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Metabolism and Abdominal Anatomy

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Médecine et santéAnglais
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1
What is the transversus abdominis?
  • The middle layer of the abdominal wall
  • A muscle running from the xiphoid process to the pubic symphysis
  • The most superficial layer of the abdominal wall
  • The deep layer of the abdominal wall
2
Which is a type of glomerular lesions associated with diabetic nephropathy?
  • Nodular glomerulosclerosis
  • Crescent formation
  • Mesangial IgA deposition
  • Podocyte foot process effacement
  • Subepithelial immune complex deposition
3
What is the deep inguinal ring?
  • Structure that connect the axial skeleton to the lower limbs
  • Where the contents of the spermatic cord enter the abdominal wall
  • Opening at the top of the femoral canal, located below the inguinal
  • Where the spermatic cord emerges from the abdominal wall
4
Which of these nerves does not supply the abdominal wall?
  • T4
  • T12
  • T10
  • L1
  • T7
5
How is insulin normally secreted in response to glucose?
  • Slow release over time
  • A first slow release followed by a second quick secretion
  • One fast release
  • A quick first release followed by a slow sustained secretion
6
A 17 tear old man is being ivestigated for T1D. Which blood marker can be used to monitor insulin production?
  • Proinsulin
  • C peptide
  • Glucagon
  • C reactive protein
  • Alkaline phosphatase
7
What is the main action of cortisol on liver in response to hypoglycaemia?
  • Promtoes gluconeogenesis by activating PKA
  • Stimulates gluconeogenesis by inducing expression of genes
  • Blocks glycogenolysis by inducing synthesis of cAMP
  • Inhibits gluconeogenesis via glucose 6 phosphotase expression
8
What is insulin resistance?
  • Reduce insulin synthesis
  • Reduced processing of preproinsulin
  • Reduced cellular response to insulin
  • Reduced response to insulin in the liver only
9
Which statement related to T1D is correct?
  • Environmental factors have been associated with initiation of or protection from isley autoimmunity
  • Antigen present cells present beta cell antigens only in the first stage of the disease
  • The majority of patients are positive for a single islet autoantibody
  • Mutations in a single geene have been detected in some forms of diabetes
  • Environmental factors only increase the risk of progression from stage 2 to stage 3
10
Which statement decsribes the physiological response to insulin resistance correctly and most accurately?
  • Pancreatic beta cells increase in number, size and functionality
  • Pancreatic beta cells secrete more insulin
  • Pancreatic alpha cells are converted into beta cells
  • Pancreatic beta cells become bigger
  • Pancreatic alpha cells stop secreting glucagon
11
Identify the correct statement related to acid excretion by the lungs.
  • Lungs excrete titrable acids
  • High pCO2 increase ventilation
  • Low pH decrease ventilation
  • Acid excretion is a slow process
12
Where does reabsorption of bicarbonate occur primarily?
  • Renal glomerulus
  • Collecting duct of the kidney
  • Proximal convoluted tubule of the kidney
  • Lungs
  • Distal tubule of the kidney
13
Why does metabolic acidosis due to diarrhea not affect the anion gap?
  • Compensatory decrease in unmeasured cations
  • Compensatory decrease in potassium
  • Compensatory increase in chloride
  • Compensatory increase in unmeasured anions
14
In a blood test, low levels of which protein can indicate liver disease?
  • Albumin
  • AST
  • Biliburin
  • ALT
  • GGT
15
What can cause hepatic fat accumulation?
  • Increased number of mitochondria
  • Reduced activity of fatty acid translocase
  • Increased transport of fatty acids in mitochondria
  • Increased delivery of fatty acids to the liver
16
Why do some patients with decompensated cirrhosis need lactulose?
  • Helps prevent hepatic encephalopathy
  • Reduces portal hypertension
  • Compensates for reduces gluconeogensis
  • Prevents oesophageal varices bleeding
  • Reduces ascites
17
What is one of the advatntages of measuring HbA1c to diagnose or monitor diabetes?
  • Inexpensive
  • Not affected by gentic factors
  • Is recommeded to detect gestational diabetes
  • Reflects average plasma glucose over time
  • Indicates glucose levels at that moment of blood test
18
Idenitfy the incrorect statement related to metformin.
  • Stimulates glucose uptake in cells
  • Has multiple beneficial actions
  • Activates AMPK
  • Closes K+ channels on pancreatic beta cells
  • Inhibits gluconeogenesis
19
What is the one effects of GLP1 Receptor agonists?
  • Reduced diuresis
  • Delayed gastric emptying
  • Increased glucagon secretion
  • Increased food intake
20
Which vein contributes to the formation of the hepatic portal vein?
