Semifinal 2nd session Question

I.      Buzzer Quiz

1.       The patients with Huntington disease have abnormal expansion of CAG repeat at the short arm of the No.4 chromosome. Which amino acid is corded in this codon?

n  AnswerGlutamine


2.       Which plant includes the component that inhibits sweet taste sensation?

n  AnswerGymmnema (sylvestre)


3.       The patients with hereditary spherocytosis often have gallstones. What is the substance which causes the gallstone?

n  AnswerBilirubin


4.       What is the neurotransmitter produced in the cell body, which is stimulate by a nerve fiber of hyper direct path?

n  AnswerGlutamic acid / Glutamate


5.       A medicine with elimination half life of 2 hours has been given at a dose of 16mg/L. How many hours does it take for plasma drug concentration to become 2mng/L?

n  Answer6 hours


6.       What is the hormone which promotes uterine involution in a lactating woman?

n  AnswerOxytocin


7.       Enzyme replacement therapy is ineffective for central nerve system(CNS). What structure prevents enzyme from moving to CNS?

n  AnswerBlood brain barrier


8.       Injuring of C5 nerve root causes a weakness of a certain muscle whose main function is abduction of shoulder joint. What is this skeletal muscle?

n  AnswerDeltoid muscle




9.       The bleeding blood is stored in the bottom of peritoneal cavity in the case of ectopic pregnancy rupture. What is the dissemination of cancer cells from digestive tracts to this area called?

n  AnswerSchnitzler metastasis


10.    A man trapped under collapsed building was rescued by his family in the Great East Japan Earthquake. After he was rescued, he presented with cyanosis and disorder of consciousness. What electrolyte is most responsible for these symptoms?

n  AnswerPotassium(K)

n  CommentPotassium is the major cation inside the cell. Necrosis of myocytes cause efflux of potassium ions into the blood. Hyperkalemia lowers the resting potential of the cells and thereby cells are easily depolarized.


11.    In patients with Addison's disease, production of energy adrenal cortex hormone is damaged. Whereas in patients with Secondary adrenal insufficiency, one of the adrenal cortex hormone productions is produced. What is this hormone?

n  AnswerAldosterone

n  CommentIn secondary adrenal insufficiency, the production of ACTH and CRH are damaged. However, Aldosterone can be produced through Renin-Angiotensin-Aldosterone system.


12.    In patients with amyotrophic lateral sclerosis(ALS), micturition and defecation troubles do not occur. What is the nucleus which keeps these functions in normal?

n  AnswerOnufrowicz nucleus (Onuf nucleus)



II.    Flip Quiz

1.       This picture shows herpes zoster. Answer the dermatome which is related to the eruption surrounded by the red circle?

n  AnswerTh10 or Th11

n  Comment

Varicella-Zoster virus reactivates in people with weakened immune systems. This virus is latent in ganglion and reactivates along the dermatome.


2.       State the changes in cardiac tamponade from normal in the following?

      Blood pressure

      Cardiac output

      Central venous pressure

      Peripheral vascular resistance

n  Answer:①:Decreased、②:Decreased、③:Increased、④:Increased

n  Comment

Since cardiac tamponade causes obstructive shock, blood pressure and cardiac output decrease. In this case, since cardiac dilatation is impaired, venous return to the heart decreases and central venous pressure rises. It also increases vascular resistance to compensate for lowering blood pressure due to reduced cardiac output.


3.       Sort out the order of migration process of leukocytes.

      Binding of ICAM-1 (vascular endothelial cells) and LFA-1 (leukocytes)

      Binding of E selectin (vascular endothelial cells) and sialyl Lewis X chain sugar chain

      Interaction between PECAM-1

      Migration to sites with high chemokine concentration

n  Answer:② → ① → ③ → ④

n  CommentE-selectin is a heterogeneous cell adhesion device and involves weak adhesion (rolling) with leukocytes. After that, ICAM-1 and LFA-1 are strongly adhered to each other, and then the leukocytes migrate by interaction of PECAM-1 between the vascular endothelial cells and leukocytes.


