hllj/quesmed huggingface dataset:
A medical student is reading about the pharmacology of the autonomic nervous system.

Which of the following statements is correct?

Options:
explanation: It is B1-adrenoceptor stimulation which leads to the release of renin. This stimulates angiotensin-2 production and leads to water and salt retention. These systemic effects lead to vasoconstriction and increase blood pressure.
name: B2-adrenoceptor stimulation leads to the release of renin
label: b
answer: no
explanation: A1-adrenoceptors stimulation leads to **hyper**kalaemia. A1-adrenoceptors stimulation leads to the release of potassium from the liver.
name: A1-adrenoceptors stimulation leads to hypokalaemia
label: e
answer: no
explanation: A1-adrenoceptor agonists such as phenylephrine are used as nasal decongestants. Swelling in the nasal passage due to infection or inflammation leads to vasodilation. A1-adrenoceptor stimulation leads to vasoconstriction and unblocks the nose.
name: A1-adrenoceptor agonists are used as nasal decongestants
label: a
answer: yes
explanation: B2-adrenoceptor simulation leads to uterine smooth muscle relaxation. This is why salbutamol is used in some cases to prevent premature labour. B2-adrenoceptor stimulation additionally leads to bronchodilation and systemic vasodilation.
name: B3-adrenoceptor stimulation leads to uterine smooth muscle relaxation
label: c
answer: no
explanation: B1-adrenoceptor stimulation leads to positive chronotropic and inotropic effects on the heart. B2-adrenoceptor stimulation leads to bronchodilation and uterine smooth muscle relaxation.
name: B2-adrenoceptor stimulation leads to positive chronotropic and inotropic effects on the heart
label: d
answer: no

Correct answer: a
A medical student is reading about the foundations of various general pharmacological concepts.

Which of the following options is correct?

Options:
explanation: LD50 and TD50 are different terms which measure therapeutic indexes. LD50 measures the lethal dose. This is a dose that produces a lethal response in 50% of animals. TD50 is the toxic dose which measures at which dose do 50% of animals have a damage-inducing response. These terms are not interchangeable.
name: LD50 and TD50 are interchangeable terms used to measure therapeutic indexes
label: d
answer: no
explanation: This statement is clearly untrue. There are many instances where partial agonists are useful drugs such as varenicline which is a partial agonist of morphine and pholcodine which is a partial agonist of nicotine. Although partial agonists do not produce the maximum available response, they are much safer drugs to administer.
name: It is always better to give full agonist drugs, rather than partial agonist drugs if they are available
label: e
answer: no
explanation: EC50 ('effective concentration, 50%') is a number which quantifies a drug's potency. The more potent, the lower the EC50 as it requires less of the drug is required to achieve 50% of the maximum possible response.

An easier way to think of it is that a higher EC50 means that the drug works 'less well', and thus more of it is required to have an effect.
name: The concentration that produces 50% of the maximum response is called EC50
label: a
answer: yes
explanation: This is untrue, as different drugs have different EC50 values, and as such have different effects at different concentrations. Effectively, different drugs have different potencies.
name: All drug agonists produce the same maximum effect
label: b
answer: no
explanation: A partial agonist would be less potent, and thus would have a higher EC50. A higher dose of the drug would be required to achieve 50% of the maximum effect possible.
name: A partial agonist has a lower EC50 compared to a full agonist
label: c
answer: no

Correct answer: a
A medical student is reading about the pharmacology of the gastrointestinal system.

Which of the following options is correct?

