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48 Cards in this Set
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ED01 [Mar96] [Mar97] [Jul99] Effects of a 24 hour fast:
A. Glycogenolysis (?gluconeogenesis) B. Protein catabolism C. Acidosis D. Ketone production from protein E. All of the above |
EM01 [ach] Effects of a 24 hour fast:
A. Glycogenolysis (?gluconeogenesis) – Yes, glycogen stores (liver 0.1kg & muscle 0.4kg) will last a day (Ganong, p290) B. Protein catabolism – only prolonged fasting C. Acidosis – only prolonged fasting D. Ketone production from protein – only prolonged fasting E. All of the above – if the question was >24 hours and A = gluconeogenesis then this would be the correct option |
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After 24 hours without food or water a healthy young adult will:
A. Deplete glycogen rapidly B. Develop a metabolic acidosis C. Demonstrate ketone body formation in the liver D. Have decreased protein content of body |
After 24 hours without food or water a healthy young adult will:
A. Deplete glycogen rapidly – No, it should only last about 24 hours (and the question states ‘after’) B. Develop a metabolic acidosis C. Demonstrate ketone body formation in the liver – Correct – lipid metabolism, production of Acetyl-CoA in the absence of adequate carbohydrates… D. Have decreased protein content of body |
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ED02 [Mar96] Which hormone causes increased BSL, increased protein anabolism & increased plasma FFA?
A. Cortisol B. Parathyroid hormone C. Growth hormone D. Insulin |
ANSWER C
A. Cortisol – Increases BSL (hepatic glycogenolysis & gluconeogenesis) and increases FFA (by producing a protein which increases the action of cAMP), but increases protein CATABOLISM B. Parathyroid hormone – no effects on CHO, protein & fat metabolism C. Growth hormone – Yes, increases hepatic glucose output, protein anabolic hormone, and increases FFA in blood (by producing a protein which enhances catecholamine’s ability to activate cAMP) – (Ganong, p297 &387) D. Insulin – No, it decreases FFA (by decreasing hormone sensitive lipase activity) |
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ED03 [Mar96] Which hormone causes increased BSL, increased protein catabolism & increased plasma FFA?
A. Cortisol B. Parathyroid hormone C. Growth hormone D. Insulin |
ANSWER A
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ED04 [Mar96] Which of the following are associated with adrenocortical hypofunction?
A. Aseptic necrosis of bone B. Osteoporosis C. Redistribution of body fat D. Decreased muscle bulk E. Delayed closure of epiphyses |
EM04 [a] Which of the following are associated with adrenocortical hypofunction?
A. Aseptic necrosis of bone B. Osteoporosis C. Redistribution of body fat D. Decreased muscle bulk E. Delayed closure of epiphyses Who knows? (obviously an examiner does)! |
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ED05 [Mar96] [Jul97] [Mar98] [Jul01] [Jul04] The hypothalamus inhibits the release of:
A. TSH B. ACTH C. FSH D. GH E. Oxytocin |
Answer D
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ED06 [Mar97] [Jul00] [Jul01] [Mar03] [Jul03] Secretion of renin is stimulated by:
A. Increased left atrial pressure B. Increased angiotensin II C. Decreased right atrial pressure D. ??erythropoietin |
EM06 [cjl] Secretion of renin is stimulated by:
A. Increased left atrial pressure – No this secretes naturetic peptide B. Increased angiotensin II – No, this stimulates angiotensinogen production, but has a negative effect on renin production C. Decreased right atrial pressure – Probably, a low pressure baroceptor response? |
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Which decreases renin release:
A. PG B. Angiotensin II C. Vasopressin D. Baroceptor stimulation E. ANP F. Increased right atrial pressure |