4.       This graph is Scammons growth curve. Choose A-D corresponding to-, respectively.





n  Answer:①:B,:C,:D,:A


5.       Choose 3 of the following metabolisms activated by insulin.

      Fatty acid oxidation

      Fatty acid synthesis







      GLUT4 translocation

n  Answer:②・⑤・⑥


6.       A 60-year-old man complains of edema and jaundice. From the pathological image shown here, choose 3 of the following that are supposed to show abnormal values in the blood test in this patient.







n  Answer:①・③・⑤

n  CommentIt is a pathological image of cirrhosis of the liver.

    Splenomegaly caused by portal hypertension causes platelet destruction to hyperactivation.

Albumin decreases due to decreased liver function.

Pancytopenia due to splenomegaly promotes red blood cell hematopoiesis.


7.       Which of the following increase in the patients with acute myocardial infarction? Choose 5 answers.


      CRP (c-reactive protein)

      ALT (alanine aminotransferase)

      ALP (alkaline phosphatase)

      LDH (lactate dehydrogenase)

      CK-MB (creatinine kinase with muscle subunits)


      BUN (blood urea nitrogen)


      RF (rheumatoid factor)

n  Answer:②・⑤・⑥・⑦・⑨

n  Comment

In the patients with AMI, cardiac muscle cells become necrotic and enzymes in the cell leak out. This enzyme is called leaking enzyme. In AMI, AST, LDH, CK-MB, Troponin, Myoglobin and H-FABP are famous example. CRP is also an important leaking enzyme in AMI. High values of them  raise the risk of cardiac rupture as a complication.





8.       Which of the following substances are metabolized and become indirect bilirubin? Choose three answers.


      Glutathione peroxidase





n  Answer:②・③・⑤



III.Time Attack


1.       Cerebrum is developed from forebrain.

n  AnswerTrue


2.       High doses of dopamine cause peripheral vasodilation.

n  AnswerFalse


n  CommentDopamine shows β action at medium dose and α action at high dose.

3.       The appearance of anti-HBe antibody means healing of hepatitis B.

n  AnswerFalse


4.       Dilated cardiomyopathy causes weight loss.

n  AnswerFalse


5.       Ptosis in patients with Horner syndrome is caused by dysfunction of Mullers muscle.

n  AnswerTrue


6.       ACTH is high in a patient with adrenal adenomas.

n  AnswerFalse






7.       Which of the following EEG appears during awakening at resting position with closing eyes?

P)     α wave

Q)    β wave

R)     δ wave

S)      θ wave

n  AnswerP


8.       Which disease causes hyponatremia?

P)     Pure-water dehydration

Q)    Diabetes insipidus

R)     SIADH

S)      Primary hyperaldosteronism

n  AnswerR

n  Comment

In SIADH(Syndrome of Inappropriate secretion of ADH), circulating plasma volume increases due to excess water reabsorption, which causes suppression of Renin-Angiotensin system and increased secretion of ANP.



9.       Which is not the symptom or finding of Vitamin B1 deficiency?

P)     Decreased Achillestendon reflex

Q)    Wernickes encephalopathy

R)     Hemolytic anemia

S)      Metabolic acidosis

n  AnswerR


10.    Which is less related to anaphylactic shock than others?

P)     Basophil

Q)    IgE

R)     Histamine

S)      Macrophage

n  AnswerS



11.    Which gene is mutated in HBOC(Hereditary Breast and Ovary Cancer)?

P)     APC

Q)    BRCA1/2

R)     BRAF

S)      NF-1

n  AnswerQ


12.    Which is the strongest risk factor of the malignant mesothelioma?

P)     Asbestos

Q)    Chlorine

R)     HPV

S)      Mycobacterium tuberculosis

n  AnswerP

n  CommentThis material brings about big problems in the whole world so it is not difficult to choose a correct answer.


13.    Why is postmenopausal obesity a risk factor for breast cancer?

P)     Insulin resistance

Q)    Incease in blood glucose level

R)     Adipose tissue aromatase

S)      Rise of progesterone

n  AnswerR

n  CommentAdipocytes contain aromatase.


