NDM MCQ Final 2001

1

Sumita Neg, a 18-year-old nursing student presents to her local GP, Dr Sarah Richards with a 5- month history of tiredness, lack of concentration, fatigue, and shortness of breath on mild effort. During the last 12 months her menstrual periods have become heavier and longer (7 to 1 O days). Her periods used to last for 2-3 days only with light to moderate bleeding. She gives no history of changes in her appetite but admits that since she moved to Australia as an international student she eats more junk food. Her bowel movements are regular except for a few bouts of diarrhoea. Her family history is unremarkable and she has no history of allergy. She is not on any medication. On examination, Sumita looks pale. Her vital signs are shown below:

Vital signs Patient Normal Range
Blood pressure 100/70 mmHg 100/60 -135/85 mmHg
Pulse rate 86/min 60- 100/min
Temperature 36.9°C 36.6 - 37.2 °C
Respiratory rate 16 12 -16 /min
Abdominal examination: No organomegaly. Her FBE reveals:
  • Haemoglobin 95
  • WBC4.5
  • Platelets 190,000
  • Blood film: Red blood cells (RBCs) are microcytic and appear to be hypochromic
Which one of the following is the most likely cause of Sumita's anaemia?


  Defective ~globulin synthesis.

  Lack of folic acid in her diet.

  Iron deficiency.

  Increased intra-vascular destruction of erythrocytes.

  Vitamin B12 deficiency.

2

This question relates to the patient described in Q1. Which one of the following would you expect to be increased in Sumita's blood?


  Target cells.

  Serum transferrin.

  Hb F

  Serum ferritin.

  Serum bilirubin.

3

This question relates to the patient described in Q1. Which one of the following findings is expected from Sumita's bone marrow smears?


  Decreased haemosiderin in bone marrow macrophages.

  Presence of large metamyelocytes.

  Presence of abnormal megakaryocytes.

  Increased myeloid:erythroid ratio

  Large fat cells replace her bone marrow.

4

This question relates to the patient described in Q1. Which one of the following abnormalities/lesions is associated with Sumita's anaemia?


  Damage of parietal cells.

  Absence of Transcobalamin 11

  Impaired DNA synthesis.

  Iron overload.

  Poikilocytosis of red blood cells.

5

This question relates to the patient in Q1. Which one of the following statements regarding the binding of oxygen to haemoglobin is CORRECT?


  Increases with a fall in pH.

  Occurs in direct proportion to the oxygen partial pressure.

  Decreases in the presence of di-phosphoglycerate.

  Binds less firmly to haemoglobin F than haemoglobin A.

  Decreases in the presence of fever.

6

In which one of the following renal diseases does diabetes mellitus NOT cause or play a role?


  Acute glomerulonephritis.

  Nodular glomerulosclerosis (Kimmelsteil-Wilson nodules).

  Acute pyelonephritis.

  Acute papillary necrosis.

  Atherosclerosis.

7

Which one of the following statements regarding the anatomy of the pancreas is CORRECT?


  The pancreas is an intraperitoneal structure.

  The head of the pancreas lies adjacent to the spleen.

  The pancreas lies anterior to the duodenum.

  The main duct of the pancreas usually enters directly into the duodenum.

  The pancreas lies anterior to the inferior vena cava.

8

Which one of the following factors will result in a DECREASE in the basal metabolic rate (BMR)?


  Fasting.

  Exposure to increased stress.

  Fever.

  Pregnancy.

  Exposure to cold environment.

9

Which one of the following regarding acute tubular necrosis (ACT) is CORRECT?


  ACT progresses to acute cortical necrosis.

  ACT is a reversible lesion.

  ACT is immune-mediated.

  ACT causes haematuria.

  ACT is caused by infection.

10

Which one of the following statements regarding peptic ulcer of the stomach is NOT correct?


  The ulceration is due to impaired mucosal defences against gastric acid and pepsin.

  Peptic ulcers penetrate beyond the muscularis mucosae of the stomach.

  Peptic ulcers may lead to severe haemorrhage due to erosion through blood vessels.

