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Formative Assessment (29/06/2012)

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Question 1
Marks: 1
An organism isolated from the sputum of patient X, when stained with an acid-fast stain
appeared to be pink, thin, and beaded when observed under the microscope. The MOST
likely organism is
Choose one answer.
a. Salmonella typhi
b. Escherichia coli
c. Treponema pallidum
d. Mycobacterium tuberculosis
e. Corynebacterium diptheriae
Question 2
Marks: 1
Which ONE of the following statements is TRUE regarding the ovary and its function?
Choose one answer.
a. It is located on the anterior aspect of broad ligament
b. Graafian follicles are situated in its medulla.
c. During ovulation, the oocyte separates along with theca interna.
d. The oocyte has undergone two mitotic divisions before ovulation.
e. Corpus luteum becomes dysfunctional 14 days after ovulation.
Question 3
Marks: 1
A childhood viral infection which can result in paralysis is preventable by vaccination. The
causal agent is transmitted primarily by the faecal-oral route. Which ONE of the following is
the MOST appropriate vaccine to prevent this infection?
Choose one answer.
a. Bacillus Calmette -Guerin (BCG) vaccine
b. Diphtheria, Pertussis and Tetanus (DPT) vaccine
c. Hepatitis B vaccine
d. Measles, Mumps and Rubella (MMR) vaccine
e. Oral polio vaccine (OPV /Sabin vaccine)
Question 4
Marks: 1
A study is performed to analyse the characteristics of malignant neoplasms in biopsy
specimens. Which ONE of the following microscopic findings MOST likely indicates that the
neoplasm is malignant?
Choose one answer.

a. Pleomorphism
b. Atypia
c. Metastasis
d. Increased Nuclear/ cytoplasmic (N/C) ratio
e. Necrosis
Question 5
Marks: 1
A 2-year-old child suffered from weakness of the legs as a residual effect of poliomyelitis.
Which ONE of the following viruses is the MOST likely causal agent?
Choose one answer.
a. Enveloped, complex, RNA virus
b. Enveloped, icosahedral, RNA virus
c. Naked, complex, RNA virus
d. Naked, icosahedral, RNA virus
e. Enveloped, helical, RNA virus
Question 6
Marks: 1
Body temperature can be increased by drugs or chemicals that inhibit the
Choose one answer.
a. secretion of thyroid hormones
b. the action of noradrenaline on blood vessels
c. binding of acetylcholine to muscarinic receptors.
d. formation of prostaglandins in the hypothalamus.
e. act of shivering.
Question 7
Marks: 1
Which ONE of the following characteristics is TRUE about the mature cyst of Entamoeba
histolytica?
Choose one answer.
a. The cytoplasm is retracted from the cyst wall creating a clear zone.
b. It has a distinct hyaline knob at the anterior end.
c. It is pear shaped with one nucleus.
d. It is elliptical with kidney shaped macronucleus.
e. It has 4 nuclei with evenly distributed peripheral nuclear chromatin.
Question 8
Marks: 1
Antibiotic resistance is developed in shigellae through the transfer of small fractions of DNA
from the donor to the recipient bacterial cell. Which ONE of the following processes is
MOST likely to be responsible?
Choose one answer.
a. Conjugation

b. Mutation
c. Transduction
d. Transformation
e. Relocation
Question 9
Marks: 1
A housewife wanted to serve dinner to her family. She decided that she wanted to finish some
of the leftover food in the refrigerator and remembered that she had some pickled vegetables
(acar) that she made three weeks ago. She took out the acar and noticed that there was a
bluish-black growth on top of the acar.
Which ONE of the following microorganisms is MOST likely to be the
growthcontaminating the acar?
Choose one answer.
a. Candida albicans
b. Tinea species
c. Aspergillus species
d. Group A streptococci
e. Staphylococcus species
Question 10
Marks: 1
Which ONE of the following chemicals may be both a disinfectant and a sterilant?
Choose one answer.
a. Formaldehyde
b. Ethanol
c. Chlorhexidine
d. Iodine
e. Phenols
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Question 11
Marks: 1
Which ONE of the following changes would occur to the ovaries of a 23 -year -old woman
who has undergone hypophysectomy (removal of pituitary glands)?
Choose one answer.
a. Hypersecretion of oestrogen
b. Hypersecretion of progesterone
c. Development of ovarian resistance against gonadotrophin

d. Reduction of the number of ovarian follicles.


