hllj/quesmed huggingface dataset:
Which of the following statements regarding the anatomy of the thyroid gland is correct?

Options:
explanation: The thyroid usually drains to the prelaryngeal and tracheal lymph nodes but may drain to the deep cervical nodes or directly into the thoracic duct or right lymphatic duct. The supraclavicular nodes drain structures of the thorax and abdomen.
name: The lymphatic drainage of the thyroid gland is usually to the supraclavicular lymph nodes
label: e
answer: no
explanation: The thyroid gland is covered anteriorly by pre tracheal fascia and the infrahyoid muscles (sternohyoid and sternothyroid. This enables the thyroid to move up and down with the larynx, but not to ascend above it.
name: The thyroid gland is covered anteriorly by pre tracheal fascia and the infrahyoid muscles
label: a
answer: yes
explanation: The thyroid ima artery is an anatomical variant present in up to 10% of the population, originating from the aortic arch. It is located in the midsagittal plane, anterior to the thyroid isthmus, and therefore sometimes provides difficulty if it becomes necessary to gain anterior access to the airway.
name: The variant thyroid ima artery originates from the thyrocervical trunk
label: b
answer: no
explanation: The superior laryngeal and recurrent laryngeal nerves, branches of the vagus nerve, provide the parasympathetic supply to the thyroid gland. The sympathetic supply to the thyroid gland is from the sympathetic trunk.
name: The sympathetic supply to the thyroid gland is from the superior laryngeal and recurrent laryngeal nerves
label: d
answer: no
explanation: The superior and middle thyroid veins drain into the internal jugular veins, and the inferior thyroid veins drain into the brachiocephalic veins.
name: The inferior thyroid veins drain into the internal jugular veins
label: c
answer: no

Correct answer: a
What is the pathophysiological process underlying Addison’s disease?

Options:
explanation: This is the pathophysiology of type 1 diabetes mellitus, where autoimmune destruction of the insulin-producing beta cells causes a deficiency of insulin, resulting in raised glucose levels.
name: Autoimmune destruction of the insulin-producing beta cells of the pancreas
label: b
answer: no
explanation: Phaeochromocytoma is a rare catecholamine-secreting tumour resulting in dangerously high levels of noradrenaline and adrenaline in the blood. This results in severe hypertension, headaches, palpitations, sweating and anxiety.
name: A tumour secreting large amounts of catecholamines
label: c
answer: no
explanation: This is the pathophysiology of Graves disease. Autoantibodies bind to the thyroid stimulating hormone receptor, stimulating the thyroid gland to produce abnormally high amounts of T3 and T4, which feedback to cause a low TSH level. This results in symptoms such as weight loss, tremor, tachycardia, diarrhoea and exophthalmos.
name: Autoimmune-mediated chronic stimulation of the thyroid stimulating hormone receptor, resulting in hyperthyroidism
label: e
answer: no
explanation: This is the pathophysiology of coeliac disease, which is characterised by symptoms such as chronic diarrhoea, bloating and malabsorption. Coeliac disease is often associated with other autoimmune conditions.
name: Autoimmune disorder primarily affecting the small intestine, where an inflammatory response against gluten-derive peptides occurs
label: d
answer: no
explanation: Addison’s disease presents with features such as lethargy, weakness, hypotension, hyperpigmentation, weight loss, nausea and vomiting, and is sometimes associated with other autoimmune conditions.
name: Autoimmune destruction of the adrenal glands, reducing the production of cortisol and aldosterone
label: a
answer: yes

Correct answer: a
Which statement regarding the anatomy of female pelvic structures is correct?

