Met SAQs Flashcards

Question

The afferent limb of the gag reflex is supplied by which nerve? a) facial nerve b) trigeminal nerve c) glossopharyngeal nerve d) hypoglossal nerve e) vagus nerve

Answer 1

The afferent limb of the gag reflex is supplied by which nerve? a) facial nerve b) trigeminal nerve **c) glossopharyngeal nerve** d) hypoglossal nerve e) vagus nerve

Answer 2

_Where is the majority of secretin secreted from?_ **S cells in upper small intestine** Zona glomerulosa of adrenal cortex I cells in upper small intestine D cells in the pancreas & stomach Sertoli cells G cells in antrum of the stomach

Answer 3

which of the following would cause cardiomyopathy if a patient had a deficiency? phosphorous iron **selenium** zinc copper

Answer 4

Symptoms can be split based on their causes for example individuals with PKU have fair skin, blonde hair --\> due to reduction in the production of melanin. CNS abnormalities --\> due to reduced neurotransmitter production and can lead to jerking, tremors, seizures

Answer 5

Which vitamin is involved in the formation of collagen? Vit A Vit B **Vit C** Vit D Vit E

Answer 6

which vitamin causes production of CCR9 & a4b9 in gut honing T cells? **vitamin A** vitamin B vitamin C vitamin D vitamin E

Answer 7

which nerve innervates sensation to the face? * *a) trigeminal nerve** b) facial nerve c) glossopharnyngeal d) vagus nerve e) hypoglossal

Answer 8

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

Answer 9

Which one of the following actions is directly caused by gastrin? Increases pancreatic secretions rich in digestive enzymes **Increases pepsinogen secretion** Decreases gastric emptying Stimulates aldosterone release Increases plasma phosphate Increases proximal tubule Na+/H+ activity

Answer 10

_Which one of the peritoneal ligaments contains the hepatic artery, hepatic portal vein and common bile duct?_ Gastrocolic ligament **Hepatoduodenal ligament** Splenorenal ligament Hepatogastric ligament Gastrosplenic ligament Falciform ligament

Answer 11

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

Answer 12

Von Gierkes disease is caused by a mutation in which gene? a) PYGT b) PYGL * *c) G6PC** d) HGD e) G1PC

Answer 13

which nerve innervates the muscles of facial expression? a) trigeminal nerve * *b) facial nerve** c) glossopharnyngeal d) vagus nerve e) hypoglossal

Answer 14

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

Answer 15

Which layer of the gastrointestinal tract contains Meissners plexus? Muscularis externa **Submucosa** Serosa Mucosa

Answer 16

A 39-year-old lady has recurrent attacks of biliary colic. What is the approximate volume of bile to enter the duodenum per 24 hours? **500 mL** 50 mL 100 mL 2000 mL 150 mL

Answer 17

Which one of the following inhibits gastric acid secretion? Histamine **Nausea** Calcium Parasympathetic vagal stimulation Gastrin

Answer 18

which metabolic disease is caused by mutation in glycogen phosphorylase in liver? a) McArdles Disease * *b) Hers Disease** c) von Gierkes d) Maple syrup disease

Answer 19

- nucleus (typically steroid hormones) - cytoplasm - plasma membrane

Answer 20

which metabolic disorder means that the following reaction cant occur? pyruvate --\> glucose-6-P --\> glucose * *a) von Gierkes** b) Hers c) McArdles d) Galactosaemia e) hereditary fructose intolerance

Answer 21

A 17-year-old lady presents with right iliac fossa pain and diagnosed as having acute appendicitis. You take her to theatre to perform a laparoscopic appendicectomy. During the procedure the scrub nurse distracts you and you inadvertently avulse the appendicular artery. The ensuing haemorrhage is likely to be supplied directly from which vessel? IMA SMA **Ileo-colic artery** Internal iliac artery None of the above

Answer 22

the coeliac trunk arises from the abdominal aorta at which vertebral level? **T12** L1 L2 L3 L4

Answer 23

_Which one of the following actions is directly caused by renin?_ Stimulates ADH release Stimulates thirst **Converts angiotensinogen to angiotensin I** Inhibits glucagon secretion Decreases appetite Vasoconstriction of vascular smooth muscle

Answer 24

A 22-year-old male presents to his general practitioner with a 4-month history of headaches, palpitations, and heavy sweating. He also reports some non-intentional weight loss. On examination, the patient is sweating heavily and is tachycardic. It is suspected that the man may have a malignancy affecting the tissue responsible for the secretion of adrenaline. Where is the most likely site of the malignancy? Adrenal cortex **Adrenal medulla** Medulla oblongata Parathyroid gland Thyroid

Answer 25

which gastric cell produces histamine in to activate stomach acid creation? a) parietal cells b) G cells c) chief cells **d) ECL cells** e) mucous secreting cells

Answer 26

which vitamin deficiency is associated with beri beri? - vit. A * *- vit B1** - vit. B2 - vit. B3 - vit. B4

Answer 27

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

Answer 28

An 18-year-old male is admitted with confusion and myoclonus. A blood test reveals a high ammonium level. He has a family history of a urea cycle disorder. What enzyme deficiency is present? **Carbomyl phosphate synthetase I** Glycogen phosphorylase Isocitrate dehydrogenase PFK-1 Glyocgen synthase

Answer 29

A 6-year-old male patient presents with signs and symptoms of severe fasting hypoglycaemia. On examination, he has hepatomegaly. His blood lactate levels, uric acid and triglycerides are raised. After extensive investigations, he is diagnosed with glycogen storage disease I (Von Gierke disease). Which enzyme is deficient in this condition? **Glucose-6-phosphatase** Glucose-6-phosphatase dehydrogenase a-1,6 glucosidase Myophosphorylase Glucocerebrosidase

Answer 30

1. restores BP, reabsorbed salt & water lvls (not excrete as much) [1] 2. restores K loss [1] (two totally differnet systems! )

Answer 31

ADH Oxytocin

Answer 32

the hepatoduodenal ligament is found which of the following: a) greater omentum **b) lesser omentum** c) mesocolon d) mesentary

Answer 33

does the spleen develop in the dorsal or ventral mesogastrium? : **dorsal mesogastrium**

Answer 34

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

Answer 35

Which of the following is true during exercise? A.Glycogenesis and lipogenesis are favoured B.Glycogenolysis and lipolysis are inhibited C.ATP is the primary driver of increased glycolysis **D.Ca2+ and AMP promote glycolysis: Drop in pH due to lactic acid accumulation inhibits glycolysis + oxidative phosphorylation**

Answer 36

which Ig is the only antibody capable of crossing the placenta to give passive immunity to the fetus? * *a) IgG** b) IgM c) IgA d) IgE e) IgD

Answer 37

growth hormone is released from anterior pituitary gland after stimulation by growth hormone releasing hormone. which hormone does it indirectly cause the release of to increase bone and muscle mass? - AMP - cAMP - IP3 * *- IGF-1** - DAG

Answer 38

which one of the followings statements is true of glucagon? - produced in response to hyperglycaemia - released by beta cells - inhibits gluconeogenesis * *- produced in response to an increase in amino acids** - composed of 2 alpha polypeptide chains linked by H bonds

Answer 39

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

Answer 40

Latency on a nerve conduction study describes: a) distance between 2 different stimulation sites b) height of electrical activity c) distance betwen stimulation site and muscle sensor * *d) time from stimulation to start of electrical activity**

Answer 41

Which cycle is used in gluconeogenesis to ger pyruvate --\> phosphoenolpyruvate (PEP) ? a) Krebs Cycle b) Cori Cycle * *c) Malate Cycle** d) Glyoxylate cycle e) Carnitine shuttle

