hllj/quesmed huggingface dataset:
The formation of urea requires 2 atoms of nitrogen.

Which of the following is a molecule they come from?

Options:
explanation: Nitric oxide is a signalling molecule with a single nitrogen atom. It is not used as a source of nitrogen for urea synthesis.
name: Nitric oxide (NO)
label: c
answer: no
explanation: Urea synthesis involves the combination of ammonia (NH3) and carbon dioxide (CO2) in a series of enzymatic reactions. Two ammonia molecules contribute their nitrogen atoms to form the two nitrogen atoms found in the urea molecule. This process occurs in the liver and is a key part of the urea cycle, which helps eliminate excess nitrogen (ammonia) from the body. Aspartate also contributes to the requirement for nitrogen atoms.
name: Ammonia (NH3)
label: a
answer: yes
explanation: Whilst nitrate contains nitrogen, it is not directly used in the synthesis of urea. Nitrate can be converted into nitrite and then into ammonia, which can then be incorporated into the urea cycle.
name: Nitrate (NO3-)
label: b
answer: no
explanation: Nitrogen gas (N2) is abundant in the atmosphere but is not a form of nitrogen that the human body can readily use for urea synthesis. It needs to be converted into ammonia before it can be incorporated into the urea cycle.
name: Nitrogen gas (N2)
label: d
answer: no
explanation: Uric acid contains nitrogen, but it is not directly involved in the synthesis of urea. Uric acid is the end product of purine metabolism, and excess nitrogen in the form of uric acid is excreted in the urine. It is not a precursor for urea formation.
name: Uric acid
label: e
answer: no

Correct answer: a
What is the primary role of calcium ions (Ca2+) during an action potential in smooth muscle cells?

Options:
explanation: Calcium ions do not initiate the opening of sodium channels. Sodium channels are primarily regulated by changes in voltage potential, specifically by depolarisation which allows sodium ions to enter the cell and initiate action potentials.
name: Calcium ions initiate the opening of sodium (Na+) channels
label: c
answer: no
explanation: In smooth muscle cells, calcium ions play a crucial role in initiating contraction. When calcium ions enter a cell, they bind to and activate myosin light chain kinase, which, in turn, phosphorylates myosin. This phosphorylation is a key step in the initiation of smooth muscle contraction. The other answer choices do not accurately describe the primary role of calcium ions in smooth muscle action potentials.
name: Calcium ions activate myosin light chain kinase
label: a
answer: yes
explanation: Whilst calcium ions do play a role in neurotransmitter release in neurons, this question is about calcium movement during action potentials in smooth muscle cells, where their primary function is related to muscle contraction, not neurotransmitter release.
name: Calcium ions trigger the release of neurotransmitters
label: d
answer: no
explanation: The repolarisation phase of an action potential typically involves the efflux of potassium ions (K+), not calcium ions. Calcium ions primarily play a role in the initiation and maintenance of muscle contraction.
name: Calcium ions are responsible for the repolarisation of the cell membrane
label: b
answer: no
explanation: Calcium ions promote, rather than inhibit, the contraction of smooth muscle. They activate myosin light chain kinase, which is a key step in the initiation of smooth muscle contraction.
name: Calcium ions inhibit the contraction of smooth muscle
label: e
answer: no

Correct answer: a
From which germ layer does the liver primarily originate during embryonic development?

Options:
explanation: The neural crest is involved in the development of various structures, including certain nerves and components of the face. It is not associated with liver development.
name: Neural crest
label: e
answer: no
explanation: The mesoderm is responsible for forming structures like muscle, bone, blood, and the urinary and reproductive systems. Whilst mesoderm contributes to many organs, it is not the primary germ layer from which the liver originates.
name: Mesoderm
label: c
answer: no
explanation: The trophoblast is a layer of cells in early embryonic development that primarily forms the placenta, which plays a crucial role in nutrient and waste exchange between the mother and the developing fetus. The trophoblast does not directly contribute to liver development.
name: Trophoblast
label: d
answer: no
explanation: The ectoderm primarily gives rise to structures such as the skin, nervous system, and parts of the eyes and ears. It does not contribute to the development of the liver.
name: Ectoderm
label: b
answer: no
explanation: The liver primarily originates from the endoderm germ layer during embryonic development. The endoderm gives rise to many of the body's internal organs, including the liver, pancreas, and gastrointestinal tract. The other answer choices represent different germ layers and do not contribute significantly to liver development.
name: Endoderm
label: a
answer: yes

Correct answer: a
Which of the following is an example of a chromosome number abnormality in which an individual has an extra chromosome 18?

