formative assessment 2

47
Formative Assessment (29/06/2012) Page: 1 2 3 4 (Next) Question 1 Marks: 1 An organism isolated from the sputum of patient X, when stained with an acid-fast stain appeared to be pink, thin, and beaded when observed under the microscope. The MOST likely organism is Choose one answer. a. Salmonella typhi b. Escherichia coli c. Treponema pallidum d. Mycobacterium tuberculosis e. Corynebacterium diptheriae Question 2 Marks: 1 Which ONE of the following statements is TRUE regarding the ovary and its function? Choose one answer. a. It is located on the anterior aspect of broad ligament b. Graafian follicles are situated in its medulla. c. During ovulation, the oocyte separates along with theca interna. d. The oocyte has undergone two mitotic divisions before ovulation. e. Corpus luteum becomes dysfunctional 14 days after ovulation. Question 3 Marks: 1 A childhood viral infection which can result in paralysis is preventable by vaccination. The causal agent is transmitted

Upload: ibrahim-foondun

Post on 08-Sep-2015

9 views

Category:

Documents


1 download

DESCRIPTION

Medicine

TRANSCRIPT

Formative Assessment (29/06/2012)Top of FormPage:1234(Next)Question 1 Marks: 1 An organism isolated from the sputum of patient X, when stained with an acid-fast stain appeared to be pink, thin, and beaded when observed under the microscope. The MOST likely organism isChoose one answer. a. Salmonella typhi

b. Escherichia coli

c. Treponema pallidum

d. Mycobacterium tuberculosis

e. Corynebacterium diptheriae

Question 2 Marks: 1 Which ONE of the following statements is TRUE regarding the ovary and its function?Choose one answer. a. It is located on the anterior aspect of broad ligament

b. Graafian follicles are situated in its medulla.

c. During ovulation, the oocyte separates along with theca interna.

d. The oocyte has undergone two mitotic divisions before ovulation.

e. Corpus luteum becomes dysfunctional 14 days after ovulation.

Question 3 Marks: 1 A childhood viral infection which can result in paralysis is preventable by vaccination. The causal agent is transmitted primarily by the faecal-oral route. Which ONE of the following is the MOST appropriate vaccine to prevent this infection?Choose one answer. a. Bacillus Calmette -Guerin (BCG) vaccine

b. Diphtheria, Pertussis and Tetanus (DPT) vaccine

c. Hepatitis B vaccine

d. Measles, Mumps and Rubella (MMR) vaccine

e. Oral polio vaccine (OPV /Sabin vaccine)

Question 4 Marks: 1 A study is performed to analyse the characteristics of malignant neoplasms in biopsy specimens. Which ONE of the following microscopic findings MOST likely indicates that the neoplasm is malignant?Choose one answer. a. Pleomorphism

b. Atypia

c. Metastasis

d. Increased Nuclear/ cytoplasmic (N/C) ratio

e. Necrosis

Question 5 Marks: 1 A 2-year-old child suffered from weakness of the legs as a residual effect of poliomyelitis. Which ONE of the following viruses is the MOST likely causal agent?Choose one answer. a. Enveloped, complex, RNA virus

b. Enveloped, icosahedral, RNA virus

c. Naked, complex, RNA virus

d. Naked, icosahedral, RNA virus

e. Enveloped, helical, RNA virus

Question 6 Marks: 1 Body temperature can be increased by drugs or chemicals that inhibit theChoose one answer. a. secretion of thyroid hormones

b. the action of noradrenaline on blood vessels

c. binding of acetylcholine to muscarinic receptors.

d. formation of prostaglandins in the hypothalamus.

e. act of shivering.

Question 7 Marks: 1 Which ONE of the following characteristics is TRUE about the mature cyst of Entamoeba histolytica?Choose one answer. a. The cytoplasm is retracted from the cyst wall creating a clear zone.

b. It has a distinct hyaline knob at the anterior end.

c. It is pear shaped with one nucleus.

d. It is elliptical with kidney shaped macronucleus.

e. It has 4 nuclei with evenly distributed peripheral nuclear chromatin.

Question 8 Marks: 1 Antibiotic resistance is developed in shigellae through the transfer of small fractions of DNA from the donor to the recipient bacterial cell. Which ONE of the following processes is MOST likely to be responsible?Choose one answer. a. Conjugation

b. Mutation

c. Transduction

d. Transformation

e. Relocation

Question 9 Marks: 1 A housewife wanted to serve dinner to her family. She decided that she wanted to finish some of the leftover food in the refrigerator and remembered that she had some pickled vegetables (acar) that she made three weeks ago. She took out the acar and noticed that there was a bluish-black growth on top of the acar. Which ONE of the following microorganisms is MOST likely to be the growthcontaminating the acar?Choose one answer. a. Candida albicans

b. Tinea species

c. Aspergillus species

d. Group A streptococci

e. Staphylococcus species

Question 10 Marks: 1 Which ONE of the following chemicals may be both a disinfectant and a sterilant?Choose one answer. a. Formaldehyde

b. Ethanol

c. Chlorhexidine

d. Iodine

e. Phenols

Page:1234(Next)Bottom of FormTime Remaining

Top of Form

Bottom of Form

Formative Assessment (29/06/2012)Top of FormPage:(Previous)1234(Next)Question 11 Marks: 1 Which ONE of the following changes would occur to the ovaries of a 23 -year -old woman who has undergone hypophysectomy (removal of pituitary glands)?Choose one answer. a. Hypersecretion of oestrogen

b. Hypersecretion of progesterone

c. Development of ovarian resistance against gonadotrophin

d. Reduction of the number of ovarian follicles.