Answer 42

gliadin binds to which antibody in the gut with a patient with CD? * *- IgA** - IgD - IgG - IgM - IgE ## Footnote **•IN COELIAC DISEASED PATIENTS, the IgA along with gliadin do not get broken down and are transferred from the apical membrane of the enterocytes down to the basolateral membrane**

Answer 43

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

Answer 44

cholesterol

Answer 45

What forms the the borders of Hesselbach's triangle? - Inguinal ligament laterally, inferior epigastric vessels laterally, pubic tubercle medially - Inguinal ligament laterally, inferior epigastric vessels laterally, umibilicus medially - Inguinal ligament laterally, ASIS laterally, pubic tubercle medially * *- Inguinal ligament laterally, inferior epigastric vessels laterally, lateral border of the rectus sheath medially** - Inguinal ligament laterally, ASIS laterally, lateral border of the rectus sheath medially

Answer 46

which of the following is not a role of micronutrients 1. co-factors 2. co-enzymes 3. antioxidants 4. control of gene expression * *5 oxidants**

Answer 47

_Where is the majority of aldosterone secreted from?_ Posterior pituitary **Zona glomerulosa of adrenal cortex** Zona fasciculata of adrenal cortex Zona reticularis of adrenal cortex Juxtaglomerular cells Adrenal medulla

Answer 48

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

Answer 49

bile salts are secreted by: a) parietal cells b) enterocytes c) goblet cells d) chief cells e) **hepatocytes**

Answer 50

polygenic – more than one type of both class I and class II ( 1 mark) polymorphic – multiple alleles in population means most individuals are heterozygous ( 1 mark)

Answer 51

* Lymphatic infiltration * Crypt hyperplasia * Flattened villi

Answer 52

what does this describe: 'directly anterior to the sulcus terminalis and extend in a V-shaped line across the root of the tongue' - foliate papillae - lingual tonsil - palatine tonsil **- vallate papillae** - foramen cecum of tongue

Answer 53

_Which one of the following actions is directly caused by gastrin?_ Stimulates aldosterone release Increases pancreatic secretions rich in digestive enzymes **Increases gastric H+ secretion** Decreases gastric emptying Increases pancreatic bicarbonate secretion Increases gut absorption of calcium

Answer 54

•Simple columnar epithelial cells (enterocytes)

Answer 55

which metabolism disorder causes a second wind of exercise? a) von Gierkes b) Hers * *c) McArdles** d) Galactosaemia e) hereditary fructose intolerance

Answer 56

ADH: 1. regulates osmolality of blood serum (increases reabsorbtion & causes dilution of blood serum) 2. vasoconstriction of arterial BP

Answer 57

which cells do you find lining peyers patches? a) G cells b) D cells c) T cells * *d) M cells** e) B cell

Answer 58

where is Fe absorbed in the body? * *a) duodenum** b) jejenum c) ileum d) ascending colon e) transverse colon

Answer 59

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

Answer 60

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

Answer 61

what type of disease if famial hypercholeserolemia? a) X linked recessive * *b) autosomal dom** c) autosomal rec d) Y-linked e) X-linked dom

Answer 62

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

Answer 63

_Filtration fraction:_ Can be estimated using creatinine clearance GFR \* plasma concentration Plasmacreatinine / urinarycreatinine Glomerular filtration rate / renal blood flow Renal plasma flow / (1 - Haematocrit) **Is typically around 0.20**

Answer 64

ubiqunione

Answer 65

which nerve is being tested here? * *a) median** b) ulnar c) radius d) axillary

Answer 66

What is the rate limiting enzyme of glycolysis? **PFK1** Glycogen synthase Glyocgen phosphorylase Glucose-6-phosphate dehydrogenase Isocitrate dehydrogenase

Answer 67

in nucleus - alter gene expression

Answer 68

what type of bacteria is *H. pylori?* gram-postive **gram-negative**

Answer 69

Hers disease result in more mild hypoglycemia (1) Hers disease PYGL gene is defected, so defect in glycogen phoshporylase means can break down liver glycogen (1) But can still undergo gluconeogensis (1) von Gierkes disease is defect in glucose-6-phosphatase, so cant break down glycogen --\> glucose at all. (1)

Answer 70

_Which one of the following actions is directly caused by CCK?_ **Decreases gastric emptying** Decreases pepsinogen secretion Decreases gallbladder contraction Increases gastric motility Decreases appetite Decreases gastric H+ secretion

Answer 71

which type of cells are bile salts secreted from? - goblet cells - paneth cells - enteroendocrine cells * *- hepatocytes** - parietal cells

Answer 72

_Glomerular filtration rate:_ Urine flow rate \* urine concentration **Is typically around 100 ml/min** UPAH \* V / PPAH GFR \* plasma concentration Is typically around 0.20 Renal plasma flow / (1 - Haematocrit)

Answer 73

how is fructose absorbed in the mucousal phase of digestion? a) primary active transport b) secondary active transport c) simple diffusion * *d) faciliated diffusion** e) paracellular transport glucose and galactose go via 2 AT through SGLT but fructose **does fac d.**

Answer 74

**hypothalamus !**

Answer 75

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

Answer 76

which type of receptor is insulin receptor? a) enzyme-linked b) GPCR c) ion channel * *d) tyrosine-kinase**

Answer 77

which cells found in the small intestine that are modified enterocytes that cover lymphoid nodules - parietal cells - goblet cells - paneth cells - enteroendocrine cells * *- m cells**

Answer 78

Which ligament is at risk in this boy? - radial collateral ligament - ulnar collateral ligament * *- annular ligament** - deltoid ligament

Answer 79

A 64-year-old man is admitted with a COPD exacerbation. He is hypoxic on admission with an SpO2 of 72%. He has a lactic acidosis on blood analysis. What is the rate limiting enzyme of the process which has resulted in the lactic acidosis? HMG-CoA reductase Fructose-1,6 biphosphatase **PFK1 -** **The rate limiting enzyme for glycoloysis is phosphofructokinase (PFK1)** Glycgen synthase Glucose 6 P deH

Answer 80

Which substance can be used to achieve the most accurate measurement of the glomerular filtration rate? Glucose Protein **Inulin** Creatitine PAH acid

Answer 81

which antibody protects agaisnt parasitic worms? a) IgG b) IgM c) IgA * *d) IgE** e) IgD

Answer 82

glutamate is an amino acid that also acts as an important ... a) steroid hormone **b) neurotransmitter** c) secondary messenger d) source of metabolic energy

Answer 83

TAG transport is mediated by: a) chylomicrons & IDLs * *b) chylomicrons & VLDLs** c) chylomicrons & LDLs d) chylomicrons & HDLs e) VLDLs and LDLs

Answer 84

which of the following messengers are use paracrine siginalling in to control stomach acid secretions? a) histamine only b) acetylcholine only c) gastrin & histamine d) somatostatin & gastrin * *e) somatostain & histamine**

Answer 85

You are developing a new drug for diabetes which acts to decrease synthesis of glucose in the liver from non-carbohydrate carbon substrates. You want to develop a drug which targets the the rate limiting enzyme. What enzyme will you target? **Fructose 1,6 biphosphatase The rate limiting enzyme for gluconeogenesis is fructose 1,6 bisphosphatase** HMG-CoA synthase HMG-CoA reductase Glutamine-PRPP amidotransferase Acetyl-CoA carboxylase

Answer 86

_Which one of the following actions is directly caused by somatostatin?_ Increases pancreatic bicarbonate secretion **Decreases pancreatic secretions** Stimulates release of insulin-like growth factors Increases glycogenolysis Increases gut absorption of calcium Stimulates thirst

Answer 87

which dietary molecule is essential for transmination to occur? **vitamin B6** vitamin B12 vitamin C vitamin B3

