hllj/quesmed huggingface dataset:
The Proximal Convoluted Tubule (PCT) is one of the primary sites of reabsorption for the kidney.

From the answers below, select which is the **most** correct in terms of percentage reabsorption in the PCT.

Options:
explanation: Na+ residues within the basolateral membrane which will facilitate a low intracellular Na+ concentration, creating a favourable electrochemical gradient for Na+  reabsorption by the Na+/H+ antiporter.
name: The Na+ pump in the apical membrane creates a low intracellular Na+ concentration and creates a favourable electrochemical gradient
label: e
answer: no
explanation: The PCT is the primary site of reabsorption of HCO3- within the kidney and it is carried out via an indirect method involving carbonic anhydrase since the apical membrane is impermeable to HCO3-
name: 10% of the HCO3-  present within the filtrate is reabsorbed in the PCT via the indirect method involving Carbonic Anhydrase
label: b
answer: no
explanation: Correct Answer
name: 90% of the HCO3- present within the filtrate is reabsorbed in the PCT via the indirect method involving Carbonic Anhydrase
label: a
answer: yes
explanation: PCT has a high permeability to water. Water reabsorption is facilitated paracellularly across tight junctions and transcellular via water channels. There is also the presence of an Osmotic pressure gradient maintained by Na+ reabsorption, and increased oncotic pressure in peritubular capillaries.
name: PCT is majorly impermeable towards the water in the filtrate, and the reabsorption of water is prevented via a lack of paracellular tight junctions and a lack of osmotic gradient
label: c
answer: no
explanation: 67% of K+ is reabsorbed in the PCT, however, this is via paracellular transport as the primary method of reabsorption. There is also an active transport of K+ inwards via Na+/K+ ATPase
name: 67% of K+ is reabsorbed in the PCT due to passive transport involved in the K+/Cl- ATPase
label: d
answer: no

Correct answer: a
In relation to the Loop of Henlé in the nephron of the kidneys, which of the following statements is correct?

Options:
explanation: The descending limb is highly permeable to water. Water will move via Aquaporin-1 channels
name: The descending limb of the Loop of Henlé is largely impermeable to water
label: d
answer: no
explanation: The fluid at the tip of the ascending limb is hypotonic
name: At the tip of the ascending limb, fluid is hypertonic
label: c
answer: no
explanation: The ascending limb is largely **im**permeable to the water where 20-30% of Na+, Cl- & K+ is reabsorbed
name: The ascending limb of the Loop of Henlé is largely permeable to water
label: b
answer: no
explanation: Correct Answer
name: Most K+ will leak back into the lumen via apical K+ channels, as a consequence tubular lumen will become positively charged relative to the interstitium
label: a
answer: yes
explanation: Most K+ will leak back into the lumen via apical K+ channels, as a consequence tubular lumen will become **positively** charged relative to the interstitium
name: Most K+ will leak back into the lumen via apical K+ channels, as a consequence, the tubular lumen will become negatively charged relative to the interstitium
label: e
answer: no

Correct answer: a
Antidiuretic hormone (ADH) is a key hormone involved in the homeostasis of the renal system.

Which one of the following statements concerning ADH is correct?

Options:
explanation: Correct Answer
name: ADH increases the permeability of the inner medullary collecting duct to urea
label: a
answer: yes
explanation: ADH is released in response to a decrease in extracellular volume not an increase in extracellular volume
name: ADH is released in response to a rise in extracellular volume
label: e
answer: no
explanation: ADH **inhibits** the release of renin from juxtaglomerular granular cells of the kidney
name: ADH stimulates release of renin from juxtaglomerular granular cells
label: d
answer: no
explanation: The secondary stimulus for the release of ADH is via baroreceptors, however, this is due to a **reduction** of blood pressure. ADH then acts to raise blood pressure to restore normotension.
name: A secondary stimulus for the release of ADH is via baroreceptors, which are stimulated by a rise in blood pressure
label: c
answer: no
explanation: The release of ADH is actually stimulated by an **increase** in plasma osmolality not by a decrease in plasma osmolality
name: The release of ADH is stimulated by a decrease in plasma osmolality
label: b
answer: no

Correct answer: a
A patient has been prescribed the medication, Furosemide.

