MCQ EOS June 2015 Summative

Description

EOS June 2015 MCQ - DLEPP Missing MCQ EOS June 2016 Formative
James Wilson
Quiz by James Wilson, updated more than 1 year ago
James Wilson
Created by James Wilson almost 4 years ago
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Resource summary

Question 1

Question
All of the following factors contribute to the virulence of mycobacteria, EXCEPT:
Answer
  • inhibition of granuloma formation
  • inhibition of lysosome acidification
  • interference with antigen presentation
  • inhibition of lysosome-phagosome fusion
  • resistance to toxic compounds within macrophages

Question 2

Question
All of the following conditions are assessed as part of the screening tests done on newborn babies, EXCEPT:
Answer
  • Cystic fibrosis
  • Galactosaemia
  • Hypothyroidism
  • Phenylketonuria
  • Patent ductus arteriosus

Question 3

Question
All of the following are chemical mediators (released during tissue injury) which stimulate nociceptors to produce pain, EXCEPT:
Answer
  • serotonin
  • histamine
  • endorphin
  • bradykinin
  • adenosine triphosphate (ATP)

Question 4

Question
All of the following are signs of poisoning with an organophosphate compound (long-acting acetylcholinesterase inhibitor), EXCEPT:
Answer
  • tachycardia
  • profuse sweating
  • excessive salivation
  • miosis (constricted pupils)
  • increased lacrimation (tearing)

Question 5

Question
All of the following statements regarding penicillin are all correct, EXCEPT:
Answer
  • 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.

Question 6

Question
All of the following ordinarily act to increase blood flow in exercising muscle, EXCEPT:
Answer
  • oxygen
  • hydrogen ion
  • potassium ion
  • carbon dioxide
  • beta adrenergic activity

Question 7

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

Question 8

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

Question 9

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

Question 10

Question
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:
Answer
  • 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

Question 11

Question
All of the following heart lesions are commonly associated with cyanosis, EXCEPT:
Answer
  • tricuspid atresia
  • tetralogy of Fallot
  • pulmonary atresia
  • atrial septal defect
  • transposition of the great arteries

Question 12

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

Question 13

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

Question 14

Question
In the grading of neoplasms, well-differentiated tumours differ from poorly-differentiated tumours in all of the following ways, EXCEPT that well-differentiated tumours:
Answer
  • are always benign
  • tend to grow slowly
  • are less aggressive
  • respond better to treatment
  • closely resemble their tissue of origin

Question 15

Question
All of the following are considered elements of a management strategy for hypertension EXCEPT:
Answer
  • Weight reduction
  • Reduced salt intake
  • Increased dietary fibre
  • Increased physical activity
  • Reduction in alcohol intake

Question 16

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

Question 17

Question
All germ cells and some cancer cells share which of the following characteristics?
Answer
  • constant replication
  • loss of DNA repair genes
  • active telomerase activity
  • suppressed apoptotic activity
  • haploid number of chromosomes

Question 18

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

Question 19

Question
A 50 year old patient presents with haemorrhages and exudates (cottonwool spots) in the retinas of his eyes. He is also MOST LIKELY to:
Answer
  • be taking heroin
  • have central cyanosis
  • require anticoagulant therapy
  • suffer from an allergic reaction
  • benefit from treatment with an angiotensin-converting enzyme (ACE) inhibitor

Question 20

Question
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:
Answer
  • mycoplasma
  • streptococcus
  • streptobacillus
  • Vibrio cholerae
  • mycobacterium

Question 21

Question
A drug that blocks pancreatic lipase will DECREASE the biochemical digestion and absorption of:
Answer
  • lipose
  • all lipids
  • triglycerides
  • free fatty acids
  • all types of ingested foodstuffs

Question 22

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

Question 23

Question
Hypertension is a risk factor for:
Answer
  • Spina bifida
  • Diverticulitis
  • Hyperlipidaemia
  • Colorectal cancer
  • Chronic kidney disease

