hllj/quesmed huggingface dataset:
A sample is taken to the lab and gram-staining is carried out. The organism stains purple and is subsequently recorded as gram +ve.

What is the name of the cellular structure responsible for this colour staining?

Options:
explanation: This is not the structure that is responsible for capturing the gram stain.
name: Periplasmic space
label: e
answer: no
explanation: This is not the structure that is responsible for capturing the gram stain.
name: Mitochondria
label: b
answer: no
explanation: This is not the structure that is responsible for capturing the gram stain.
name: Cytoplasmic membrane
label: c
answer: no
explanation: The cell wall (thick peptidoglycan layer) is responsible for staining gram-positive cells purple.
name: Cell wall
label: a
answer: yes
explanation: Gram-positive bacteria do not have an outer membrane due to the thickness of the peptidoglycan layer. Only gram-negative bacteria have an outer membrane.
name: Outer membrane
label: d
answer: no

Correct answer: a
A patient is diagnosed with cellulitis. A culture is sent to look for the offending micro-organism, which is identified as Staphylococcus aureus.

What is the most likely finding on the gram stain?

Options:
explanation: Gram-negative cocci include the Neisseria species (arranged in pairs).
name: Gram-negative coccus
label: b
answer: no
explanation: Gram-negative bacilli include Escherichia coli (E.coli).
name: Gram-negative bacillus
label: d
answer: no
explanation: Staphylococcus aureus is a gram-positive coccus which grows in clusters. Other examples of gram-positive cocci include streptococcus, but these are usually arranged in chains.
name: Gram-positive coccus
label: a
answer: yes
explanation: Examples of gram-positive bacilli include the Listeria and Clostridium species.
name: Gram-positive bacillus
label: c
answer: no
explanation: Gram-negative coccobacilli include Haemophilus influenzae and Bordetella pertussis.
name: Gram-negative coccobacillus
label: e
answer: no

Correct answer: a
A patient is diagnosed with lung cancer. He is told by his consultant that the underlying mechanism for this is cellular change.

What is the correct descriptor for the change that has taken place?

Options:
explanation: Neoplasia is new, uncontrolled growth of cells which is not under physiological control. This abnormal growth is termed a neoplasm and the resulting mass can be benign or malignant.
name: Neoplasia
label: d
answer: no
explanation: Hyperplasia is an increase in the number of cells. However, the cells appear normal under a microscope and have not changed.
name: Hyperplasia
label: e
answer: no
explanation: Dysplasia is the presence of abnormal cells within a tissue or organ.
name: Dysplasia
label: b
answer: no
explanation: Hypertrophy is the increase and growth of muscle cells. The cells themselves have not mutated.
name: Hypertrophy
label: c
answer: no
explanation: Metaplasia is a change of the orginal cells to a form that does not normally occur in the tissue in which it is found.
name: Metaplasia
label: a
answer: yes

Correct answer: a
A patient presents with a pigmented skin lesion. The GP undertakes a thorough examination and believes the lesion to be benign.

What feature distinguishes this lesion as most likely benign rather than malignant?

Options:
explanation: Increasing size over time would signify a higher chance of malignant melanoma.
name: Increasing size over time
label: e
answer: no
explanation: Heterogeneity in colour would signify a higher chance of malignant melanoma.
name: Heterogenous colour
label: b
answer: no
explanation: Diameter >6mm would signify a higher chance of malignant melanoma.
name: Diameter >6mm
label: c
answer: no
explanation: Bleeding would signify a higher chance of malignant melanoma.
name: Bleeding
label: d
answer: no
explanation: Following the ABCDE rule of melanoma. The GP would have looked for "asymmetry". However, a lesion that is symmetrical is much more likely to be benign. He would also have looked at the "border" for regularity, where irregular borders would indicate a higher chance of malignant melanoma. Colour would be the next indicator, and a heterogenous colour would indicate a higher chance of malignant melanoma. Diameter >6mm would indicate a higher chance of malignant melanoma. Evolution of the lesion in any way to comprise bleeding, itching or increasing size would also indicate a higher chance of a malignant rather than benign lesion.
name: Symmetrical
label: a
answer: yes

Correct answer: a
A woman presents to her GP complaining of a myriad of symptoms. She is diagnosed with hyperthyroidism with the results of her blood tests showing elevated T4 and reduced TSH.

