hllj/quesmed huggingface dataset:
Which of the following is not an effect of parathyroid hormone (PTH)?

Options:
explanation: PTH decreases phosphate reabsorption, which results in more ionised calcium in the blood, as there are fewer phosphate ions to form salts with calcium.
name: Decreases phosphate reabsorption in the proximal convoluted tubule
label: b
answer: no
explanation: PTH stimulates osteoclasts to break down bone which releases the calcium and phosphorus.
name: Increases calcium and phosphorus release from bone
label: d
answer: no
explanation: PTH increases calcium reabsorption in the kidneys, which also decreases urinary calcium excretion.
name: Decreases calcium reabsorption in the kidneys
label: a
answer: yes
explanation: PTH stimulates the formation of this active form of vitamin D. Vitamin D then exerts negative feedback on PTH secretion. The active form of vitamin D increases the amount of calcium absorbed in the small intestine and decreases loss from the kidneys.
name: Increases 1,25-dihydroxyvitamin D production in the kidney
label: e
answer: no
explanation: PTH increases dietary calcium reabsorption from the duodenum and jejunum, and into the blood.
name: Increases calcium reabsorption in the small intestine
label: c
answer: no

Correct answer: a
A 28-year-old woman is diagnosed with Brown-Sequard syndrome following a traumatic car accident.

Which of the following examination findings are most likely to be seen?

Options:
explanation: The spinothalamic tract decussates in the spinal cord, leading to contralateral loss of pain, temperature and crude touch sensations below the lesion.
name: Contralateral loss of pain sensation below the level of the lesion
label: a
answer: yes
explanation: The dorsal column decussates in the medulla, leading to ipsilateral loss of proprioception and fine touch below the lesion.
name: Contralateral loss of fine touch below the level of the lesion
label: d
answer: no
explanation: The spinothalamic tract decussates in the spinal cord, leading to contralateral loss of crude touch sensations below the lesion.
name: Ipsilateral loss of crude touch below the level of the lesion
label: e
answer: no
explanation: The dorsal column decussates in the medulla, leading to ipsilateral loss of proprioception and fine touch below the lesion.
name: Contralateral loss of proprioception below the level of the lesion
label: c
answer: no
explanation: The corticospinal tract decussates in the medulla, leading to ipsilateral motor weakness below the lesion.
name: Contralateral motor weakness below the level of the lesion
label: b
answer: no

Correct answer: a
Which of the following is not an effect of angiotensin II?

Options:
explanation: Angiotensin II increases K+ excretion in the distal tubule to stimulate aldosterone production. A rise in aldosterone increases Na+ reabsorption which raises plasma volume and maintains osmolarity, increasing blood pressure.
name: Increased tubular K+ excretion
label: c
answer: no
explanation: Angiotensin II acts on arterioles by causing vasoconstriction which increases blood pressure.
name: Arterial vasoconstriction
label: b
answer: no
explanation: Angiotensin II acts on the hypothalamus to increase vasopressin and activate thirst centres, which raises plasma volume and maintains osmolarity, increasing blood pressure.
name: Increased vasopressin secretion
label: d
answer: no
explanation: Angiotensin II stimulates the sympathetic nervous system, which can lead to increased vasopressin secretion, cardiovascular response and thirst sensation.
name: Increased sympathetic activity
label: e
answer: no
explanation: The renin-angiotensin system is stimulated by a decrease in blood pressure. Angiotensin II works to increase blood pressure by acting on multiple systems.
name: Decreases blood pressure
label: a
answer: yes

Correct answer: a
What effect, if any, does increasing cortisol have on female hormones?

Options:
explanation: High cortisol levels inhibit gonadotropin releasing hormone, leading to decreased progesterone and oestrogen in females.
name: Increase in progesterone, increase in oestrogen
label: c
answer: no
explanation: High cortisol levels inhibit gonadotropin releasing hormone, leading to decreased progesterone and oestrogen in females.
name: It has no effect on progesterone or oestrogen
label: e
answer: no
explanation: High cortisol levels inhibit gonadotropin releasing hormone leading to decreased progesterone and oestrogen in females. It can lead to reduced ovulation and sexual activity in women, and a reduced sperm count in men.
name: Decrease in progesterone, decrease in oestrogen
label: a
answer: yes
explanation: High cortisol levels inhibit gonadotropin releasing hormone, leading to decreased progesterone and oestrogen in females.
name: Increase in progesterone, decrease in oestrogen
label: b
answer: no
explanation: High cortisol levels inhibit gonadotropin-releasing hormone, leading to decreased progesterone and oestrogen in females.
name: Decrease in progesterone, increase in oestrogen
label: d
answer: no

Correct answer: a
A baby is born prematurely at 30 weeks. Her mother is worried about her lung development as surfactant has not yet been sufficiently produced to allow for effective breathing.