Answer 88

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

Answer 89

which is the sensory nerve innervation for gagging? a) trigeminal nerve b) facial nerve **c) glossopharnyngeal** d) vagus nerve e) hypoglossal

Answer 90

which of the following is correct? glucagon works on the liver and muscles to build up glycogen stores insulin works on liver to build glycogen stores **insulin works on the muscle and liver to build glycogen stores** glucagon works on the liver and muscles to break down glycogen stores insulin works on the muscle and liver to break down glycogen stores **1. insulin: muscle and liver - builds glycogen stores** **2. glucagon: only liver - breaks down glyocgen stores to release glucose** **3. adrenaline: muscles via a & b adrergic receptors - release glucose** **4 calcium: muscles via a & b adrergic receptors - release glucose**

Answer 91

_Increases pepsinogen secretion:_ VIP Renin CCK **Gastrin** Secretin Ghrelin

Answer 92

_Which one of the following actions is directly caused by antidiuretic hormone?_ Increases Na+ reabsorption in the renal distal tubule Stimulates aldosterone release Up-regulates alpha-1 receptors on arterioles Increases plasma calcium Vasoconstriction of vascular smooth muscle **Promotes water reabsorption in the collecting ducts of the kidneys by the insertion of aquaporin-2 channels**

Answer 93

Which one of the following stimulates gastric acid secretion? CCK Gastric inhibitory peptide Secretin **Histamine** Somatostatin

Answer 94

if you bang your elbow and get pins & needles running down you hand, which nerve is most likely affected? a) median b) radial * *c) ulnar** d) musculocutaneous

Answer 95

Which one of the following is the main inhibitory neurotransmitter in the spinal cord? Adrenaline Glutamate Serotonin Dopamine **Glycine** Glycine is the principal **inhibitory** neurotransmitter of the spinal cord

Answer 96

A 52-year-old male presents to his general practitioner with a two-month history of abdominal pain, occasional haematemesis and significant weight loss. He is sent for a gastroscopy, which identifies multiple gastric ulcers and thickened gastric folds. It is therefore suspected that the patient may have a gastrinoma and is sent for a secretin stimulation test (involves exogenous secretin administration) to confirm the diagnosis. What is the mechanism of action of this exogenous hormone? Carbohydrate digestion **Decreases gastric acid secretion** Stimulates gallbladder contractin Stimulates gastric acid secretion Stimulates pancreatic enzyme secretion

Answer 97

A patient has pins and needles in this distribution, which nerve is compressed? ## Footnote a) ulnar * *b) median** c) radius d) musculocutanous

Answer 98

which enzyme is not present in skeletal muscle? a) debranching enzyme b) phosphoglucomutase * *c) glucose-6-phosphatase** d) glycogen phosphorylase e) pyruvate dehydrogenase

Answer 99

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

Answer 100

which nerve innervates the muscles that causes gagging? a) trigeminal nerve b) facial nerve c) glossopharnyngeal **d) vagus nerve** e) hypoglossal

Answer 101

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

Answer 102

during the mechanism of T cell gut honing, what do gut dendritic cells secrete? a) CCR9 **b) retinoic acid - activates T cells to make a4B7 & CCR9** c) a4B7 d) MADCAM e) IgA

Answer 103

which nerve provides special sensory innervation to anterior portion of tongue? a) glossopharnygeal b) trigeminal c) vagus nerve d) hypoglossal * *e) facial nerve**

Answer 104

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

Answer 105

Which of the following best describes the mechanism of the body's response to a decrease in blood pressure? Decreased HR and vasoconstriction Decreased epithelial sodium channels in DCT Increased bradykinin **Insertion of AQP-2 channels in CD** Insertion of AQP-2 channels in thick ascending loop of Henle

Answer 106

intermediate density lipoproteins cause left over chylomicrons to become: a) HDLs & LDLs b) VLDL & HDLs **c) VLDL & LDLs** d) HDLs e) LDLs

Answer 107

the receptive reflex in the proximal part of the stomach causes what to be released? a) Ach * *b) CCK - vagal-vagal interaction that causes proximal stomach stretch so not immediatly full** c) NO d) Ca2+ e) cAMP

Answer 108

fats (& cholesterol) absorbed from GI tract, turn into chylomicrons and go into lymphatic system: here they interact with HDLs **- ApoC2 added:** allows chylomicrons to give its triglycerides to peripheral cells **- ApoE added:** allows chylomicron remenant to be taken up by the liver to deliver FA & cholesterol

Answer 109

**preproinsulin** gets turned into proinsulin, then at GA = insulin

Answer 110

A 6-day-old child is referred to a community paediatrician by a general physician for poor feeding, vomiting and increasing lethargy. The child was born at term via spontaneous vaginal delivery, and his antenatal scans report no complications. On examination, the baby looks floppy and tired. His nappy is wet and has a characteristic maple syrup odour. Given the most likely diagnosis, which of the following is a known complication if left untreated? Metabolic and resp acidosis Metabolic alkalosis Resp alkalosis **Metabolic acidosis** Resp acidosis **If left untreated, alpha-ketoacids build up in the blood resulting in metabolic acidosis (ketoacidosis).**

Answer 111

what type of transport do proteins undergo during mucosal phase of digestion? - facilitated diffusion - primary active transport * *- secondary active transport** - endocytosis

Answer 112

A 60-year-old male patient experiences uncontrolled hepatic bleeding during liver resection surgery. The 'Pringle manoeuvre' is performed whereby the hepatic artery, portal vein and common bile duct are clamped, thus interrupting the blood flow. The structures mentioned form the anterior boundary of the epiploic foramen. Which other vessel forms a boundary to this region? Abdominal aorta **IVC** Thoracic aorta Common hepatic artery Right renal artery

Answer 113

You are designing a research project looking at the effects of prolonged fasting on lipid stores. You want to study the effects of diet on breakdown of fats. You decide to monitor the concentrations of the rate limiting enzyme of this process in response to a high glucose load. What enzyme will you measure? Glycogen phosphorylase Isocitrate dehydrogenase PFK-1 Glycogen synthase **Cartinine-palmitoyl transferase -** ## Footnote **The rate limiting enzyme for lipolysis is carnitine-palmitoyl transferase I**

Answer 114

* Commonest HLA in people with celiac disease is.. * HLA-DQ1 **•HLA-DQ2** * HLA-DQ3 * HLA-DQ4

Answer 115

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

Answer 116

_Which one of the following actions is directly caused by growth hormone?_ Inhibits glucagon secretion **Increases gluconeogenesis** Increases glycogenolysis Inhibits insulin secretion Decreases gastric H+ secretion Increases renal reabsorption of calcium

Answer 117

**pyroxidal phosphate derived from vitamin B6**

Answer 118

_With regards to the gastrointestinal tract, submucosa:_ Contains the lamina propria Contains Auerbach's (myenteric) plexus **Contains Meissner's plexus** Contains the muscularis mucosae

Answer 119

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

Answer 120

which enzyme breaks alpha 1-4 glycosidic bonds? a) debranching enzyme b) phosphoglucomutase c) glucose-6-phosphatase * *d) glycogen phosphorylase** e) pyruvate dehydrogenase

Answer 121

_Which one of the following actions is directly caused by somatostatin?_ Increases gastric motility Increases growth hormone secretion Increases appetite Promotes water reabsorption in the collecting ducts of the kidneys by the insertion of aquaporin-2 channels Increases renal conversion of 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol **Decreases gallbladder contraction**

Answer 122

where in the GI tract are bile acids mostly absorbed? a) duodenum b) jejunum **c) ileum** d) ascending colon e) transverse colon (also absorbed in colon, but less so)

Answer 123

movement of water in gut crypt cells is controlled by which transporters? a) aquaporins b) ENAC c) ROMK * *d) CFTR** e) Na/K/Cl2

