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WorksheetsBSMS MODULE 102 PULSE CHECK 2 (WEEKS 5->8) QUIZ
Total questions: 72
Worksheet time: 54mins
Name
Class
Date
1.
Approximately how many days post-fertilization does the morula stage occur?
a)
1 day
b)
2 days
c)
3 days
d)
4 days
e)
5 days
2.
Which germ layer is primarily responsible for the development of the nervous system?
a)
Ectoderm
b)
Mesoderm
c)
Endoderm
d)
Trophoblast
e)
Hypoblast
3.
Which of the following statements correctly describes the role of the epiblast during the formation of the bilaminar disc?
a)
It forms the amniotic cavity and contributes to the formation of the embryo
b)
It contributes to the formation of the yolk sac
c)
It differentiates into the trophoblast
d)
It degenerates after the formation of the inner cell mass
e)
It develops into the placenta
4.
Scientists are undergoing testing on a particular cell. The cell is in a state where it has only sodium channels open. After the cell is given drug A, the sodium channels close and has equal permeability of potassium and chlorine channels. What can be said about the membrane potential of the cell?
a)
The cell starts at a potential of +60mV and then becomes -65mV
b)
The cell starts at a potential of +60mV and then becomes fluctuates between -40mV and then -90mV
c)
The cell is at depolarising as it has received an action potential
d)
The cell starts at a potential of +123mV and then becomes -40mV
e)
The cell has a resting potential of -70mV and during the action potential it becomes +40mV
5.
Which of the following statements correctly describes an action potential?
a)
The first stage of an action potential is the initial depolarisation where any increase in Vm will cause the next step of the positive feedback of depolarisation
b)
The positive feedback of depolarisation is due to K+ channels opening
c)
Repolarisation is caused by Na+ channel inactivation and delayed rectifier K+ channels opening
d)
During after-hyperpolarisation the K+ permeability decreases and Na+ permeability increases so the membrane potential moves closer to EK
e)
During the refractory period a new action potential can be initiated if the depolarisation is strong enough
6.
Which of the following is an example of motherese?
a)
New words at the start of the sentence
b)
More challenging language and sentences as Chomsky said adult speech was important for children’s to learn grammar rules
c)
Use a variety of tenses
d)
Usually more flat tone to help understanding
e)
Lots of repetition
7.
A 18 month girl comes into see the doctor as her mother is worried for her language development. Which of the following milestones is she yet to achieve according to average ages of development?
a)
Responsive to human voice
b)
Associate facial movement and sound
c)
Babble and association of sounds with things
d)
One word stage
e)
Two word stage
8.
How can we prove that the immune system has memory?
a)
IgM spikes following primary infection
b)
IgG lag periods following secondary infection
c)
IgM decline following secondary infection
d)
IgG lag periods following primary infection
e)
B cell somatic hypermutation
9.
Which of the following antibodies is found predominantly in secretions?
a)
IgM
b)
IgD
c)
IgA
d)
IgE
e)
IgG
10.
10) According to lay definitions of health, which of the following is MOST commonly seen as an important component of good health?
a)
Not having any diagnosed medical conditions
b)
Having a healthy lifestyle
c)
Possessing vitality and energy every day
d)
Being able to function effectively in daily life
e)
Passing all your medical school exams with zero stress
11.
Wright Mills (1959) introduced the concept of the sociological imagination. Which of the following BEST describes this concept?
a)
The ability to memorise major sociological theories to pass university exams
b)
The capacity to recognise how individual “private troubles” are shaped by wider social “public issues”
c)
The belief that society is entirely determined by biological factors
d)
The assumption that personal problems have no connection to social structures
e)
The practice of analysing society without questioning taken-for-granted assumptions
12.
How can intracellular signalling molecules be controlled?
a)
By post translational modifications such as phosphorylation done by phosphatases
b)
By regulating whether a G protein has bound GDP or GTP. GEFs promote the exchange of GTP for GDP
c)
By Ras molecules which act as a kinase molecule
d)
By provision of activators such as Ca2+ and cAMP
e)
By the use of integral membrane proteins
13.
