MCQ EOS June 2015 Summative

All of the following factors contribute to the virulence of mycobacteria, EXCEPT:

All of the following conditions are assessed as part of the screening tests done on newborn babies, EXCEPT:

All of the following are chemical mediators (released during tissue injury) which stimulate nociceptors to produce pain, EXCEPT:

All of the following are signs of poisoning with an organophosphate compound (long-acting acetylcholinesterase inhibitor), EXCEPT:

All of the following statements regarding penicillin are all correct, EXCEPT:

All of the following ordinarily act to increase blood flow in exercising muscle, EXCEPT:

All of the following are thought to be risk factors for spina bifida, EXCEPT:

All of the following statements regarding the pathology of pneumonia are correct, EXCEPT:

All of the following are histopathological features of an atheromatous plaque / atheroma, EXCEPT:

Sam, a builder, aged 42, has fallen from a ladder at work and sustained multiple fractures to his arms and legs. All of the following describe the doctor’s role in the management of Sam’s work related injuries, EXCEPT:

All of the following heart lesions are commonly associated with cyanosis, EXCEPT:

All of the following disease related factors are requirements for a successful screening program, EXCEPT:

All of the following statements regarding the role of chemical mediators released by mast cells are correct, EXCEPT:

In the grading of neoplasms, well-differentiated tumours differ from poorly-differentiated tumours in all of the following ways, EXCEPT that well-differentiated tumours:

All of the following are considered elements of a management strategy for hypertension EXCEPT:

A patient with cancer might be expected to be on any of the following drugs, EXCEPT:

All germ cells and some cancer cells share which of the following characteristics?

Which of the following is the definition of a representative heuristic in diagnostic clinical pattern recognition?

A 50 year old patient presents with haemorrhages and exudates (cottonwool spots) in the retinas of his eyes. He is also MOST LIKELY to:

The microbes in the sputum of a patient with suspected pneumonia appear to be spherical and linked in pairs. This microbe is MOST LIKELY to be a:

A drug that blocks pancreatic lipase will DECREASE the biochemical digestion and absorption of:

In which of the following pairs of pressures do both pressures act to move fluid from interstitial spaces into capillaries?

Hypertension is a risk factor for:

A systemic, sympathetic, ‘fight or flight’ response MOST LIKELY includes:

DLEPP - Choose A

Which of the following drugs is MOST LIKELY to result in decreased activity at neuromuscular junctions?

A good screening test needs to have high:

A 38 year old woman presents to you at 11 weeks of pregnancy. Which of the following best fits the definition of a screening test for a Down syndrome fetus?

DLEPP - choose A

The National Vision for primary health care has, as one of its MAIN priorities

In the blastocyst, the:

You are considering working for the World Health Organisation in a socially and economically disadvantaged developing region where there is a tuberculosis epidemic. Your specific brief is to address the social determinants of health through tuberculosis control programs. Which of the following should you address as part of your brief?

Drug X is said to be more potent than drug Y. Therefore, drug X produces a:

The goal of immunization (vaccination) is to induce:

DLEPP - Choose A

The conversion of angiotensin I to angiotensin II by angiotensin converting enzyme occurs primarily in the circulation through the:

One of the advantages of high risk population approaches to blood pressure control in comparison to population wide interventions is that high risk population approaches:

Which of the following lifestyle change would MOST benefit a patient in terms of modifying hyperlipidaemia?

In the human body, carbon monoxide:

Which of the following is an example of secondary prevention?

Consider the following reaction as it occurs in the body: CO2 + H20 ⇔ H2CO3 ⇔ H+ + HC03

The MOST important reason for initiating quarantining activities is to:

The FIRST priority of a medical practitioner in treating a patient with suspected cholera is to:

With regard to blood transfusions, what blood type is referred to as the “Universal Recipient?”

Which of the following is a clinical feature of haemolytic anaemia?

DLEPP - Choose A

Which of the following inhibits thrombosis?

Sandra, 29, presents to you following a recent visit to Thailand. She is complaining of severe diarrhoea, abdominal cramps, nausea and bloating. She says that it commenced shortly after arriving home. When taking a travel history from Sandra, it is MOST important that you ask Sandra about:

Which of the following human diseases is covered by the Quarantine Act and are therefore subject to quarantine laws in Australia?

The results of a screening test for adolescent depression are compared to depression designated by the DSM 4 criteria (the ‘gold standard’ in this example).