Options:
explanation: Cri du chat syndrome results from a deletion of a part of chromosome 5, not from having an extra chromosome 18.
name: Cri du chat syndrome
label: e
answer: no
explanation: Klinefelter syndrome is associated with having an extra X chromosome, resulting in a karyotype of 47, XXY. It does not involve an extra chromosome 18.
name: Klinefelter syndrome
label: d
answer: no
explanation: Turner syndrome is characterised by having only one X chromosome, leading to a total of 45 chromosomes (45, X), not an extra chromosome 18.
name: Turner syndrome
label: c
answer: no
explanation: Edwards' syndrome, or Trisomy 18, is characterised by an extra copy of chromosome 18. Individuals with Edwards' syndrome typically have severe intellectual and physical disabilities, as well as multiple congenital anomalies. The other syndromes mentioned are caused by different chromosomal abnormalities, and none of them involve an extra chromosome 18.
name: Edwards' syndrome
label: a
answer: yes
explanation: Down syndrome is caused by an extra copy of chromosome 21 (Trisomy 21), not chromosome 18.
name: Down syndrome
label: b
answer: no

Correct answer: a
Which of the following is an example of a catabolic process?

Options:
explanation: Photosynthesis is an anabolic process. It involves the synthesis of complex organic molecules, such as glucose, from simpler substances (carbon dioxide and water) using energy from sunlight.
name: Photosynthesis
label: b
answer: no
explanation: In the bone marrow, erythropoiesis is the process of creating new red blood cells from precursor cells. This is essential to maintain adequate oxygen-carrying capacity in the blood. This requires energy.
name: Erythropoiesis
label: d
answer: no
explanation: Protein synthesis is an anabolic process. It involves the assembly of complex proteins from amino acids, and it requires energy input.
name: Protein synthesis
label: c
answer: no
explanation: Glycogenesis is the process of forming glycogen from glucose molecules. This is a way for the body to store excess glucose for later use when energy demands are high, such as during physical activity or between meals. This is anabolic as a more complex molecule is formed from a comparatively simpler molecule using energy.
name: Glycogenesis
label: e
answer: no
explanation: This is a catabolic process. ATP (adenosine triphosphate) is broken down to ADP (adenosine diphosphate) to release energy for various cellular processes. Anabolic processes, on the other hand, involve the synthesis of complex molecules from simpler ones, often requiring energy input.
name: Conversion of ATP to ADP
label: a
answer: yes

Correct answer: a
Which of the following is an example of a primary enzyme required for glycogen degeneration?

Options:
explanation: Glucokinase is an enzyme primarily involved in regulating glucose levels in the liver and pancreas. It phosphorylates glucose during its uptake and storage as glycogen but is not a key enzyme in glycogen degradation.
name: Glucokinase
label: b
answer: no
explanation: Amylase is an enzyme responsible for the hydrolysis of starches and glycogen into simpler sugars. Whilst it plays a role in the digestion of glycogen in the digestive system, it is not the primary enzyme for glycogen degradation within cells.
name: Amylase
label: d
answer: no
explanation: This is a crucial enzyme in the breakdown of glycogen into glucose-1-phosphate, allowing for the release of glucose when needed. The other 2 primary enzymes are glycogen debranching enzyme & phosphoglucomutase.
name: Glycogen phosphorylase
label: a
answer: yes
explanation: Phosphofructokinase is an enzyme involved in glycolysis, specifically in the conversion of fructose-6-phosphate to fructose-1,6-bisphosphate. It is not a primary enzyme in glycogen degradation.
name: Phosphofructokinase
label: c
answer: no
explanation: Hexokinase is an enzyme involved in the initial steps of glycolysis, where glucose is converted to glucose-6-phosphate. It is not directly involved in glycogen degradation.
name: Hexokinase
label: e
answer: no

Correct answer: a
With reference to the morphology of bacterial pathogens, *Escherichia coli* is an example of a:

Options:
explanation: *Escherichia coli* is a rod-shaped bacterium that does not retain the crystal violet stain and takes up the red counterstain during the Gram staining procedure, classifying it as Gram-negative.
name: Gram-negative bacilli
label: a
answer: yes
explanation: Gram-positive bacilli are rod-shaped bacterial cells that retain the crystal violet stain during Gram staining. Examples include *Bacillus* and *Clostridium*.
name: Gram-positive bacilli
label: c
answer: no
explanation: Gram-positive cocci refer to spherical bacterial cells that retain the crystal violet stain during the Gram staining procedure. Examples include *Staphylococcus* and *Streptococcus*.
name: Gram-positive cocci
label: e
answer: no
explanation: Gram-negative cocci refer to spherical bacterial cells that do not retain the crystal violet stain and take up the red counterstain during the Gram staining procedure. *Neisseria gonorrhoeae* is an example of a Gram-negative cocci.
name: Gram-negative cocci
label: d
answer: no
explanation: Gram-negative spirilla are spiral-shaped bacterial cells, an example of which is *Helicobacter pylori*.
name: Gram-negative spirilla
label: b
answer: no

Correct answer: a
In order to prevent haemolytic disease of the newborn (HDN), which of the following should be administered to a Rhesus-negative mother after delivery of her first Rhesus-positive child?

Options:
explanation: Oxytocin is a hormone often used to induce or augment labour, but it is not administered to the mother after the delivery of her first child to prevent HDN. HDN is primarily related to Rh incompatibility.
name: Oxytocin
label: c
answer: no
explanation: The correct answer is "anti-D immunoglobulin" (Rh immunoglobulin), which is administered to the Rh-negative mother after the delivery of her first Rh-positive child to prevent sensitisation to the Rh antigen, which can lead to haemolytic disease of the newborn in subsequent pregnancies.
name: Anti-D Immunoglobulin
label: a
answer: yes
explanation: "Anti-F immunoglobulin" is not a recognised or standard term in the context of medical immunoglobulins or blood group antibodies.
name: Anti-F immunoglobulin
label: d
answer: no
explanation: The hepatitis B vaccine is recommended for infants shortly after birth to protect against hepatitis B infection, but it is not administered to the mother after the delivery of her first child to prevent HDN.
name: Hepatitis B vaccine
label: b
answer: no
explanation: Vitamin K is administered to newborns to prevent bleeding disorders. It is not administered to the mother after the birth of her first child to prevent HDN.
name: Vitamin K
label: e
answer: no

Correct answer: a
Which of the following describes the mechanism of action of an NSAID?

Options:
explanation: Inhibiting leukotriene receptors is not the primary mechanism of action of NSAIDs. Leukotrienes are primarily targeted by leukotriene modifiers, a different class of anti-inflammatory drugs.
name: Inhibition of leukotriene receptors
label: e
answer: no
explanation: This is not the primary mechanism of action of NSAIDs. Inhibiting 5-lipoxygenase is associated with another class of anti-inflammatory drugs called leukotriene modifiers, not NSAIDs.
name: Inhibition of 5-lipoxygenase
label: b
answer: no
explanation: This is an effect of NSAIDs, but the primary mechanism is the inhibition of cyclooxygenases (COX). NSAIDs can inhibit the production of prostacyclin (a vasodilator and platelet aggregation inhibitor) as a result of COX inhibition.
name: Inhibition of prostacyclin synthesis
label: c
answer: no
explanation: NSAIDs do not activate COX-2; they inhibit it. COX-2 is an enzyme involved in the production of inflammatory prostaglandins. Inhibition of COX-2 is one of the key mechanisms of NSAIDs.
name: Activation of COX-2
label: d
answer: no
explanation: NSAIDs work by inhibiting COX enzymes, particularly COX-1 and COX-2. This inhibition reduces the production of prostaglandins, which are involved in inflammation, pain, and fever.
name: Inhibition of cyclooxygenases (COX)
label: a
answer: yes

Correct answer: a
During the late phase of wound healing, which of the following are produced by activated leukocytes and macrophages, and contribute to the degradation of damaged tissue?