Question 24

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

Question 25

Question
DLEPP - Choose A
Answer
  • A
  • B
  • C
  • D
  • E

Question 26

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

Question 27

Question
A good screening test needs to have high:
Answer
  • sensitivity
  • specificity
  • diagnostic accuracy
  • positive predictive value
  • negative predictive value

Question 28

Question
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?
Answer
  • 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

Question 29

Question
DLEPP - choose A
Answer
  • A
  • B
  • C
  • D
  • E

Question 30

Question
The National Vision for primary health care has, as one of its MAIN priorities
Answer
  • Complex case management
  • Evidence based general practice
  • Improved access to hospital care
  • Increased focus on tertiary prevention
  • Reduced inequity in health outcomes for all

Question 31

Question
In the blastocyst, the:
Answer
  • 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

Question 32

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

Question 33

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

Question 34

Question
The goal of immunization (vaccination) is to induce:
Answer
  • autoimmunity
  • innate immunity
  • active immunity
  • passive immunity
  • cell-mediated immunity

Question 35

Question
DLEPP - Choose A
Answer
  • A
  • B
  • C
  • D
  • E

Question 36

Question
The conversion of angiotensin I to angiotensin II by angiotensin converting enzyme occurs primarily in the circulation through the:
Answer
  • liver
  • heart
  • brain
  • lungs
  • adrenal cortex

Question 37

Question
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:
Answer
  • 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

Question 38

Question
Which of the following lifestyle change would MOST benefit a patient in terms of modifying hyperlipidaemia?
Answer
  • Restrict salt
  • Reduce stress
  • Increase monitoring of lipids
  • Decrease saturated fats in diet
  • Increase dietary sources of potassium

Question 39

Question
In the human body, carbon monoxide:
Answer
  • 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

Question 40

Question
Which of the following is an example of secondary prevention?
Answer
  • Mammography
  • An arthritis self-management program
  • Immunisation for communicable disease
  • Foot care education for a diabetic patient
  • Community based smoking cessation programs

Question 41

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

Question 42

Question
The MOST important reason for initiating quarantining activities is to:
Answer
  • 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

Question 43

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

Question 44

Question
With regard to blood transfusions, what blood type is referred to as the “Universal Recipient?”
Answer
  • O - positive
  • A - negative
  • O - negative
  • AB - positive
  • AB - negative

Question 45

Question
Which of the following is a clinical feature of haemolytic anaemia?
Answer
  • normal levels of serum bilirubin
  • increased serum conjugated bilirubin
  • decreased serum conjugated bilirubin
  • increased serum unconjugated bilirubin
  • decreased serum unconjugated bilirubin

Question 46

Question
DLEPP - Choose A
Answer
  • A
  • B
  • C
  • D
  • E

Question 47

Question
Which of the following inhibits thrombosis?
Answer
  • fibrin
  • α-2 macroglobulin
  • endothelial damage
  • oral cyclooxygenase inhibitors
  • conversion of factor X to factor Xa

Question 48

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

Question 49

Question
Which of the following human diseases is covered by the Quarantine Act and are therefore subject to quarantine laws in Australia?
Answer
  • Smallpox
  • Diphtheria
  • Q fever disease
  • Listeria
  • Rotavirus

Question 50

Question
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).
Answer
  • 90/100
  • 90/360
  • 10/400
  • 390/660
  • 480/760

Question 51

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

Question 52

Question
Which of the following types of cells are targeted by natural killer cells?
Answer
  • antibody marked cells
  • virus infected cells only
  • bacteria and cancerous cells
  • bacteria and virus-infected cells
  • cancerous cells and virus-infected cells

Question 53

Question
Which of the following diseases is vaccine preventable?
Answer
  • Whooping cough
  • Hepatitis C
  • HIV
  • Orolabial herpes
  • Glandular fever

Question 54

Question
The limiting factor to maximal aerobic power in an endurance-trained human is expected to be:
Answer
  • myoglobin
  • cardiac output
  • respiratory rate
  • pulmonary blood pressure
  • oxidative capacity of Type IIx muscle fibres

Question 55

Question
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’?
Answer
  • 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.