  • Internal iliac vein
  • Renal veinE
  • External iliac vein
  • Superior mesenteric vein
  • Gonadal vein
21
What are the liver sinusoids?
  • Bile drainage channels
  • Small branches of the hepatic artery
  • Liver specialised capillaries
  • Small branches of the hepatic vein
  • Digestive organ capillaries
22
A 30 year old has stones in the common bile duct. Which clinical finding is most likely?
  • Generally asymptomatic
  • Acute cholecysistis
  • Gallstone pancreatitis
  • Biliary colic
  • Jaundice
23
What is the name of the structual and functional unit of the liver?
  • Hepatic lobule
  • Spaces of Disse
  • Sinusoids
  • Parenchyma
24
Which of the following is not a general response to all hepatic injuries?
  • Fibrosis
  • Degeneration and intracellular accumulation
  • Inflammation
  • Regernation
  • Bleeding
25
Identify the incorrect statement related to liver cancer.
  • Adenoma is well circucmscribed
  • Carcinoma shows necrosis
  • Background liver of a carcinoma may have abnomrlatiies
  • Adenoma is a benign liver tumour
  • Carcinoma has homegnous surface
26
What is one of the mechanisms by which higher than required insulin or sulfonylureas doses can cause hypoglycaemia?
  • GLUT4 translocation independent of blood glucose levels
  • Hypercativation of glycogenolysis
  • Increased inhibition of glycolysis
  • Hyperstimulation of gluconeogensis
  • Increased inhibition of glycogenesis
27
What is one of the effects of aixdative stress on blood vessels and capillaries?
  • Hypercativation of glycolysis
  • Inhibition AGEs formation
  • Activation of pro inflammatory signal
  • Inhibtion of cell apoptosis
  • Reduced vasoconstriction
28
How can AGEs damage cells?
  • They bind to receptor trigger oxidaitve stress
  • The modify proteins altering their functions
  • By binding to RAGEs
  • They modify lipids altering their functions
  • All of the above
29
Which statement related to exocrine glands is correct?
  • They elicit a delayed response
  • Examples include ovariesT
  • Their secretions include mucins
  • They control growth and development of specific organs
  • They are ductless
30
What is one of the functions of the cavernous sinus?
  • Lymphatic drainage
  • Houses the pituitary gland
  • Thermoregulation
  • Prevents infection spread
31
Which part of the adrenal gland receives direct sympathetic innervation?
  • Zona recticularis
  • Zona glomerulosa
  • Medulla
  • Zone fasciculata
32
What are analytic variations in biochemical testing?
  • Variation related to the specific machine used
  • Differences betwen patients due to lifestyles
  • Variations due to sex or age
  • Variations caused by the storgae of the samples
  • Differences due to normal fluctuations in the analyte
33
In a lipid profile test which one is not usually measured directly?
  • Total cholesterol
  • HDL cholesterol
  • LDL cholestrol
  • Triglycerides
  • ALT
34
Which enzymes primarily converts ethanol to acetaldehyde?
  • Cytochrome P450 2E1
  • Acetyl CoA synthetase
  • Catalase
  • Alcohol dehydrogease
  • Aldehyde dehyrogenase
35
Which neurotransmitter is primarily responsible for mediating rebound wakefulness
  • Glutamate
  • GABA
  • Serotonin
  • Adenosine
  • Dopamine
36
A 19 year old man is brought to A&E after a night of heavy drinking. He hasnt eaten all day. He is drowsy and his capillary glucose is 2.4mmol/L. What is the main mechanism?
  • Acetaldeyde inhibits glucagon release
  • High NADH/NAD+ ratio impairs gluconeogensis
  • Increased renal glucose excretion
  • Increased glycogen synthesis
37
What is one of the reasons why C epptide can be used to monitor pancreatic beta cells functionality?
  • Has a shorter half life than insulin so it is best indicative of the functionality
  • Is undeteactable in early onset of T1D
  • Levels are interpreted independently of serum glucose measurement
  • Is not signifcantly cleared by the liver
38
Why do indiciduals carrying the HLA-DR3-DQ2 and or HLA-DR4-DQ8 halotypes have an increased genetic predispositon to developing T1D?
  • Encode for proteins on CD4+ T cells that bind to high affinity pancreatic beta cells autoantigens
  • Encode MHC class II proteins that form short lasting complexes on antigen presenting cells
  • Encode for MHC class II proteins that increase tolerance thresholds
  • Encode for MHC class II proteins that are particulay effecttive at presenting pacreatic beta cell autoantigens to CD4+ T cells
39
What is the main mechanism of action of TZDs?