GPCRs control lots of processes, including the relaxation of vasculature in skeletal muscle. Which of the following is correct for this relaxation?
a)
Beta adrenergic receptors activate Gai proteins which inhibit adenylyl cyclase
b)
Phospholipase C plays a role in causing the relaxation
c)
Beta adrenergic receptors activate Gas proteins causing the activation of PKA
d)
Relaxation is caused by K+ moving out of the cell
e)
Muscarinic M2 acetylcholine receptors bind to the GPCR and activate the GBY unit
14.
What is the mechanism of Cholera?
a)
Vibrio Cholerae inhibits GTPase activity of the Gas subunit
b)
Bordetella Pertussis releases an active adenylyl cyclase domain rendering Gai inactive
c)
Prolonged signal causes water and chlorine to move into the cells lining the intestine
d)
Vibrio Cholerae interferes with Ca2+ that allow normal gut function
e)
Whooping cough causes Cholera
15.
Which statement is true about interferon alpha and beta?
a)
Its production is activated bacterial infections
b)
One of its effects is that it stops cells dividing
c)
One of its effects is that it stimulates the synthesis of new proteins
d)
One of its effects is that it inhibits the production of antiviral proteins by host cells
e)
It is made only by viral host cells
16.
Which type of cell is believed to be most important in defence against parasites?
a)
Neutrophils
b)
Eosinophils
c)
NK cells
d)
Basophils
e)
Macrophages
17.
What type of muscle cell is mononucleated, striated, branching and has intercalated discs?
a)
Skeletal Muscle
b)
Endothelium
c)
Endocardium
d)
Cardiomyocyte
e)
Smooth Muscle
18.
Which correctly describes the hepatic portal system?
a)
Veins from the spleen, stomach and intestine drain into the kidney
b)
Blood is filtered at the kidneys
c)
Blood enters the liver via the hepatic vein and leaves via the hepatic portal vein
d)
Blood leaving the liver goes to the heart via the inferior vena cava
e)
The arterial blood is high in products of digestion
19.
Which type of ligand binds to a site on the receptor distinct from the agonist-binding site, thereby reducing the efficacy of the agonist?
a)
Competitive Antagonist
b)
Non-Competitive Agonist
c)
Partial Agonist
d)
Inverse Agonist
e)
Non-Competitive Antagonist
20.
Which of the following is true regarding the 2-State model of receptor function?
a)
Inverse agonists have a higher affinity for the active state
Neutral antagonists have higher for the resting state
b)
Neutral antagonists have higher for the resting state
c)
Agonists have a higher affinity for the resting state and shift the equilibrium towards it
d)
For constitutively active receptors there is no activity when an agonist is not present
e)
Agonists have a higher affinity for the active state and shift the equilibrium towards it
21.
Following prolonged exposure to a drug stimulus, receptor desensitisation refers to:
a)
Loss of intrinsic activity of receptor complexes
b)
Loss of a number of receptors from the cell surface
c)
Receptors continuously signal without a change in amplitude
d)
Enhancement of receptor activity on exposure to agonist
e)
Increase in receptor sensitivity upon ligand binding
22.
Regarding G-protein coupled receptors which of the following is true?
a)
Gs activation decreases adenylate cyclase activity and decreases cAMP production
b)
Gq activation decreases PLC activity and IPE and CA2+ Levels
c)
Gi activation increases adenylate cyclase activity and increases cAMP production
d)
Gi activation decreases adenylate cyclase activity and decreases cAMP production
e)
Gq activation increases adenylate cyclase activity and increases cAMP production
23.
Which of the following best describes the role of acetylcholinesterase (AChE) at the neuromuscular junction?
a)
Synthesizes acetylcholine
b)
Packages acetylcholine into vesicles
c)
Degradation of acetylcholine
d)
Stimulates the muscle cell to contract
e)
Acts as a receptor for acetylcholine
24.
The sarcomere is the functional unit of a muscle and its contraction results in:
a)
Movement of Z lines away from each other
b)
Decreased overlap between thick and thin filaments
c)
Z lines being pulled toward each other
d)
The A band shortening in length
e)
The I band increasing in length
25.
