Complication of duodenal ulcer:

 # Complication of  duodenal ulcer: 

A. Hypoacidity

B. Pernicious anemia

C. Stenosis

D. Malignant transformation

The correct answer is C. Stenosis.

Obstruction from edema or scarring occurs in about 2% of the patients. Most often due to pyloric channel ulcers. May also occur with duodenal ulcers.

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Gluconeogenesis occurs in the liver and:

 # Gluconeogenesis occurs in the liver and ________.

 A. Kidney

 B. Muscle

 C. Heart

 D. Fat

The correct answer is A. Kidney.

Gluconeogenesis (GNG) is a metabolic pathway that results in the generation of glucose from certain non-carbohydrate carbon structures. 

In vertebrates, gluconeogenesis occurs mainly in the liver and, to a lesser extent, in the cortex of the kidneys. It is one of two primary mechanisms – the other being degradation of glycogen (glycogenolysis) – used by humans and many other animals to maintain blood sugar levels, avoiding low levels (hypoglycemia). Although most gluconeogenesis occurs in the liver, the relative contribution of gluconeogenesis by the kidney is increased in diabetes and prolonged fasting.

Gluconeogenesis is a pathway consisting of a series of eleven enzyme-catalyzed reactions. The pathway will begin in either the liver or kidney, in the mitochondria or cytoplasm of those cells, this being dependent on the substrate being used. Many of the reactions are the reverse of steps found in glycolysis. 

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Fluid mosaic model of membrane structure was proposed by:

 # Fluid mosaic model of membrane structure was proposed by:

A. Watson and Crick

B. Edward H. Angle

C. G.V. Black

D. Singer and Nicolson

The correct answer is D. Singer and Nicolson.

The fluid mosaic model explains various observations regarding the structure of functional cell membranes. According to this biological model, there is a lipid bilayer (two molecules thick layer consisting primarily of amphipathic phospholipids) in which protein molecules are embedded. The phospholipid bilayer gives fluidity and elasticity to the membrane. Small amounts of carbohydrates are also found in the cell membrane. The biological model, which was devised by SJ Singer and G. L. Nicolson in 1972, describes the cell membrane as a two-dimensional liquid that restricts the lateral diffusion of membrane components. 

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Which of the following does not occur in mitochondria?

 # Which of the following does not occur in mitochondria?

A. TCA

B. HMP shunt

C. Urea cycle

D. Beta oxidation of fatty acids

The correct answer is B. HMP shunt.

HMP shunt or hexose monophosphate pathway or pentose phosphate pathway (PPP) or phosphogluconate pathway : for oxidation of glucose as an alternative pathway to glycolysis and TCA cycle. Enzymes for HMO shunt are located in cytosol/cytoplasm.

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Muller’s muscle is seen in:

 # Muller’s muscle is seen in:

A. Nose tip

B. Upper eye lid

C. Lower eye lid

D. Mid canthus

The correct answer is B. Upper eyelid.

Posterior to the levator aponeurosis is the underlying Muller's muscle complex- Orbitalis muscle or the circular fibres of the ciliary muscle, both of which are also known as Muller's muscle. 

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Why is morphine contraindicated in maxillofacial injury or head injury?

 # In patients with maxillofacial injury, narcotics like morphine are contraindicated because:

A. Morphine causes miosis

B. Morphine causes mydriasis

C. Morphine is respiratory irritant

D. Morphine is circulatory depressant

The correct answer is A. Morphine causes miosis.

Miosis masks the neurological signs of cerebral hemorrhage.

  Morphine is a phenanthrene derivative opioid analgesic. It is contraindicated in head injuries due to:

- Retention of carbondioxide leading to increased intracranial pressure

- exaggerated depression of respiration and the potential need to control ventillation of the patient must be considered

- vomitting, miosis (miosis will interrupt in monitoring the eye signs in case of probable head injury in the patients of maxillofacial injury), and altered mental state interfere with assessment of prognosis in patients with head injury

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‘Chicken-wire’ appearance of enlarged bone marrow spaces is seen in:

 # ‘Chicken-wire’ appearance of enlarged bone marrow spaces is seen in:

A. Fetal alcohol syndrome

B. Sickle cell anemia

C. Hemophilia A

D. Beta thalassemia major

The correct answer is D. Beta thalassemia major.

Radiographic changes of thalassemia include generalized rarefaction of alveolar bone, chicken-wire appearance of enlarged marrow spaces and coarse trabeculation. In the skull, proliferation of marrow may completely erode the cortex, leaving only periosteum, and produce a ‘hair-on-end’ radiographic appearance.

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