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Basic Biomedical Sciences Question Paper
Basic Biomedical Sciences
Course:Bachelor Of Medicine And Bachelor Of Surgery
Institution: Moi University question papers
Exam Year:2005
MOI UNIVERSITY
FACULTY OF HEALTH SCIENCES
END OF TERM I EXAMINATION (ETE I) 2004/2005
COURSE CODE: MSB 100
COURSE TITLE: BASICS OF BIOMEDICAL SCIENCES
PROGRAMME: MBChB/NUR/ YEAR OF STUDY: 1(ONE)
DATE: 26TH APRIL 2005 TIME: 9.00 A.M. - 12.00 NOON
GENERAL INSTRUCTIONS:
i) Write your University Registration Number on every piece of paper you use.
ii) Do not write your names on any piece of paper you use.
iii) This paper consists of six (6) sections, headed: Section A -Immunology, Section B - Forensic Medicine & Toxicology, Section C - Biochemistry D - Pharmacology, Section E - Microbiology & Parasitology, Section F - Radiology & Imaging. All to be answered in a total time of three (3) hours.
iv) Each section constitutes a CAT relating to the discipline named.
v) Answer all the questions in all the six (6) sections.
vi) Questions in each section must be answered in separate answer booklets or answer sheets so that they can be handed in separately at the end of the examination.
vii) Read carefully the additional instructions preceeding each section.
SECTION A: IMMUNOLOGY (30 Minutes)
INSTRUCTIONS:-
(i) THIS PAPER CONSISTS OF THIRTY (30) MULTIPLE CHOICE QUESTIONS (MCQs) TO BE ANSWERED IN THIRTY (30) MINUTES.
(ii) EACH MCQ CONSISTS OF A STATEMENT/STEM WHOSE MOST CORRECT RESPONSE IS PROVIDED AMONG THE FIVE OPTIONS NUMBERED A TO E.
(iii) FOR EACH MCQ, SELECT ONLY ONE MOST APPROPRIATE OPTION AND INDICATE BY CIRCLING IT.
EXAMPLE:
Major features of innate immunity include
(a) recognition
(b) specificity
(c) memory
d first line of defense
(e) adaptability
the appropriate response is d
(iv) A CORRECT RESPONSE IN THE MCQs EARNS YOU PLUS ONE (+1) MARK. AN INCORRECT RESPONSE EARNS YOU MINUS HALF (-½)A MARK. NO PENALTY FOR UNATTEMPTED MCQ.
(v) ATTEMPT ALL QUESTIONS.
SECTION A: MULTIPLE CHOICE QUESTIONS (MCQs) (3O minutes)
1. Basic immunology involves the understanding of:
(a) Hypersensitivity reactions
(b) Autoimmune diseases
(c) Immunodeficiency disorders
(d) Normal body immune system
(e) Immunopathology
2. Haptens are:
(a) Substances which elicit and react with products of an immune response
(b) Substances which can elicit an immune response if coupled to another molecule
(c) Substances capable of inducing B cells to produce antibodies without T cell help
(d) Substances which are processed and expressed by accessory antigen presenting cells
(e) Part of the T cell antigen receptor
3. Cell-mediated immunity:
(a) Can be transferred passively using immune sera
(b) Is mediated by T cells, macrophages and cytokines
(c) Is not effect against most of the obligate intracellular pathogens
(d) Is mediated by B lymphocytes
(e) Forms part of the innate immunity
4. Plasma cells:
(a) Are the only memory cells of virgin B lymphocytes
(b) Secrete complement factors
(c) Express surface membrane immunoglobulin markers (Smlg)
(d) Are derived from both B and t lumphocytes
(e) Are derived from B lymphocytes and secret immunoglobulins
5. In the Kenya Expanded Programme of Immunization (KEPI) the last vaccine to be given is against:
(a) Tuberculosis
(b) Measles
(c) Hepatitis
(d) Tetanus
(e) Polio
6. Immunology is not at the forefront of:
(a) Genetically modified (GM) foods
(b) Apprehending hardcore criminals
(c) Prevention of childhood diseases
(d) Human genome research
(e) Replacement of dysfunctional organs
7. Louis Pasteur is credited for:
(a) Cowpox vaccination
(b) Blood group antigens
(c) Complement system proteins
(d) Attenuated vaccines
(e) Opsonins
8. Self-tolerant single positive CD4+ and CD8+ T cells are generated through:
(a) Positive selection
(b) Negative selection
(c) Clonal cell selection
(d) Cortical cell selection
(e) Thymocyte cell selection
9. Antigens are not represented by:
(a) Surface cell components of pathogens
(b) Glycoproteins
(c) Toxins and toxoids
(d) Head shock proteins
(e) Complement system proteins
10. Innate immunity is not associated with:
(a) First line of detance
(b) Phagocytes and NK cells
(c) Cytolines and interferons
(d) Skin as natural barriers
(e) B cells
11. Adaptive immunity does not involve:
(a) Burnet clonal inhibition theory
(b) Extracellular elimination of pathogens
(c) Control of intracellular pathogens
(d) B and T lymphocytes
(e) Recognition, specificity and memory
12. B and T lymphocytes posses:
(a) Antigen specific receptors
(b) Antibody specific receptors
(c) Foreign antigens
(d) Self components
(e) Memory receptors
13. T cells:
(a) Control intracellular pathogens
(b) Eliminate extracellular pathogens
(c) Do not posses antigen specific receptors
(d) Do not recognize foreign antigens in association with self components
(e) Neutralize toxins
14. Infants at birth are normally vaccinated with the following vaccines:
(a) Tetanus toxoid
(b) Measles
(c) BCG and polio
(d) Rubella
(e) Haemophilus influenza
15. Pentavalent vaccine under KEPI does not protect against:
(a) Diphtheria Tetanus and Pertussis
(b) Hepatitis B virus
(c) Haemophilus influenza type B (Hib)
(d) Hepatitis and Tetanus
(e) Measles and Polio
16. CD19 and CD20 are Cluster of Differentiation (CD) antigens of all:
(a) T cells
(b) Natural killer (NK) cells
(c) Thymocytes
(d) Plasma cells
(e) B cells
17. The central principle of adaptive immunity was pioneered by:
(a) Susum Tonegawa
(b) Burnet and co-workers
(c) Karl Landsteiner
(d) Louis Pasteur
(e) Milstein and Kohler
18. Cell membrane components expressed by certain individuals in a population are called:
(a) Mitogens
(b) Carriers
(c) Alloantigens
(d) Immunogens
(e) Cluster of differentiation (CD) antigens
19. Major features of innate immunity exclude:
(a) Inhibition of viral replication by interferons
(b) Physcial barrier of skin and surface epithelia
(c) Neutralizing antibodies
(d) Production of nitric oxide (NO)
(e) Natural killer (NK) cells mediated immunosurveillance
20. Primary immune response is characterized by:
(a) Longer big phase
(b) Shorter long phase
(c) IgG antibody
(d) Quicher onset and high magnitude
(e) Long lived memory
21. CD4 Th1 T cells are activated when processed foreign antigens are presented in association with:
(a) Class 1 MHC molecules
(b) Class II MHC molecules
(c) Class III MHC molecules
(d) Non-self components
(e) CD8+ molecules
22. Humoral components exclude:
(a) T cells and cytokines
(b) Antibodies
(c) Complement system proteins
(d) Memory B cells
(e) IgM, IgG, IgA, IgE and IgD
23. Paternity identity is confirmed through:
(a) Blood group typing
(b) Maternal antigen evaluations
(c) DNA and HLA typing
(d) Finger print evaluation
(e) Physical appearance determination
24. Secondary (peripheral) lymphoid organs exclude the following:
(a) Bone marrow and thymus
(b) Spleen
(c) Peyer’s patches
(d) Tonsils and adenoids
(e) Lymph nodes
25. The smallest binding unit of an antigen is referred to as:
(a) Complementarily determining region
(b) An epitope
(c) Surface membrane Ig
(d) Appendix
(e) Self-component
26. Travelers or tourists to certain areas are advised to receive:
(a) Anthrax vaccine
(b) Rabies vaccine
(c) Hepatitis B vaccine
(d) Yellow fever vaccine
(e) BCG vaccine
27. Requirements for immunogenecity exclude:
(a) Dose and route of antigen administration
(b) High degree of foreigners
(c) High degree of physiocochemical complexity
(d) Individual genetic make up
(e) Low degree of specificity
28. Myeloid pathway of cell differentiation leads to production of:
(a) Helper T cells
(b) Cytotoxic T cells
(c) Neutrophils and Posionophils
(d) Plasma cells
(e) Cytokines
29. In the secondary lymphoid organ the paracortical areas are associated with:
(a) Mostly B cells
(b) Mostly T cells
(c) Macrophages
(d) Plasma cells
(e) Germinal centers
30. The mammalian equivalent of the avian Bursa of Fabricious is the:
(a) Spleen
(b) Gut associated lymphoid tissue (GALT)
(c) Thymus
(d) Bone marrow
(e) Liver
SECTION B: FORENSIC MEDICINE AND TOXICOLOGY (30 Minutes)
TYPE III
MULTIPLE CHOICE QUESTIONS (MCQs)
INSTRUCTIONS:-
(I) EACH OF THE QUESTIONS IN THIS SUBSECTION CONSISTS OF A STATEMENT/QUESTION WHOSE MOST APPROPRIATE COMPLETION/ANSWER IS PROVIDED AMONG THE FIVE OPTIONS NUMBERED (a) - (e).
