hllj/quesmed huggingface dataset:
A 32-year-old woman is being assessed for sudden onset loss of vision. She is confirmed to have damage to the optic chiasm.

What visual field defect would she have presented with?

Options:
explanation: This is caused by a lesion to the inferior optic radiation (Meyer’s loop) in the temporal lobe. An inferior quadrantanopia is caused by a lesion to the superior optic radiation (Baum’s loop) in the parietal lobe.
name: Contralateral homonymous superior quadrantanopia
label: d
answer: no
explanation: This is caused by a lesion to the left optic tract and leads to loss of vision in the temporal field of the left eye and the nasal field of the right eye.
name: Left homonymous hemianopia
label: c
answer: no
explanation: This is caused by a lesion to the optic chiasm and leads to loss of vision in both temporal visual fields.
name: Bitemporal hemianopia
label: a
answer: yes
explanation: This is caused by a lesion to the left optic nerve and leads to complete loss of vision in the left eye.
name: Total left blindness
label: b
answer: no
explanation: This is caused by a lesion to the optic cortex in the occipital lobe and leads to loss of vision on the temporal field, with sparing in the centre.
name: Contralateral homonymous hemianopia with macular sparing
label: e
answer: no

Correct answer: a
Which of the following secretes oestrogen in the luteal phase of menstruation?

Options:
explanation: These are found in the anterior pituitary, and produce FSH and LH.
name: Gonadotropic cells
label: e
answer: no
explanation: Granulosa cells differentiate into theca cells. The two work together to synthesise oestrogen in the follicular phase of menstruation.
name: Granulosa and theca cells
label: c
answer: no
explanation: The dominant follicle released becomes the corpus luteum, which produces oestrogen and progesterone in the luteal phase. It also produces oestrogen and progesterone for the first ten weeks of pregnancy, before the placenta takes over.
name: Corpus luteum
label: a
answer: yes
explanation: If the corpus luteum is not fertilised within ten days, it reaches its maximum development and then rapidly degenerates via apoptosis, triggering menstruation. When the corpus luteum collapses it becomes the corpus albicans, and marks the end of the luteal phase.
name: Corpus albicans
label: d
answer: no
explanation: The antrum is a fluid-filled space formed from granulosa cell secretions.
name: Antrum
label: b
answer: no

Correct answer: a
The release of anterior pituitary hormones is stimulated by hypophysiotropic hormones produced by the hypothalamus.

Which hypophysiotropic hormone has an inhibitory effect on an anterior pituitary hormone?

Options:
explanation: Stimulates the release of growth hormone from the anterior pituitary. Somatostatin inhibits the release of GHRH.
name: Growth hormone-releasing hormone (GHRH)
label: b
answer: no
explanation: Dopamine inhibits the release of prolactin from the anterior pituitary.
name: Dopamine
label: a
answer: yes
explanation: TRH stimulates the release of thyroid-stimulating hormone from the anterior pituitary.
name: Thyrotropin-releasing hormone (TRH)
label: d
answer: no
explanation: CRH stimulates the release of adrenocorticotropic hormone from the anterior pituitary.
name: Corticotropin-releasing hormone (CRH)
label: e
answer: no
explanation: GRH stimulates the release of luteinising hormone and follicle-stimulating hormone from the anterior pituitary.
name: Gonadotropin-releasing hormone (GRH)
label: c
answer: no

Correct answer: a
The primitive gut is derived from the endoderm and the visceral mesoderm.

Which of the following is derived from the endoderm?