Which of the following statements is the correct regarding Furosemide?

Options:
explanation: Furosemide will increase the delivery of Na+ to the DCT, leading to a promotion of K+ loss, so patients taking Furosemide are at risk of hypokalaemia.
name: Furosemide decreases Na<sup>+</sup> delivery to the Distal Convoluted Tubule which will help to promote the retention of K<sup>+</sup> ions
label: d
answer: no
explanation: Loop diuretics actually **block** sodium chloride’s entry into the Macula Densa causing the patient to have volume depletion. As a consequence, the Renin-Angiotensin-Aldosterone System will be activated to stimulate Na+ retention and K+ loss.
name: Loop diuretics like Furosemide stimulate NaCl entry into the Macula Densa, helping to increase a patient’s circulating volume and causing an activation of the renin-angiotensin-aldosterone (RAAS) system
label: e
answer: no
explanation: Incorrect. Furosemide in fact blocks the Na<sup>+</sup>/2Cl<sup>-</sup>/K<sup>+</sup> symporter of the thick ascending limb of the Loop of Henlé
name: Furosemide works on the Na<sup>+</sup>/H<sup>+</sup> antiporter within the thick ascending limb of the Loop of Henlé
label: c
answer: no
explanation: Correct Answer. This will create an osmotic gradient which will increase water loss from the kidneys.
name: Furosemide is a loop diuretic, which causes 15-25% of filtered sodium (Na<sup>+</sup>) to be excreted within the urine
label: a
answer: yes
explanation: The mechanism of action of Furosemide will **reduce** the ability of the loop of henlé to concentrate urine by preventing the creation of a hypertonic interstitium in the medulla
name: Furosemide increases the ability of the loop of Henlé to concentrate urine by creating a hypotonic interstitium in the medulla
label: b
answer: no

Correct answer: a
The Anterior Pituitary produces critical hormones, necessary for maintaining homeostasis within the body.

Which of the following statements with respect to these hormones is correct?

Options:
explanation: Growth Hormone and Prolactin are hormones which are comprised of single-chain polypeptides with disulfide bridges
name: Adrenocorticotrophic Hormone (ACTH) and LH are made up of single-chain polypeptides connected via disulfide bridges
label: b
answer: no
explanation: Prolactin stimulates the mammary glands to produce lactation and promote the growth and development of the breasts. Follicle stimulating hormone will stimulate follicular development rather than stimulating ovulation. A surge of LH acts to trigger ovulation.
name: Prolactin and FSH act to stimulate steroid hormone synthesis in the Gonads and within Females, causing ovulation
label: c
answer: no
explanation: Thyroid stimulating hormone and adrenocorticotrophic hormone do not work together, they work independently as TSH stimulates the synthesis and release of thyroid hormones and ACTH will stimulate the synthesis and release of cortisol.
name: TSH and ACTH are working synergistically to stimulate the mammary glands to produce lactation
label: d
answer: no
explanation: This is incorrect because TSH is released from the anterior pituitary via the process of **exocytosis**
name: When TSH is produced within the anterior pituitary, it is released via endocytosis
label: e
answer: no
explanation: Correct answer
name: Thyroid-Stimulating Hormone (TSH), Luteinising Hormone (LH) and Follicle Stimulating Hormone (FSH) are glycoproteins comprised of 2 subunits
label: a
answer: yes

Correct answer: a
With regards to the Hypothalamus and Pituitary Glands, which of the following is correct?

Options:
explanation: This is incorrect because most of the anterior pituitary hormones are regulated or controlled via **negative feedback **
name: The majority of hormones secreted by the anterior pituitary gland are regulated and/or controlled via positive feedback
label: b
answer: no
explanation: Thyroid hormones are circulated bound to plasma proteins because they are lipophilic in nature, so thyroid hormones are unable to dissolve in plasma
name: Thyroid hormones are circulated as free hormones unbounded
label: e
answer: no
explanation: This is incorrect because the posterior pituitary is actually neural tissue secreting neurohormones, and the lobe is formed by a down growth of neural tissue from the brain
name: In the development of the posterior pituitary, it is composed of "true" endocrine tissue
label: c
answer: no
explanation: Correct answer
name: The posterior pituitary is primarily comprised of axons of the hypothalamic neurons which extend downwards
label: a
answer: yes
explanation: This is actually an example of endocrine communication
name: The thyroid hormones being sent out via the bloodstream to various target organs is an example of intracrine communication
label: d
answer: no

Correct answer: a
A patient presents with symptoms of weight loss, palpitations and sweating. A diagnosis of Hyperthyroidism is made.

