All of the following statements concerning antianginal drugs are true EXCEPT:
A. The effect of calcium channel blockers on afterload is more than their effect on preload.
B. The beta-blockers are effective in treating exertional angina since they decrease cardiac oxygen consumption during exercise.
C. The dihydropyridines present no hazard when used alone in the treatment of angina.
D. Organic nitrates are effective in treating Printzmetal's angina because they decrease preload and dilate coronary arteries.
Answer
Section A - 40 Marks
1. Name the movements of the eyeball and give, in the form of a table, the origin, insertion and nerve supply of the muscles responsible for these movements.
(3+3+3+3 = 12 marks)
2. Draw and label the horizontal section of the cerebral hemispheres at the level of the interventricular foramen.
12 marks
3. Write short notes on:
- Maxillary air sinus
- Internal capsule
- Orbital fissure
- Lymphatic drainage of tongue
4x4=16 marks
Section B - 40 Marks
4. Discuss the lateral wall of the nose under the following headings:
- Formation
- Blood supply
- Nerve supply
(6+3+3 = 12 marks)
5.Discuss the interossei muscles of the hand under the following headings:
- Origin
- Insertion
- Nerve supply
- Action (s)
(3+3+3+3 = 12 marks)
6. Write short notes on:
- Abduction of shoulder joint
- Somites
- chorionic vili
- Nerve fibre
4x4=16 marks
A 4-year-old girl is discovered pulling the tail of the family dog. Her mother, who had warned her previously that this behavior was unacceptable, now assigns the girl to a 5 minute time out period. A timer is set up so that the girl can keep track of the time period. After two minutes of the period, the girl begins to scream and cry. At this point, the mother's best response would be to
A. do nothing until the time out period has ended
B. explain to the child why this type of punishment is necessary
C. offer the child a choice between becoming quiet or "being paddled"
D. reset the timer to add an additional 5 minutes to the time out period
E. tell the child that if she quiets down she will be rewarded by a treat at the end of the time out period
Answer
A 48-year-old white female secretary presents with progressive difficulty typing over the past month. She also notes that her hands begin to feel numb and weak after typing for long periods of time. Upon testing, which of the following deficits would be predicted?
A. Difficulty in abducting the fifth finger
B. Difficulty in adducting the thumb
C. Difficulty in flexing digits two and three at the metacarpophalangeal joints
D. Loss of sensation over the lateral half of the dorsum of the hand
E. Loss of sensation over the lateral half of the palm
F. Loss of sensation over the medial half of the dorsum of the hand
G. Loss of sensation over the medial half of the palm
Answer
A 34-year-old woman is prescribed an antidepressant, which she has taken for the past 3 months. She is on no other medications and is in generally good health. After attending a party, at which she consumed wine and cheese, she is rushed to the emergency room with tachycardia, headache, and a blood pressure of 200/100. Which antidepressant is she most likely taking?
A. Amitriptyline
B. Fluoxetine
C. Phenelzine
D. Sertraline
E. Trazodone
Answer
Administration of an experimental drug that acts on PNS myelin is shown to increase the space constant of an axon in a peripheral nerve. Action potentials traveling down the axon would be predicted to be
A. faster
B. larger
C. slower
D. smaller
E. unchanged
Answer
A child psychiatrist would like to evaluate the intellectual ability of a 3-year-old patient. Which of the following is the most appropriate test for him to use?
A. Denver Developmental Scale
B. Stanford-Binet Scale
C. WAIS-R
D. WISC III
E. WPPSI
Answer
A 24-year-old woman in her third trimester of pregnancy presents with urinary frequency and burning for the past few days. She denies fever, nausea, vomiting, or chills. She takes no medications besides prenatal vitamins and is generally in good health. Physical examination is remarkable for mild suprapubic tenderness, and a urine dipstick is positive for white blood cells, protein, and a small amount of blood. Culture produces greater than 100,000 colonies of gram-negative bacilli. which of the following attributes of this uropathogenic organism is most strongly associated with its virulence?
A. Bundle-forming pili
B. GVVPQ fimbriae
C. Heat labile toxins
D. Heat stable toxins
E. P pili
F. Type 1 pili
Answer
A baby who was apparently normal at birth, develops persistent regurgitation and vomiting in the second and third weeks of life. No fever is present and hematologic studies and blood chemistries are normal. Which of the following therapies is most likely to be effective in this case?
A. Antacids
B. Barium enema
C. Gastric resection
D. Oral antibiotics
E. Pyloromyotomy
answer
An archaeologist who has been excavating a very old Middle Eastern site develops a pustule on his hand. The pustule then ruptures to form a black eschar surrounded by expanding brawny
edema. Which of the following organisms is the most likely cause of this condition?