Which of the following symptoms would she be most likely to report?

Options:
explanation: Weight loss, palpitations and heat intolerance are all symptoms of HYPERthyroidism. As these are all consistent with the same diagnosis, this is the correct combination of answers.
name: Weight loss, palpitations and heat intolerance
label: a
answer: yes
explanation: Although palpitations are commonly associated with HYPERthyroidism, weight gain and constipation are associated with HYPOthyroidism. Therefore, this is not the correct combination of symptoms.
name: Palpitations, weight gain and constipation
label: d
answer: no
explanation: Although a lump in the neck (goitre) is seen in both HYPER and HYPO thyroidism, weight gain and low mood are commonly seen in HYPOthyroidism. Therefore, this is not the correct combination of symptoms.
name: Weight gain, neck lump and low mood
label: c
answer: no
explanation: Although irritability is seen in both HYPER and HYPO thyroidism, weight gain and cold intolerance are symptoms of HYPOthyroidism. Therefore, this is not the correct combination of symptoms.
name: Weight gain, irritability and cold intolerance
label: b
answer: no
explanation: All of the symptoms listed above are indicative of HYPOthyroidism.
name: Menorrhagia, low mood, constipation
label: e
answer: no

Correct answer: a
Which of the following combination of hormones is released from the posterior pituitary gland?

Options:
explanation: Oxytocin and vasopressin are the hormones released from the posterior pituitary gland. FSH is secreted from the anterior pituitary. Therefore this is the incorrect combination of answers.
name: Oxytocin and follicle-stimulating hormone (FSH)
label: b
answer: no
explanation: Oxytocin and vasopressin are the hormones released from the posterior pituitary gland. LH is secreted from the anterior pituitary. Therefore this is the incorrect combination of answers.
name: Oxytocin and luteinizing Hormone (LH)
label: e
answer: no
explanation: Oxytocin and Vasopressin (antidiuretic hormone) are the two hormones released from the posterior pituitary gland.
name: Oxytocin and Vasopressin
label: a
answer: yes
explanation: Oxytocin and vasopressin are the hormones released from the posterior pituitary gland. FSH is secreted from the anterior pituitary. Therefore this is the incorrect combination of answers.
name: Vasopressin and follicle-stimulating hormone (FSH)
label: c
answer: no
explanation: Oxytocin and vasopressin are the hormones released from the posterior pituitary gland. LH is secreted from the anterior pituitary. Therefore this is the incorrect combination of answers.
name: Vasopressin and luteinizing Hormone (LH)
label: d
answer: no

Correct answer: a
A patient is prescribed amiodarone to help control his ventricular arrhythmia.

To which antiarrhythmic class does this drug belong and what is its mechanism of action?

Options:
explanation: Amiodarone belongs to the Class 3 antiarrhythmic agents. Class 2 antiarrhythmics are beta-blockers. A good mnemonic to use in order of the classes 1-4 is "some block potassium channels" whereby S = sodium blockers, B = beta blockers, P = potassium blockers, C = calcium blockers.
name: Class 2, potassium channel blocker
label: e
answer: no
explanation: Amiodarone belongs to the Class 3 antiarrhythmic agents. Class 3 antiarrhythmics block potassium channels. A good mnemonic to use in order of the classes 1-4 is "some block potassium channels" whereby S = sodium blockers, B = beta blockers, P = potassium blockers, C = calcium blockers.
name: Class 3, potassium channel blocker
label: a
answer: yes
explanation: Amiodarone belongs to the Class 3 antiarrhythmic agents. Class 4 antiarrhythmics block calcium channels. A good mnemonic to use in order of the classes 1-4 is "some block potassium channels" whereby S = sodium blockers, B = beta blockers, P = potassium blockers, C = calcium blockers.
name: Class 3, calcium channel blocker
label: c
answer: no
explanation: Amiodarone belongs to the Class 3 antiarrhythmic agents. Class 1 antiarrhythmics block sodium channels. A good mnemonic to use in order of the classes 1-4 is "some block potassium channels" whereby S = sodium blockers, B = beta blockers, P = potassium blockers, C = calcium blockers.
name: Class 3, sodium channel blocker
label: b
answer: no
explanation: Amiodarone belongs to the Class 3 antiarrhythmic agents. Class 1 antiarrhythmics block sodium channels. A good mnemonic to use in order of the classes 1-4 is "some block potassium channels" whereby S = sodium blockers, B = beta blockers, P = potassium blockers, C = calcium blockers.
name: Class 1, potassium channel blocker
label: d
answer: no

Correct answer: a
What is the order that the electrical conduction travels through the heart?

