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Question 1 Correct Mark 1.00 out of 1.00

Wednesday, 15 January 2014, 5:13 PM Finished Wednesday, 15 January 2014, 5:16 PM 2 mins 51 secs 40.00/40.00 10.00 out o a ma!imum o 10.00 "100#$

Question text Doctors are most unlikely to write prescription of drugs using Select one: a. generic name b. approved name c. chemical name chemical name- Complete description of the substance chemically, e.g. 1-(Isopropyl amino)-3-(1naphthyloxy) propan-2-ol for propranolol d. proprietary (Brand) name e. official name Feedback The correct answer is: chemical name
Question 2 Correct Mark 1.00 out of 1.00

Question text Patients with chronic diseases like diabetes mellitus require daily administration of drugs. Which of the following parenteral routes is most suitable for self-administration of Insulin by patient? Select one: a. intramuscular b. intravenous c. subcutaneous Subcutaneous- Ready to use preparation available and suitable. d. intradermal

e. intra-arterial Feedback The correct answer is: subcutaneous

Question 3 Correct Mark 1.00 out of 1.00

Question text Bioavailability of an oral drug is MOST likely to remain normal in patient with Select one: a. liver dysfunction. b. cardiac failure. c. hyperthyroidism. d. extensive metabolism in gut wall. e. respiratory disorder. Respiratory disorder- Poor respiratory function may not disturb drug absorption from GI tract. Feedback The correct answer is: respiratory disorder.
Question 4 Correct Mark 1.00 out of 1.00

Question text The plasma protein with highest capacity to carry drugs in circulation is Select one: a. alpha-1 acid glycoprotein b. lipoprotein c. albumin Albumin has the highest capacity to bind drugs, being most abundant and possess weak to strong affinity to many drugs. Other plasma proteins are much lesser in amount and tend to be more selective for particular drug groups. d. globulin

e. fibrinogen Feedback The correct answer is: albumin

Question 5 Correct Mark 1.00 out of 1.00

Question text Adverse drug reactions can be predictable or unpredictable. Which of the following is unpredictable and can occur regardless of the dose? Select one: a. bleeding due to an anticoagulant (heparin, warfarin) b. postural hypotension with alpha adrenergic receptor blockers c. anaphylactic shock with penicillin anaphylactic shock with penicillin is unrelated to dose and unpredictable. d. hypoglycaemia with insulin e. cardiac arrhythmia with digoxin Feedback The correct answer is: anaphylactic shock with penicillin
Question 6 Correct Mark 1.00 out of 1.00

Question text Bronchoconstriction can result from activation of receptors on smooth muscle. Histamine H1receptor blockers can be of some help in treatment of bronchoconstriction due to Select one: a. methacholine (muscarinic Acetylcholine agonist) challenge b. anaphylactic shock in penicillin allergy anaphylactic shock in penicillin allergy, used as an adjunct i/v drug- Specific and most important drug is adrenaline inj. Chlorpheniramine can be given i/v as an adjunct, to prevent further effects. Adrenaline is a physiological antagonist to histamine and fully reverses bronchoconstriction.

c. bronchial asthma d. beta-1 adrenergic receptor blockers are used for hypertension e. an injection of adenosine for cardiac arrhythmia Feedback The correct answer is: anaphylactic shock in penicillin allergy
Question 7 Correct Mark 1.00 out of 1.00

Question text Mrs. M was treated with captopril (ACEI) for hypertension and she soon complained of dry cough. Which of the following mediators is MOST likely to cause this adverse effect? Select one: a. Serotonin b. Prostaglandin c. Histamine d. Bradykinin Bradykinin- ACEI (captopril etc.) blocks formation of angiotensin II and inhibits bradykinin metabolism. Bradykinin can cause dry hacking cough, first dose hypotension and angioedema. e. Thromboxane Feedback The correct answer is: Bradykinin
Question 8 Correct Mark 1.00 out of 1.00

Question text The MOST important therapeutic use of H2-antihistamines is in Select one: a. peptic ulcer disease peptic ulcer disease- therapeutic use of H2-antihistamines blocks gastric acid secretion mediated by H2 receptor, efficacy second to proton pump inhibitors.

b. nasal allergy c. anaphylactic shock d. urticaria e. motion sickness Feedback The correct answer is: peptic ulcer disease
Question 9 Correct Mark 1.00 out of 1.00

Question text A laboratory technologist was trying to identify bacteria X. He described the microscopic morphology of these bacteria as being Gram positive cocci and occurring as clusters. What are these bacteria MOST likely to be? Select one: a. Streptococcus pyogenes b. Staphylococcus aureus Staphylococcus aureus displays this form of microscopic morphology. c. Chlamydia trachomatis d. Escherichia coli e. Bacillus cereus Feedback The correct answer is: Staphylococcus aureus
Question 10 Correct Mark 1.00 out of 1.00