In Barrett’s oesophagus, abnormal columnar epithelial cells can be found in response to stomach acid reflux. Through which process do these cells appear?
a)
Hypertrophy
b)
Hyperplasia
c)
Atrophy
d)
Metaplasia
e)
Necrosis
26.
Hypertrophic cardiomyopathy causes hypertrophy of cardiac muscle cells. Through which pathway does this process occur?
a)
Ubiquitin-proteasome pathway
b)
PI3K/AKT and G-coupled pathways
c)
Autophagy genes regulation pathway
d)
Caspase activation for apoptosis
e)
Lactic acid fermentation pathway
27.
A 63 year old man presents with SOB and productive cough and is subsequently diagnosed with a pleural effusion secondary to pneumonia. Describe the pathophysiology of his infection.
a)
Vasoconstriction, emigration of neutrophils, extravasation of fluids
b)
Maximising the movement plasma proteins and leukocytes into the circulation from the site of insult
c)
Formation of a granuloma
d)
Increased hydrostatic pressure, increased vascular permeability, emigration of neutrophils
e)
Ulceration and abscess formation
28.
Which mediators are involved in vasodilation in acute inflammation?
a)
Histamine, Complement C3a and C5a, bradykinin and leukotrienes
b)
TNF, IL-1, Complement C3a and C5a
c)
TNF, IL-1, prostaglandins
d)
Prostaglandins, bradykinin
e)
Histamine, NO, prostaglandins
29.
A 53 year old male is prescribed a selective Beta 1 antagonist for his hypertension. Which of the following is an example of this drug?
a)
Labetalol
b)
Carvedilol
c)
Atenolol
d)
Propranolol
e)
Phentolamine
30.
A 23 year old female takes tiotropium bromide for her asthma. Which of the following is NOT a side effect of this drug?
a)
Blurred vision
b)
Saliva reduction
c)
Tachycardia
d)
Decreased urine
e)
Increased gut motility
31.
Which of the following sentences best describes why adolescents have more ‘risk-taking’ behaviour?
a)
Improved decision making skills give them the ability to weigh up risks better
b)
Abstract thinking allows for the understanding of formal operations with logic
c)
They usually just have faulty reasoning and make mistakes
d)
A combination of egocentric thinking, identity formulation and hormonal changes
e)
Lack of psychosocial maturity and mis-perceived norms leading to peer pressure, as well as a personal fable formulation
32.
Which of the following statements accurately depicts the principles of The Fraser Guidelines/Gillick Competence?
a)
Parents / carers will always have legal rights / responsibilities if a child is aged under 16
b)
A treatment can be initiated given a child can accurately display intelligence and understanding of a given treatment
c)
These protect adolescents who may be uncomfortable with a 3-way consultation
d)
A child/adolescent may not understand what confidentiality means therefore doctors must encourage parental disclosure
e)
Prevents a child being embarrassed by parents in a consultation
33.
This is an image of an abscess. What is the pink material?
a)
granulomatous tissue
b)
excess number of neutrophils
c)
glandular tissue
d)
collagen deposits
e)
dead tissue
34.
A 42-year old woman undergoes an excision of a chronic breast abscess site, which subsequently heals to form a raised fibrotic scar. Which cell type is primary responsible for synthesising and depositing significant amounts of collagen that replaces the granulation tissue and form a mature scar?
a)
Neutrophil
b)
Macrophage
c)
Endothelial cell
d)
Fibroblast
e)
Mast cell
35.
A 10 y/o male presents to A&E with flu like symptoms, he has had a recent Thymectomy due to a tumour, what type of immune cell will be depleted?
a)
Naive B cells
b)
T cell precursors
c)
Developed T cells
d)
Developed B cells
e)
Macrophages
36.
A Patient tests positive for COVID-19, which of these structures will the virus NOT go through in the Class I pathway?
a)
TAP Protein
b)
Proteasome
c)
Endoplasmic reticulum
d)
Lysosome
e)
Golgi apparatus
37.
