2015 module exam Flashcards
1
Q
Innervation to gemellus inferior?
a. nerve to obturator internus
b. nerve to quadratus femoris
c. superior gluteal nerve
d. inferior gluteal nerve
A
b. nerve to quadratus femoris
2
Q
Product of de-novo purine synthesis? A) IMP B) AMP C) Ribose 5 phosphate D) 5 phosphoribosyl pyrophosphate
A
A) IMP
inosine monophosphate
3
Q
What causes medial flexion of hip? A) quadratus femoris B) gluteus maximus C) piriformis D) gluteus medius
A
D) gluteus medius
4
Q
What is miniature EPP?
A) single acetylcholine molecule is released
B) single vesicle is released from the presynaptic end
A
B) single vesicle is released from the presynaptic end
5
Q
What will result if extracellular calcium concentration decreased from 2.5 to 1.5 (lower than normal levels)?
A
Less EPP will be produced
6
Q
What would happen if Strautosporin was administered in a synapse?
A
less phosphorylation of synapse protein
7
Q
What is the function of Synapsin?
A
fixation of the synaptic vesicle to the actin cytoskeleton
8
Q
What allows propagation of AP in an axon?
A
Sodium channels
9
Q
What is the function of T tubule?
A
propagation of AP
10
Q
A 70-year-old male with osteoporosis, which of the following is true about osteoporosis?
A) estrogen-mediated bone loss
B) osteoclast dysfunction
C) osteoblast forming weak osteoid
A
C) osteoblast forming weak osteoid
11
Q
A 63-year-old female. What is most likely the cause of her osteoporosis?
A) postmenopausal effect
B) vitamin D deficiency
A
A) postmenopausal effect
12
Q
What is the mutation found in Ewing sarcoma?
A
Translocation (11, 22)
13
Q
A person fell from a bike and injured his C8, T1. Which is true?
A) weak flexion of elbow
B) weak adduction of the thumb
A
B) weak adduction of the thumb
14
Q
A cohort study smoking risk factor of smoking in SLE with age and gender as covariates. What would be the best choice to eliminate confounding get the most information?
A
Cox multivariate regression, Time to event outcome
15
Q
Why do we use logistic regression?
A
the outcome is binary categorical
16
Q
Why is it a major challenge to study the epidemiology of OA?
A
Because there is no correlation between the radiological and clinical findings
17
Q
Dancers fracture?
A) Talus
B) Calcaneus
C) Metatarsals
A
C) Metatarsals
18
Q
which of the following is not used with gold compounds because it chelates metals?
A
D-penicillamine
19
Q
Which drug inhibits iL-2?
A
cycolsporin A
20
Q
which drug won’t cause bone marrow suppression?
A
cyclosporin A
21
Q
Which drug is given IV every 2 weeks to treat gout?
A
Pegloticase
22
Q
During the proliferative phase of bone healing, what will you find?
A) Hematoma
B) Granulation tissue
C) Soft callus
A
B) Granulation tissue
23
Q
A 4-year-old boy has osteogenesis imperfecta and fractured his arm, what type of fracture is this? A) Pathological B) Compound C) Simple D) Greenstick
A
A) Pathological
24
Q
Mass on chest wall after lymphadenectomy and breast radiation?
A
angiosarcoma
25
```
What is linked to SLE onset/exacerbates it?
A) high TGF-a
B) t cell apoptosis
C) dysfunctional neutrophils
D) MHC gene
```
D) MHC gene
26
What’s true about lamellar bone?
A) Has parallel collagen fibers
B) Is later converted to woven bone
A) Has parallel collagen fibers
27
A woman got a tick bite and later developed arthritis, what is the diagnosis?
Lyme disease
28
what’s the function of aggrecan in collagen?
A) water retention
B) cross links collagen to hyaluronic acid
A) water retention
29
MELAS is caused by mutation in what tRNA?
A) lysine
B) leucine
C) glutamic acid
B) leucine
30
Severe deficiency in what causes impaired collagen production?
Vit C
31
```
What’s the innervation of hypaxial muscles?
A) ventral ramus
B) ventral root
C) dorsal ramus
D) dorsal root
```
A) ventral ramus
32
Hemophilus influenza is common in what age group?
A) 3 months to 2 years
B) 10-12 years
C) 20-30 years
A) 3 months to 2 years
33
What organism is responsible for osteomyelitis in a diabetic person?
pseudomonas aeruginosa
34
In SLE, what is the most common cause of avascular necrosis?