e. Gonadal atrophy

Question 12 Marks: 1 A 32-year-old man presented with symptoms of gastric ulcer. Gastric biopsy tissue cultured on enriched media yielded Gram-negative, spiral-shaped bacteria. What is the MOST likely causal agent of this patients illness?Choose one answer. a. Campylobacter fetus

b. Helicobacter pylori

c. Spirillum minus

d. Vibrio cholerae

e. Yersinia enterocolitica

Question 13 Marks: 1 Oral antacids can bind to some drugs given orally at the same time, thus preventing their absorption. This is an example of aChoose one answer. a. pharmacodynamic drug interaction.

b. drug with a narrow toxic therapeutic ratio.

c. drug causing enzyme inhibition.

d. pharmacokinetic drug interaction.

e. drug causing pharmacological antagonism.

Question 14 Marks: 1 Which ONE of the following statements is TRUE regarding the germinal epithelium of the seminiferous tubule?Choose one answer. a. It is a simple epithelium.

b. It has no basal lamina.

c. It is divided into two compartments by the processes of Leydig cells (interstitial cells).

d. Late spermatids are in its basal compartment.

e. Secondary spermatocytes are in its adluminal compartment.

Question 15 Marks: 1 Which ONE of the following is responsible for the formation of mesoderm?Choose one answer. a. Hypoblast

b. Notochord

c. Primitive streak

d. Trophoblast

e. Placenta

Question 16 Marks: 1 Aplasia of which ONE of the following organs is incompatible with life?Choose one answer. a. Kidney

b. Lung

c. Adrenal

d. Pituitary

e. Testis

Question 17 Marks: 1 A young man is practicing for an important upcoming sports event in the noon-day sun, and does not realize that it was very hot. He noticed that he did not pass urine for many hours after that. Which ONE of the following events had taken place in his body?Choose one answer. a. There is fall in plasma osmolality.

b. The extracellular fluid volume rises.

c. Anti-diuretic hormone (ADH) is released from the anterior pituitary.

d. ADH is acting on the proximal convoluted tubules of the kidney.

e. The membrane of the collecting ducts becomes permeable to water.

Question 18 Marks: 1

These organisms are described as Gram positive bacteria with a Chinese letter like formation. Which ONE of the following diseases is MOST likely to be caused by these organisms?Choose one answer. a. Cholera

b. Diptheria

c. Typhoid

d. Syphilis

e. Tuberculosis

Question 19 Marks: 1 The blood tends to pool at the lower limbs and causes oedema in the passengers of a long flight. Which ONE of the following factors would be increased to cause the oedema?Choose one answer. a. Intravascular hydrostatic pressure

b. Interstitial fluid hydrostatic pressure

c. Intravascular oncotic pressure

d. Interstitial fluid oncotic pressure

e. Vascular permeability

Question 20 Marks: 1 Which ONE of the following characteristic features is TRUE regarding Plasmodium malariae?Choose one answer. a. The gametocyte is crescent shaped.

b. The infected red blood cell is larger than the normal RBC.

c. The infected RBC is fimbriated and oval shaped.

d. The trophozoite stage is band-shaped.

e. The hypnozoites are found in the liver.

Page:(Previous)1234(Next)Bottom of FormTime Remaining

Top of Form

Bottom of Form

Formative Assessment (29/06/2012)Top of FormPage:(Previous)1234(Next)Question 21 Marks: 1 Which ONE of the following is a metabolic effect of cortisol?Choose one answer. a. Increased protein synthesis in extrahepatic tissues

b. Increased glycogenolysis in the liver

c. Increased gluconeogenesis in the liver

d. Increased triglyceride synthesis in the liver

e. Increased uptake of glucose by skeletal muscles

Question 22 Marks: 1 A 6-year-old child has attained the full stature of an adult and the brain scan shows a tumour in the pituitary. Which ONE of the following hormones is MOST likely to have a direct effect on the bone?Choose one answer. a. Growth hormone releasing hormone(GHRH)

b. Growth hormone(GH)

c. Insulin-like growth factor 1 (IGF-1)

d. Insulin

e. Platelet derived growth factor(PDGF)

Question 23 Marks: 1 Which ONE of the following statements is TRUE regarding drugs having antagonistic actions?Choose one answer. a. Competitive antagonists bind to a site different from the agonist site.

b. Non-competitive antagonists are likely to bind covalently with the receptor.

c. Competitive antagonists are not useful as drugs.

d. Non-competitive antagonists primarily affect the potency of drug.

e. Inverse agonists do not have intrinsic activity.