One consequence of an INCREASE in the pH of blood and interstitial fluid within the homeostatic range is that:

Which of the following types of cells are targeted by natural killer cells?

Which of the following diseases is vaccine preventable?

The limiting factor to maximal aerobic power in an endurance-trained human is expected to be:

Australia has been at the forefront of a unique approach to drug policy and practice known as ‘harm minimisation’. Which of the following BEST describes the strategy of ‘harm minimisation’?

Which one of the following diseases currently contributes to the burden of illness in Australia, and is classified as a National Health Priority area?

DLEPP - Choose A

An example of tertiary prevention is:

Which of the following organ system pairs is derived from the ectoderm?

An example of primary prevention is:

DLEPP - Choose A

Which of the following changes would MOST LIKELY be an expected consequence of ageing in a subject, in the absence of illness?

Marie, aged 30, attends your general practice with a cold, and you note that she smokes. She has never thought about quitting, and is keen to leave. You have just one minute to prompt discussion around smoking with a question. Which of the following questions is the most appropriate ‘brief intervention’?

Which of the following organisms has been commonly linked to cruise ship outbreaks?

Pernicious anaemia is characterised by low haemoglobin and large red blood cells (megaloblastic anaemia). This statement is:

A feature that distinguishes screening tests from diagnostic tests is that screening tests are:

DLEPP - Choose A

Which of the following diseases is subject to quarantine under the Australian Notifiable Diseases Surveillance system?

Identify the pair of treatment and effect, which represents an accurate rationale for the use of therapies in treatment of allergy/anaphylaxis:

Which of the following infectious agents can cause bloody diarrhoea?

Alfred, aged 56, attends your general practice for an unrelated condition and you note his blood pressure is somewhat high, at 155/90 mmHg. The most usual next step would be:

The host immune system does not launch a response against its own body’s antigens because of:

The best place to assist with notifiable diseases is the nearest:

In inflammatory responses, leukocytes migrate across the endothelium and blood vessel wall by:

A pleasant 45 year-old woman presents to the clinic with shortness of breath, chest pain and a mild fever (38.2oC). She is diagnosed and treated as a case of upper respiratory tract infection. Two days later, she returns to the clinic, worried, with no improvement. She is again sent home, with a course of antibiotics. On the following day, she is admitted to hospital and dies of pulmonary embolism. The most significant contribution to this diagnostic error was LIKELY:

A pleasant 45 year-old woman presents to the clinic with shortness of breath, chest pain and a mild fever (38.2oC). She is diagnosed and treated as a case of upper respiratory tract infection. Two days later, she returns to the clinic, worried, with no improvement. She is again sent home, with a course of antibiotics. On the following day, she is admitted to hospital and dies of pulmonary embolism. If this case occurred during a winter influenza epidemic, the decision to consider pulmonary embolism would have been complicated by the addition of which of the following?

Relative to a healthy individual, an untreated patient with which one of the following conditions is MOST LIKELY to present with decreased afferent (to the brain) signals from all types of peripheral chemoreceptors and decreased arterial partial pressure of carbon dioxide?

Relative to a healthy individual, an untreated patient with which one of the following conditions is MOST LIKELY to present with increased cardiac output and decreased peripheral vascular resistance?

Relative to a healthy individual, an untreated patient with which one of the following conditions is MOST LIKELY to present with increased arterial pH and increased peripheral vascular resistance?

Bazza, Dazza, Gazza, Shazza and Wazza are all 35-year-old male patients at a local emergency department. On the basis of history and physical examination: • one has been tentatively diagnosed with a respiratory infection for 48 hours, likely to be Streptococcus pneumoniae; • one with Conn’s syndrome (hyperaldosteronism) of several months duration; • one with an incompetent mitral valve that has not shut properly during systole – a condition he has had for several months; • one with diabetic ketoacidosis; and • one with an overdose of heroin over the last hour. The results of their vital signs are summarized in the Table below: Which of the patients is MOST LIKELY to have elevated hydrostatic pressure in his pulmonary capillaries?

