Environmental and Nutritional
1. Which of the following is an onti-oxidant?
a. Vitamin D
b. Vitamin B12
c. Vitamen E <=
d. Vitamin K
e. Vitamin B6
2. With electrical injury
a. Death is always due to thermal burn
b. Dry skin is a good electrical conductor
c. Ampage of the current is important <=
d. All body tissues conduct electricity
e. ?
3. Which deficiency causes diarrhoea, dermatitis and dementia
a. Pyridoxine – B6 peripheral neuropathy, dermatitis, glossitis
b. Vitamin A – night blind, blind, infection vulnerability
c. Riboflavin - B2
d. Vitamin B1 – thiamine: beriberi, wernicke, korsakoff
e. Niacin <= pellagra: the 3 D’s
4. Decreased levels of B12 are associated with all of the following EXCEPT:
a. Autoimmune gastritis
b. Crohn’s Disease
c. Subacute combined degeneration of the cord
d. ?
e. ?
5. Regarding Iron, which of the following is INCORRECT?
a. Absorption is increased by vitamin C
b. Most is found in myoglobin <= haem
c. Most is absorbed in the duodenum
d. Women have smaller iron stores than men
e. Transferrin is usually 33% saturated
6. in males the relative risk of cigarette smoking causing a cancer is highest for
a. lung
b. larynx
c. oesophagus
d. pancreas
e. lip, oral and pharynx <=
7. Cessation in cigarette smoking causes the most prompt reduction in the risk of
a. Lung cancer
b. Stroke
c. Cancer of the bladder
d. MI <=
e. COPD
8. Smoking is associated with all of the following diseases EXCEPT:
a. Spontaneous abortion
b. Atherosclerosis
c. Bladder carcinoma
d. Chronic liver disease <=
e. ?
9. Smoking is associated with
a. ?
b. ?
c. ?
d. particle depositioin in alveolar macrophages
e. ?
10. Concerning radiation injury
a. 1 gray (Gy) corresponds to 1000 rad – 1 rad = 10-4 Gy, so 1 rad = 10,000 Gy
b. divided doses can have greater effect than single doses – single dose worse (tumor Rx… spread)
c. intermediate doses (1-2Gy) kill mainly proliferating cells <=
d. Chronic effects are mainly caused by damage to cellular DNA
e. Free radicals may protect against radiation injury
11. Shock in burns patients is primarily due to
a. Neurogenic factors
b. Hypovolaemia
c. Acute erythrocyte haemolysis
d. Myocardial depression factor
e. All of the above <=
12. The immediate lethal dose of radiation exposure for humans in a non-mass casualty situation is
a. 50rad <= >50Sv in the table…? 2-10 will kill slowly 0-80%, 10-20 100%
b. 150rad
c. 250rad
d. 350rad
e. 450rad
13. Which tissue is most susceptible to radiation?
a. Gastrointestinal mucosa
b. CNS
c. Haematopoietic <=
d. Lymph
e. ?
14. A deficiency of which can cause heart failure?
a. Pyridoxine
b. Vitamin D
c. Vitamin C
d. Zinc
e. Thiamine <= alcoholic… wet beriberi
15. The black colour seen in chronic smokers lungs is due to deposition of particles in
a. alveolar macrophages <=
b. alveolar endothelial cells
c. alveolar type 1 epithelial cells
d. type 2 epithelial cells
e. ?
16. The oral contraceptive pill is protective against
a. Venous thrombosis
b. Breast carcinoma
c. Cervical carcinoma
d. Ovarian carcinoma <= ovarian, endometrial and colorectal (no increased lifetime risk of any, but
possibly more breast cancer incidence in first 5 years of use)
e. Hepatic carcinoma
17. A man is brought to the ED with heart failure and has a cardiac index of 81. Which is most likely
to cause this?
a. Thiamine deficiency <=
b. Myocardial ischaemia
c. Vitamin B6 deficiency
d. B12 deficiency
e. Arrythmia
18. In iron deficiency
a. Increased serum ferritin
b. Decreased transferrin saturation <=
c. Decreased total iron binding capacity
d. ?
e. ?
19. coal causes all except
a. pneumoconiosis <=
b. pulmonary fibrosis
c. Caplan’s syndrome
d. Bronchial Ca
e. Anthracosis
20. smoking related cancers include all except
a. pancreas
b. bladder
c. kidney <=
d. larynx
e. lung
21. lead poisoning causes
a. macrocytosis
b. early fusion of epiphysis
c. diabetes mellitus
d. learning difficulties in kids <=
e. weak hand flexors
22. heroin overdose causes all of the following EXCEPT:
a. coma
b. pulmonary oedema
c. acute myocardial infarction due to vasospasm <=
d. miosis
e. confusion
23. Which is true of iron?
a. It is absorbed in the stomach
b. It has increased absorption in the presence of vitamin C <=
c. It causes pulmonary fibrosis
d. ?
e. ?
24. Use of oral contraceptives is associated with increased risk of
a. Breast carcinoma in women over 45 years of age
b. Endometrial carcinoma
c. Ovarian carcinoma
d. Cervical carcinoma
e. Ischaemic heart disease <=
25. Which of the following combinations of symptoms and vitamin deficiency are correct?
a. Vitamin A: chelosis, glossitis, dermatitis – 2 riboflavin and 6 pyridoxine
b. Niacin: dementia, diarrhoea, dermatitis <= pellagra, the 3 D’s
c. Vitamen E: xerophthalmia, night blindness - A
d. Vitamin B2: megaloblastic anaemia, neural tube defects – folate
e. Folate: scurvy - C
26. megaloblastic anaemia due to vitamin B12 deficiency occurs in
a. haemodialysis
b. anticonvulsant use
c. markedly increased haematopoiesis
d. loss of intestinal bacteria with antibiotic use
e. disseminated cancer <=
27. hyperbaric oxygen therapy
a. is useful in the treatment of clostridial infection <=
b. is not effective for leprosy
c. is usually administed at 5-6 atmospherers
d. prevents the formation of oxygen free radicals
e. can be administered in sealed negative pressure isolation rooms
28. with regards to air pollution
a. sulphur dioxide is a major component of smog and has minimal effect on the airways
b. ultrafine particles cause injury due to free radical formation in the atmosphere
c. ozone is a minor component of smog and decreases airway reactivity
d. radon is prevalent in homes and is associated with lung cancer <=
e. formaldehyde in low concentration causes nasal tumours in humans