MCQ EOS June 2015 Summative

Question 1 of 90

1

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

Select one of the following:

inhibition of granuloma formation
inhibition of lysosome acidification
interference with antigen presentation
inhibition of lysosome-phagosome fusion
resistance to toxic compounds within macrophages

Explanation

Question 2 of 90

1

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

Select one of the following:

Cystic fibrosis
Galactosaemia
Hypothyroidism
Phenylketonuria
Patent ductus arteriosus

Explanation

Question 3 of 90

1

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

Select one of the following:

serotonin
histamine
endorphin
bradykinin
adenosine triphosphate (ATP)

Explanation

Question 4 of 90

1

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

Select one of the following:

tachycardia
profuse sweating
excessive salivation
miosis (constricted pupils)
increased lacrimation (tearing)

Explanation

Question 5 of 90

1

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

Select one of the following:

Penicillin acts by inhibiting bacterial cell wall synthesis.
Macrolides such as erythromycin may be safely used in penicillin hypersensitivity.
Cephalosporins such as cefotaxime may be safely used in penicillin hypersensitivity.
Carbapenams (e.g. imipenem) may be used with caution in penicillin hypersensitivity.
Penicillin hypersensitivity (allergy) can result in potentially fatal angioneurotic oedema.

Explanation

Question 6 of 90

1

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

Select one of the following:

oxygen
hydrogen ion
potassium ion
carbon dioxide
beta adrenergic activity

Explanation

Question 7 of 90

1

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

Select one of the following:

Valproic acid and carbamazepine
Pregestational maternal diabetes
Inadequate maternal intake of folic acid
High maternal alcohol intake in the first trimester
Past history of affected pregnancy with the same partner

Explanation

Question 8 of 90

1

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

Select one of the following:

secondary bacterial pneumonia may follow viral pneumonia
lobar pneumonia commonly affects one or more pulmonary lobules
smoking may predispose to pneumonia by damaging cilia in the respiratory tract
streptococcal infection is the most common cause of community-acquired pneumonia
smoking may predispose to pneumonia by decreasing the phagocytic ability of alveolar macrophages

Explanation

Question 9 of 90

1

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

Select one of the following:

cholesterol clefts
collagen-rich fibrous cap
tissue necrosis in the basal layer
foam cells derived from lipid-filled neutrophils
intra-intimal accumulation of plasma-derived lipids

Explanation

Question 10 of 90

1

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:

Select one of the following:

Providing ongoing treatment
Completing a Workcover Medical certificate
Supporting Sam to regain functionality and independence
Liaising and communicating with the Insurer’s case manager
Advising the insurer about Sam’s eligibility to qualify for benefits

Explanation

Question 11 of 90

1

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

Select one of the following:

tricuspid atresia
tetralogy of Fallot
pulmonary atresia
atrial septal defect
transposition of the great arteries

Explanation

Question 12 of 90

1

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

Select one of the following:

The disease is multi-causal.
The disease has a detectable latent period.
The disease is an important health problem.
Early detection potentially improves outcomes.
The epidemiology of the disease is well understood.

Explanation

Question 13 of 90

1

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

Select one of the following:

Prostaglandins induce pain.
Histamine induces vasodilatation.
Leukotrienes induce bronchodilation.
Cytokines initiate the adaptive immune response.
Chemotactic factors attract neutrophils and eosinophils to the site of inflammation.

Explanation

Question 14 of 90

1

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

Select one of the following:

are always benign
tend to grow slowly
are less aggressive
respond better to treatment
closely resemble their tissue of origin

Explanation

Question 15 of 90

1

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

Select one of the following:

Weight reduction
Reduced salt intake
Increased dietary fibre
Increased physical activity
Reduction in alcohol intake

Explanation

Question 16 of 90

1

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

Select one of the following:

procoagulents, such as vitamin K
antiemetics, such as metoclopramide
hormone antagonists, such as tamoxifen
cytotoxic drugs, such as nitrogen mustard
angiogenesis blockers, such as bevacizumab

Explanation

Question 17 of 90

1

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

Select one of the following:

constant replication
loss of DNA repair genes
active telomerase activity
suppressed apoptotic activity
haploid number of chromosomes