(II) FOR EACH QUESTION SELECT THE MOST APPROPRIATE OPTION AND INDICATE BY PRINTING AN X IN THE APPROPRIATE BOX IN THE ANSWER SHEETS PROVIDED. IF YOU DO NOT KNOW THE ANSWER, PRINT X IN THE BOX IN THE `D'' COLUMN
(III) A CORRECT RESPONSE EARNS YOU PLUS ONE (1) MARK. AN INCORRECT RESPONSE EARNS YOU MINUS HALF (½) MARK.
Analyse the following case and answer question 1-20: Did the beautiful 25-year old Wairimu have to die such a death? A death so painful as to make all fear being in such an environment. Wairimu and her family lived in a region surrounded by eleven mountains with only one pass to the north of the region. She lived a normal life just like any other resident of a place I now nickname Judasia. This place had a population of slightly over 5000 people. More than half of the population was composed of young people under the age of 30 years. The Judasians do mixed farming and encourage the use of traditional and natural methods of agriculture. They do not use agrochemicals. Despite this, the annual agricultural produce is adequate for the residents with surplus being exported to the people in other parts of Kenya when their stores are filled. Since Judasia is at the bottom of the mountains, they have to depend on the one spring which has water believed to originate from the Nandi plateau, another area with entirely different groups of people. Whereas in this plateau the peasants cannot use the ordinary hoes (jembes) and rely mainly on tractor for land tilling, sowing and use herbicides for weeding and pesticides for the preservation of their produce, the Judasians rely on their hoes and manpower. The other water source is from a river whose source is also in Nandi plateau. This river has a good gradient towards Judasia and meanders through large modern Nandi farms and passes various topography with different ecological variations.
Judasia has a very unique climate due to its geographical location. Day temperatures can sore up to about 40 degrees in the hottest day in the year when Judasians burn agricultural wastes clearing their farms. There is no night with temperatures below 25 degrees C. In fact Judasian men rarely wear shirts and women do not wear bra. The average daily temperature is about 28 degrees C. Rainfall can be heavy often with hails. It has been rightly described by environmentalists as the hot pot of Kenya where the African love is brewed. Our attention to Judasia was drawn by Wairimu’s death. While her body was still in our Morgue, we sent a team of experts to investigate the cause of Wairimu’s death to establish or dispel the possible involvement of environmental factors. The team started by studying the health data in the nearest health center, 7 kms away from Judasia. The purpose was to find out whether or not the Judasian health centre clinic attendance was any different from attendance of patients from the other catchment areas. Comparatively, it was established that Judasian’s attendance was the lowest throughout the year except for the month of November when it topped the list and dropping sharply in the following month. This month and year was also the odd one out during the last 10 years of data examined. Certainly something had happened in Judasia in the month of November. Could Judasia have been deliverately poisoned? Could this have been due to God’s wrath for their sins? With this in mind we moved into Judasia. It was too hot for ordinary Kenyans not resident there. It did not take us long to realize that not only Wairimu had died, 80 other Judasians had died at the same time within a period of two weeks in November and many were still sick in the place. It is in November when Judasians usually burn maize stalk in preparation for planting some exotic grains they normally use for making traditional delicacies. Could this have been the main cause of this tragedy? Grossly, we noted that most of the dead were elderly except for a few young ones including some babies and young people who had pre-existing debilitating diseases such as asthma and AIDS. Certainly, a tragedy had struck the Judasians. Some survivors told us there was a volcanic eruption in the area a few days ago although geological tests did not find any truth in this. We took sample specimens of grain, soil spring and river water, cooked foods, blood from human, chicken and cattle. We also took several sample specimens of both