyer’s loop d) Left Baum’s loop e) Optic chiasm

Answer 59

E

Question 60

50. Where is Broca’s area located and what is its primary function? a) Frontal lobe, speech expression b) Frontal lobe, understanding speech c) Temporal lobe, speech expression d) Temporal lobe, understanding speech e) Parietal lobe, speech expression

Answer 60

A

Question 61

51. Natural moisturising factor is important in maintaining skin barriers. Which cells contain natural moisturising factor? a) Keratinocytes b) Corneocytes c) Merkel cells d) Melanocytes e) Meissner corpuscles

Answer 61

B

Question 62

52. The kidney plays a key role in regulating electrolytes in the body. Which is the correct order for the filtration system of the kidney? (DCT = Distal Convoluted Tubule) (PCT = Proximal Convoluted Tubule) a) Renal corpuscle -> DCT -> PCT -> loop of Henle -> collecting duct b) PCT -> renal corpuscle -> loop of Henle -> DCT -> collecting duct c) Renal corpuscle -> PCT -> loop of Henle -> DCT -> collecting duct d) Renal corpuscle -> DCT -> loop of Henle -> PCT -> collecting duct e) DCT -> renal corpuscle -> PCT -> loop of Henle -> collecting duct

Answer 62

C

Question 63

53. The renal pelvis comprises of urothelium. Which of the following best describes urothelium? a) Simple columnar with umbrella cells b) Simple squamous with umbrella cells c) Stratified squamous with umbrella cells d) Simple cuboidal with umbrella cells e) Stratified cuboidal with umbrella cells

Answer 63

E

Question 64

54. If a child has a cardiac output of 3.5 L / min. How many litres of blood pass through her kidneys per minute? a) 500ml b) 600ml c) 700ml d) 800ml e) 900ml

Answer 64

C

Question 65

55. By what method does the majority of sodium cross the epithelium in the proximal convoluted tubule? a) Na/K/ATPase pump b) Ligand gated sodium channel c) Voltage gated sodium channel d) Passive diffusion e) Sodium-glucose transporter

Answer 65

A

Question 66

56. A 20-year-old man is 5ft 7in and weights 55kg. How much of this man’s weight is water, and how much is found in the intracellular and extracellular compartments? a) Water: 33kg // Intracellular: 11kg // Extracellular 22kg b) Water: 33kg // Intracellular: 22kg // Extracellular 11kg c) Water: 33kg // Intracellular: 8kg // Extracellular 25kg d) Water: 33kg // Intracellular: 25kg // Extracellular 8kg e) Water: 33kg // Intracellular: 20kg // Extracellular 13kg

Answer 66

B

Question 67

57. The renin-angiotensin-aldosterone system (RAAS) is important for the maintenance of a healthy blood pressure. What is the function of renin? a) To produce angiotensinogen b) To convert angiotensinogen to angiotensin I c) To convert angiotensin I to angiotensin II d) To convert angiotensin II to aldosterone e) To produce aldosterone

Answer 67

B

Question 68

58. Which of the following is not an endocrine organ? a) Kidney b) Liver c) Uterus d) Heart e) Pancreas

Answer 68

D

Question 69

59. Which of the following is not an action of vitamin D? a) Increase intestinal phosphate absorption b) Increase bone resorption c) Increase renal calcium reabsorption d) Decrease renal phosphate reabsorption e) Decreased parathyroid hormone production

Answer 69

D

Question 70

60. Which area of the adrenal gland produces dehydroepiandrosterone (DHEA)? a) Zona glomerulosa b) Zona fasciculata c) Zona reticularis d) Medulla e) Renal pelvis

Answer 70

C

Question 71

61. Which nerve is responsible for conscious control of the external urethral sphincter? a) Pudendal nerve b) Hypogastric nerve c) Ilioinguinal nerve d) Pelvic splanchnic nerve e) Genitofemoral nerve

