Case 23 Questions 1-16

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Enjoy working thorugh the following questions. We hope they aid your learning. If you have any issues or feedback, please email [email protected]

Question 1

Which of these are not a type of synovial joint?

  1. Saddle
  2. Pivot
  3. Synarthrosis
  4. Condyloid
  5. Plane

The correct answer is option c, Synarthrosis

Synarthrosis – this is a type of joint which allows no movement under normal conditions. Examples include gomphosis which is the socket of a tooth.

Question 2

Friction between bones at a synovial joint is reduced by?

  1. Meniscus
  2. Fat pads
  3. Tendon sheath
  4. Articular cartilage
  5. Bursae

The correct answer is option d, Articular cartilage

Articular cartilage – this is a thin layer of hyaline cartilage that covers the entire articulating surface of each bone. In osteoarthritis this becomes damaged leading to joint pain and inflammation.

Question 3

What is the major cell type in connective tissue?

  1. Fibroblasts
  2. Collagen
  3. Osteocytes
  4. Adipocytes
  5. Chondrocytes

The correct answer is option a, Fibroblasts

Fibroblasts – synthesise extracellular matrix, collagen and elastin

Question 4

Body fat is a type of loose connective tissue made up of?

  1. Fibroblasts
  2. Adipocytes
  3. Macrophages
  4. Osteocytes
  5. Chondroblasts

The correct answer is option b, adipocytes

Adipocytes – Its main role is to store energy in the form of lipids, although it also cushions and insulates the body

Question 5

What vitamin is necessary in the synthesis of collagen?

  1. Thiamine
  2. Asorbic acid
  3. Vitamin B12
  4. Vitamin D
  5. Folate

The correct answer is option b, Asorbic acid

Asorbic acid is also called Vitamin C – a lack of vitamin C results in scurvy

Question 6

Which of these aren’t a major function of connective tissue?

  1. Binding and supporting
  2. Protecting
  3. Immune protection
  4. Transporting substances within the body
  5. Insulating

The correct answer is option c, Immune protection

Immune protection – even though it can contain white blood cells it isn’t cartilages main function.

Question 7

The brachial plexus originates from which vertebrae?

  1. C4-C8
  2. C5-C8
  3. C5-T1
  4. C3-C5
  5. C4-T1

The correct answer is option c, C5-T1

C5-T1 – C5 & C6 form superior trunk, then C7 forms the middle trunk and C8 & T1 form the inferior trunk.

Question 8

Which of these is not a compartment of the brachial plexus?

  1. Terminal nerves
  2. Anterior rami
  3. Cords
  4. Trunks
  5. Posterior rami

The correct answer is option e, Posterior rami

Posterior rami – the brachial plexus leaves the anterior rami of C5-T1

Question 9

What are the terminal branches of the brachial plexus?

  1. Ulnar, median, radial, axillary and musculocutaneous
  2. Lateral pectoral nerve, ulnar, radial, subscapular and median
  3. Ulnar, phrenic, radial, axillary and musculocutaneous
  4. Ulnar, median, radial, axillary and lateral pectoral nerve
  5. Lateral pectoral nerve, median, radial, axillary and subscapular

The correct answer is option a, Ulnar, median, radial, axillary and musculocutaneous

Question 10

Synovial joints ________.

  1. Are the least common joint in the human body
  2. Are joints where the bones are connected to each other by hyaline cartilage
  3. May be functionally classified as a amphiarthrosis
  4. Are joints where the bones are connected to each other by fibrocartilage
  5. May be functionally classified as diarthosis

The correct answer is option e, May be functionally classified as diarthosis

may be functionally classified as diarthosis – they provide the majority of body movements and are divided into three categories; uniaxial, biaxial or multiaxial depending on how many planes they can move through.

Question 11

The main function of proteoglycans in extracellular matrix is ______.

  1. Adhesion
  2. Secretions
  3. Tensile strength
  4. Resist compressive forces
  5. Proliferate in response to injury

The correct answer is option d, Resist compressive forces

Resist compressive forces – through the production of a hydration gel.

Question 12

Which of these is not a pharmacokinetic property of NSAIDs?

  1. Highly plasma protein bound
  2. Extensively metabolised in the liver
  3. Renal excretion
  4. Conjugated to an active form
  5. Peak plasma concentrations within 1-3h

The correct answer is option d, Conjugated to an active form

NSAIDs are highly plasma protein bound (>90%), extensively (>99%) metabolised in liver, excreted renally in urine and peak plasma concentrations within 1-3h. However, they are conjugated to an inactive form, not an active form.

Question 13

Which of these is not a pharmacokinetic property of codeine?

  1. Metabolised by CYP450 enzymes in the liver
  2. Taken IV to treat acute severe pain
  3. Metabolised to morphine
  4. Considerable first pass metabolism
  5. Conjugation with glucuronide

The correct answer is option b, Taken IV to treat acute severe pain

Codeine is metabolised by CYP450 enzymes in the liver, metabolised to morphine, has a considerable first pass metabolism and undergoes conjugation with glucuronide. It is not given IV-it is given orally.

Question 14

Which of these is true regarding NSAIDs?

  1. All users will sustain some degree of GI damage
  2. They are inhibitors of gastric COX-2 enzymes
  3. They block synthesis of prostaglandins
  4. They inhibit acid secretion
  5. Co-prescribing a PPI increases risk of GI damage

The correct answer is option c, They block synthesis of prostaglandins

Only 34-46% of users of NSAIDs will sustain degree of GI damage, they inhibit gastric COX-1 enzymes, they don’t inhibit acid secretion-they indirectly increase acid secretion, coprescribing PPI decreases risk of GI damage. They do block synthesis of synthesis of prostaglandins.

Question 15

Which of these is not a common side effect of opioids?

  1. Respiratory depression
  2. Nausea and vomiting
  3. Pupillary dilation
  4. Euphoria and sedation
  5. Constipation due to reduced GI motility

The correct answer is option c, Pupillary dilation

Opioids can cause respiratory depression, nausea, vomiting, euphoria, sedation and constipation due to reduced GI motility. They also cause pupillary constriction not dilation.

Question 16

In which situation is prescription of naproxen not recommended?

  1. Severe heart failure
  2. Acute gout
  3. Dysmenorrhoea
  4. Rheumatoid arthritis
  5. Migraine

The correct answer is option

Naproxen is available for prescription in acute gout, dysmenorrhoea, rheumatoid arthritis, and migraine but contraindicated in severe heart failure.

Credits

  • 1-11 (Blaise Hickson, 3rd year),
  • 12-16 (Oliver Mann, 3rd year)