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Q) ou see a 55 year old lady in menopause clinic. Taking a history she tells you she gets
general aches and pains and has been worried about diabetes as she is constantly thirsty.
Otherwise she has no significant past medical history and is on no regular medication. You
organise bloods and the results are below. What is the likely diagnosis? Na 135 mmol/l
K3.8 mmol/l
Ur 7.6 mmol/l
Cr 82 mmol/l
ESR 15 mm/h
PTH 80 pg/ml (HIGH)
HBA1C 38 mmol/mol
Adjusted calcium 2.76 mol/l (HIGH)
Parathyroid adenoma
Secondary hyperparathyroidism
Tertiary hyperparathyroidism
MEN type 1
MEN type 2
High PTH with hypercalcaemia is seen in Primary Hyperparathyroidism.
Although tumours of the parathyroid occur in MEN, parathyroid adenoma accounts for 97%
of cases of primary hyperparathyroidism.
High PTH with hypercalcaemia is also seen in tertiary hyperparathyroidism. Tertiary
hyperparathyroidism usually follows a long period of secondary hyperparathyroidism (most
commonly due to renal failure). This patient has no medical history of being unwell or having
had a long period of renal impairment.
Parathyroid
Hyperparathyroidism
Primary Hyperparathyroidism
Excessive parathyroid hormone production by parathyroid adenoma.
Causes hypercalcaemia
Secondary Hyperparathyroidism
Secondary to hypocalcaemia
Stomach, and
Colon.
Current figures suggest an 80% five year survival of all patients with breast cancer
Q)
Ans D
Excessive fluid intake is obvious, it's not the interpretation. Sensory function
can't be interpreted from bladder diary. For cystitis you need a urine culture. It's
not urge incontinence as she has this only once. It's overactive bladder
22.ans
37
1 in 1000
3in 1000 ...in 100000
Endometrial is 18/100,000
Vulval is 1.8/100,000
Q) dome of bladder from yolk sac
-trigone from mesonephric duct
-bladder from urogenital sinus
-ureter until collecting duct are from ureteric bud
- glomerulus and tubules til the distal convoluted
tubules are from mesonephric duct
- urethal meatus from ectoderm
Q) Type I found in skin, fascia, tenson and dentin
Type II found in cartilage
Type III (reticulin) found in skin, blood vessels,
alongside of type I, embryonic dermis,
uterus,fetus, heart and granulation tissue,
Type IV found in Basement laminae of epithelial
and endothelial cells
Type V: cell surfaces hair and placenta
1 in bone dermis tendone
2 cartilage
3 fetal / cardiac / scar/ synovium
4 basement membrane
Answer :G1
DNA & histone synthesis & centriole replication?
Answer : S phase
Cell become quiescent in ?
Answer :G0
Chromosomal study done in?
Answer : metaphase
Q) Following are correctly matched except A)ACTH 29 A A..ans ,39
B)prolactin 199 A A
C)growth hormone 191 AA
D)leptin 167 AA
E)none above
Q)
For HRT
Q)
Ans D
Q) 35 year old women attends clinic following laparotomy
and unilateral oophorectomy. The histology shows mucin
vacuoles. What type of tumour would this be consistent with?
Serous
Mucinousans
Endometrial
Transitional
Cear cell
Q)
Q) reciprocal Translocation
Q) Brain liquifective...
Kidney n heart coagulative...
Limb n gut gangrene...
Fat necrosis breast n pancreas
B. 2
C. 4ans
D. 6
E. 8
Q) Which artery supplies distal portion of round
ligament of uterus? 1 . ovarian artery
2.ut artery
3.inf epigastric artery..ans
Q) WHICH VESSELS CAN BE POSSIBLY INJURED IN
THE SUBCUTANEOUS TISSUE WHEN A
TRANSVERSE SUPRAPUBIC SKIN INCISION IS
MADE? A. SUPERFICIAL EPIGASTRICans
B. SUPERFICIAL CIRCUMFLEX ILLIAC
C. DEEP CIRCUMFLEX ILLIAC
D. SUPERIOR EPIGASTRIC
E. INFERIOR EPIGASTRIC
Q) At what level of HBA1 C the diabetic lady Should not
conceive - 1_6%
2_7%
3_8%
4_10% . ans
5_11%
Q) Which of foll ligaments allows us to stand
upright with a minimum of muscular support?A.