  Peptic ulcers are associated with a history of taking aspirin or related drugs in more than 80% of cases.

  Peptic ulcers may result in perforation of the stomach wall with leakage of gastric


contents into the abdominal cavity.

11

With regard to vitamin E, which one of the following statements is CORRECT?


  Vitamin E is synthesized from cholesterol.

  Vitamin E deficiency is associated with decreased blood clotting time.

  Vitamin E is primarily obtained in the diet from leafy green vegetables.

  The primary function of vitamin E is as an antioxidant.

  Vitamin E is important for night vision.

12

Which one of the following statements regarding the right ureter is NOT correct? 1 . The right ureter passes posterior to the genitofemoral nerve on psoas major.


  The right ureter overlies the tips of lumbar transverse processes.

  The right ureter has a narrowing at its origin and where it crosses the pelvic brim.

  The right ureter passes behind the root of the mesentery and right gonadal vessels.

  The right ureter typically refers pain to right lumbar region and right iliac fossa.

13

Which one of the following statements regarding the stomach is NOT correct? 1 . The pylorus lies at the level of the L 1-2 intervertebral disc.


  Pain arising from the stomach is typically referred to the umbilical region.

  The stomach has a sphincter surrounding the pyloric canal.

  The cardiac orifice is at the level of the left 7th costal cartilage.

  The stomach has a mesentery attached to the greater curvature.

14

Which one of the following statements about amino acid metabolism is NOT correct?


  Body nitrogen stores are not expandable, in contrast to carbohydrate and fat stores

  Positive nitrogen balance refers to a net gain in nitrogen as occurs during growth.

  Excess nitrogenous compounds must be converted to waste (eg. urea) and excreted.

  Degradation of muscle proteins is highly selective.

  Removal of amino groups from amino acids of muscle protein yields urea which is


transported to the liver for excretion.

15

Which one of the following statements regarding the left renal vein is NOT correct?


  The left renal vein is longer than the right renal vein.

  The left renal vein receives the left gonadal vein.

  The left renal vein passes between the aorta and the superior mesenteric artery.

  The left renal vein receives a left suprarenal vein.

  The left renal vein is part of the portal venous system.

16

Which one of the following statements regarding the bile duct is NOT correct?


  The bile duct lies in a groove behind the head of the pancreas.

  The bile duct is formed by the union of the common hepatic duct with the cystic duct.

  The bile duct enters the third part of the duodenum.

  The bile duct passes behind the first part of the duodenum.

  The bile duct has a sphincter at its distal end.

17

Which one of the following statements about the response of amino acid metabolism to stress is NOT correct?


  Decreased rates of protein synthesis occur in response to starvation.

  Decreased rates of protein synthesis result in a negative nitrogen balance.

  Upon fasting for 48 - 72 hours the falling glucagon I insulin ratio results in the stimulation of hepatic gluconeogenesis.

  The increase in gluconeogenesis upon fasting for 48-72 hours results from increased availability of alanine and glutamine supplied to the liver.

  Increased lipolysis in adipose tissue upon fasting for 48-72 hours provides glycerol


for gluconeogenesis in the liver.

18

Which one of the following statements regarding the kidney is NOT correct?


  The kidneys are important for regulation of osmotic pressure of the plasma.

  The kidneys are important for regulation of the volume of extracellular fluid.

  The kidneys are important for regulation of plasma calcium concentration.

  The kidneys are important for regulation of plasma bicarbonate concentration.

  The kidneys are important for excretion of lipid-soluble waste.

19

Which one of the following statements regarding prostaglandin 12 (prostacyclin) is CORRECT?


  Prostacyclin is synthesised predominantly in endothelial cells.

  Prostacyclin is a vasodilator that does not affect platelet aggregation.

  Prostacyclin decreases mucus secretion in the stomach.

  Prostacyclin has a half life of several hours.

  Prostacyclin is hyperalgesic

20

Which one of the following statements regarding the role of ATP in skeletal muscle function is NOT correct?


  ATP is required for crossbridge attachment and turnover.