e. Gonadal atrophy
Question 12
Marks: 1
A 32-year-old man presented with symptoms of gastric ulcer. Gastric biopsy tissue cultured
on enriched media yielded Gram-negative, spiral-shaped bacteria. What is the MOST likely
causal agent of this patients illness?
Choose one answer.
a. Campylobacter fetus
b. Helicobacter pylori
c. Spirillum minus
d. Vibrio cholerae
e. Yersinia enterocolitica
Question 13
Marks: 1
Oral antacids can bind to some drugs given orally at the same time, thus preventing their
absorption. This is an example of a
Choose one answer.
a. pharmacodynamic drug interaction.
b. drug with a narrow toxic therapeutic ratio.
c. drug causing enzyme inhibition.
d. pharmacokinetic drug interaction.
e. drug causing pharmacological antagonism.
Question 14
Marks: 1
Which ONE of the following statements is TRUE regarding the germinal epithelium of the
seminiferous tubule?
Choose one answer.
a. It is a simple epithelium.
b. It has no basal lamina.
c. It is divided into two compartments by the processes of Leydig cells (interstitial
cells).
d. Late spermatids are in its basal compartment.
e. Secondary spermatocytes are in its adluminal compartment.
Question 15
Marks: 1
Which ONE of the following is responsible for the formation of mesoderm?
Choose one answer.
a. Hypoblast
b. Notochord
c. Primitive streak
d. Trophoblast

e. Placenta
Question 16
Marks: 1
Aplasia of which ONE of the following organs is incompatible with life?
Choose one answer.
a. Kidney
b. Lung
c. Adrenal
d. Pituitary
e. Testis
Question 17
Marks: 1
A young man is practicing for an important upcoming sports event in the noon-day sun, and
does not realize that it was very hot. He noticed that he did not pass urine for many hours
after that. Which ONE of the following events had taken place in his body?
Choose one answer.
a. There is fall in plasma osmolality.
b. The extracellular fluid volume rises.
c. Anti-diuretic hormone (ADH) is released from the anterior pituitary.
d. ADH is acting on the proximal convoluted tubules of the kidney.
e. The membrane of the collecting ducts becomes permeable to water.
Question 18
Marks: 1

These organisms are described as Gram positive bacteria with a Chinese letter like formation.
Which ONE of the following diseases is MOST likely to be caused by these organisms?
Choose one answer.
a. Cholera
b. Diptheria
c. Typhoid
d. Syphilis
e. Tuberculosis
Question 19
Marks: 1
The blood tends to pool at the lower limbs and causes oedema in the passengers of a long
flight. Which ONE of the following factors would be increased to cause the oedema?
Choose one answer.
a. Intravascular hydrostatic pressure
b. Interstitial fluid hydrostatic pressure
c. Intravascular oncotic pressure

d. Interstitial fluid oncotic pressure


e. Vascular permeability
Question 20
Marks: 1
Which ONE of the following characteristic features is TRUE regarding Plasmodium
malariae?
Choose one answer.
a. The gametocyte is crescent shaped.
b. The infected red blood cell is larger than the normal RBC.
c. The infected RBC is fimbriated and oval shaped.
d. The trophozoite stage is band-shaped.
e. The hypnozoites are found in the liver.
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Question 21
Marks: 1
Which ONE of the following is a metabolic effect of cortisol?
Choose one answer.
a. Increased protein synthesis in extrahepatic tissues
b. Increased glycogenolysis in the liver
c. Increased gluconeogenesis in the liver
d. Increased triglyceride synthesis in the liver
e. Increased uptake of glucose by skeletal muscles
Question 22
Marks: 1
A 6-year-old child has attained the full stature of an adult and the brain scan shows a tumour
in the pituitary. Which ONE of the following hormones is MOST likely to have a direct effect
on the bone?
Choose one answer.
a. Growth hormone releasing hormone(GHRH)
b. Growth hormone(GH)
c. Insulin-like growth factor 1 (IGF-1)
d. Insulin
e. Platelet derived growth factor(PDGF)
Question 23
Marks: 1

Which ONE of the following statements is TRUE regarding drugs having antagonistic
actions?
Choose one answer.
a. Competitive antagonists bind to a site different from the agonist site.
b. Non-competitive antagonists are likely to bind covalently with the receptor.
c. Competitive antagonists are not useful as drugs.
d. Non-competitive antagonists primarily affect the potency of drug.
e. Inverse agonists do not have intrinsic activity.
Question 24
Marks: 1
Which ONE of the following conditions is MOST likely to show rudimentary organs which
are smaller than the normal organ and lacking the full complement of cells?
Choose one answer.
a. Hyperplasia
b. Neoplasia
c. Metaplasia
d. Hypoplasia
e. Dysplasia
Question 25
Marks: 1
A 50-year-old patient developed sepsis in his superficial skin incision after a thoracic
operation. The causal organisms were Gram-positive and were from an endogenous source.
Which ONE of the following is the MOST likely cause of his wound sepsis?
Choose one answer.
a. Bacteroides fragilis
b. Clostridium perfringens
c. Escherichia coli
d. Peptostreptococcus
e. Staphylococcus aureus
Question 26
Marks: 1
Which ONE of the following is the predominant form of thyroid hormones found in the blood
circulation?
Choose one answer.
a. Thyroxine (T4)
b. Triiodothyronine (T3)
c. Monoiodothyronine (MIT)
d. Diiodothyronine (DIT)
e. Reverse T3
Question 27
Marks: 1
Transport of drugs across cell membranes is reduced by