Options:
explanation: This arises from the visceral mesoderm of the primitive gut.
name: Muscle of the gut wall
label: b
answer: no
explanation: This arises from the visceral mesoderm of the primitive gut.
name: Connective tissue for glands
label: e
answer: no
explanation: This arises from the visceral mesoderm of the primitive gut.
name: Peritoneal components of the gut wall
label: c
answer: no
explanation: The epithelial lining of the digestive tract, along with liver hepatocytes and endocrine and exocrine cells of the pancreas, is derived from the endoderm of the primitive gut.
name: Epithelial lining of the digestive tract
label: a
answer: yes
explanation: This arises from the visceral mesoderm of the primitive gut.
name: Connective tissue of the gut wall
label: d
answer: no

Correct answer: a
Which of the following are produced in each round of beta-oxidation of a fatty acid?

Options:
explanation: This is converted and reformed in the carnitine shuttle in order to cross the outer mitochondrial membrane to be used in beta-oxidation.
name: Acyl coA
label: d
answer: no
explanation: These are the products of ketone synthesis.
name: 1 beta-hydroxybutyrate, 1 acetoacetate, and 1 acetone
label: e
answer: no
explanation: These are the products of the Krebs cycle.
name: 3 NADH, 1 FADH2 and 1 GTP
label: b
answer: no
explanation: These are the products of beta-oxidation of a fatty acid.
name: 1 NADH, 1 FADH2 and 1 acetyl coA
label: a
answer: yes
explanation: These are the net products of glycolysis. Glycolysis produces 4 ATP in total but consumes 2 ATP in the process, so has a net total of 2 ATP. As it produces 2 glyceraldehyde-3-phosphate, it also produces 2 pyruvate and 2 NADH in the process.
name: 2 NADH, 2 ATP and 2 pyruvate
label: c
answer: no

Correct answer: a
A 35-year-old woman has been attending her local GP for smoking cessation advice. She has decided that she is on her last pack of cigarettes and has set a stop date in one week's time.

According to the transtheoretical model, what stage is the patient currently at?

Options:
explanation: This is the first stage of the transtheoretical model, where the patient is still doing the undesired behaviour and does not intend to take action in the foreseeable future. For example, in this scenario, the patient may still be smoking and may not wish to stop for the next six months.
name: Pre-contemplation
label: b
answer: no
explanation: This is the second stage of the transtheoretical model, where the patient intends to change their behaviour in the next six months, but is yet to put in any active changes. For example, in this scenario, the patient may be thinking about or talking about quitting smoking, but is not ready to participate in any STOP programmes immediately.
name: Contemplation
label: c
answer: no
explanation: This is the fourth stage of the transtheoretical model, where the patient has made specific, observable changes to their lifestyle within the past six months. For example, in this scenario, the patient may have been an ex-smoker for less than six months.
name: Action
label: d
answer: no
explanation: This is the third stage of the transtheoretical model where the patient intends to take action in the immediate future, usually in the next month. In this scenario, the patient is preparing to stop in one week, but has not yet stopped smoking
name: Preparation
label: a
answer: yes
explanation: This is the fifth stage of the transtheoretical model where the patient has made a sustained change to their behaviour for at least six months. They are still actively working to prevent relapse, but do not need to apply change processes as frequently as before. For example, in this scenario, the patient may have been an ex-smoker for more than six months. From here, they can either go on to lead a stable changed lifestyle, or relapse.
name: Maintenance
label: e
answer: no

Correct answer: a
A 52-year-old man has an ECG which shows QRS prolongation.

What part of the cardiac cycle does the QRS complex correspond to?

Options:
explanation: This corresponds to the P wave.
name: Atrial depolarisation
label: c
answer: no
explanation: This corresponds to the PR interval.
name: Interval between atrial depolarisation and ventricular depolarisation
label: e
answer: no
explanation: This corresponds to the ST segment.
name: Interval between depolarisation and repolarisation of the ventricles
label: d
answer: no
explanation: This corresponds to the T wave.
name: Ventricular repolarisation
label: b
answer: no
explanation: This corresponds to the QRS complex.
name: Ventricular depolarisation
label: a
answer: yes

Correct answer: a
A 65-year-old man with poorly controlled COPD is brought into hospital. An arterial blood gas (ABG) is carried out showing type II respiratory failure.

