Kings College London MBBS Past Paper PDF

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Guy’s, King’s College & St Thomas’ Hospitals School of MedicineSample Test QuestionsMB BS Part 12010 /2010 © King‟s College LondonTABLE OF CONTENTSA Guide to Completing Multiple Choice Questions Please see visit the following webpage, virtualcampus.kcl.ac/vc/exams/complete_mcq.pdfNote: MBBS 1 an...

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Guy’s, King’s College & St Thomas’ Hospitals School of Medicine

Sample Test Questions MB BS Part 1 2010/11

2010 © King‟s College London

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TABLE OF CONTENTS

A Guide to Completing Multiple Choice Questions Please see visit the following webpage, http://virtualcampus.kcl.ac.uk/vc/exams/complete_mcq.pdf Note: MBBS 1 and 2 examinations now contain only single best answer and extended matching questions. Although some of the questions in this booklet are in the true/false format, this format is no longer used for examinations. Questions from 2005-6 Session Sample Questions – Timed Test 1 .......................... 4 Answers to – Timed Test 1 .................................... 9 Sample Questions – Mid-sessional Exam ................. 11 Answers to – Mid-sessional Exam........................... 35 Sample Questions – Timed Test 2 .......................... 42 Answers to – Timed Test 2 .................................... 48 Sample Questions – Timed Test 3 .......................... 50 Answers to – Timed Test 3 .................................... 56

Questions from 2006-7 Session Sample Questions – Timed Test 1 .......................... 59 Answers to – Timed Test 1 .................................... 65 Sample Questions – Mid-sessional Exam ................. 66 Answers to – Mid-sessional Exam........................... 89 Sample Questions – Timed Test 2 .......................... 93

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Answers to – Timed Test 2 .................................... 99 Sample Questions – Timed Test 3 .......................... 100 Answers to – Timed Test 3 .................................... 105

Questions from 2007-8 Session Sample Questions – Timed Test 1 .......................... 106 Answers to – Timed Test 1 .................................... 111 Sample Questions – Mid-sessional Exam ................. 113 Answers to – Mid-sessional Exam........................... 138 Sample Questions – Timed Test 2 .......................... 141 Answers to – Timed Test 2 .................................... 146 Sample Questions – Timed Test 3 .......................... 147 Answers to – Timed Test 3 .................................... 153

Questions from 2008-9 Session Sample Questions – Timed Test 1 .......................... 154 Answers to – Timed Test 1 .................................... 158 Sample Questions – Mid-sessional Exam ................. 159 Answers to – Mid-sessional Exam........................... 172 Sample Questions – Timed Test 2 .......................... 174 Answers to – Timed Test 2 .................................... 178 Sample Questions – Timed Test 3 .......................... 179 Answers to – Timed Test 3 .................................... 184

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Timed Test 1 (2005-6) Please allow 30 minutes to complete this test Section A – Determinate Questions 1.

Which of the following statements concerning cell structure and function is true and which is false?

A) B) C)

Mitochondria are present in all eukaryotic cells The cytosol is the location of the enzymes of the glycolysis pathway Microtubules are involved in the transport of secretory vesicles to the plasma membrane Gap junctions allow the movement of ions such as Ca2+ between adjacent cells Lysosomes are visible in the light microscope

D) E)

2.

Which of the following statements about acids and bases are true and which are false?

A)

In an aqueous solution, the H+ and OH- concentrations are equal at pH 7. the pH value of a 0.001M solution of HCl is 4 More than 50% a weak acid will be present in the dissociated state (as the conjugate base) at pH values above its pKa the zwitterion form of glycine, NH3+CH2COO-, is a good buffer in aqueous solution The predominant form of glycine at pH 7 is NH2 CH2 COOH

B) C) D) E) 3.

With respect to proteins associated with the phospholipid bilayer of cell membranes

A)

the acetylcholine receptor is an example of an integral membrane protein anchored proteins can be removed easily by treatment with solutions of high salt content glycosylated proteins are located with the carbohydrate residues on the extracellular surface peripheral proteins can be removed by treatment with lipase enzymes the membrane spanning regions of membrane proteins may contain -helical regions

B) C) D) E)

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4.