Choose one answer.


a. a high lipid solubility.
b. being unionized at environmental pH.
c. a passive diffusion process.
d. the P- Glycoprotein pump.
e. a small molecular size.
Question 28
Marks: 1
A study showed that the mean systolic blood pressure of a group of students before sitting an
examination was raised. What could be the MOST likely factor that causes the rise in the
systolic blood pressure?
Choose one answer.
a. Increased urination
b. Increased vasodilation
c. Increased breathing rate
d. Increased heart rate
e. Increased water intake
Question 29
Marks: 1
The strongest ligament which is responsible for the maintenance of the uterus in its normal
position within the pelvic cavity is the
Choose one answer.
a. broad ligament.
b. round ligament.
c. uterosacral ligament.
d. transverse cervical ligament.
e. ovarian ligament.
Question 30
Marks: 1
One of the mechanisms by which bacteria acquire drug resistance is through the development
of an altered metabolic pathway. Which ONE of the following drugs is this mechanism of
resistance MOST relevant?
Choose one answer.
a. Chloramphenicol
b. Erythromycin
c. Penicillin
d. Sulphonamides
e. Tetracyclines
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Question 31
Marks: 1
Cell X releases hormone Y as it is synthesized. Stimulation on cell X causes a gradual rise in
plasma concentrations of hormone Y over a few days. Based on the observation, what can
you conclude about the nature of hormone Y?
Choose one answer.
a. Protein
b. Polypeptide
c. Amine
d. Fatty acid derivative
e. Steroid
Question 32
Marks: 1
In bronchial asthma, relaxation of bronchiolar smooth muscle can be achieved by a drug that
activates/stimulates the
Choose one answer.
a. alpha-1 adrenergic receptor.
b. beta-1 adrenergic receptor.
c. beta-2 adrenergic receptor.
d. nicotinic cholinergic receptor.
e. muscarinic cholinergic receptor.
Question 33
Marks: 1
An increase in libido in both sexes is contributed by
Choose one answer.
a. testosterone
b. dehydroepiandrosterone
c. progesterone
d. oestrogen
e. oxytocin
Question 34
Marks: 1
During the fight-or-flight reaction, sympathetic stimulation results in widespread effects.
Some of these effects are mediated through alpha and some through beta receptor stimulation.
Which ONE of the following is an alpha adrenergic effect?
Choose one answer.
a. Bronchoconstriction
b. Contraction of circular muscles of the iris
c. Vasoconstriction of blood vessels supplying the viscera

d. Increase in heart rate


e. Contraction of the radial muscles of gastro-intestinal sphincters
Question 35
Marks: 1
Hepatic microsomal drug metabolizing enzymes can be inhibited by
Choose one answer.
a. smoking
b. drinking grape fruit juice.
c. chronic alcoholism.
d. using herbs like St. Johns wort.
e. eating charbroiled (barbecued) meat.
Question 36
Marks: 1
A 45-year-old patient developed sepsis after bowel surgery. The causal organisms which were
isolated under strict anaerobic culture were Gram-negative bacteria. What is the MOST likely
organism for the patients sepsis?
Choose one answer.
a. Bacteroides fragilis
b. Clostridium perfringens
c. Escherichia coli
d. Pseudomonas aeruginosa
e. Peptostreptococcus
Question 37
Marks: 1
A 25-year-old HIV positive patient presented to the family physician with recurring painful
vesicular lesions on the lips. The causal agent was an enveloped DNA virus. Which ONE of
the following is the MOST likely cause of the vesicular lesions?
Choose one answer.
a. Adenovirus
b. Coxsackie virus
c. Herpes simplex virus
d. Papilloma virus
e. Kaposi sarcoma virus
Question 38
Marks: 1
Which ONE of the following is MOST likely a physiological function of mediators formed
by the cyclooxygenase pathway of arachidonic acid?
Choose one answer. 2
a. vasodilatation by thromboxane (TxA2).
b. platelet aggregation by prostacyclin (PGI2).
c. increased gastric acid secretion.

d. reduction of intraocular pressure.


e. reduction of renal blood flow.
Question 39
Marks: 1
At which ONE of the following circumstances the meiotic II division of the oocyte will be
completed?
Choose one answer.
a. Cleavage
b. Fertilization
c. Gastrulation
d. Implantation
e. Ovulation
Question 40
Marks: 1

The following bacteria were isolated from a patient suffering from syphilis. These bacteria
cannot be gram stained. Which ONE of the following organisms cause this condition?
Choose one answer.
a. Treponema pallidum
b. Mycobacterium tuberculosis
c. Salmonella typhi
d. Chlamydia trachomatis
e. Rickettsia prowazeki
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Formative Assessment (29/06/2012)
Review of attempt 1
Started on