What cells produce surfactant in the lung?

Options:
explanation: These are globular cells within the alveolar wall that synthesise, store and secrete surfactant. From 24-28 weeks surfactant begins to be produced by the foetal lungs, but it is not sufficiently produced until 32-34 weeks. Surfactant reduces surface tension and allows equal aeration of alveoli.
name: Type II alveolar pneumocytes
label: a
answer: yes
explanation: These are phagocytic cells derived from blood monocytes. They help remove particulates that have entered the alveolar air space. The alveolar phagocytes produced can be removed via the mucociliary escalator or lymphatics.
name: Alveolar macrophages
label: c
answer: no
explanation: These are found within the alveolar wall and produce reticulin and elastic tissue that allow for the elastic recoil of the lungs during exhalation.
name: Fibroblasts
label: e
answer: no
explanation: These are squamous epithelial cells that have a flattened nucleus and few organelles to allow for rapid gas exchange.
name: Type I alveolar pneumocytes
label: b
answer: no
explanation: This is pseudostratified columnar ciliated epithelium that contains mucus-secreting goblet cells that line the conducting airways of the respiratory system. The alveoli, where surfactant is produced, have a single layer of squamous epithelium to allow for gas exchange.
name: Respiratory epithelium
label: d
answer: no

Correct answer: a
Which of the following best describes a mis-sense mutation?

Options:
explanation: This is a mutation of the regulatory sequence.
name: The genome coding sequence is still intact, but the gene is abnormally switched on or off
label: e
answer: no
explanation: This is a duplication mutation, which can lead to the incorrect protein being generated.
name: Sections of the genome are repeated
label: c
answer: no
explanation: This is a mis-sense mutation, such as in sickle cell disease where CAG is replaced with CTG. Mis-sense mutations can have a varied effect, such as being a silent mutation or resulting in a non-functional protein.
name: Point mutation where a single nucleotide change results in a codon that codes for a different amino acid
label: a
answer: yes
explanation: This is an in-frame deletion mutation, which only leads to one amino being lost and keeping the reading frame intact. An out-of-frame deletion would cause the whole gene sequence to sift, causing the reading frame of the gene to change.
name: One codon is removed, so only one amino acid is lost
label: d
answer: no
explanation: This is a non-sense mutation, such as in Duchenne’s muscular dystrophy. This results in an incomplete, usually non-functional protein.
name: Point mutation that produces a stop codon
label: b
answer: no

Correct answer: a
In a study looking at people with and without cancer, participants with cancer were more likely to remember having smoked even one time. However, researchers believe that this data may be subject to bias.

Which bias is this process describing?

Options:
explanation: This is a type of information bias where information is recorded in a distorted manner e.g an incorrectly calibrated instrument.
name: Measurement bias
label: e
answer: no
explanation: This is a type of information bias where participants do not accurately remember previous events or leave out details. In this scenario, the participants' disease status is affecting their likelihood of reporting the exposure.
name: Recall bias
label: a
answer: yes
explanation: This is a type of information bias where variables are reported differently between assessors.
name: Observer bias
label: d
answer: no
explanation: There is an error in the process of selecting or retaining participants for the study and assigning them to particular arms of the study.
name: Selection bias
label: b
answer: no
explanation: There is a systematic error in the collection of data and has many different sources.
name: Information bias
label: c
answer: no

Correct answer: a
Which of the following best describes the sarcolemma of a cardiomyocyte?