Options:
explanation: The germinal epithelium is the posterior fold of the broad ligament within which the ovary, not the uterine artery, lies.
name: The section of the broad ligament surrounding the uterine artery is called the germinal epithelium
label: b
answer: no
explanation: The inferior mesenteric artery arises from the abdominal aorta and once it crosses the pelvic brim, it becomes the superior rectal artery, supplying much of the rectum.
name: Once the inferior mesenteric artery crosses the pelvic brim, it becomes the superior rectal artery
label: a
answer: yes
explanation: The four fornices of the vagina form a ring around the uterine cervix. The posterior fornix of the vagina is important in that it is covered by the peritoneum.
name: The anterior fornix of the vagina is significant in that it is covered by peritoneum
label: d
answer: no
explanation: The cardinal ligaments are the strongest of the pelvic ligaments, connecting the cervix to the lateral pelvic wall. They are thickenings of pelvic fascia that add to the muscular support of the uterus. The cervix is attached to the sacrum by the uterosacral ligaments.
name: The cardinal ligaments attach the cervix to the sacrum
label: c
answer: no
explanation: The internal iliac arteries branch into anterior divisions, which mainly supply pelvic viscera and posterior divisions, which mainly supply pelvic walls. The external iliac vessels supply the lower limbs.
name: The blood supply to the pelvic viscera mainly comes from the external iliac arteries
label: e
answer: no

Correct answer: a
Which set of findings would most likely point to a diagnosis of Hodgkin’s lymphoma?

Options:
explanation: These are general symptoms often seen in both haematological and non-haematological malignancy, but would not specifically point to a diagnosis of Hodgkin’s lymphoma.
name: Anaemia, fever, weight loss, lymphadenopathy
label: d
answer: no
explanation: Hodgkin’s lymphoma is a malignant proliferation of lymphocytes, the pathological hallmark of which is the Reed-Sternberg cell- a giant, multinucleate cell derived from B lymphocytes. The other features listed above are also classically seen in Hodgkin’s lymphoma.
name: Reed-Sternberg cells, lymphadenopathy, weight loss, splenomegaly
label: a
answer: yes
explanation: These are features seen in acute promyelocytic leukaemia. This is a subtype of acute myeloid leukaemia seen in younger patients and generally carries a good prognosis.
name: Disseminated intravascular coagulation, Auer rods, PML/RARa gene fusion
label: e
answer: no
explanation: These are features of chronic myeloid leukaemia, another type of haematological malignancy. The presence of the Philadelphia chromosome, a shortened chromosome 22 containing an abnormal BCR-ABL fusion gene, is the Gold standard of CML diagnosis.
name: Philadelphia chromosome, splenomegaly, leucocytosis, severe anaemia
label: b
answer: no
explanation: These are features of multiple myeloma, a haematological malignancy involving neoplastic proliferation of monoclonal plasma cells in the bone marrow.
name: Hypercalcaemia, anaemia, renal insufficiency, bone pain, high free serum light chains
label: c
answer: no

Correct answer: a
Which statement correctly describes an aspect of oogenesis?

Options:
explanation: The oogonium is a diploid cell produced in utero. It is arrested at prophase I until puberty, where FSH triggers the completion of meiosis I.
name: The oogonium is a diploid cell held at prophase I until puberty
label: a
answer: yes
explanation: Meiosis I is completed at the start of puberty, following FSH, not LH production and secretion. This produces the secondary oocyte, which completes meiosis II after fertilisation.
name: Meiosis II is completed at the start of puberty, following LH production and secretion
label: c
answer: no
explanation: Meiosis I is completed at the start of puberty, following FSH production and secretion. This produces the secondary oocyte, which is arrested at metaphase II until fertilisation.
name: The secondary oocyte is arrested at prophase I
label: e
answer: no
explanation: The primary oocyte is diploid, and produces two haploid cells of unequal size: the first polar body (smaller cell) and the secondary oocyte (larger cell).
name: Before ovulation, the primary oocyte completes meiosis I, producing two diploid cells of unequal size
label: d
answer: no
explanation: Following fertilisation, the secondary oocyte splits into two haploid cells of unequal size. The larger cell is the ovum and the smaller cell is the second polar body. These cells are both haploid.
name: The smaller cell formed by the secondary oocyte after fertilisation is the ovum
label: b
answer: no

Correct answer: a
What happens during the developmental stage of neurulation?