Normal values for PaO2 and PaCo2 are shown below:

- PaO2 = 10-14kPa
- PaCO2 = 4-6kPa

What would his spirometry and ABG results most likely show?

Options:
explanation: This is showing a restrictive spirometry pattern (FEV1<80%, FVC <80% and FEV1/FVC normal) and type 2 respiratory failure (hypoxaemia and hypercapnia). A COPD patient is more likely to have an obstructive respiratory pattern.
name: FEV1 = 31%, FVC = 26%, FEV1/FVC = 115%, PaO2 = 6kPa, PaCO2 = 7kPa
label: d
answer: no
explanation: This is showing a normal spirometry pattern with no respiratory failure.
name: FEV1 = 85% , FVC = 90%, FEV1/FVC = 94%, PaO2 = 12kPa, PaCO2 = 5kPa
label: e
answer: no
explanation: This is showing an obstructive spirometry pattern (FEV1<80%, FVC normal and FEV1/FVC<70%) and type 2 respiratory failure (hypoxaemia and hypercapnia), which is most typical for COPD.
name: FEV1 = 58.5%, FVC = 91.1%, FEV1/FVC = 68.8%, PaO2 = 6kPa, PaCO2 = 7kPa
label: a
answer: yes
explanation: This is showing a restrictive spirometry pattern (FEV1<80%, FVC <80% and FEV1/FVC normal) and type 1 respiratory failure (only hypoxaemia). A COPD patient is more likely to have an obstructive spirometry pattern and type 2 respiratory failure.
name: FEV1 = 31%, FVC = 26%, FEV1/FVC = 115%, PaO2 = 6kPa, PaCO2 = 5kPa
label: c
answer: no
explanation: This is showing an obstructive spirometry pattern (FEV1<80%, FVC normal and FEV1/FVC<70%) and type 1 respiratory failure pattern (only hypoxaemia). A COPD patient is more likely to have type 2 respiratory failure.
name: FEV1 = 58.5%, FVC = 91.1%, FEV1/FVC = 68.8%, PaO2 = 6kPa, PaCO2 = 5kPa
label: b
answer: no

Correct answer: a
A 19-year-old woman who has a rare congenital defect affecting her fat metabolism, is found to be deficient in Vitamin E.

Which of the following conditions is she most at risk of developing?

Options:
explanation: This is caused by a deficiency of vitamin A, which helps with vision, growth and stabilisation of cell membranes. Deficiency can also cause xerophthalmia.
name: Night blindness
label: b
answer: no
explanation: This is caused by a deficiency of vitamin C, which plays a part in collagen synthesis and iron absorption. Deficiency can also cause scurvy, hair loss and easy bruising and bleeding.
name: Teeth and gum disease
label: d
answer: no
explanation: This is caused by a deficiency of vitamin E, which works as an important antioxidant. Deficiency can also cause myopathy, neuropathy and ataxia.
name: Haemolytic anaemia
label: a
answer: yes
explanation: This is caused by a deficiency of vitamin B12, which helps form red blood cells and DNA. Deficiency can also cause macrocytic anaemia and peripheral neuropathy.
name: Malabsorption
label: c
answer: no
explanation: This is caused by deficiency of vitamin D, which increases intestinal absorption of calcium and is used in the resorption and formation of bone. Deficiency can also cause rickets in adults due to the demineralisation of bone.
name: Osteomalacia
label: e
answer: no

Correct answer: a
Which of the following is the correct order for fracture healing?