Question 24 Marks: 1 Which ONE of the following conditions is MOST likely to show rudimentary organs which are smaller than the normal organ and lacking the full complement of cells?Choose one answer. a. Hyperplasia

b. Neoplasia

c. Metaplasia

d. Hypoplasia

e. Dysplasia

Question 25 Marks: 1 A 50-year-old patient developed sepsis in his superficial skin incision after a thoracic operation. The causal organisms were Gram-positive and were from an endogenous source. Which ONE of the following is the MOST likely cause of his wound sepsis?Choose one answer. a. Bacteroides fragilis

b. Clostridium perfringens

c. Escherichia coli

d. Peptostreptococcus

e. Staphylococcus aureus

Question 26 Marks: 1 Which ONE of the following is the predominant form of thyroid hormones found in the blood circulation?Choose one answer. a. Thyroxine (T4)

b. Triiodothyronine (T3)

c. Monoiodothyronine (MIT)

d. Diiodothyronine (DIT)

e. Reverse T3

Question 27 Marks: 1 Transport of drugs across cell membranes is reduced byChoose one answer. a. a high lipid solubility.

b. being unionized at environmental pH.

c. a passive diffusion process.

d. the P- Glycoprotein pump.

e. a small molecular size.

Question 28 Marks: 1 A study showed that the mean systolic blood pressure of a group of students before sitting an examination was raised. What could be the MOST likely factor that causes the rise in the systolic blood pressure?Choose one answer. a. Increased urination

b. Increased vasodilation

c. Increased breathing rate

d. Increased heart rate

e. Increased water intake

Question 29 Marks: 1 The strongest ligament which is responsible for the maintenance of the uterus in its normal position within the pelvic cavity is theChoose one answer. a. broad ligament.

b. round ligament.

c. uterosacral ligament.

d. transverse cervical ligament.

e. ovarian ligament.

Question 30 Marks: 1 One of the mechanisms by which bacteria acquire drug resistance is through the development of an altered metabolic pathway. Which ONE of the following drugs is this mechanism of resistance MOST relevant?Choose one answer. a. Chloramphenicol

b. Erythromycin

c. Penicillin

d. Sulphonamides

e. Tetracyclines

Page:(Previous)1234(Next)Bottom of FormTime Remaining

Top of Form

Bottom of Form

Formative Assessment (29/06/2012)Top of FormPage:(Previous)1234Question 31 Marks: 1 Cell X releases hormone Y as it is synthesized. Stimulation on cell X causes a gradual rise in plasma concentrations of hormone Y over a few days. Based on the observation, what can you conclude about the nature of hormone Y?Choose one answer. a. Protein

b. Polypeptide

c. Amine

d. Fatty acid derivative

e. Steroid

Question 32 Marks: 1 In bronchial asthma, relaxation of bronchiolar smooth muscle can be achieved by a drug that activates/stimulates theChoose one answer. a. alpha-1 adrenergic receptor.

b. beta-1 adrenergic receptor.

c. beta-2 adrenergic receptor.

d. nicotinic cholinergic receptor.

e. muscarinic cholinergic receptor.

Question 33 Marks: 1 An increase in libido in both sexes is contributed byChoose one answer. a. testosterone

b. dehydroepiandrosterone

c. progesterone

d. oestrogen

e. oxytocin

Question 34 Marks: 1 During the fight-or-flight reaction, sympathetic stimulation results in widespread effects. Some of these effects are mediated through alpha and some through beta receptor stimulation. Which ONE of the following is an alpha adrenergic effect?Choose one answer. a. Bronchoconstriction

b. Contraction of circular muscles of the iris

c. Vasoconstriction of blood vessels supplying the viscera

d. Increase in heart rate

e. Contraction of the radial muscles of gastro-intestinal sphincters

Question 35 Marks: 1 Hepatic microsomal drug metabolizing enzymes can be inhibited by Choose one answer. a. smoking

b. drinking grape fruit juice.

c. chronic alcoholism.

d. using herbs like St. Johns wort.

e. eating charbroiled (barbecued) meat.