Which of the following statements is correct?

Options:
explanation: Hypothalamic or anterior pituitary failure would cause *hypo-* rather than hyper-thyroidism.
name: This may be secondary to hypothalamic or anterior pituitary failure
label: b
answer: no
explanation: This is incorrect, these are symptoms a patient suffering from hypothyroidism would present with, this patient may present with tremors, goitre and eye protrusion.
name: Other symptoms the patient may be experiencing are cold intolerance, menstrual irregularity, hair loss
label: e
answer: no
explanation: This would be the treatment for a patient suffering from hypothyroidism, as this medication would replicate the hormones produced by the thyroid to achieve a euthyroid state
name: The management of this condition is via synthetic thyroid hormones, Levothyroxine (T4)
label: d
answer: no
explanation: Correct answer
name: Goitre can be observed in this patient
label: a
answer: yes
explanation: Propranolol can be prescribed for symptomatic relief of palpitations in hyperthyroidism. However, it does not treat the underlying condition. The first line treatment in hyperthyroidism may include radioactive iodine, anti-thyroid drugs such as carbimazole, or surgery.
name: Propranolol can be prescribed to treat the underlying cause
label: c
answer: no

Correct answer: a
A patient had a suspected diagnosis of Hypothyroidism secondary to hypothalamic failure. Blood work was carried out.

What results are likely to be consistent with this diagnosis?

Options:
explanation: This would be hyperthyroidism that is secondary due to excess hypothalamic or anterior pituitary secretion
name: Increased T3 and T4 levels and an increase in Thyroid Stimulating Hormone
label: d
answer: no
explanation: This is unlikely to be consistent with the diagnosis of the patient’s case
name: Decreased T3 and T4 levels, but a normal plasma concentration of Thyroid Stimulating Hormone
label: e
answer: no
explanation: This blood work would be consistent with a diagnosis of hyperthyroidism due to Grave’s Disease or hyper-secreting thyroid tumour
name: Increased T3 and T4 and decreased Thyroid Stimulating Hormone
label: c
answer: no
explanation: This would be consistent with a diagnosis of primary failure of the thyroid gland, with 90% of the cases being due to Hashimoto’s Thyroiditis or due to a lack of dietary iodine
name: Decreased T3 and T4 levels, increased Thyroid Stimulating Hormone
label: b
answer: no
explanation: Correct answer
name: Decreased T3 and T4 levels and decreased Thyroid Stimulating Hormone
label: a
answer: yes

Correct answer: a
A patient has been suffering from Type 2 Diabetes Mellitus for 8 years. They have a history of uncontrolled blood sugars.

From this information, which of the following statements below is the most correct in regard to complications this patient might suffer from?

Options:
explanation: This is an unlikely side effect of uncontrolled blood sugars unless is extreme case scenarios such as nerve damage as a result of diabetes
name: Constipation
label: b
answer: no
explanation: This is incorrect, as this is not a likely complication of uncontrolled blood sugars
name: Nose bleeds
label: c
answer: no
explanation: This is incorrect. Peripheral sensory **loss** is however a common side effect of poorly controlled blood sugars. This will ascend in glove and stocking distribution. This loss of sensation, and increased risk of infections, can lead to ulceration and necrosis of the feet, ankles or digits. As such, patients with diabetes are invited for annual feet check appointments.
name: Peripheral hypersensitivity
label: d
answer: no
explanation: Correct answer. Diabetic retinopathy is a common complication of poor glucose control. As such, diabetic patients are invited for annual eye screening in addition to their regular management.
name: Retinopathy
label: a
answer: yes
explanation: This is incorrect as it is unlikely to be a side effect of uncontrolled blood sugars
name: Acid reflux
label: e
answer: no

Correct answer: a
In regards to the stimulus and release of cortisol, which of the following statements is correct?