Options:
explanation: H2 histamine receptors in the stomach are responsible for gastric acid secretion. This is an important fact you should know! H3 histamine receptors are responsible for neurotransmitter modulation and are an important target for anti-emetic drugs.
name: H3 histamine receptors in the stomach are responsible for gastric acid secretion
label: c
answer: no
explanation: Enterochromaffin-like cells (ECLs) produce histamine in the stomach. Hydrochloric acid is produced by parietal cells
name: Enterochromaffin-like cells produce hydrochloric acid in the stomach
label: b
answer: no
explanation: Antacids such as Gaviscon, consist of sodium bicarbonate which neutralises gastric acid. They do not suppress gastric acid secretion. They are used to relieve pain from ulceration but do not raise the pH high enough to achieve ulcer healing.
name: Antacids such as Gaviscon work by suppressing gastric acid secretion
label: e
answer: no
explanation: This statement is correct. Helicobacter Pylori is a Gram-negative bacteria which increases gastric acid secretion and is associated with duodenal ulcers. The treatment regime is a proton pump inhibitor, amoxicillin and metronidazole.
name: Helicobacter Pylori treatment includes proton pump inhibitors and antibacterial agents
label: a
answer: yes
explanation: Omeprazole is an example of a proton pump inhibitor which is an H2 histamine receptor antagonist. It is commonly used for the treatment of gastric ulcers.
name: Omeprazole is a drug which inhibits H1 histamine receptors in the stomach
label: d
answer: no

Correct answer: a
A patient attends their GP practice to ask about their pernicious anaemia which they recently got diagnosed with.

Which of the following options correctly states where in the gastrointestinal tract vitamin B12 is absorbed?

Options:
explanation: Intrinsic factor which binds to vitamin B12 is secreted from gastric parietal cells. It proceeds to form a protective complex with vitamin B12, allowing its absorption in the terminal ileum.
name: Stomach
label: c
answer: no
explanation: This is incorrect as vitamin B12 is absorbed in the terminal ileum. The colon is the main site for salt, chloride and water reabsorption.
name: Colon
label: e
answer: no
explanation: Jejunum is incorrect as vitamin B12 is absorbed in the terminal ileum. To 'avoid' being absorbed in the jejunum, it is coupled with intrinsic factor for protection.
name: Jejunum
label: d
answer: no
explanation: Duodenum is incorrect as vitamin B12 is absorbed in the terminal ileum. To 'avoid' being absorbed in the duodenum, it is coupled up with intrinsic factor for protection.
name: Duodenum
label: b
answer: no
explanation: The terminal ileum is where Vitamin B12 is absorbed. To 'avoid' being absorbed in gut structures which are 'upstream', it is coupled up with intrinsic factor for protection. Additionally, the terminal ileum has a role in bile salt absorption.
name: Terminal ileum
label: a
answer: yes

Correct answer: a
Barrett's oesophagus is a condition where a patient develops metaplasia as a result of long-term gastric acid reflux.

Which of the following options correctly describes which epithelial cell type lines the oesophagus?

Options:
explanation: The oesophagus is covered in the squamous stratified epithelium. In Barrett's oesophagus, this epithelial change is driven to withstand the activity of regurgitation of the stomach. The transformation of one tissue type into another is known as metaplasia.
name: Stratified squamous epithelium
label: a
answer: yes
explanation: The pseudostratified epithelium is found in the respiratory epithelium. It is characterised by epithelial cells which sit on the basal lamina at different heights.
name: Pseudostratified epithelium
label: e
answer: no
explanation: Simple columnar epithelium lines the stomach and intestines. This allows secretion, absorption and protection of these structures.
name: Simple columnar epithelium
label: b
answer: no
explanation: Simple squamous epithelium differs from stratified squamous epithelium as it consists of a single layer of cells on a basement membrane. Simple squamous epithelium is present in blood and lymphatic vessel lining where it is known as the endothelium.
name: Simple squamous epithelium
label: c
answer: no
explanation: Stratified cuboidal epithelium is present in exocrine glands, and is composed of a few layers of cuboidal cells.
name: Stratified cuboidal epithelium
label: d
answer: no

Correct answer: a
An 18-year-old male presents to his GP with symptoms of increased thirst and abnormally increased urine output. A urine dip test comes back with inappropriately dilute urine, and a glucose finger prick test rules out diabetes mellitus.

The patient is diagnosed with diabetes insipidus.

Which of the following describes the most likely mechanism causing this patient's presentation and results?