Sacrospinous ligament
B. Sacrotuberous ligament
C. Iliolumbar ligament
D. Iliofemoral ligamentans
E. Pubofemoral ligament
Q)
Q)
Q)
c. Ovarian failure
d. Polycystic ovary syndrome
e. Weight-related amenorrhoea
The answer is Midcycle LH surge. Polycystic ovary syndrome
(PCOS) is associated with high LH levels and usually normal
estradiol levels. Ovarian failure will result in high LH levels
but low estradiol levels. Hypogonadotrophic hypogonadism
and weight-related amenorrhoea are associated with low LH
levels and low estradiol levels. PCOS results in a ratio of
LH/Follicle-stimulating hormone (FSH) > 1. The blood test
may have been taken midcycle. In this case we are not able to
diagnose PCOS because we do not have a value for FSH.
Generally, women with PCOS have normal estradiol levels.
Q) Monopolar diathermy cause coagulation effect
with sparkling to stop the bleeding vessels by
Which of the following procedures? A.
Electrosurgical cutting
B. Electrosurgical desiccation
C. Electrosection
D. Fulguration
E. Vaporization
ANSWER : Fulguration
Q)Which hypothalamic hormone stimulates release of Prl ?
a. Dopamine
b. Growth hormone releasing hormone
c. Gonadotrophin-releasing hormone
d. Somatostatin
e. Thyrotrophin-releasing hormone . ans
Q)
Q)
Q)GnRH decapeptide
Q) GnRH is :
A. Produced by anterior pituitary gland
B. Produced by the posterior pituitary gland
C. Produced by placenta..ans
Ans C
Q)The release of CRH,ACTH & cortisol follows a circardian
rhythm. When is highest peak of those hormones? a. at night
b. early morning..ans
c. afternoon
d. mid afternoon
e. midnight
Q) The axial filament of the sperm tail has what
type of arrangement of filaments?1+5
1+7
3+5
7+5
9+2 . ans
Q)
Ans C,C
Q) A patient was seen in your clinic and was diagnosed of
having pituitary adenoma. She was referred to an
ophthalmologist because she complained of blurring of vision
over the past 3 months. Which would be the finding of the
ophthalmologist? ( blind spot is shaded pink)
a. 1st image
b. 2nd image
c. 3rd image.ans,bitemp hemianopsia
d. 4th image
e. normal findings
Q)
Q)
.47XXY
. 45XO
. 46 XY.ans
.45XY
Q)
d. 10
e. 11
Q) A girl is said to have delayed puberty when :
a. no pubic hair at 16 years old
b. no menses at 16 years old
c. no breast development at 13.5 years old .. ans
d. no pubic hair at 13.5 years old
e. no breast development at 16 years old
delayed puberty is when testicular volume is less than 4 mls at
14 years old
Q) Which lung volume is decreased in pregnancy?
A. Peak flow rate
B. Tidal volume
C. Vital capacity
D. Functional residual capacity
E. Forced expiratory volume
:
The answer is Functional residual capacity. The pushing up of
the diaphragm reduces the functional residual volume.
10%
25%...........ans
50%
95%
Q) Placental hormone which is produced by the
syncytiotrophoblast but not by the
cytotrophoblast
A. Human chorionic gonadotropin.ans
B. Human placental lactogen
C. Inhibin
D. Human chorionic thyrotropin
E. Estriol
Q) Terbutaline has a preference for stimulation of
which of the following receptors? A. Alpha
B. Gamma
C. Beta 1
D. Beta 2 ans
E. Dopaminergic
Q)
D. Macrophagesans
E. Mast cells
Q) 19 years old female presented with
ammenorhea for 3 months. She was previously
having normal menses. She also complaints of
headache associated with certain degree of
vision loss. During the 2 hours consultation, she
excused herself to the washroom for 4 times.