exotic and food plants for analysis. All the dead and the specimens collected including air were taken to our departmental poison’s Unit. The cause of death of Wairimu and in the majority of people who died during the tragedy time was fixed as respiratory failure due to meterological inversion. In addition, Wairimu’s lungs had signs of a pre-tragedy tuberculosis. A week later after the release of our report, the Ministry of Health sent a team of health workers who pitched a tent in Judasia and treated those who were still sick. After a week of treatment, a number of patients were still complaining of lethargy which called for more tests. Several environmental and human tests were conducted with healthy volunteers. Test drugs were given orally to human volunteers and the time taken to exit in urine was recorded together with their breakdown products. All the physiological and toxic effects were also recorded. Test chemicals were also put in water in the Nandi plateau and traces detected in Judasia spring water and a much much lower level found in Judasia river water. Several environmental chemicals were analysed for in the post-mortem liver which was enlarged in most cadavers and with only traces found in blood. Of the poisons labeled as Q,R,S,T,U, only U was found in the body fat especially in women. Although disputable, it was thought that some environmental chemicals had become toxic as a result of a sudden climatic change in Judasia. Although there was no detection of a serious surface environmental toxin in Judasia, biological sample specimens collected had the presence of some known poisons just below the acceptable threshold level values. A meeting convened by the Judasia elders in conjunction with the Public Health Officer (PHO) with his team from the Ministry of Health resolved to start a toxicovigillance in the area to avoid a similar tragedy. Toxicovigillance will also facilitate the assessment of the Effectivity Index (EI) of all the chemicals used in Nandi plateau and in Judasia to ensure safety. EI is determined in the same way therapeutic Index of drugs is calculated. All of the currently used chemicals in Judasia were later found to be within the safety margin. A crude meteorological office was also opened to monitor and focus for the possibility of occurrence of intolerance climatic changes in the future. The PHO also said to Judasia chief that the farmers in Nandi plateau should be taken to court for polluting the river as it meanders down to Judasia valley for compensation purposes to the bereaved people of Judasia.
1. Which type of toxic exposure occurred in Judasia at the time of the tragedy?
(a) Acute
(b) Subacute
(c) Chronic
(d) Subchronic
(e) Undetermined
2. What best described the fate of the human drugs used with volunteers?
(a) Biotransformation
(b) Disposition
(c) Excretion
(d) Detoxification
(e) Absorption
3. What best described the fate of the test chemicals put in water at the Nandi plateau?
(a) Pharmacokinetics
(b) Toxicokinetics
(c) Biotranslocation
(d) Biomagnifications
(e) Toxicogenesis
4. Which toxicological data is pivotal in the establishment of threshold level values referred to in the case?
(a) LD50
(b) ED50
(c) TD50
(d) No Effect Level
(e) All the above
5. Which quoted statement or clause in the case is directly referring to a toxicodynamic impact?
(a) “All the physiological effects were also recorded”
(b) “It was too hot for ordinary Kenyans….”
(c) “80 other Judasians had died at the same time”
(d) “….patients were still complaining of lethargy”.
(e) “….about 40 degrees in the hottest day….”
6. Which one of the detected poisons had the greatest apparent volume of distribution in Judasia dead?
(a) Poison Q
(b) Poison R
(c) Poison S
(d) Poison T
(e) Poison U
7. What was the environmental immediate cause of Wairimu’s death?
(a) Smoke emanating from a borehole
(b) Gasses and other atmospheric reactive free radicals
(c) Tuberculosis germs
(d) Spring water pollutants
(e) Hyperthermia due to high temperatures
8. What is forensic about this case?
(a) Mystery about sudden death of many people
(b) Post-mortem detection of tuberculosis
(c) Meterorological inversion
(d) Absence of seasonality of the incident
(e) Selective effects in the children and the elderly
9. Which one of the following detected poisons is most likely to have the highest biological half life in the exposed Judasians?