Options:
explanation: Angiotensin is a hormone which regulates vasoconstriction and triggers water and sodium retention. Both of these functions lead to increased blood volume and pressure. It does not play a role in diabetes insipidus.
name: Increased angiotensin
label: e
answer: no
explanation: Diabetes insipidus is characterised by an abnormal quantity (cranial cause) or insensitivity in response to antidiuretic hormone (nephrogenic causes). Antidiuretic hormone (ADH) regulates blood pressure by controlling water retention in the kidneys, thus changing urine output. Decreased secretion of ADH will lead to decreased urine retention and thus excessive urine output.
name: Decreased secretion of antidiuretic hormone (ADH)
label: a
answer: yes
explanation: Aldosterone is a hormone which regulates the amount of sodium and water retention. Increased aldosterone will lead to water retention which increased blood volume and pressure. Aldosterone, however, is not the hormone affected in diabetes insipidus.
name: Increased secretion of aldosterone
label: c
answer: no
explanation: Aldosterone is a hormone which regulates the amount of sodium and water retention. Decreased aldosterone will lead to less water retention which decreases blood volume and pressure. Aldosterone, however, is not the hormone affected in diabetes insipidus.
name: Decreased secretion of aldosterone
label: d
answer: no
explanation: Diabetes insipidus is characterised by an abnormal quantity (cranial cause) or insensitivity in response to antidiuretic hormone (nephrogenic causes). Antidiuretic hormone (ADH) regulates blood pressure by controlling water retention in the kidneys, thus changing urine output. Increased secretion of ADH will lead to increased urine retention and thus decreased urine output. This is not what is described in the question stem.
name: Increased secretion of antidiuretic hormone (ADH)
label: b
answer: no

Correct answer: a
A medical student is in the clinic with a nephrologist and is asking questions about renal physiology.

Which of the following best describes which transporter is responsible for the majority of glucose transport in the kidney?

Options:
explanation: Epithelial sodium (ENaC) channels are responsible for sodium reabsorption in the distal tubules in the kidney. Aldosterone has a role in this channel and it increases the activity of sodium reabsorption.
name: Epithelial sodium (ENaC) channels
label: e
answer: no
explanation: Aquaporin 1 (AQP1) is a protein which is involved in the passive transport of water. Genetic defects involving the aquaporin gene can cause nephrogenic diabetes insipidus.
name: Aquaporin 1 (AQP1)
label: c
answer: no
explanation: The Na/K ATPase, as the name implies is responsible for the movement of sodium and potassium. Sodium is pumped out of the cell and potassium into the cell to create a membrane potential in the cell.
name: Na/K ATPase
label: b
answer: no
explanation: Sodium-Glucose Linked Transporter 2 (SGLT2) are responsible for ~96% of renal glucose transport. SGLT2 inhibitors are widely used in Type 2 diabetic patients to decrease their blood glucose long-term.
name: Sodium-Glucose Linked Transporter 2 (SGLT2)
label: a
answer: yes
explanation: Na-K-Cl (NKCC) co-transporter is a transport protein responsible for the active transport of sodium, potassium and chloride into the cell. It does not have an immediate role in glucose transport across membranes.
name: Na-K-Cl (NKCC) co transporter
label: d
answer: no

Correct answer: a
A medical student is in a clinic with a nephrologist and is asking questions about hormones and their effect on renal physiology.

Which of the following is the hormone which stimulates calcium absorption and phosphate excretion in the kidneys?

Options:
explanation: Aldosterone is a hormone which regulates the amount of sodium and water retention. Decreased aldosterone will lead to less water retention which decreases blood volume and pressure. Aldosterone is not involved in calcium and phosphate regulation.
name: Aldosterone
label: e
answer: no
explanation: Insulin is a hormone which is secreted by the pancreatic beta islet cells. Its main function is to lower serum glucose levels.
name: Insulin
label: c
answer: no
explanation: 1,25-dihydroxy vitamin D (calcitriol), is a hormone metabolite of Vitamin D. It acts on the parathyroid gland by suppressing parathyroid hormone (PTH) production. This has the effect of increasing both the absorption of calcium and phosphate through the gut.
name: 1,25-dihydroxyvitamin D (calcitriol)
label: d
answer: no
explanation: Parathyroid hormone (PTH) increases plasma calcium and decreases phosphate through a direct effect on bone and kidneys. It stimulates the kidneys to actively reabsorb calcium and excrete phosphate.
name: Parathyroid hormone (PTH)
label: a
answer: yes
explanation: Calcitonin is secreted by thyroid parafollicular cells. The effect of this hormone is to lower serum calcium by inhibiting bone metabolism by osteoclasts.
name: Calcitonin
label: b
answer: no

Correct answer: a
A researcher wants to set up a study design between two drugs to assess which one is superior in treating a certain condition.

