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Question 1
Incorrect
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What is the usual initiator of the complement system cascade in the absence of specific antibodies?
Your Answer: C3a
Correct Answer: C3b
Explanation:The Complement Cascade and its Three Pathways
The complement cascade is a series of pro-enzymes found in the serum and tissue space that are activated by generic pathogenic markers. There are three pathways to activation: alternative, mannose-binding lectin, and classical. The classical pathway requires the presence of antigen-specific antibody or C-RP. This pathway predominates in response to re-challenge of a bacterium. However, when faced with a new bacterium, C3b binds to foreign surfaces and activates the alternative pathway.
C1 is an early component of the classical pathway, while C3a is the other part formed from hydrolysis of C3 and causes mast cell degranulation. C5 acts as a neutrophil chemoattractant, while C6-9b form the membrane-attack complex, which causes bacterial lysis. the complement cascade and its pathways is crucial in developing effective treatments for infections and other diseases.
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This question is part of the following fields:
- Clinical Sciences
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Question 2
Incorrect
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A 82-year-old woman named Mrs. Smith visits her GP complaining of constant fatigue. She has a medical history of hypothyroidism and takes oral levothyroxine. Her routine blood tests reveal the following results: Hb 87 g/L (115-160), MCV 108 fL (76-96), Platelets 136 ×109/L (150-400), TSH 3.6 (0.3-5), and T4 88 (70-150). What is the appropriate treatment plan for Mrs. Smith?
Your Answer: Encourage to eat more iron-containing foods
Correct Answer: Vitamin supplementation
Explanation:Pernicious Anaemia: An Autoimmune Disease
Pernicious anaemia is an autoimmune disease that occurs when the body produces antibodies against gastric parietal cells. These cells are responsible for producing intrinsic factor, which is necessary for the absorption of vitamin B12 in the terminal ileum. Vitamin B12 is essential for the synthesis of thymine, which is required for effective DNA synthesis. As a result, patients with pernicious anaemia may experience symptoms related to other cell lines, such as diarrhoea caused by gut mucosa turnover.
The failure of DNA synthesis leads to a large mean cell volume in erythrocytes as they mature through the erythroid cell line. Treatment for pernicious anaemia involves the replacement of vitamin B12, usually through hydroxycobalamin injections. Blood transfusions are unnecessary unless the patient is severely compromised, as they do not address the underlying problem.
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This question is part of the following fields:
- Clinical Sciences
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Question 3
Correct
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What is the primary process of growth that causes benign enlargement of the prostate?
Your Answer: Hyperplasia
Explanation:Benign Prostatic Hyperplasia
Benign prostatic hyperplasia (BPH) is a common condition that affects men as they age. It is characterized by an increase in the number of cells in the prostate gland, which leads to its enlargement. This process is known as hyperplasia and is the main method for age-related prostate enlargement. BPH is caused by an increase in the number of exocrine glands and ducts, which are structurally normal.
Hypertrophy, which is an increase in the size of cells, also plays a role in BPH, but to a lesser extent. It mainly affects the central (periurethral) zone of the prostate, causing urethral compression and the symptoms of bladder outlet obstruction. On the other hand, dysplasia, which is the abnormal growth of cells, is more likely to occur in the peripheral zone of the prostate. This area has the potential to develop into malignancy, making it important to monitor any changes in the prostate gland. the mechanisms behind BPH can help in the diagnosis and management of this condition.
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This question is part of the following fields:
- Clinical Sciences
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Question 4
Correct
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A 30-year-old woman visits her doctor. She had a health assessment for her job's insurance and was informed that she is obese with a BMI of 36 kg/m2. She is in denial and finds it hard to accept that her weight is unhealthy.
What stage of behavioral change is she demonstrating?Your Answer: Pre-contemplation
Explanation:The Importance of Lifestyle Advice in Healthcare
Giving lifestyle advice to patients is a challenging task for doctors, but it is crucial in helping patients change their unhealthy habits. The behavioural model of change is a useful tool for clinicians to guide patients through the stages of behavioural change. Although it is an oversimplification of a complex process, it can provide guidance on how to approach difficult situations.
One example of this is when a patient is in the pre-contemplation stage, where they are unwilling to accept that they need to change their behaviour. In this situation, the clinician may choose to encourage the patient towards the contemplation stage by focusing on their attitude towards their weight and any potential problems it may cause in the future. Simply giving the patient a diet plan and exercise regimen is unlikely to be effective if they do not acknowledge the problem.
In conclusion, providing lifestyle advice is an essential skill for doctors to help patients make positive changes in their lives. The behavioural model of change can be a helpful tool in guiding patients through the stages of behavioural change, but it is important to approach each patient’s situation individually and with empathy.
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This question is part of the following fields:
- Clinical Sciences
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Question 5
Incorrect
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What is the net ATP production per glucose molecule during glycolysis?
Your Answer: Net production of 4 molecules of ATP per molecule glucose
Correct Answer: Net production of 2 molecules of ATP per molecule glucose
Explanation:ATP Production during Glycolysis
During glycolysis, two molecules of ATP are initially used up. One molecule is utilized to convert glucose to glucose 6 phosphate, while the other is used for the conversion of fructose 6 phosphate to fructose 1,6 bisphosphate. The fructose 1,6 bisphosphate is then split into two 3-carbon molecules, each of which can generate 2 molecules of ATP. As a result, for each molecule of glucose, two molecules of ATP are consumed, and four are produced, resulting in a net gain of two molecules of ATP.
It is important to note that glycolysis does not require oxygen to function. In the absence of oxygen, the glycolysis pathway can still operate, resulting in a small net gain of ATP. However, when oxygen is available, the net ATP gain is much higher for each molecule of glucose. This is because the pyruvate generated during glycolysis can be further metabolized during the Kreb cycle and electron transfer chain.