14.    What is the change in enzyme activity called when the tertiary structure is altered by the binding of the regulatory factor?

n  AnswerAllosteric effect


15.    What is the movement to transfer food toward the anus by contraction of the smooth muscle of the gastrointestinal tract?

n  AnswerPeristalsis (Peristaltic motion)


16.    What is the name of the artery that passes through the Calots triangle in 75of individuals?

n  AnswerCystic artery


17.    What is the name of the organelle that stores calcium ions?

n  AnswerEndoplasmic reticulum/ mitochondria/ sarcoplasmic reticulum


18.    What is the substance necessary for fatty acid to pass through the mitochondrial membrane?

n  Answercarnitine


19.    What is the phenomenon that dendritic cell combines an antigen with MHC classand exhibits the antigen to cell surface?

n  AnswerCross presentation

n  CommentIn cross presentation causes antigen presentation through MHC classand enables to present antigen to CD8T cell.


20.    What is the fastest feedback mechanism in blood pressure regulation?

n  AnswerBaroreceptor reflex


21.    What is the region of respiratory system which doesnt participate in gas exchange called?

n  Answerdead space


22.    What nerve transmits sensation of the urinary bladder extension to the mieturition center?

n  AnswerPelvic (splanchnic) nerve


23.    What is the largest lipo-protein?

n  AnswerChylomicron


24.    A 27-year-old female, came to her physician complaining vomiting of blood. She was suffering from epigastralgia for 3 months. She had a fever few days ago so took a medicine. The inhibition of what enzyme causes blood vomiting?

n  AnswerCyclooxygenase


25.    What is the lowest concentration of a macrolide antibiotics which prevents visible growth of a bacterium called?

n  AnswerMinimum inhibitory concentration(MIC)

n  CommentTime dependent antibiotics such as macrolides can be effective while their concentration exceeding the MIC for the microorganism and therefore they should be administered to the patient several times a day to keep the concentration higher than MIC. Concentration dependent antibiotics are more effective when the concentration of the chemical is higher. They are recommended to be administered once a day.





1.       Peristalsis of ureter is inhibited by the parasympathetic system.

n  AnswerFalse


2.       The mucosal intercellular adhesion device is mainly desmoglein -1.

n  AnswerFalse

n  CommentDesmoglein-1 is common in the epidermis. Desmoglein-3 is common in mucous membranes. Therefore, there is little mucosal injury due to the production of anti-Dsg1 antibody in pemphigus.


3.       Acetyl CoA is used for gluconeogenesis.

n  AnswerFalse

n  CommentSince the carbon atoms in acetyl CoA are discharged as carbon dioxide in the TCA circuit, it is impossible to become oxaloacetate along the TCA circuit.


4.       Spore can be inactivated by alcohol disinfection.

n  AnswerFalse


5.       The secretion of the Brunnellian glands is more alkaline than that from the other intestinal tracts.

n  AnswerTrue

n  CommentThe acidic contents from the stomach and pancreatic enzymes with alkaline pH optimum come together in the duodenum. Therefore, the Brunnell glands secrete alkaline secretion because of supply of optimum pH to pancreatic enzymes and neutralization of acid content.


6.       Primary aldosteronism causes metabolic alkalosis

n  AnswerTrue












7.       For Olympic athletes, which medicine is allowed to use?

P)     Epinephrine

Q)    Steroid hormone

R)     Penicillin

S)      Erythropoietin

n  AnswerR

n  Comment

Taking drugs is prohibited which promotes an athletes body performance. They have to avoid taking Epinephrine, βactivator , Erythropoietin(EPO) which promotes creation of erythrocyte, EPO receptor activator anabolic steroid. On the other hand, Penicillin is just an antibiotics, which doesnt promote body performance.


8.       Which vitamin contributes to stable triple helix structure of the collagen fiber?

P)     Vitamin B1

Q)    Vitamin B12

R)     Vitamin C

S)      Vitamin E

n  AnswerR

n  CommentThe pathology of scurvy is the destabilization of collagen fiber due to Vitamin C deficiency, which causes vulnerability of vascular supporting tissue.