Concerning the fluidity of cell membranes:

A)

fluidity is increased when the proportion of polyunsaturated fatty acids increases in the component phospholipids fluidity is unaffected by the presence of cholesterol „flip-flop‟ movement of phospholipids from one leaflet of the bilayer to the other is very frequent fluidity is increased by the presence of short chain fatty acids fluidity is important for the processes of exocytosis and endocytosis

B) C) D) E)

5. Which of the following statements about joints is true and which is false? A) B) C) D) E)

A synchondrosis is a cartilaginous joint providing an area for growth. No movement is possible at a symphysis. A suture is an example of a fibrous joint. In a gomphosis, collagen unites the tooth with the bone. Sutural joints ossify soon after puberty.

Section B – Extended Matching Questions Theme: Structure and Function of Lipids From the lipid molecules listed as Options A – I below, choose the most appropriate answer to match the statements in Questions 1-5. Options A arachidonic acid B cholesterol C cholic acid D glycerol E oleic acid F phosphatidylcholine G phosphatidylinositol H stearic acid I triacylglycerol

1. 2. 3. 4. 5.

the precursor molecule for the synthesis of steroid hormones the major store of lipid in adipose tissue a mono-unsaturated fatty acid a common saturated fatty acid a polyunsaturated fatty acid

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Theme: Arm movements The figure is a schematic representation of the arm, forearm & hand with the arrow (a) showing the direction of movement.

Options A) (not used) B) Muscle “b” C) Muscle “c” D) Muscle “d” E) abduction F) adduction G) extension H) flexion I) lateral rotation J) medial rotation Questions 6. Which muscle is acting as the agonist? 7. Which muscle is acting as the antagonist? 8. Which muscle is acting as the fixator? 9. From the options describe the movement indicated by „A‟. 10. Which muscle would act as the agonist if the direction of movement was reversed?

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Theme: Brain Architecture Study the diagram below and answer the questions:

Options A) Astrocytes B) Blood vessel C) Ependymal cells D) Microglia E) Myelinated axon F) Nerve cell body G) Node of Ranvier H) Nucleus of nerve cell I) Oligodendrocyte J) Schwann cell K) Unmyelinated axon Questions 11. Identify 12. Identify 13. Identify 14. Identify 15. Identify

the the the the the

label label label label label

“a” “b” “c” “d” “e”

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Theme: Spinal Roots Study the diagram below and answer the questions:

Options A) anterior rami B) anterior root C) cranial nerve D) inferior root E) lateral rami F) motor G) parasympathetic ganglion H) posterior ganglion I) posterior rami J) posterior root K) rami communicantes L) sensory M) spinal nerve N) superior rami O) superior root P) sympathetic ganglion Q) sympathetic chain R) vagus nerve Questions 16. Identify 17. Identify 18. Identify 19. Identify 20. Identify

the the the the the

label label label label label

“a” “b” “c” “d” “e”

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Answers to Timed Test 1 (2005-6) Section A – Determinate Questions 1. A) F B) T C) T D) T E) F 2. A) T B) F C) T D) F E) F 3. A) T B) F C) T D) F E) T 4. A) T B) F C) F D) T E) T 5. A) T B) F C) T D) T E) F

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Section B – Extended Matching Questions Theme: Structure and Function of Lipids 1. 2. 3. 4. 5.

B I E H A

Theme: Arm movements 6. 7. 8. 9. 10.

B D C H D

Theme: Brain Architecture 11. 12. 13. 14. 15.

I F E C A

Theme: Spinal Roots 16. 17. 18. 19. 20.

J H B P K

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Mid-sessional Exam (2005-6) Please allow 2hrs & 30 minutes to complete this exam Section A – Determinate Questions

1.

Using the diagram as a guide, indicate whether the following statements are true or false. A) B) C) D) E)

The The The The The

radius is proximal to the humerus radius lies lateral to the ulna. stomach is inferior to the heart. oesophagus is superficial to the trachea. stomach lies superficial to the transverse colon

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2.

Which of the following statements about the autonomic nervous system is true and which is false? A) B) C) D) E)

3.

Which of the following statements concerning the peritoneum is true and which is false? A) B) C) D) E)

4.

A mesentery is a double-fold of peritoneum Parietal peritoneum is insensitive Inflammation of parietal peritoneum usually gives pain around the umbilicus The lesser omentum passes from the lesser curvature of the stomach and is attached to the liver The omental bursa is continuous with the peritoneal cavity through the epiploic foramen.

