NDM MCQ Final 2006

1

Which of the following statements regarding arachidonic acid metabolism is CORRECT?


2

Which one of the following statements about metabolic changes during an overnight fast is CORRECT?


3

Which one of the following statements about the structure and secretion of insulin is CORRECT?


4

Which one of the following statements about turnover (ie synthesis and breakdown) of muscle protein is CORRECT?


5

Which one of the following statements about the role of the liver in metabolism is CORRECT?


6

Which one of the following statements about the metabolism of cholesterol is CORRECT?


7

Which one of the following statements about lipid metabolism and lipoproteins is CORRECT?


8

Which one of the following statements about the maintenance of blood glucose concentration is CORRECT?


9

Which one of the following statements about the role and metabolism of proteins is CORRECT?


10

Which one of the following is the major fuel for contracting skeletal muscle during exercise at approximately 75% of maximal aerobic capacity?


11

Visceral obesity is associated with an increased risk of metabolic disease. Which one of the following is an important intramuscular characteristic that is related to a lower accumulation of visceral fat?


12

With respect to insulin secretion, which one of the following statements is CORRECT?


13

With respect to the aetiology of type 2 diabetes, which one of the following statements is NOT CORRECT?


14

Which one of the following is NOT a method of gradation of skeletal muscle contraction?


15

With respect to segmented neutrophil granulocytes which one of the following is CORRECT?


16

With respect to beta thalassaemia minor which one of the following is CORRECT?


17

The triad of subnormal serum iron, low normal serum transferrin, and high normal serum ferritin best correlates with:


18

The posterior wall of the inguinal canal is formed throughout by the


19

The arterial supply to the stomach is derived from the


20

The hilum of the spleen is directly related to the


21

The accessory pancreatic duct drains into


22

Below the arcuate line the posterior rectus sheath is


23

In portal hypertension alternative venous drainage is provided via sites of portosystemic anastomosis including the


24

Which one of the following is an anabolic pathway in metabolism?


25

Identify the one CORRECT statement.


26

Which one of the following statements is CORRECT with respect to glycogen in liver?


27

The obese mouse achieves normal weight in the experiment illustrated below. Although a number of the following statements may be correct, indicate the one that is supported by the evidence of the experiment. [PICTURE HERE]


28

Which one of the following statements is CORRECT with respect to this structure? [PICTURE HERE]


29

Which one of the following statements is CORRECT with respect to fat digestion?


30

Which one of the following statements is CORRECT with respect to nutritional diseases due to lack of vitamins?


31

Select the one CORRECT statement about the reaction illustrated below. [PICTURE HERE]


32

Which one of the following statements describing events in oxidative phosphorylation is CORRECT?


33

The liver component designated CYP 2E1 is involved in which one of the following ways with drug/metabolite metabolism?


34

Which one of the following statements about triacyglycerols (TAGs) is CORRECT?


35

Select the one CORRECT statement about dietary protein.


36

Select the one cluster of symptoms that suggests a primary cause other than excessive alcohol consumption.


37

Select the one CORRECT statement with respect to type 1 diabetes.


38

A patient who is taking propranolol for migraine prophylaxis presents at a general practice clinic suffering from a severe allergic reaction after eating crayfish involving hypotension and bronchospasm. Which of the following statements concerning adrenaline is CORRECT?


39

With regard to the early development of the kidney which one of the following statements on development of the mesonephros is CORRECT?


40

Which of these statements concerning control of water and electrolyte secretion through the Enteric Nervous System is NOT CORRECT?


41

Which of these statements concerning neuronal control of intestinal muscle is NOT CORRECT?


42

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


43

Indicate the CORRECT statement regarding the intestinal microbiota:


44

Which one of the following statements regarding arachidonic acid metabolites is CORRECT?


45

Which of the following is CORRECT?


46

Which type of large intestinal polyp is associated with an increased risk of developing colorectal carcinoma?


47

Adenocarcinoma of the large bowel:


48

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


49

In radiological imaging of the abdomen which one of the following is CORRECT?


50

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


51

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


52

Which one of the following statements concerning haemochromatosis is CORRECT?


53

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


54

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


55

Which one of the following statements concerning the location and function of podocytes found in the renal corpuscle is CORRECT?


56

Which one of the following combinations characterises the nephrotic syndrome?


57

In normal anatomy which one of the following are observed on the posterior abdominal wall?


58

Which one of the following statements about metabolic responses to prolonged starvation is CORRECT?


59

Which of the following statements is/are CORRECT? A) There is only one known hormone that stimulates food intake. B) Hormonal signals that inhibit food intake are made in the gut, the adipocytes and the islets of Langerhans. C) Some food intake-inhibitory signals act via activation of the Vagus nerve. D) The Vagus nerve communicates with the hypothalamus via projections from the nucleus of the tractus solitarius (NTS).