Answer 124

A patient becomes dehydrated which leads to increased absorption of water in the collecting duct. If you were to measure the concentration of his urine you would find that it is near to 1200mOsm/L Where in the nephron would you expect a similar osmolarity to be found? PCT Descending loop of Henle **Tip of loop of Henle** Thin ascending Loop of Henle Thick ascending Loop of Henle

Answer 125

* Tetrahydrobiopterin

Answer 126

Which one of the following best accounts for the action of PTH in increasing serum calcium levels? **Activation of vit. D to increase absorption of calcium from the small intestine** Direct stimulation of osteoclasts to absorb bone with release of calcium Stimulation of phosphate absorbtion at the DCT of the kidney Decreased porosity of the vessels at the Bowmans capsule to calcium Vasospasm of the afferent renal arteriole thereby reducing GFR and calcium urinary loss **PTH increases the activity of 1-α-hydroxylase enzyme, which converts 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol, the active form of vitamin D. Osteoclasts do not have a PTH receptor and effects are mediated via osteoblasts.**

Answer 127

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

Answer 128

ID the branch of the brachial plexus identified by the arrow axillary radial median **ulnar**

Answer 129

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

Answer 130

- **villus atrophy - crypt hyperplasia**

Answer 131

how are lipids absorbed in the mucosal phase of lipid digestion? a) primary active transport b) secondary active transport * *c) simple diffusion** d) faciliated diffusion e) paracellular transport

Answer 132

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

Answer 133

Where in the body is angiotensinogen produced? Adrenal cortex **Liver** Lungs Kidneyss Pancreas

Answer 134

ileal brake is caused be what entering the ileum? a) proteins b) carbs * *c) fats** d) minerals e) vitamins **- fats reach the ileum (even tho theyre meant to have been absorbed in duodenum) - causes release of peptide YY & glucagon-like peptide-1 (GLP-1) by enteroendocrine cells = slows gastric emptying**

Answer 135

A patient presents to their GP with dehydration due to diarrhoea and vomiting. This is detected by the kidneys as reduced renal perfusion causing the renin-angiotensin-aldosterone system to be activated. Which part of the adrenal gland is needed as part of this system? JXG cells Pulmonary endothelium **Zona glomerulosa - aldosterone is secreted from the zona glom** Zona fasciculata Zona reticularis

Answer 136

what colour does CLO test go if H. pylori is present? a) blue b) yellow c) green * *d) orange / red** e) purple

Answer 137

_What effect does angiotensin II have on common renal measurements?_ Decreased GFR, decreased renal plasma flow, no change in filtration fraction Increased GFR, no change in renal plasma flow, increase in filtration fraction Decreased GFR, no change in renal plasma flow, decrease in filtration fraction Decreased GFR, increased renal plasma flow, decrease in filtration fraction **Increased GFR, decreased renal plasma flow, increase in filtration fraction** Increased GFR, increased renal plasma flow, no change in filtration fraction

Answer 138

metabolism of glutamine releases a lot of what? urea NH3 **NH4+** uric acid NADH ## Footnote * a-keto glutarate glutamate glutamine: generates free ammonia (as NH4+) - a-ketoglutarate is needed for TCA cycle for energy.* * - Glutamine has 2 amino groups, glutmate has 1, a-keto glutarate has 0 - so each step removes/adds an amino group so the metabolism of glutamine releases a lot of ammonium.*

Answer 139

what do chief cells secrete in children? [1] **chymosin / rennin** function? [1] **coagulate** **milk** allowing it to be **retained longer in the stomach**

Answer 140

_Where is the majority of somatostatin secreted from?_ P/D1 cells lining the fundus of the stomach and epsilon cells of the pancreas S cells in upper small intestine Sertoli cells **D cells in the pancreas & stomach** I cells in upper small intestine Zona glomerulosa of adrenal cortex

Answer 141

Which one of the following hormonal agents will increase secretions of water and electrolytes in pancreatic juice? **- secretin** - aldosterone - somatostatin - cholecystokinin - adrenaline

Answer 142

_The thoracic duct of the lymphatic system empties in the.._ **•Left subclavian vein** * Left internal jugular vein * Left brachiocephalic vein * Left hemiazygos vein

Answer 143

cells can make which vitamin from tryptophan if they are deficient in it? vitamin B1 vitamin B2 **vitamin B3** vitamin B4 vitamin B5

Answer 144

A 6-month-old boy presents to the genetics clinic with a one-month history of swallowing and movement difficulties. A genetic test is done for rare diseases which demonstrates a four base-pair insertion on chromosome 15, causing defects in the enzyme hexosaminidase A. What type of genetic mutation is this? **Frameshift** Missense Nonsense Silent Synonymous

Answer 145

Class I: HLA-A, B and C Class II: HLA-DR, DP and DQ

Answer 146

A 16-year-old boy presents to the Emergency Department with acute onset pain in the right iliac fossa, nausea, vomiting, and fever. He has no significant past medical or surgical history. On examination, you find rebound tenderness at McBurney's point, guarding, and a positive Rovsing's sign. You strongly suspect appendicitis and the patient is later taken for surgery. Which of these is most likely to be a physiological response in this scenario? **Increased glucagon secretion: physiological stresses increase secretion of glucagon !!** Increased insulin secretion Reducde cortisol secretion Increased T4 secretion Reduced ACTH secretion

Answer 147

You are designing a research project looking at the pathophysiology of abetalipoproteinemia. You decide that a suitable target would be the rate limiting enzyme of lipogenesis. What enzyme will you target? Carbomyl phosphate synthestase I **Acetly CoA carboxylase** Glycogen phosphorylase Isocitratre dehydrogenase PFK-1 **Lipogenesis is the process by which acetyl-CoA is converted to fatty acids. The rate limiting enzyme for lipogenesis is acetyl CoA carboxylase.**

Answer 148

The most effective class of gastric anti-secretory drug **a.Proton pump inhibitors** b. Histamine (H2) receptor blocker c. Aluminium hydroxide d. Amoxycillin

Answer 149

_Which one of the following actions is directly caused by somatostatin?_ **Decreases gastric emptying** Increases secretion of melanocyte-stimulating hormone (MSH) and corticotrophin-releasing hormone (CRH) Increases renal reabsorption of calcium Increases gastric H+ secretion Increases glycogenolysis Increases growth hormone secretion

Answer 150

which of the following have supranuclear granules? - goblet cells * *- paneth cells** - enteroendocrine cells - m cells - parietal cells

Answer 151

Which ligament in the knee is being tested here? - anterior cruciate ligament * *- posterior cruciate ligament** - medial collateral ligament - lateral collateral ligament

Answer 152

which of the following binds to basophils and mast cells and activates these cells to produce antimicrobial factors to participate in respiratory immune defense in humans? - IgA - IgM - IgE * *- IgD** - IgG

Answer 153

which micronutrient is important in imprinting home to the gut mucosa from peyers patches? * *a) Vitamin A** b) Vitamin B c) Vitamin C d) Vitamin D e) Vitamin E makes **retinoic acid !!** - gut dendritic cells use retinoic acid to inform the niave T cells - causes niave T cells to change transcription to express CCR9 & a4B& to do gut honing

Answer 154

_What effect does vasodilation of afferent arterioles have on common renal measurements?_ Decreased GFR, increased renal plasma flow, decrease in filtration fraction Decreased GFR, decreased renal plasma flow, no change in filtration fraction **Increased GFR, increased renal plasma flow, no change in filtration fraction** Increased GFR, decreased renal plasma flow, increase in filtration fraction Decreased GFR, no change in renal plasma flow, decrease in filtration fraction Increased GFR, no change in renal plasma flow, increase in filtration fraction