Options:
explanation: Implantation is the stage of development when the blastocyst adheres to and invades the uterine wall. This occurs a few days before gastrulation when the primary germ layers are formed.
name: The blastocyst adheres to and invades the uterine wall
label: e
answer: no
explanation: Organogenesis is the process of the formation and development of the organs. This starts between week 3 and week 8 of embryonic development, and continues until birth.
name: Formation and development of the organs
label: c
answer: no
explanation: Gastrulation is the stage of embryonic development in which the pluripotent stem cells form the primary germ layers: endoderm, ectoderm and mesoderm.
name: Pluripotent stem cells form primary germ layers
label: d
answer: no
explanation: This is the process of blastulation. The blastula becomes the gastrula, which forms the primary germ layers during gastrulation.
name: Formation of the blastula from the morula
label: b
answer: no
explanation: Neurulation is the folding process that transforms the neural plate into the neural tube, occurring after the formation of the primary germ layers.
name: The neural plate folds into the neural tube
label: a
answer: yes

Correct answer: a
Which statement describes how oncogenes may affect tumour growth?

Options:
explanation: Oncogenes code for oncoproteins, which act to promote cell division and tumour growth. One of the methods by which they do this is by binding to tumour suppressor genes, inactivating them.
name: The proteins they code for bind to and inactivate tumour suppressor genes, allowing rapid uncontrolled cell division
label: a
answer: yes
explanation: This is one of the actions of the p53 tumour suppressor gene, which has several mechanisms of action aiming to maintain genomic stability.
name: They initiate apoptosis if there becomes irreparable DNA damage in a cell
label: e
answer: no
explanation: The elongation of telomeres is not well characterised. Shortening of the telomeres of chromosomes happens as cells divide as we age, and is associated with ageing and the development of disease (e.g. cancer). Oncogenes may have effects to increase telomere shortening.
name: They allow elongation of telomeres, protecting cancer cells from apoptosis
label: c
answer: no
explanation: Pro-apoptotic proteins that interact with mitochondria to trigger apoptosis include BAX and BAK. These are regulated by a complex protein system, including pro-survival BCL2-like proteins. In tumour cells, oncogenes act to prevent apoptosis, so that cells can grow and divide in a rapid, uncontrolled way.
name: They both directly and indirectly interact with mitochondria to trigger apoptosis
label: b
answer: no
explanation: Mutations or down regulation of tumour suppressor genes, not oncogenes, is a common mechanism tumour cells use to become resistant to cytotoxic drugs.
name: Mutation or down regulation of oncogenes allows tumour cells to be highly resistant to cytotoxic drugs
label: d
answer: no

Correct answer: a
Which statement best describes an aspect of thyroid or parathyroid gland development?

Options:
explanation: The migration of the thyroid along the thyroglossal duct happens at week 7 of development. The thyroglossal duct eventually regresses and destroys at the end of week 7.
name: At week 12 of development, the thyroid begins to migrate along the thyroglossal duct
label: e
answer: no
explanation: The inferior parathyroid glands develop from the 3rd pharyngeal pouch. The 4th pharyngeal pouch is where the superior parathyroid glands develop from
name: The inferior parathyroid glands develop from the 4th pharyngeal pouch
label: d
answer: no
explanation: The inferior parathyroid glands develop from the 3rd pharyngeal pouch and the superior glands from the 4th pharyngeal pouch. As the thyroid migrates down into the neck through the thyroglossal duct, the inferior parathyroid glands are pulled downwards to their final position below the superior glands.
name: The inferior parathyroid glands start to develop above the superior glands and are pulled to their final position when the thyroid gland migrates downwards
label: a
answer: yes
explanation: The thyroid gland develops as an epithelial proliferation at the foramen cecum of the developing tongue at week 4 of development.
name: The thyroid gland develops as an epithelial proliferation at the foramen cecum of the developing tongue at week 10
label: b
answer: no
explanation: The superior parathyroid glands develop from the 4th pharyngeal pouch. The 2nd pharyngeal pouch is where the tonsil develops from.
name: The superior parathyroid glands develop from the 2nd pharyngeal pouch
label: c
answer: no

Correct answer: a
Which statement regarding hormones in pregnancy is correct?