Options:
explanation: Growth factors, such as transforming growth factor-beta (TGF-beta) and platelet-derived growth factor (PDGF), play a role in tissue repair and regeneration, rather than tissue degradation. They stimulate cell proliferation and extracellular matrix production.
name: Growth factors
label: b
answer: no
explanation: Antioxidants, such as vitamins C and E, help protect cells from oxidative damage and support tissue healing but are not directly responsible for tissue degradation.
name: Antioxidants
label: c
answer: no
explanation: Whilst metalloproteinases, such as matrix metalloproteinases (MMPs), are involved in tissue remodelling and the degradation of damaged tissue, they are not produced by leukocytes and macrophages but by various cell types, including fibroblasts and endothelial cells. Leukocytes and macrophages release cytokines, such as IL-1, which can stimulate the production of metalloproteinases by other cells.
name: Metalloproteinases
label: e
answer: no
explanation: Fibroblasts are involved in the synthesis of collagen and other extracellular matrix components, contributing to tissue repair and remodelling. They are not primarily responsible for tissue degradation.
name: Fibroblasts
label: d
answer: no
explanation: During the late phase of wound healing, activated leukocytes and macrophages produce various factors, including cytokines, that contribute to the degradation of damaged tissue by influencing various processes, including the production of metalloproteinases by other cells. The cytokine IL-1 is indeed one of these factors. TNF is also another factor of note.
name: Cytokine IL1
label: a
answer: yes

Correct answer: a
Which of the following is a commonly experienced side effect when using anti-muscarinic drugs?

Options:
explanation: A commonly experienced side effect when using antimuscarinic drugs is "blurred vision." These drugs block the action of acetylcholine at muscarinic receptors, which can affect the function of the eye and lead to visual disturbances. Dry mouth, urinary retention and constipation are other common side effects with this class of drugs.
name: Blurred vision
label: a
answer: yes
explanation: Antimuscarinic drugs typically decrease gastrointestinal motility, leading to constipation rather than increased motility. They block muscarinic receptors in the gastrointestinal tract, inhibiting the normal contractions that move food through the digestive system.
name: Increased gastrointestinal motility
label: e
answer: no
explanation: Antimuscarinic drugs are more likely to cause an increase in blood pressure (hypertension) rather than hypotension. This is due to the inhibition of muscarinic receptors, which can lead to increased sympathetic activity.
name: Hypotension
label: b
answer: no
explanation: Antimuscarinic drugs often lead to dry mouth (xerostomia) rather than increased salivation. They block muscarinic receptors in salivary glands, reducing saliva production.
name: Increased salivation
label: c
answer: no
explanation: Antimuscarinic drugs tend to cause tachycardia (increased heart rate) rather than bradycardia. This is due to the inhibition of the parasympathetic nervous system, which normally slows the heart rate.
name: Bradycardia
label: d
answer: no

Correct answer: a
A patient is prescribed 500 mg of a medication. The medication is available in a liquid form with a concentration of 250 mg/5 mL.

How many millilitres (mL) of the liquid medication should the patient take to receive the prescribed dose?

Options:
explanation: This is incorrect as per the formula above.
name: 20 mL
label: c
answer: no
explanation: This is incorrect as per the formula above.
name: 15 mL
label: b
answer: no
explanation: This is incorrect as per the formula above.
name: 30 mL
label: e
answer: no
explanation: This is incorrect as per the formula above. Remember the concentration mentioned in the question is per 5mL.
name: 2 mL
label: d
answer: no
explanation: To calculate the required volume (in mL) of the medication to receive the prescribed dose, you can use the following formula:
Volume (mL) = Prescribed Dose (mg)/Concentration (mg/mL)
In this case, the prescribed dose is 500 mg, and the concentration of the liquid medication is 250 mg/5 mL (which can be simplified to 50 mg/mL). Plugging these values into the formula:
Volume (mL)= 500 mg/(250/5) mg/mL = 10 mL
name: 10 mL
label: a
answer: yes

Correct answer: a
A 22-year-old girl is a known asthmatic. For this, she uses a salbutamol inhaler. She has presented to the GP for anxiety-related palpitations and nausea.

Based on this information, which of the following drugs should the GP be careful not to prescribe?