Bazza, Dazza, Gazza, Shazza and Wazza are all 35-year-old male patients at a local emergency department. On the basis of history and physical examination: • one has been tentatively diagnosed with a respiratory infection for 48 hours, likely to be Streptococcus pneumoniae; • one with Conn’s syndrome (hyperaldosteronism) of several months duration; • one with an incompetent mitral valve that has not shut properly during systole – a condition he has had for several months; • one with diabetic ketoacidosis; and • one with an overdose of heroin over the last hour. The results of their vital signs are summarized in the Table below: Which of the patients is MOST LIKELY to have a decreased plasma renin activity?

Bazza, Dazza, Gazza, Shazza and Wazza are all 35-year-old male patients at a local emergency department. On the basis of history and physical examination: • one has been tentatively diagnosed with a respiratory infection for 48 hours, likely to be Streptococcus pneumoniae; • one with Conn’s syndrome (hyperaldosteronism) of several months duration; • one with an incompetent mitral valve that has not shut properly during systole – a condition he has had for several months; • one with diabetic ketoacidosis; and • one with an overdose of heroin over the last hour. The results of their vital signs are summarized in the Table below: Which of the patients is MOST likely to have the lowest arterial carbon dioxide pressure?

Bazza, Dazza, Gazza, Shazza and Wazza are all 35-year-old male patients at a local emergency department. On the basis of history and physical examination: • one has been tentatively diagnosed with a respiratory infection for 48 hours, likely to be Streptococcus pneumoniae; • one with Conn’s syndrome (hyperaldosteronism) of several months duration; • one with an incompetent mitral valve that has not shut properly during systole – a condition he has had for several months; • one with diabetic ketoacidosis; and • one with an overdose of heroin over the last hour. The results of their vital signs are summarized in the Table below: Which of the patients is MOST LIKELY to have consolidation of one or both lungs?

The figure schematically illustrates the somatic (voluntary) and autonomic innervation of the urinary bladder. The autonomic nervous system facilitates both the filling and emptying of the bladder. As with other organs, the bladder is controlled by both sympathetic and parasympathetic efferents, which exert opposing actions. Although you may not have studied the physiology of the bladder in depth, you should already know all you will need to answer this question. For example, the effects and mechanisms of sympathetic neurotransmitters on bladder smooth muscle are the same as on vascular smooth muscle. During early filling of the bladder, afferents carry information indicating the bladder walls are not stretched, and sympathetic efferent innervation of the internal sphincter is increased which causes contraction of the sphincter and holds the urine in the bladder. As the filling proceeds and the walls of the bladder stretch, an emptying reflex can be initiated in which parasympathetic efferents are activated, conveying information to contract the smooth muscle in the walls of the bladder (which increases the pressure inside and forces urine out through the sphincters and urethra. The main neurotransmitter released at site C in the figure is:

The figure schematically illustrates the somatic (voluntary) and autonomic innervation of the urinary bladder. The autonomic nervous system facilitates both the filling and emptying of the bladder. As with other organs, the bladder is controlled by both sympathetic and parasympathetic efferents, which exert opposing actions. Although you may not have studied the physiology of the bladder in depth, you should already know all you will need to answer this question. For example, the effects and mechanisms of sympathetic neurotransmitters on bladder smooth muscle are the same as on vascular smooth muscle. During early filling of the bladder, afferents carry information indicating the bladder walls are not stretched, and sympathetic efferent innervation of the internal sphincter is increased which causes contraction of the sphincter and holds the urine in the bladder. As the filling proceeds and the walls of the bladder stretch, an emptying reflex can be initiated in which parasympathetic efferents are activated, conveying information to contract the smooth muscle in the walls of the bladder (which increases the pressure inside and forces urine out through the sphincters and urethra. The postsynaptic or target receptor at site D in the figure is:

The figure schematically illustrates the somatic (voluntary) and autonomic innervation of the urinary bladder. The autonomic nervous system facilitates both the filling and emptying of the bladder. As with other organs, the bladder is controlled by both sympathetic and parasympathetic efferents, which exert opposing actions. Although you may not have studied the physiology of the bladder in depth, you should already know all you will need to answer this question. For example, the effects and mechanisms of sympathetic neurotransmitters on bladder smooth muscle are the same as on vascular smooth muscle. During early filling of the bladder, afferents carry information indicating the bladder walls are not stretched, and sympathetic efferent innervation of the internal sphincter is increased which causes contraction of the sphincter and holds the urine in the bladder. As the filling proceeds and the walls of the bladder stretch, an emptying reflex can be initiated in which parasympathetic efferents are activated, conveying information to contract the smooth muscle in the walls of the bladder (which increases the pressure inside and forces urine out through the sphincters and urethra. Acetylcholine is the main neurotransmitter released at which of the following sites labelled in the figure?

