End of Phase (part 3)

1.

1 point

Which of the following statements most accurately describes a cohort study?

In a cohort trial the researchers and the health care workers who randomise, treat and assess the individuals do not know to which groups the patients are assigned

In a cohort study, individuals are assigned to groups according to their exposure to a risk factor under investigation

In a cohort study there is a control group that is assigned to take a placebo or comparison intervention

In a cohort study, researchers compare the association between cases and a possible cause, with the same possible cause and people who are not cases (the controls)

A cohort study is usually retrospective

2.

1 point

Regarding digestion, which of the following is most correct?

PepT1 is a sodium dependent transporter of proteins

Deficiency of lipase causes problems with fat absorption

A large protein transporter is required for absorption of large peptides

Fat is absorbed into the bloodstream in chylomicrons

GLUT 5 on the basal membrane is required for absorption of sugars

3.

1 point

What is the best measure of efficacy of a drug?

The affinity of the drug to its receptor

Related to the side effects

Negative log of the dose required for half the maximal effect (related to ED50)

The maximal agonist action of the drug

The potency of the drug

4.

1 point

With regard to the liver, which ONE of the following is MOST CORRECT?

It is related to the heart and the base of the lungs by its diaphragmatic surface

It is always located in the left hypochondrium and epigastrium

It is covered by the 9-11 th rib on the left side

It is usually in contact with the spleen

The left colic flexure is related to the inferior margin

5.

1 point

Regarding opioids, which of the following are MOST CORRECT?

Opioids act directly on G-protein coupled receptors to decrease adenylate cyclase activity

Methadone is used in patient controlled infusion systems because it has a short duration of action

Mu opioids are less likely to cause dependence than kappa opioids

Administration of high therapeutic doses of morphine results in diarrhoea, nausea and vomiting

The short duration of action of fentanyl is due to its low lipid solubility

6.

1 point

Regarding a picture of a large lung tumour, which of the following is incorrect?

This lesion is likely to be associated with smoking

This lesion is likely to have invaded the hilum

This lesion is likely to be associated with cachexia

This lesion is likely to have resulted from metastasis to the lung

This lesion is likely to be associated with coughing and haemoptysis

7.

1 point

Which is incorrect about tuberculosis?

Tuberculosis is highly sensitive to glucopeptide antibiotics such as vancomycin

Isoniazid can be used prophylactically for family in contact with TB

Isoniazid is a first line treatment

Can survive in macrophages

Rifampicin blocks DNA dependent RNA polymerase, and also kills gram negative bacteria

8.

1 point

What is the main difference between mitosis and meiosis?

Mitosis but not meiosis uses microtubular assembly

Mitosis occurs in cells but meiosis occurs in mitochondria

Mitosis and not meiosis occurs in plant cells

Mitosis leads to formation of 2 daughter cells

Meiosis but not mitosis involves halving of DNA

9.

1 point

Patient has left homonymous hemianopia with macula sparing. Which ONE of these arteries is MOST LIKELY to be occluded?

Left middle cerebral artery

Right middle cerebral artery

Right posterior cerebral artery

Left posterior cerebral artery

Posterior communicating artery

10.

1 point

What is true regarding the larynx?

It houses the vocalis muscle and the vocal ligament, creating tension to produce sound

It is located below the pharynx and above the oesophagus

It is a hollow structure surrounded by a ring of small bones

It holds the true vocal cords, lined by respiratory epithelium

It holds the false vocal cords, lined by stratified squamous epithelium

11.

1 point

What is MOST CORRECT regarding cerebral infarction?

Overall it has lower mortality than cerebral haemorrhage

It is most commonly haemorrhagic

Healing with formation of scar tissue

Hydrocephalus is a common complication

It is most commonly caused by a thrombosis superimposed by an ulcerated atheromatous plaque

12.

1 point

The hilum of the left lung:

Is inferior to the arch of aorta

Lies in front of the phrenic nerve

Is opposite thoracic vertebrae 2, 3 and 4

Is surrounded by tracheobronchial lymph nodes

Is anterior to the superior vena cava

13.