Options:
explanation: The correct order is inflammation (0-7 days after injury), repair (2-3 weeks after injury) and remodelling (can continue from months-years after injury).
name: Inflammation, remodelling and repair
label: b
answer: no
explanation: The correct order is inflammation (0-7 days after injury), repair (2-3 weeks after injury) and remodelling (can continue from months-years after injury).
name: Repair, inflammation and remodelling
label: e
answer: no
explanation: The correct order is inflammation (0-7 days after injury), repair (2-3 weeks after injury) and remodelling (can continue from months-years after injury).
name: Remodelling, inflammation and repair
label: c
answer: no
explanation: The correct order is inflammation (0-7 days after injury), repair (2-3 weeks after injury) and remodelling (can continue from months-years after injury).
name: Remodelling, repair and inflammation
label: d
answer: no
explanation: Inflammation occurs 0-7 days after injury, followed by repair 2-3 weeks after injury, and,finally, remodelling which can continue from months-years after injury.
name: Inflammation, repair and remodelling
label: a
answer: yes

Correct answer: a
What type of neurotransmitter receptors are found in the neuromuscular junction?

Options:
explanation: These receptors respond to acetylcholine and nicotine and are present in the neuromuscular junction. In skeletal muscle, Ach promotes muscle contraction, but in the heart, it inhibits muscle contraction.
name: Nicotinic acetylcholine receptors
label: a
answer: yes
explanation: Glutamate is the main excitatory neurotransmitter in the brain.
name: Glutamate receptors
label: c
answer: no
explanation: These receptors respond to acetylcholine, and are present in the brain and where the PNS innervates peripheral glands or organs.
name: Muscarinic acetylcholine receptors
label: b
answer: no
explanation: Noradrenaline is the main neurotransmitter in the heart and CNS.
name: Noradernaline receptors
label: e
answer: no
explanation: GABA is the main inhibitory neurotransmitter in the brain.
name: GABA receptors
label: d
answer: no

Correct answer: a
Spermatogenesis is the process of forming sperm from the primordial germ cells.

In this process, from which of the following cells do spermatozoa directly differentiate?

Options:
explanation: Type B spermatogonia are progenitor cells that differentiate into primary spermatocytes.
name: Type B spermatogonia
label: c
answer: no
explanation: Spermatozoa are the final form of sperm and these differentiate from spermatids.
name: Spermatids
label: a
answer: yes
explanation: Type A spermatogonia are undifferentiated germ cells and remain as stem cells to produce more daughter cells, or mature into type B spermatogonia.
name: Type A spermatogonia
label: b
answer: no
explanation: A primary spermatocyte will undergo meiosis I to produce two secondary spermatocytes. These will then undergo meiosis II to produce a total of four spermatids.
name: Secondary spermatocytes
label: e
answer: no
explanation: Primary spermatocytes are differentiated from type B spermatogonia.
name: Primary spermatocytes
label: d
answer: no

Correct answer: a
A 43-year-old man has been started on spironolactone and requires monthly renal function monitoring. His two most recent results show a significant raise in eGFR.

Which of the following is the most likely cause of his results?

Options:
explanation: Dehydration reduces systemic blood volume, which decreases renal blood flow, causing the kidneys to release angiotensin II (which vasoconstricts efferent arterioles) and prostaglandins (which dilates afferent arterioles). This leads to reduced fluid pressure in the glomerulus, reducing GFR.
name: Dehydration
label: c
answer: no
explanation: Chronic kidney disease can lead to issues such as dehydration and volume loss as the kidneys are responsible for maintaining fluid balance. This decreases renal blood flow, causing the kidneys to release angiotensin II (which vasoconstricts efferent arterioles) and prostaglandins (which dilates afferent arterioles). This leads to reduced fluid pressure in the glomerulus, reducing GFR.
name: Chronic kidney disease
label: d
answer: no
explanation: Raised GFR can be caused by a build-up of pressure in the glomerulus from constricted efferent or dilated afferent arterioles. High dietary proteins can lead to afferent arteriole dilation.
name: Increased dietary protein
label: a
answer: yes
explanation: Hypotension decreases renal blood flow, causing the kidneys to release angiotensin II (which vasoconstricts efferent arterioles) and prostaglandins (which dilates afferent arterioles ). This leads to reduced fluid pressure in the glomerulus, reducing GFR.
name: Low blood pressure
label: e
answer: no
explanation: Large losses of blood cause hypotension, which decreases renal blood flow, causing the kidneys to release angiotensin II (which vasoconstricts efferent arterioles) and prostaglandins (which dilates afferent arterioles). This leads to reduced fluid pressure in the glomerulus, reducing GFR.
name: Blood loss
label: b
answer: no

Correct answer: a
A two-year-old girl is found to have a heart murmur caused by a patent foramen ovale.

