NDM MCQ Final 2004

1

The specific dynamic effect (SDE) is one of the categories of energy use in the normal daily routine of humans. Which one of the following statements is CORRECT?


2

When humans become morbidly obese all of the following diseases increase in incidence. Indicate the one condition that has the highest elevation of incidence in the morbidly obese.


3

Which one of the following observations about nutrition is consistent with currently available evidence?


4

Atwater measured the heat output from various categories of food. Which one of the following foods produces 37 kJ/gram in humans (as measured by Atwater)?


5

With respect to the vitamin thiamin, which one of the following statements is INCORRECT?


6

Select the one CORRECT statement completion. Vitamin C is:


7

Which one of the following statements relating to nitrogen metabolism is CORRECT?


8

Identify the one CORRECT statement about alcoholic diseases and treatment.


9

Identify the one CORRECT statement about alcohol effects, pathology and treatment.


10

Consider the metabolic interactions shown in the diagram below. Identify the one CORRECT statement. [PICTURE HERE]


11

The drug metabolising factor designated as CYP 2D6 is inactive in 5-10% of Caucasians and 2% of Asians and Arabs. Affected individuals exhibit:


12

Select the one CORRECT completion of the following statement. Carnitine is sometimes used as a dietary supplement for athletes because:


13

Folate is a vitamin. Choose the one CORRECT statement relating to the vitamin folate.


14

One round of the Krebs (TCA) cycle (considered independently of other reactions) produces:


15

Peter Mitchell formulated the idea that a proton motive force (expressed as free energy) drives ATP synthesis associated with oxidative phosphorylation. It is known that a pH gradient and an electrical gradient both form about the inner mitochondrial membrane and we know that:


16

Pyruvate dehydrogenase is an enzyme:


17

Which one of the following statements about protein degradation is CORRECT?


18

Regarding the metabolism of nitrogen arising from protein degradation, which one of the following statements is CORRECT?


19

Regarding the role of ketone bodies in metabolism, which one of the following statements is CORRECT?


20

Which one of the following statements about the antagonists of insulin is INCORRECT?


21

Regarding the lipids associated with lipoproteins, which one of the following statements is CORRECT?


22

Regarding the LDL receptor, which one of the following statements is CORRECT?


23

The major source of muscle ATP during a 30 second bout of "all-out", high intensity exercise is:


24

As exercise intensity approaches maximal oxygen uptake, the predominant substrate for energy metabolism is:


25

Which one of the following is not used in the classification of a muscle fibre into a particular fibre type (i.e. fast or slow, Type I, IIA or IIB etc)?


26

Which one of the following statements about smooth muscle structure and function is INCORRECT?


27

Which one of the following statements comparing smooth and striated muscle is INCORRECT?


28

Which one of the following is an INCORRECT completion? Muscle fatigue may correlate with:


29

Which one of the following statements concerning skeletal muscle damage is INCORRECT?


30

Which one of the following statements about motor units in skeletal muscle is INCORRECT?


31

A patient has infarction of the jejunum and ileum due to an embolus arising from the left atrium of the heart. The vessel most likely occluded by this embolus is the:


32

A patient was stabbed in the left costovertebral angle (between the 12th rib and the 1st lumbar vertebra). The organ most likely penetrated is the:


33

A patient has obstructive jaundice due to a cancer in the head of the pancreas. The part of the biliary tract most likely compressed by the cancer at this site is the:


34

A patient presents with massive haemorrhage due to a peptic ulcer on the posterior wall of the body of the stomach. The vessel most likely eroded by this ulcer is the:


35

A vertical incision, through all layers of the anterior abdominal wall, just lateral to the margin of the rectus sheath and above the level of the arcuate line is contraindicated because:


36

Which one of the following statements concerning hepatic sinusoidal endothelial cells is INCORRECT?


37

Which one of the following statements concerning Kupffer cells is INCORRECT?


38

Which one of the following statements concerning hepatic regeneration is INCORRECT?


39

Which one of the following statements concerning haemochromatosis is INCORRECT?


40

Which one of the following statements concerning the features of fulminant hepatitis is INCORRECT?


41

Which one of the following statements concerning hepatic stellate cells is INCORRECT?


42

Which one of the following is an INCORRECT statement?


43

Which one of the following is NOT a clinical feature of anorexia nervosa?


44

Which one of the following is NOT a feature of the metabolic syndrome?


45

Nephrotic kidney disease presents with which one of the following key symptoms?