Explanation

Question 18 of 90

1

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

Select one of the following:

the tendency to seek out data to confirm one’s original idea
the tendency to stay with an original diagnosis despite evidence to the contrary
the tendency to use mental matching to diagnose conditions with characteristic presentation
the tendency to be biased by previous diagnoses or factors that lead to framing in the wrong context
the tendency to narrow the choice of diagnostic possibilities too early in the diagnostic process

Explanation

Question 19 of 90

1

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

Select one of the following:

be taking heroin
have central cyanosis
require anticoagulant therapy
suffer from an allergic reaction
benefit from treatment with an angiotensin-converting enzyme (ACE) inhibitor

Explanation

Question 20 of 90

1

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:

Select one of the following:

mycoplasma
streptococcus
streptobacillus
Vibrio cholerae
mycobacterium

Explanation

Question 21 of 90

1

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

Select one of the following:

lipose
all lipids
triglycerides
free fatty acids
all types of ingested foodstuffs

Explanation

Question 22 of 90

1

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

Select one of the following:

interstitial fluid hydrostatic pressure and capillary oncotic pressure
interstitial fluid oncotic pressure and capillary hydrostatic pressure
interstitial fluid hydrostatic pressure and capillary hydrostatic pressure
interstitial fluid hydrostatic pressure and interstitial fluid oncotic pressure
interstitial fluid colloid osmotic (oncotic) pressure and capillary oncotic pressure

Explanation

Question 23 of 90

1

Hypertension is a risk factor for:

Select one of the following:

Spina bifida
Diverticulitis
Hyperlipidaemia
Colorectal cancer
Chronic kidney disease

Explanation

Question 24 of 90

1

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

Select one of the following:

acceleration of heart rate and pupillary constriction
stimulation of upper intestinal action and pupillary constriction
sweating, paling or flushing and stimulation of stomach activity
increased respiratory rate and constriction of blood vessels in skeletal muscle
constriction of blood vessels in the skin and dilation of blood vessels in skeletal muscle

Explanation

Question 25 of 90

1

DLEPP - Choose A

Select one of the following:

A
B
C
D
E

Explanation

Question 26 of 90

1

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

Select one of the following:

cocaine, which blocks uptake of catecholamines by presynaptic neurons
botox, which blocks fusion of exocytotic vesicles with plasma membranes
carbachol, which acts like acetylcholine and is resistant to choline esterases
propranolol, which competes with noradrenaline for binding at beta receptors
diazepam, which hyperpolarises neurons that have receptors for gamma-aminobutyric acid

Explanation

Question 27 of 90

1

A good screening test needs to have high:

Select one of the following:

sensitivity
specificity
diagnostic accuracy
positive predictive value
negative predictive value

Explanation

Question 28 of 90

1

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?

Select one of the following:

Amniocentesis
Nuchal translucency test
Second trimester foetal morphology ultrasound
Checking for a family history of Downs syndrome
A blood test for chromosome analysis of the mother

Explanation

Question 29 of 90

1

DLEPP - choose A

Select one of the following:

A
B
C
D
E

Explanation

Question 30 of 90

1

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

Select one of the following:

Complex case management
Evidence based general practice
Improved access to hospital care
Increased focus on tertiary prevention
Reduced inequity in health outcomes for all

Explanation

Question 31 of 90

1

In the blastocyst, the:

Select one of the following:

trophoblast is destined to become the fetus
blastocoele is destined to become the fetus
trophoblast is destined to become the inner cell mass
trophoblast is destined to become the fetal portion of the placenta
blastocoele serves the functions of the digestive system, lungs, and kidneys for the fetus

Explanation

Question 32 of 90

1

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?

Select one of the following:

Co-existing illnesses
Medication supplies
Crowded housing conditions
Evidence based medical care
Community health professional training

Explanation

Question 33 of 90

1

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

Select one of the following:

quicker effect than drug Y
longer lasting effect than drug Y
greater maximum effect than drug
similar effect at a lower EC50 than drug Y
greater area under the curve effect than drug Y

Explanation

Question 34 of 90

1

The goal of immunization (vaccination) is to induce:

Select one of the following:

autoimmunity
innate immunity
active immunity
passive immunity
cell-mediated immunity

Explanation

Question 35 of 90

1

DLEPP - Choose A

Select one of the following:

A
B
C
D
E

Explanation

Question 36 of 90

1

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

Select one of the following:

liver
heart
brain
lungs
adrenal cortex

Explanation

Question 37 of 90

1

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:

Select one of the following:

Don’t need to involve the medical system
Are not reliant on individual behaviour change
Have a greater benefit to risk ratio for each individual
Are not reliant on an arbitrary ‘cut off’ of blood pressure values
Tend to be more costly compared to population wide approaches

Explanation

Question 38 of 90

1

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

Select one of the following:

Restrict salt
Reduce stress
Increase monitoring of lipids
Decrease saturated fats in diet
Increase dietary sources of potassium

Explanation

Question 39 of 90

1

In the human body, carbon monoxide:

Select one of the following:

irreversibly binds to haemoglobin
binds less tightly to haemoglobin than does oxygen
does not alter oxygen delivery to peripheral cells and tissues
does not alter the partial pressure of oxygen (PO2) in arterial blood
does not alter the electron transport chain in oxidative phosphorylation

Explanation

Question 40 of 90

1

Which of the following is an example of secondary prevention?

Select one of the following:

Mammography
An arthritis self-management program
Immunisation for communicable disease
Foot care education for a diabetic patient
Community based smoking cessation programs

Explanation

Question 41 of 90

1

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

Select one of the following:

The reaction occurs only outside of cells
Breath-holding shifts the equilibrium to the left
Hyperventilation shifts the equilibrium to the left
Water and carbon dioxide combine as readily as hydrogen ion and bicarbonate
In a healthy individual, lowering the PO2 of the inspired air would have no effect on the equilibrium

Explanation

Question 42 of 90

1

The MOST important reason for initiating quarantining activities is to:

Select one of the following:

ensure the patient is given specialised care, if needed
apply public health measures to prevent further spread
collect data for national communicable disease surveillance systems
gather detailed histories about the clinical signs and symptoms of rare communicable diseases
enable a safe and systematic collection of information about contacts and recent travel history

Explanation

Question 43 of 90

1

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

Select one of the following:

Immunise the patient’s contacts
Maintain fluid and electrolytes of the patient
Ensure appropriate infection control measures
Ensure that the patient’s used linen and clothing is washed in boiled water
Closely observe the patient for 5 days, from the date of notification of symptoms

Explanation

Question 44 of 90

1

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

Select one of the following:

O - positive
A - negative
O - negative
AB - positive
AB - negative

Explanation

Question 45 of 90

1

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

Select one of the following:

normal levels of serum bilirubin
increased serum conjugated bilirubin
decreased serum conjugated bilirubin
increased serum unconjugated bilirubin
decreased serum unconjugated bilirubin

Explanation

Question 46 of 90

1

DLEPP - Choose A

Select one of the following:

A
B
C
D
E

Explanation

Question 47 of 90

1

Which of the following inhibits thrombosis?

Select one of the following:

fibrin
α-2 macroglobulin
endothelial damage
oral cyclooxygenase inhibitors
conversion of factor X to factor Xa

Explanation

Question 48 of 90

1

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:

Select one of the following:

Sudden weight loss
Usual sexual practices
Foods consumed whilst away
Alcohol intake whilst travelling
Medications taken during travels

Explanation

Question 49 of 90

1

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

Select one of the following:

Smallpox
Diphtheria
Q fever disease
Listeria
Rotavirus

Explanation

Question 50 of 90

1

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).

Select one of the following:

90/100
90/360
10/400
390/660
480/760

Explanation

Question 51 of 90

1

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

Select one of the following:

lungs will excrete more carbon dioxide
respiratory rate will increase to compensate
oxygen binds more avidly with haemoglobin
total oxygen capacity of haemoglobin decreases
the level of hydrogen ions in these fluids increases

Explanation

Question 52 of 90

1

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

Select one of the following:

antibody marked cells
virus infected cells only
bacteria and cancerous cells
bacteria and virus-infected cells
cancerous cells and virus-infected cells

Explanation

Question 53 of 90

1

Which of the following diseases is vaccine preventable?

Select one of the following:

Whooping cough
Hepatitis C
HIV
Orolabial herpes
Glandular fever

Explanation

Question 54 of 90

1

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

Select one of the following:

myoglobin
cardiac output
respiratory rate
pulmonary blood pressure
oxidative capacity of Type IIx muscle fibres

Explanation

Question 55 of 90

1

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’?