1 point

A lady comes in and the superior gluteal nerve is injured. Which of the following might she present with?

When the knee is flexed, lateral rotation is weakened

When she stands on one leg on the affected side, the opposite side will descend

Extension is weakened

14.

1 point

Which of the following statements about chorionic villus sampling is most correct?

It is usually performed at 15 - 17 weeks gestation

It leads to miscarriage in 5% of cases

It can be used to detect spina bifida in the fetus

It has a lower miscarriage rate than amnioscentesis

It can be used to test for conditions such as cystic fibrosis

15.

1 point

A patient involved in a severe car accident comes in to emergency is tested for any potential infectious agents. The patient sample returns the following results for hepatitis C virus (HCV) analysis:

HCV EIA antibody negative
HCV RNA positive

Which ONE of the following options BEST EXPLAINS these results?

Prior vaccination against HCV

Past infection with HCV followed by viral clearance

Reinfection with HCV

Latent infection with HCV

Probable recent HCV infection

16.

1 point

Which of the following is MOST CORRECT regarding the hippocampal formation?

Bilateral lesion may result in anterograde amnesia

It is the first structure to degenerate in Parkinson’s disease

It is involved in the consolidation of procedural memory

It is part of the neocortex

It is located in the parietal lobe

17.

1 point

Carbon monoxide poisoning:

Binds to haem with twice the affinity of oxygen

Will decrease the PaO2

Will cause the oxygen curve to shift to the left

Blood with have lots of methhaemoglobin

Will cause the patient to be cyanosed

18.

1 point

With the following organs or tissues, which ONE is normally dependent on aerobic glucose catabolism for ATP?

Brain

Cardiac muscles

Red blood cells

Liver

Adipose tissues

19.

1 point

When is a normally developing child able to strong two words together?

10 months

6 months

12 months

30 months

24 months

20.

1 point

According to various studies, what is the most effective way of reducing the risk of HIV transmission?

Consistently using male condoms

Early initiation of HRT in HIV positive people

Daily antiretroviral medications in HIV negative homosexual men

Application of vaginal antiretroviral microbicides in women at high risk of HIV

Early treatment of STIs

21.

1 point

Which of the following is true regarding the spinal cord:

Ends caudally at L1-L2

It has a prominent midline groove on its dorsal surface

It is made up of 29 spinal segments

The dorsal root has primary sensory neurons

There is a greater amount of white matter at the lumbar and cervical enlargements

22.

1 point

A population experiences an increase in the proportion of Aa heterozygotes. What is the most likely cause:

Negative assortive mating by homozygotes

Positive assortive mating by homozygotes

Mutation of 'a' allele to 'A'

Genetic drift due to the founder effect

Increased population size

23.

1 point

Which one of the following is most correct about the female uterus?

It has a myometrium consisting of striated muscle

It is lined with stratified non-keratinising squamous epithelium

It has glands which dilate and secrete mucous and glycogen during the secretory phase of the menstrual cycle

It has a cylindrical superior part, termed the cervix

There is an inner perimetrium followed by endometrium and myometrium

24.

1 point

Which one of the following is most correct about the female uterus?

It has glands which dilate and secrete mucous and glycogen during the secretory phase of the menstrual cycle

There is a cylindrical superior part, termed the cervix

There is an inner perimetrium followed by the endometrium and myometrium

It is lined with stratified non-keratinising squamous epithelium

The myometrium consists of striated muscle

25.

1 point

Regarding the portal vein, which ONE of the following statements is CORRECT?

It is formed at the junction of the superior and inferior mesenteric veins

It passes through the head of the pancreas to enter the lesser omentum

Its function is to return deoxygenated blood from the liver

It is in the anterior boundary of the lesser sac

It crosses anterior to the duodenum

26.

1 point

Which one of the following interpretations of an abnormal liver function test is most correct?

Elevated GGT and serum alkaline phosphatase (SAP) reflect an obstruction in the bile duct

Low albumin in the blood is due to a dietary protein deficiency

Elevated bilirubin is due to extravascular haemolysis

Darkened urine is due to unconjugated bilirubinaemia

Elevated transaminases (ALT and AST) reflects hepatocellular regeneration

27.