60

Which of the following statements about obesity is/are CORRECT? A) Obesity results from eating too much and not exercising enough. B) Identical twin studies suggest that 30-50% of the variance of body weight is genetically determined. C) Of the 5 gene abnormalities identified that lead to massive obesity, three are involved in the production or function of Melanocyte Stimulating Hormone (a MSH). D) The CB-1 (endocannabinoid receptor) inhibits food intake when activated.


61

Which of the following statements related to digestion of food is/are CORRECT? A) Trypsin is an endopeptidase. B) Triglycerides are digested by lipases. C) Carboxypeptidase is an exopeptidase. D) Bile acids (salts) are essential for triglyceride breakdown.


62

Which of the following statements related to the absorption of food is/are CORRECT? A) Chylomicrons are formed in the intestinal lumen. B) Glucose is absorbed by primary active transport in the small intestine. C) Chylomicron formation depends upon bile salts. D) Glucose absorption is achieved by cotransport of Na+.


63

Which of the following statements related to the pancreas and its secretions is/are CORRECT? A) Glucagon is secreted from ß cells of the pancreas. B) a amylase digests starches only from molecular ends to monosaccharides. C) Insulin is secreted from a cells of the pancreas. D) a amylase breaks down 1-4 glucosidic linkages.


64

Which of the following statements related to malabsorption is/are CORRECT? A) Bile salts are essential for the absorption of fat soluble vitamins. B) Calcium problems in fat malabsorption are due completely to poor Vitamin D absorption. C) Coagulation problems can be causally linked to disorders of fat absorption. D) Triglyceride digestion requires bile salts to proceed.


65

Which of the following statements related to malabsorption is/are CORRECT? A) Protein (amino acid) malabsorption is usually due to failure of protein digestion. B) Absorption of calcium takes place predominantly in the terminal ileum. C) Lack of pancreatic amylase leads to severe carbohydrate malabsorption. D) Disease of the terminal ileum may cause problems with calcium absorption.


66

Which of the following statements related to malabsorption is/are CORRECT? A) Iron malabsorption is usually due to mucosal defects. B) Lactose and galactose may accumulate in the intestinal lumen in lactase deficiency. C) Calcium malabsorption may occur with long standing bile acid deficiency. D) Parathyroid hormone directly stimulates intestinal calcium absorption.


67

Which of the following statements related to sodium and water absorption by the small intestine is/are CORRECT? A) Sodium absorption is increased by prostaglandin. B) A high pH stimulates sodium and water absorption. C) Sodium absorption is stimulated by increased free cytosolic calcium. D) Sodium absorption is inhibited by cholera toxin.


68

Which of the following statements related to the causation of diarrhoea is/are CORRECT? A) Excess somatostatin may cause diarrhoea. B) Increased cyclic AMP levels in intestinal cells stimulates Cl- secretion. C) Increased transit time in the small intestine may cause diarrhoea. D) Increased intestinal cell cytosolic Ca++ causes diarrhoea.


69

Which of the following statements related to liver metabolic function is/are CORRECT? A) Synthesis of blood clotting factors by the liver is Vitamin K dependent. B) Blood clotting factors are synthesised by the liver. C) Albumin is synthesised by the liver. D) Fibrinogen synthesis by the liver depends upon Vitamin K.


70

Which of the following statements related to abnormal liver function and bilirubin is/are CORRECT? A) Conjugation of bilirubin is defective in premature infants. B) Unconjugated bilirubin is excreted in the urine. C) Unconjugated bilirubin is converted to soluble bilirubin by ultra violet light. D) Failure of conjugation of bilirubin is the primary defect leading to jaundice in hepato cellular disease.


71

Which of the following statements related to acute jaundice and liver is/are CORRECT? A) Oedema due to a low plasma albumin is common in acute hepato cellular jaundice. B) Plasma albumin is low in acute hepato cellular jaundice. C) Electrolyte disturbances are common in acute hepato cellular jaundice. D) Albumin synthesis is impaired in acute hepato cellular jaundice.


72

Which of the following statements related to liver dysfunction is/are CORRECT? A) Transaminases are usually markedly raised in chronic liver dysfunction. B) Portal-systemic venous anastomosis is common in chronic liver disease. C) In chronic liver dysfunction plasma bilirubin is unconjugated. D) A low plasma albumin may be the only plasma abnormality in chronic liver dysfunction.


73

Which of the following statements related to the glomerulus and glomerular filtration is/are CORRECT? A) GFR is decreased by efferent arteriole constriction. B) Substances with MW > 2000 are not filtered by the glomerulus. C) Glomerular capillary pressure is about 70-80 mmHg. D) Glomerular filtration rate increases if plasma albumin is low.


