EMQ 2004

Question 1

What is epithelium of

a) Trachea
b) Sigmoid colon
c) skin

Answer 1

a) Trachea -Pseudostratified columnar
b) Sigmoid colon- Simple columnar epithelium with simple tubular glands
c) skin - Stratified squamous keratinising epithelium

Question 2

p53 gene product will halt the growth of cells at the end of which phase of the cell cycle?

Answer 2

G1

Question 3

Chromatids are present at opposite poles of these cells. These cells are in which phase of the cell cycle?

Answer 3

ANAPHASE

Question 4

MITOSIS

Answer 4

1. (Interphase) - DNA replication, centrosome replication
   (G1, SYNTHESIS, G2)
2. Prophase - Chromatin condenses into chromosomes , centrosomes migrate to opposite poles of the nucleus, nucleolus dissipates, spindle network forms
3. Premetaphase - Nuclear membrane breaks down, microtubles invade the nuclear space, chromatids attach to microtubles
4. Metaphase- Chromosomes line up along equatorial plane
5. Anaphase - Sister chromatids separate and are pushed to the opposite poles of the cell
6. Telophase - Nuclear membrane reforms, chromosomes unfold into chromatin,
7. Cytokinesis begins (cell divides into two)

Question 5

A patient has removal of part of the liver for metastatic colorectal carcinoma. At what phase of the cell cycle will the remaining stable hepatocytes re-enter the cell cycle.

Answer 5

G1

Question 6

A 68 year old male has a resting pulse rate of 40 beats/min. An ECG show atrial depolarisation occurring at a rate of 90/min and ventricular depolarisation occurring at a rate of 40/min. Ventricular depolarisation is not preceded by a P Wave.

Answer 6

Answer: D – AV Node

Question 7

17. A 28 year old female complains of palpitations after drinking two cups of strong coffee.

Answer 7

Answer: A – Sympathetic nerves

Question 8

18. A 62 year old male with a long history of ischaemic heart disease complains of palpitations. His pulse is irregular and his ECG shows atrial depolarisation occurring at a rate of about 400/min with an irregularly irregular ventricular rate of about 90/min.

Answer 8

Answer: G – Right atrium

Question 9

What are each of the waves in an ECG?

Answer 9

P wave is the first short upward movement of the ECG tracing. It indicates that the atria are contracting, pumping blood into the ventricles.

The QRS complex, normally beginning with a downward deflection, Q; a larger upwards deflection, a peak (R); and then a downwards S wave. The QRS complex represents ventricular depolarization and contraction.

The PR interval indicates the transit time for the electrical signal to travel from the sinus node to the ventricles.

T wave is normally a modest upwards waveform representing ventricular repolarization.

Question 10

22. This is produced by the pancreas and buffers the stomach contents on entering the duodenum.

Answer 10

Answer: B – Bicarbonate ions

Question 11

23. This hormone stimulates the production of pancreatic juice after eating.

Answer 11

Answer: H – Secretin

Question 12

24. Elevated serum levels of this enzyme are commonly found in patients with acute pancreatitis.

Answer 12

Answer: D – Amylase

Question 13

A 45 year old male complains that he has been experiencing pain around the right side of his abdomen for the last few days. Previously he has been well. On examination he is very sensitive on touching him in an area extending from his lower thoracic vertebrae to the umbilicus. In the region affected by the pain you can see some small spots that look like blisters.

Answer 13

Answer: F – Nerve roots from the spinal cord

Shingles = follow nerve root = blisters

Question 14

A 40 year old woman (weight 102kg) states that she suddenly developed severe right upper abdominal pain lasting for 5 hours after eating a meal of fish and chips.

Answer 14

Answer: I – Gallbladder

Fatty food = gall bladder, bile to breakdown = upper R region

Biliary colic is abdominal pain in the right upper quadrant or epigastrium that is usually episodic, occurs after eating greasy or fatty foods, and leads to nausea and/or vomiting

Question 15

A 65 year old man complains of pains in the upper central abdomen and in the back. The pain in the back is particularly noticeable at night. These symptoms have been present for four months during which time he has lost about 5kg in weight. On examination he is jaundiced.

Answer 15

Answer: H – Pancreas

-upper L behind stomach, often spreads to back at night

Jaundice due to compression - post-hepatic

Question 16

A 21 year old female student, who supports herself by part-time modelling, complains of diarrhoea. She is light for her height (1.78 m, 56 kg, BMI 17.7) and admits to self-induced vomiting. Her colonic mucosa is seen to be abnormally pigmented at colonoscopy.

Answer 16

Answer: G – Laxative abuse

melanosis coli = laxative absorbed by GI tract, damage cells = appear as dark pigment = pigmentation

Question 17

A 36 year old male complains of abdominal distention and intermittent diarrhoea. On examination he has a slightly distended abdomen and swollen ankles. Blood tests show that he has a large red blood cells, and low concentrations of calcium and albumin.

Answer 17

Answer: I – Malabsorption

=low Ca
=Low albumin = protein malabsorption = odema

Question 18

A 65 year old man develops swollen ankles and a tender enlarged liver a few days after his second heart attack.

Answer 18

Raised central venous pressure

R sided heart failure = back up and high venous pressure return = affects liver = enlargement

high venous pressure = odema

?

Question 19

34. A 28 year old man develops a cough productive of green sputum and sharp chest pain that is made worse by inspiration. This illness follows an episode of influenza.

Answer 19

Answer: G – Inflammation of the pleura

cough productive of green sputum = inflammation
inspiration = pleura

Question 20

35. A 56 year old man who has been a life-long smoker suddenly develops severe central chest pain and sweats profusely. He also complains of pain in the right arm.

Answer 20

Answer: F – Acute coronary thrombosis

severe chest pain = heart
R arm = referred pain (heart)
smoker = heart etc, oxygen

pain in other parts of the body - it can feel as if the pain is travelling from your chest to your arms, jaw, neck, back and abdomen
lightheadedness
sweating
nausea
breathlessness

Question 21

36. An overweight 34 year old man complains of chest pain behind the lower end of the sternum. The pain occurs usually at night when he is flat in bed but lately he has noticed it when he bends to pick things up from the floor.

Answer 21

Answer: I – Gastroesophageal reflux

GORD = heart burn, acid reflux
Location of oesophagus and stomach (lower esophageal sphincter)
after a large meal, or when bending forward.