  • Promote adipogenesis
  • Stimulate glucose uptake in the liver
  • Stimulate gluconeogenesis
  • Increase lipid deposition in the liver
  • Promote lipolysis
40
Which factor directly facilitates the iodination of tyrosine residues in thryoglobulin?
  • TSH receptor
  • Thryoid peroxidase
  • D'-deiodonases
  • Na/I- symporter
  • Pendrin
41
Excessive thryoid hormone therapy increases the risk of osteoporosis by which mechanism?
  • Reducing PTH
  • Increasing bone resorption
  • Blcoking calcium absoprtion
  • Inhibiting Vitamin D synthesis
  • Stimulating oestoblast activity
42
PTH indiectly increases calcium absoprtion from the gut by stimulating which process?
  • Inhibition of aldosterone
  • Inhibition of phosphate excretion
  • Activation of Vitamin D
  • Secretion of calcitonin
43
What is one of the causes of hypocalcaemia?
  • Granulomatous disease
  • Thiazide diuretic use
  • Hypomagneseamia
  • PTHrP
  • Bone metastasis
44
What is a maifestation of high phosphate?
  • Hypocalcaemia
  • Myopathy
  • Hypercacliuria
  • Ostemalacia
  • Haematological dysfunction
45
Identify the incorrect staement related to the pudendal nerve.
  • It is formed from the sacral plexus
  • Its large branch innervates muscles of the perinuem and pelvic floor
  • Arises from the ventral rami of the spinal nerves S2-S4
  • Provides motor function
  • Does not provide sensory function
46
Which striated muscle layer supports the external anal sphincter and assists in creating the anorectal angle?
  • Coccygeus
  • Puborectalis
  • Obturatory canali
  • Pirofrmis
  • Internal anal sphincter
47
Which type of incontienenc is caused by inadequate fibre or water intake?
  • Prolonged transit
  • Physiological
  • Normal transit
  • Dyssynergia
  • Delayed trasnit
48
If anti TPO antibodies, lymphoid follicles full of infiltrating lymphocytees and atrophic follicles are present what is the most likely cause?
  • Cushing's syndrome
  • Addison's disease
  • Graves disease
  • Hashimotos thyroiditis
  • Pheochrmocytoma
49
Which glands consit of groups of chief and oxyphilic cells?
  • Parathyroid
  • Islets of Langerhans
  • Pituitary
  • Adrenal
  • Thryoid
50
What is a histological feature of T2D?
  • Prescence of amyloid deposits in the islets of Lanagerhans
  • Prominent infoldings of hyperplastic follicular epithelium
  • Lymphoctyic infiltrates (Th17) in oedematous islet
  • Prescence of antibodies against the TSH receptor
  • Prescence of anti insulin antibodies
51
Which hormones is secreted by the adrenal medulla?
  • Vasopressin
  • Adrenaline
  • Aldosterone
  • Adrenal androgen
  • Cortsiol
52
Which one can be a symptom of catechloamine excess?
  • Hypoglycaemia
  • Hypotension
  • Orthostatic hypertension
  • Epigastric pain
  • Weight gain
53
Which is a sign of Conn's syndrome?
  • Metabolic alkalosis
  • High renin levels
  • Hyperkalaemia
  • Supprsed aldosterone after saline infusion
  • Hypotension
54
Identify the correct staement related to the kidney.
  • Blood exits the glomerulus via afferent arterioles
  • The right renal vein is longer than the left one
  • Reabsoprtion occurs in the glomerulus
  • The interlobar arteries give rise to efferent arterioles
  • The renal artery branches off from the abdmonial aorta
55
Which one of the sympathetic nerves that supplies the kidneys?
  • Pelvic splanchnic
  • Least splanchnic
  • Vagus nerve
  • Phrenic nerve
  • Greater splanchnic
56
Where does the renalpelvis become the ureter?
  • Uretoropelvic junction
  • Pelvic brim
  • Vesicoureteric junction
  • Renal ilum
  • Major calyx
57
Which structure is part of the renal corpuscle?
  • Collecting duct
  • Bowman's capusule
  • Collecting tubule
  • Proximal tubule
  • Loop of Henle
58
Which is a biopsy feature of membranous glomerulonephritis ( nephropathy)?
  • Podocyte foot process effacemnet without immune deposits
  • Nodular mesangia expanison
  • Mesangial IgA depositon
  • Subendothelial immune complex depositon
  • Subepithelial immunoglobulin containg deposits along the GBM
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