A) change in RBC morphology
B) ab against IgG
C) corticosteroid therapy
C) corticosteroid therapy
| vasculitis wasn’t an option, nor was thrombosis/embolism
35
What describes the pathophysiology of RA?
A) Th1 cells and immune complexes
B) Th1 and NK cells
A) Th1 cells and immune complexes
36
Rituximab binds on what cells?
A) T cells
B) monocytes
C) B cells
C) B cells
37
What is responsible for the extended structure of proteoglycans?
Polysaccharide negative charges
38
Deposition of immune complex in RA induces what?
A) Ab formation
B) inflammation
C) Th2 cytokine production
B) inflammation
39
A 50-year-old man presented with shooting pain to his lower leg, he had an Intervertebral disk prolapse, what is the initial step to manage this patient?
A) Bed rest and follow up
B) NSAIDs and Physiotherapy
B) NSAIDs and Physiotherapy
40
```
Which component is needed for de novo synthesis and purine salvage pathways?
A) IMP
B) AMP
C) Xanthine
D) Guanine
E) Ribose 5 phosphate
F) 5 phosphoribosyl pyrophosphate
```
F) 5 phosphoribosyl pyrophosphate
41
What causes defective clearance of immune complexes in SLE?
Defective complements
42
What is the mechanism of methotrexate?
A) Metabolized to mercaptopurine which inhibits DNA
B) Inhibits IL2
C) Inhibits JAK
D) Competitive inhibitor of dihydrofolate reductase enzyme
D) Competitive inhibitor of dihydrofolate reductase enzyme
43
What structure is torn due to hyper-eversion of the ankle joint?
a. Tibial collateral ligament
b. Fibular collateral ligament
c. Lower border of the patella
d. Medial to the patellar ligament
e. Deltoid ligament
e. Deltoid ligament
44
What is hurt with hyper dorsiflexion of foot?
Head of talus
45
Which group of muscles are responsible for lateral rotation of the arm?
a) Infraspinatous & teres minor
b) subscapularis
c) subclavicus
a) Infraspinatous & teres minor
46
```
Ligation of the axillary artery on the second part may move blood in reverse direction in which artery?
A) subscapular
B) anterior circumflex
C) lateral thoracic
D) superior thoracic
E) thoracoacromial
```
A) subscapular
47
```
A 70-year-old man complained of clicking and pain of his right knee. There was significant varus deformity of both legs. What is the diagnosis?
A) RA
B) OA
C) SLE
D) Septic Arthritis
E) Reactive Arthritis
F) AS
G) Paget’s disease
```
B) OA
48
```
What forms the lateral border of the cubital fossa
A) Pronator teres
B) Brachialis
C) Biceps brachii
D) Brachioradialis
```
D) Brachioradialis
49
```
A person with a laceration in the anterior compartment of the wrist and hand, had nothing wrong with the motor but sensory loss above the thumb part of the palmar area, which nerve is severed?
A) Median
B) Radial
C) Ulnar
D) Musculocutaneous
```
A) Median
50
(diagram) Which of the following activates glycogen phosphorylase and glycogen phosphorylase kinase?
A) ATP and Cl-
B) AMP and Ca+2
B) AMP and Ca+2
51
What are the carpal bones involved in the wrist joint?
scaphoid, lunate, triquetrum
52
What is the amino acid in the first position of the triplet structure in the collagen?
A) Glycine
B) Alanine
C) Valine
A) Glycine
53
```
What nerve is affected when you're unable to retract the scapula?
A) Dorsal scapular
B) Suprascapular
C) Thoracodorsal
D) Long thoracic
```
A) Dorsal scapular
54
Its high concentration in blood indicate collagen production?
A) CP I
B) CP II
C) CP III
B) CP II
55
Upon knee aspiration of an immunocompromised patient with swollen painful knee, pseudohyphae was seen. What is this fungus?
a. Streptococcus agalactiae
b. Neisseria gonorrhea
c. Candida albicans
d. Pseudomonas aeroginusa
e. Mucorales
Candida albicans
56
```
Which of the following symptoms suggest the inflammatory nature of the joint pain?
A) clicking
B) swelling
C) morning stiffness
D) giveaway
```
C) morning stiffness
57
```
Higher production of which component after trauma or mechanical stress may lead to the development of osteoarthritis?