9.       Which amino acid is related to the synthesis of porphyrin?

P)     Alanine

Q)    Tyrosine

R)     Serine

S)      Glycine

n  AnswerS

n  CommentFirst substrates of Porphyrin synthesis are Glycine and Succinyl CoA.


10.    Which does not occur in Basedows disease?

P)     Exophthalmos

Q)    Increased β1 receptor

R)     Increased serum TSH

S)      Increased activity of Na+/K+ATPase

n  AnswerR




11.    Which of the following organ has the highest blood flow per cardiac output?

P)     Liver

Q)    Brain

R)     Lung

S)      Kidney

n  AnswerP

n  CommentLiver has 25% of blood flow per cardiac output. But it decreases during exercise.


12.    Which of the following nerves is related to curtain sign?

P)     Oculomotor nerve

Q)    Trigeminal nerve

R)     Vestibular nerve

S)      Glossopharyngeal nerve

n  AnswerS


13.    In a patient with renal diabetes insipidus, why thiazide diuretics causes an increase in circulating plasma volume?

P)     Activation of renin-angiotensin system

Q)    Increased expression of AQP2

R)     Increase in serum ADH

S)      Increase in V2 receptor expression

n  AnswerP

n  CommentReduction of circulating plasma volume due to thiazide diuretic and Na diuretic cause reabsorption of Na and water via renin-angiotensin system.


14.    What is the transportation mechanism using concentration gradient of sodium formed by Na+/K+ ATPase?

n  AnswerSecondary active transport


15.    Helicobacter pylori can survive by neutralizing gastric acid, what is this secretion called?

n  AnswerUrease


16.    What is the name of the junction of internal jugular vein and subclavian vein?

n  Answervenous angle


17.    What is the parameter of enzyme that indicates the affinity for its substrate?

n  AnswerThe Michaelis constant


18.    What is the name of the substance produced by decarboxylation of glutamic acid?

n  AnswerGABA


19.    What is the change called, when esophageal squamous cell changes into columnar epitherium in the patient with chronic reflux esophagitis?

n  AnswerMetaplasia


20.    What is the interval between atrial systolic period and ejection period?

n  AnswerIsovolumetric contraction period


21.    What is the respiration pattern in which changes in PaO2 cause periodic breathing characterized by waxing and waning respiration?

n  AnswerCheyne-stokes breathing


22.    In the patient with the atrophy of thenar eminence, what nerve is injured?

n  Answermedian nerve


23.    What hormone promotes milk ejection and delivery?

n  AnswerOxytocin


24.    Which anti-hypertensive drug is effective against aspiration pneumonia?

n  AnswerACE inhibitor (Angiotensin-converting enzyme)

n  CommentDry cough induced by side effect of ACE inhibitor helps excretion of aspiration matters.


25.    Aortic aneurysm does not disappear naturally. What is the name of the law that support this fact?

n  AnswerLaplaces law

n  CommentAccording to the Laplaces law, wider the diameter of aneurysm gets, greater the tension to the wall of Aorta gets. Therefore, once an aneurysm is formed, tension to the wall of the aneurysm undergo an increase in tension until it is removed.




1.       ADH promotes the reabsorption of sodium in the collecting duct.

n  AnswerFalse


2.       Tissue factor is produced mainly in the liver.

n  AnswerTrue

3.       Fish oil contains a lot of ω-6 unsaturated fatty acid.

n  AnswerFalse

n  CommentFish oil is considered healthy because it contains many ω - 3 unsaturated fatty acids with cardiovascular protective action.


4.       Homolytic complement 50(CH50) activity decreases in type allergy.

n  AnswerTrue


5.       Pulmonary artery wedge pressure equals right atrial pressure.

n  AnswerFalse


6.       Secretin promotes secretion of the pancreatic enzyme

n  AnswerFalse


7.       Which part of the brain lacks blood brain barrier(BBB)?

P)     Pineal body

Q)    Caudate nucleus

R)     Globus pallidus

S)      Putamen

n  AnswerP


8.       Which hormone decreases serum potassium?

P)     Estrogen

Q)    Insulin

R)     Growth hormone(GH)

S)      Gastrin

n  AnswerQ

n  CommentInsulin activates Na+/K+ATPase.