Which decreases renin release:
A. PG – No, this stimulates renin secretion B. Angiotensin II – Correct, negative feedback by A2 on renin release C. Vasopressin – Correct, this inhibits renin secretion D. Baroceptor stimulation – No, this would increase renin secretion E. ANP |
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ED07 [Mar97] [Apr01] Regarding hyperglycaemia: Which of the following is untrue? It causes:
A. Increased H+ B. Increased Na+ (?K+) C. Increased urine output D. Increased ECF (or blood volume) E. Increased glucagon |
EM07 [ck] Regarding hyperglycaemia: Which of the following is untrue? It causes:
A. Increased H+ B. Increased Na+ (?K+) C. Increased urine output D. Increased ECF (or blood volume) E. Increased glucagon – No, decreased |
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ED08 [Jul97] [Mar99] [Feb00] [Apr01] [Feb04] Mechanism of action of ADH:
A. Insertion of water channels (pores) into basolateral membrane B. Increase in GFR C. Insertion of water channels into luminal (apical) membrane D. Increased Na+ uptake in DCT E. Removal of water pores from apical membrane |
ANSWER C
A. Insertion of water channels (pores) into basolateral membrane – No, apical membrane B. Increase in GFR – No, nil effect on afferent/efferent arterioles or GFR - (may have indirect effect when ADH from hypotension) C. Insertion of water channels into luminal (apical) membrane – V2 receptors -> Adenalyl cyclase -> cAMP acting on vesicles containing Aquaporin-2 Channels (removed when cAMP levels fall) D. Increased Na+ uptake in DCT E. Removal of water pores from apical membrane – No, this occurs when cAMP levels fall |
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ADH and the cortical collecting ducts
A. Inserts water channels into the apical membrane B. Inserts water channels into the basolateral membrane C. Increases paracellular flow |
ADH and the cortical collecting ducts
A. Inserts water channels into the apical membrane – Correct B. Inserts water channels into the basolateral membrane - Incorrect C. Increases paracellular flow – No, the water flows down its osmotic gradient, THROUGH the cells, not between them |
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ED09 [Jul97] How many hours after a meal is Basal Metabolic Rate (BMR) measured?
A. 1 hour B. 2 hours C. 6 hours D. 12 hours E. 18 hours |
ANSWER D
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ED10 [Jul97] [Feb00] Which ONE of the following is a water soluble vitamin?
A. Vitamin A B. Vitamin B C. Vitamin D D. Vitamin E E. Vitamin K |
EM10 [di] Which ONE of the following is a water soluble vitamin?
A. Vitamin A B. Vitamin B – Correct (also other B vitamins & vitamin C) C. Vitamin D D. Vitamin E E. Vitamin K |
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ED11 [Jul97] [Jul99] [Apr01] Insulin (? OR: Insulin receptor):
A. Receptor site intracellular B. Inactivates tyrosine kinase C. Activates membrane glucose transport D. Acts via activation of transport protein to increase glucose transport into cells |
ANSWER C
A. Receptor site intracellular – No, extracellular (2 alpha subunits), and the 2 beta subunits are intracellular B. Inactivates tyrosine kinase – Insulin binds to receptor, triggering the tyrosine kinase activity of the beta subunits C. Activates membrane glucose transport – probably most correct (it acts by fusing vesicles containing glucose transporters to the membrane) D. Acts via activation of transport protein to increase glucose transport into cells – Doesn’t strictly ‘activate’ the channel protein… |
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ED11b [Mar02] [Jul02] How does insulin act?
A. Voltage gated ion channels B. Tyrosine kinase membrane receptor C. Nuclear receptor D. G protein E. ? |
EM11b [mn] How does insulin act?