Friday, 29 June 2012, 02:43 PM

Completed on

Friday, 29 June 2012, 03:35 PM

Time taken
Grade
Question 1
Marks: 1

52 mins 21 secs
30 out of a maximum of 40 (75%)

An organism isolated from the sputum of patient X, when stained with an acidfast stain appeared to be pink, thin, and beaded when observed under the
microscope. The MOST likely organism is
Choose one answer.
a. Salmonella typhi

b. Escherichia coli
c. Treponema
pallidum
d. Mycobacterium
tuberculosis

Mycobacterium tuberculosis is stained using the acid


fast stain. Under the microscope it appears pink,
beaded and thin.

e. Corynebacterium
diptheriae
Correct
Marks for this submission: 1/1.
Question 2
Marks: 1
Which ONE of the following statements is TRUE regarding the ovary and its
function?
Choose one answer.
a. It is located on
the anterior aspect
of broad ligament
b. Graafian follicles
are situated in its
medulla.
c. During ovulation,
the oocyte
separates along with
theca interna.
d. The oocyte has
undergone two
mitotic divisions

before ovulation.
The corpus luteum continues to secrete progesterone
e. Corpus luteum
which produces changes in the uterine wall for
becomes
implantation. If fertilization does not happen, it withers
dysfunctional 14
away 14 days after ovulation. This causes reduction in
days after ovulation.
progesterone level causing initiation of menstrual
bleeding.
Correct
Marks for this submission: 1/1.
Question 3
Marks: 1
A childhood viral infection which can result in paralysis is preventable by
vaccination. The causal agent is transmitted primarily by the faecal-oral route.
Which ONE of the following is the MOST appropriate vaccine to prevent this
infection?
Choose one answer.
a. Bacillus
Calmette
-Guerin (BCG)
vaccine
b. Diphtheria,
Pertussis and
Tetanus (DPT)
vaccine
c. Hepatitis B
vaccine
d. Measles,
Mumps and
Rubella (MMR)
vaccine
The vaccines listed above form part of the childhood
e. Oral polio
immunization programme. BCG and DPT vaccines prevent
vaccine (OPV
bacterial infections. Hepatitis B, MMR, and OPV vaccines
/Sabin vaccine) prevent viral infections. Polio is transmitted primarily by the
faecal-oral route. The Oral polio vaccine (OPV) is the
appropriate vaccine to prevent this infection.
Correct

Marks for this submission: 1/1.


Question 4
Marks: 1
A study is performed to analyse the characteristics of malignant neoplasms in
biopsy specimens. Which ONE of the following microscopic findings MOST likely
indicates that the neoplasm is malignant?
Choose one answer.
a. Pleomorphism
b. Atypia

c. Metastasis

The ability of a neoplasm to metastasize is the most


important indicator of malignancy. The neoplasms
initially invade and later metastasize or spread to
other places.

d. Increased Nuclear/
cytoplasmic (N/C)
ratio
e. Necrosis
Correct
Marks for this submission: 1/1.
Question 5
Marks: 1
A 2-year-old child suffered from weakness of the legs as a residual effect of
poliomyelitis. Which ONE of the following viruses is the MOST likely causal agent?
Choose one answer.
a. Enveloped,
complex, RNA virus
b. Enveloped,
icosahedral, RNA
virus
c. Naked, complex,
RNA virus

d. Naked,
icosahedral, RNA
virus

Poliomyelitis is caused by poliovirus types 1, 2 and 3


which belong to the picornaviridae family which
comprises naked, icosahedral, RNA viruses.

e. Enveloped,
helical, RNA virus
Correct
Marks for this submission: 1/1.
Question 6
Marks: 1
Body temperature can be increased by drugs or chemicals that inhibit the
Choose one answer.
a. secretion of
thyroid hormones
b. the action of
noradrenaline on
blood vessels

c. binding of
acetylcholine to
muscarinic
receptors.

Acetylcholine released by postganglionic sympathetic


nerve endings binds to muscarinic receptors in glands
(including the sweat glands) causing an increase in
secretion. Inhibition of this binding will reduce sweat
secretion and subsequently the evaporative heat loss.
Decreased heat loss can raise the body temperature,
particularly if the person is already feverish.

d. formation of
prostaglandins in
the
hypothalamus.
e. act of
shivering.
Correct
Marks for this submission: 1/1.
Question 7
Marks: 1

Which ONE of the following characteristics is TRUE about the mature cyst of
Entamoeba histolytica?
Choose one answer.
a. The cytoplasm is retracted from the
cyst wall creating a clear zone.