What is the most probable diagnosis : a.
prolactinoma
b. craniopharyngiomaans
c. acromegaly
d. Addison's disease
e. Cushing's syndrome
menstrual disturbance, headache with vision loss
and diabetes insipidus are features of
craniopharyngioma. It is a tumour arising from
rathke cleft (embryogenic origin of pituitary
gland) and most of the time benign.
Q) vomiting:- meta alkalosis
diarrhoea:- meta acidosis
Hypokelemia.. Hypochloremia met alkalosis(due
to hypokal) in vomitings
Q) Which of the following was a disadvantage of
depoprovra
A)Inc risk of hepatic ca
B)impairment of lactation
C)prolonged anovulation..ans
D)irreversible bone loss
E)iron Def anemia
Q)
Ans A
Q) Which of the following is true regarding POP's
A)more effective than inj contraceptive
B)may worsen acneans
B. Inf mesentric
C. Sup inguinal
affected? a) Overies
b) Uterusans
c) Pituitary
d) Hypothalamus
e) Fallopian tubes
Q) Incidence of pheochromocytoma in pregnanc?
1/1000
1/10,000
1/50,000..ans
1/100
<1/1,000
Q) What is % age change in ventilation during 1st
trim ?
20% decrease
40% decrease
20% increase
40% increase ..ans
50% increase
Q) What is overall change in airway resistance in
preg compared to a non- pregnant woman?
Decreases by 10%
Decreases by 50%
Increases by 10%
Increases by 50%
None of the above .ans
c. pulmonary hypertension
d. pulmonary stenosis ans
e. left ventricular hypertrophy
37 weeks
b) Salbutamol promotes FLM.ans
c) It is often the result of pre-eclampsia
d) It is often the result of polyhydramnios
e) It is often associated with trichomonas
infection
Q)
Ans E
Q)What percentage of women with a diagnosis of Gonorrhoea
will develop PID? 2%
5%
15%
25% ans
50%
Q)
d. day 10
e. day 12
Q)
Vagus nerve
Muscles of mastication
Q)
Parathyroids
Skin
Spleen
the cell.ans
c. it is use to prevent eclampsia
d. oliguria is a sign of magnesium toxicity..ans
e. calcium gluconate can be given if patient develops
cardiorespiratory depression
Q) Regarding transportation of drugs, following are true
except :
a. transcapillary movement is transfer of drugs with water due
to hydrostatic/ osmotic pressure
b. paracellular movement occurs between cell junction
c. passive transport is movement along a concentration
gradient
d. active transportation is movement against concentration
gradient and energy dependent
e. Facilitated diffusion is carrier mediated movement along
concentration gradient and energy dependent..ans
facilitated diffusion do not require energy. C is
true. passive diffusion do occur along
concentration gradient. active transportation
occurs against concentration gradient
Q) A 16-y is seen in the gyn OP with prim
amenorrhoea and excessive facial hair growth.
Examn reveals normal genitalia, apart from an
apparently large clitoris. DDx includes CAH.CAH
(21-OH defcy) is characterised by which of foll ?
A HTN, hypokalaemia and hyponatraemia
B Hypertension, hyperkalaemia and
hyponatraemia
110-30=80 ml
Now 80 65=5200 ml=5.2 L
Q) The following is/are the correct
correspondents between male and female :
a. gubernaculum = ovarian ligament
b. gubernaculum = round ligament
c. both of the above.ans
d. penile glans = labia majora
e. scrotum = labia minora
Q) From which germ layer does myenteric plexus of GIT
developed: Neural crest of Ectoderm.ans
Neural tube of Ectoderm
Mesoderm
Endoderm
None of the above
Q) A 51-y has been referred by her GP for hot flushes and
night sweats. Her LMP was 6 w ago. She is concerned that she
may be going through the "change" and would like to go onto
HRT, because her symptoms are unbearable.Which of foll is
true regarding menopause?