A) collagen II
B) collagen IV
C) aggrecan
D) linking protein
E) hyaluronic acid
F) TIMPs
G) ADAMTs
H) glucosamine
```
G) ADAMTs
58
```
Which of the following when it decreases, stimulates cartilage fragmenting?
A) collagen II
B) collagen IV
C) aggrecan
D) linking protein
E) hyaluronic acid
F) TIMPs
G) ADAMTs
H) glucosamine
```
F) TIMPs
59
```
injury to shoulder occurred. The shoulder was flat and loss of sensation to the lateral shoulder, which was hurt?
A) accessory nerve
B) axillary nerve
C) thoracodorsal nerve
D) nerve to subclavius
```
B) axillary nerve
60
Upward dislocation of shoulder joint is prevented by?
coracoacromial arch
61
```
A 70-year-old male with crepitus and feels pain in right knee while walking. What is the issue?
A) RA
B) OA
C) SLE
D) Reactive Arthritis
```
B) OA
62
```
Which muscle is affected in piriformis syndrome?
A) gluteus maximus
B) semitendinosus
C) semimembranosus
D) biceps femoris
E) adductor magnus
```
D) biceps femoris
63
What will be seen in a man with osteoarthritis?
Osteophytes
64
```
A patient suffered from gluteal region injury due to a road traffic accident. When he stood on one leg, the pelvis tilted to the unsupported side. What of these nerves might have been injured?
A) Superior gluteal
B) Inferior gluteal
C) Nerve to obturator internus
D) Nerve to quadratus femoris
E) Sciatic
```
A) Superior gluteal
65
A 40-year-old male had an avulsion fracture of great tubercle of the right humerus secondary to shoulder dislocation. He presented with a medially rotated arm. What is the explanation of this presentation?
A) unopposed action of subscapularis
B) unopposed action of pec. minor
A) unopposed action of subscapularis
66
```
Common Interosseus is the main branch of which artery?
A) Middle collateral artery
B) Radial recurrent artery
C) Inferior ulnar collateral artery
D) Superior ulnar collateral artery
E) Ulnar artery
F) Radial artery
G) Brachial artery
H) Axillary artery
```
E) Ulnar artery
67
```
What is a branch of profunda brachii?
A) Middle collateral artery
B) Radial recurrent artery
C) Inferior ulnar collateral artery
D) Superior ulnar collateral artery
E) Ulnar artery
F) Radial artery
G) Brachial artery
H) Axillary artery
```
A) Middle collateral artery
(Middle and Radial collateral artery are both branches of profunda brachii
C&D= branches of brachial artery)
68
```
In the bottlebrush structure of proteoglycans, what forms the stem?
A) Linker protein
B) Hyaluronic acid
C) Mylase
D) Collagen type 2
```
B) Hyaluronic acid
69
```
Inability to extend the knee indicate injury of which nerve? A) Nerve to quadratus femoris
B) Nerve to obturator internis
C) tibial nerve
D) femoral nerve
E) superior gluteal
F) sciatic
```
D) femoral nerve
70
Dorsiflexion and inversion of the foot is mainly by which muscle?
tibialis anterior
71
```
A 26-year-old in soccer match had a middle humeral fracture that injured the radial nerve, what is the effect?
A) Lack of flexion of elbow
B) Weakened extension of elbow
C) Abduct hand wrist
D) Loss sensory of lateral forearm
```
B) Weakened extension of elbow
72
```
A rugby player had a hyperextension neck injury and there was a rupture of the intervertebral disc, he felt pain on the radial side of the forearm and the thumb, what IV disc is most likely to be affected?
A) C3/C4
B) C4/C5
C) C6/C7
D) C5/C6
```
D) C5/C6
73
A patient with poor glycemic control had septic arthritis. What could be the causative agent?
a. Streptococcus agalactiae
b. Neisseria gonorrhea
c. Candida albicans
d. Pseudomonas aeroginusa
e. Mucorales
a. Streptococcus agalactiae
74
What’s the commonest fracture site in elderly?
Femoral neck
75
The hamstring muscles common attachment?
ischial tuberosity
76
A Case of 5 years old boy, can’t play with his friends, he had elevated creatinine kinase (and other things indicating Duchenne muscular dystrophy with fibrosis). How would u confirm diagnosis?
A) Immunostaining of Dystrophin
B) PCR for the gene XR27
A) Immunostaining of Dystrophin
77
A 30 years old patient presented w/Heavy eyelids and progressive muscle weakness for 3-5 weeks. What will we find?