Options:
explanation: Sarcolemmas are the plasma membrane of cardiomyocytes or skeletal muscle fibres.
name: Plasma membrane of the muscle
label: a
answer: yes
explanation: This is describing the thin actin filament in a myocyte.
name: Globular, double-stranded protein in a helical structure with a myosin-binding site
label: b
answer: no
explanation: This is describing transverse-tubules in a myocyte.
name: Extensions of the cell membrane that penetrate to the centre of the myocyte
label: e
answer: no
explanation: This is describing titin, which prevents muscle fibres from overstretching.
name: Responsible for the elasticity of muscle, allowing it to recoil to its normal form
label: d
answer: no
explanation: This is describing the sarcoplasmic reticulum, which is a specialised form of endoplasmic reticulum necessary for muscle contraction and relaxation. Activation of the sarcoplasmic reticulum releases stored Ca2+ which binds to troponin and induces the actin-myosin complex.
name: Holds ATPase on its membrane and is dedicated to Ca2+ handling
label: c
answer: no

Correct answer: a
Which of the following best describes the role of a central chemoreceptor?

Options:
explanation: This is describing a juxtapulmonary receptor. They are found in the alveolar walls in close proximity to the pulmonary capillaries.
name: Stimulate bronchoconstriction in response to irritants and lung volume
label: e
answer: no
explanation: This is describing an arterial baroreceptor. They are found in the aortic arch and carotid sinuses.
name: Regulate systemic circulation in response to the distortion of the arterial wall due to pressure changes
label: c
answer: no
explanation: This is describing a central chemoreceptor. They are located in the medulla, and they activate the sympathetic nervous system to trigger arterial vasoconstriction.
name: Stimulates arterial vasoconstriction in response to changes in pCO2 and pH
label: a
answer: yes
explanation: This is describing a cardiopulmonary baroreceptor. They are located in the atria, ventricles and pulmonary artery.
name: Decrease vasoconstriction and blood pressure in response to pressure changes
label: d
answer: no
explanation: This is describing a peripheral chemoreceptor. They are located in the aortic arch and carotid sinuses. They activate the sympathetic nervous system to increase respiration.
name: Stimulates increased respiration in response to decreases in pO2
label: b
answer: no

Correct answer: a
The von Ebner gland is the only minor salivary gland that produces purely serous secretions.

Which of the following salivary glands also produces purely serous secretions?

Options:
explanation: The submandibular glands are continuously active glands that produce mixed serous and mucous secretions.
name: Submandibular glands
label: b
answer: no
explanation: Weber’s glands are minor salivary glands found at the superior pole of the tonsils. They are continuously active glands that produce purely mucous secretions.
name: Weber’s glands
label: d
answer: no
explanation: The palatine glands are minor salivary glands found in the hard palate of the mouth. They are continuously active glands that produce purely mucous secretions.
name: Palatine glands
label: e
answer: no
explanation: The parotid glands are intermittently active glands that produce purely serous secretions.
name: Parotid glands
label: a
answer: yes
explanation: The sublingual glands are continuously active glands that produce purely mucous secretions.
name: Sublingual glands
label: c
answer: no

Correct answer: a
Which of the following best describes a type IIa muscle fibre?

Options:
explanation: This is describing troponin. It works with other structures in the sarcomere to produce muscle contraction. Troponin-C binds to calcium ions. Troponin-I inhibits actin and myosin action. Troponin T binds to tropomyosin.
name: A globular protein that can form three types of thin filaments
label: d
answer: no
explanation: This is describing tropomyosin, which regulates muscle contraction.
name: A thin filament made of two helical peptide chains within the grooves between actin strands
label: e
answer: no
explanation: This is describing a type IIa muscle fibre.
name: Fast-twitch oxidative fibres which can use aerobic and anaerobic energy sources
label: a
answer: yes
explanation: This is describing a type I muscle fibre.
name: Slow-twitch oxidative fibres which use aerobic energy sources
label: b
answer: no
explanation: This is describing a type IIb muscle fibre.
name: Fast-twitch glycolytic fibres which use anaerobic energy sources
label: c
answer: no

Correct answer: a
Which of the following is not an example of a monosynaptic reflex?