Answer 155

A 16-year-old boy presents with muscle pain during exercise, early fatigue, and dark urine. He is diagnosed with McArdle's disease. What is the rate-limiting enzyme for the defective pathway in this disease? Isocitrate dehydrogenase Phosphofructokinase-1 Glycogen synthase **Glyocgen phosphorylase** Glucose-6-phosphate dehydrogenase

Answer 156

**B12 & vitamin D**

Answer 157

_Increases glycogenolysis:_ Cortisol Somatostatin Gastrin **Glucagon** Growth hormone Ghrelin

Answer 158

Which cell secretes hydrochloric acid? a. Mast cell b. Columnar cell **c.Parietal cell** d. Chief cell e. Goblet cell

Answer 159

which apoprotein acts as recognition signal for LDL to be taken up by peripheral cells? - Apo B48 * *- Apo B100** - Apo C2 - Apo E - Apo B10

Answer 160

which cells found in the small intestine secrete antimicrobe substances? - enterocytes - goblet cells * *- paneth cells** - enteroendocrine cells - m cells

Answer 161

which lipoprotein carries fats from the liver to peripheral cells: a) chylomicrons * *b) VLDLs** c) IDLs d) LDLs e) HDLs

Answer 162

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

Answer 163

lipoprotein lipase breaks down fats from inside lipoproteins and carries them into the cells. Which apoprotein is it activated by? - Apo B48 - Apo B100 * *- Apo C2** - Apo E - Apo B10

Answer 164

which of the following is correct? - glycogen synthase is activated by addition of P, glycogen phosphorylase is activated by removal of P * *- glycogen synthase is activated by removal of P, glycogen phosphorylase is activated by addition of P** - glycogen synthase is inhibited by addition of P, glycogen phosphorylase is inhibited by removal of P - glycogen synthase is inhibited by removal of P, glycogen phosphorylase is inhibited by addition of P ## Footnote **glycogen synthase is activated by removing P, inactivated by adding P glycogen phosphorylase is activated by adding P, inactivated by removing P**

Answer 165

the duodenal and jejunal breaks cause what to be released? a) Ach * *b) CCK** c) NO d) Ca2+ e) cAMP 2. release of CCK activates vagal efferents 3. as a result of vagal efferents: - reduces opening of pyloric sphincter - reductions contractions in corpus - enhances relaxation of fundus

Answer 166

insulin inhibits gluconeogenesis

Answer 167

what is used to capture this image? * *a) CT** b) MRI T1 c) MRI T2 d) plain radiograph

Answer 168

Tissue transglutaminase (tTG) or endomysium Gluten

Answer 169

_1. A patient with suspected celiac disease has IgA anti-TTG test which comes back within normal range. What could contribute to the false negative nature of this investigation? (2)_ * IgA deficient patient (1) * Patient isn’t actively consuming gluten (1) _2. What could be done to verify the patient’s celiac disease?_ * Perform total IgA blood test to assess IgA status of pt (1) * IgG-anti-TTG (1) * Ask patient to consume gluten for some time before redoing the tests (1) * Duodenal biopsy (after patient consumes gluten!!) (1)

Answer 170

where is the largest microbial colony found in the GI tract? a) stomach b) duodenum c) jejunum d) ileum * *e) colon** - not in small intestine bc: difficult env. for growth

Answer 171

The flat bones of the skull are formed by intramembranous ossification **True** False

Answer 172

immune cells have increased requirement for which co factor - B6 * *- NADPH - made via the pentose phosphate pathway** - NADH - FADH - B12

Answer 173

_Which one of the peritoneal ligaments connects the liver to the anterior abdominal wall?_ **Falciform ligament** Gastrocolic ligament Splenorenal ligament Hepatogastric ligament Gastrosplenic ligament Hepatoduodenal ligament

Answer 174

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

Answer 175

Which layer of the gastrointestinal tract contains Auerbach's (myenteric) plexus? **Muscularis externa** Submucosa Serosa Mucosa

Answer 176

zollinger-ellison syndrome (ZES) causes innappropriate secretions from which cell? a) parietal cells * *b) G cells - causes increased gastrin productio n** c) chief cells d) ECL likes e) mucous secreting cells

Answer 177

submanidublar gland recieves parasympathetic innervation from which nerve? a) glossopharnygeal b) trigeminal c) vagus nerve d) hypoglossal * *e) facial nerve**

Answer 178

_Which one of the following actions is directly caused by secretin?_ Vasoconstriction of vascular smooth muscle Decreases pepsinogen secretion Stimulates parietal cell maturation **Increases pancreatic bicarbonate secretion** Increases pancreatic secretions rich in digestive enzymes Stimulates release of insulin-like growth factors

Answer 179

parotid gland recieves parasympathetic innervation from which nerve? * *a) glossopharnygeal** b) trigeminal c) vagus nerve d) hypoglossal e) facial nerve

Answer 180

hypocalcemia causes the release of which hormone to regulate Ca2+ levels? - TSH * *- PTH** - FH - GHRH - ADH

Answer 181

_With respect to the phosphorylation of glucose, which one of the following is most associated with glucokinase?_ High affinity for glucose (low Km) **Induced by insulin** Low capacity (low Vmax) Not affected by insulin When glucose levels are low helps sequester glucose in the tissues Located in most tissues

Answer 182

_Where is the majority of CCK secreted from?_ P/D1 cells lining the fundus of the stomach and epsilon cells of the pancreas S cells in upper small intestine Sertoli cells D cells in the pancreas & stomach **I cells in upper small intestine** Zona glomerulosa of adrenal cortex

Answer 183

A 56-year-old man has chronic pancreatitis and is struggling to absorb fat-soluble components of his diet. Which of the following is a fat-soluble vitamin which has a role as an anti-oxidant during processes such as immune function and protection of cell membranes? Vit B **Vit E** Vit K Vit C Vit B

Answer 184

_Which one of the peritoneal ligaments contains the short gastric vessels?_ Splenorenal ligament **Gastrosplenic ligament** Hepatoduodenal ligament Hepatogastric ligament Falciform ligament Gastrocolic ligament

Answer 185

which vitamin deficiency is associated with pellegra? - vit. A - vit B1 - vit. B2 * *- vit. B3** - vit. B4

Answer 186

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

Answer 187

which vitamin is used in the as a cofactor in the Krebs Cycle and glycolysis? **- vitamin B1** - vitamin B2 - vitamin B3 - vitamin B6 - vitamin B12

Answer 188

where are CD4 T cells usually found in the gut? - epithelium - submucosa * *- lamina propria** - muscularis mucosa

Answer 189

which apoprotein do chylomicrons have on them: a) B100 b) B49 c) B101 * *d) B48** e) B102

Answer 190

_Which one of the following actions is directly caused by VIP?_ Increases proximal tubule Na+/H+ activity Increases gallbladder contraction Increases pancreatic bicarbonate secretion Decreases pancreatic secretions **Increases secretion of water from pancreas and intestines** Up-regulates alpha-1 receptors on arterioles

Answer 191

From which of the following does the epigastric artery originate? Internal iliac artery **External iliac artery** Superior vesical artery Inferior vesical artery None of the above

Answer 192

The citric acid cycle is responsible for the major share of energy release and supply during aerobic respiration. What is the rate limiting enzyme of the citric acid cycle? PFK1 Glycogen synthase Glyocgen phosphorylase Glucose-6-phosphate dehydrogenase **Isocitrate dehydrogenase**

Answer 193

Which one of the following is not an effect of cholecystokinin? It causes gallbladder contraction **It increases the rate of gastric emptying** It relaxes the sphincter of oddi It stimulates the pancreatic acinar cells It has a trophoc effect on pancreatic acinar cells

Answer 194

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

Answer 195

which lipoprotein carries fats from the liver to peripheral cells? chylomicron **very low density lipo** intermediate DL LDL HDL