Options:
explanation: This is incorrect as cortisol have immunosuppressive effects by which there is a decrease in the number and activation of T-Lymphocytes, making patients under extreme stress more susceptible to illnesses and pathogens. Cortisol levels will increase when a patient is under extreme stress.
name: When a patient is under extreme stress, there will be an increase in the number and activation of T-lymphocytes, allowing enhancement of the patients’ immune system, there will also be a decrease in the circulating volume of Cortisol
label: d
answer: no
explanation: This is incorrect because cortisol actually has a catabolic effect on muscle and adipose tissue, meaning it will break down both muscle and fat cells
name: Cortisol has an anabolic effect on skeletal muscle and adipose tissue
label: b
answer: no
explanation: Correct answer
name: Within the Liver, Cortisol will stimulate gluconeogenesis and glycogen storage
label: a
answer: yes
explanation: this is incorrect because cortisol will stimulate the production of lipocortin which will result in the anti-inflammatory properties of cortisol.
name: The production of lipocortin will be inhibited under an environment high in cortisol
label: c
answer: no
explanation: Cortisol is produced by the adrenal glands however, it is produced from the Zona fasciculata region of the adrenal gland.
name: Cortisol is produced from the Zona glomerulosa of the adrenal gland
label: e
answer: no

Correct answer: a
A patient presents with symptoms of muscle weakness, fat deposition around the centre of the abdomen and high blood pressure. A 48hr low dose dexamethasone test was carried out to investigate. The result of this was a non-suppression of the patient's plasma cortisol.

Which of the following conditions is consistent with the symptoms and investigations?

Options:
explanation: Congenital adrenal hyperplasia can present in patients with short height and early puberty in both males and females
name: Congenital Adrenal Hyperplasia
label: d
answer: no
explanation: Addison's disease is incorrect as it manifests as postural hypotension, muscle weakness, weight loss and increased pigmentation
name: Addision’s disease
label: b
answer: no
explanation: Conn's disease presents as frequent urination, muscle cramps and heart palpitations, so this diagnosis would be incorrect
name: Conn’s disease
label: e
answer: no
explanation: This is correct because Cushing’s syndrome is clinically characterised by muscle weakness, hypertension, and purple abdominal striae. When investigated by a 48hr low dose dexamethasone test, if there is non-suppression of plasma cortisol at 48hrs is a confirmatory investigation
name: Cushing’s Syndrome
label: a
answer: yes
explanation: Grave’s disease is an example of hyperthyroidism, characterised by weight loss, sweating and palpitations, so this is incorrect
name: Grave’s disease
label: c
answer: no

Correct answer: a
The reproductive system of both males and females has distinctive hormones with distinctive functions.

Which one of the following statements is correct?

Options:
explanation: This is incorrect, FSH stimulates around 30-40 primordial follicles
name: Follicle stimulating hormone stimulates the development of 5-10 primordial follicles at puberty
label: e
answer: no
explanation: This is incorrect as the right ovary drains into the IVC itself and the left ovary is the left renal vein
name: The venous drainage of the right ovary is the left renal vein and the left ovary is the inferior vena cava
label: d
answer: no
explanation: This is incorrect as it is actually luteinizing hormone that stimulates the Leydig cells to produce testosterone
name: Testosterone stimulates Leydig cells to produce Luteinizing hormone, which will bind to the receptor on the Sertoli cells
label: c
answer: no
explanation: Correct answer
name: The process of capacitation, that takes place within the female reproductive system is the process by which the glycoprotein coat and seminal plasma proteins from the acrosomal region of the sperm are removed
label: a
answer: yes
explanation: This is incorrect, as this is the role of the Testes. The ductal system will facilitate the carriage of spermatozoa to the exterior and the maturation of sperm
name: In regard to the male genital system, the ductal system produces and temporarily stores sperm, and also synthesises and secretes testosterone and oxytocin
label: b
answer: no

Correct answer: a
A 28 year old female patient presents with pelvic, and abdominal pain with cervical motion tenderness and a fever.

Which of the following is the most likely diagnosis?