Question 56

Question
Which one of the following diseases currently contributes to the burden of illness in Australia, and is classified as a National Health Priority area?
Answer
  • Diabetes
  • Hyperlipidaemia
  • Childhood Influenza
  • Mild cognitive impairment
  • Chronic obstructive pulmonary disease

Question 57

Question
DLEPP - Choose A
Answer
  • A
  • B
  • C
  • D
  • E

Question 58

Question
An example of tertiary prevention is:
Answer
  • Vector control
  • Tax on tobacco products
  • Fluoridation of drinking water
  • HEEADSSS assessment for adolescents
  • Cardiac rehabilitation post-myocardial infarction

Question 59

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

Question 60

Question
An example of primary prevention is:
Answer
  • 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

Question 61

Question
DLEPP - Choose A
Answer
  • A
  • B
  • C
  • D
  • E

Question 62

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

Question 63

Question
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’?
Answer
  • 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?

Question 64

Question
Which of the following organisms has been commonly linked to cruise ship outbreaks?
Answer
  • Mycobacterium tuberculosis
  • Norovirus
  • Human herpes virus 6
  • Bordetella pertussis
  • Streptococcus pyogenes

Question 65

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

Question 66

Question
A feature that distinguishes screening tests from diagnostic tests is that screening tests are:
Answer
  • 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

Question 67

Question
DLEPP - Choose A
Answer
  • A
  • B
  • C
  • D
  • E

Question 68

Question
Which of the following diseases is subject to quarantine under the Australian Notifiable Diseases Surveillance system?
Answer
  • Cholera
  • Hepatitis C
  • Legionnaires disease
  • Pneumococcal pneumonia
  • Glandular fever

Question 69

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

Question 70

Question
Which of the following infectious agents can cause bloody diarrhoea?
Answer
  • Escherichia coli
  • Candida albicans
  • Gardnerella vaginalis
  • Staphylococcus gastroenteralis
  • Streptococcus faecalis

Question 71

Question
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:
Answer
  • 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

Question 72

Question
The host immune system does not launch a response against its own body’s antigens because of:
Answer
  • autoimmunity
  • self-tolerance
  • passive immunity
  • adaptive immunity
  • immune suppression

Question 73

Question
The best place to assist with notifiable diseases is the nearest:
Answer
  • emergency department
  • police station
  • public health unit
  • hospital
  • laboratory

Question 74

Question
In inflammatory responses, leukocytes migrate across the endothelium and blood vessel wall by:
Answer
  • diapedesis
  • chemotaxis
  • margination
  • phagocytosis
  • angiogenesis

Question 75

Question
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:
Answer
  • affect error
  • framing error
  • confirmation bias
  • anchoring heuristic
  • availability heuristic

Question 76

Question
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?
Answer
  • affect error
  • framing error
  • confirmation bias
  • anchoring heuristic
  • availability heuristic

Question 77

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

Question 78

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

Question 79

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

Question 80

Question
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?
Answer
  • Bazza
  • Dazza
  • Gazza
  • Wazza
  • Shazza

Question 81

Question
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?
Answer
  • Bazza
  • Dazza
  • Gazza
  • Wazza
  • Shazza

Question 82

Question
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?
Answer
  • Bazza
  • Dazza
  • Gazza
  • Wazza
  • Shazza

Question 83

Question
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?
Answer
  • Bazza
  • Dazza
  • Gazza
  • Wazza
  • Shazza

Question 84

Question
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:
Answer
  • nicotine
  • histamine
  • adrenaline
  • acetylcholine
  • noradrenaline

Question 85

Question
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:
Answer
  • GABA
  • nicotinic
  • muscarinic
  • α-adrenergic
  • β-adrenergic

Question 86

Question
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?
Answer
  • A and B
  • C and D
  • A, B and C
  • B, C and D
  • A, B and D

Question 87

Question
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?
Answer
  • 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.

Question 88

Question
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?
Answer
  • Site A
  • Site B
  • Site C
  • Site D
  • at the external sphincter

Question 89

Question
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:
Answer
  • 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

Question 90

Question
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?
Answer
  • A and B
  • B and C
  • C and D
  • A and C
  • B and D
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