Options:
explanation: This is a monosynaptic (myotatic) reflex, where afferent fibres synapse directly with the motor neurons without any interneurons. Stretch reflexes are the only monosynaptic reflexes.
name: Biceps reflex
label: b
answer: no
explanation: This is a polysynaptic reflex, where there is at least one interneuron between the afferent and efferent neurons. Another example is the inverse stretch reflex.
name: Withdrawal reflex
label: a
answer: yes
explanation: This is a monosynaptic (myotatic) reflex, where afferent fibres synapse directly with the motor neurons without any interneurons. Stretch reflexes are the only monosynaptic reflexes.
name: Achilles tendon reflex
label: e
answer: no
explanation: This is a monosynaptic (myotatic) reflex, where afferent fibres synapse directly with the motor neurons without any interneurons. Stretch reflexes are the only monosynaptic reflexes.
name: Patellar stretch reflex
label: d
answer: no
explanation: This is a monosynaptic (myotatic) reflex, where afferent fibres synapse directly with the motor neurons without any interneurons. Stretch reflexes are the only monosynaptic reflexes.
name: Triceps reflex
label: c
answer: no

Correct answer: a
Which of the following is true with regards to the process of micturition?

Options:
explanation: This statement is true.
name: Stimulation to the pelvic nerve causes a release of ACh, which works on M3 muscarinic ACh receptors on the detrusor muscle
label: a
answer: yes
explanation: Neurons of the pontine micturition centre excite the sacral preganglionic neurons. This centre inhibits Onuf’s nucleus which leads to a reduction in sympathetic stimulation to the internal urethral sphincter causing relaxation.
name: Neurons of Onuf’s nucleus excite the sacral preganglionic neurons
label: b
answer: no
explanation: Detrusor muscle contraction causes a conscious reduction in voluntary contraction of the external urethral sphincter from the cerebral cortex, allowing for distention of the urethra and the passing of urine.
name: A sub-conscious reduction in voluntary contraction of the internal urethral sphincter from the cerebral cortex allows for distention of the urethra and the passing of urine
label: e
answer: no
explanation: The sacral preganglionic neurones cause parasympathetic stimulation to the pelvic nerve (S2-S4). Passing urine is under parasympathetic control.
name: The sacral preganglionic neurons cause sympathetic stimulation to the pelvic nerve
label: c
answer: no
explanation: The pelvic nerve causes detrusor muscle contraction which leads to micturition.
name: Detrusor muscle relaxation leads to micturition
label: d
answer: no

Correct answer: a
Which of the following is false with regards to thyroid hormones?

Options:
explanation: TSH increases protein synthesis in thyroid follicular cells. It also increases DNA replication, cell division and the amount of rough endoplasmic reticulum.
name: TSH decreases protein synthesis in thyroid follicular cells
label: a
answer: yes
explanation: T3 also acts on the liver, has metabolic actions and is required for growth and nervous system development.
name: T3 stimulates carbohydrate absorption from the small intestine and increases fatty acid release from adipocytes
label: b
answer: no
explanation: TBG is produced in the liver, and reversibly binds to T3 and T4.
name: In the bloodstream T3 and T4 bind to Thyroxine-Binding Globulin (TBG)
label: d
answer: no
explanation: TSH acts on the thyroid gland to secrete T3 and T4. T4 is converted to T3 and acts on its target cells. The rise in T3 causes a negative feedback loop on the anterior pituitary to inhibit TSH and TRH.
name: Thyroid-stimulating hormone (TSH) actions are inhibited through a negative feedback loop
label: c
answer: no
explanation: T4 is the most abundant form, but T3 is the biologically active form.
name: T4 is converted to T3 in peripheral tissues by 5’-deiodinase
label: e
answer: no

Correct answer: a
From which secondary brain vesicle does the midbrain arise?

Options:
explanation: The metencephalon originates from the rhombencephalon primary brain vesicle (hindbrain). It gives rise to the pons and cerebellum.
name: Metencephalon
label: d
answer: no
explanation: The mesencephalon originates from the mesencephalon primary brain vesicle. It gives rise to the cerebral hemispheres.
name: Mesencephalon
label: a
answer: yes
explanation: The telencephalon originates from the prosencephalon primary brain vesicle (forebrain). It gives rise to the thalamus, hypothalamus and lateral and third ventricle.
name: Telencephalon
label: b
answer: no
explanation: The myelencephalon originates from the rhombencephalon primary brain vesicle (hindbrain). It gives rise to the medulla oblongata.
name: Myelencephalon
label: e
answer: no
explanation: The diencephalon originates from the prosencephalon primary brain vesicle (forebrain). It gives rise to the midbrain and cerebral aqueduct.
name: Diencephalon
label: c
answer: no

Correct answer: a
A three-month -old boy is found to be positive for a genetic disease. He is heterozygous for the condition, as well as his father who is also affected by the disease. His mother and older brother do not possess the mutated gene.