Answer 71

A

Question 72

62. Which of the following hormones is not produced by the hypothalamus? a) Corticotrophin-releasing hormone (CRH) b) Thyroid stimulating hormone (TSH) c) Gonadotrophin-releasing hormone (GnRH) d) Dopamine e) Growth hormone-releasing hormone (GHRH)

Answer 72

B

Question 73

63. Which protein do the delta cells of the endocrine pancreas produce? a) Glucagon b) Insulin c) Somatostatin d) Amylase e) Lipase

Answer 73

C

Question 74

64. In a normal, regular 28-day menstrual cycle, which day would you expect ovulation to occur? a) 1 b) 7 c) 14 d) 21 e) 28

Answer 74

C

Question 75

65. Which of the following is not a component of the spermatic cord? a) Vas deferens b) Pampiniform plexus c) Testicular vein d) Cremasteric fascia e) Pudendal nerve

Answer 75

E

Question 76

66. Which of the following best describes the social model of health? a) Focuses on diagnosis, cure and treatment of disease b) Mind and body dualism – both mind and body can be treated separately c) Only health professionals practice it d) Focuses on the prevention of disease e) Physical and biological factors of disease can be repaired

Answer 76

D

Question 77

67. Which of the following is not a component of the sick role theory? a) The patient should try to get well b) The patient should seek help and cooperate with c) The patient should allow the clinician to decide the most appropriate course of action on their behalf d) The patient is not responsible for their condition e) The patient is exempt from normal social roles

Answer 77

C

Question 78

68. Which of the following best describes the functionalist sociological model of health? a) Health is the state of optimum capacity of an individual for being effective at the tasks required of them by society b) Economy is the base of society and this changes the pattern of health within society c) Diseases can be caused by social factors but are treated with biological interventions d) Healthcare professionals see problems in their own profession, thus doctor’s function to see everything medically e) Disease can be caused by the unintended adverse effects of therapeutic intervention which can be clinical, social or cultural

Answer 78

A

Question 79

69. Which of the following is not a Public Health England notifiable disease? a) Malaria b) Rubella c) Yellow fever d) Tuberculosis e) HIV

Answer 79

E

Question 80

70. Which of the following is defined as ‘the proportion of a population affected by a disease’? a) Incidence b) Burden of disease c) Incidence rate d) Prevalence e) Penetrance

Answer 80

D

Question 81

71. The NHS cervical smear programme is an example of which level of disease prevention? a) Empirical b) Primary c) Secondary d) Tertiary e) Population

Answer 81

C

Question 82

72. Which of the following was one of the main findings of the Acheson report (1998)? a) Handwashing is crucial to disease prevention and control b) Higher priority must be given to the health of families with children c) Poorer people behave in more unhealthy ways d) Those in lower social groups suffer higher rates of mortality e) Sick people tend to sink both socially and economically

Answer 82

B

Question 83

73. You are on your GP placement and take a history from a patient with gastric reflux. You ask them how much alcohol they drink, and they tell you they drink two 750ml bottles of red wine (14% ABV) and three 500ml cans of lager (5% ABV) each week without fail. The GP tutor asks you to calculate the number of units that the patient is drinking per week. Which is the correct answer? a) 28.5 units per week b) 42 units per week c) 21 units per week d) 39 units per week e) 24.5 units per week

Answer 83

A

Question 84

75. Which of the following would not result in an increased respiratory rate? a) Decreased CSF pH b) Decreased PaO2 c) Increased PaCO2 d) Increased CSF pH e) Decreased blood pH

Answer 84

D

Question 85

74. Which of the following best describes the process of normal inspiration at rest? a) Contraction of the diaphragm, relaxation of external intercostal muscles b) Contraction of the diaphragm and rectus abdominus muscle c) Contraction of the diaphragm, sternocleidomastoid, scalene and internal intercostal muscles d) Contraction of the diaphragm and external intercostal muscles e) Relaxation of the diaphragm and contraction of external intercostal muscles

Answer 85

D

Question 86

In a healthy individual, what would the ideal V/Q (ventilation/perfusion) ratio be? a) >1.5 b) 1.0to1.5 c) =1.0 d) 0.5to1.0 e) <0.5