46

There are multiple causes of insulin resistance. Select one of the following that is NOT considered to be a contributor to insulin resistance.


47

Which one of the following statements regarding arachidonic acid metabolism is INCORRECT?


48

Select one statement about gastritis that is CORRECT.


49

Select one statement about gastric ulcers that is CORRECT.


50

Select one statement about acute appendicitis that is CORRECT.


51

With regard to enteric neurons which one of the following statements is INCORRECT?


52

Which one of the following is NOT among the known enteric neurotransmitters?


53

In radiographic (X-ray) imaging of the abdomen which one of the following does NOT influence the amount of absorption of X-rays by the body?


54

In regard to the blood supply of the liver which one of the following is CORRECT?


55

In regard to radiological imaging of the bile ducts which one of the following is NOT able to display normal bile ducts?


56

In vitro cultivation of intestinal contents from healthy humans has indicated that the predominant community of the intestinal microbiota comprises:


57

Which one of the following enzymes is not elevated in liver damage?


58

Identify the one condition that is LEAST LIKELY to be the cause of elevated serum ALP (alkaline phosphatase) levels.


59

Select the one statement about serum AST (aspartate transaminase) and ALT (alanine transaminase) levels that is INCORRECT.


60

Select the one statement about serum enzymes measured in pathology tests that is INCORRECT.


61

Select the one statement regarding the role of specific blood cells that is INCORRECT.


62

Given that the molecule diphosphoglycerate is also known as 1,2-bisphosphoglycerate, select the one statement about oxygen transport and red cells that is INCORRECT.


63

Select the one statement about thalassaemia that is INCORRECT.


64

Which of the following statements regarding full and partial agonists is always CORRECT?


65

Which one of the following statements is CORRECT?


66

Which one of the following types of drugs could selectively inhibit the increase in cardiac contractile force in response to adrenaline, but not in response to histamine?


67

The glomerulus consists of a tuft of capillaries within Bowman's capsule. The filtration barrier between the capillary lumen and Bowman's space includes which one of the following cell types?


68

The tubule of each nephron runs through both the cortex and medulla before connecting to the collecting duct. Which one of the following segments of this system are confined to the medulla?


69

Regarding secretion of drugs by the kidney, which one of the following statements is INCORRECT?


70

Which of the following statements related to liver metabolic functions is/are CORRECT? A) Fibrinogen is synthesised by the liver. B) The liver synthesises glucagon. C) Urea is synthesised by the liver. D) The liver synthesises glucose from fatty acid metabolic products (Acetyl Co A).


71

Which of the following statements related to abnormal liver function and bilirubin is/are CORRECT? A) The presence of unconjugated bilirubin in plasma helps to distinguish hepato cellular from obstructive jaundice. B) Failure of conjugation of bilirubin is the primary defect leading to jaundice in hepato cellular disease. C) Defective uptake of bilirubin by liver cells is the major reason for jaundice in premature babies. D) An early sign of hepato cellular disease is a dark urine.


72

Which of the following statements related to acute jaundice and liver is/are CORRECT? A) In complete obstruction of the bile duct neurological symptoms develop rapidly. B) Transaminases in plasma are markedly elevated in obstructive jaundice. C) In hepato cellular jaundice bilirubin in plasma is principally unconjugated. D) Serum alkaline phosphatase is elevated in obstructive jaundice.


73

Which of the following statements related to liver dysfunction is/are CORRECT? A) A low plasma albumin is a common finding in acute liver dysfunction. B) Albumin synthesis is impaired in acute liver failure. C) Portal-systemic venous anastomosis are common in acute liver disease. D) Albumin synthesis is impaired in chronic liver dysfunction.


74

Which of the following statements related to liver dysfunction is/are CORRECT? A) An impaired coagulation mechanism is often present in acute liver dysfunction. B) Impaired coagulation responds to Vit K injections in acute liver failure. C) Synthesis of some of the coagulation factors requires Vitamin K. D) Signs of abnormal oestrogen metabolism are frequently seen in acute liver failure.


75

Which of the following statements related to the glomerulus and glomerular filtration is/are CORRECT? A) GFR depends upon filtration area. B) There is little or no pressure drop along the glomerular capillary. C) GFR may increase with increased blood flow. D) The albumin concentration in the efferent arteriole is lower than in the afferent arteriole.