A) increased antibodies to acetylcholine
B) elevated CK
C) loss of dystrophin staining
A) increased antibodies to acetylcholine
| An acetylcholine receptor antibody test is used to help diagnose myasthenia gravis
78
```
Injury to which nerve results in the following inability to initiate abduction?
A) Dorsal scapular
B) Suprascapular
C) Thoracodorsal
D) Long thoracic
```
B) Suprascapular
79
```
Injury to which nerve results in the inability to retract the scapula?
A) Dorsal scapular
B) Suprascapular
C) Thoracodorsal
D) Long thoracic
```
A) Dorsal scapular
80
```
Injury to which nerve cause loss of sensation in the lateral side of forearm?
a. Radial n
b. Median n
c, Ulnar n
d. Musculocutaneous n
e. Med cutaneous n
```
d. Musculocutaneous n
81
```
Which part of the lumbar vertebra attaches to the body of the lumbar vertebra?
A) Spinous process
B) Lamina
C) Transverse process
D) Pedicle
E) Mammilary body
```
D) Pedicle
82
```
Aspirin will lower or eliminate the activity of which drug in patients with gout?
A) Allopurinol
B) Prednisone
C) Probenecid
D) Celecoxib
E) Paracetamol
```
C) Probenecid
83
```
A patient presented with obturator nerve injury from trauma to the pelvic wall. Which muscle is affected?
A) gracilis
B) iliacus
C) sartorius
D) obturator internus
```
A) gracilis
84
```
Which of the following muscles is a flexor of the knee?
A) Tibialis anterior
B) Fibularis longus
C) Flexor hallicus longus
D) Flexor digitorum longus
E) Gastrocnemius
```
E) Gastrocnemius
85
```
A 39-year-old male complains of clicking and locking knee while walking. Which test is positive would be?
A) varus stress test
B) valgus stress test
C) anterior drawer test
D) posterior drawer test
E) patella apprehension test
F) mc Murry
```
F) mc Murry
86
```
A 22-year-old male sustained hyperextended knee trauma in a soccer game. He complains of giveaway of his knee when he tries to walk. Which test is positive would be?
A) varus stress test
B) valgus stress test
C) anterior drawer test
D) posterior drawer test
E) patella apprehension test
F) mc Murry
```
C) anterior drawer test
87
```
A 40-year-old male had complete tear to medial collateral ligament. Which test is positive would be?
A) varus stress test
B) valgus stress test
C) anterior drawer test
D) posterior drawer test
E) patella apprehension test
F) mc Murry
```
B) valgus stress test
88
```
A gymnast with recurrent patellar dislocation. Which test is positive would be?
A) varus stress test
B) valgus stress test
C) anterior drawer test
D) posterior drawer test
E) patella apprehension test
F) mc Murry
```
E) patella apprehension test
89
A 40-year old man, a drug addict, experiences tight knee pain, swelling and fever for last 2 days. What is the diagnosis?
a. OA
b. Septic arthritis
c. RA
d. Reactive Arthritis
e. Paget’s disease
b. Septic arthritis
90
```
A 16-year-old child presented with a fracture of the medial epicondyle. Which nerve is most likely affected?
A) ulnar
B) radial
C) median
D) musculocutaneous
```
A) ulnar
91
What restricts the movement of the vertebra?
a. spinous process
b. transverse process
c. articular process
c. articular process
92
If the dorsiflexion of foot is lost, which nerve is affected? A) tibial
B) common fibular
C) medial plantar
D) lateral plantar
B) common fibular
93
```
What nerve innervates tensor fascia lata?
A) superior gluteal nerve
B) inferior gluteal nerve
C) nerve to obturator internus
D) nerve to quadratus femoris
```
A) superior gluteal nerve
94
Which one of the following conveys pain sensation from the shoulder joint?
A) Accessory
B) Axillary
C) Thoracodorsal
B) Axillary
95
A woman presents with right knee pain, swelling and pain of fingers in the morning. What is the diagnosis?
a. rheumatoid arthritis
b. Septic arthritis
a. rheumatoid arthritis
96
What is used to non-enzymatically stabilize collagen/cross link extracellularly?
Allysine
97
Homer-wright rosettes are found in which tumor?
Ewing sarcoma
98
Bone tumor in the metaphyseal area?
osteosarcoma
99
What happens after myosin power stroke?
ATP binds to myosin head
100
What happens when myosin binds ATP?