This morphology is only seen in a


mature cyst of Giardia lamblia.

b. It has a distinct hyaline knob at the


anterior end.
c. It is pear shaped with one nucleus.
d. It is elliptical with kidney shaped
macronucleus.
e. It has 4 nuclei with evenly distributed
peripheral nuclear chromatin.
Incorrect
Marks for this submission: 0/1.
Question 8
Marks: 1
Antibiotic resistance is developed in shigellae through the transfer of small
fractions of DNA from the donor to the recipient bacterial cell. Which ONE of the
following processes is MOST likely to be responsible?
Choose one answer.
a. Conjugation
b. Mutation
c. Transduction

Lysogenic conversion /transduction is mediated by a


bacteriophage.

d. Transformation

e. Relocation
Incorrect
Marks for this submission: 0/1.
Question 9
Marks: 1

A housewife wanted to serve dinner to her family. She decided that she wanted
to finish some of the leftover food in the refrigerator and remembered that she
had some pickled vegetables (acar) that she made three weeks ago. She took
out the acar and noticed that there was a bluish-black growth on top of the
acar.
Which ONE of the following microorganisms is MOST likely to be the
growthcontaminating the acar?
Choose one answer.
a. Candida
albicans
b. Tinea
species
Aspergillus species are highly aerobic and are found in almost
all oxygen-rich environments, where they commonly grow as
molds on the surface of a substrate, as a result of the high
c. Aspergillus oxygen tension. Commonly, fungi grow on carbon-rich
substrates such as monosaccharides (such as glucose) and
species
polysaccharides (such as amylose). Aspergillus species are
common contaminants of starchy foods (such as bread and
potatoes), and grow in or on many plants and trees.
d. Group A
streptococci
e.
Staphylococc
us species
Correct
Marks for this submission: 1/1.
Question 10
Marks: 1
Which ONE of the following chemicals may be both a disinfectant and a sterilant?
Choose one answer.
a. Formaldehyde
b. Ethanol
c. Chlorhexidine

All the other options act as disinfectants only.

d. Iodine
e. Phenols
Incorrect
Marks for this submission: 0/1.
Question 11
Marks: 1
Which ONE of the following changes would occur to the ovaries of a 23 -year -old
woman who has undergone hypophysectomy (removal of pituitary glands)?
Choose one answer.
a. Hypersecretion of
oestrogen
b. Hypersecretion of
progesterone
c. Development of
ovarian resistance
against gonadotrophin
d. Reduction of the
number of ovarian
follicles.

e. Gonadal atrophy

The gonadotrophin secretion will be absent if the


pituitary glands are removed. The gonads will
regress if there is no stimulation from the
gonadotrophins chronically (hypogonadodism).

Correct
Marks for this submission: 1/1.
Question 12
Marks: 1
A 32-year-old man presented with symptoms of gastric ulcer. Gastric biopsy
tissue cultured on enriched media yielded Gram-negative, spiral-shaped bacteria.
What is the MOST likely causal agent of this patients illness?
Choose one answer.

a.
Campylobacter
fetus
b. Helicobacter
pylori

The organisms stated are Gram-negative bacteria.


Helicobacter pylori is documented to be associated with
gastritis and gastric ulcer.

c. Spirillum
minus
d. Vibrio cholerae
e. Yersinia
enterocolitica
Correct
Marks for this submission: 1/1.
Question 13
Marks: 1
Oral antacids can bind to some drugs given orally at the same time, thus
preventing their absorption. This is an example of a
Choose one answer.
a. pharmacodynamic
drug interaction.
b. drug with a narrow
toxic therapeutic
ratio.
c. drug causing
enzyme inhibition.
d. pharmacokinetic
drug interaction.

Pharmacokinetic interactions between drugs can


occur during absorption, distribution, metabolism or
excretion of drugs (ADME). This is an example of an
interaction during drug absorption.

e. drug causing
pharmacological
antagonism.
Correct
Marks for this submission: 1/1.

Question 14
Marks: 1
Which ONE of the following statements is TRUE regarding the germinal
epithelium of the seminiferous tubule?x
Choose one answer.
a. It is a simple
epithelium.
b. It has no basal
lamina.
c. It is divided into two
compartments by the
processes of Leydig
cells (interstitial cells).
d. Late spermatids are
in its basal
compartment.
e. Secondary
spermatocytes are in
its adluminal
compartment.

Secondary spermatocytes have haploid number of


chromosomes. Thus they are considered as foreign.
Therefore they are located in the adluminal
compartment of the germinal epithelium and
prevented from coming into contact with antibody
forming cells by the blood- testes barrier

Correct
Marks for this submission: 1/1.
Question 15
Marks: 1
Which ONE of the following is responsible for the formation of mesoderm?
Choose one answer.
a.
Hypoblast
b.
Notochord