Question 36 Marks: 1 A 45-year-old patient developed sepsis after bowel surgery. The causal organisms which were isolated under strict anaerobic culture were Gram-negative bacteria. What is the MOST likely organism for the patients sepsis?Choose one answer. a. Bacteroides fragilis

b. Clostridium perfringens

c. Escherichia coli

d. Pseudomonas aeruginosa

e. Peptostreptococcus

Question 37 Marks: 1 A 25-year-old HIV positive patient presented to the family physician with recurring painful vesicular lesions on the lips. The causal agent was an enveloped DNA virus. Which ONE of the following is the MOST likely cause of the vesicular lesions?Choose one answer. a. Adenovirus

b. Coxsackie virus

c. Herpes simplex virus

d. Papilloma virus

e. Kaposi sarcoma virus

Question 38 Marks: 1 Which ONE of the following is MOST likely a physiological function of mediators formed by the cyclooxygenase pathway of arachidonic acid?Choose one answer. 2 a. vasodilatation by thromboxane (TxA2).

b. platelet aggregation by prostacyclin (PGI2).

c. increased gastric acid secretion.

d. reduction of intraocular pressure.

e. reduction of renal blood flow.

Question 39 Marks: 1 At which ONE of the following circumstances the meiotic II division of the oocyte will be completed?Choose one answer. a. Cleavage

b. Fertilization

c. Gastrulation

d. Implantation

e. Ovulation

Question 40 Marks: 1

The following bacteria were isolated from a patient suffering from syphilis. These bacteria cannot be gram stained. Which ONE of the following organisms cause this condition?Choose one answer. a. Treponema pallidum

b. Mycobacterium tuberculosis

c. Salmonella typhi

d. Chlamydia trachomatis

e. Rickettsia prowazeki

Page:(Previous)1234Bottom of FormTime Remaining

Top of Form

Bottom of Form

Formative Assessment (29/06/2012)Review of attempt 1Started onFriday, 29 June 2012, 02:43 PM

Completed onFriday, 29 June 2012, 03:35 PM

Time taken52 mins 21 secs

Grade30 out of a maximum of 40 (75%)

Question 1 Marks: 1 An organism isolated from the sputum of patient X, when stained with an acid-fast stain appeared to be pink, thin, and beaded when observed under the microscope. The MOST likely organism isChoose one answer. a. Salmonella typhi

b. Escherichia coli

c. Treponema pallidum

d. Mycobacterium tuberculosis Mycobacterium tuberculosis is stained using the acid fast stain. Under the microscope it appears pink, beaded and thin.

e. Corynebacterium diptheriae

CorrectMarks for this submission: 1/1.Question 2 Marks: 1 Which ONE of the following statements is TRUE regarding the ovary and its function?Choose one answer. a. It is located on the anterior aspect of broad ligament

b. Graafian follicles are situated in its medulla.

c. During ovulation, the oocyte separates along with theca interna.

d. The oocyte has undergone two mitotic divisions before ovulation.

e. Corpus luteum becomes dysfunctional 14 days after ovulation. The corpus luteum continues to secrete progesterone which produces changes in the uterine wall for implantation. If fertilization does not happen, it withers away 14 days after ovulation. This causes reduction in progesterone level causing initiation of menstrual bleeding.

CorrectMarks for this submission: 1/1.Question 3 Marks: 1 A childhood viral infection which can result in paralysis is preventable by vaccination. The causal agent is transmitted primarily by the faecal-oral route. Which ONE of the following is the MOST appropriate vaccine to prevent this infection?Choose one answer. a. Bacillus Calmette -Guerin (BCG) vaccine

b. Diphtheria, Pertussis and Tetanus (DPT) vaccine

c. Hepatitis B vaccine

d. Measles, Mumps and Rubella (MMR) vaccine

e. Oral polio vaccine (OPV /Sabin vaccine) The vaccines listed above form part of the childhood immunization programme. BCG and DPT vaccines prevent bacterial infections. Hepatitis B, MMR, and OPV vaccines prevent viral infections. Polio is transmitted primarily by the faecal-oral route. The Oral polio vaccine (OPV) is the appropriate vaccine to prevent this infection.

CorrectMarks for this submission: 1/1.Question 4 Marks: 1 A study is performed to analyse the characteristics of malignant neoplasms in biopsy specimens. Which ONE of the following microscopic findings MOST likely indicates that the neoplasm is malignant?Choose one answer. a. Pleomorphism

b. Atypia

c. Metastasis The ability of a neoplasm to metastasize is the most important indicator of malignancy. The neoplasms initially invade and later metastasize or spread to other places.

d. Increased Nuclear/ cytoplasmic (N/C) ratio

e. Necrosis

CorrectMarks for this submission: 1/1.Question 5 Marks: 1 A 2-year-old child suffered from weakness of the legs as a residual effect of poliomyelitis. Which ONE of the following viruses is the MOST likely causal agent?Choose one answer. a. Enveloped, complex, RNA virus

b. Enveloped, icosahedral, RNA virus

c. Naked, complex, RNA virus

d. Naked, icosahedral, RNA virus Poliomyelitis is caused by poliovirus types 1, 2 and 3 which belong to the picornaviridae family which comprises naked, icosahedral, RNA viruses.

e. Enveloped, helical, RNA virus

CorrectMarks for this submission: 1/1.Question 6 Marks: 1 Body temperature can be increased by drugs or chemicals that inhibit theChoose one answer. a. secretion of thyroid hormones

b. the action of noradrenaline on blood vessels

c. binding of acetylcholine to muscarinic receptors. Acetylcholine released by postganglionic sympathetic nerve endings binds to muscarinic receptors in glands (including the sweat glands) causing an increase in secretion. Inhibition of this binding will reduce sweat secretion and subsequently the evaporative heat loss. Decreased heat loss can raise the body temperature, particularly if the person is already feverish.

d. formation of prostaglandins in the hypothalamus.

e. act of shivering.