Question text Mycobacterium tuberculosis needed to be identified under the microscope. Which of the following stains would be useful in its identification? Select one: a. Dark ground microscopy

b. Ziehl-Neelsen stain Ziehl Neelsen stain is used to stain and identify Mycobacterium tuberculosis. c. Endospore staining d. Negative staining e. Giemsa staining Feedback The correct answer is: Ziehl-Neelsen stain
Question 11 Correct Mark 1.00 out of 1.00

Question text Which of the following structures in the bacterial cell is responsible for motility? Select one: a. the capsid b. the capsule c. flagella Only the flagella is involved with movement d. 70S ribosomes e. peptidoglycan layer Feedback The correct answer is: flagella
Question 12 Correct Mark 1.00 out of 1.00

Question text Organism Y is a gram positive, spore producing bacterium which produces neurotoxins. Which of the following organisms below BEST fits this description? Select one: a. Staphylococcus aureus

b. Corynebacterium diphtheriae c. Escherichia coli d. Clostridium tetani Clostridium tetani is a rod-shaped, anaerobic bacterium of the genus species Clostridium. Like other Clostridium genus species, it is Gram-positive, and its appearance on a gram stain resembles tennis rackets or drumsticks. C. tetani is found as spores in soil or in the gastrointestinal tract of animals. C. tetani produces a potent biological toxin, tetanospasmin, and is the causative agent of tetanus, a disease characterized by painful muscular spasms that can lead to respiratory failure and, in up to 40% of cases, death. e. Streptococcus pyogenes Feedback The correct answer is: Clostridium tetani
Question 13 Correct Mark 1.00 out of 1.00

Question text Which of the following chemicals is effective in destroying endospores? Select one: a. Chlorhexidine b. Ethyl alcohol c. Formaldehyde Among the most effective antimicrobials are the aldehydes such as formaldehyde. In the form of an aqueous solution, this gas is called formalin and is used to preserve biological specimens. Glutaraldehyde is a less irritating form; in a 2% solution (Cidex), it is bactericidal, tuberculocidal, and virucidal in 10 minutes. It is sporicidal after about 3 to 10 hours of contact. Both glutaraldehyde and formaldehyde are used for embalming. A possible replacement for glutaraldehyde is ortho-phthalaldehyde (OPA). d. Phenol e. chlorine Feedback The correct answer is: Formaldehyde
Question 14 Correct Mark 1.00 out of 1.00

Question text In the following immunoassay a test antigen is added to a solid phase antibody-1. This antigen binds with the antibody -1 and is then detected by an enzyme labelled antibody-2. The bound antigen and antibody is detected by colorimetric means. This assay is referred to as the Select one: a. Southern Blot b. Indirect immunoflourescence test c. Complement fixation test d. Enzyme Linked Immunosorbent Assay(ELISA) Enzyme-linked immunosorbent assay (ELISA), is a popular format of a "wet-lab" type analytic biochemistry assay that uses one sub-type of heterogeneous, solid-phase enzyme immunoassay (EIA) to detect the presence of a substance, usually an antigen, in a liquid sample or wet sample. Performing an ELISA involves at least one antibody with specificity for a particular antigen. The sample with an unknown amount of antigen is immobilized on a solid support (usually a polystyrene microtiter plate) either non-specifically (via adsorption to the surface) or specifically (via capture by another antibody specific to the same antigen, in a "sandwich" ELISA). After the antigen is immobilized, the detection antibody is added, forming a complex with the antigen. The detection antibody can be covalently linked to an enzyme, or can itself be detected by a secondary antibody that is linked to an enzyme through bioconjugation. Between each step, the plate is typically washed with a mild detergent solution to remove any proteins or antibodies that are not specifically bound. After the final wash step, the plate is developed by adding an enzymatic substrate to produce a visible signal, which indicates the quantity of antigen in the sample. e. Immunoprecipitation Feedback The correct answer is: Enzyme Linked Immunosorbent Assay(ELISA)
Question 15 Correct Mark 1.00 out of 1.00

Question text A 30-year-old patient in an intensive care unit developed sepsis in the tracheostomy wound. The causal organisms were aerobic, Gram-negative bacilli and were from an endogenous source. Which of the following is the MOST likely cause of the wound sepsis? Select one: a. Bacteroides fragilis b. Clostridium difficile

c. Mycobacterium smegmatis d. Pseudomonas aeruginosa The organisms stated are commensals and thus form an endogenous source of infection. Among the options given Pseudomonas and Bacteroides are gram-negative bacilli of which only Pseudomonas is aerobic. e. Staphylococcus epidermidis Feedback The correct answer is: Pseudomonas aeruginosa
Question 16 Correct Mark 1.00 out of 1.00