Primitive streak appears on the midline of the caudal half of the


epiblast surface of the bilaminar germ disc. Cells of the epiblast
c. Primitive migrate in the direction of primitive streak and on reaching the
primitive streak the cells detach themselves from the epiblast
streak
and invaginate between the epiblast and hypoblast layer thus
forming the mesoderm.
d.
Trophoblas
t
e. Placenta
Correct
Marks for this submission: 1/1.
Question 16
Marks: 1
Aplasia of which ONE of the following organs is incompatible with life?
Choose one answer.
a.
Kidney
b. Lung
c.
Adrenal
Aplasia or Agenesis is failure of development of tissue or organ,
which is a developmental abnormality that presumably develops
d.
early in intra uterine life. Aplastic organs are either totally absent or
Pituitar
represented by small mass of fibrous or fatty tissue containing a few
y
rudimentary cells. In unpaired organs like aplasia of aorta or
pituitary, it is incompatible with life.
e. Testis
Correct
Marks for this submission: 1/1.
Question 17

Marks: 1
A young man is practicing for an important upcoming sports event in the noonday sun, and does not realize that it was very hot. He noticed that he did not
pass urine for many hours after that. Which ONE of the following events had
taken place in his body?
Choose one answer.
a. There is fall in
plasma osmolality.
b. The
extracellular fluid
volume rises.
c. Anti-diuretic
hormone (ADH) is
released from the
anterior pituitary.
d. ADH is acting
on the proximal
convoluted
tubules of the
kidney.
Antidiuretic hormone (ADH) binds to receptors on cells in
the collecting ducts of the kidney and promotes
reabsorption of water back into the circulation. In the
e. The membrane absence of antidiuretic hormone, the collecting ducts are
of the collecting
virtually impermeable to water, and it flows out as urine.
ducts becomes
Antidiuretic hormone stimulates water reabsorption by
permeable to
stimulating insertion of "water channels" or aquaporins
into the membranes of kidney tubules. These channels
water.
transport solute-free water through tubular cells and back
into blood, leading to a decrease in plasma osmolarity
and an increase osmolarity of urine.
Correct
Marks for this submission: 1/1.
Question 18
Marks: 1

These organisms are described as Gram positive bacteria with a Chinese letter
like formation. Which ONE of the following diseases is MOST likely to be caused
by these organisms?
Choose one answer.
a. Cholera

b. Diptheria

Corynebacterium diphtheriae are the causative agents of


diphtheria. They are often described as having Chinese letterlike formation.

c. Typhoid
d. Syphilis
e.
Tuberculosis
Correct
Marks for this submission: 1/1.
Question 19
Marks: 1
The blood tends to pool at the lower limbs and causes oedema in the passengers
of a long flight. Which ONE of the following factors would be increased to cause
the oedema?
Choose one answer.
a. Intravascular
hydrostatic
pressure
b. Interstitial
fluid hydrostatic
pressure
c. Intravascular
oncotic pressure

When the blood pools at the vein of the lower limbs due to
muscle inactivity, the capillary pressure which is
equivalent to intravascular hydrostatic pressure will be
increased. This will promote fluid filtration and oedema.

d. Interstitial
fluid oncotic
pressure
e. Vascular
permeability
Correct
Marks for this submission: 1/1.
Question 20
Marks: 1
Which ONE of the following characteristic features is TRUE regarding Plasmodium
malariae?
Choose one answer.
a. The gametocyte is
crescent shaped.
b. The infected red blood cell
is larger than the normal
RBC.
c. The infected RBC is
The infected RBC is fimbriated and oval
fimbriated and oval shaped. shaped. This morphological feature is seen only
in Plasmodium ovale.
d. The trophozoite stage is
band-shaped.
e. The hypnozoites are found
in the liver.
Incorrect
Marks for this submission: 0/1.
Question 21
Marks: 1
Which ONE of the following is a metabolic effect of cortisol?
Choose one answer.
a. Increased
protein synthesis
in extrahepatic

tissues
b. Increased
glycogenolysis in
the liver
Cortisol is produced by the adrenal gland in the zona
fasciculata, the second of three layers comprising the
c. Increased
adrenal cortex. This release is controlled by the
gluconeogenesis in
hypothalamus, a part of the brain. It stimulates
the liver
gluconeogenesis (formation, in the liver, of glucose from
certain amino acids, glycerol, lactate and/or propionate)
d. Increased
triglyceride
synthesis in the
liver
e. Increased
uptake of glucose
by skeletal
muscles
Correct
Marks for this submission: 1/1.
Question 22
Marks: 1
A 6-year-old child has attained the full stature of an adult and the brain scan
shows a tumour in the pituitary. Which ONE of the following hormones is MOST
likely to have a direct effect on the bone?
Choose one answer.
a. Growth hormone releasing
hormone(GHRH)
b. Growth hormone(GH)
c. Insulin-like growth factor 1
(IGF-1)
d. Insulin
e. Platelet derived growth
factor(PDGF)

GH would definitely have an effect on bone


but such effect is mediated by IGF -1.