A 22 y/o Female patient presents to a Sexual Health Clinic with a first time Chlamydia infection. The Doctor does a serology test 1 week later, what would you expect to see on Serology to confirm this diagnosis?
a)
Negative IgG and Negative IgM for Chlamydia
b)
Positive IgA and Negative IgM
c)
Positive IgG and Positive IgM
d)
Positive IgE and Positive IgM
e)
Negative IgG and Positive IgM
38.
A Patient on the Orthopaedic ward has COVID-19 symptoms. Which diagnostic tool would give the most accurate diagnosis?
a)
PCR Test
b)
Blood Culture
c)
Sputum Culture
d)
Lateral Flow Test
e)
Gram Staining
39.
A lady presents to her GP with cellulitis, the GP wants to give her a macrolide, which is the best antibiotic to give?
a)
Clarithromycin
b)
Amoxicillin
c)
Panipenem
d)
Cefaclor
e)
Moxalactam
40.
You are an FY2 on the orthogeriatric ward, a 72y/o lady has an infected surgical site which cultured Penicillin Resistant S. aureus. She has no known drug allergies, what is the first line clinical treatment for this?
a)
Penicillin
b)
Flucloxacillin
c)
Vancomycin
d)
Ceftriaxone
e)
Imipenem
41.
Which of these is exclusive to a Commensal rather than a Pathogen?
a)
Invasion
b)
Adherence
c)
Survive
d)
Multiply
e)
Disseminate
42.
Which of these is a Non-Bacterial Commensal?
a)
Neisseria meningitidis
b)
Candida
c)
Staphylococcus aureus
d)
Streptococcus pneumoniae
e)
Escherichia coli
43.
Which of these will reduce susceptibility of infections?
a)
Sickle cell Anaemia
b)
Tuberculosis infection
c)
Leprosy
d)
Having a high population density
e)
AIDS
44.
A 45 y/o Male has a splenectomy, which infection is he most susceptible to?
a)
Haemophilus influenzae
b)
COVID-19
c)
Norovirus
d)
Varicella Zoster Virus
e)
Influenza
45.
A patient presents to A&E with a cut to his hand with bleeding and inflammation. What is the correct sequence of next events of Scar formation?
a)
Formation of Granulation tissue → Formation of connective tissue/ scar → Final Scar → Remodelling of scar
b)
Formation of connective tissue/ scar → Formation of granulation tissue → Final scar
c)
Formation of granulation tissue → Remodelling of scar → Formation of connective tissue → Final Scar
d)
Formation of Granulation tissue → Formation of connective tissue → Remodelling of scar → Final Scar
e)
Formation of connective tissue → Remodelling of scar → Formation of granulation scar → Final scar
46.
Which of these can cause abdominal adhesions?
a)
Hypercholesterolaemia
b)
Hypothyroidism
c)
Being immunocompromised
d)
Von Willebrand Disease
e)
Crohn’s Disease
47.
What is the definition of a sarcoma?
a)
Malignant neoplasm of epithelial tissue
b)
Malignant neoplasm of connective tissue or muscle
c)
Malignant neoplasm of melanocytes
d)
Malignant neoplasm of leucocytes
e)
Neoplasm comprising of many different tissues
48.
What is NOT a feature of malignant neoplasms?
a)
Invasion of surrounding tissues
b)
Metastasis
c)
Pushing, well circumscribed borders or encapsulated
d)
Usually grow very rapidly
e)
Variable differentiation
49.
Which of these structures can be visualised by a Phased transducer?
a)
The heart
b)
The liver
c)
The spleen
d)
The biceps brachii
e)
The uterus
50.
Which of the following is NOT an application of bedside ultrasound?
a)
Cardiac assessment
b)
Deep Vein Thrombosis assessment
c)
Joint effusion
d)
Peripheral Nerve Block
e)
Pulmonary function test
51.
What is the function of VEGF when secreted from a tumour?
a)
Resist cell death
b)
Sustained proliferative signalling
c)
Help evade growth suppressors
d)
Increases blood vessel expression and movement of vessels to tumour
e)
Activate invasion and metastasis
52.