  ATP is needed for calcium uptake by the sarcoplasmic reticulum.

  ATP is required to fuel activity of channels responsible for Ca2 + influx needed for contraction.

  ATP is required to allow dissociation of attached crossbridges.

  ATP is generated predominantly in muscle mitochondria.

21

Which one of the following biological substances is NOT produced by the kidney?


  Erythropoietin.

  Renin.

  Kallikrein.

  Aldosterone.

  1,25-dihydroxy vitamin 03.

22

Which one of the following statements regarding smooth muscle function is NOT correct? (In comparison to skeletal muscle)


  Smoo~h muscle generally uses less ATP for contraction

  Smooth muscle generates less force per cross sectional area of muscle.

  Smooth muscle can undergo larger changes in length during contraction.

  Smooth muscle crossbridges remain attached for longer time periods.

  Smooth muscle contracts at lower velocities.

23

Cyanide inhibits the transfer of electrons to oxygen in the mitochondrial electron transport chain. Which one of the following is NOT a likely metabolic consequence of cyanide poisoning?


  Accumulation of NADH.

  Increased lactate production.

  Increased ketone body production.

  Decreased ATP production.

  Inhibition of the pyruvate dehydrogenase complex.

24

Which one of the following statements regarding hepatitis B infection is NOT correct?


  Hepatitis B infection may lead to acute liver failure due to widespread liver cell necrosis.

  Hepatitis B infection may lead to chronic hepatitis and cirrhosis.

  Hepatitis B infection may be asymptomatic.

  Hepatitis B infection is spread via the faecal-oral route (ingesting the virions).

  Hepatitis B infection may result in a significantly increased risk of primary liver cell cancer.

25

Which one of the following statements regarding imaging of the abdomen is NOT correct?


  The fat planes will be darker on a radiograph than the liver.

  A cyst in the liver will appear darker on an ultrasound scan compared with the surrounding liver.

  A cyst in the liver will appear darker on computed tomography compared with the surrounding liver.

  The pancreas lies at the level of the fourth lumbar vertebra.

  The splenic vein joins the superior mesenteric vein posterior to the pancreas.

26

Which one of the following statements about the synthesis of triacylglycerol is NOT correct?


  Dietary protein can contribute to the synthesis of triacylglycerol.

  Dietary carbohydrate can contribute to the synthesis of triacylglycerol.

  Dietary ethanol can contribute to the synthesis of triacylglycerol.

  Triacylglycerol synthesis occurs only in the liver.

  Triacylglycerol synthesis from acetyl-CoA requires the vitamin biotin.

27

Which one of the following statements regarding primary hepatocellular carcinomas in the liver is NOT correct?


  Primary hepatocellular carcinoma is the most common form of carcinoma involving the liver.

  Most forms of cirrhosis are associated with an increased risk of primary hepatocellular carcinoma.

  Primary heptocellular carcinoma often invades veins within the liver.

  The incidence of primary hepatocellular carcinoma is high in countries where hepatitis 8 is endemic.

  Primary hepatocellular carcinoma is associated with elevated plasma levels of alphafetoprotein.

28

Which one of the following statements regarding colorectal carcinoma is NOT correct?


  The most common histological type is an adenocarcinoma<

  It may present clinically as chronic occult blood loss leading to anaemia.

  Multiple adenomas of the colon is a risk factor.

  There is an increased risk of this tumour in patients with ulcerative colitis.

  It occurs more commonly in the proximal colon, near the ileocaecal junction.

29

Which one of the following statements regarding glycogen metabolism is CORRECT?


  Glycogen is synthesized primarily in liver and adipose tissues.

  The product of glycogen breakdown in muscle is free glucose.

  Glycogen synthesis is catalyzed by the same enzyme that catalyzes breakdown.

  Excess dietary amino acids can contribute to the net synthesis of glycogen.

  Glycogen breakdown in the muscle is stimulated by high levels of glucagon.

30

Which one of the following statements regarding alcoholic hepatitis is NOT correct?