Options:
explanation: The correct order of the electrical signal conduction through the heart is: SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres.
name: SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres
label: a
answer: yes
explanation: The correct order of the electrical signal conduction through the heart is: SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres.
name: SA node → AV node → Bundle branches → Bundle of His → Purkinje fibres
label: d
answer: no
explanation: The correct order of the electrical signal conduction through the heart is: SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres.
name: AV node → SA node → Bundle of His → Bundle branches → Purkinje fibres
label: b
answer: no
explanation: The correct order of the electrical signal conduction through the heart is: SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres.
name: SA node → AV node → Bundle of His → Purkinje fibres → Bundle branches
label: c
answer: no
explanation: The correct order of the electrical signal conduction through the heart is: SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres.
name: AV node → SA node → Bundle of His → Purkinje fibres → Bundle branches
label: e
answer: no

Correct answer: a
What hormone is released that triggers ovulation?

Options:
explanation: Testosterone is essential in the production of oestrogen.
name: Testosterone
label: c
answer: no
explanation: Progesterone serves a number of functions, but predominantly, it is there to get the body ready for pregnancy. When an egg is released by an ovary, progesterone encourages the thickening of the uterine lining, ready for a fertilised egg to implant into.
name: Progesterone
label: d
answer: no
explanation: Ovulation is spontaneously triggered about 36-40 hours after blood levels of a hormone called luteinizing hormone (LH) rise. This is termed the LH surge.
name: LH
label: a
answer: yes
explanation: Oestrogen thickens the lining of the uterus (endometrium) to prepare it for pregnancy.
name: Oestrogen
label: e
answer: no
explanation: FSH functions to stimulate the growth of eggs in the ovaries. The levels are at their highest just before ovulation.
name: FSH
label: b
answer: no

Correct answer: a
For fertilisation to occur, what is the name of the layer of the egg that the sperm must penetrate?

Options:
explanation: Cortical granules prevent polyspermy during fertilisation. Cortical granules are secretory vesicles poised at the cortex of an egg that, upon stimulation by sperm contact at fertilization, secrete their contents. These contents modify the extracellular environment and block additional sperm from reaching the egg.
name: Cortical granule
label: e
answer: no
explanation: The Zona pellucida is a thick extracellular matrix that surrounds the oocyte and pre-implantation embryo. The acrosome reaction occurs after sperm capacitation/ calcium ion influx causes the exocytotic event where the spermatozoa can then penetrate the zona pellucida and fuse with the egg plasma membrane.
name: Zona pellucida
label: a
answer: yes
explanation: The perivitelline space is the space between the zona pellucida and the cell membrane of an oocyte or fertilized ovum. In the slow block to polyspermy, the cortical granules released from the ovum are deposited in the perivitelline space.
name: Perivitalline space
label: d
answer: no
explanation: Granulosa cells are a population of somatic cells whose role after ovulation is progesterone production.
name: Granulosa cells
label: b
answer: no
explanation: The corona radiata surrounds the egg and consists of up to three layers of cells from the follicle. They are attached to the zona pellucida and their main purpose is to supply vital proteins to the cell.
name: Corona radiata
label: c
answer: no

Correct answer: a
What cells within the testicles are responsible for male androgen production?

Options:
explanation: Myoid cells are contractile and thus are involved in the transport of mature spermatozoa and testicular fluid in the seminiferous tubules.
name: Myoid cells
label: c
answer: no
explanation: Sertoli cells are somatic cells found within the testes. They are necessary for facilitating spermatogenesis within the seminiferous tubules of the testes.
name: Sertoli cells
label: b
answer: no
explanation: Leydig cells are the primary source of testosterone in males. They produce testosterone under the pulsatile control of luteinizing hormone from the anterior pituitary.
name: Leydig cells
label: a
answer: yes
explanation: Spermatocytes divide and produce immature sperm called spermatids. Spermatids then undergo spermiogenesis and mature into spermatozoa (sperm) which are then able to fertilise a female ovum.
name: Spermatocyte
label: d
answer: no
explanation: Dendritic cells are also found within the testes. They function as antigen-presenting cells (APCs) to the immune system, boosting the immune response when a foreign pathogen is recognised.
name: Dendritic cell
label: e
answer: no

Correct answer: a
Which of the following bones are formed through intramembranous ossification?