Options:
explanation: Human chorionic gonadotrophin is produced by the placenta and maintains the corpus luteum in early pregnancy. Its levels significantly decrease at week 15-16 of pregnancy.
name: Human chorionic gonadotrophin levels rise until week 26-28 of pregnancy, then suddenly reduce to undetectable levels
label: d
answer: no
explanation: Progesterone is mostly produced by the corpus luteum until around week 10 of pregnancy. After this, progesterone is mostly produced by the placenta.
name: The corpus luteum is the main source of progesterone until week 10 of pregnancy
label: a
answer: yes
explanation: Oxytocin is produced at the start of labour, stimulating uterine muscle (myometrium) contractions. It is produced and secreted by the posterior pituitary gland, not the placenta.
name: Oxytocin, produced by the placenta, stimulates myometrial contraction at the start of labour
label: b
answer: no
explanation: The increase in oxytocin, not progesterone, at the beginning of labour triggers prostaglandin production, which helps to increase uterine contractions.
name: Increased prostaglandin production at the start of labour is triggered by progesterone
label: e
answer: no
explanation: Prolactin does cause enlargement of the mammary glands during pregnancy, preparing them for milk production. It is produced and secreted by the anterior pituitary gland, not the posterior pituitary gland.
name: Prolactin, produced by the posterior pituitary gland, causes mammary gland enlargement
label: c
answer: no

Correct answer: a
Which statement describes the developmental abnormality aphallia?

Options:
explanation: Hypospadia, the second most common congenital abnormality of the male reproductive tract, is when the urethral meatus is not situated in the head of the penis.
name: The meatus of the urethra is not situated in the head of the penis
label: c
answer: no
explanation: Monorchism is when there is only one testicle in the scrotum. This can be as a result of cryptorchidism, or other reasons such as surgical removal of a testicle (orchiectomy).
name: Only one testicle is present within the scrotum
label: e
answer: no
explanation: Aphallia is a very rare developmental abnormality resulting from the failed formation of the fatal genital tubercle.
name: Absence of the phallus (penis or clitoris)
label: a
answer: yes
explanation: Cryptorchidism is the failure of one or both testes to descend into the scrotum. This is the most common birth defect of the male genital tract and is classified according to the position of the undescended testicle.
name: The failure of one or both testes to descend into the scrotum
label: b
answer: no
explanation: Anorchia is when a person with an XY karyotype is born without testes. If the testes fail to develop within the first 8 weeks of life, the infant will develop female genitalia.
name: Being born without testes
label: d
answer: no

Correct answer: a
Which legal term best describes the action of intentionally leaving a patient to die, for example by withholding artificial life-supporting treatment?

Options:
explanation: Passive euthanasia occurs when a patient is intentionally let to die, for example by withholding artificial life-supporting treatment (e.g. ventilation or nutritional support). Passive euthanasia may be voluntary (when the patient consents), which is legal in the USA, or involuntary (when the patient does not consent).
name: Passive euthanasia
label: a
answer: yes
explanation: Manslaughter is the crime of ending someone's life unintentionally or without planning.
name: Manslaughter
label: e
answer: no
explanation: Active euthanasia is when a presume deliberately does something that causes the death of a patient, for example directly administering the patient with a lethal dose of a drug that results in their death.
name: Active euthanasia
label: d
answer: no
explanation: Involuntary euthanasia is the term used when the person does not want to die. Passive euthanasia may be voluntary or involuntary.
name: Involuntary euthanasia
label: b
answer: no
explanation: Assisted suicide describes assisting someone with a long-term progressive condition, or without illness, to end their life. In cases of assisted suicide, the fatal action/drug dose is self-administered. For example, the partner of a terminally ill patient stockpiling enough paracetamol for the patient to self-administer a fatal dose.
name: Assisted suicide
label: c
answer: no

Correct answer: a
Which statement correctly describes a term used in pharmacology?

