RMCQ-PART

Question 1

What is the term used to describe the strength of mechanical deformation necessary to elicit an action potential in somatosensory cutaneous mechanoreceptors?
a) Adaptation threshold
b) Receptor threshold
c) Generator potential threshold
d) Action potential threshold

Answer 1

c) Generator potential threshold

Question 2

Which of the following cutaneous mechanoreceptors is considered a slowly-adapting receptor?
a) Merkel cell
b) Meissner corpuscle
c) Pacinian corpuscle
d) Ruffini ending

Answer 2

a) Merkel cell

Question 3

How does the Merkel complex convert a mechanical stimulus into an electrical signal in the afferent neuron?
a) By producing a rapid stream of neuropeptides
b) By generating a rapidly adapting action potential
c) By distorting the Merkel cell and releasing neuropeptides
d) By triggering the activation of surrounding mechanoreceptors

Answer 3

c) By distorting the Merkel cell and releasing neuropeptides

Question 4

Which two macrovascular diseases are Mr. Abrahams at risk of developing if he doesn’t maintain appropriate glucose control?
a) Diabetic retinopathy and peripheral arterial disease
b) Myocardial infarction and stroke
c) Diabetic nephropathy and deep vein thrombosis
d) Atherosclerosis and congestive heart failure

Answer 4

b) Myocardial infarction and stroke

Question 5

Apart from the ulcer and decreased sensation in his feet, which two other end organs are at risk for microvascular disease in Mr. Abrahams?
a) Liver and lungs - Screening: Liver function tests and chest X-ray
b) Kidneys and retina - Screening: Urine dipstick and fundoscopy
c) Brain and heart - Screening: CT scan and ECG
d) Pancreas and spleen - Screening: Pancreatic enzymes and ultrasound

Answer 5

b) Kidneys and retina - Screening: Urine dipstick and fundoscopy

Question 6

Why is an increased prolactin a common feature of primary hypothyroidism?
a) Thyroid hormones directly stimulate prolactin production
b) Hypothyroidism causes decreased dopamine release, leading to increased prolactin
c) Hypothyroidism increases thyroid-releasing hormone (TRH), which stimulates prolactin
d) Prolactin inhibits the production of thyroid hormones, leading to hypothyroidism

Answer 6

c) Hypothyroidism increases thyroid-releasing hormone (TRH), which stimulates prolactin

Question 7

Match the most likely thyroid hormone pattern with the clinical diagnosis:
Clinical Diagnosis Thyroid Hormone Pattern

Thyroid hormone resistance _____
Untreated primary hypothyroidism _____
Subclinical hyperthyroidism _____
Molar pregnancy producing excessive hCG _____
a) a - Increased free T4, increased TSH
b) b - Normal free T4, decreased TSH
c) c - Decreased free T4, increased TSH
d) d - Increased free T4, decreased TSH

Answer 7

Thyroid hormone resistance - a) Increased free T4, increased TSH
Untreated primary hypothyroidism - c) Decreased free T4, increased TSH
Subclinical hyperthyroidism - b) Normal free T4, decreased TSH
Molar pregnancy producing excessive hCG - d) Increased free T4, decreased TSH

Question 8

What could cause a falsely decreased level of HbA1c?
a) Increased red blood cell lifespan
b) Decreased red blood cell turnover
c) Hemolysis of red blood cells
d) Spherocytosis

Answer 8

d) Spherocytosis

Question 9

What happens to extracellular potassium levels when insulin is administered?
a) They remain unchanged
b) They increase
c) They decrease
d) They fluctuate irregularly

Answer 9

c) They decrease

Question 10

Which counter-regulatory hormone increases blood glucose levels and belongs to the peptide hormone category?
a) Epinephrine
b) Cortisol
c) Growth hormone (GH)
d) Glucagon

Answer 10

d) Glucagon

Question 11

Mr. Abrahams is on metformin for his type 2 diabetes. Which of the following is the primary mechanism of action of metformin?
a) Stimulation of insulin secretion
b) Inhibition of hepatic gluconeogenesis
c) Enhancement of peripheral glucose uptake
d) Promotion of beta-cell regeneration

Answer 11

b) Inhibition of hepatic gluconeogenesis

Question 12

What is the most likely cause of Mr. Abrahams’ burning feeling in his feet and his difficulty in adhering to his diet and exercise?
a) Peripheral neuropathy
b) Plantar fasciitis
c) Gout
d) Osteoarthritis

Answer 12

a) Peripheral neuropathy

Question 13

How often should Mr. Abrahams take his metformin medication based on the information provided?
a) Once daily
b) Twice daily
c) Three times daily
d) Four times daily

Answer 13

b) Twice daily

Question 14

Which type of diabetes is Mr. Abrahams diagnosed with?
a) Type 1 diabetes
b) Type 2 diabetes
c) Gestational diabetes
d) Latent autoimmune diabetes in adults (LADA)

Answer 14

b) Type 2 diabetes

Question 15

What is the purpose of referring Mr. Abrahams to a dietician?
a) To receive counseling on lifestyle changes related to diabetes management
b) To provide dietary supplements for weight loss
c) To recommend a specific exercise regimen
d) To monitor his blood glucose levels

Answer 15

a) To receive counseling on lifestyle changes related to diabetes management

Question 16

What is the significance of Mr. Abrahams’ elevated HbA1c level?
a) It indicates his current blood glucose level
b) It reflects his average blood glucose levels over the past few months
c) It is a measure of his fasting blood glucose level
d) It shows his blood glucose levels after meals

