Answers for the Bofs: Clinical sciences and statistics

1. A The absolute risk reduction is 5% and relative risk reduction is 20%

B The number needed to treat = 1/absolute risk reduction 1/0.05 (i.e. 5%) = 20

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" #sed $or test values that are normall% distributed
2. A The data are not normall% distributed so a non&'arametric test is indicated. (aired t&tests are not a''ro'riate $or
unrelated sam'les
B )on&'arametric test* +ann&,hitne% # test can also be used
#se$ul -hen observations are di$$icult to .uanti$%
! #se$ul $or anal%sin/ data /rou'ed b% cate/or%0 e./. e%e colour
" A 1correction1 that is used -hen makin/ multi'le com'arisons0 to reduce the likelihood o$ $alse 'ositive results.
2. A #sed to com'are data sets that have di$$erent variances or are non&normall% distributed
B
All reduce selection bias to reduce sam'lin/ errors0 i.e. biases in the data
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3. A
B The 'o-er o$ the stud% de'ends on the sam'le si4e0 $re.uenc% o$ the main outcome measure0 si4e o$ e$$ect one
-ishes to detect0 and the si/ni$icance level desired

! 5$ 'atients dro' out because o$ dru/ intolerance0 this -ill reduce dru/ e$$icac% and reduce the 'o-er o$
the stud%. An allo-ance $or dro'&outs is necessar% in calculatin/ the sam'le si4e re.uired
" B% de$inition these are tests done in addition to the 'rimar% anal%sis and should not in$luence the sam'le si4e
calculation
5. A This is the mode
B

!
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6. A )on&ske-ed or 'arametric data
B The mode is the value that occurs most $re.uentl%* the median is the middle value
75% is mean 'lus or minus t-o standard deviations
! 8tandard deviation o$ the mean divided b% the s.uare root o$ )
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9. A (seudon%m o$ the mathematician0 ,illiam :osset
B

! means not medians
" 75% con$idence limits = (1.76 ; standard error) < and = the mean
>. A The null h%'othesis that there is no di$$erence bet-een /rou's is bein/ tested
B ?$ten @ates correction re.uired i$ numbers < 30 and this reduces value o$ chi&s.uare

! An% chance less than 1 in 20 (( < 0.05)
" The test is desi/ned to com'are 'ro'ortions rather than actual values0 e./. the number o$ 'atients losin/
-ei/ht0 not their mean -ei/ht loss
7. A This is the 'revalence o$ a disease (includes all cases)
B
Aess than the 'revalence* the incidence is the number o$ ne- cases arisin/ each %ear
!
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10. A A&ar/inine is the substrate 'roducin/ nitric o;ide and A&citrulline
B A vasodilator in s%stemic and 'ulmonar% circulations
5ncreases :+(
! Too hi/hl% reactive to be stored
" Bi/hl% soluble due to its hi/h a$$init% $or haemo/lobin
11. A 5t is s%nthesi4ed and released b% atrial m%oc%tes in res'onse to the stimulus o$ atrial stretch
B 5t inhibits renin 'roduction
atal%sed b% /uan%l%l c%clase
! 5t is a vasodilator and lo-ers blood 'ressure
" 5t inhibits vaso'ressin secretion
12. A +%elination increases the conduction velocit%
B 8mall $ibres conduct more slo-l% than lar/e ones
!ue to inactivation o$ volta/e&/ated sodium channels
! Tetrodoto;in is 'roduced b% the 'u$$er or blo- $ish
" Ce'olari4ation results $rom the inhibition o$ sodium entr%
12. A )ormal blood /lucose* 'eri'heral 'er$usion is common in severe acidosis includin/ diabetic ketoacidosis
B auses metabolic alkalosis -ith a normal anion /a'
#nusual to /et such severe lactic acidosis
! +a% occur -ith as'irin (but res'irator% alkalosis is more t%'ical)
" Alkalosis is characteristic
13. A 5t is s%nthesi4ed in endothelial cells and acts on smooth muscle cells
B 5t is $ormed b% the action o$ c%clo&o;%/enase on arachidonic acid
Dasodilator lo-erin/ both s%stemic and 'ulmonar% vascular resistance
!
" (:" inhibits contractilit% o$ the non&'re/nant uterus but stimulates the 're/nant uterus
15. A Also /lucose and $ructose
B :lucose and /alactose