Options:
explanation: This describes metabolism, one of the phases of pharmacokinetics (liberation, absorption, distribution, metabolism, excretion). Pharmacokinetics is the overall term used to describe how the body affects a certain drug.
name: Pharmacokinetics is the study of the breakdown of a drug into metabolites
label: b
answer: no
explanation: This describes affinity. Efficacy is the ability of a ligand to produce a functional biological response when it binds to its target receptor.
name: Efficacy is the strength with which a ligand binds to its receptor at a certain concentration
label: d
answer: no
explanation: Antagonists are substances that have affinity but no efficacy for a certain receptor. These may bind to the main active site, or an alternative (allosteric) site to mediate this effect. Allosteric modulators are any substances that bind to an alternative site on the receptor to that of the endogenous agonist and may have a range of effects on the receptor activity.
name: Allosteric modulators are substances that have affinity but no efficacy for a certain receptor
label: c
answer: no
explanation: Pharmacodynamics is the study of the physiological and biochemical effects of a substance on the body, from a molecular to a phenotypic level.
name: Pharmacodynamics is the term used to describe the physiological and biochemical effects of a substance
label: a
answer: yes
explanation: This describes efficacy. Affinity is the strength with which a ligand binds to its receptor at a certain concentration.
name: Affinity is the ability of a ligand to produce a functional biological response when it binds to its target receptor
label: e
answer: no

Correct answer: a
A group of researchers would like to assess the clinical efficacy of a new drug.

Which of the following study designs would be most appropriate for this and why?

Options:
explanation: Cross-sectional studies are observational studies, so no intervention (drug) is given. They are carried out at a single point in time, assessing the prevalence of disease in groups exposed to risk factors and those not exposed to the risk factor. As the exposure and disease factors are measured at the same time, it is difficult to establish cause and effect.
name: Cross-sectional study, as this is good for assessing cause and effect
label: b
answer: no
explanation: Case-control studies are a type of observational study where a group with a disease and a group of controls without the disease are selected, and their past exposure (risk factor) status is compared, and are not used to assess the effect of an intervention (drug). All observational studies, such as case-control studies, are subject to influence by confounding factors.
name: Case-control study, as this decreases the change that results are affected by confounding factors
label: c
answer: no
explanation: Cohort studies involve the classification of participants based on their risk factor status at baseline, and following-up to determine who develops the disease outcome. This requires large numbers of participants, resulting in cohort studies being time-consuming and expensive. Cohort studies are not used to assess the efficacy of an intervention.
name: Cohort study, as this is cheaper and quicker than other types of observational study
label: d
answer: no
explanation: A randomised control trial (RCT) is an interventional trial and is used to assess the efficacy of a particular intervention (e.g. treatment for a specific disease). The act of randomising the participants reduces confounding factors and bias, so any differences in outcome can be attributed to the effect of the intervention- in this case, the new drug.
name: Randomised control trial, as you can attribute any differences in observed outcome to the new drug
label: a
answer: yes
explanation: One of the weaknesses of randomised control trials is that they often don’t mimic the clinical, real-life treatment situation, for example, due to the trial being a highly controlled setting, often with strict inclusion and exclusion criteria.
name: Randomised control trial, as this mimics the clinical real-life treatment situation
label: e
answer: no

Correct answer: a
Which statement correctly describes a feature of NMDA receptors?

Options:
explanation: Activation of NMDA receptors requires the binding of two co-agonists, glutamate and glycine, which bind to separate sites on the extracellular domains, allowing channel opening and ion influx.
name: Activation of NMDA receptors requires the binding of two co-agonists, glutamate and aspartate
label: e
answer: no
explanation: This is the structure of G-protein coupled receptors. NMDA receptors are ligand-gated ion channels, not G-protein coupled receptors, which consist of 4 different subunits, each with 3 transmembrane domains.
name: They are monomeric receptors consisting of seven transmembrane domains
label: d
answer: no
explanation: Memantine is an uncompetitive antagonist of the receptor, decreasing its action by entering the receptor channel after it has been opened, physically blocking ion influx into the postsynaptic cell.
name: Its action is enhanced by memantine, a drug used in the treatment of Alzheimer’s disease
label: c
answer: no
explanation: The NDMA receptor is one of four types of ionotropic glutamate receptors, meaning that ligand binding opens a central ion pore, allowing ion influx into the postsynaptic cell.
name: It is one of two types of metabotropic glutamate receptors
label: b
answer: no
explanation: In the receptors’ resting conformation, magnesium ions are tightly bound to the receptor pore, restricting activation and ion entry. With sufficiently strong depolarisation, the magnesium ion is displaced from the pore, allowing a large influx of cations into the postsynaptic cell.
name: They are blocked by magnesium ions in a voltage-dependent manner
label: a
answer: yes

Correct answer: a