Is associated with menorrhagia
Is synonymous with the climacteric
Occurs later in smokers
Occurs on average at age 45.5 years
Symptoms may occur long before menstruation ceases
ans
Glucagon Stimulants
Hypoglycemia
Epinephrine
Arginine
Alanine
Acetylcholine
Cholecystokinin
Glucagon Inhibitors
Somatostatin
Insulin
Uraemia
Increased free fatty acids and keto acids into the blood
Q) You see a 32 year old women in clinic who mentions she
has been sweating and has frequent headaches. On
examination you note her blood pressure is 195/105 and pulse
rate is 110. You suspect pheochromocytoma.
Pheochromocytoma accounts for what percentage of cases of
hypertension? 0.1%........ans
0.5%
1%
2%
10%
Pheochromocytoma is rare accounting for around 0.1% of
cases of hypertension.
The rate of pheochromocytoma is quoted at around 1 in
54,000 pregnancies
20% are familial
The maternal mortality rate is 2% to 4% if diagnosed in the
antenatal period, rising to 14% to 25% if it is diagnosed
intrapartum or postpartum.
species
Q)
Prolactin.ans
Luteinizing hormone
Q) With regard to the neuromuscular junction, what causes a
reduction in the release of acetylcholine?
A. Alcuronium
B. Aminoglycoside
C. Neostigmine
D. Suxamethonium
E. Tubocurarine
The answer is Aminoglycoside. All the other agents actions
are mediated on the postsynaptic membrane.
Q) Testosterone Binding
70% testosterone bound to SHBG,
25-30% testosterone bound to albumin
Percentage free testosterone can vary significantly
depending on the analysis method used. Typical laboratory
reference ranges are Male 1.5-3% and female approx 1%.
Q) A 23 year old primigravida at 32weeks of gestation
presented with very minimal per vaginal spotting for two
days. She is clinically stable. Scan reveal placenta previa
grade 3 posterior. Fetal status is good. Your consultation plans
for an expectant management. What is the definition of
expectant management?
a. To offer medical intervention as outpatient
b. To offer a surgical intervention
c. Offer no treatment and see if condition resolve
naturallyans
Paracetamol
Ramipril
Q)You suspect a drug cause. Which of the above medications
is most likely to be responsible for her raised prolactin?
Amlodipine
Fluoxetine.ans
Omeprazole
Paracetamol
Ramipril
There are several causes of raised Prl
(hyperprolactinaemia):
Hypothyroidism
CRF
Liver disease
Pregnancy
Stress
Lactation
Chest wall stimulation & surgery
Drugs (Opiates, H2 antagonists e.g. Ranitidine,
SSRI's e.g. Fluoxetine, Verapamil, Atenolol, some
antipsychotics e.g risperidone and haloperidol,
Amitriptyline, Methyldopa and Oestragen
conatining compounds)
Hypothalamus tumours
Prolactinoma
Agromegaly
PCOS
Q)
Ans C
Q) 24 years old patient who is 10 week pregnant presented
with per vaginal bleed and passing out vesicular like structure.
Per abdomen, uterus is palpable at 14 week size. You
diagnosed her with a complete molar pregnancy. Following
are true except :
a. you expect a snow storm appearance on ultrasound
b. you may expect a theca lutein cyst on ultrasound
c. it is 46XX of both paternal origin
d. It is 46XY of both paternal origin
e. it is 69XXX of all paternal origin.ans
Ans A
Q) A patient is seen in clinic 6 w pp. The pregnancy was
complicated by intrapartum haemorrhage requiring fluid
resuscitation and a 2 U BT. Mum reports feeling very tired,
struggling to lose baby wt and needing to bottle feed due to
very low volume lactation. What is suspected diagnosis?