A. Voltage gated ion channels B. Tyrosine kinase membrane receptor - Correct C. Nuclear receptor D. G protein E. ? |
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EM12]] [Jul97] [Jul01] Heat production at rest is mostly due to:
A. Skeletal muscle activity B. Na-K ATPase pump C. Dynamic action of food D. ? |
EM12 [dl] Heat production at rest is mostly due to:
A. Skeletal muscle activity – Not really the ‘most’ correct B. Na,K ATPase pump – Yes, accounts for about 30% of basal activity, most is actually for ATP synthesis C. Dynamic action of food D. ? |
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ED12b [Feb00] [Mar02]
Decreased heat production under general anaesthesia is due to: A. Decreased skeletal muscle tone B. Decreased anterior pituitary function C. Vasodilatation D. Starvation E. Decreased Na+/K+ ATPase activity |
EM12b [i] Decreased heat production under general anaesthesia is due to:
A. Decreased skeletal muscle tone – Correct (as the question mentions ‘decreased production’ and ‘GA’) B. Decreased anterior pituitary function C. Vasodilatation D. Starvation E. Decreased Na+/K+ ATPase activity |
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Mar 2002 version:
Heat loss in anaesthesia due to A. Loss Na/K ATPase (?) B. Loss of skeletal muscle tone C. Vasodilatation D. Respiratory tract E. ? |
Mar 2002 version:
Heat loss in anaesthesia due to A. Loss Na/K ATPase (?) B. Loss of skeletal muscle tone C. Vasodilatation – Correct (the question has ‘heat loss’ in it) D. Respiratory tract E. ? |
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EM13]] [Jul97] [Mar99] [Jul00] Angiotensinogen secretion is increased by:
A. ACTH B. Beta-endorphin C. Growth hormone D. Antidiuretic hormone E. Prolactin |
EM13 [dgj] Angiotensinogen secretion is increased by:
A. ACTH - Probably, glucocorticoids increase angiotensinogen secretion (Ganong, p439) B. Beta-endorphin C. Growth hormone D. Antidiuretic hormone E. Prolactin |
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ED14 [Jul97] [Jul01] The energy value of 1g of carbohydrate is:
A. 3 kcal B. 4 kcal C. 5 kcal D. 7 kcal E. 9 kcal |
EM14 [dl] The energy value of 1g of carbohydrate is:
A. 3 kcal B. 4 kcal – 4.1kcal/g liberated from carbohydrate C. 5 kcal D. 7 kcal E. 9 kcal |
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ED15 [Mar98] [Jul01] Oxytocin causes:
A. Decrease in systolic blood pressure B. Water intoxication C. Increase in cardiac output D. Increase in systolic blood pressure E. All of the above |
ANSWER A
A. Decrease in systolic blood pressure - Yes, most correct of the options… B. Water intoxication – Not necessarily C. Increase in cardiac output – Yes, but not directly (vasodilatation, reflex tachycardia and therefore increased CO) D. Increase in systolic blood pressure – Not usually E. All of the above |
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ED16 [Mar98] [Mar99] ADH secretion:
A. Plasma osmolality at osmoreceptors in posterior hypothalamus B. Decreased ECF volume C. ? |
EM16 [eg] ADH secretion:
A. Plasma osmolality at osmoreceptors in posterior hypothalamus – Yes, very sensitive (1-2% change) – location ??posterior (could be wrong) B. Decreased ECF volume – Yes, hypovolaemia is not as sensitive, but is very potent cause of ADH secretion C. ? |
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ED18 [Jul98] [Jul99] [Apr01] [Jul02] G protein coupled receptors. All true EXCEPT:
A. Seven transmembrane components B. Hydrophobic links C. Extracellular portion for phosphorylation D. G protein has intrinsic GTPase activity E. The receptor is a heterotrimeric protein |
EM18 [fhk] G protein coupled receptors. All true EXCEPT:
A. Seven transmembrane components – yes B. Hydrophobic links C. Extracellular portion for phosphorylation – No, they are intracellular D. G protein has intrinsic GTPase activity – Yes, the alpha-subunit has GTPase activity E. The receptor is a heterotrimeric protein – No, the G protein is – the receptor is coupled to it… |
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G proteins include:
A. Multiple external phosphorylation sites B. Alpha subunit has GTPase activity C. |
G proteins include:
A. Multiple external phosphorylation sites B. Alpha subunit has GTPase activity – true C. (Comment: also remembered as ATPase activity. The intrinsic GTPase activity resides in the alpha sub-unit. The G protein is the heterotrimer not the GPCR) |