74

Which of the following statements related to the proximal tubule is/are CORRECT? A) Carbonic anhydrase is in the luminal membrane of the proximal tubule. B) Na+-H+ countertransport takes place in the proximal tubule. C) Paracellular reabsorption of sodium and water take place in the proximal tubule. D) Renin directly stimulates Na+-H+ countertransport by the proximal tubule.


75

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. B) 15-30% of water filtered is reabsorbed in the loop of Henle. C) Na+ concentration at end of the loop of Henle is about 100 mmol/l. D) 15-30% of Na+ filtered is reabsorbed in the thick ascending limb of the loop of Henle.


76

Which of the following statements related to the collecting tubule and/or duct is/are CORRECT? A) Permeability to water of the collecting tubule and duct is increased by ADH. B) H+ is secreted down an electrochemical gradient in the collecting tubule. C) Na+ absorption is increased by aldosterone in the collecting tubule. D) Net H+ secretion is greater in the collecting tubule than in the proximal tubule.


77

Which of the following statements related to the collecting tubule and/or duct is/are CORRECT? A) Aldosterone decreases K+ secretion by the collecting tubule. B) HCO3- in lumen of the collecting tubule increases H+ excretion by the kidney. C) Aldosterone decreases H+ secretion by the collecting tubule. D) There can be net K+ reabsorption in the distal nephron.


78

In the kidney which of the following statements related to JGA or the cortical diluting segment is/are CORRECT? A) The efferent arteriole is more sensitive to circulating angiotensin II than the afferent arteriole. B) Low NaCl at macula densa ? dilatation of efferent arteriole. C) NO may modulate and control TG feedback. D) Renin secretion from the afferent arteriole controls TG feedback.


79

Which of the following statements related to the renin angiotensin aldosterone system is/are CORRECT? A) ACTH is a major stimulus for aldosterone release. B) A high NaCl at the macula densa causes renin release. C) Aldosterone has an immediate effect increasing Na+-K+ ATPase. D) A high NaCl at the macula densa causes afferent arteriole constriction.


80

Which of the following statements related to acid base is/are CORRECT? A) H2PO4 - is a major titratable acid in urine. B) NH4 + in the urine is the major excretory mechanism of an acid load. C) Organic acids contribute to titratable acid in urine. D) pH = pK + log - 3 2 3 HCO H CO


81

Which of the following statements related to water balance and urine concentration is/are CORRECT? A) Impairment of urine concentrating ability is an early sign of renal insufficiency. B) Concentrating ability is reduced by thiazide diuretics. C) Too little vasopressin causes hypernatraemia. D) Vasopressin decreases water permeability of the collecting tubule.


82

Which of the following statements related to calcium and phosphate is/are CORRECT? A) Calcium absorption in the loop of Henle and distal nephron is increased by parathyroid hormone. B) Plasma ionized calcium levels controls parathyroid hormone secretion. C) Parathyroid hormone decreases proximal tubule Na+ reabsorption. D) Administration of parathyroid hormone causes calcium to be lost in the urine.


83

Which of the following statements related to diuretics is/are CORRECT? A) Furosemide binds to the NaCl cotransporter. B) Hyperkalaemic alkalosis may occur with diuretic therapy. C) Furosemide inhibits the diluting ability of the kidney. D) Hypokalaemic alkalosis is a common side effect of diuretic therapy.


84

Which of the following statements related to proteinuria is/are CORRECT? A) Proteinuria is always due to increased glomerular filtration of protein. B) Microalbuminuria is an early sign of renal vascular damage. C) The filtration fraction of albumin is about 0.5%. D) The amount of albumin filtered may be many times greater than the amount in the urine.


85

Which of the following statements related to hypotension and acute renal failure is/are CORRECT? A) A urine osmolality < 400 but > 200 mosmol in a hypotensive patient suggests that acute tubular necrosis has occurred. B) A urine creatinine <10 times plasma level in an oliguric patient suggests that the problem is probably reversible. C) A urine sodium < 30 mmol/litre in an oliguric patient suggests that the process is probably reversible. D) There is usually no glomerular filtration in a person with acute tubular necrosis.


86

Which of the following statements related to hypotension and acute renal failure is/are CORRECT? A) Afferent arteriolar constriction causes increased GFR. B) The afferent arteriole is more sensitive to angiotensin II than the efferent arteriole. C) The AT2 receptor is the receptor by which angiotensin II has most of its action. D) Efferent arteriolar constriction causes increased filtration fraction.


87

Which of the following statements related to chronic liver failure is/are CORRECT? A) Plasma calcium is below the normal range early in the course of chronic renal failure. B) pH is usually normal early in the course of chronic renal failure. C) pH is usually below the normal range early in the course of chronic renal failure. D) Plasma bicarbonate is usually below the normal range in patients with chronic renal failure.