(a) Poison Q
(b) Poison R
(c) Poison S
(d) Poison T
(e) Poison U
10. What is your understanding of toxicovigillance being started in Judasia?
(a) Examination of the sick for the purpose of immediate treatment
(b) Making continuous observations of adverse effects of chemicals introduced in the environment for the purpose of control
(c) Providing awareness of diseases that have caused havoc in Judasia
(d) Protecting water sources against agrochemical pollution
(e) Having monthly meeting of the elders to discuss monthly poisoning cases so that specialized treatment may come on time
11. Which one of the following suggestions to the people of Nandi plateau would you least recommend as a strategy for controlling exposures to hazardous substances in the environment to protect the people of Judasia down stream?
(a) Elimination of offending chemicals
(b) Substitution of chemicals with less toxic ones
(c) Containment of chemicals being used
(d) Encouraging farming to be done by only those with proper education
(e) Use of agrochemicals when it is only absolutely necessary
12. What branch of toxicology deals with the production of data for the purpose of evaluation of the safety of environmental chemicals before introduction into the market?
(a) Descriptive toxicology
(b) Mechanistic toxicology
(c) Information toxicology
(d) Clinical toxicology
(e) Forensic toxicology
13. What is the best indicator in this care showing that part of the environmental toxic exposure was chronic
(a) Enlarged liver
(b) The high average daily environmental temperature of 28 degrees C
(c) Presence of pre-tragedy tuberculosis
(d) Presence of toxins in body fats of women tested
(e) Both A and D
14. Which one of the following liver enzymes was most likely potentiating the effect of meteorological inversion?
(a) Glucokinase
(b) Mixed functional oxidases
(c) Hydrolases
(d) Aminotransferases
(e) ?-Reductase
15. Which uncertainty factor in setting exposure standards of new chemicals would the toxicovigillance team use when a suitable human data from volunteers is available?
(a) 10000
(b) 1000
(c) 100
(d) 10
(e) 00
16. Select the best description of meteorological change that had occurred and led to such mortality and morbidity in Judasia?
(a) There was an upsurge of environmental ambient temperatures intolerable to the majority of Judasia?
(b) There was a sustained situation where the Judasian warm air could not effectively rise to the upper troposphere
(c) The brief and sudden climatic change catalysed the decomposition of environmental wastes with evolution of toxic gasses
(d) Heavy rainfall together with sudden rise of environmental temperatures increased geological release of toxic substances in the air.
(e) There was a volcanic eruption releasing toxic gasses which changed Judasian wind direction interfering with the elimination of pollutants.
17. Which one of the following Judasian analysed chemicals was found to be relatively most toxic in the group below?
(a) Solanin soap (EI-1.8)
(b) Arubaine medication (EI-0.8)
(c) Lantana herb (E-0.5)
(d) Omboga (EI-0.8)
(e) Stramonium (E-1.0)
18. The toxicovigillance ratios of data for the following environmental chemicals used in Judasian households were given as follows: A=LD50/ED50, B=ED50/LD5O, C=LD1.0/ED99, D=ED99/LD1.0, E=ED30/LD30
Which one of the following ratios gives the best margin of safety?
(a) D
(b) E
(c) B
(d) A
(e) C
19. What is the fundamental criterion on which poisoning is based?
(a) Type of a chemical
(b) Quantity of exposure
(c) Exposure route
(d) Age
(e) Duration of exposure
20. Which was the most likely route of exposure in the Judasain community that led to most deaths?
(a) Inhalational
(b) Dermal
(c) Oral
(d) Percutaneous
(e) All routes
SECTION C: BIOCHEMISTRY
(30 Minutes)
MULTIPLE CHOICE QUESTIONS (MCQs) (20 Minutes)
TYPE III
INSTRUCTIONS:-
(I) EACH OF THE QUESTIONS IN THIS SUBSECTION CONSISTS OF A STATEMENT/QUESTION WHOSE MOST APPROPRIATE COMPLETION/ANSWER IS PROVIDED AMONG THE FIVE OPTIONS NUMBERED (a) - (e).