The pelvic diaphragm A) B) C) D) E)

5.

All motor axons of the autonomic nervous system synapse outside the CNS The autonomic nervous system has no sensory components. Sympathetic fibres arise form the lateral horn of the spinal cord from segments T1-L2. The vagus nerve is the only cranial nerve which contains parasympathetic fibres. Sympathetic stimulation decrease salivation and peristalsis in the gut.

is innervated by the deep peroneal nerve is composed of skeletal muscle is involved in the sphincteric action around the anal canal supports the prostate gland inserts partly into the perineal body

The abdominal aorta: A) B) C) D) E)

enters the abdomen behind the diaphragm normally gives origin directly to the splenic artery is crossed superficially by the left renal vein is related to many lymph nodes bifurcates at the level of the fifth lumbar vertebra

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6.

Gastrulation is A) B) C) D) E)

7.

The T cell receptor: A) B) C) D) E)

8.

the stage at which the embryo forms the mesoderm the stage at which the embryo forms somites characterised by formation of the Spemann Organiser regulated by signalling molecules expressed by the Organiser the stage at which the neural territory is induced

is absent from naïve T cells recognises antigenic peptides on MHC molecules is present on CD4+ and CD8+ T cells will bind different antigens simultaneously binds to IL-2

Forced expiratory volume in one second divided by forced vital capacity (FEV1/FVC), expressed as a percentage, when measured in a random sample of 2500 adults, was found to have a mean of 80.0%, standard deviation 5.0%, standard error of mean 0.1%. A) B)

C)

D) E)

The standard error has been calculated as 5.0 divided by the square root of 2500 Mean plus and minus 2 standard errors provides a valid 95% confidence interval for the mean only if FEV1/FVC has a Normal distribution. If FEV1/FVC has a Normal distribution, approximately 95% of the values of FEV1/FVC are in the range 70% to 90%. A 99% confidence interval for the mean is wider than a 95% confidence interval. The standard deviation is small compared to the mean because the sample size is large.

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9.

Concerning stress in health and illness: A) B) C) D) E)

10.

A 60 year old man who has been admitted to hospital with a myocardial infarction: A) B) C) D) E)

11.

can choose which ward he is admitted to can discharge himself from hospital at any time can have access to his own hospital notes can refuse to be examined by a medical student will have his inpatient care controlled by his general practitioner

The membrane potential of an excitable cell: A) B) C) D) E)

12.

stress is associated with an increase in anabolic hormone concentrations in the blood stress is associated with a decrease in production of pituitary hormones there is a general consensus across individuals and cultures as to what constitutes stressful stimuli stress is associated with an increase in cortisol concentration in the blood provision of information about a potentially stressful situation is always effective in helping individuals to deal with that stressor

is dependent on the selective permeability of the cell membrane depolarises when extracellular potassium is raised is generated by the sodium pump is largely determined by the sodium concentration gradient is typically around 40 mV

Renal clearance values: A) B) C) D) E)

always rise as the plasma concentration of the relevant solute rises. for glucose are normally zero. greater than the glomerular filtration rate (GFR) are indicative of tubular secretion. less than the GFR are always indicative of tubular reabsorption. represent the volume of plasma which would be cleared of a substance per unit time.

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13.

Which of the following statements about acids and bases are true, and which are false? A) B) C) D) E)

14.

With regard to protein and amino acid metabolism: A) B) C) D) E)

15.

the body is said to be in positive nitrogen balance when nitrogen excretion is greater than nitrogen intake highly regulated proteins such as polypeptide hormones have a very short half-life most amino acids are both glucogenic and ketogenic both sulphur-containing amino acids are essential amino acids aminotransferases require pyridoxal phosphate as a co-enzyme

Regarding human genetic material: A) B) C) D) E)

16.