Which of the following options describes the study design used in the scenario?

Options:
explanation: A cross-sectional study is an example of an observational study design ie where interventions are not carried out. It involves taking a sample of a population and measuring specific parameters at a single point in time. It is often used to assess disease prevalence.
name: Cross-sectional study
label: b
answer: no
explanation: Randomised controlled trial (RCT) is an example of an interventional/experimental study design. It takes two groups of people and randomly allocates each participant to a control group and an intervention group. Over time, participants are followed up and inferences between the two groups are made.
name: Randomised controlled trial (RCT)
label: a
answer: yes
explanation: A cohort study is an example of an observational study design i.e. where interventions are not carried out. It selects a certain group of participants (cohort) and follows them over time looking forward prospectively. It is commonly used to assess disease risk.
name: Cohort study
label: d
answer: no
explanation: A non-randomised intervention study is an example of an interventional/experimental study design. It is similar to randomised controlled trials except there is no randomisation of participants into two groups (control and interventional). Over time, participants are followed up and inferences between the two groups are made.
name: Non-randomised intervention study
label: e
answer: no
explanation: A case-control study is an example of an observational study design i.e. where interventions are not carried out. It selects a certain group of participants (cases) and looks back to determine certain characteristics. It is an example of a retrospective study.
name: Case-control study
label: c
answer: no

Correct answer: a
A researcher sets out to find out what is the risk of acquiring a certain disease. He prospectively does this by selecting a group of participants and following them up over time.

Which of the following options describes the study design used in the scenario?

Options:
explanation: A cross-sectional study is an example of an observational study design ie where interventions are not carried out. It involves taking a sample of a population and measuring specific parameters at a single point in time. It is often used to assess disease prevalence.
name: Cross-sectional study
label: b
answer: no
explanation: A cohort study is an example of an observational study design ie where interventions are not carried out. It selects a certain group of participants (cohort) and follows them over time looking forward prospectively. It is commonly used to assess disease risk.
name: Cohort study
label: a
answer: yes
explanation: A case-control study is an example of an observational study design ie where interventions are not carried out. It selects a certain group of participants (cases) and looks back to determine certain characteristics. It is an example of a retrospective study.
name: Case-control study
label: d
answer: no
explanation: A non-randomised intervention study is an example of an interventional/experimental study design. It is similar to randomised controlled trials except there is no randomisation of participants into two groups (control and interventional). Over time, participants are followed up and inferences between the two groups are made.
name: Non-randomised intervention study
label: c
answer: no
explanation: Randomised controlled trial (RCT) is an example of an interventional/experimental study design. It takes two groups of people and randomly allocates each participant to a control group and an intervention group. Over time, participants are followed up and inferences between the two groups are made.
name: Randomised controlled trial (RCT)
label: e
answer: no

Correct answer: a
A medical student is asked to conduct a research study to investigate whether there is an association between exposure to a virus and obtaining a chronic disease.

Which of the following options describes the study design which would be used in the scenario?

Options:
explanation: A cross-sectional study is an example of an observational study design ie where interventions are not carried out. It involves taking a sample of a population and measuring specific parameters at a single point in time. It is often used to assess disease prevalence.
name: Cross-sectional study
label: c
answer: no
explanation: A cohort study is an example of an observational study design ie where interventions are not carried out. It selects a certain group of participants (cohort) and follows them over time looking forward prospectively. It is commonly used to assess disease risk.
name: Cohort study
label: d
answer: no
explanation: A case-control study is an example of an observational study design i.e. where interventions are not carried out. It selects a certain group of participants (cases) and looks back to determine certain characteristics. It is an example of a retrospective study. A cohort study would take too long as the medical student would have to start following the participants now.
name: Case-control study
label: a
answer: yes
explanation: A non-randomised intervention study is an example of an interventional/experimental study design. It is similar to randomised controlled trials except there is no randomisation of participants into two groups (control and interventional). Over time, participants are followed up and inferences between the two groups are made.
name: Non-randomised intervention study
label: e
answer: no
explanation: Randomised controlled trial (RCT) is an example of an interventional/experimental study design. It takes two groups of people and randomly allocates each participant to a control group and an intervention group. Over time, participants are followed up and inferences between the two groups are made.
name: Randomised controlled trial (RCT)
label: b
answer: no