76

Which of the following statements related to the proximal tubule is/are CORRECT? A) Na+-K+-2Cl cotransport is important for Na+ reabsorption by the proximal tubule. B) Angiotensin II stimulates Na+-H+ cotransport in the proximal tubule. C) Renin directly stimulates Na+-H+ countertransport by the proximal tubule. D) Weak acids are actively reabsorbed by the proximal tubule.


77

Which of the following statements related to the proximal tubule is/are CORRECT? A) Phosphate reabsorbed in proportion to sodium reabsorption by the proximal tubule. B) Increased cyclic AMP in proximal tubule increases sodium reabsorption. C) Natriuretic peptide reduces sodium and water reabsorption by the proximal tubule. D) Angiotensin II stimulates Na+-H+ cotransport in the proximal tubule.


78

Which of the following statements related to the collecting tubule or duct is/are CORRECT? A) Lumen PD (potential difference) of the collecting tubule is made more negative by aldosterone. B) HCO3 - in lumen of the collecting tubule increases H+ excretion by the kidney. C) The collecting tubule can dilute the urine. D) Low plasma pH causes increased K+ excretion.


79

Which of the following statements related to the loop of Henle is/are CORRECT? A) ADH increases water permeability of the thick ascending limb of the loop of Henle Na+ concentration at end of the loop of Henle is about 100 mmol/l. B) K+ leaks back into the lumen of the thick ascending limb of the loop of Henle. C) Transport in the thick ascending limb of the loop of Henle depends upon primary chloride transport. D) Na+ K+ 2Cl- cotransport exists at the luminal membrane of the thick ascending limb of the loop of Henle.


80

Which of the following statements related to JGA (juxtaglomerular apparatus) or the cortical diluting segment is/are CORRECT? A) Angiotensin II mediates TG (tubulo glomerular) feedback. B) Efferent arteriole is the main controller of TG (tubulo glomerular) feedback. C) Aldosterone increases transport in the macula densa cells. D) Efferent arteriole is more sensitive to circulating angiotensin II than the afferent arteriole.


81

Which of the following statements related to the renin angiotensin aldosterone system is/are CORRECT? A) Increased angiotensin II will increase filtration fraction. B) A low blood pressure in the kidneys causes renin release. C) Angiotensin II increases salt appetite. D) Angiotensin II decreases thirst.


82

Which of the following statements related to acid base is/are CORRECT? A) HCO3 - loss in the urine corrects metabolic alkalosis. B) Na+-H+ counter transport is important in the proximal tubule. C) H+ K+ ATPase causes H+ secretion in the collecting tubule. D) Na+-H+ counter transport is important in the collecting duct to secrete H+.


83

Which of the following statements related to acid base is/are CORRECT? A) Proton (H+) secretion in the collecting tubule is increased by aldosterone. B) Proton (H+) excretion in the urine is increased by a high HCO3 - in the lumen of the collecting tubule. C) Proton (H+) secretion in the collecting tubule is increased by HCO3 - in the lumen. D) NH3 in the urine is the major excretory carrier of an acid load.


84

Which of the following statements related to water balance and urine concentration is/are CORRECT? A) Vasopressin activates adenyl cyclase in the collecting duct. B) Vasopressin release is increased by alcohol. C) Vasopressin action altering water permeability depends on activation of microfilaments. D) Vasopressin is secreted in response to a low plasma osmolality.


85

Which of the following statements related to calcium and phosphate is/are CORRECT? A) Plasma phosphate rises in proportion to a decrease in GFR. B) Plasma ionized calcium is decreased by acidosis. C) Parathyroid hormone decreases proximal tubule Na+ reabsorption. D) Parathyroid hormone causes increased urine Na+ excretion.


86

Which of the following statements related to diuretics is/are CORRECT? A) Hypokalaemic alkalosis is a common side effect of diuretic therapy. B) Amiloride reduces adverse effects of thiazide diuretics. C) Hyperkalaemic acidosis may occur with diuretic therapy. D) Furosemide binds to the NaCl cotransporter.


87

Which of the following statements related to hypotension and acute renal failure is/are CORRECT? A) A person with acute tubular necrosis usually has a urine output < 400 ml/day. B) Acidosis is common in acute renal failure. C) A urine sodium > 60 mmol/litre in an oliguric patient suggests that the process is not immediately reversible. D) Hypokalaemia is common in acute renal failure.


88

Which of the following statements related to proteinuria is/are CORRECT? A) In established oedema, due to hypoalbuminaemia, plasma volume measured by albumin space may be normal or increased. B) Total body sodium is the important determinant of plasma volume. C) Urinary albumin excretion in normal people is < 30 mg/day. D) A person with pitting oedema up to their knees and a serum Na+ of 125 mmols/l will be depleted of Na+.