(II) FOR EACH QUESTION SELECT THE MOST APPROPRIATE OPTION AND INDICATE BY PRINTING AN X IN THE APPROPRIATE BOX IN THE ANSWER SHEETS PROVIDED.
(III) A CORRECT RESPONSE EARNS YOU ONE MARK.
1. Which of the following statements is not true about isoelectric pH:
(a) NH4+ will move to the cathode
(b) Amino acids are dipolar at neutral pH
(c) NH3 will move to the anode
(d) Amino acids are zwitterionic at neutral pH
(e) Coo- will move to the cathode
2. Which of the following ?-amino acid groups gives an amino acid its distinctive reaction features:
(a) An amino group
(b) A side chain
(c) A hydrogen atom
(d) An aldehyde group
(e) A carboxyl group
3. Which of the following amino acids has sulfur containing side chain?
(a) Lysine
(b) Threonine
(c) Methionine
(d) Serine
(e) Asperagine
4. Which of the following amino acids has an acidic side chain?
(a) Aspartate
(b) Valine
(c) Tyrosine
(d) Alanine
(e) Leucine
5. To which ordered conformation of polypeptides does myoglobin belong?
(a) Primary structure
(b) Quarternery structure
(c) ?-helix
(d) Tertiary structure
(e) ?-pleated sheet
6. Which of the following amino acids produces a yellow colour with ninhydrin?
(a) Threonine
(b) Lysine
(c) Arginine
(d) Phenylalanine
(e) Proline
7. Which of the following statements is true about michaelis constant (km)?
(a) Km is equal to the substrate concentration at which the reaction rate is equal its maximal value
(b) Km is half the substrate concentration at which the reaction rate is half its maximal value
(c) Km is equal to the substrate concentration at which the reaction rate is half its maximal value
(d) Km is equal to the substrate concentration at which the reaction rate is twice its maximal value
(e) Km is twice the substrate concentration at which the reaction rate is half its maximal value
8. Which of the following statements is not true of enzyme inhibition?
(a) In competitive inhibition the enzyme can bind substrate forming an ES complex
(b) In competitive inhibition the enzyme can bind inhibitor forming an E1 complex
(c) In competitive inhibition the enzyme can bind both substrate and inhibitor forming an ES1 complex
(d) Competitive inhibition can be overcome by sufficiently high concentration of substrate
(e) Non competitive inhibition cannot be overcome by increasing the substrate concentration