Select one of the following:

A strategy aimed to address the harmful effects of drugs on the individual
A national public health strategy that addressed the environmental sources of drug use
A strategy aimed at the reduction in harm from drugs, supply of drugs and demand for drugs
A strategy built on community development programs to prevent the uptake of harmful drug use
A strategy that aims to address drug use, by conceptualising it as an interaction between the drug and environmental factors.

Explanation

Question 56 of 90

1

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

Select one of the following:

Diabetes
Hyperlipidaemia
Childhood Influenza
Mild cognitive impairment
Chronic obstructive pulmonary disease

Explanation

Question 57 of 90

1

DLEPP - Choose A

Select one of the following:

A
B
C
D
E

Explanation

Question 58 of 90

1

An example of tertiary prevention is:

Select one of the following:

Vector control
Tax on tobacco products
Fluoridation of drinking water
HEEADSSS assessment for adolescents
Cardiac rehabilitation post-myocardial infarction

Explanation

Question 59 of 90

1

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

Select one of the following:

muscular and skeletal systems
integumentary and nervous systems
integumentary and muscular systems
circulatory system and skeletal system
lining of the gut and the nervous system

Explanation

Question 60 of 90

1

An example of primary prevention is:

Select one of the following:

Syphilis serology in pregnant women
Air quality guidelines and monitoring
Rehabilitation programme after stroke
The national breast screening programme
Benzanthine penicillin monthly following rheumatic fever

Explanation

Question 61 of 90

1

DLEPP - Choose A

Select one of the following:

A
B
C
D
E

Explanation

Question 62 of 90

1

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

Select one of the following:

increased bone mineralisation
decreased susceptibility to infections
enhanced response to drugs (per dose)
decreased plasma creatinine concentration
blood pressure formerly 120/80 mmHg; now 115/83 mmHg

Explanation

Question 63 of 90

1

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’?

Select one of the following:

Do you know much about e-cigarettes?
Has anyone in your family had lung cancer?
Would you prefer a patch or tablet to help you quit?
Have you considered switching to low tar cigarettes?
Can you see any benefits, if you were to quit smoking?

Explanation

Question 64 of 90

1

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

Select one of the following:

Mycobacterium tuberculosis
Norovirus
Human herpes virus 6
Bordetella pertussis
Streptococcus pyogenes

Explanation

Question 65 of 90

1

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

Select one of the following:

true; and the cause is a deficiency of iron
true; and the cause is a deficiency of vitamin B12
false; it is characterised by sickle shaped red cells
true; and the cause is a deficiency of erythropoietin
false; it is characterised by small red cells (microcytic anaemia)

Explanation

Question 66 of 90

1

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

Select one of the following:

More affordable than diagnostic tests
Conducted on people who have symptoms
Likely to have a higher overall test accuracy
More likely to have a high false positive rate
More likely to have a high true negative rate

Explanation

Question 67 of 90

1

DLEPP - Choose A

Select one of the following:

A
B
C
D
E

Explanation

Question 68 of 90

1

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

Select one of the following:

Cholera
Hepatitis C
Legionnaires disease
Pneumococcal pneumonia
Glandular fever

Explanation

Question 69 of 90

1

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

Select one of the following:

antihistamine to facilitate ventilation
adrenaline for inhibiting the immune system
beta-2 adrenergic agonist for reducing urticaria
cromoglycate to stabilise mast cell membranes
glucocorticoid to reduce tongue swelling in anaphylaxis

Explanation

Question 70 of 90

1

Which of the following infectious agents can cause bloody diarrhoea?

Select one of the following:

Escherichia coli
Candida albicans
Gardnerella vaginalis
Staphylococcus gastroenteralis
Streptococcus faecalis

Explanation

Question 71 of 90

1

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:

Select one of the following:

Recheck his BP, preferably on a separate occasion
Commence an antihypertensive medication
Order an echocardiogram
Examine Alfred to rule out a stroke
Ensure Alfred rests more over the next few days until you can repeat his BP

Explanation

Question 72 of 90

1

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

Select one of the following:

autoimmunity
self-tolerance
passive immunity
adaptive immunity
immune suppression

Explanation

Question 73 of 90

1

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

Select one of the following:

emergency department
police station
public health unit
hospital
laboratory

Explanation

Question 74 of 90

1

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

Select one of the following:

diapedesis
chemotaxis
margination
phagocytosis
angiogenesis

Explanation

Question 75 of 90

1

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:

Select one of the following:

affect error
framing error
confirmation bias
anchoring heuristic
availability heuristic

Explanation

Question 76 of 90

1

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?