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This question is part of the following fields:
- Clinical Sciences
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Question 6
Incorrect
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A 45-year-old man presents with erectile dysfunction and a history of poorly controlled type 2 diabetes mellitus. What is the percentage of men over the age of 45 with erectile dysfunction who have an underlying organic cause?
Your Answer: 80%
Correct Answer: 50%
Explanation:Erectile Dysfunction
Erectile dysfunction, also known as impotence, is a condition where a man is unable to maintain an erection long enough for satisfactory sexual intercourse. This condition is more common in older men, but it can also affect younger men due to psychological factors such as depression, stress, and performance anxiety.
However, around 50% of men over the age of 40 who suffer from erectile dysfunction have an underlying organic cause. This is often due to vascular and neuropathic consequences of diabetes, but it can also be caused by neurological pathology such as spinal cord trauma and multiple sclerosis, as well as hyperprolactinaemia.
It’s important to note that certain prescription drugs can also cause erectile dysfunction, particularly anti-hypertensives and diuretics.
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This question is part of the following fields:
- Clinical Sciences
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Question 7
Incorrect
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For a healthy adult, how much moderate-intensity physical activity is recommended per week by the World Health Organization?
Your Answer: > 240 minutes
Correct Answer: > 150 minutes
Explanation:WHO Physical Activity Recommendations for Adults
The World Health Organization (WHO) recommends that adults aged 18-64 engage in a minimum of 150 minutes of moderate-intensity physical activity per week. This can be achieved through 30 minutes of exercise on at least 5 days per week. However, additional health benefits can be gained by increasing the amount of exercise beyond this minimum level.
The recommended physical activity can be achieved through either moderate-intensity aerobic activity, vigorous-intensity aerobic activity, or a combination of both. Aerobic activity should be performed in bouts of at least 10 minutes duration. For even greater health benefits, adults should aim for 300 minutes of moderate-intensity aerobic activity per week, or 150 minutes of vigorous-intensity aerobic activity per week, or a combination of both.
In addition to aerobic activity, adults should also engage in muscle-strengthening activities involving major muscle groups on two or more days per week. By following these recommendations, adults can improve their overall health and reduce the risk of chronic diseases.
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This question is part of the following fields:
- Clinical Sciences
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Question 8
Incorrect
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A clinical research group is conducting a study on diabetes epidemiology. As part of the study, researchers are collecting data on the age profile of a sample population in India.
Among the various data collected, one of the variables was the age of a person. This was divided into four categories: under 18, 18-30, 30-50, and over 50. Respondents were asked to select one of these four options.
What is this type of variable called?Your Answer: Discrete metric data
Correct Answer: Ordinal categorical variable
Explanation:Different Types of Data
When analyzing data, it is important to understand the different types of variables that can be encountered. One such variable is socio-economic status, which is not a numerical value but can be categorized into four ordinal categories. Ordinal categorical data has a logical order to its categorization, but mathematical functions cannot be performed with the numbers assigned to each category.
Continuous metric data, on the other hand, can take any value and allows for mathematical functions to be performed. Examples of continuous data include height and weight. Discrete metric data is numerical but only takes certain values, such as the number of children in a family. Nominal categorical data has no hierarchy or gradation, such as blood group or yes/no questions.
Normal parametric data assumes that variables are normally distributed, but this may not be the case for small sample populations. It is important to note that data can often fall into multiple categories. For example, systolic blood pressure can be considered continuous metric data, but in practice, it is often recorded as integers, making it somewhat like a discrete variable. Additionally, if a cut-off point is used, such as 140 mmHg, the data may become dichotomous and fall into the nominal category. the different types of data is crucial for accurate analysis and interpretation.
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This question is part of the following fields:
- Clinical Sciences
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Question 9
Incorrect
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A 37-year-old pregnant woman has experienced premature rupture of membranes (PROM) four hours prior to the onset of labour. What is the most significant predictor of PROM?
Your Answer: Alcohol intake during pregnancy
Correct Answer: Second trimester haemorrhage
Explanation:Premature Rupture of Membranes: Causes and Complications
Premature rupture of membranes (PROM) is a condition where the amniotic sac ruptures more than an hour before the onset of labor. This sudden loss of amniotic fluid vaginally is a common symptom experienced by the mother. PROM is often associated with first and second trimester hemorrhage, although smoking is also a predisposing factor. Infection is a rare cause of PROM, but Chlamydia trachomatis and B haemolytic Streptococci are among the implicated organisms.
Complications of PROM include infection, which can affect both the mother and infant. Additionally, fetal pulmonary dysplasia may occur if there is insufficient remaining amniotic fluid. It is important to monitor and manage PROM to prevent these complications.
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This question is part of the following fields:
- Clinical Sciences
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Question 10
Correct
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A 10-year-old patient presents with recurrent skin cancer and is diagnosed with xeroderma pigmentosum. What is the defective biochemical mechanism in this disease?
Your Answer: DNA excision repair
Explanation:DNA and its Processes
Deoxyribonucleic acid (DNA) found in the epidermal cells absorbs UV light, which results in the formation of pyrimidine dimers. These dimers are then removed through the process of excision repair, where the DNA is copied and re-annealed. Failure in this process can lead to mutations in tumour suppressor genes or oncogenes, which can cause malignancy.
DNA polymerisation is the process of synthesizing DNA from nucleotides, which is driven by the enzyme DNA polymerase. On the other hand, mRNA splicing is the removal of introns from RNA to allow for exons to join together before coding. Lastly, nucleotide transition refers to a point mutation of nucleotides, such as in sickle cell anaemia. these processes is crucial in comprehending the role of DNA in the body and how it can affect our health.
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This question is part of the following fields:
- Clinical Sciences
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