Hyperpituitarism
Q)
Q)
Q)
D. krebs cycle
E. Oxidative phosphorylation
Q) A 17 years old women is reffered by primary
care physician for the evaluation of primary
amenorrhea . on physical examination pt has sign
of virilization. She has also a pelvic mass . During
the work up of pt she is found to have sex
chromosome mosaicism (45x/46 XY )
A)immature teratoma
B)serous adenocarcinoma
C)sertoli leydig cell
D)granulosa cell tumor
E)gonadoblastoma..ans
Q)
Q) Which pharyngeal arch is closest to the head of the
embryo? 1stans
2nd
3rd
4th
6th
Q) What process changes a spermatogonium into a prim
spermatocyte?Meiosis 1
Meiosis 2
Differentiation
Maturation.ans
Spermosis
Spermatogonium mature or grow into primary
spermatocytes (this process is also called
spermatocytogenesis)
Spermatocytes undergo 2 meiotic divisions to become
spermatids (this process is also called spermatidogenesis)
Spermatids differentiate into spermatozoa (this process is
also called spermiogenesis)
Q) Ootidogenesis refers to which process during Oogenesis?
1st Meiotic Division
2nd Meiotic Division
1st and 2nd Meiotic Divisions.ans
Differentiation
Growth and maturation
Oogonium become Primary Oocyte via Growth/Maturation.
This process is called oocytogenesis
Primary Oocyte undergoes 2 meiotic divisions to become
Ootids. This process is called Ootidogenesis
Ootids differentiate into Ovum
Q) What process would you expect a secondary spermatocyte
to undergo during spermatogenesis? 1st Meiotc Division
2nd Meiotc Division.ans
1st Mitotic Division
2nd Mitotic Division
Differentiation
Q)
Q) During formation of the mid, fore and hind guts the initial
gut tube undegoes rotation. Which of the following is correct
regarding rotation of the midgut during this process?
rotates 90 degrees clockwise
rotates 130 degrees anticlockwise
rotates 180 degrees clockwise
rotates 270 degrees anticlockwise..ans
rotates 270 degrees clockwise
5 weeks
8 weeks..ans
12 weeks
Gubernaculumans
Urachus
Allantois
Medial umbilical ligament
Median umbilical ligament
Q) Whilst reviewing a 34 year old patient with amenorrhoea
in clinic they tell you they have gained over 10kg in weight in
the past 8 weeks and have noticed worsening acne. Routine
bloods taken that morning show a random glucose
11.1mmol/l, normal thyroid function tests and negative
pregnancy test. BP is 168/96 mmHg.
Addisons disease
Addisonian crisis
Cushing's syndromeans
Flammer syndrome
Hyperthyroidism
Q) Which pharyngeal arch gives rise to no muscular or
skeletal structures? 1st
2nd
3rd
4th
5thans
Q)Branches V2 and V3 of Trigeminal nv develop from which
pharyngeal arch? 1st..ans
2nd
3rd
4th
6th
Metaphase
Interphase
Mitosis is where cell division occurs and this
happens in a the following phases:
Prophase Chromatin condenses to
chromosomes (paired as chromatids). Mitotic
spindle forms
Metaphase Chromatids align at the equatorial
plane AKA the metaphase plate
Anaphase Chromotids pulled apart into 2
constituent daughter chromosomes
Telophase New nuclear envelopes form around
each daughter chromosome
Cytokinesis Cells divide
Q)
Ans D
Q) What is the causative organism of Scarlet Fever?
Staphylococcus aureus
Streptococcus epidermidis
Streptococcus pyogenes.ans
Streptococcus Pneumonia
Parvovirus B19
Q) Which of foll best describes MOA of Ondansetron?
Histamine H1-receptor agonist
Histamine H1-receptor antagonist
Serotonin 5-HT3 receptor antagonistans
Dopamine D2 receptor agonist
Dopamine D2 receptor antagonist
Q) Lidocaine works by blocking which of the following ion
channels?
slow voltage gated sodium channels
fast voltage gated sodium channelsans
slow voltage gated potassium channels
fast voltage gated potassium channels
fast voltage gated calcium channels
Q) Which of the following drugs is most appropriate to use to
stimulate stimulate lactation?