Correct answer: a
A medical student is carrying out research for a project. They find that the average FEV1 values in men are higher compared to those of women in a certain cohort. They calculate the p-value as 0.03.

Which of the following options fits this data most appropriately?

Options:
explanation: The null hypothesis cannot be accepted when the p-value is less than 0.05. This means that we have enough evidence against the null hypothesis.
name: The null hypothesis can be accepted
label: b
answer: no
explanation: A p-value of < 0.05 signifies a statistical difference. The null hypothesis can be rejected when the p-value is less than 0.05. This means that we have enough evidence against the null hypothesis.
name: No conclusions can be made from this dataset
label: e
answer: no
explanation: The null hypothesis can be rejected when the p-value is less than 0.05. This means that we have enough evidence against the null hypothesis.
name: The null hypothesis can be rejected
label: a
answer: yes
explanation: The null hypothesis cannot be accepted when the p-value is less than 0.05. This means that we have enough evidence against the null hypothesis.
name: We do not have enough evidence to accept or reject the null hypothesis
label: c
answer: no
explanation: This is not true, as we cannot say this is for certain, and nothing has been proven. There is some evidence that men have a higher mean FEV1.
name: The medical student has proved men have a higher mean FEV1 than women
label: d
answer: no

Correct answer: a
A medical student is reading up on medical ethics and law for an upcoming tutorial. She is reading about a principle where a doctor's actions are compared to a standard of care to determine if negligence has occurred as a result of a breach of the duty of care.

Which of the following ethical principles is being described?

Options:
explanation: The Doctrine of Double Effect explains how we can accept an action if the intention is to cause a 'good outcome' (e.g. pain relief), even if it may foreseeably lead to a 'bad outcome' (e.g. death).
name: Doctrine of Double Effect
label: b
answer: no
explanation: Principle of autonomy describes the modern medicine approach of patient-centred medicine. This principle means that a patient should be provided with enough information and support to make their own informed decision about their healthcare, and this decision should be respected.
name: Principle of autonomy
label: d
answer: no
explanation: Montgomery Ruling describes how much information should be given to patients about the risks of a procedure, in order to obtain valid informed consent.
name: Montgomery Ruling
label: c
answer: no
explanation: The Bolam test established that a doctor will not be found negligent if he/she acts with ordinary care and his/her actions are sanctioned by a responsible body of medical opinion.
name: Bolam test
label: a
answer: yes
explanation: If someone cannot make a specific decision, a decision may have to be made in their best interests. This means that a decision will be made on their behalf, having been considered from their point of view.
name: Best interest decisions in patients who lack capacity
label: e
answer: no

Correct answer: a
A medical student is reading up on Professional Duties of Care.

Which of the following options is NOT a notifiable disease?

Options:
explanation: Meningitis is a notifiable disease. Meningitis is the inflammation of the meninges. It is a very serious disease and requires urgent treatment.
name: Meningitis
label: b
answer: no
explanation: Hepatitis A, alongside Hepatitis B and Hepatitis C, are all notifiable diseases. These are viruses which cause inflammation of the liver.
name: Hepatitis A
label: e
answer: no
explanation: Rabies is a notifiable disease. It is a fatal viral disease which infects the nervous system.
name: Rabies
label: c
answer: no
explanation: Chickenpox is a notifiable disease. Chickenpox is an extremely contagious infection which causes an itchy rash.
name: Chickenpox
label: d
answer: no
explanation: HIV is not a notifiable disease. This is a commonly tested fact for exams!
name: HIV
label: a
answer: yes

Correct answer: a