Answer 196

Which cell secretes pepsinogen? a. Mast cell b. Columnar cell c. Parietal cell **d.Chief cell** e.Goblet cell

Answer 197

A: **component of visual pigments; anitoxidnat; prevents damage to lipids of cell surface membranes**(1) D: **Aids in the use of calcium and phosphorus** (1) E: **antioxidant** 1) K; **part of blood clotting cascade** (1)

Answer 198

which vitamin is used for closure of neural tube during development and if deficient, causes spina bifida: zinc copper **B9 - folate !!** B12 selenium

Answer 199

pectinate line [1] simple columnar --\> stratified squamous nonk epithelium

Answer 200

chylomicrons pick up which two apoproteins from HDL? * *a) ApoCII and ApoE** b) ApoCI and ApoB100 c) ApoCII and ApoB100 d) ApoC and ApoB48 e) ApoB48 and ApoB100

Answer 201

Prolactin is secreted from which part of the body? **Anterior pituitary** Hypothalamus Parathyroid gland Adrenal gland Posterior pituitary

Answer 202

which of the following is autosomal dominant? a) PKU b) medium chain actly coenzyme dehydrogenase (MCAD) c) von Gierkes disease d) Maple Syrup Urine Disease * *e) familal hypercholesterolemia**

Answer 203

Among all the masticatory muscles, X is the only one with horizontally arranged fibers. X =? a) medial pterygoid **b) lateral pterygoid** c) masseter d) temporalis

Answer 204

NSAIDS block which receptor on parietal cells? a) M3 b) CCK2 c) H2 d) somatostatin receptor * *e) prostaglandin receptor - causes decresease in mucous and bicarbonate production :(**

Answer 205

Julie, a 54-year-old female, presents to her GP with a lump in her groin. It is not associated with pain but becomes more prominent when she coughs. On examination, the GP notes the lump is inferior and lateral to the pubic tubercle, which aids his diagnosis of a femoral hernia. Therefore part of Julie's bowel had entered the femoral canal which causes a bulge into the femoral triangle, an anatomical region in the upper thigh. Laterally to medially, what contents can be found in this anatomical region? **Femoral nerve, femoral artery, femoral vein, empty space, lymphatics** Femoral artery, femoral vein, femoral nerve, empty space, lymphatics Femoral nerve, femoral vein, femoral artery, empty space, lymphatics Lymphatics, empty space, femoral nerve, femoral artery, femoral vein Lymphatics, empty space, femoral vein, femoral artery, femoral nerve

Answer 206

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

Answer 207

which micronutrient helps to improve childrens learning ability and cognitive development - vitamin A - vitamin B12 - zinc * *- iron: Fe helps Hb to carry oxygen to neurons in brain** - vitamin C

Answer 208

_Which layer of the gastrointestinal tract contains the muscularis mucosae?_ Submucosa **Mucosa** Serosa Muscularis externa

Answer 209

What is measured to obtain renal plasma flow? Creatinine **Para-amino hippuric acid (PAH)** Inulin Glucose Protein

Answer 210

paneth cells are found in **right side of colon only**

Answer 211

NAD & NADP pellegra

Answer 212

The left colic artery supplies the upper and lower parts of the descending colon. What artery does the left colic artery branch off? SMA Inferior gluteal artery **IMA** Inferior rectal artery Inferior epigatric artery

Answer 213

_Glomerular filtration rate:_ Is typically around 0.20 **Can be estimated using creatinine clearance** Glomerular filtration rate / renal blood flow Plasmacreatinine / urinarycreatinine UPAH \* V / PPAH Urine flow rate \* urine concentration

Answer 214

during glucose metabolism, the if there is a little cAMP levels, which of the following occurs? - glucagon and adrenaline activated - insulin is activated * *- glucagon an adrenaline inhibited** * *less glucose is released**

Answer 215

A 28-year-old man with a long-term history of alcohol is rushed to the emergency department following a prolonged seizure. His work-up fails to reveal any sinister causes of seizures. He has no history of epilepsy. The consultant attending to him believes that the seizure may be caused by a vitamin deficiency secondary to his chronic alcohol intake. Which one of the following vitamin deficiency may have caused the seizure? Vitamin B7 Vitamin B2 Vitamin B3 Vitamin B5 **Vitamin B6 -** **Vitamin B6 (pyridoxine) is required for the synthesis of GABA**

Answer 216

gastrin is secreted by G cells. which receptor does it bind to on parietal cells? a) M3 * *b) CCK₂** c) H₂ d) somatostatin receptor e) prostaglandin receptor

Answer 217

interstilial cells of cajal are associated with a major influx of what? a) Na+ b) K+ * *c) Ca2+** d) ACh into SMC - contraction occurs (also Na)

Answer 218

which nerve innervates the muscle that elevates the pharnyx during swallowing ? a) trigeminal nerve b) facial nerve * *c) glossopharnyngeal - stylopharnygeus muscle** d) vagus nerve e) hypoglossal

Answer 219

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

Answer 220

This patient has a congenital absence of a muscle. Which action at the shoulder would be significantly weakened? * *a) flexion** b) extension c) abduction d) external rotation

Answer 221

blunt trauma to peritoneum can be tear away from the which artery and cause internal bleeding? - left gastric artery - right gastric artery * *- splenic artery - cuz spleen is intraperitoneal so moves lots** - common hepatic artery - gastroduodenal artery

Answer 222

what is the correct label for this strucutre? a) rotundudm foramen b) manibular foramen * *c) mental foramen** d) ovale foramen e) hypoglossal foramen

Answer 223

An 8-year-old girl is brought to the physician due to developmental delay and seizure attacks since the age of 6. She presented with abnormal behaviour, ataxia, unusual laughing, intellectual disability, and mandibular prognathism. Genomic testing revealed a deletion in the 15q11-q13 chromosome. She was diagnosed with Angelman syndrome (AS). AS originates from the dysfunctional expression of the ubiquitin-protein ligase E3A gene on chromosome 15. Which of the following cellular activities is most likely to be impaired? Aerobic respiration Catabolism of very long chain fatty acids and AAs Folding of new proteins **Proteasomal degradation of protein**s - **Ubiquitin tagging destines proteins to proteasome for degradation** Translation of RNA into proteins

Answer 224

_Which one of the peritoneal ligaments contains the tail of the pancreas?_ **Splenorenal ligament** Gastrosplenic ligament Hepatoduodenal ligament Hepatogastric ligament Gastrocolic ligament Falciform ligament

Answer 225

_Which one of the following actions is directly caused by glucagon?_ Vasoconstriction of vascular smooth muscle Decreases osteoclastic activity Inhibits insulin secretion Decreases plasma phosphate **Increases glycogenolysis** Decreases renal reabsorption of phosphate

Answer 226

which of the following vitamins are antioxidants? - vitamin A & C - vitamin C only - vitamin A & E - vitamin A & C * *- vitamin A, C & E**

Answer 227

A 12-year-old boy is being investigated for coeliac disease and has recently had biopsies of both the small and large intestinal linings. In a normal biopsy, which of the following can be found in the lining of the small intestine but not in that of the large intestine? Muscularis mucosae Myenteric nerve plexus **Villi** Columnar epithelium Goblet cells

Answer 228

dorsal mesogastrium forms connections between: stomach & spleen [1] spleen and posterior ab. wall [1]

Answer 229

hormonal (RAAS) CNS (osmorecptors) kindeys

Answer 230

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

Answer 231

An 18-year-old man is referred to the acute medical team with nausea and vomiting. He is a type 1 diabetic and has recently been unwell. Blood tests confirm diabetic ketoacidosis, and he is started on an insulin infusion. What type of receptor does this treatment bind to? Beta-1 receptors GPRC Guanylate cylase receptors Ligand-gated ion channel receptors **Tyrosine kinase receptors**

Answer 232

_Which of the following is not a catabolic pathway?_ Glycolysis TCA cycle Glycogenolysis Gluconeogenesis **Glycogenesis** **Anabolic pathways** **build** complex molecules from simpler ones and typically need an input of energy. **Catabolic pathway**s involve the **degradation** (or breakdown) of complex molecules into simpler ones. Molecular energy stored in the bonds of complex molecules is released in catabolic pathways and harvested in such a way that it can be used to produce ATP.