  Alcoholic hepatitis is associated with infiltration of the liver by neutrophils.

  Alcoholic hepatitis is associated with infiltration of the portal tracts by lymphocytes.

  Alcoholic hepatitis is associated with an increased risk of the development of cirrhosis.

  Alcoholic hepatitis is associated with the presence of Mallory bodies in injured hepatocytes.

  Alcoholic hepatitis no longer occurs once cirrhosis is established.

31

Which one of the following statements regarding the transverse colon is NOT correct?


  The transverse colon has appendices epiploicae, taeniae coli and haustrations.

  The transverse colon develops from both midgut and hindgut.

  The transverse colon is supplied by branches of the superior and inferior mesenteric arteries.

  The transverse colon does not possess a mesentery.

  The transverse colon is variable in position.

32

Which one of the following statements regarding kidney disease associated with type 1 diabetes mellitus is NOT correct?


  Type 1 diabetes mellitus is an important cause of chronic renal failure.

  Type 1 diabetes mellitus causes hyaline sclerosis of the afferent arterioles, but not efferent arterioles.

  Type 1 diabetes mellitus causes nodular sclerosis of glomeruli.

  Type 1 diabetes mellitus causes thickening of the glomerular basement membrane.

  Type 1 diabetes mellitus is a cause of the nephrotic syndrome.

33

Which one of the following statements regarding liver enzyme changes in viral hepatitis is NOT correct?


  The alanine amino transferase/aspartate aminotransferase (ALT/AST) ratio is usually high in viral hepatitis.

  ALT levels indicate the degree of hepatocellular damage in viral hepatitis.

  Gamma glutamyl transferase (GGT) levels may be elevated in viral hepatitis.

  Alkaline phosphatase (ALP) levels may be elevated in viral hepatitis.

  Isolated elevation of AST is often seen in viral hepatitis.

34

In which one of the following does the microbiota of the gastrointestinal tract of humans NOT play a role?


  Protection against infection with pathogenic bacteria.

  Maturation of the mucosa! immune system.

  Conversion of procarcinogens to carcinogens.

  Provision of digestive enzymes for essential nutrients.

  Provision of a source of bacteria that may cause opportunistic infections.

35

Which one of the following statements regarding cholesterol in the blood of humans is CORRECT?


  Synthesis of the low density lipoprotein (LDL) receptor is increased in response to elevated blood cholesterol.

  High density lipoproteins (HDL) are the primary carriers of cholesterol in the blood.

  High triacylglycerol levels in the blood are often associated with decreased HDL blood cholesterol.

  Dietary saturated fats are precursors for cholesterol, contributing directly to elevated blood cholesterol levels.

  Drugs that inhibit cellular cholesterol synthesis have little effect on blood cholesterol levels.

36

Which one of the following is the primary mechanism or system involved in the elimination of small hydrophobic foreign molecules from the circulation?


  The mononuclear phagocyte (reticule-endothelial) system.

  Macrophage ingestion.

  Kidney mediated excretion.

  Hepatic modification to soluble metabolites.

  Biliary excretion.

37

Which of the following statements regarding the pharmacokinetic behaviour of drugs is/are CORRECT? A) Absorption of drugs often takes place via the process of lipid diffusion. B) Renal excretion of a drug depends upon the processes of glomerular filtration, tubular secretion and tubular reabsorption. C) Extensive first pass hepatic metabolism may reduce the oral bioavailability of a drug. D) Following oral administration, drugs usually distribute evenly throughout the body.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

38

Which of the following statements related to malabsorption is/are CORRECT? A) Fatty acids aid the dispersion of fat into small particles. B) Disease of the terminal ileum may cause problems with calcium absorption. C) Bile acids are essential for absorption of fat soluble vitamins. D) Absorption of calcium takes place predominantly in the terminal ileum.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

39

Which of the following is/are the likely metabolic consequences of an overnight fast? A) An increase in glycogen phosphorylase activity in the liver. B) An increase in hormone sensitive lipase activity in adipose tissue. C) A decrease in the muscle glucose transporter, GLUT 4, due to decreased insulin levels. D) Increased synthesis of very low density lipoproteins (VLDL) for the transport of fatty


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.


acids to the liver.