Question text The stomach does not harbour microorganisms due to its very acid pH. However, Gram-negative spiral bacteria can survive the gastric acidity and may cause disease. Which of the following is the MOST likely microorganism? Select one: a. Bacteroides fragilis b. Escherichia coli c. Klebsiella species d. Helicobacter pylori Helicobacter pylori is spiral and can survive the gastric acidity. e. Pseudomonas aeruginosa Feedback The correct answer is: Helicobacter pylori
Question 17 Correct Mark 1.00 out of 1.00

Question text A childhood viral infection which can result in congenital infection and birth defects in the baby if a woman is infected during pregnancy is preventable by vaccination. Which of the following is the appropriate vaccine to prevent this infection?

Select one: a. BCG vaccine b. DPT vaccine c. Hepatitis B vaccine d. MMR vaccine Measles,Mumps or rubella preventable by the MMR vaccine can cause transplacental transmission. Inutero rubella infection can result in congenital infection. e. OPV (Sabin vaccine) Feedback The correct answer is: MMR vaccine
Question 18 Correct Mark 1.00 out of 1.00

Question text An 23-year-old injecting drug user developed fever and sepsis. Which of the following microorganisms is MOST likely to be responsible? Select one: a. Diphtheroids b. Escherichia coli c. Lactobacilli d. Staphylococcus epidermidis The organism listed above form part of the normal flora of the body and can give rise to opportunistic infection. Staphylococcus epidermidis form part of the normal flora of the skin and is the most likely cause of sepsis in an injecting drug user. e. Streptococci Feedback The correct answer is: Staphylococcus epidermidis
Question 19 Correct Mark 1.00 out of 1.00

Question text

DPT is a vaccine included in the childhood immunisation programme in Malaysia to prevent three infectious diseases. Which of the following combination of infectious diseases will the vaccine prevent? Select one: a. Dengue, papilloma, tuberculosis b. Dengue, polio, tuberculosis c. Diarrhoea, plague, tularaemia d. Diphtheria, pertussis, tetanus DPT is a triple antigen vaccine that prevents three important childhood infectious diseases namely diphtheria, pertussis, and tetanus. Polio and tuberculosis are preventable by OPV and BCG vaccination respectively. e. Diphtheria, pneumococcal infection, tetanus Feedback The correct answer is: Diphtheria, pertussis, tetanus
Question 20 Correct Mark 1.00 out of 1.00

Question text A 45-year-old patient who was administered prolonged broad spectrum antibiotics developed oral thrush caused by budding yeast cells with pseudohyphae. What is the MOST likely organism for the patients illness? Select one: a. Aspergillus fumigatus b. Candida albicans The organisms stated are fungi which can cause opportunistic infection in a person whose defence mechanism has been compromised. Candida albicans is a fungus with budding yeast cells and pseudohyphae causing thrush. c. Cryptococcus neoformans d. Histoplasma capsulatum e. Pneumocystis jirovecii Feedback The correct answer is: Candida albicans
Question 21

Correct Mark 1.00 out of 1.00

Question text An infectious disease outbreak caused by an enveloped, icosahedral, RNA virus was reported. An aerial insecticide spraying was undertaken to control transmission of the infection. Which of the following infections is MOST likely to be responsible for this outbreak? Select one: a. Chikungunya Chikungunya is an arboviral infection and transmission is preventable by aerial spraying of insecticide. b. Measles c. Mumps d. Poliomyelitis e. Rabies Feedback The correct answer is: Chikungunya
Question 22 Correct Mark 1.00 out of 1.00

Question text A 24-year-old patient presented with tuberculosis and combination antimicrobial therapy was initiated. Which of the following is the MOST appropriate drug to be given in combination with Ethambutol and INH (Isoniazid)? Select one: a. Aminoglycoside b. Chloramphenicol c. Erythromycin d. Rifampicin Ethambutol, INH (Isoniazid) and Rifampicin are anti-tuberculous drugs given in combination as first-line treatment. e. Tetracycline Feedback

The correct answer is: Rifampicin

Question 23 Correct Mark 1.00 out of 1.00

Question text Which of the following statements is a definition for a reservoir host? Select one: a. Long term host that does not get the disease. Refers to the long-term host of a parasite which does not get the disease. It can be source of transmission to humans. b. Parasite larva survives, remains viable but does not develop further to adult stage. c. Parasite does not sexually reproduce. d. No exchange of genetic material between parasites in the host. e. Host in which the disease is symptomatic. Feedback The correct answer is: Long term host that does not get the disease.
Question 24 Correct Mark 1.00 out of 1.00