Answer 233

PKU is a condition which is caused a mutation on the enzyme phenylalanine hydroxylase (or insufficiency of tetrahydrobiopterin) [1] therefore prevents conversion of phenylalanine into tyrosine. [1] The condition is normally autosomal recessive, which means that two individuals need to be carriers in order to for their offspring to have PKU. [1]

Answer 234

what type of cells line stomach? a. Squamous cell b. Pseudostratified cell **c.Columnar cell - simple columnar cells** d.Cuboidal call

Answer 235

which part of the manible serves as the muscle attachment point and moves the mandible? * *a) coronoid process** b) neck c) head d) ramus e) body

Answer 236

**Fructose-6-phosphate to Fructose-1,6-bisphosphate via the enzyme Phosphofructokinase-1.** Is regulated by: 1. ATP:AMP ratio 2. Citrate _(decreases activity)_ 3. Fructose-2,6-bisphosphate (_increased activity)_

Answer 237

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

Answer 238

which of the following is found in the stomach body? a) parietal and chief cells * *b) parietal and D cells & chief cells** c) mucous cells, D cells & chief cells d) mucous cells and D cells & G cells e) parietal cells, G cells & chief cells

Answer 239

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

Answer 240

during ox. phosph H+ are pumped across the inner mitochondrial matrix at which complexes? - complexes 1, 2 & 3 - complexes 1, 2 & 4 * *- complexes 1, 3, & 4** - complexes 2, 3 & 4

Answer 241

expression of VEGF - induces angiogenesis reduces expression of mitochondria

Answer 242

Where in the body is most angiotensin-converting-enzyme located? Adrenal cortex Liver **Lungs** Kidneyss Pancreas

Answer 243

this indicates weakenss of which muscle? **a) serratus anterior** b) deltoid c) trapezuis d) latissimus dorsi

Answer 244

insulin is present as what form when it is not used / stored? a) monomer b) dimer c) pentameter * *d) hexamer** **when active: monomer**

Answer 245

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

Answer 246

Which one of the following types of epithelium lines the lumenal surface of the normal oesophagus? **Non keratinsed stratified squamous epithelium** Ciliated columnar epithelium Keratinsed stratified squamous epithelium Non ciliated columnar epithelium None of the above

Answer 247

1. The sprinter uses anaerobic respiration to produce the required amount of ATP for his race. 2. This involves the break down of glucose to pyruvate to produce a net of 2 ATP. 3. This is converted into lactic acid to prevent entry into the TCA cycle, which ultimately requires oxygen. 4. The lactic acid is sent to the liver via the blood, and hence, as an acid, lowers the pH. 5. The lactic acid is converted back into glucose, at the cost of 6 ATP and is delivered back to the muscle.

Answer 248

which molecule coming into B langerhan cells in pancreas causes the secretion of insulin? a) Na+ b) K+ c) ACh **d) Ca2+** e) Cl-

Answer 249

which condition renders the body in a positive nitrogen balance? endurance exercise starvation a car accident **pregnancy**

Answer 250

Which one of the following structures will lie posterior to the epiploic foramen at this level? hepatic artery cystic duct hepatic portal vein greater omentum SMA **IVC** The epiploic foramen has the following boundaries: Anteriorly (in the free edge of the lesser omentum): Bile duct to the right, portal vein behind and hepatic artery to the left. PosteriorlyInferior vena cava Inferiorly1st part of the duodenum SuperiorlyCaudate process of the liver

Answer 251

which of the following is found in the stomach antrum? a) D cells and G cells b) G cells and mucous cells c) mucous cells, D cells & chief cells * *d) mucous cells and D cells & G cells** e) D cells & G cells & chief cells

Answer 252

which two hormones cause glycogen breakdown at the muscles? - insulin and adrenaline - adrenaline and glucagon * *- adrenaline and calcium** - calcium and glucagon - glucagon and insulin ## Footnote **glucagon only works in liver !!**

Answer 253

muscles of mastication are supplied by which nerve? a) hypoglossal b) glossopharyngeal c) facial nerve * *d) trigeminal nerve - V3 mandibular branch** e) vagus nerve

Answer 254

where in GI tract most likely to find payers patches? a) stomach b) duodenum c) jejunum * *d) ileum** e) colon

Answer 255

the transverse mesocolon

Answer 256

which of the following would a clinical deficiency cause peripheral neuropathy? ## Footnote vitamin A vitamin D **vitamin E** vitamin K

Answer 257

which nerve is most as risk from this fracture * *a) median** b) ulnar c) radius d) axillary

Answer 258

_Which one of the following actions is directly caused by angiotensin II?_ Promotes water reabsorption in the collecting ducts of the kidneys by the insertion of aquaporin-2 channels Increases Na+ reabsorption in the renal distal tubule Increases gut absorption of calcium Increases gluconeogenesis **Vasoconstriction of vascular smooth muscle** Converts angiotensinogen to angiotensin I

Answer 259

the adaptive reflex in the proximal part of the stomach causes what to be released? a) Ach b) CCK * *c) NO - causes relaxation of the stomach via ENS** d) Ca2+ e) cAMP

Answer 260

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

Answer 261

Rate controlling step: **o HCO3- + NH4+ --\> carbamoyl phosphate (via enzyme carbamoyl phosphate synthase 1)** o Requires 2 ATP. o Controlled allosterically by glutamate metabolite: N-acetyl glutamate - this is formed in an excess of glutamate, so drives urea cycle. **b) the two amino groups required from: aspartate (1) & ammonia (1)** **essentially is a shuttle reaction of NH4 into from aspartate and ammonia into urea**

Answer 262

hard palatine is made of which two bones? * *a) maxilla and palatine** b) vomer and ethmoid c) palatine and ethmoid d) vomer and palatine e) palatine and mandible

Answer 263

which of the following is not a primary retroperitoneal structure? - aorta - kidneys * *- pancreas** - ureter - anal canal

Answer 264

which apoprotein, added by HDL to a chylomicron, means the chylomicron remnant can be taken up by the liver to deliver FA & cholesterol? - Apo B48 - Apo B100 - Apo C2 * *- Apo E** - Apo B10

Answer 265

Which one of the following inhibits the secretion of insulin? **Adrenaline** Lipids Gastrin Arginine Vagal cholinergic activty

Answer 266

A 54-year-old woman is admitted with symptoms of a stroke, including difficulty speaking and vision changes. She was in a hair salon at the time and got a headache after having her hair washed. Investigation shows a vertebral arterial dissection, which is thought to be caused by hyperextending her neck. How does this blood vessel enter the cranial cavity? carotid canal **foramen magnum** foramen ovale foramane spinosum jugular foramen

Answer 267

T3 inhibits pituitary release of TSH

Answer 268

which of the following is not a pancreatic enzyme? * *-Pepsin** - Trypsinogen - Chymotripsinogen - Amylase - Lipase

Answer 269

A 24-year-old woman presents to her general practitioner with a 7-month history of fatigue, abdominal cramping, and abdominal bloating. It is suspected that she may have coeliac disease and the following blood test result is obtained: Tissue transglutaminase IgA+ve Which of the following immune cells is responsible for the production of this result? Eosinophils Macrophages Memory cells **Plasma cells** T cells

Answer 270

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

Answer 271

which cells in the stomach secrete pepsinogen? a) mucous secreting cells **b) chief cells** c) parietal cells d) D cell e) G cells

Answer 272

**CCK GIP -** (gastric inhibitory protein) **Secretin**

Answer 273

The soft palatine is supplied by which nerve? a) facial nerve b) trigeminal nerve c) glossopharyngeal nerve d) hypoglossal nerve * *e) vagus nerve**

Answer 274

which of the following have subnuclear granules? - goblet cells - paneth cells * *- enteroendocrine cells** - m cells

Answer 275

1. HIF1: Hypoxia induced factor down regulates mitochondria, which require oxygen to produce ATP via the TCA cycle and are therefore less useful in hypoxic conditions. Promotes VEGF expression. 2. VEGF: Increased vasculature and therefore oxygen supply, countering hypoxic conditions. 3. EPO increases the number erythrocytes produced, causing a higher haematocrit and therefore higher oxygen binding capacity. This is necessary for the marathon runner who primarily uses the TCA cycle to produce ATP in aerobic conditions, which requires large amounts of oxygen.