40

Which of the following statements regarding the glomerular filtration barrier is/are CORRECT? A) The glomerular filtration barrier consists of three layers -fenestrated endothelium, a fused basement membrane and podocytic epithelium. B) The glomerular filtration barrier has fenestrated endothelium with diaphragms. C) The glomerular filtration barrier has expanses of interdigitating podocyte foot processes. D) The glomerular filtration barrier is about the width of an erythrocyte (7-8 microns).


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

41

Which of the following statements regarding red blood cell destruction is/are CORRECT? A) When increased, red blood cell destruction causes increased numbers of blood retic~locytes. B) Red blood cell destruction normally occurs in macrophages. C) Red blood cell destruction is the main source of bilirubin production. D) Red blood cell destruction results in increased iron loss from the body.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

42

Which of the following is/are able to contribute to glucose synthesis in the liver during fasting? A) Even chain length fatty acids (e.g. palmitic acid, 16:0). B) Lactate. C) Ketone bodies. D) Branched chain amino acids (e.g. valine).


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

43

Which of the following statements regarding the metanephric diverticulum (ureteric bud) is/are CORRECT? A) The metanephric diverticulum is invaded by the metanephric mesoderm. B) The metanephric diverticulum arises from the mesonephric duct. C) The metanephric diverticulum gives rise to the nephron. D) The metanephric diverticulum gives rise to the collecting ducts.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

44

In a patient with anaemia, which of the following findings is confirmatory of a diagnosis of iron deficiency? A) Subnormal red cell MCV (Mean Cell Volume). B) Subnormal serum iron level. C) Normal percentage of Haemoglobin A2 in red cells. D) Subnormal serum ferritin level.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

45

Which of the following is/are the metabolic consequences of insulin deficiency? A) Significantly decreased glucose uptake into the liver cell (hepatocyte). B) Stimulation of protein synthesis in the liver. C) Unregulated glycogen synthesis in the liver. D) Enhanced production of ketone bodies.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

46

Which of the following statements regarding variability of drug action is/are CORRECT? A) Renal clearance of drugs is low in neonates. B) Elderly patients typically have reduced renal clearance. C) Enzymic polymorphism accounts for differences in the rates of metabolism of some drugs by certain ethnic groups. D) In patients with renal disease, it will be necessary to reduce the dose of any drug


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.


they are taking.

47

Which of the following statements regarding abnormal liver function and bilirubin is/are CORRECT? A) Vitamin C is not well absorbed in obstructive jaundice. B) Unconjugated bilirubin is converted to soluble bilirubin by ultra violet light. C) Vitamin K is not well absorbed in hepato cellular jaundice. D) Conjugation of bilirubin is defective in premature infants.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

48

Which of the following statements regarding the pathogenesis of type 2 diabetes is/are CORRECT? A) Impaired insulin secretion is the first abnormality noted. B) There is an increase in endogenous glucose production. C) Insulin resistance is demonstrable in every tissue in the body. D) Insulin resistance is an early defect.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

49

Which of the following statements regarding the proximal tubule is/are CORRECT? A) Na+-H+ cotransport takes place in the proximal tubule. B) Weak acids are actively reabsorbed by the proximal tubule. C) Na+-glucose countertransport takes place in the proximal tubule. D) Weak acids are actively secreted by the proximal tubule.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

50

Which of the following statements related to liver metabolic functions is/are CORRECT? A) Globulins are synthesised by the liver. B) Aldosterone is metabolized by the liver. C) The liver synthesises glucose from fatty acid metabolic products (Acetyl Co A). D) Glycogen is broken down by the liver.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

51

Which of the following is/are components of the Metabolic Syndrome (Syndrome X)? A) Obesity. B) Insulin resistance. C) Dyslipidaemia. D) Hyperuricaemia.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

