Practice Questions

Practice QuestionsTrue or FalseThe antibody-mediated class of hypersensitivies primarily involves IgE

False IgE is in immediate hypersensitivity; IgG and IgM are in antibody-mediated hypersensitivityContact dermatitis is an example of cell-mediated hypersensitivity

TrueThe sensitisation phase of immediate hypersensitivity involves activation of Th2 cells, IgE class-switching, production of IgE and binding of IgE to Fc receptors on mast cells

TrueImmediate hypersensitivity reactions have both an immediate and a late phase

TrueOnly exogenous antigens can cause immune complex-mediated hypersensitivity

False both endogenous and exogenous antigens canActivation of mast cells anywhere within the body will produce the same allergic response

False it depends on where the mast cell is (eg. circulatory Vs respiratory Vs skin)Anaphylactic shock is due to pump failure

False anaphylactic shock is a type of distributive shock (not cardiogenic)Corticosteroids can be used as treatment for asthma and eczema

False glucocorticoids are usedAntihistamines selectively inhibit the H1 receptor

TrueDeep partial thickness burns are commonly painful, thus requiring strong pain relief.

False they are painlessFull thickness burns involve burns to the muscle underlying the subcutaneous tissue

False This burn only reaches the subcutaneous tissueSuperficial burns do not cause scarring

TrueThe Parkland formula is used to determine the volume of colloid needed for fluid resuscitation in burns patients.

False Parkland formula is used for crystalloids, Muir/Barclay formula is used for colloidsANZBA guidelines stipulate that full thickness burns >10%TBSA should be referred to a burns unit

False full thickness: >5% but other burns are >10%The first step in wound healing is inflammation

False it is haemostasis then inflammationHealing by second intention results in the formation of more granulation tissue and a larger fibrin clot than healing by first intention does

TrueAn autograft is a graft between sites on the same person

TrueSystemic inflammatory response syndrome is also known as the acute-phase response

TrueThe major manifestations of SIRS is a decreased HR, decreased BP, increased RR and increased partial pressure of CO2

False: increased HR, decreased BP, increased RR and decreased partial pressure of CO2The defining feature of severe sepsis is that it does not respond to fluid therapy

False Septic shock does not respond to fluid therapyHealth-care associated infections and hospital-acquired infections are the same

FalseFirst-line antibiotic choice is based on pathogen-directed therapy

False it is based on empiric therapy (aetiology is unknown)Tetracyclines bind the 30S ribosomal subunit to prevent protein synthesis

TrueTrimethoprim is a dihydrofolate reductase inhibitor

TrueThe vascular layer of the eyeball includes the choroid, ciliary body and iris

TrueThe superior rectus muscle caused elevation, adduction and medial rotation of the eye

TrueThe superior oblique is innervated by the abducens nerve

False it is innervated by the trochlear nerveThe ophthalmic artery supplies the orbit

TrueAccommodation is controlled by the ciliary muscles

TrueRods (photoreceptor cells) are concentrated at the fovea

False concentrated at the periphery of the retina (cones are concentrated at the fovea)The corneal reflex involves afferent facial nerve fibres and efferent trigeminal nerve fibres

False afferent trigeminal and efferent facialCataracts are growths of tissue on the sclera that may extend onto the cornea

False cataract = clouding of the lens; pterygium = growth of tissue on the sclera that may extend onto the corneaFreckles are a skin lesion which involve an increase in the number of pigment cells

False they involve increased pigment, but without an increase in the number of pigment cells34Adnexal tumours are benign epithelial tumours

TrueActinic keratosis are dysplastic lesions which can become SCCs

TrueThe growth phases of a malignant melanoma are (in correct order): lentigenous melanocytic hyperplasia; lentigenous junctional naevus; lentigenous compound naevus; early melanoma; advanced melanoma

TrueLentigo maligna melanoma usually occur on the chest

False they usually occur on the face of elderly patientsClark level II involves invasion of the reticular dermis

False papillary dermis onlyBCCs arise due to high-intensity sun exposure

False they are due to chronic sun exposureSCCs can be either in situ or invasive

TrueIt is a legal requirement for doctors to report on any patients lack of fitness to drive

FalseIn adults, red marrow is found in the appendicular skeleton

False it is found in the axial skeletonAplastic anaemia causes microcytic anaemia

False it causes normocytic anaemiaIn iron deficiency, MCV is decreased

TrueIron is stored attached to cytochrome B

False iron is stored as ferritin. Cytochrome B reduces Fe3+ to Fe2+ at the brush borderHepcidin inhibits ferroportin on enterocytes

TrueIntrinsic factor is secreted by chief cells in the gastric fundus

False - it is secreted by parietal cellsMegaloblastic anaemia is commonly treated by blood transfusion.

False it is generally treated by B12 supplementation, folate therapy and/or treatment of the underlying conditionThere can be both immediate and delayed haemolytic transfusion reactions

TrueHLA genes have been implicated in the development of autoimmunity

TrueParathyroid hormone is released in response to an increase in plasma Ca2+

False a decrease in plasma Ca2+Parathyroid acts on bone and kidney

True (bone resorption, Vit D3 activation, inc reabsorption of Ca2+, dec reabsorption of PO43-)RANKL stimulates osteoblast differentiation

False stimulates osteoclast differentiationRickets and osteomalacia have the same cause

TrueHyperplastic marrow is when red marrow is replaced by yellow marrow

False it is yellow marrow replaced by red marrow to facilitate production of blood cellsMyelodysplastic syndromes are caused by the ineffective differentiation of bone marrow cells

TrueMonoclonal gammopathy of uncertain significance show signs of anaemia

False elevated gamma globulin bands are seen on electrophoresis, but the patient is asymptomaticIn multiple myeloma, myeloma cell proliferation causes bone marrow replacement, an increase in monoclonal antibodies and osteoclast activation

TrueMultiple myeloma commonly affects the appendicular skeleton

False mostly it affects the axial skeletonChronic tiredness is defined by the lack of significant benefit being provided by rest (if present for >6 months)

TrueWe should generally encourage early mobilisation in patients with lower back pain

TrueIf there is already a PBS drug which adequately treats a condition, a newer, cheaper drug will not be added to the PBS list for the same disease

TrueExcessive prescription of antibiotics is an example of medical overservicing

TrueNeoplasms of peripheral B cells include CLL and Burkitt Lymphoma

True