CorrectMarks for this submission: 1/1.Question 7 Marks: 1 Which ONE of the following characteristics is TRUE about the mature cyst of Entamoeba histolytica?Choose one answer. a. The cytoplasm is retracted from the cyst wall creating a clear zone. This morphology is only seen in a mature cyst of Giardia lamblia.

b. It has a distinct hyaline knob at the anterior end.

c. It is pear shaped with one nucleus.

d. It is elliptical with kidney shaped macronucleus.

e. It has 4 nuclei with evenly distributed peripheral nuclear chromatin.

IncorrectMarks for this submission: 0/1.Question 8 Marks: 1 Antibiotic resistance is developed in shigellae through the transfer of small fractions of DNA from the donor to the recipient bacterial cell. Which ONE of the following processes is MOST likely to be responsible?Choose one answer. a. Conjugation

b. Mutation

c. Transduction Lysogenic conversion /transduction is mediated by a bacteriophage.

d. Transformation

e. Relocation

IncorrectMarks for this submission: 0/1.Question 9 Marks: 1 A housewife wanted to serve dinner to her family. She decided that she wanted to finish some of the leftover food in the refrigerator and remembered that she had some pickled vegetables (acar) that she made three weeks ago. She took out the acar and noticed that there was a bluish-black growth on top of the acar. Which ONE of the following microorganisms is MOST likely to be the growthcontaminating the acar?Choose one answer. a. Candida albicans

b. Tinea species

c. Aspergillus species Aspergillus species are highly aerobic and are found in almost all oxygen-rich environments, where they commonly grow as molds on the surface of a substrate, as a result of the high oxygen tension. Commonly, fungi grow on carbon-rich substrates such as monosaccharides (such as glucose) and polysaccharides (such as amylose). Aspergillus species are common contaminants of starchy foods (such as bread and potatoes), and grow in or on many plants and trees.

d. Group A streptococci

e. Staphylococcus species

CorrectMarks for this submission: 1/1.Question 10 Marks: 1 Which ONE of the following chemicals may be both a disinfectant and a sterilant?Choose one answer. a. Formaldehyde

b. Ethanol All the other options act as disinfectants only.

c. Chlorhexidine

d. Iodine

e. Phenols

IncorrectMarks for this submission: 0/1.Question 11 Marks: 1 Which ONE of the following changes would occur to the ovaries of a 23 -year -old woman who has undergone hypophysectomy (removal of pituitary glands)?Choose one answer. a. Hypersecretion of oestrogen

b. Hypersecretion of progesterone

c. Development of ovarian resistance against gonadotrophin

d. Reduction of the number of ovarian follicles.

e. Gonadal atrophy The gonadotrophin secretion will be absent if the pituitary glands are removed. The gonads will regress if there is no stimulation from the gonadotrophins chronically (hypogonadodism).

CorrectMarks for this submission: 1/1.Question 12 Marks: 1 A 32-year-old man presented with symptoms of gastric ulcer. Gastric biopsy tissue cultured on enriched media yielded Gram-negative, spiral-shaped bacteria. What is the MOST likely causal agent of this patients illness?Choose one answer. a. Campylobacter fetus

b. Helicobacter pylori The organisms stated are Gram-negative bacteria. Helicobacter pylori is documented to be associated with gastritis and gastric ulcer.

c. Spirillum minus

d. Vibrio cholerae

e. Yersinia enterocolitica

CorrectMarks for this submission: 1/1.Question 13 Marks: 1 Oral antacids can bind to some drugs given orally at the same time, thus preventing their absorption. This is an example of aChoose one answer. a. pharmacodynamic drug interaction.

b. drug with a narrow toxic therapeutic ratio.

c. drug causing enzyme inhibition.

d. pharmacokinetic drug interaction. Pharmacokinetic interactions between drugs can occur during absorption, distribution, metabolism or excretion of drugs (ADME). This is an example of an interaction during drug absorption.

e. drug causing pharmacological antagonism.