! :lucose dimer
" +altose 'ol%mer
16. A "rror in convertin/ 'hen%laianine to t%rosine ('hen%lalanine h%dro;%lase de$icienc%)
B "rror in t%rosinase 'ath-a% (t%rosinase de$icienc%)
!e$ective al'ha&/lucosidase a$$ectin/ s'hin/oli'id metabolism
! !e$ective c%stathione beta&s%nthase
" !e$ective branched chain keto&acid decarbo;%lase
19. A "ach com'rises $our haem /rou's
B "ach haem /rou' binds one o;%/en molecule
The $errous state (EeFG)* EeHG0 occurs in methaemo/lobinaemia
! ontains $our 'ol%'e'tide chains
" BbA2 com'rises t-o al'ha and t-o delta chains
1>. A arbo;%haemo/lobin shi$ts the curve to the le$t
B The e$$ect o$ 'B on the ?! is called the Bohr e$$ect
202 !(: lo-ers a$$init% o$ haemo/lobin $or ?2
!
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17. A Adrenaline (e'ine'hrine) like /luca/on 'romotes /l%co/enol%sis
B 5ncreased muscle $att% acid utili4ation
5ncreases $att% acid release $rom adi'oc%tes
! 5ncreased he'atic ketone bod% 'roduction
" #nlike the beta rece'tors -hich activate aden%l c%clase
20. A And crackin/ o$ the skin around the mouth0 ears and e%elids
B (eri'heral neuro'ath%
auses ;ero'hthalmia0 es'eciall% i$ com'licated b% measles
! )iacin de$icienc% causes 'ella/ra (dermatitis0 diarrhoea and dementia)
" auses both associated -ith me/aloblastic anaemia
21. A 8timulated b% nitrates0 an e$$ect mediated b% nitric o;ide
B A)( and B)( both increase c%clic :+( levels

! (hos'hodiesterases mediate the de/radation o$ :+(
" The )?&haem com'le; chan/es the molecule1s sha'e resultin/ in a 200&$old increase in the catal%tic e$$ects o$ the
en4%me
22. A <5%
B 15%
<5%
! 95%
" )e/li/ible
22. A ranial nerve I
B ranial nerve I55
ranial nerve D e;its via the $oramen rotundum and ovale
!
" The $oramen ma/num contains the cranial nerve I5
23. A Bronchodilatation
B Dasodilatation
#terine rela;ation in the 're/nant state
! 5ncreased s-eat /land secretion
"
25. A 8u''lied b% the radial nerve
B 8u''lied b% the ulnar nerve
Also the o''onens 'ollicis
! ?nl% the lateral t-o lumbricals
" 8u''lied b% the radial nerve
26. A
B 30 times /reater in the intracellular com'artment