Answer 276

•**Intramuscular** **injections** of **hydroxocobalamin** because patient cannot release IF.

Answer 277

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

Answer 278

A 61-year-old man undergoes a carotid endarterectomy after carotid artery stenosis was found in investigations following a TIA. When he wakes he has a hoarse voice, which is still present and has not improved after 72 hours. He has also been refusing food. On examination, his gag reflex is not present. A CT head is performed which shows no abnormalities. What is the most likely cause of his symptoms? - Facial nerve injury - glossopharnygeal nerve injury - hypoglossal nerve injury **- vagus nerve injury** - stroke **All innervation for speech originates from the vagus (X) nerve so injuries to the vagus will cause speech problems**

Answer 279

* *internal thoracic artery** --\> superior epigastric artery * *external iliac artery** --\> inferior epigastric artery

Answer 280

A 13-year-old female presents with painful muscle cramp associated with early fatigue and 'red urine' with strenuous exercise. Blood glucose and lactate levels are normal. She is diagnosed with glycogen storage disease type V (McArdle disease). Which of the following enzymes is deficient in this patient? Glucose-6-phosphatase Glucose-6-phosphate dehydrogenase debranching enzyme **glycogen phosphorylase aka myophosphatase** GLucocerebroisdae

Answer 281

which is the active form of thyroid hormone? - T1 - T2 **- T3** - T4 - T5 ``` T4 = inactive T3 = active ```

Answer 282

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

Answer 283

_With respect to the phosphorylation of glucose, which one of the following is most associated with glucokinase?_ Not affected by insulin Low capacity (low Vmax) High affinity for glucose (low Km) Inhibited by glucose-6-phosphate When glucose levels are low helps sequester glucose in the tissues **When glucose levels are high helps store excessive glucose in the liver**

Answer 284

GLUT4 is located in which 3 locations? [3] - **adipose tissues - liver** - **skeletal muscle**

Answer 285

the motor supply to all of muscles of the tongue except the pataoglossus are innervated by? a) glossopharnygeal b) trigeminal c) vagus nerve * *d) hypoglossal** e) facial nerve

Answer 286

cytochrome C transfers electrons to oxygen at which complex in oxidative phosphorlyation? a) complex 1 b) complex 2 c) complex 3 * *d) complex 4**

Answer 287

the presence of which immune cell would signify significant oesphagitus? macrophage lymphocyte plasma cell neutrophil **eiosonophil**

Answer 288

interstitial cells of cajal

Answer 289

pepsinogen is activated by secretions from which cell? mucous lining stem **parietal: pepsinogen --\> pepsin by HCl of parietal** D cell G cell

Answer 290

which inflammatory cytokines are associated with CD? **IFN-γ** TNF-a IL-1 IL-6

Answer 291

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

Answer 292

which of the following is the linear alba? **A** B C D E F

Answer 293

which of the following is the inguinal ligmanet? A B **C** D E F

Answer 294

which of the following is the external oblique? A **B** C D E F

Answer 295

which of the following is the rectus abdominus? A B C D E **F**

Answer 296

which of the following is the tendinous intersections? A B C **D** E F

Answer 297

which artery becomes the inferior epigastric artery? internal iliac artery SMA IMA **external iliac artery** lower intercosal arteries

Answer 298

inability for cells to produce Acetyl CoA is produced by a deficiency in **vitamin B1** vitamin K vitamin C vitamin B2 vitamin B6

Answer 299

cricopharyngeus

Answer 300

**_upper oesophageal sphincter_:** produced by skeletal muscle **cricopharyngeus.** _anatomical sphincter_ * *_lower oesophageal sphincter:_** looks the same as oesophagus. _physiological sphincter._ aided by: a) **acute angle** of stomach enter b) right curs of the diaphragm: **pinch-cock** effect

Answer 301

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

Answer 302

geniohyoid

Answer 303

which of the following is foramen cecum of tongue? A B C **D** E

Answer 304

which of the following is foliate papillae? **A** B C D E

Answer 305

which of the following is lingual tonsil? A B **C** D E

Answer 306

which of the following is vallate papillae? A **B** C D E

Answer 307

which of the following is the foramen cecum ? A B C D **E**

Answer 308

which hormone acts to counter hypocalcemia? LH T3 TSH GnRH **PTH (parathyroid hormone)**

Answer 309

what is the overall net / gain or loss of ATP during glycolysis? **2 ATP gain** 2 ATP loss 4 ATP gain 4 ATP loss 38 Gain

Answer 310

what is the overall net / gain or loss of ATP during cori cycle? 2 ATP gain 2 ATP loss 4 ATP gain **4 ATP loss** 38 Gain

Answer 311

**ligamentum teres:** inferior aspect of the falciform ligament

Answer 312

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

Answer 313

which of the following is not a suprahyoid muscle? Stylohyoid Digastric **Sternohyoid** Geniohyoid Mylohyoid

Answer 314

which of the following is not an infrahyoid muscle? **Geniohyoid** Sternohyoid Omohyoid Sternothyroid Thyrohyoid

Answer 315

during ox. phosph H+ are pumped across the inner mitochondrial matrix at which complexes? - complexes 1, 2 & 3 - complexes 1, 2 & 4 * *- complexes 1, 3, & 4** - complexes 2, 3 & 4

Answer 316

**jejunum:** long vasa recta and fewer loops - A **ileum:** larger arcades and vasa recta are shorter - B

Answer 317

**jejunum:** long vasa recta and fewer loops - A **ileum:** larger arcades and vasa recta are shorter - B

Answer 318

which part of the gut is the appendix in? foregut **midgut** hindgut

Answer 319

_Which nerve provides parasympathetic innervation to the hindgut?_ Vagus nerve pelvic splachnic nerves pudendal nerve phrenic nerce

Answer 320

1. falicform ligament 2. greater omentum

Answer 321

cysteic artery

Answer 322

cysteic artery

Answer 323

lumbar splachnic nerve

Answer 324

absorption of amino acids through apical surface of intestinal cells occurs via? faciliated diffusion **Na-linked secondary active transport** Ca-linked secondary active transport Simple diffusion Paracellular diffusion

Answer 325

absorption of amino acids through basolateral surface of intestinal cells occurs via? **faciliated diffusion** Na-linked secondary active transport Ca-linked secondary active transport Simple diffusion Paracellular diffusion

Answer 326

which enzyme acts a sensor initiating production of insulin? **glucokinase** glycogen synthase glycogen phosphorylase PFK-1 PDH

Answer 327

Ach binds to which receptor on parietal cell to stimulate HCl production? M1 M2 **M3** H2 CCK2

Answer 328

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

Met SAQs Flashcards

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