CorrectMarks for this submission: 1/1.Question 14 Marks: 1 Which ONE of the following statements is TRUE regarding the germinal epithelium of the seminiferous tubule?xChoose one answer. a. It is a simple epithelium.

b. It has no basal lamina.

c. It is divided into two compartments by the processes of Leydig cells (interstitial cells).

d. Late spermatids are in its basal compartment.

e. Secondary spermatocytes are in its adluminal compartment. Secondary spermatocytes have haploid number of chromosomes. Thus they are considered as foreign. Therefore they are located in the adluminal compartment of the germinal epithelium and prevented from coming into contact with antibody forming cells by the blood- testes barrier

CorrectMarks for this submission: 1/1.Question 15 Marks: 1 Which ONE of the following is responsible for the formation of mesoderm?Choose one answer. a. Hypoblast

b. Notochord

c. Primitive streak Primitive streak appears on the midline of the caudal half of the epiblast surface of the bilaminar germ disc. Cells of the epiblast migrate in the direction of primitive streak and on reaching the primitive streak the cells detach themselves from the epiblast and invaginate between the epiblast and hypoblast layer thus forming the mesoderm.

d. Trophoblast

e. Placenta

CorrectMarks for this submission: 1/1.Question 16 Marks: 1 Aplasia of which ONE of the following organs is incompatible with life?Choose one answer. a. Kidney

b. Lung

c. Adrenal

d. Pituitary Aplasia or Agenesis is failure of development of tissue or organ, which is a developmental abnormality that presumably develops early in intra uterine life. Aplastic organs are either totally absent or represented by small mass of fibrous or fatty tissue containing a few rudimentary cells. In unpaired organs like aplasia of aorta or pituitary, it is incompatible with life.

e. Testis

CorrectMarks for this submission: 1/1.Question 17 Marks: 1 A young man is practicing for an important upcoming sports event in the noon-day sun, and does not realize that it was very hot. He noticed that he did not pass urine for many hours after that. Which ONE of the following events had taken place in his body?Choose one answer. a. There is fall in plasma osmolality.

b. The extracellular fluid volume rises.

c. Anti-diuretic hormone (ADH) is released from the anterior pituitary.

d. ADH is acting on the proximal convoluted tubules of the kidney.

e. The membrane of the collecting ducts becomes permeable to water. Antidiuretic hormone (ADH) binds to receptors on cells in the collecting ducts of the kidney and promotes reabsorption of water back into the circulation. In the absence of antidiuretic hormone, the collecting ducts are virtually impermeable to water, and it flows out as urine. Antidiuretic hormone stimulates water reabsorption by stimulating insertion of "water channels" or aquaporins into the membranes of kidney tubules. These channels transport solute-free water through tubular cells and back into blood, leading to a decrease in plasma osmolarity and an increase osmolarity of urine.

CorrectMarks for this submission: 1/1.Question 18 Marks: 1

These organisms are described as Gram positive bacteria with a Chinese letter like formation. Which ONE of the following diseases is MOST likely to be caused by these organisms?Choose one answer. a. Cholera

b. Diptheria Corynebacterium diphtheriae are the causative agents of diphtheria. They are often described as having Chinese letter- like formation.

c. Typhoid

d. Syphilis

e. Tuberculosis

CorrectMarks for this submission: 1/1.Question 19 Marks: 1 The blood tends to pool at the lower limbs and causes oedema in the passengers of a long flight. Which ONE of the following factors would be increased to cause the oedema?Choose one answer. a. Intravascular hydrostatic pressure When the blood pools at the vein of the lower limbs due to muscle inactivity, the capillary pressure which is equivalent to intravascular hydrostatic pressure will be increased. This will promote fluid filtration and oedema.

b. Interstitial fluid hydrostatic pressure

c. Intravascular oncotic pressure

d. Interstitial fluid oncotic pressure

e. Vascular permeability

CorrectMarks for this submission: 1/1.Question 20 Marks: 1 Which ONE of the following characteristic features is TRUE regarding Plasmodium malariae?Choose one answer. a. The gametocyte is crescent shaped.

b. The infected red blood cell is larger than the normal RBC.

c. The infected RBC is fimbriated and oval shaped. The infected RBC is fimbriated and oval shaped. This morphological feature is seen only in Plasmodium ovale.

d. The trophozoite stage is band-shaped.

e. The hypnozoites are found in the liver.

IncorrectMarks for this submission: 0/1.Question 21 Marks: 1 Which ONE of the following is a metabolic effect of cortisol?Choose one answer. a. Increased protein synthesis in extrahepatic tissues

b. Increased glycogenolysis in the liver

c. Increased gluconeogenesis in the liver Cortisol is produced by the adrenal gland in the zona fasciculata, the second of three layers comprising the adrenal cortex. This release is controlled by the hypothalamus, a part of the brain. It stimulates gluconeogenesis (formation, in the liver, of glucose from certain amino acids, glycerol, lactate and/or propionate)

d. Increased triglyceride synthesis in the liver

e. Increased uptake of glucose by skeletal muscles

CorrectMarks for this submission: 1/1.Question 22 Marks: 1 A 6-year-old child has attained the full stature of an adult and the brain scan shows a tumour in the pituitary. Which ONE of the following hormones is MOST likely to have a direct effect on the bone?Choose one answer. a. Growth hormone releasing hormone(GHRH)

b. Growth hormone(GH) GH would definitely have an effect on bone but such effect is mediated by IGF -1.