Options:
explanation: The humerus forms via endochondral ossification. Endochondral ossification is the process whereby all long bones of the axial skeleton, and all the bones of the appendicular skeleton form. The process begins with mesenchymal cells derived from the mesoderm differentiating into chondrocytes. Chondrocytes then proliferate and secrete extracellular matrix (ECM) to form the cartilage model on which bone forms.
name: Humerus
label: e
answer: no
explanation: Flat bones of the body e.g. the skull are formed via intramembranous ossifcation. This process occurs whereby mesenchymal cells derived from the neural crest differentiate into osteoblasts.
name: Skull
label: a
answer: yes
explanation: The ribs form via endochondral ossification. Endochondral ossification is the process whereby all long bones of the axial skeleton, and all the bones of the appendicular skeleton form. The process begins with mesenchymal cells derived from the mesoderm differentiating into chondrocytes. Chondrocytes then proliferate and secrete extracellular matrix (ECM) to form the cartilage model on which bone forms.
name: Ribs
label: c
answer: no
explanation: The femur forms via endochondral ossification. Endochondral ossification is the process whereby all long bones of the axial skeleton, and all the bones of the appendicular skeleton form. The process begins with mesenchymal cells derived from the mesoderm differentiating into chondrocytes. Chondrocytes then proliferate and secrete extracellular matrix (ECM) to form the cartilage model on which bone forms.
name: Femur
label: d
answer: no
explanation: Vertebrae form via endochondral ossification. Endochondral ossification is the process whereby all long bones of the axial skeleton, and all the bones of the appendicular skeleton form. The process begins with mesenchymal cells derived from the mesoderm differentiating into chondrocytes. Chondrocytes then proliferate and secrete extracellular matrix (ECM) to form the cartilage model on which bone forms.
name: T12 vertebrae
label: b
answer: no

Correct answer: a
What is the name given to the structure that attaches bone to bone?

Options:
explanation: Muscles allow the body to move. Muscles attach to bone via tendons.
name: Muscle
label: c
answer: no
explanation: Ligaments connect bones to other bones.
name: Ligament
label: a
answer: yes
explanation: Tendons connect the ends of muscles to bones.
name: Tendon
label: b
answer: no
explanation: Cartilage has many functions, including the ability to resist compressive forces, enhance bone resilience, and provide support in bony areas where there is a need for flexibility.
name: Cartilage
label: e
answer: no
explanation: Bursae are small fluid-filled sacs that reduce friction between moving parts in your body's joints.
name: Bursae
label: d
answer: no

Correct answer: a
Which of the following is specific to cervical vertebrae?

Options:
explanation: The lamina is not a specific anatomical structure of the cervical vertebrae. The lamina is the roof of the spinal canal that provides support and protection for the backside of the spinal cord.
name: Lamina
label: b
answer: no
explanation: Although cervical vertebrae have a specific spinous process which is bifid in shape, the spinous process as an anatomical structure is not a specific feature of the cervical vertebrae. The spinous process functions as an important anatomical and biomechanical structure. It protects the neural structures in the spinal canal, and acts as an anchor for the interspinous and supraspinous ligaments, and the intersegmental paraspinal muscles.
name: Spinous process
label: e
answer: no
explanation: Each vertebra has a vertebral body anteriorly. The size of this vertebral body increases as you descend the spinal cord.
name: Vertebral Body
label: c
answer: no
explanation: The pedicle is not specific to cervical vertebrae. The pedicle functions as a structural buttress, providing support to the posterior wall of the vertebral body when constrained through the posterior arch.
name: Pedicle
label: d
answer: no
explanation: Only the cervical vertebrae possess the transverse foramina. The reason for this is that the transverse foramina function as a canal for the vertebral artery, vertebral vein and sympathetic nerves to reach the skull.
name: Transverse foramen
label: a
answer: yes

Correct answer: a
What is the main collagen type found within the cartilage of the ribcage?