Options:
explanation: This is incorrect because *chlamydia trachomatis* is frequently asymptomatic in women. If symptoms are present, they may include dysuria, intermenstrual bleeding and vaginal discharge. Abdomina pain and systemic upset such as fever are less common. Cervical motion tenderness indicate peritoneal infection, which makes an uncomplicated sexually transmitted infection less likely than pelvic inflammatory disease.
name: *Chlamydia Trachomatis *
label: b
answer: no
explanation: Primary *Treponema Pallidum*, or primary syphilis, presents as a painless ulcer at the site of inoculation (mouth or genitals) and regional lymphadenopathy.
name: Primary *Treponema Pallidum *
label: d
answer: no
explanation: Secondary *Treponema Pallidum* usually presents with fever and rash (on palms and soles) headaches and diffuse lymphadenopathy
name: Secondary *Treponema Pallidum *
label: e
answer: no
explanation: This is the correct answer based on a clinical diagnosis. This condition does need a bi-manual examination for rebound and cervical motion tenderness. Cervical motion tenderness indicate peritoneal infection.
name: Pelvic Inflammatory Disease
label: a
answer: yes
explanation: Gonococcal Urethritis presents as an abrupt onset of severe dysuria and yellowish-green purulent urethral discharge in males and the cervix presenting as red and possible bloody discharge in females
name: Gonococcal Urethritis/Cervicitis
label: c
answer: no

Correct answer: a
Erectile dysfunction affects up to 50% of men aged between 40 and 70 years old.

Which of the following is correct?

Options:
explanation: This is incorrect as this often can be managed by the GP in the community. All men that present with erectile dysfunction should have a diabetes screen, a lipid profile for CVD disease via Q risk 3 and a morning total testosterone measured, all of which can cause and exacerbate the condition
name: All men that present with erectile dysfunction should be referred to an erectile dysfunction specialist
label: d
answer: no
explanation: This is incorrect because taking PDE5Is on a full stomach slows drug absorption
name: When taking phosphodiesterase type 5 inhibitors, it is important to take on a full stomach
label: e
answer: no
explanation: this is incorrect, as the nerve impulses actually **stimulate** the release of nitric oxide from cavernous nerve terminals which will diffuse into cavernosal smooth muscle cells
name: In the development of an erection, nerve impulses inhibit the release of nitric oxide from cavernous nerve terminals which diffuse into cavernosal smooth muscle cells
label: c
answer: no
explanation: This is incorrect as one of the treatments for erectile dysfunction is a phosphodiesterase type 5 **inhibitors**, which works by blocking the enzyme which breaks down cGMP to GMP, leading to a sharp rise in cGMP levels. This causes smooth muscle **relaxation** which improves erection
name: Treatment with phosphodiesterase Type 5 stimulates smooth muscle contraction to promote erection
label: b
answer: no
explanation: This is the correct answer. Hypercholesterolaemia is also a vasculogenic cause
name: Some of the vasculogenic causes of erectile dysfunction are atherosclerosis, hypertension, and diabetes
label: a
answer: yes

Correct answer: a
There are distinct differences between puberty in males and females.

In regards to this, which of the following is correct?

Options:
explanation: This is correct because the production of oestrogens requires androgens as precursors, which are in fact steroids.
name: The production of oestrogens requires the synthesis of steroids as precursors
label: a
answer: yes
explanation: This is incorrect as telarche and menarche are exclusive to females as this is the development of breast tissue and menstruation respectively.
name: The first stage of puberty in males is stimulated by the beginning of telarche and menarche
label: b
answer: no
explanation: This is incorrect as the growth of facial hair in males is described as being a later androgen-dependent event
name: The growth of facial hair in males is described as being an early androgen-dependent event
label: c
answer: no
explanation: TRH will affect the pituitary to release TSH for the thyroid not to stimulate puberty. The hypothalamic neurons that produce GnRH will ‘awake’ the HPG axis
name: One of the triggers for puberty in both sexes is the maturation of hypothalamic neurons to produce TRH
label: d
answer: no
explanation: This is incorrect as later androgen-dependent events for example is the growth of facial hair in males, are driven by androgens produced by the Gonads
name: Later androgen-dependent events are driven by androgens produced by the adrenal cortex
label: e
answer: no

Correct answer: a