Answer 16

b) It reflects his average blood glucose levels over the past few months

Question 17

Which medication is commonly used as a first-line treatment for hypertension?
a) Beta-blockers
b) Calcium channel blockers
c) Angiotensin-converting enzyme (ACE) inhibitors
d) Diuretics

Answer 17

c) Angiotensin-converting enzyme (ACE) inhibitors

Question 18

What is the primary purpose of taking Mr. Abrahams’ fasting HGT measurement?
a) To assess his blood glucose levels after a meal
b) To evaluate his blood glucose control during the night
c) To determine his blood glucose levels before starting medication
d) To monitor his blood glucose response to exercise

Answer 18

c) To determine his blood glucose levels before starting medication

Question 19

What are hematopoietic growth factors?
a) Soluble proteins that regulate proliferation and differentiation of hematopoietic progenitor cells
b) Enzymes involved in DNA replication during hematopoiesis
c) Transcription factors that control gene expression in red blood cells
d) Receptors on platelets that promote blood clotting

Answer 19

a) Soluble proteins that regulate proliferation and differentiation of hematopoietic progenitor cells

Question 20

How do growth factors act on a cellular level?
a) They directly activate gene transcription in hematopoietic cells
b) They bind to cell surface receptors and activate intracellular signaling pathways
c) They inhibit the differentiation of hematopoietic progenitor cells
d) They induce apoptosis in mature blood cells

Answer 20

b) They bind to cell surface receptors and activate intracellular signaling pathways

Question 21

What is the main difference between lymphoma and leukemia?
a) Lymphoma originates in lymphoid tissues, while leukemia originates in bone marrow
b) Lymphoma spreads to the bone marrow, while leukemia spreads to lymphoid tissues
c) Lymphoma is characterized by abnormal proliferation of mature lymphocytes, while leukemia involves immature blasts
d) Lymphoma is typically associated with solid tumors, while leukemia is characterized by circulating malignant cells

Answer 21

a) Lymphoma originates in lymphoid tissues, while leukemia originates in bone marrow

Question 22

Which of the following is NOT a possible cause of lymphocytosis?
a) Reactive viral infection
b) Transient stress response
c) Adrenaline administration
d) Splenectomy

Answer 22

d) Splenectomy

Question 23

How can bone marrow aspiration and trephine biopsy contribute to the diagnosis of a lymphoid malignancy?

a) They provide information about the patient’s immune status
b) They help identify specific gene mutations associated with lymphoid malignancies
c) They allow for the examination of morphological and immunophenotypic features of the bone marrow
d) They provide direct visualization of lymph nodes affected by the malignancy

Answer 23

c) They allow for the examination of morphological and immunophenotypic features of the bone marrow

Question 24

What are the three basic components of treatment for leukemia?
a) Surgery, radiation therapy, and targeted therapy
b) Chemotherapy, immunotherapy, and stem cell transplantation
c) Chemotherapy, supportive care, and psychosocial support
d) Hormone therapy, targeted therapy, and immunotherapy

Answer 24

c) Chemotherapy, supportive care, and psychosocial support

Question 25

Which drug is used in the immediate management of acute promyelocytic leukemia (APL)?
a) Methotrexate
b) Cyclophosphamide
c) All-trans retinoic acid (ATRA)
d) Imatinib

Answer 25

c) All-trans retinoic acid (ATRA)

Question 26

What is the main difference between autologous and allogeneic transplantation?
a) Autologous transplantation uses the patient’s own stem cells, while allogeneic transplantation uses a donor’s stem cells.
b) Autologous transplantation is performed in the patient’s bone marrow, while allogeneic transplantation is performed in the spleen.
c) Autologous transplantation is used for solid tumors, while allogeneic transplantation is used for hematological malignancies.
d) Autologous transplantation requires a fully matched sibling donor, while allogeneic transplantation does not.

Answer 26

a) Autologous transplantation uses the patient’s own stem cells, while allogeneic transplantation uses a donor’s stem cells.

Question 27

What specific test should be requested on the bone marrow sample of a patient with suspected chronic myeloid leukemia (CML) to confirm the diagnosis?
a) Complete blood count (CBC)
b) Bone marrow biopsy
c) Cytogenetics/Karyotyping
d) Immunophenotyping by flow cytometry.

Answer 27

c) Cytogenetics/Karyotyping

Question 28

Which genetic abnormality is associated with chronic myeloid leukemia (CML)?
a) t(9;22) - Philadelphia chromosome
b) t(14;18) - Burkitt’s lymphoma translocation
c) t(8;21) - Acute myeloid leukemia (AML) translocation
d) t(15;17) - Acute promyelocytic leukemia (APL) translocation

Answer 28

a) t(9;22) - Philadelphia chromosome

Question 29

Which drug is used to treat herpes simplex infections, and what is its mechanism of action?
a) Amantadine - blocks viral entry into host cells
b) Acyclovir - inhibits viral DNA synthesis by acting as a chain terminator
c) Oseltamivir - inhibits viral neuraminidase activity
d) Ribavirin - disrupts viral protein synthesis

Answer 29

b) Acyclovir - inhibits viral DNA synthesis by acting as a chain terminator

Question 29

Which drug is used to treat herpes simplex infections, and what is its mechanism of action?
a) Amantadine - blocks viral entry into host cells
b) Acyclovir - inhibits viral DNA synthesis by acting as a chain terminator
c) Oseltamivir - inhibits viral neuraminidase activity
d) Ribavirin - disrupts viral protein synthesis

Answer 29

b) Acyclovir - inhibits viral DNA synthesis by acting as a chain terminator