The figure schematically illustrates the somatic (voluntary) and autonomic innervation of the urinary bladder. The autonomic nervous system facilitates both the filling and emptying of the bladder. As with other organs, the bladder is controlled by both sympathetic and parasympathetic efferents, which exert opposing actions. Although you may not have studied the physiology of the bladder in depth, you should already know all you will need to answer this question. For example, the effects and mechanisms of sympathetic neurotransmitters on bladder smooth muscle are the same as on vascular smooth muscle. During early filling of the bladder, afferents carry information indicating the bladder walls are not stretched, and sympathetic efferent innervation of the internal sphincter is increased which causes contraction of the sphincter and holds the urine in the bladder. As the filling proceeds and the walls of the bladder stretch, an emptying reflex can be initiated in which parasympathetic efferents are activated, conveying information to contract the smooth muscle in the walls of the bladder (which increases the pressure inside and forces urine out through the sphincters and urethra. Of the following statements about the inferior mesenteric ganglion (indicated in the figure), which is CORRECT?

The figure schematically illustrates the somatic (voluntary) and autonomic innervation of the urinary bladder. The autonomic nervous system facilitates both the filling and emptying of the bladder. As with other organs, the bladder is controlled by both sympathetic and parasympathetic efferents, which exert opposing actions. Although you may not have studied the physiology of the bladder in depth, you should already know all you will need to answer this question. For example, the effects and mechanisms of sympathetic neurotransmitters on bladder smooth muscle are the same as on vascular smooth muscle. During early filling of the bladder, afferents carry information indicating the bladder walls are not stretched, and sympathetic efferent innervation of the internal sphincter is increased which causes contraction of the sphincter and holds the urine in the bladder. As the filling proceeds and the walls of the bladder stretch, an emptying reflex can be initiated in which parasympathetic efferents are activated, conveying information to contract the smooth muscle in the walls of the bladder (which increases the pressure inside and forces urine out through the sphincters and urethra. Intense exercise inhibits the voiding of urine. At which site does the autonomic response to exercise MOST LIKELY exert this effect?

The figure schematically illustrates the somatic (voluntary) and autonomic innervation of the urinary bladder. The autonomic nervous system facilitates both the filling and emptying of the bladder. As with other organs, the bladder is controlled by both sympathetic and parasympathetic efferents, which exert opposing actions. Although you may not have studied the physiology of the bladder in depth, you should already know all you will need to answer this question. For example, the effects and mechanisms of sympathetic neurotransmitters on bladder smooth muscle are the same as on vascular smooth muscle. During early filling of the bladder, afferents carry information indicating the bladder walls are not stretched, and sympathetic efferent innervation of the internal sphincter is increased which causes contraction of the sphincter and holds the urine in the bladder. As the filling proceeds and the walls of the bladder stretch, an emptying reflex can be initiated in which parasympathetic efferents are activated, conveying information to contract the smooth muscle in the walls of the bladder (which increases the pressure inside and forces urine out through the sphincters and urethra. Withdrawal of all autonomic and voluntary neural input to the bladder, as would occur in spinal shock, is characterized by:

The figure schematically illustrates the somatic (voluntary) and autonomic innervation of the urinary bladder. The autonomic nervous system facilitates both the filling and emptying of the bladder. As with other organs, the bladder is controlled by both sympathetic and parasympathetic efferents, which exert opposing actions. Although you may not have studied the physiology of the bladder in depth, you should already know all you will need to answer this question. For example, the effects and mechanisms of sympathetic neurotransmitters on bladder smooth muscle are the same as on vascular smooth muscle. During early filling of the bladder, afferents carry information indicating the bladder walls are not stretched, and sympathetic efferent innervation of the internal sphincter is increased which causes contraction of the sphincter and holds the urine in the bladder. As the filling proceeds and the walls of the bladder stretch, an emptying reflex can be initiated in which parasympathetic efferents are activated, conveying information to contract the smooth muscle in the walls of the bladder (which increases the pressure inside and forces urine out through the sphincters and urethra. Increased release of neurotransmitter at which of the following pairs of sites will ultimately lead to an increase in intracellular calcium in bladder smooth muscle?