9.       Which metabolic pathway acts only in the liver?

P)     Glycogenesis

Q)    Pentose phosphate pathway

R)     Tricarboxylic cycle(TCA cycle)

S)      Urea cycle

n  AnswerS




10.    Which category is tuberculin reaction classified?

P)     type

Q)    type

R)     type

S)      type

n  AnswerS


11.    Which is the symptom of Cushing disease?

P)     Hemoptysis

Q)    Hyperkalemia

R)     Pigmentation

S)      Hypotension

n  AnswerR

n  CommentCushing disease is the same as ACTH-producing pituitary adenoma, which causes pigmentation due to high ACTH.


12.    Which of the following vessels provides the greater part of blood flow to the liver ?

P)     Proper hepatic artery

Q)    Portal vein

R)     Central vein

S)      Bile duct

n  AnswerQ

n  CommentPortal vein provides 75% of hepatic blood flow. Proper hepatic artery provides 25% of it.


13.    In a right-handed patient with semi-lateral agnosia(hemiasomatognosia), which of the following is injured?

P)     Frontal association area

Q)    Right upper parietal association area

R)     Right temporal association area

S)      Left upper parietal association area

n  AnswerQ

n  CommentIt is the obstacle of the parietal association field of the inferior hemisphere that causes semi-lateral disapproval and semi-lateral spatial neglect.


14.    Where is most of Vitamin B12 absorbed in the small intestine?

n  Answer(Terminal) ileum



15.    What is the membrane potential called when no net migration of the electrolyte occurs?

n  AnswerEquilibrium potential


16.    What is the name of the artery that arises from the abdominal aorta and supplies blood to the sigmoid colon?

n  Answerinferior mesenteric artery


17.    How many times do G-protein coupled receptors transverses the cell membrane?

n  Answer7times


18.    What is the name of the carrier that transports glucose through the brush border of the intestinal epithelium?

n  AnswerSGLT1(Sodium-dependent glucose transporter-1)


19.    What is the name of the substance that is delivered by thiazolidines and related to the differentiation of adipocyte?

n  AnswerPPAR-γ

n  CommentPPAR-γ promotes adipogenesis. Thiazolidines activate PPAR gannma as a means to secrete adiponectin from adipocytes and improve insulin resistance.


20.    What is the phenomenon in which leftright shunt changes to right-left shunt in congenital heart disease?

n  AnswerEisenmenger syndrome


21.    The decrease in production of a certain substance by aspirin may cause gastric ulcer. What is the substance?

n  Answerprostaglandin


22.    What is the deep and regular respiration which occurs in a patient with metabolic acidosis?

n  AnswerKussmaul respiration


23.    What is the inclusion body in the cell of substantia nigra in a patient with Parkinson disease?

n  AnswerLewy body






24.    Hereditary spherocytosis causes hemolysis due to poor plasticity of the erythrocyte. Which organ should be removed as a symptomatic therapy?

n  AnswerSpleen

n  Splenectomy decreases destruction of spherocyte. However, this treatment increases the risk of Streptococcus pneumoniae infection, so prevention is essential by injecting vaccine and so on.


25.    Most of the abnormal ECG findings that were present at the onset of myocardial infarction gradually disappear. Which abnormal finding remains as a sign of old infarction?

n  Answerpathological(abnormal) Q waves

n  CommentPathological Q wave is formed by the normal myocyte located on the other side of the myocytes that underwent necrosis. The pathological Q wave remains permenantly because myocytes do not regenerate.




1.       Dopamine secreted from the hypothalamus promotes the secretion of prolactin.

n  AnswerFalse


2.       The vertebral artery passes through transverse foramen of cervical vertebrae.

n  AnswerTrue


3.       The de novo synthesized TG in the liver binds to apo B-48.

n  AnswerFalse

n  CommentThe newly synthesized TG in the liver binds to apoB - 100 and exists in the blood as VLDL.