9. What is the pH of normal human blood?
(a) 5.1
(b) 10.4
(c) 7.4
(d) 6.0
(e) 4.0
10. Which enzyme catalyses the decomposition of carbonic acid?
(a) Carbonic ahydrase
(b) Carbonic dehydrase
(c) Acid anhydrase
(d) Acid dehydrase
(e) Carbonicase
11. Buffer capacity is equal to one, when:
(a) pH = 0
(b) pH = 14
(c) pH = pKa
(d) pKa = 0
(e) None of the above
12. Which of the following sugars are epimers with respect to carbon atom 4?
(a) Galactose and mannose
(b) Ribose and arabinose
(c) Treose and erythrose
(d) Mannose and glucose
(e) Galactose and glucose
13. Which of the following is not a phospholipid?
(a) Cephalin
(b) Lecithin
(c) Cariolipin
(d) Glycolipid
(e) Sphingomyelin
14. Compounds containing a carbohydrate and a non carbohydrate residue are called:
(a) Ascorbic acids
(b) Aldaric acids
(c) Glycosides
(d) Mannitols
(e) Sorbitals
15. Which of the following is not a derived lipid?
(a) Oleic acid
(b) Glyceride
(c) Acetone
(d) Glycerol
(e) Cholesterol
16. Hydrolysis of trehatose will yield:
(a) Two glucose residues
(b) Two fructose residues
(c) Galactose and glucose
(d) Two galactose residues
(e) Fructose and glucose
17. The hydrophilic portion of lipid bilayer membrane is made up of all of the following except:
(a) Phosphate unit
(b) Nitrogenous base
(c) Sugar residue
(d) Hydroxyl group
(e) Sphingosine
18. Which of the following is a structural polysaccharide?
(a) Starch
(b) Inulin
(c) Dextrin
(d) Cellulose
(e) Glycogen
19. Which of the following is a non-volatile fatty acid?
(a) Caprylic
(b) Capric
(c) Lauric
(d) Butyric
(e) Caproic
20. Which of the following is not an oxidative product of carbohydrates?
(a) Ascorbic acid
(b) Ribitol
(c) Uronic acid
(d) Saccharid acid
(e) Aldonic acid
SECTION C II: SHORT ANSWER QUESTIONS (SAQs) (10 minutes)
INSTRUCTIONS:
I) THERE IS ONE (1) QUESTION IN THIS SECTION
II) ANSWER THE QUESTION
III) START THE QUESTION ON A SEPARATE PIECE OF PAPER OF THE BOOKLET
SAQ 1. Describe briefly three (3) buffer systems found in the blood
SECTION D : PHARMACOLOGY (30 Minutes)
SUB-SECTION D I: MULTIPLE CHOICE QUESTIONS (MCQs) (30 minutes)
TYPE 3
INSTRUCTIONS:
(i) EACH OF THE QUESTIONS IN THIS SECTION CONSISTS OF A STATEMENT WHOSE MOST APPROPRIATE ANSWER IS PROVIDED AMONG THE FIVE OPTIONS NUMBERED (a) - (e).
(ii) FOR EACH QUESTION SELECT THE MOST APPROPRIATE OPTION AND INDICATE BY PRINTING AN X IN THE APPROPRIATE BOX IN THE ANSWER SHEETS PROVIDED. IF YOU DO NOT KNOW THE ANSWER, PRINT X IN THE BOX IN THE `D'' COLUMN
(iii) A CORRECT RESPONSE EARNS YOU PLUS ONE MARK.
1. In teaching of pharmacology, drugs should be referred to by which ONE of the following names?
(a) Generic name
(b) Proprietary name
(c) Brand name
(d) Botanic name
(e) Chemical name
2. The clinical studies of a new drug consists of four (4) phases. Phase III studies:
(a) Test experimental laboratory animals for teratogenesis
(b) Gather data on drug pharmacokinetic properties and safety in healthy humans
(c) Gather and analyze voluntary reports of adverse effects submitted by health care professionals
(d) Involve large group of patients, multiple clinical sites, investigations with respect to evidence of drug’s safety and efficacy
(e) Determination of proper dosage in small group of patients with a particular disease
3. All of the following statements about routes of drugs administration are true, EXCEPT:
(a) Patient’s compliance is not guaranteed in the oral route of drug administration
(b) Intravenous route has 100% drug bioavailability
(c) Intravenous route poses more risks for toxicity
(d) Oral route avoids first pass metabolism
(e) Intramuscular route is suitable for oily vehicles
4. All of the following statements about drug transport across biological membranes are true, EXCEPT:
(a) Facilitated diffusion requires no energy
(b) Passive diffusion is a saturable process
(c) Active transport, transports molecules against a concentration gradient
(d) Facilitated diffusion is selective for chemical structure
(e) Filtration allows only some polar molecules with low molecular weight to pass through the pores of the membrane
5. To produce its characteristic pharmacologic effects, a drug must:
(a) Achieve adequate concentration at the site(s) of action
(b) Be metabolized in the liver
(c) Be excreted by the kidneys
(d) Be formulated into a dosage form that produces the most rapid onset and duration of action
(e) Be absorbed from the intramuscular injection site
6. Which of the following factors does not affect drug biotransformation?
(a) Age
(b) Liver disease
(c) Nutrition
(d) Environmental factors
(e) Body mass
7. Which ONE of the following is TRUE for a drug whose elimination from plasma shows first-order kinetics?
(a) The elimination half-life of the drug is proportional to the plasma drug concentration