Answer 86

C

Question 87

77. Which nerve provides both the motor and sensory innervation to the larynx? a) Glossopharyngeal b) Vagus c) Hypoglossal d) Phrenic e) Trigeminal

Answer 87

B

Question 88

78. Which of the following is described by the statement below? “the shift in the oxygen dissociation curve caused by changes in the concentration of carbon dioxide (pH)” a) Dalton’s law b) Henry’s law c) Boyle’s law d) Bohr effect e) Tom’s effect

Answer 88

D

Question 89

79. Which of the following is not a cause of hypoxia? a) Reduced respiratory rate b) Anaemia c) Reduced blood flow to lung tissues d) Increased red blood cell count e) Breath holding

Answer 89

D

Question 90

80. A 72-year-old man is sent for a spirometry test. Which of the following does the statement below best describe? “the greatest volume of air that can be expelled from the lungs after taking the deepest possible breath” a) Inspiratory reserve volume b) Functional residual capacity c) Vital capacity d) Residual volume e) End respiratory reserve

Answer 90

C

Question 91

Which enzyme catalyses the breakdown of fructose-1,6-bisphosphate into 2 3-carbon molecules? a) Phosphofructokinase-1 b) Enolase c) Aldolase d) Phosphoglucose isomerase e) Hexokinase

Answer 91

C

Question 92

Which statement is true regarding ketone synthesis in the liver? a) Ketones are used by the liver for energy b) Ketogenesis occurs during high rates of fatty acid beta oxidation when the acetyl coA produced exceeds the capacity of the TCA cycle. c) Acetoacetate is used by extrahepatic tissues for energy. d) The brain can’t use ketones for energy. e) High levels of ketone bodies in the blood raise the pH.

Answer 92

B

Question 93

What is the probability that a healthy Caucasian couple who have not undergone any genetic screening will give birth to a child with Cystic fibrosis? a) 1/25 b) 2/25 c) 1/625 d) 1/500 e) 1/100

Answer 93

C

Question 94

Which of the following cells has a Perinuclear hoff on light microscopy? a) B lymphocytes b) T lymphocytes c) Plasma cells d) Monocytes e) Kupffer cells

Answer 94

C

Question 95

Which of the following statements is true regarding connective tissue? a) Basement membranes are composed of type IV collagen & fibronectin. b) Cartilage contains blood vessels & lymphatics. c) Skin contains type II collagen. d) Collagen is secreted by fibroblasts & assembled intracellularly. e) Placenta contains type 1 collagen.

Answer 95

A

Question 96

A study aims to test the effectiveness of breast cancer screening with a mammogram. Of 900 patients sampled, 250 patients had breast cancer and 75 of these were correctly identified via screening. What is the sensitivity of this test? 27.8% 30.0% 8.3% 35.2% 32.0%

Answer 96

B

Question 97

Which receptors do platelets use to adhere to exposed subendothelial collagen? a) PAR 1 b) PAR 4 c) P2Y1 d) P2Y12 e) GP2b/3a

Answer 97

E

Question 98

A 46 year old man is started on Warfarin for his atrial fibrillation which is a Vitamin K antagonist. Which of the following will not be affected by this medication? Factor 9 Prothrombin Time Factor 10 Factor 3 Factor 7

Answer 98

D

Question 99

Which of the following statements is false regarding angiotensin II? a) Atrial natriuretic peptide works synergistically to it & is released from atria when blood pressure is low. b) It is a potent vasoconstrictor thus increases total peripheral resistance & blood pressure. c) It stimulates the release of mineralocorticoid from the zona glomerulosa of the adrenal cortex. d) It stimulates thirst sensation in the hypothalamus to encourage fluid intake. e) It increases secretion of ADH from the posterior pituitary gland to increase permeability of collecting ducts of nephrons to water.

Answer 99

A

Question 100

At what vertebral level does the common carotid artery bifurcate? C2 C3 C4 C5 C6

Answer 100

C4