Options:
explanation: The GP should be careful not to prescribe propranolol for this patient with known asthma and presenting symptoms of anxiety-related palpitations and nausea. Propranolol is a non-selective beta-blocker and can potentially worsen asthma symptoms by causing bronchoconstriction due to its effects on beta-2 receptors in bronchial smooth muscle. Beta-blockers are contraindicated with salbutamol and should not be prescribed, especially in primary care.
name: Propranolol
label: a
answer: yes
explanation: Ranitidine is an H2 receptor antagonist used to reduce stomach acid production. Whilst it can be used for nausea relief, it does not have a direct effect on asthma symptoms.
name: Ranitidine
label: d
answer: no
explanation: Lorazepam is a benzodiazepine medication used to treat anxiety and does not have a direct impact on respiratory function, although overdoses can cause respiratory depression. It can be prescribed for anxiety without significant risk to asthma control.
name: Lorazepam
label: b
answer: no
explanation: Diphenhydramine is an antihistamine often used to relieve allergy symptoms and can cause drowsiness. It does not have a direct impact on asthma symptoms and can be used for nausea relief in some cases.
name: Diphenhydramine
label: e
answer: no
explanation: Sertraline is a selective serotonin reuptake inhibitor (SSRI) used to treat anxiety and depression. It does not have direct effects on respiratory function and can be prescribed without significant concern for asthma symptoms.
name: Sertraline
label: c
answer: no

Correct answer: a
Which of the following is an example of a Type I hypersensitivity reaction?

Options:
explanation: Type I hypersensitivity reactions, also known as immediate hypersensitivity reactions, are characterised by a rapid onset of symptoms due to the release of histamine and other inflammatory mediators from mast cells and basophils. Anaphylaxis is a classic example of a Type I hypersensitivity reaction, and it can lead to severe, systemic symptoms, including difficulty breathing and hives. Type I hypersensitivity reactions are IgE-mediated; other examples include asthma and bee stings.
name: Anaphylaxis
label: a
answer: yes
explanation: Rheumatoid arthritis is an autoimmune disease that involves immune-mediated inflammation of the joints (Type III hypersensitivity).
name: Rheumatoid arthritis
label: b
answer: no
explanation: Contact dermatitis is a delayed-type hypersensitivity reaction (Type IV) involving a local skin response to allergens.
name: Contact dermatitis
label: c
answer: no
explanation: The tuberculin skin test reaction is a Type IV hypersensitivity reaction, also known as delayed-type hypersensitivity, in response to exposure to the tuberculosis antigen.
name: Tuberculin skin test reaction
label: e
answer: no
explanation: Systemic lupus erythematosus is an autoimmune disease characterised by immune complex deposition (Type III hypersensitivity) and the production of autoantibodies (Type II hypersensitivity).
name: Systemic lupus erythematosus
label: d
answer: no

Correct answer: a
A 65-year-old female is suspected to have COPD. The registrar has ordered a CXR as part of his initial investigations.

Which of the following findings is he expecting to see on the CXR if the woman has COPD?

Options:
explanation: Consolidation refers to the replacement of air in the lung's alveoli with fluid or other substances. It is not a typical finding in COPD but can be seen in conditions such as pneumonia.
name: Consolidation
label: d
answer: no
explanation: The characteristic finding in COPD on a CXR is hyperinflated lungs due to the chronic airway obstruction and air trapping that are hallmarks of the disease. This results in an increased lung volume, which can be visualised on imaging. Other characteristic findings are a flattened diaphragm, narrowed heart shadow, bullae and decreased lung markings.
name: Hyperinflated Lungs
label: a
answer: yes
explanation: Pulmonary nodules are small, rounded or oval-shaped growths in the lung tissue. They are not typically associated with COPD but may be seen in conditions like lung cancer or infections.
name: Pulmonary nodules
label: b
answer: no
explanation: A pleural effusion is the accumulation of excess fluid in the pleural space surrounding the lungs. Whilst pleural effusions can occur in various conditions, they are not a characteristic finding of COPD.
name: Pleural effusion
label: c
answer: no
explanation: Ground-glass opacities on a CXR may indicate a variety of conditions, such as interstitial lung diseases, infections, or pulmonary oedema, but they are not the primary findings associated with COPD.
name: Ground-glass opacities
label: e
answer: no

Correct answer: a