A) Myosin detaches from f-actin?
B) Release of myosin head from f-actin
B) Release of myosin head from f-actin
| According to Dr. Henkel, the myosin head is released from the actin filament and then the whole myosin is detached
101
A woman with white purulent urethral discharge before developing arthritis. What could be the causative organism?
a. Streptococcus agalactiae
b. Neisseria gonorrhea
c. Candida albicans
d. Pseudomonas aeroginusa
e. Mucorales
b. Neisseria gonorrhea
102
(picture) There are metabolic changes that occur during exercise.
a. with higher intensity, higher amount of fat burned for energy
b. with higher intensity, higher amount of glucose burned for energy
b. with higher intensity, higher amount of glucose burned for energy
103
What if increased, especially during exercise, activates anabolerotic pathway to replenish fumarate?
AMP
104
What nerve is affected in a person who can’t initiate abduction?
suprascapular
105
FGF3 receptor mutation is found in what disease?
achondroplasia
106
Defective collagen synthesis and degradation is in which disease?
OI
107
Fracture in someone with communication to the skin is what type of fracture?
compound
108
```
Which is formed by C7?
A) medial cord
B) lateral cord
C) posterior cord
D) superior trunk
E) middle trunk
F) musculocutanous nerve
G) median nerve
H) axillary nerve
```
E) middle trunk
109
```
Which is formed mainly by C8 & T1?
A) medial cord
B) lateral cord
C) posterior cord
D) superior trunk
E) middle trunk
F) musculocutanous nerve
G) median nerve
H) axillary nerve
```
A) medial cord
110
What motor deficit results when the common fibular nerve is compressed near the fibular head?
eversion
111
Which of the following is a Uricosuric drug?
Probenacid
112
Patient on long term indomethacin. What will be given along with it to decrease chances of peptic ulceration?
misoprostol
113
Where is a safe area to aspirate the knee joint?
A) Lower border of the patella
B) Medial to the patellar ligament
B) Medial to the patellar ligament
114
Osteomyelitis in drug user. What is the causative agent?
a. Streptococcus agalactiae
b. Neisseria gonorrhea
c. Candida albicans
d. Pseudomonas aeroginusa
e. Mucorales
d. Pseudomonas aeroginusa
115
What is the mechanism of Immune complex induced damage in RA?
Inflammation inducing TH2 cytokines
116
What predisposes a child to OM?
A) Slowdown of blood flow in capillary loops of epiphysis
B) low ossification of deep layer of cartilage
A) Slowdown of blood flow in capillary loops of epiphysis
117
A Diabetic patient undergoing surgery got infected with nonseptate hyphae branched at right angle. What is this fungus?
a. Streptococcus agalactiae
b. Neisseria gonorrhea
c. Candida albicans
d. Pseudomonas aeroginusa
e. Mucorales
e. Mucorales
118
Boxer said, 'OW I CAN’T PUNCH'. what nerve could be affected?
A) thoracodorsal
B) dorsal scapular
C) long thoracic
C) long thoracic
119
A male with sickle cell disease presented with arthralgia. What could be the causative organism?
a. Cryptococcus neoformans
b. Salmonella enteriditis
c. Candida albicans
d. Neisseria gonorrhea
b. Salmonella enteriditis
120
Which one of these is associated with SLE?
A) Joint deformity
B) Mononuclear infiltrates
C) Synovial membrane damage
B) Mononuclear infiltrates
121
In fracture of the middle part of clavicle, the proximal side is elevated while the lateral part is stationary. What keeps the lateral side in such position?
A) Action of subclavius muscle
B) Corcacoclavicular ligament
B) Corcacoclavicular ligament
122
A 5 years old girl presented with acute onset of fever, swollen lymph nodes, sore throat, and ulcers in the posterior part of the mouth. What is the causative agent?
A) Hep B
B) Influenza
C) Enterovirus
C) Enterovirus
123
What causes low fatigue in a muscle?
low ATP/ADP ratio
124
Patient with HIV and disseminated cutaneous lesions, showing Capsulated yeast upon investigation. What could be the causative organism?
a. Cryptococcus neoformans
b. Salmonella enteriditis
c. Candida albicans
d. Aspergillosis
a. Cryptococcus neoformans
125
Neutropenic patient, was infected with branched septate hyphae. What is the causative organism?
a. Cryptococcus neoformans
b. Salmonella enteriditis
c. Candida albicans
d. Aspergillosis
d. Aspergillosis