!
" 8imilar concentrations in intra& and e;tracellular $luid
29. A )on&'er$used lun/
B Bi/h D/J ratio
)o chan/e overall in the D/J ratio
! Bi/h D/J ratio
" Bi/h D/J ratio
2>. A Ceduces /astric em't%in/
B
!ecreases motilit% due to lab%rinthine stimulation
! !ecreases motilit%
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27. A o&locali4ed -ith entero/luca/on & 1ileal G colonic brake1
B Celeased $rom A cells in the distal ileum* reduces motilit%
:C( stimulates the release o$ D5(0 decreasin/ motilit%
! !ecreases motilit% and inhibits secretion
" Celeased $rom ) cells in the distal ileum
20. A
B Autosomal recessive
Autosomal recessive
! Autosomal recessive
" Autosomal recessive
21. A Autosomal dominant (Cendu&?sler&,eber s%ndrome)
B #suall% autosomal dominant a$$ectin/ 1&2 'er 10 000
hromosome 12 de$ect causin/ he'ato&lenticular de/eneration
! Autosomal dominant
" I&linked dominant mode o$ inheritance 'redominates
22. A 50% o$ dau/hters are carriers. 50% o$ sons are a$$ected
B All dau/hters o$ a$$ected males are carriers
Because onl% the I chromosome is 'assed to dau/hters
! 1 in 3* 1 in 2 chance o$ bein/ male* 1 in 2 chance o$ a male bein/ a$$ected
" ?nl% usuall% a$$ected in the homo4%/ous state
22. A Acet%l oA is the startin/ 'oint o$ Kreb1s ener/%&'roducin/ c%cle -ith the 'roduction o$ o;aloacetate
B )e/ative $eedback
:lucose&6&'hos'hate and $ructose&6&'hos'hate are $reel% convertible but acet%l oA 'romotes /lucose&6&'hos'hate
and hence /l%col%sis
! #nlike the Kreb1s c%cle -hich is ener/%&'roducin/
" Acet%l oA is $ormed $rom the o;idative decarbo;%lation o$ '%ruvate
23. A About 60% o$ DA!A
B This is a constituent o$ B!A
About 5% o$ DA!A
! About 13% o$ DA!A
" About 9%
25. A lmmuno$luorescence is a techni.ue $or assessin/
B cell and tissue structures to identi$% and
locali4e 'articulate 'roteins such as
! immuno/lobulins
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26. A 8ecreted b% trans$ormed B l%m'hoc%tes
B 5/A* also 'roduced in res'irator% tract
5/: is the onl% immuno/lobulin -hich crosses the 'lacenta
!
" 5nvolved in h%'ersensitivit% reactions
29. A Both classical and alternative 'ath-a%s 'roduce 2 convertase
B 8%nthesi4ed in liver
Alternative 'ath-a%* the classical 'ath-a% is
! tri//ered -hen immune com'le; combines -ith l.
" l. esterase de$icienc% 'roduces con/enital an/io&oedema
2>. A Bone mass declines (osteo'orosis) but minerali4ation is normal
B Ceduced insulin sensitivit% and /lucose tolerance declines
Aimits abilit% to mount a tach%cardia
! !ecreased number o$ ne'hrons0 :EC and medullar% $unction
" !ecreased $unction ma% contribute to increase in autoimmune disease
27. A !ecreased belo- normal (normal value 3L)
B "lderl% can detect chan/es = 2L c$ 1L chan/e in %oun/er 'eo'le
+etabolic heat 'roduction is 50% < than %oun/er 'eo'le
! Th%roid $unction is normal
" Autonomic d%s$unction im'airs thermore/ulation es'eciall% in the elderl%
30. A 5ncreased ste' len/th variabilit%
B !ecreased ste' $re.uenc% and a slo-er /ait
A broader&based /ait
! 8horter ste's
" A&( s-a% is /reater in $emales than men in all the adult a/e /rou's
31. A I&linked recessive* 50% dau/hters are carriers0 50% sons are a$$ected
B
Cemember onl% the I chromosome 'asses $rom $ather to dau/hters
! 1 in 3 chance o$ bein/ a$$ected
" Bomo4%/osit% in $emales
32. A 22 'airs 'lus t-o se; chromosomes
B :amete nuclei are ha'loid
The @ chromosome is the smaller
! Eluorescent s'ots on inter'hase nuclei o$ male cells
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32. A !irect co'%in/ o$ one strand o$ !)A occurs in all nuclei
B
A c%to'lasmic event
! Eorms the 'rocessed +C)A
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33. A The ei/ht essential amino acids are
B methionine0 l%sine0 tr%'to'han0 'hen%lalanine0
leucine0 isoleucine0 threonine and valine
!
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35. A 5ntrinsic 'rotein t%rosine kinase activit%
B 5nhibits aden%late c%clase
Bistamine 2 and 'rostac%clin
! activate aden%late c%clase
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36. A &ras
B

!
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39. A Ca'idl% as ha''ens in $ear or cold
B !ecreased ra'idl% as blood /lucose rises
5ncreased slo-l%0 in res'onse to stress
! 5ncreased slo-l%0 in res'onse to hun/er
" !e'endent on activated li'o'rotein li'ase
3>. A :reater
B 8ubarachnoid s'ace

! Total volume 120&150 ml
" (roduced b% the choroid 'le;uses* arachnoid villi reabsorb 8E
37. A
B :ram&'ositive coccus
:ram&'ositive aerobic
! :ram&'ositive coccus
" Ela/ellated s'irochaete
50. A Dibration and 'ro'rioce'tion
B
8'inal cord ends at the $irst lumbar vertebra
! 8u''lies 'rinci'all% the anterior (motor) com'onents
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