What does is the consequence of a lack of p53?
a)
Increased cell cycle arrest leading to enhanced DNA repair
b)
Activation of apoptosis resulting in reduced tissue degeneration
c)
Prevention of mutation accumulation and reduced cancer risk
d)
Failure to arrest the cell cycle, promoting mutation accumulation and cancer development
e)
Induction of senescence to maintain genome stability
53.
Which of the following correctly describes the unidirectional flow of lymph through a lymph node?
a)
Efferent vessels → lymph node → afferent vessel
b)
Afferent vessel → lymph node → efferent vessel
c)
Lymph node → deep lymphatic vessels → afferent vessel
d)
Superficial lymphatic vessels → efferent vessels → lymph node
e)
Lymphatic trunks → afferent vessels → lymph node
54.
Which statement best describes how lymph is formed in the body?
a)
Lymph is created when venous pressure forces blood cells directly into lymphatic vessels
b)
Lymph forms when plasma proteins leak from veins during low-pressure flow.
c)
Lymph forms as interstitial fluid enters blind-ended lymphatic capillaries after being pushed out of blood capillaries by high arterial hydrostatic pressure.
d)
lymph forms as interstitial fluid enters blind-ended lymphatic capillaries after being pushed out of blood capillaries by high arterial osmotic pressure.
e)
Lymph arises when tissue cells secrete fluid directly into lymphatic trunks.
55.
Which of the below is categorised as a primary lymphoid organ?
a)
lacteals
b)
Lymph nodes
c)
BALT
d)
Thymus
e)
Cisterna chyle
56.
Which of these are NOT changes expected to be seen in older adult patients?
a)
Decrease in Fluid intelligence but maintained of crystalline intelligence
b)
Physical fitness may slow down the rate of memory decline
c)
Decreased speech recognition ∴ increased need of ‘oldese’ in practice
d)
Reduced ability to distinguish between relevant and irrelevant information
e)
Crystalline memory may compensate for fluid memory
57.
How do stereotypes held by healthcare professionals negatively impact older patients shown specifically in the CQC findings of the NHS?
a)
Dignity and Nutrition is not upheld due to attitudes towards the elderly in hospitals
b)
Assumptions of lower cognitive function leads to isolation
c)
Assumptions of constant chronicity of physical frailty may lead to neglect of pain
d)
Stigmatization leads to use of ’oldese’ which is demeaning
e)
Higher incidences of elder abuse in hospital wards
58.
What is p53’s primary response to DNA damage?
a)
Triggers Apoptosis
b)
Inhibits cell cycle arrest by acting as a transcription factor leading to DNA repair
c)
Initiates Cell proliferation
d)
Induces cell cycle arrest by acting as a transcription factor leading to DNA repair
e)
Facilitates protein folding and post translational modification
59.
Which of the following statements accurately differentiates between oncogenes and tumour suppressor genes (TSG)?
a)
Oncogenes promote cell cycle arrest, while TSG initiate uncontrolled cell growth
b)
Oncogenes are normal genes involved in DNA repair, whereas TSG are mutated forms that stimulate cancer development
c)
Oncogenes are mutated forms of genes that inhibit cell growth, TSG are involved in promoting cell division
d)
Oncogenes are exclusively linked to apoptosis, while tumor suppressor genes solely regulate cell proliferation
e)
Oncogenes are mutated forms of genes that promote cell proliferation. TSG’s normal function is regulating proliferation
60.
Which function is primarily attributed to oligodendrocytes in the central nervous system (CNS)?
a)
Providing structural support
b)
Neurotransmitter uptake
c)
Myelinating axons
d)
Forming the blood-brain barrier
e)
Phagocytosis
61.
What is the primary function of the somatic component of the peripheral nervous system?
a)
Supply skeletal muscles and sensory input from skin
b)
Regulate the endocrine system
c)
Control respiration and the cardiovascular system
d)
Myelinate peripheral axons
e)
Control the autonomic functions of viscera
62.