A. Bacillus anthracis
B. Borrelia burgdorferi
C. Francisella tularensis
D. Spirillium minus
E. Yersinia pestis
Answer
A chronic alcoholic develops severe memory loss with marked confabulation. Deficiency of which of the following vitamins would be most likely to contribute to the neurologic damage underlying these symptoms?
A. Folic acid
B. Niacin
C. Riboflavin
D. Thiamine
E. Vitamin B12
Answer
A 72-year-old male is noted as having a 9-pound weight loss over the past few weeks. His past medical history is significant for oat cell carcinoma of the lung, without known metastases, for which he is currently undergoing treatment. The patient states that even though his wife is preparing his favorite meals, he is not hungry.
Which of the following would be the best treatment option to improve his eating habits?
A. Amitriptyline
B. Megestrol acetate
C. Methotrexate
D. Neostigmine
E. Prochlorperazine
Answer
A cardiovascular physiologist is performing experiments using a new alpha1 adrenergic agonist to determine the amount of vasoconstriction the new drug can produce compared with a phenylephrine control. Which of the labeled structures is the cellular target of both of these drugs?
A. A
B. B
C. C
D. D
E. E
Answer
A 35-year-old woman notices a change in the appearance of a mole on her neck. Physical examination reveals that the lesion is an irregular, nodular, superficial mass with a variegated appearance. Biopsy demonstrates a primary malignant tumor. Which of the following factors is most predictive of the patient's long term prognosis?
A. Circumference of lesion
B. Darkness of lesion
C. Degree of color variation
D. Depth of lesion
E. Sharpness of border between lesion and adjacent skin
Answer
A 43-year-old, insulin-dependent diabetic patient is diagnosed with hypertension and begins therapy with an antihypertensive agent. Three days later, he measures his blood glucose at home and finds that it is 53 mg/dL. He recalibrates his glucose testing apparatus and repeats the test, only to find that the first reading was accurate. He is concerned that his hypoglycemia did not produce the normal premonitory signs and symptoms. Which of the following medications was most likely prescribed to treat his hypertension?
A. Captopril
B. Diltiazem
C. Methyldopa
D. Prazosin
E. Propranolol
Answer
A 33-year-old woman presents with fever, vomiting, severe irritative voiding symptoms, and pronounced costovertebral angle tenderness. Laboratory evaluation reveals leukocytosis with a left shift; blood cultures indicate bacteremia. Urinalysis shows pyuria, mild hematuria , and gram-negative bacteria. Which of the following drugs would best treat this patient's infection?
A. Ampicillin and gentamicin
B. Erythromycin
C. Gentamicin and vancomycin
D. Phenazopyridine and nitrofurantoin
E. Tetracycline
Answer
A 9 year old African child develops a high grade lymphoma of the jaw. Which of the following features would probably NOT be present?
a) CD4 positivity
b) CD10 positivity
c) Epstein-Barr virus
d) Starry sky pattern
e) t (8,14)
Answer
A 32-year-old, blood type A positive male receives a kidney transplant from a blood type B positive female donor with whom he had a 6-antigen HLA match. Once the kidney is anastomosed to the man's vasculature, the transplant team immediately begins to observe swelling and interstitial hemorrhage. After the surgery, the patient developed fever and leukocytosis and produced no urine. Which of the following is the most likely explanation?
A. Acute rejection due to antibody-mediated immunity
B. Acute rejection due to cell-mediated immunity
C. Chronic rejection due to cell-mediated immunity to minor HLA antigen
D. Hyperacute rejection due to lymphocyte and macrophage infiltration
E. Hyperacute rejection due to preformed ABO blood group antibodies
Answer
A previously healthy 11-year-old girl develops a gastrointestinal infection with cramping and watery stools. After several days, she begins to pass blood per rectum, and is hospitalized for dehydration. In the hospital, she is noted to have decreasing urine output with rising blood
urea nitrogen (BUN). Total blood count reveals anemia and thrombocytopenia, and the peripheral smear is remarkable for fragmented red cells (schistocytes). Infection with which of the following bacterial genera is most likely responsible for this syndrome?
A. Campylobacter
B. Clostridium
C. Salmonella
D. Shigella
E. Vibrio
Answer
In the clotting process, as the hemostatic plug develops, fibrin polymerizes into monomeric threads which are held together by noncovalent bonds. Which clotting protein increases the strength of the clot by crosslinking the newly formed fibrin threads?
A. Factor XIII
B. High molecular weight kininogen (HMWK)
C. Plasminogen
D. Thrombin
E. von Willebrand Factor (vWF)
Answer
Which one of the following blood cells contains large cytoplasmic structures that exhibit metachromatic staining with toluidine or methylene blue?
a) Basophil
b) Eosinophil
c) lymphocyte
d) monocyte
e) neutrophil
Answer
Adults with sickle cell anemia most commonly experience neurological complications as which of the following:
A. Intracranial hemorrhage
B. Cerebral infarction
C. Seizures
D. Visual changes
E. Ataxia
Answer