1 point

Which of the following are anterior relations of the left kidney?

Stomach, spleen, Second part of duodenum

Stomach, small intestines, spleen

Ascending colon, pancreas, spleen

Pancreas head and bile duct

Spleen, liver, stomach

28.

1 point

Match the following conditions (1, 2, 3), with the symptoms (a,b,c,d,e,f)

1. mineralocorticoid deficiency
2. glucocorticoid deficiency
3. androgen excess

a. lack/loss of menstrual periods
b. low blood pressure
c. high blood pressure
d. low blood glucose
e. high blood glucose
f. early puberty in boys
g. impaired response to physiological stress or impaired immunological response
h. excess hair on the face and body

1: c, d; 2: f, e; 3: b, g, h

1: d; 2: a, c; 3: b, e, f

1: b, c; 2: c, d; 3: e, f

1: b; 2: d, g; 3: a, f, h

1: a; 2: b, c; 3: d, e, f

29.

1 point

Which of these is used as a disease-modifying treatment of AD?

Rivastigmine

Memantine

Tacrine

Donepezil

Galantine

30.

1 point

A 64 year old man develops progressive jaundice over several weeks, associated with central abdominal pain. He has a long history of alcohol abuse, and in the past has suffered from recurrent episodes of chronic pancreatitis. An abdominal ultrasound shows a dilated common bile duct 15mm in diameter.

Which ONE of the following diagnoses is the LEAST likely cause of the clinical and investigative abnormalities?

Choledocholithiasis (gall stone impacted in the common bile duct)

Carcinoma of the head of the pancreas

Enlarged lymph nodes in the porta hepatis secondary to metastatic spread of cancer

Bile duct obstruction secondary to chronic pancreatitis

Cirrhosis of the liver

31.

1 point

Which of the following is NOT a feature of osteoarthritis?

Subchondral sclerosis

Thickening and hypertrophy of the cartilage

Clumping of chondrocytes

Vertical and horizontal clefts

Smaller joint space

32.

1 point

Which of the following correctly describes a change that occurs during the luteal phase of the ovarian cycle?

LH gradually increases, stimulating the increase of progesterone

Inhibin A has a negative feedback response on the release of FSH

17-beta-Estradiol exerts feedback on the anterior pituitary, stimulating an increase in the release of FSH and LH

GnRH has a positive feedback response on the release of FSH and LH

Granulosa cells become more sensitive to FSH

33.

1 point

An infarct to the inferior frontal gyrus of the left hemisphere of the brain is most likely to lead to what problems?

Cognitive deficits

Hemiplegia on the right side

Loss of recent memory

Impaired comprehension of spoken language

Impairment of the expressive (motor) aspects of speech.

34.

1 point

200 women in an RCT to compare new osteoporosis treatment with old. The new group had 3% of people with fractures. The old treatment group had 6% of people with fractures. What is the most appropriate measurement?

RRR (relative risk reduction)

ARR (absolute risk reduction)

RR (relative risk)

Experimental risk ratio vs control risk ratio

Odds ratio

35.

1 point

Which of the following statements is correct in regards to the Indigenous population?

There has been a sharp decline in low birth weight rates since 2010

Indigenous health focuses on the individual

Studies have indicated 1.5 of Indigenous Australians between the ages of 18 - 24 experience high or very high levels of psychological distress

Culturally appropriate and supportive care for Indigenous mothers leads to better birth outcomes and improved access to care

Life expectancy is 11 years lower than for non-Indigenous Australians

36.

1 point

Regarding the use of exendin-4 in type 2 diabetes, which of the following is most correct?

May result in weight gain

Readily absorbed in the GIT

May result in nausea and vomiting

Degradation of glucagon-like protein 1

Decreases insulin release via potassium channels in beta cells

37.

1 point

Growth hormone is synthesised and secreted by endocrine cells in the anterior pituitary. How is this process regulated?