Which group of spinal cord segments is primarily responsible for innervating only lower limb?
a)
Cervical (C1-C7)
b)
Thoracic (T1-T12)
c)
Lumbar (L1-L5)
d)
Sacral (S1-S4)
e)
Coccygeal
63.
Which of the following is primarily responsible for the "fight or flight" response in the autonomic nervous system?
a)
Parasympathetic division
b)
Somatic nervous system
c)
Sympathetic division
d)
Cranial parasympathetic
e)
Sacral parasympathetic
64.
Why are dermatomes clinically important?
a)
each dermatome corresponds to a single muscle group, allowing precise testing of motor weakness
b)
dermatomes determine the pattern of blood supply to the skin
c)
dermatomes indicate the exact location of visceral organs beneath the skin
d)
loss or alteration of sensation in a dermatome can help localize injury to a specific spinal cord segment, nerve root, or spinal nerve
e)
dermatomes change significantly between individuals and help track developmental variation
65.
What is the significance of the dorsal root in spinal nerve organization?
a)
Contains somatic motor and sympathetic axons
b)
Contains somatosensory axons
c)
Provides motor supply to muscles
d)
Innervates erector spinae muscles
e)
Transmits action potentials
66.
In chronic lymphocytic leukaemia (CLL), which blood test finding often serves as the initial indicator prompting further investigation?
a)
Elevated platelet count
b)
Decreased lymphocyte count
c)
Increased white blood cell count
d)
Reduced haemoglobin levels
e)
Elevated red blood cell count
67.
What is the primary mechanism of action of ibrutinib in the treatment of B-cell malignancies?
a)
Inhibition of mTOR signaling
b)
Blockade of Bcl-2
c)
Inhibition of Bruton's tyrosine kinase (BTK)
d)
Antagonism of CD20 receptor
e)
Suppression of JAK2 signalling
68.
Which of the following best describes the underlying cause of Chronic Lymphocytic Leukaemia (CLL)?
a)
Uncontrolled proliferation of immature myeloid stem cells in the bone marrow
b)
A clonal disorder of mature B lymphocytes expressing CD5 and CD19
c)
Failure of T-cell maturation in the thymus
d)
Viral infection that directly transforms neutrophils into tumour cells
e)
Overproduction of red blood cells due to erythropoietin excess
69.
A 55 y/o man presents with crushing chest pain. A biopsy taken 3 days after onset shows the histological findings below. Which of the following best describe the current stage of the pathology?
a)
Acute inflammatory response with neutrophil infiltration
b)
Chronic inflammatory response with macrophage and granulation tissue formation
c)
Reversible ischemic injury with cellular swelling and fatty change
d)
Dense collagen deposition indicating mature myocardial scar
e)
Hyperacute phase with wavy myocardial fibres due to early ischaemic change
70.
A resected appendix is examined histologically. The slide shows loss of mucosa, dense transmural neutrophilic infiltration and marked vasodilation/congestion of serosal vessels. Which is the most appropriate diagnosis? No parasites or tumors identified.
a)
Acute appendicitis
b)
Chronic appendicitis
c)
Crohn disease involving the appendix
d)
Appendiceal carcinoid tumour
e)
Enterobius vermicularis infection
71.
A patient suffers a small area of liver injury due to a drug reaction. The basement membrane and extracellular matrix scaffolding remain intact. What best describes the expected mechanism of healing in this tissue?
a)
Repair by formation of collagenous scar
b)
Regeneration by stem cells in a permanent tissue
c)
Scar formation because liver is a permanent tissue
d)
Regeneration by proliferation of remaining hepatocytes
e)
No healing because stable tissues cannot enter the cell cycle once damaged
72.
A patient presents with signs of acute inflammation. Histology of affect tissues shows vasodilation, vascular congestion, increase vascular permeability and leukocyte infiltration. Fluid collected is cloudy and high in protein content containing neutrophils. What type of fluid is this?
a)
Transudate
b)
Pure plasma leakage due to increase hydrostatic pressure only
c)
Lymphatic obstruction fluid
d)
Serous effusion
e)
Exudate
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