What is the function of the foramen ovale in utero?

Options:
explanation: This is the function of the umbilical arteries. After birth, the proximal umbilical arteries become the internal iliac and superior vesical arteries, while distal portions are obliterated and form the medial umbilical ligaments.
name: Carries deoxygenated blood from the foetus to the placenta
label: e
answer: no
explanation: This is the function of the ductus arteriosus. It shunts oxygenated blood to bypass the non-functioning foetal lungs. Its' remnant forms the ligamentum arteriosum shortly after birth.
name: Shunts blood from the pulmonary trunk to the aorta
label: b
answer: no
explanation: This is the function of the foramen ovale. It shunts oxygenated blood to bypass the non-functioning foetal lungs, which are fluid-filled. Normally, the foramen ovale completely closes a few months after birth.
name: Shunts blood from the right atrium to the left atrium
label: a
answer: yes
explanation: This is the function of the umbilical vein. After birth, the umbilical vein obliterates and its' remnant forms the ligamentum teres.
name: Carries oxygenated blood from the placenta to the foetus
label: d
answer: no
explanation: This is the function of the ductus venosus. It shunts oxygenated blood to bypass the semi-functional foetal liver. Its' remnant forms the ligamentum venosum shortly after birth.
name: Shunts blood from the umbilical vein to the inferior vena cava
label: c
answer: no

Correct answer: a
In the Krebs Cycle, which of the following does succinate dehydrogenase convert succinate into?

Options:
explanation: This is produced from oxaloacetate and Acetul-CoA via citrate synthase and marks the start of a new Krebs cycle rotation. It then produces isocitrate via aconitase.
name: Citrate
label: e
answer: no
explanation: This is produced from alpha-ketoglutarate via alpha-ketoglutarate dehydrogenase, and produces NADH and CO2 as a byproduct. It then produces succinate via succinate thiokinase.
name: Succinyl-CoA
label: b
answer: no
explanation: This is produced from malate via malate dehydrogenase and produces NADH as a byproduct. It then produces succinate via succinate thiokinase.
name: Oxaloacetate
label: d
answer: no
explanation: This is produced from citrate via aconitase. It then produces alpha-ketoglutarate via isocitrate dehydrogenase.
name: Isocitrate
label: c
answer: no
explanation: This is produced from succinate via succinate dehydrogenase and produces FADH2 as a byproduct. It then produces malate via fumarate hydrase.
name: Fumarate
label: a
answer: yes

Correct answer: a
During mitosis, at what stage do sister chromatids separate to opposite poles of the cell?

Options:
explanation: This is the first stage of mitosis, where the nuclear membrane disintegrates. The chromatin in the cells condenses into chromosomes.
name: Prophase
label: b
answer: no
explanation: This is the third stage of mitosis, where the chromosomes line up along the metaphase plate in the centre.
name: Metaphase
label: d
answer: no
explanation: This is the second stage of mitosis, where the cell no longer has a nucleus. Microtubules also invade the nuclear space, chromatids attach to the microtubules, and chromosomes attach to spindle fibres via the centromere.
name: Prometaphase
label: c
answer: no
explanation: This is the fourth stage of mitosis, where sister chromatids separate and are pulled to opposite poles of the cells via their centromeres as spindle fibres contract.
name: Anaphase
label: a
answer: yes
explanation: This is the fifth stage of mitosis where the nuclear membrane reforms, the chromosomes unfold into chromatin and cytokinesis begins.
name: Telophase
label: e
answer: no

Correct answer: a
An ECG shows an anteroseptal infarction suggestive of ischaemia to the left ventricle and the interventricular septum.