88

Which of the following statements related to chronic liver failure is/are CORRECT? A) 1,25 dihydroxy Vit D is deficient in chronic renal failure. B) Protein restriction will cause a fall in blood urea. C) Plasma parathyroid hormone is usually elevated in patients with chronic renal failure. D) Protein restriction in chronic renal failure is important to reduce the proton load requiring excretion.


89

Which of the following statements related to abnormal liver function and bilirubin is/are CORRECT? A) Conjugated bilirubin is carried in plasma bound to albumin. B) Unconjugated bilirubin is toxic to neural tissue. C) Gilberts disease is associated with neurological symptoms. D) Conjugation of bilirubin may be defective in Gilberts disease.


90

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) In chronic liver dysfunction bilirubin is conjugated. C) In acute liver failure bilirubin is conjugated. D) A low plasma albumin is a common finding in acute liver dysfunction.


91

Which of the following statements related to liver metabolic function is/are CORRECT? A) Aldosterone is metabolized by the liver. B) The liver synthesises glucagon. C) The liver synthesizes glucose from proteins. D) The liver synthesises bilirubin.


92

Which of the following statements about volume of distribution is/are CORRECT? A) A drug that binds strongly to plasma proteins will be likely to have a small volume of distribution. B) Volume of distribution can be calculated by dividing the amount of drug in the body by the concentration of drug in the plasma. C) Volume of distribution may be one or two orders of magnitude greater than total body water. D) Volume of distribution depends on the dose and route of administration of a drug.


93

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 intravenous injection. B) A bolus intravenous injection is often used when a rapid onset of drug action is required. C) For most drugs, the steady state concentration of drug in plasma achieved following a long term intravenous infusion is proportional to the rate of administration. D) Drugs administered intravenously typically show complete (i.e. 100%) bioavailability.


94

Which of the following statements regarding the behaviour of drugs following oral administration is/are CORRECT? A) 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. B) Basic drugs such as morphine tend to be well absorbed from the stomach following oral administration. C) The bioavailability of drugs following oral administration is affected by the extent to which they are absorbed from the gastrointestinal tract and undergo first pass hepatic metabolism. D) Drugs administered orally usually distribute evenly throughout the body.


95

Which of the following statements regarding the half life of drugs is/are CORRECT? A) The half life of a drug is a useful guide in the choice of dosing frequency. 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 liver disease may increase the half life of a drug.


96

Which of the following statements regarding the pharmacokinetic behaviour of drugs is/are CORRECT? A) Drugs that distribute slowly exhibit a higher peak concentration than would be predicted for a rapidly distributing drug. B) Drugs that are eliminated according to zero order kinetics would not be expected to give steady state levels of drug in plasma. C) Drugs that are eliminated solely by glomerular filtration would likely exhibit first order elimination kinetics. D) Drugs that distribute slowly are generally regarded as conforming to a one compartment pharmacokinetic model.


97

Which of the following statements regarding the behaviour of partial agonists is/are CORRECT? A) Partial agonists always cause smaller maximal responses than full agonists acting at the same receptors. B) Partial agonists always have to be administered at higher doses than full agonists for an equivalent effect. C) Partial agonists may lose their effectiveness entirely after receptor desensitization has occurred. D) Partial agonists act at a different receptor from full agonists.


98

Which of the following statements regarding competitive antagonists is/are CORRECT? A) Competitive antagonists bind to the same site as agonists thereby preventing the agonist from binding. B) Antagonism by a competitive antagonist can always be overcome by increased agonist concentration. C) Competitive antagonists have little or no ability to activate the receptor when bound. D) Competitive antagonist have higher affinity than the agonist for the receptor.


99

Which of the following types of drugs would inhibit the increase in cardiac contractile force in response to adrenaline and to histamine? A) An agonist that mediates a decrease in contractile force by activating adenosine receptors. B) A competitive antagonist of the ß1-adrenoceptor. C) An inhibitor of the opening of cardiac L-type calcium channels. D) A competitive antagonist of the histamine H2 receptor.


100

Which of the following statements is/are true regarding enzymes levels in alcoholic cirrhosis and acute alcoholic hepatitis. A) Lactate dehydrogenase (LD) level is not elevated in alcoholic hepatitis or acute alcoholic cirrhosis. B) Gamma Glutaryl Transferase (GGT) is usually not elevated by liver pathologies other than acute alcoholic hepatitis. C) All liver enzyme levels in plasma are generally higher in advanced cirrhosis. D) Both alcoholic cirrhosis and acute alcoholic hepatitis may be associated with pancreatitis (i.e alcohol consumption predisposes to pancreatitis).