Question text Which of the following cestodes causes neurocysticercosis in humans? Select one: a. Diphyllobothrium latum b. Hymenolepis nana c. Dipylidium caninum d. Taenia solium Taenia solium is found in the pig and is commonly known as the pork tapeworm. Due to its ability to auto-infect the host, the larval stage can migrate to other parts of the body especially the brain and cause neurocysticercosis. e. Taenia saginata Feedback

The correct answer is: Taenia solium

Question 25 Correct Mark 1.00 out of 1.00

Question text Which of the following parasites reproduces asexually by binary fission? Select one: a. Brugia malayi b. Entamoeba histolytica Entamoeba histolytica is gastrointestinal protozoan that can divide asexually by binary fission. c. Ascaris lumbricoides d. Trichuris trichiura e. Necator americanus Feedback The correct answer is: Entamoeba histolytica
Question 26 Correct Mark 1.00 out of 1.00

Question text A child is running high fever. His skin is hot and dry. He has a history of febrile fits. Which of the following should you do as an emergency measure to rapidly bring down his temperature? Select one: a. Administer paracetamol orally b. Inject a drug which blocks muscarinic receptors c. Immerse the child in ice water for 15 minutes d. sponging the whole body with tepid water under electric fans Best among the given choices. Heat will be lost through skin vasodilation. At the same time, fanning will promote evaporation of water on the skin (a form of artificial sweating). e. keep him in a hot room to induce sweating Feedback

The correct answer is: sponging the whole body with tepid water under electric fans
Question 27 Correct Mark 1.00 out of 1.00

Question text The blood tends to pool at the lower limbs and causes oedema in the passengers of a long flight. Which of the following factors would be increased to cause the oedema? Select one: a. Intravascular hydrostatic pressure When the blood pools at the vein of the lower limbs due to muscle inactivity, the capillary pressure which is equivalent to intravascular the hydrostatic pressure will be increased. This will promote fluid filtration and oedema. b. Interstitial fluid hydrostatic pressure c. Intravascular oncotic pressure d. Interstitial fluid oncotic pressure e. Vascular permeability Feedback The correct answer is: Intravascular hydrostatic pressure
Question 28 Correct Mark 1.00 out of 1.00

Question text A study showed that the mean systolic blood pressure of a group of students before sitting an exam was raised. What could be the MOST likely factor that causes the rise in the systolic blood pressure? Select one: a. Increased urination b. Increased vasodilation c. Increased breathing rate d. Increased heart rate The sympathetic outflow to the heart will be increased in an anticipatory period. This would raise the heart rate and subsequently blood pressure. e. Increased water intake

Feedback The correct answer is: Increased heart rate

Question 29 Correct Mark 1.00 out of 1.00

Question text Cell X releases hormone Y as it is synthesized. Stimulation on cell X causes a gradual rise in plasma concentrations of hormone Y over a few days. Based on the observation, what can you conclude about the nature of hormone Y? Select one: a. Protein b. Polypeptide c. Amine d. Fatty acid derivative e. Steroid The steroid hormone is not stored in cells and is usually released once synthesized and therefore the increase in the hormonal levels may take days to happen. e.g. oestrogen. Feedback The correct answer is: Steroid
Question 30 Correct Mark 1.00 out of 1.00

Question text A 6-year-old child has attained the full stature of an adult and the brain scan shows a tumour in the pituitary. Which of the following hormones is most likely to have a direct effect on the bone? Select one: a. Growth hormone releasing hormone(GHRH) b. Growth hormone(GH) c. Insulin-like growth factor 1 (IGF-1) The boy could have a pituitary adenoma that secretes GH which stimulates the release of IGF-1. Increased IGF- 1 release will cause bone cell hyperplasia. d. Insulin

e. Platelet derived growth factor(PDGF) Feedback The correct answer is: Insulin-like growth factor 1 (IGF-1)
Question 31 Correct Mark 1.00 out of 1.00

Question text Which of the following is a metabolic effect of cortisol? Select one: a. Increased protein synthesis in extrahepatic tissues b. Increased glycogenolysis in the liver c. Increased gluconeogenesis in the liver Cortisol is produced by the adrenal gland in the zona fasciculata, the second of three layers comprising the outer adrenal cortex. This release is controlled by the hypothalamus, a part of the brain. It stimulates gluconeogenesis (formation, in the liver, of glucose from certain amino