4.       The focus of urticaria is the epidermis.

n  AnswerFalse

n  CommentThe lesion is the dermis. Urticaria is edema due to vasodilatation / vascular permeability, and it is understood that this sentence is not correct because there is no blood vessel in the epidermis. Necrotic fasciitis attacks the fascia and muscle.


5.       In patent ductus arteriosus, continuous murmur is heard.

n  AnswerTrue


6.       Gastric acid inhibits gastrin secretion in feedback manner.

n  AnswerTrue


7.       Which physical finding indicates excess infusion?

P)     Decreased turgor of the skin

Q)    Jugular venous distention

R)     Increased tendon reflex

S)      Decreased urine volume

n  AnswerQ


8.       Which amino acid is the substrate of the hypothalamic hormone which inhibits secretion of PRL?

P)     Valine

Q)    Threonine

R)     Tyrosine

S)      Tryptophan

n  AnswerR


9.       Which immunoglobulin increases in a patient with autoimmune hepatitis?

P)     IgG

Q)    IgA

R)     IgE

S)      IgM

n  AnswerP


10.    Which receptor does HIV bind when invading T cell?

P)     CD4

Q)    CD8

R)     CD20

S)      CD45

n  AnswerP


11.    Which part of the body is convulsion observed most frequently in Roland seizure(BECTS)?

P)     Foot

Q)    Arm

R)     Finger

S)      Face

n  AnswerS





12.    Which of the following increases with hypovolemic shock?

P)     Skin temperature

Q)    Peripheral vascular resistance

R)     Cardiac output

S)      Central venous pressure

n  AnswerQ

n  Comment

Ø  P) Skin temperature declines because of decrease of blood flow

Ø  Q) R) Peripheral vessel contracts to compensate for decline of blood pressure.

Ø  S) Venous pressure doesnt rise because of decrease of blood flow.


13.    Which of the findings follows immediately after cervical spinal cord injury?

P)     Intestinal peristalsis hyperactivity

Q)    Urinary incontinence

R)     Flaccid paralysis

S)      Blood pressure elevation

n  AnswerR

n  CommentImmediately after spinal cord injury, it is called the spinal shock period, and all functions below the injured part are lost. Therefore, although it is spinal cord injury, flaccid paralysis occurs for several weeks after injury.


14.    What is the serum copper transport protein that declines in Wilsons disease?

n  AnswerCeruloplasmin


15.    Where is the most of bile acid absorbed in the small intestine?

n  AnswerIleum


16.    What is the name of the structure that passes through the inguinal canal in female?

n  Answerthe round ligament of the uterus


17.    Along a myelinated nerve, what is the space without myelin called?

n  AnswerNode of Ranvier, Ranviers node


18.    What is the name of the substance that produces ATP from ADP in skeletal muscles in a short-term high intensity activity lasting about 10 seconds?

n  Answercreatine phosphate



19.    What is the value which is measured with Swan-Ganz catheter and indicates left atrial pressure?

n  Answerpulmonary wedge pressure


20.    What is the pancreatic enzyme which is activated by Enterokinase?

n  AnswerTrypsinogen

n  CommentEnterokinase activates trypsinogen and change it to trypsin. Trypsin activates other pancreatic enzyme.


21.    What hormone proliferates endometrium?

n  AnswerEstrogen



22.    Donepezil inhibits which enzyme in a patient with Alzheimer dementia?

n  AnswerChE(Choline esterase)


23.    What kind of factor is essential for platelet to bind to collagen fiber?

n  Answervon Willebrand factor(vWF)


24.    In which valvular disease does pulse pressure increase?

n  AnswerAortic regurgitation

n  CommentIn patients with aortic regurgitation, the systolic pressure rises and the diastolic pressure drops. This causes the pulse pressure to widen.


25.     What is calculated from Harris-Benedict equation?

n  AnswerBasal energy expenditure