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ED19 [Jul98] Regarding the interthreshold range in temperature control:
A. Is constantly altered by feedback from temperature sensors in the periphery B. Is lowered by general anaesthetic agents C. ? D. |
EM19 [f] Regarding the interthreshold range in temperature control:
A. Is constantly altered by feedback from temperature sensors in the periphery – Nope… B. Is lowered by general anaesthetic agents – No the range is INCREASED by anaesthesia C. ? D. |
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ED19b [Jul98] The set-point of temperature of an adult is normally 37.1C. This:
A. Is fixed in individuals B. ? C. Parallels rectal temperature D. Decreases with exercise E. Decreases with anaesthesia |
EM19b [f] The set-point of temperature of an adult is normally 37.1C. This:
A. Is fixed in individuals – No, variation (SD2 – 95%) – 36.3-37.1 – and changes with diseases/drugs etc B. ? C. Parallels rectal temperature – Not if they are hypo/hyperthermic (no correlation with ‘set point’) D. Decreases with exercise – No, unchanged E. Decreases with anaesthesia – No, the set-point is unaltered but the interthreshold range in increased… |
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ED20 [Jul98] [Feb00] Decrease in set temperature in anaesthesia due to:
A. Decreased Na+-K+ ATPase activity B. Decreased skeletal muscle activity C. Vasodilatation D. Starvation E. None of the above |
ANSWER E
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ED21 [Jul98] [Mar99] [Apr01] Endothelins:
A. Produced by damaged vascular endothelium B. Vasoactive C. Found in brain & intestine D. ? |
EM21 [fgk] Endothelins:
A. Produced by damaged vascular endothelium - Correct B. Vasoactive - Correct C. Found in brain & intestine – Correct D. ? Ganong p576-577 |
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ED22 [Jul98] [Feb04] Growth hormone:
A. Increases fatty acid production B. Increases glucose output form the liver C. Causes ketosis D. Provides a source of energy during hypoglycaemia E. Increases free fatty acids F. all of the above G. Increase glucose output from liver H. Increase plasma FFA I. Can act as an energy source during starvation |
Growth Hormone DOES all of the above with increased FFA production and release from adipose tissue, therefore, can lead to ketosis. Hepatic glycogenolysis is promoted with reduced glucose uptake by tissues.
Therefore, the answer is F |
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ED23 [Mar99] [Jul00] [Feb04] A low respiratory quotient in a septic patient is due to:
A. Increased lactic acid B. Fat metabolism C. Increased ventilation D. Fever E. Hypoxaemia |
EM23 [gj] A low respiratory quotient in a septic patient is due to:
A. Increased lactic acid B. Fat metabolism – Correct, sepsis -> increased fat metabolism -> decreased RQ C. Increased ventilation – No, this increases CO2 ‘output’ and therefore increases RQ D. Fever E. Hypoxaemia |
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Respiratory exchange ratio increased in septic patient because
A. Increased C02 output B. Increased 02 uptake C. Increased fat utilisation D. ? (? respiratory quotient) |
Respiratory exchange ratio increased in septic patient because
A. Increased C02 output – No, this increases CO2 ‘output’ and therefore increases RQ B. Increased 02 uptake C. Increased fat utilisation – Correct, sepsis -> increased fat metabolism -> decreased RQ D. ? |
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ED23b [Mar03] [Jul03] Respiratory exchange ratio:
A. Always equals respiratory quotient B. Increases in strenuous exercise C. Decreases after payment of oxygen debt D. Is measured at steady state E. ? |
EM23b [o] Respiratory exchange ratio:
A. Always equals respiratory quotient – West says they’re the same! Pfft… B. Increases in strenuous exercise – Yes, may be as hight as 2 C. Decreases after payment of oxygen debt - Correct D. ? |
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ED24 [Feb00] Lactate
A. The way products of glucose enter the citric acid cycle B. Formation used to regenerate NADP C. ? |
EM24 [i] Lactate
A. The way products of glucose enter the citric acid cycle – No, Pyruvate -> Acetyl-CoA enters TCA B. Formation used to regenerate NADP – No, pyruvate -> lactate generates NAD+ from NADH (NADH isn’t converted by oxidative phosphorylation anaerobically – not possible!) C. ? |