Incorrect
Marks for this submission: 0/1.
Question 23
Marks: 1
Which ONE of the following statements is TRUE regarding drugs having
antagonistic actions?
Choose one answer.
a. Competitive
antagonists bind to a
site different from the
agonist site.
b. Non-competitive
Non-competitive antagonist can bind covalently
antagonists are likely to (irreversibly) to the same site as the agonist or to a
bind covalently with the different site. Hence, increasing the concentration
of the agonist cannot overcome the blockade.
receptor.
c. Competitive
antagonists are not
useful as drugs.
d. Non-competitive
antagonists primarily
affect the potency of
drug.
e. Inverse agonists do
not have intrinsic
activity.
Correct
Marks for this submission: 1/1.
Question 24
Marks: 1
Which ONE of the following conditions is MOST likely to show rudimentary organs
which are smaller than the normal organ and lacking the full complement of
cells?
Choose one answer.
a.
Hyperplasi

a
b.
Neoplasia
c.
Metaplasia
Hypoplasia is failure of organ to attain full size. This is a less
d.
severe abnormality than aplasia. There are rudimentary organs,
Hypoplasi smaller than normal that lack the full complement of cells, so the
function may be reduced. Usually affects the same paired &
a
unpaired organs as aplasia.
e.
Dysplasia
Correct
Marks for this submission: 1/1.
Question 25
Marks: 1
A 50-year-old patient developed sepsis in his superficial skin incision after a
thoracic operation. The causal organisms were Gram-positive and were from an
endogenous source. Which ONE of the following is the MOST likely cause of his
wound sepsis?
Choose one answer.
a. Bacteroides
fragilis
b. Clostridium
perfringens
c. Escherichia coli
d.
Clostridium and Peptostreptococcus are strict
Peptostreptococcus anaerobes and thus are unlikely in a superficial skin
wound.
e. Staphylococcus
aureus
Incorrect

Marks for this submission: 0/1.


Question 26
Marks: 1
Which ONE of the following is the predominant form of thyroid hormones found in
the blood circulation?
Choose one answer.
a. Thyroxine (T4)

T4 is the major form of thyroid hormones


secreted

b. Triiodothyronine (T3)
c. Monoiodothyronine (MIT)

d. Diiodothyronine (DIT)
e. Reverse T3
Correct
Marks for this submission: 1/1.
Question 27
Marks: 1
Transport of drugs across cell membranes is reduced by
Choose one answer.
a. a high lipid
solubility.
b. being unionized
at environmental
pH.
c. a passive
diffusion process.
P glycoprotein is the efflux pump, situated at GI mucosa,
d. the Pbiliary tree, blood brain barrier and renal tubules. This
Glycoprotein pump.
pump transports drugs back to the original site and
reduces absorption.

e. a small
molecular size.
Correct
Marks for this submission: 1/1.
Question 28
Marks: 1
A study showed that the mean systolic blood pressure of a group of students
before sitting an examination was raised. What could be the MOST likely factor
that causes the rise in the systolic blood pressure?
Choose one answer.
a. Increased
urination
b. Increased
vasodilation
c. Increased
breathing rate

d. Increased
heart rate

The sympathetic outflow to the heart will be increased in an


anticipatory period. This would raise the heart rate and
subsequently the blood pressure.

e. Increased
water intake
Correct
Marks for this submission: 1/1.
Question 29
Marks: 1
The strongest ligament which is responsible for the maintenance of the uterus in
its normal position within the pelvic cavity is the
Choose one answer.
a. broad ligament.
b. round ligament.

Broad ligament is a peritoneal fold covering the


uterus and the fallopian tubes.

c. uterosacral ligament.
d. transverse cervical
ligament.
e. ovarian ligament.
Incorrect
Marks for this submission: 0/1.
Question 30
Marks: 1
One of the mechanisms by which bacteria acquire drug resistance is through the
development of an altered metabolic pathway. Which ONE of the following drugs
is this mechanism of resistance MOST relevant?
Choose one answer.
a.
Chloramphenicol
b. Erythromycin

c. Penicillin
d. Sulphonamides The sulphonamides develop resistance by altering the
metabolic pathway.
e. Tetracyclines
Correct
Marks for this submission: 1/1.
Question 31
Marks: 1
Cell X releases hormone Y as it is synthesized. Stimulation on cell X causes a
gradual rise in plasma concentrations of hormone Y over a few days. Based on
the observation, what can you conclude about the nature of hormone Y?
Choose one answer.
a. Protein

b. Polypeptide

c. Amine
d. Fatty acid
derivative
e. Steroid

The steroid hormone is not stored in cells and is usually


released once synthesized and therefore the increase in the
hormonal levels may take days to happen. e.g. oestrogen.