52

Which of the following statements regarding the collecting tubule is/are CORRECT? A) Low plasma K+ increases K+ secretion by the collecting tubule. B) HC03- in lumen of the collecting tubule increases H+ excretion by th_e kidney. C) Low plasma Na+ increases Na+ reabsorption by the collecting tubule. D) HC03- in the lumen increases H+ secretion in the collecting tubule.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

53

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


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

54

Which of the following statements regarding gastrin is/are CORRECT? A) Gastrin increases gastric acid secretion. B) Gastrin decreases the tone of the gastro oesophageal sphincter. C) Gastrin increases stomach contractility. D) Gastrin relaxes the sphincter of Oddi.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

55

Which of the following statements related to the loop of Henle is/are CORRECT? A) ADH increases reabsorptive capacity of the thick ascending limb of the loop of Henle. B) If the loop of Henle is not functioning the kidney cannot concentrate urine. C) Osmolality at end of the loop of Henle is about 100 mosmol/I. D) If the loop of Henle is not functioning the kidney cannot dilute urine.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

56

Which of the following statements regarding partial agonists is/are CORRECT? A) Partial agonists have greater affinity than full agonists. B) Partial agonists can produce a response on their own. C) Partial agonists have higher potency than full agonists. D) Partial agonists can hinder the action of full agonists acting at the same receptors.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

57

Which of the following statements regarding sodium absorption by the small intestine is/are CORRECT? A) Sodium absorption proceeds by Na+ glucose cotransport. B) Sodium absorption proceeds by Na+ -H+ countertransport. C) Sodium absorption proceeds by Na+-amino acid cotransport. D) Sodium absorption depends on luminal membrane Na+ K+ ATPase.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

58

Which of the following statements related to juxtaglomerular apparatus or the cortical diluting segment is/are CORRECT? A) High NaCl at macula densa results in increased renin release. B) Efferent arteriole is more sensitive to circulating angiotensin 11 than the afferent arteriole. C) Angiotensin 11 mediates tubular glomerular feedback. D) Renin is present predominantly in the afferent arteriole.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

59

Which of the following statements regarding drug-drug interactions is/are CORRECT? A) Pharmacodynamic drug-drug interactions may result from receptor antagonism. B) Both of the drugs involved in the interaction will usually have a large therapeutic index. C) Displacement of drug A from plasma protein by drug B may result in a transient increase in the plasma concentration of free (unbound) drug A. D) Drug-drug interactions always result in unwanted effects clinically.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

60

Which of the following statements regarding the causation of diarrhoea is/are CORRECT? A) Histamine increases free Ca++ in small intestinal cells. B) Excess somatostatin may cause diarrhoea. C) Cholera toxin increases cyclic AMP levels in intestinal cells. D) Excess sodium chloride in the diet may cause diarrhoea.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

61

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.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

62

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


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.


concentration of the drug.

63

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.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

64

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) Increased parathyroid hormone causes increased absorption of Ca++ by the kidney. C) Parathyroid hormone decreases proximal tubule Na+ reabsorption. D) Parathyroid hormone increases renal calcium excretion.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

65

Which of the following statements regarding volume of distribution (V d) is/are CORRECT? A) Volume of distribution may be used to calculate the loading dose of a drug. 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 extracellular fluid volume. D) Volume of distribution may be one or two orders of magnitude greater than total body water.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

66

Which of the following statements related to the absorption of food is/are CORRECT? A) Glucose is absorbed by primary active transport in the small intestine. B) Glucose must be present for the absorption of sodium. C) The hexose sugars use a common transport carrier. D) Disaccharides are poorly or not absorbed by the small intestine.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

67

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


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.

68

Which of the following statements concerning the potency of a competitive antagonist is/are CORRECT? A) It may be affected by the efficacy of the antagonist. B) It may be affected by the density of the receptors for the antagonist. C) It may be affected by the efficiency of the stimulus-response coupling of the agonist and its receptor. D) It may be affected by the equilibrium dissociation constant of the antagonist.


  If only A, B and C are correct.

  If only A and C are correct.

  If only B and D are correct.

  If only D is correct.

  If all are correct.