Options:
explanation: Type 1 collagen is the most common type of collagen.
name: Type 1
label: c
answer: no
explanation: Type 5 collagen is found in some layers of skin, but is mostly found in the cornea of the eyes, hair, and placental tissue.
name: Type 5
label: d
answer: no
explanation: Type 3 collagen is found in muscles, arteries and organs.
name: Type 3
label: b
answer: no
explanation: Type 4 collagen is found in the skin layers.
name: Type 4
label: e
answer: no
explanation: Type 2 collagen is found in elastic cartilage. It helps to provide support to joints. Hyaline cartilage is found between the ribs and this is comprised of type 2 collagen.
name: Type 2
label: a
answer: yes

Correct answer: a
A 27-year-old woman presents to General Practice with double vision, difficulty smiling and drooping of both of her eyelids. She is alert and her cognition is intact. She is presenting with the classical symptoms of an autoimmune condition.

Which receptors are being attacked by autoantibodies in this condition?

Options:
explanation: Noradrenaline receptors are responsible for producing an adrenergic effect when stimulated. These effects include an increase in heart rate, increased blood pressure, bronchodilation, and constriction of the pupils. Noradrenaline does not affect the eyelid muscles or the jaw - therefore damaging these receptors is unlikely to cause isolated symptoms of eye and jaw muscle weakness.
name: Noradrenaline (NA) receptors
label: e
answer: no
explanation: This patient is experiencing weakness in her skeletal muscles - specifically her eye and jaw muscles. This is what is causing the drooping of her eyelids. This is the classical presentation of myasthenia gravis, an autoimmune condition.

ACh (acetylcholine) receptors are found at the neuromuscular junction and are responsible for skeletal muscle contraction. An autoimmune attack in the form of autoantibodies against these receptors would be consistent with the signs and symptoms reported by this patient.
name: Acetylcholine receptor
label: a
answer: yes
explanation: GABA receptors are responsible for inhibiting the stimulation of nerves in the central nervous system. If GABA receptors are damaged, you would expect to see an increased level of excitation in the nervous system - the opposite of what this patient is reporting.
name: GABA Receptors
label: c
answer: no
explanation: Histamine receptors are responsible for vasodilation, bronchoconstriction, and the recruitment of inflammatory cells. Histamine receptors do not affect the skeletal muscles in the body - therefore this is not the correct choice.
name: Histamine Receptors
label: d
answer: no
explanation: Serotonin (5-HT) receptors, are G-protein coupled receptors, that are activated by the neurotransmitter serotonin. Serotonin controls neurological processes such as anxiety, appetite, cognition, memory, mood and sleep. This patient is not reporting a change in any of these - this is not the correct answer.
name: Serotonin (5-HT) Receptors
label: b
answer: no

Correct answer: a
A 78-year-old woman presents with an ischaemic stroke in the left middle cerebral artery territory.

Which of the following signs and symptoms could she present with?

Options:
explanation: A left MCA lesion would not produce left arm paralysis (ipsilateral) - the paralysis would be contralateral instead.
name: Inability to understand or produce speech, left arm paralysis
label: b
answer: no
explanation: A left MCA lesion would produce **right**-sided arm and leg paralysis, not left-sided paralysis.
name: Left arm and leg paralysis
label: c
answer: no
explanation: A left MCA lesion would also produce contralateral visual-field defects - therefore we would expect right-sided visual-field defects. However, we would expect right-sided motor dysfunction instead of left-sided dysfunction as the left middle cerebral artery supplies blood to the left primary motor cortex, which controls motor function on the right side of the body.
name: Right visual-field defect, left arm and leg paralysis
label: e
answer: no
explanation: A left MCA lesion would also produce contralateral visual-field defects - therefore we would expect right-sided visual-field defects instead of left-sided ones.
name: Left visual-field defects, inability to understand speech
label: d
answer: no
explanation: The left middle cerebral artery (MCA) supplies Broca's area (production of speech) and Wernicke's area (understanding of speech).

It also supplies blood to the left primary motor cortex, which controls motor function on the right side of the body.

A lesion in these areas would therefore produce impairments in producing and understanding speech, and contralateral paralysis.
name: Inability to understand or produce speech, right arm paralysis
label: a
answer: yes

Correct answer: a