Correct
Marks for this submission: 1/1.
Question 32
Marks: 1
In bronchial asthma, relaxation of bronchiolar smooth muscle can be achieved by
a drug that activates/stimulates the
Choose one answer.
a. alpha-1
adrenergic
receptor.
b. beta-1
adrenergic
receptor.
c. beta-2
adrenergic
receptor.

beta-2 adrenergic receptors are abundant in the bronchiolar


smooth muscle. Activation/stimulation of the beta-2 receptor
leads to activation of adenylate cyclase, increasing formation
of cAMP and relaxation of smooth muscle.

d. nicotinic
cholinergic
receptor.
e. muscarinic
cholinergic
receptor.
Correct
Marks for this submission: 1/1.
Question 33

Marks: 1
An increase in libido in both sexes is contributed by
Choose one answer.

a. testosterone

Testosterone is secreted in large amounts by the


testes only in males. Therefore it is mainly responsible
an increase in libido in males but not in females.

b.
dehydroepiandrostero
ne
c. progesterone
d. oestrogen
e. oxytocin
Incorrect
Marks for this submission: 0/1.
Question 34
Marks: 1
During the fight-or-flight reaction, sympathetic stimulation results in widespread
effects. Some of these effects are mediated through alpha and some through
beta receptor stimulation. Which ONE of the following is an alpha adrenergic
effect?
Choose one answer.
a. Bronchoconstriction
b. Contraction of circular muscles of the iris
c. Vasoconstriction of blood vessels
supplying the viscera
d. Increase in heart rate
e. Contraction of the radial muscles of
gastro-intestinal sphincters
Incorrect
Marks for this submission: 0/1.

Sympathetic stimulation causes


bronchodilation.

Question 35
Marks: 1
Hepatic microsomal drug metabolizing enzymes can be inhibited by
Choose one answer.
a. smoking
b. drinking
grape fruit
juice.

Grape fruit juice inhibits CYP3A4, which is the major


microsomal enzyme responsible for metabolism of drugs.
When drugs are prescribed to patients who were taking
grapefruit juice, the drug metabolism is inhibited leading to
higher plasma concentration and toxicity.

c. chronic
alcoholism.
d. using herbs
like St. Johns
wort.
e. eating
charbroiled
(barbecued)
meat.
Correct
Marks for this submission: 1/1.
Question 36
Marks: 1
A 45-year-old patient developed sepsis after bowel surgery. The causal organisms
which were isolated under strict anaerobic culture were Gram-negative bacteria.
What is the MOST likely organism for the patients sepsis?
Choose one answer.
a. Bacteroides
fragilis
b. Clostridium
perfringens
c. Escherichia coli

The organisms stated are commensals of the intestinal


tract and thus can constitute a source of infection.
Bacteroides is gram negative and a strict anaerobe.

d. Pseudomonas
aeruginosa
e.
Peptostreptococcus
Correct
Marks for this submission: 1/1.
Question 37
Marks: 1
A 25-year-old HIV positive patient presented to the family physician with
recurring painful vesicular lesions on the lips. The causal agent was an
enveloped DNA virus. Which ONE of the following is the MOST likely cause of the
vesicular lesions?
Choose one answer.
a.
Adenovirus
b.
Coxsackie
virus
c. Herpes
simplex
virus

The viruses listed are DNA viruses except Coxsackie virus, and
can cause opportunistic infection in a patient who is HIV
positive with possible immunosuppression. Herpes simplex
virus presents with vesicular lesions on the lips known as cold
sores.

d. Papilloma
virus
e. Kaposi
sarcoma
virus
Correct
Marks for this submission: 1/1.
Question 38
Marks: 1

Which ONE of the following is MOST likely a physiological function of mediators


formed by the cyclooxygenase pathway of arachidonic acid?
Choose one answer.
a. vasodilatation by
thromboxane (TxA2).

Thromboxane (TxA2) is a potent


vasoconstrictor. Prostacyclin causes
vasodilatation.

b. platelet aggregation by
prostacyclin (PGI2).
c. increased gastric acid
secretion.
d. reduction of intraocular
pressure.
e. reduction of renal blood
flow.
Incorrect
Marks for this submission: 0/1.
Question 39
Marks: 1
At which ONE of the following circumstances the meiotic II division of the oocyte
will be completed?
Choose one answer.
a.
Cleavage
Fertilization results in the completion of meiotic II division.
Meiosis is a process of cell division which results in the division
of diploid parental cell into haploid progeny. Meiosis I is followed
b.
by meiosis II. Cell division following meiosis I is asymmetrical,
Fertilizatio resulting in the production of small polar body and an oocyte
that retain its large size. The oocyte then enters into meiosis II
n
without having reformed a nucleus or decondensed its
chromosome. Most vertebrate oocytes are arrested in
metaphase II, where they remain until fertilization.
c.
Gastrulatio
n

d.
Implantatio
n
e.
Ovulation
Correct
Marks for this submission: 1/1.
Question 40
Marks: 1

The following bacteria were isolated from a patient suffering from syphilis. These
bacteria cannot be gram stained. Which ONE of the following organisms cause
this condition?
Choose one answer.
a. Treponema pallidum
b. Mycobacterium
tuberculosis
c. Salmonella typhi
d. Chlamydia trachomatis
e. Rickettsia prowazeki
Correct
Marks for this submission: 1/1.

Treponema pallidum is the aetiological agent of


syphilis.