Select one of the following:

affect error
framing error
confirmation bias
anchoring heuristic
availability heuristic

Explanation

Question 77 of 90

1

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?

Select one of the following:

anaphylactic shock
diabetic ketoacidosis
carbon monoxide poisoning
left heart failure and pulmonary oedema
a panic attack and who is hyperventilating

Explanation

Question 78 of 90

1

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?

Select one of the following:

anaphylactic shock
ß-blocker overdose
carbon monoxide poisoning
left heart failure and pulmonary oedema
a panic attack and who is hyperventilating

Explanation

Question 79 of 90

1

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?

Select one of the following:

anaphylactic shock
diabetic ketoacidosis
carbon monoxide poisoning
left heart failure and pulmonary oedema
a panic attack and who is hyperventilating

Explanation

Question 80 of 90

1

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?

Select one of the following:

Bazza
Dazza
Gazza
Wazza
Shazza

Explanation

Question 81 of 90

1

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?

Select one of the following:

Bazza
Dazza
Gazza
Wazza
Shazza

Explanation

Question 82 of 90

1

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?

Select one of the following:

Bazza
Dazza
Gazza
Wazza
Shazza

Explanation

Question 83 of 90

1

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?

Select one of the following:

Bazza
Dazza
Gazza
Wazza
Shazza

Explanation

Question 84 of 90

1

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:

Select one of the following:

nicotine
histamine
adrenaline
acetylcholine
noradrenaline

Explanation

Question 85 of 90

1

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:

Select one of the following:

GABA
nicotinic
muscarinic
α-adrenergic
β-adrenergic

Explanation

Question 86 of 90

1

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?

Select one of the following:

A and B
C and D
A, B and C
B, C and D
A, B and D

Explanation

Question 87 of 90

1

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?

Select one of the following:

It is part of the parasympathetic nervous system.
The main neurotransmitter released at the ganglion is noradrenaline.
The postsynaptic neurotransmitter receptor at the ganglion is inhibited by atropine.
The postsynaptic neurotransmitter receptor found in the ganglion is a G-protein coupled receptor.
Activation of the postsynaptic neurotransmitter receptor at the ganglion results in the entry of sodium ions through the receptor ion channel.

Explanation

Question 88 of 90

1

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?

Select one of the following:

Site A
Site B
Site C
Site D
at the external sphincter

Explanation

Question 89 of 90

1

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:

Select one of the following:

constant sensation of a full bladder
reflex, but not voluntary, emptying of the bladder
filling until pressure inside the bladder exceeds that of the sphincters and urine begins to flow
involuntary contraction of the internal sphincter, requiring catheterization to facilitate emptying
reflex emptying of a full bladder, but no voluntary retention of urine through contraction of the external sphincter

Explanation

Question 90 of 90

1

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?

Select one of the following:

A and B
B and C
C and D
A and C
B and D

	Created by James Wilson over 4 years ago

EOS June 2015 MCQ - DLEPP Missing MCQ EOS June 2016 Formative

MCQ EOS June 2015 Summative

MCQ EOS June 2015 Summative

Question 1 of 90

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

Select one of the following:

Explanation

Question 2 of 90

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

Select one of the following:

Explanation

Question 3 of 90

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

Select one of the following:

Explanation

Question 4 of 90

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

Select one of the following:

Explanation

Question 5 of 90

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

Select one of the following:

Explanation

Question 6 of 90

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

Select one of the following:

Explanation

Question 7 of 90

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

Select one of the following:

Explanation

Question 8 of 90

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

Select one of the following:

Explanation

Question 9 of 90

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

Select one of the following:

Explanation

Question 10 of 90

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:

Select one of the following:

Explanation

Question 11 of 90

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

Select one of the following:

Explanation

Question 12 of 90

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

Select one of the following:

Explanation

Question 13 of 90

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

Select one of the following:

Explanation

Question 14 of 90

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

Select one of the following:

Explanation

Question 15 of 90

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

Select one of the following:

Explanation

Question 16 of 90

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

Select one of the following:

Explanation

Question 17 of 90

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

Select one of the following:

Explanation

Question 18 of 90

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

Select one of the following:

Explanation

Question 19 of 90

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

Select one of the following:

Explanation

Question 20 of 90