Negative feedback by gonadotropin-releasing hormone

Growth hormone releasing hormone acting on the anterior pituitary, stimulating release

Negative feedback by somatostatin on the hypothalamus

Somatostatin, which stimulates release

Dopamine inhibits secretion by acting on the anterior pituitary

38.

1 point

Regarding menopause in women, which of the following is most correct?

Hot flushes are psychological

Hormone Replacement Thearpy is associated with an increased risk of hip fractures

Smoking accelerates the onset of menopause

Antimullerian hormone levels increase

Ovulation ceases after menstruation ceases

39.

1 point

Surveillance is useful for all of the following, except:

Describing

Evaluating

Monitoring

Showing a cause and effect relationship

40.

1 point

Which of the following is most correct regarding treatment of asthma?

Muscarinic receptor agonists relax bronchial smooth muscle and stabilise mast cells

Sodium cromoglycate

Beta 2 adrenoreceptor agonists relax bronchial smooth muscle and stabilise mast cells

Beclometasone diproprionate

41.

1 point

Regarding the molecule that is used to assess glomerular filtration rate (GFR) which of the following is most correct:

Glucose transporters affected

It undergoes secretion

It cannot exist in the renal vein

Net excretion

It must be filtered at the same rate as it is excreted

42.

1 point

Regarding the body’s response to stress, what is MOST CORRECT?

It illustrates the intimate relationship between the brain and the body

It is mainly mediated by the HPA axis

Subjective cognitive appraisal is not important

The sympathetic response occurs after subjective cognitive appraisal

All life events cause stress

43.

1 point

What is true of epithelium?

It has no basement membrane

Stratified squamous epithelium lines the trachea

It has an excellent blood supply

Keratinised stratified squamous epithelium lines the oesophagus

Simple columnar epithelium with goblet cells lines the small intestine

44.

1 point

Which ONE of the following statements regarding the treatment of hypertension is MOST CORRECT?

Propanolol exerts its antihypertensive action in the medulla of the brain

Losartan lowers blood pressure by blocking angiotensin converting enzyme

Enalapril may reduce the plasma concentration of potassium

Prazosin is an alpha-adrenoceptor agonist

Nifedipine blocks L-type calcium channels

45.

1 point

How do you calculate the NNT?

1/(new treatment/old treatment)

1/(new treatment - old treatment)

100/(new treatment/old treatment)

100/(|new treatment - old treatment|)

46.

1 point

With regards to the pathogenesis of pneumonia, which of the following statements is most correct?

Influenza predisposes to bacterial pneumonia

Bacterial pneumonia predisposes to tuberculosis pneumonia

Pyogenic bacteria cause atypical pneumonia

Legionnaire's disease occurs in epidemics due to person-to-person spread

Pyogenic bacterial pneumonia occurs in epidemics due to person-to-person spread

47.

1 point

Which ONE of the following determines whether skeletal muscle in fast or slow?

The organisation of mitochondria in relation to myofibrils

The difference in number of t-tubules per sarcomere in fast- and slow- twitch

The elasticity of endomysium

Its cross sectional diameter

The speed of myosin ATPase and the density of internal calcium stores in the sarcoplasmic reticulum

48.

1 point

A new human enzyme is found that attacks the walls of gram negative bacteria. Which is most correct?

It is part of the adaptive immune system as it is specific to gram negative bacteria

It is part of the adaptive immune system as it is only attacking bacteria

It is part of the innate immune system, as it broadly attacks a large group of bacteria

It is part of the innate immune system as it has a rapid response

It is neither part of the adaptive or innate immune system as it does not involve cellular defences

49.

1 point

Which ONE of the following statements is MOST CORRECT?
Compared to sinoatrial cells, ventricular muscle cells will have:

A smaller amplitude action potential

An action potential with a shorter duration of action

A slower depolarisation during the action potential

A more negative resting membrane potential

A slower conduction velocity

50.

1 point

Regarding human papilloma virus (HPV), which one of the following statements is correct?

HPV does not infect mature squamous epithelial cells

Most HPV infections become chronic

In benign lesions, HPV integrates into the host genome

HPV carcinogenesis involves mutations of the p53 gene

HPV is an RNA virus