What is the most likely mode of this genetic inheritance?

Options:
explanation: In this scenario, the child inherited his condition from his father. Mitochondrial conditions are always inherited from the mother, as all mitochondria of the foetus are maternal.
name: Mitochondrial
label: e
answer: no
explanation: With autosomal dominant conditions, the disease can manifest in a heterozygous state. In this scenario, the child is heterozygous and inherited his condition solely from his father.
name: Autosomal dominant
label: a
answer: yes
explanation: These are caused by a mutation on the X-chromosome. 100% incidence of affected sons from an affected mother suggests X-linked recessive. In this scenario, the child’s brother is unaffected and it was inherited from his father, who would have been unable to pass on his affected X-chromosome.
name: X-linked recessive
label: d
answer: no
explanation: These are caused by a mutation on the X-chromosome. 100% incidence of affected daughters from an affected father suggests X-linked dominance. In this scenario, as it is the child’s father who is affected, if it was an X-linked condition he would not be able to pass the affected X-chromosome to his son, as he would receive the Y-chromosome.
name: X-linked dominant
label: c
answer: no
explanation: With autosomal recessive conditions, the disease manifests in only a homozygous state. In this scenario, the child is heterozygous and so cannot be autosomal recessive.
name: Autosomal recessive
label: b
answer: no

Correct answer: a
A researcher is interested in carrying out a cross-sectional study.

Which of the following is a disadvantage of this study design?

Options:
explanation: This is incorrect because it is untrue. In fact, cross-sectional, cohort and case-control studies are not suitable for studying rarer diseases or exposures. This is because even in large samples, there may still be no one with the disease.
name: Not suitable for common diseases
label: e
answer: no
explanation: This is a disadvantage mainly associated with case-control studies. Here, groups are defined by the presence or absence of disease, so only one condition can be studied at a time. This is not an issue in cross-sectional studies as data from multiple diseases can be collected simultaneously.
name: Only a single disease can be studied at a time
label: c
answer: no
explanation: This is a disadvantage mainly associated with cross-sectional studies. They are descriptive in nature and cannot show causal relationships.
name: Limited potential to establish disease aetiology
label: a
answer: yes
explanation: This is an advantage of cross-sectional studies. Since data only needs to be collected at a single point in time, they are less time-consuming than other study design methods.
name: Relatively fast and inexpensive
label: b
answer: no
explanation: This is a disadvantage mainly associated with cohort studies. They may require long periods of follow-up as it may take a long time after exposure for the disease to occur. This is not an issue in cross-sectional studies as data is only collected at a single point in time.
name: Expensive and time-consuming
label: d
answer: no

Correct answer: a
A 62-year-old man attends his general practitioner complaining of shortness of breath on exertion and a dry cough which has been present for the past two months. The patient is a long-term smoker. Following further tests, the patient is diagnosed with COPD. When asked if the patient has considered giving up smoking, he explains that he is currently researching alternatives to cigarettes, stating that he would like to start weaning off cigarettes in the next few weeks. He also asks the GP for any advice on how he can quit.

What stage in the transtheoretical model of behaviour change is this patient in?

Options:
explanation: This patient is not in relapse as there is no evidence that he has attempted to give up smoking in the past and subsequently failed.
name: Relapse
label: c
answer: no
explanation: In this stage, people intend to start the healthy behaviour in the near future, and recognise that their current behaviour may be problematic. Once specific plans are being made about how the change will be implemented, the person will move to the preparation stage of behaviour change.
name: Contemplation
label: d
answer: no
explanation: The patient is ready and preparing to take action in the near future. People in the preparation stage will often take small steps towards the behaviour change, and believe that changing their behaviour will lead to a healthier life.
name: Preparation
label: a
answer: yes
explanation: Although the patient has expressed a desire to change his actions and is actively looking at ways to change his behaviour, he has not yet implemented any of these. A person in the action stage would have recently changed their behaviour and intend to continue with this behaviour change.
name: Action
label: e
answer: no
explanation: In this stage, people have no intention of taking action to elicit change in the foreseeable future. People in this stage are often unaware of the consequences of their actions.
name: Precontemplation
label: b
answer: no

Correct answer: a