Which coronary artery has most likely been affected by the infarction?

Options:
explanation: This supplies the right atrium and the right ventricle.
name: Right coronary artery
label: e
answer: no
explanation: This supplies part of the right ventricle, the left ventricle and the interventricular septum.
name: Left anterior descending artery
label: a
answer: yes
explanation: This supplies the right ventricle and apex of the heart.
name: Right marginal artery
label: d
answer: no
explanation: This supplies the left atrium and part of the left ventricle, but it does not supply the interventricular septum.
name: Left circumflex artery
label: b
answer: no
explanation: This only supplies the left ventricle, so would not explain the ischaemia of the interventricular septum.
name: Left marginal artery
label: c
answer: no

Correct answer: a
A 72-year-old man is brought to A&E with persistent vomiting, new onset arrhythmia and normal breathing. An arterial blood gas (ABG) is taken and is shown below:

- pH: 7.55 (7.35-7.45)
- pO2: 10.5 (10-14)
- pCO2: 5.0 (1.5-6.0)
- HCO3-: 30 (22-26)
- BE: +5 (-2 to +2)
What is the most appropriate interpretation of this ABG?

Options:
explanation: There would be an increase in HCO3-, and buffering capacity, causing a rise in pH, suggesting metabolic alkalosis. With respiratory compensation, lung chemoreceptors are inhibited, reducing respiration and increasing CO2, which decreases pH.
name: Metabolic alkalosis with respiratory compensation
label: e
answer: no
explanation: There would be a rise in H+ (acid) production and loss of buffering, leading to a decreased HCO3- and decreased pH, suggesting metabolic acidosis. With respiratory compensation, lung chemoreceptors are stimulated, increasing respiration and decreasing CO2, to help increase the pH.
name: Metabolic acidosis with respiratory compensation
label: b
answer: no
explanation: There would be an increase in pCO2 causing a drop in pH, suggesting respiratory acidosis. With renal compensation the kidneys increase H+ secretion, which increases HCO3- release, leading to a pH increase.
name: Respiratory acidosis with renal compensation
label: d
answer: no
explanation: There would be a decrease in CO2, leading to a raised pH, suggesting respiratory alkalosis. With renal compensation, the kidneys retain H+ by decreasing H+ secretion, which also results in decreased HCO3- reabsorption which lowers the buffering capacity and base excess, decreasing the pH.
name: Respiratory alkalosis with renal compensation
label: c
answer: no
explanation: The patient has a raised pH, suggesting alkalosis. His pO2 and pCO2 levels are normal, whilst his HCO3- is raised, suggesting a metabolic cause. If he had respiratory compensation, he would have a raised pCO2, essentially meaning he would have to hypoventilate.
name: Metabolic alkalosis with no respiratory compensation
label: a
answer: yes

Correct answer: a
Which of the following is not a component of hepatic bile?

Options:
explanation: Small amounts of hepatic bile are made from bilirubin and proteins.
name: Protein
label: e
answer: no
explanation: Small amounts of hepatic bile are made from cholesterol.
name: Cholesterol
label: d
answer: no
explanation: Carbohydrates are not a component of hepatic bile. Hepatic bile is a complex lipid-rich micellar solution that contains water, inorganic electrolytes and organic solutes.
name: Carbohydrate
label: a
answer: yes
explanation: Lithocholic is a bile acid. Two-thirds of hepatic bile is made of bile acids, which also includes cholic, chenodeoxycholic, deoxycholic and ursodeoxycholic.
name: Lithocholic
label: c
answer: no
explanation: Phospholipids make up one-quarter of hepatic bile.
name: Phospholipid
label: b
answer: no

Correct answer: a