89

Which of the following statements related to chronic renal failure is/are CORRECT? A) Body sodium depletion may occur in chronic renal failure. B) Body sodium excess may occur in chronic renal failure. C) Hypotension may occur in chronic renal failure. D) Hypertension may occur in chronic renal failure.


90

Which of the following statements related to gastrin is/are CORRECT? A) Gastrin increases stomach contractility. B) Gastrin secretion is stimulated by stomach distension. C) Gastrin increases gastro oesophagal sphincter tone. D) Gastrin effects on acid secretion are additive to that of acetyl choline.


91

Which of the following statements related to acid secretion by the gastric gland is/are CORRECT? A) The effect on acid secretion of acetyl choline and gastrin is additive. B) The effect on acid secretion of histamine and gastrin is additive. C) The effect on acid secretion of acetyl choline and histamine is additive. D) Acid secretion is inhibited by sodium bicarbonate.


92

Which of the following statements related to peptic ulceration is/are CORRECT? A) Most acid is secreted from the body of the stomach. B) Aspiration of gastric juice will lead to a metabolic alkalosis. C) Acid secretion can be reduced by antrectomy. D) Bicarbonate is secreted by gastric mucosal cells.


93

Which of the following statements related to the pancreas and its secretion is/are CORRECT? A) Secretion of bicarbonate by the pancreas is stimulated by cholecystokinin. B) Pancreatic duct cell secretions are stimulated by secretin. C) Trypsinogen is activated in the pancreas. D) Pancreatic secretions contain a lipase.


94

Which of the following statements related to sodium and water absorption by the small intestine is/are CORRECT? A) Sodium absorption proceeds by Na+-amino acid cotransport. B) Sodium absorption proceeds by Na+-glucose countertransport. C) Sodium absorption proceeds by Na+-H+ countertransport. D) Sodium absorption proceeds by Na+-fructose cotransport.


95

Which of the following statements related to liver metabolic functions is/are CORRECT? A) Globulins are synthesised by the liver. B) Fibrinogen synthesis by the liver depends upon Vitamin K. C) Clotting factor synthesis by the liver depends upon Vitamin D. D) Blood clotting factors are synthesised by the liver.


96

Which of the following statements about volume of distribution is/are CORRECT? A) Drugs which are highly lipid soluble tend to have large volumes of distribution. B) Volume of distribution is equal to the amount of drug in the body divided by the concentration of drug in the plasma. C) Volume of distribution may correspond to a physiological volume, such as plasma volume. D) Volume of distribution may be one or two orders of magnitude greater than total body water.


97

Which of the following statements regarding drug concentration following intravenous administration is/are CORRECT? A) The peak concentration of drug in plasma will be lower following an intravenous infusion than for the same dose of drug administered by a bolus injection. B) For most drugs, the rise in concentration of drug in plasma is linear during intravenous infusion. C) For most drugs, doubling the intravenous infusion rate of a drug will lead to a doubling of the steady state concentration of drug in plasma. D) Once an intravenous infusion of a drug is stopped, the concentration of drug in plasma remains constant.


98

Which of the following statements regarding the behaviour of drugs following oral administration is/are CORRECT? A) The bioavailability of drugs following oral administration is affected by the extent to which they are absorbed. B) The bioavailability of drugs following oral administration is affected by the extent to which they undergo first pass hepatic metabolism. C) The peak concentration of drug in plasma will be lower following oral administration than for the same dose of drug administered by a bolus intravenous injection. D) Drugs administered orally usually distribute evenly throughout the body.


99

Which of the following statements regarding the half life of drugs is/are CORRECT? A) The half life of a drug can be used to determine the frequency of dosing of a drug. B) Drugs with a long half life may require administration of a loading dose. C) The time taken to reach a steady state concentration of drug in plasma during a long term intravenous infusion is proportional to the half life of the drug. D) Kidney and renal disease often shorten the half life of a drug.


100

Administration of the competitive muscarinic receptor antagonist atropine to a patient can sometimes cause an increase in heart rate, but sometimes does not. When would atropine cause an increase in heart rate? A) When the parasympathetic tone to the heart is high because of acutely elevated blood pressure. B) When both parasympathetic and sympathetic tone to the heart are elevated. C) When the patient is being treated with a stable muscarinic receptor agonist. D) When the sympathetic tone to the heart is high because of acutely lowered blood pressure.