c. Insulin-like growth factor 1 (IGF-1)

d. Insulin

e. Platelet derived growth factor(PDGF)

IncorrectMarks for this submission: 0/1.Question 23 Marks: 1 Which ONE of the following statements is TRUE regarding drugs having antagonistic actions?Choose one answer. a. Competitive antagonists bind to a site different from the agonist site.

b. Non-competitive antagonists are likely to bind covalently with the receptor. Non-competitive antagonist can bind covalently (irreversibly) to the same site as the agonist or to a different site. Hence, increasing the concentration of the agonist cannot overcome the blockade.

c. Competitive antagonists are not useful as drugs.

d. Non-competitive antagonists primarily affect the potency of drug.

e. Inverse agonists do not have intrinsic activity.

CorrectMarks for this submission: 1/1.Question 24 Marks: 1 Which ONE of the following conditions is MOST likely to show rudimentary organs which are smaller than the normal organ and lacking the full complement of cells?Choose one answer. a. Hyperplasia

b. Neoplasia

c. Metaplasia

d. Hypoplasia Hypoplasia is failure of organ to attain full size. This is a less severe abnormality than aplasia. There are rudimentary organs, smaller than normal that lack the full complement of cells, so the function may be reduced. Usually affects the same paired & unpaired organs as aplasia.

e. Dysplasia

CorrectMarks for this submission: 1/1.Question 25 Marks: 1 A 50-year-old patient developed sepsis in his superficial skin incision after a thoracic operation. The causal organisms were Gram-positive and were from an endogenous source. Which ONE of the following is the MOST likely cause of his wound sepsis?Choose one answer. a. Bacteroides fragilis

b. Clostridium perfringens

c. Escherichia coli

d. Peptostreptococcus Clostridium and Peptostreptococcus are strict anaerobes and thus are unlikely in a superficial skin wound.

e. Staphylococcus aureus

IncorrectMarks for this submission: 0/1.Question 26 Marks: 1 Which ONE of the following is the predominant form of thyroid hormones found in the blood circulation?Choose one answer. a. Thyroxine (T4) T4 is the major form of thyroid hormones secreted

b. Triiodothyronine (T3)

c. Monoiodothyronine (MIT)

d. Diiodothyronine (DIT)

e. Reverse T3

CorrectMarks for this submission: 1/1.Question 27 Marks: 1 Transport of drugs across cell membranes is reduced byChoose one answer. a. a high lipid solubility.

b. being unionized at environmental pH.

c. a passive diffusion process.

d. the P- Glycoprotein pump. P glycoprotein is the efflux pump, situated at GI mucosa, biliary tree, blood brain barrier and renal tubules. This pump transports drugs back to the original site and reduces absorption.

e. a small molecular size.

CorrectMarks for this submission: 1/1.Question 28 Marks: 1 A study showed that the mean systolic blood pressure of a group of students before sitting an examination was raised. What could be the MOST likely factor that causes the rise in the systolic blood pressure?Choose one answer. a. Increased urination

b. Increased vasodilation

c. Increased breathing rate

d. Increased heart rate The sympathetic outflow to the heart will be increased in an anticipatory period. This would raise the heart rate and subsequently the blood pressure.

e. Increased water intake

CorrectMarks for this submission: 1/1.Question 29 Marks: 1 The strongest ligament which is responsible for the maintenance of the uterus in its normal position within the pelvic cavity is theChoose one answer. a. broad ligament. Broad ligament is a peritoneal fold covering the uterus and the fallopian tubes.

b. round ligament.

c. uterosacral ligament.

d. transverse cervical ligament.

e. ovarian ligament.

IncorrectMarks for this submission: 0/1.Question 30 Marks: 1 One of the mechanisms by which bacteria acquire drug resistance is through the development of an altered metabolic pathway. Which ONE of the following drugs is this mechanism of resistance MOST relevant?Choose one answer. a. Chloramphenicol

b. Erythromycin

c. Penicillin

d. Sulphonamides The sulphonamides develop resistance by altering the metabolic pathway.

e. Tetracyclines

CorrectMarks for this submission: 1/1.Question 31 Marks: 1 Cell X releases hormone Y as it is synthesized. Stimulation on cell X causes a gradual rise in plasma concentrations of hormone Y over a few days. Based on the observation, what can you conclude about the nature of hormone Y?Choose one answer. a. Protein

b. Polypeptide

c. Amine

d. Fatty acid derivative

e. Steroid The steroid hormone is not stored in cells and is usually released once synthesized and therefore the increase in the hormonal levels may take days to happen. e.g. oestrogen.