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Normal blood lactate level is 2 mmol/l. Where does this come from
A. Even in resting individuals there is some anaerobic metabolism B. Lactate is the substrate that is produced to enter the citric acid cycle |
Normal blood lactate level is 2 mmol/l. Where does this come from
A. Even in resting individuals there is some anaerobic metabolism – Lactate produced under normal conditions comes from overflow from glycolysis, not anaerobic metabolism -> it’s then metabolised in the liver to glucose or TCA (Cori Cycle) B. Lactate is the substrate that is produced to enter the citric acid cycle – No, Acetyl-CoA (from Pyruvate) |
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ED25 [Jul00] [Mar02] [Jul02] [Mar03] [Jul03] Phosphorylase:
A. Is found in all human cells B. Present in liver & muscle C. Increased activity by adrenaline D. In liver increases glycogen production and reduce breakdown of glycogen E. “Something about cAMP/adrenergic transmission” |
EM25 [j] Phosphorylase:
A. Is found in all human cells - no B. Present in liver & muscle – Correct (and kidneys) C. ? D. Something about glucagon & the liver – (liver only) similar to below… E. Something about cAMP/adrenergic transmission – (in muscle & ?liver) B2 receptor->adenylyl cyclase- >cAMP->Protein Kinase A->Phosphorylase a->glycogenolysis |
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During starvation:
A. Glucagon causes increased phosphorylase activity in liver/muscle B. Adrenaline causes increased phosphorylase activity in liver/muscle C. ? |
During starvation:
A. Glucagon causes increased phosphorylase activity in liver/muscle B. Adrenaline causes increased phosphorylase activity in liver/muscle - Correct C. ? |
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ED26 [Jul99] [Feb00] [Apr01] [Jul01] [Jul02] [Jul04] Creatine phosphate:
A. Is a source of creatinine for protein synthesis. B. Is a source of cyclic AMP for second messenger systems. C. Is a high energy phosphate source for muscle contraction. D. Is a source of urea for loop of Henle gradient E. Energy source for ADP production. |
ANSWER C
A. Is a source of creatinine for protein synthesis.- it is not used for protein synthesis (most is excreted renally) B. Is a source of cyclic AMP for second messenger systems – No, cAMP formed from ATP by adenylyl cyclase C. Is a high energy phosphate source for muscle contraction. – Yes, but not directly (phosphorylcreatine), in muscle used as source of energy to replenish ATP (probably the most correct answer though) D. Is a source of urea for loop of Henle gradient – No, urea is from NH4+ which is a byproduct of deamination of amino acids in the liver E. Energy source for ADP production. – No, used for ATP production in muscle (Q 54 Jul 01) |
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Creatine phosphate is important in:
A. Readily usable phosphate for muscle upon intensive exercise B. Synthesis of urea C. Supply of ATP D. ? |
ANSWER C
Creatine phosphate is important in: A. Readily usable phosphate for muscle upon intensive exercise – Yes, but not directly (see below) B. Synthesis of urea – No (see above) C. Supply of ATP – the primary process in muscle is that it supplies energy to replenish ATP, muscle doesn’t take the energy directly from the Creatine-phosphate (Ganong, p286) D. ? |
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?Creatinine ?Creatine
A. ?Phosphorylcreatine is synthesised in the liver B. ?Phosphorylcreatine is excreted in the urine C. ?During exercise phosphorylcreatine reacts with ADP D. ? E. Rate of creatinine (?excretion/production) remains constant throughout life |
?Creatinine ?Creatine
A. ?Phosphorylcreatine is synthesised in the liver – No, muscle B. ?Phosphorylcreatine is excreted in the urine – No, needs to be converted to Creatinine C. ?During exercise phosphorylcreatine reacts with ADP – Yes, it reacts with ADP to form ATP D. ? E. Rate of creatinine (?excretion/production) remains constant throughout life - No |
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ED27 [Apr01] Metabolic rate is increased least with:
A. Exercise B. Specific dynamic action of food C. Hot climate D. Cold climate E. Increased CNS activity |
EM27 [k] Metabolic rate is increased least with:
A. Exercise B. Specific dynamic action of food C. Hot climate D. Cold climate E. Increased CNS activity – Provided no significant impact on SNS |
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ED28 [Apr01] Glucocorticoids
A. Increases RBC B. Increases lymphocytes C. ? |
EM28 [k] Glucocorticoids
A. Increases RBC – Correct, increases erythrocyte count (Goodman & Gillman 10th Ed, p1661) B. Increases lymphocytes – No, decreases (as well as eosinophils, monocytes, basophils) C. ? They also increase neutrophils |
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ED29 [Jul01] ADH secretion is decreased by:
A. Morphine B. Nicotine C. Nausea (?and vomiting) D. Hypoxia (or: ACTH) E. Alcohol |
EM29 [l] ADH secretion is decreased by:
A. Morphine B. Nicotine C. Nausea (?and vomiting) – No, increases ADH (Stress Response) D. Hypoxia (or: ACTH) E. Alcohol – Correct (Ganong, p237) |
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ED30 [Mar03] [Jul03] Calcitriol: Main actions on calcium by
A. Increased absorption of Ca++ and PO4 from gut B. Negative feedback on PTH C. Increased absorption of vit D from gut D. Increased parathormone levels |
ANSWER B
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PH28
Free fatty acids: A. Can be used as an energy source by heart and skeletal muscle B. Are bound to albumin C. Can be used by the brain once they are changed to ketones D. Can be changed to glucose |
ANSWER ABC
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PH42a [Jul97] [Jul98]
Thyroid hormones: A. Mainly release T4 which is converted to rT3 in the periphery B. Mainly releases T4 which is converted to T3 (which is the active form) in the periphery C. Peripherally converted to T3 and reverse T3 in equal proportions D. Releases equal amounts of T3 & T4 E. Converted peripherally to T2 & reverse T2 |
ANSWER C
The Thyroid gland releases three hormones. * T4 - majority * T3 - minority * Reverse T3 - relative minority Reverse T3 is pharmacologically inactive, whilst T4 and T3 have activity. T3 is more active than T4. In the periphery, T4 is converted to T3 and Reverse T3, by two enzymes - 5'-deiodinase and 5-deiodinase. Note the naming convention - the presence of absence of the prime indicates which portion of T4 is affected by each respective enzyme. Figures vary, but approximately: 40-60% of T4 converted to T3 by 5'-deodinase 40-60% of T4 converted to reverse T3 by 5-deodinase. Ie. Essentially in equal parts. |
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PH42b ANZCA version [2002-Mar] Q40
Tetra-iodothyronine (T4) is converted peripherally in the tissues to A. equal quantities of tri-iodothyronine (T3) and reverse T3 B. mainly reverse T3 since this is the biologically active hormone C. mainly T3 D. a greater proprtion of T3 during periods of surgical stress E. equal quantities of di-iodothyronine (T2) and reverse T2 |
ANSWER A
Option A is correct. B incorrect. T4 is converted approximately equally to T3 and RT3. C incorrect. T4 is converted equally. D incorrect. Greater proportion of reverse T3 during times of surgical stress. E is clearly made up. |
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PH47 [Aug99] [Mar00]
Albumin: A. Produced at 12G/day B. Interstitial fluid concentration is 7G% C. Mostly intravascular D. Leaks out of intravascular space at ?1.5g/day E. ? half-life of 18 hours |
ANSWER A
A True - 9-12g/day 120-300mg/kg/day B IV concentration is 30-40g/l = 30mg/ml = 3%. Lower concentration in interstitium. Think4% albumex. C False Although albumin is perceived as intravascular protein, the total extravascular albumin actually exceeds the total intravascular amount by 30%. * The ratio of albumin to water is, however higher in the intravascular space (the extracellular fluid is 2/3 interstitial and 1/3 intravascular), hence the colloidal effect. D FALSE 4 - 5% of total intravascular albumin extravascates in this way per hour 0.05 x 30g/L = 1.5g/h E False - Half life is 20 days |
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PH58 [Mar06] [Jul06]
The magnesium concentration at which loss of deep tendon reflexes typically occurs is: A. 2 mmol/l B. 3.5 mmol/l C. 5 mmol/l D. 8 mmol/l E. 12 mmol/l |
ANSWER C
Therapeutic 4-6mEq/L (=2-3 mmol/l) Loss of deep tendon reflex and widened QRS at 10mEq/L (= 5 mmol/l) Respiratory arrest 15mEq/L (=7.5 mmol/l) Asystole 20mEq/L (=10 mmol/l) |