(b) The amount eliminated per unit time is constant
(c) The rate of elimination is proportion to the plasma concentration
(d) A plot of drug concentration in plasma versus time is a straight line
(e) Clearance in inversely proportional to drug concentration
8. Which ONE of the following factors will determine the number of drug – receptor complexes formed?
(a) Renal secretion of the drug
(b) Apparent volume of drug distribution
(c) Intrinsic activity of the drug
(d) Receptor affinity for the drug
(e) Efficacy of the drug
9. Which of the following is NOT an action of a competitive antagonist?
(a) Binds to the same site on the receptor as the agonist
(b) Decreases the maximum response to an agonist
(c) Shifts the dose-response curve of an agonist to the right
(d) Alters the mechanism of action of an agonist
(e) Alters the potency of an agonist
10. Displacement of a drug from plasma protein binding sites would usually be expected to:
(a) Decrease tissue levels of the drug
(b) Decrease volume of distribution
(c) Decrease metabolism of the drug
(d) Decrease excretion of the drug
(e) Increase tissue levels of the drug
SUBSECTION DII: SHORT ANSWER QUESTIONS (SAQs)
INSTRUCTIONS:-
I) THERE ARE TWO (2) QUESTIONS IN THIS SECTION
II) ANSWER ALL THE TWO (2) QUESTIONS
III) START EACH QUESTION ON A FRESH PIECE OF PAPER OF THE BOOKLET.
SAQ 1. Differentiate between the following pairs
(a) Pharmacology and pharmacy
(b) Drug absorption and drug bioavailability
(c) Full agonist and partial agonist
(d) Elimination half-life (t½) of a drug and drug clearance
(e) Graded dose response and Quantal dose response relationships
SAQ 2. Briefly answer the following
(a) ______________________ is the science concerned with the formulation and chemical properties of pharmaceutical products e.g. tablets, capsules.
(b) ______________________ is a book containing a list of drugs used in medicine with details of their formulas, methods of preparation, dosages, standards.
(c) The continuous exposure to agonists may reduce number of receptors via a process called ______________________________
(d) _______________________ is a measure of how much drug is required to elicit a given response.
(e) _______________________ is when the combined effects of two drugs is greater that the sum of the effect of each drug given alone.
(f) _______________________ is the ration of the median lethal dose (LD50) to the median effective dose (ED50).
(g) _______________________ is a pharmacokinetic parameter that pertains to situations in which the rate of drug elimination is constant and it occurs when drug elimination processes are saturated.
(h) The first-pass metabolism occurs most often after which route of drug administration?
(i) List two processes by which the drug effects from the body can be terminated.
SECTION E: MICROBIOLOGY AND PARASITOLOGY (30 minutes)
SHORT ANSWER QUESTIONS (SAQs)
INSTRUCTIONS:-
I) THERE ARE SIX (6) QUESTIONS IN THIS SECTION
II) ANSWER ALL THE SIX (6) QUESTIONS
III) START EACH QUESTION ON A FRESH PIECE OF PAPER OF THE BOOKLET.
SAQ 1. List one (1) genera and species of bacteria in the following categories
(a) Gram positive facultative anaerobe rod
(b) Gram positive strict anaerobe rod
(c) Gram negative facultative anaerobe cocci
(d) Gram negative strict anaerobe rod
(e) Obligate intracellular bacteria
(5 min)
SAQ 2. List the steps which are essential in gram staining
(5 min)
SAQ 3. Classify with examples the Class Trematoda
(3 min)
SAQ 4. (a) List five (5) cestodes of medical importance stating its genus,
species and common name
(b) Indicate the diseases which may be caused by the cestodes listed above (a)
(7 min)
SAQ 5. Briefly describe the broad classification of viruses
(7½ min)
SAQ 6. Briefly describe the broad classification of fungi
(2½ min)
SECTION F - RADIOLOGY AND IMAGING
SHORT ANSWER QUESTIONS (SAQs) (30 Minutes)
INSTRUCTIONS:
I) THERE ARE THREE (3) QUESTIONS IN THIS SECTION
II) ANSWER ALL THE THREE (3) QUESTIONS
III) START EACH QUESTION ON A FRESH PIECE OF PAPER OF THE BOOKLET.
SAQ 1. Describe sound, its properties and uses in medicine
(10 minutes)
SAQ 2. Describe with the help of an annotated diagram, the production of X-rays.
(20 minutes)
SAQ 3. List five (5) examples of electro-magnetic waves
(5 minutes)
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