CorrectMarks for this submission: 1/1.Question 32 Marks: 1 In bronchial asthma, relaxation of bronchiolar smooth muscle can be achieved by a drug that activates/stimulates theChoose one answer. a. alpha-1 adrenergic receptor.

b. beta-1 adrenergic receptor.

c. beta-2 adrenergic receptor. beta-2 adrenergic receptors are abundant in the bronchiolar smooth muscle. Activation/stimulation of the beta-2 receptor leads to activation of adenylate cyclase, increasing formation of cAMP and relaxation of smooth muscle.

d. nicotinic cholinergic receptor.

e. muscarinic cholinergic receptor.

CorrectMarks for this submission: 1/1.Question 33 Marks: 1 An increase in libido in both sexes is contributed byChoose one answer. a. testosterone Testosterone is secreted in large amounts by the testes only in males. Therefore it is mainly responsible an increase in libido in males but not in females.

b. dehydroepiandrosterone

c. progesterone

d. oestrogen

e. oxytocin

IncorrectMarks for this submission: 0/1.Question 34 Marks: 1 During the fight-or-flight reaction, sympathetic stimulation results in widespread effects. Some of these effects are mediated through alpha and some through beta receptor stimulation. Which ONE of the following is an alpha adrenergic effect?Choose one answer. a. Bronchoconstriction Sympathetic stimulation causes bronchodilation.

b. Contraction of circular muscles of the iris

c. Vasoconstriction of blood vessels supplying the viscera

d. Increase in heart rate

e. Contraction of the radial muscles of gastro-intestinal sphincters

IncorrectMarks for this submission: 0/1.Question 35 Marks: 1 Hepatic microsomal drug metabolizing enzymes can be inhibited by Choose one answer. a. smoking

b. drinking grape fruit juice. Grape fruit juice inhibits CYP3A4, which is the major microsomal enzyme responsible for metabolism of drugs. When drugs are prescribed to patients who were taking grapefruit juice, the drug metabolism is inhibited leading to higher plasma concentration and toxicity.

c. chronic alcoholism.

d. using herbs like St. Johns wort.

e. eating charbroiled (barbecued) meat.

CorrectMarks for this submission: 1/1.Question 36 Marks: 1 A 45-year-old patient developed sepsis after bowel surgery. The causal organisms which were isolated under strict anaerobic culture were Gram-negative bacteria. What is the MOST likely organism for the patients sepsis?Choose one answer. a. Bacteroides fragilis The organisms stated are commensals of the intestinal tract and thus can constitute a source of infection. Bacteroides is gram negative and a strict anaerobe.

b. Clostridium perfringens

c. Escherichia coli

d. Pseudomonas aeruginosa

e. Peptostreptococcus

CorrectMarks for this submission: 1/1.Question 37 Marks: 1 A 25-year-old HIV positive patient presented to the family physician with recurring painful vesicular lesions on the lips. The causal agent was an enveloped DNA virus. Which ONE of the following is the MOST likely cause of the vesicular lesions?Choose one answer. a. Adenovirus

b. Coxsackie virus

c. Herpes simplex virus The viruses listed are DNA viruses except Coxsackie virus, and can cause opportunistic infection in a patient who is HIV positive with possible immunosuppression. Herpes simplex virus presents with vesicular lesions on the lips known as cold sores.

d. Papilloma virus

e. Kaposi sarcoma virus

CorrectMarks for this submission: 1/1.Question 38 Marks: 1 Which ONE of the following is MOST likely a physiological function of mediators formed by the cyclooxygenase pathway of arachidonic acid?Choose one answer. a. vasodilatation by thromboxane (TxA2). Thromboxane (TxA2) is a potent vasoconstrictor. Prostacyclin causes vasodilatation.

b. platelet aggregation by prostacyclin (PGI2).

c. increased gastric acid secretion.

d. reduction of intraocular pressure.

e. reduction of renal blood flow.

IncorrectMarks for this submission: 0/1.Question 39 Marks: 1 At which ONE of the following circumstances the meiotic II division of the oocyte will be completed?Choose one answer. a. Cleavage

b. Fertilization Fertilization results in the completion of meiotic II division. Meiosis is a process of cell division which results in the division of diploid parental cell into haploid progeny. Meiosis I is followed by meiosis II. Cell division following meiosis I is asymmetrical, resulting in the production of small polar body and an oocyte that retain its large size. The oocyte then enters into meiosis II without having reformed a nucleus or decondensed its chromosome. Most vertebrate oocytes are arrested in metaphase II, where they remain until fertilization.

c. Gastrulation

d. Implantation

e. Ovulation

CorrectMarks for this submission: 1/1.Question 40 Marks: 1

The following bacteria were isolated from a patient suffering from syphilis. These bacteria cannot be gram stained. Which ONE of the following organisms cause this condition?Choose one answer. a. Treponema pallidum Treponema pallidum is the aetiological agent of syphilis.

b. Mycobacterium tuberculosis

c. Salmonella typhi

d. Chlamydia trachomatis

e. Rickettsia prowazeki

CorrectMarks for this submission: 1/1.