The zwitterion form of an amino acid in solution provides the most efficient buffering processes generating hydrogen ions in the body include the oxidation of sulphur-containing amino acids pKa is defined as -log Ka the normal range of [H+] in blood is 35-45 n mol/L The carboxyl and amino groups of the constituent amino acids contribute significantly to the buffering properties of plasma proteins

all DNA in the cell is present in the nucleus most of the genomic DNA is found in introns introns are regions of DNA that are not translated promoter regions of DNA influence the production of mRNA the TATA box is an example of an enhancer region

Mitochondria: A) B) C) D) E)

contain the enzymes of the citric acid cycle contain the components of the electron transport chain on their outer membrane increase their rate of ATP production in the presence of cyanide ions increase their rate of O2 consumption in the presence of uncoupling agents such as 2,4 dinitrophenol (DNP) contain ribosomes with properties similar to prokaryotic ribosomes

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Section B - Extended Matching Questions

Theme:

Doctor-patient communication A

acknowledging someone‟s feelings and communicating this back to them B checking for mutual understanding C commencing the interview effectively D exploring the patient‟s problems E identifying sameness and minimising difference F increasing patient adherence G increasing patient satisfaction H promoting active listening I sharing decision making

From the options A – I above, choose the most appropriate Answer for each question: When a patient sees his GP: 1. 2. 3. 4. 5.

Which option refers to establishing and maintaining rapport? Which option describes empathy? A patient-centred approach allows for which of the above? What is the main aim in using probing questions? What is the main purpose of reflecting and clarifying what the patient has said?

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Theme:

Anatomy of a synovial joint

Options A B C D E F G H I J K L 6. 7. 8. 9. 10.

Compact (cortical) bone disc elastic cartilage fibrous capsule fibrous cartilage hyaline cartilage interosseous membrane joint cavity ligament periosteum synovial membrane trabecular (spongy) bone

Identify Identify Identify Identify Identify

label label label label label

“a” “b” “c” “d” “e”

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Theme:

Microbial identification and habitat A B C D E F G H I

a facultative anaerobe such as escherichia (E.) coli a strict anaerobe such as bacteroides spp. herpes simplex virus influenza virus mycobacterium tuberculosis salmonella spp. staphylococcus aureus staphylococcus epidermidis streptococcus pyogenes

From the options A – I above, choose the organism that most closely relates to the statement: 11. 12. 13. 14. 15.

A common skin commensal of low pathogenicity An organism that can replicate only in the absence of oxygen A slow-growing acid-fast bacillus A Gram positive coccus that forms clusters An organism that can integrate its DNA into the host‟s DNA

Theme: A B C D E F G H I

Cardiac cycle atrial contraction atrial relaxation the closure of aortic and pulmonary valves the closure of mitral and tricuspid valves isovolumetric contraction isovolumetric relaxation the opening of aortic and pulmonary valves the opening of mitral and tricuspid valves the rapid ejection phase

From the options A – I above, choose the best Answer to the following questions:

16. 17. 18. 19. 20.

The first heart sound is a consequence of: The second heart sound occurs immediately before: Ventricular filling immediately follows: Aortic pressure reaches a peak immediately after: During systole all cardiac valves are closed during:

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Theme: people

the structure and function of the airways in normal

Choose from the following airway options the one which best fits the description in the questions below:

Options: A nose and pharynx B larynx C trachea, airway generation 0 D right and left main bronchi, airway generation 1 E bronchi, airway generation 3 F bronchi, airway generation 10 G bronchioles, airway generation 14 H respiratory bronchioles generation 18 I alveolar ducts J alveolar sacs

21. 22. 23. 24.

25.

In a normal person this part is most likely to collapse during a forced expiration This part of the respiratory system has a structure which tends to create turbulence even at rest U-shaped cartilage is a characteristic of this part of the respiratory system When considering the entire respiratory system during quiet breathing, this part contributes most to the total airway resistance These airways which are part of the anatomical dead space lack cartilaginous support

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Theme:

Cholinergic neurotransmission

A B C D E F G H I J

acetylcholine atropine botulinum toxin ecothiopate hexamethonium neostigmine nicotine noradrenaline pancuronium suxamethonium

Pick the drug from the above list, A – J, which best corresponds to the definitions below: 26. 27. 28. 29. 30.

a cholinesterase inhibitor used to treat myasthenia gravis a muscarinic receptor blocker used to treat sinus bradycardia a nicotinic agonist used to cause a brief period of muscle paralysis a nicotinic antagonist used to cause muscle paralysis an agonist at both muscarinic and nicotinic receptors

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Theme:

autonomic nervous system

3 1

2

eg. salivary gland

5

4

eg.blood vessel

7 6

eg. sweat

gland

9 8

The diagram abo...