Cabergoline
Bromocriptine
Domperidone.ans
Sertraline
Metoclopramide
Domperidone and Metoclopramide are
recognised galactagogues (substances that
increase milk production). UK Medical Information
Western Blotting..ans
Southwestern Blotting
Q) You are asked to review a 65 year old ladies legs preoperatively. You diagnose cellulitis. What is the most common
causative organism?
Staphylococcus Aureus
Staphylococcus Epidermidis
Clostridium Perfringens
Streptococcus Mutans
Streptococcus Pyogenes.ans
Q) What is the incidence of placenta accrete (including increta
and percreta) in the UK?
1.0 per 1000 deliveries
2.3 per 1000 deliveries
7 per 1000 deliveries
1.7 per 10,000 deliveries . ans
17 per 10,000 deliveries
Q) How can the mechanism of action of the
immunosupressive agent azathioprine best be described?
A. Blocking of T cell activation
B. Inhibition of nucleic acid synthesis in all mitotic cells
C. Inhibition of T cell proliferation
D. Prevention of the generation of cytotoxic effector cells and
general anti-inflammatory effect
E. Promotion of unresponsiveness in alloreactive T cells
Q)
D-VITAL CAPACITYans
E-RESIDUAL VOLUME
Q) Which test is most sensitive in detecting PID? A. Cell
culture
B. Endocervical biopsy
C. Enzyme immunoassay
D. Microscopy
E. Nucleic acid amplification test ans
The answer is Nucleic acid amplification test (NAAT). NAAT
(polymerase chain reaction or strand displacement
amplification) is more than 95% sensitive in detecting
Chlamydia or Gonorrhoea from the endocervical specimen.
The absence of endocervical or vaginal pus cells on a wetmount smear has a good negative predictive value (95%) for a
diagnosis of PID but their presence is non-specific (poor
positive predictive value).
NAAT is more sensitive and specific than enzyme
immunoassay (EIA) and the Department of Health has
advised that the use of sub-optimal EIA is no longer
appropriate and has provided funding to support laboratories
moving from EIA to NAAT. However, no test is 100%
sensitive or specific.
Q) Patient was diagnosed of having right ovarian
teratoma of 6x8cm. RMI score is 25. Patient was
counselled for surgery and opted for laparoscopic
cystectomy. What is the mc nerve injury
associated with this procedure? a. sciatic nerve
b. femoral nerve
c. obturator nerveans
d. genitofemoral nerve
e. ilioinguinal nerve
ovarian fossa is in close relationship to the
obturator nerve. post operatively, patient will
have difficulties in adducting her lower limb.
Q) You reviewed a 45 years old patient in your
clinic. She is diagnosed of having a huge
submucosal uterine fibroid. She is planned for a
total abdominal hysterectomy. You explained the
risk of bleeding and blood transfusion. Further
history revealed that she is a Jehovah's witness.
What option you may offer in regards to her
operation?
a. autologous blood donation preoperatively
b. intraoperative blood salvage
c. recombinant erythropoietin therapy
d. all of the above.ans
e. get a family member of her similar blood group
to donate
Q) A fetus is formed from partial maternal and
partial paternal genes. A fetus is, therefore,
considered foreign to the maternal's immune
system. However, the fetus escapes maternal
immunity because of a few reasons. Following are
the reason :
Q)
Q)
Q) Which of foll factors shifts O2 dissociation curve to Lt ?
Increased temperature
Increased partial pressure CO..ans
Increased [H+]
Increased 2,3 DPG
Increased partial pressure CO2
Q) Buffers : Blood... HB
Urine... PO4
ECF... HCO3
B. IgD
C. IgE
D. IgG
E. IgM
The correct answer is IgA.
Q) Which is the most abundant complement
protein? a. C2
b. C3.ans
c. C4
d. C5
e. C9
complement C3 is the most abundant. cleavage
of this protein will then be followed by activation
of the lytic sequence.
Q) Which immunoglobulin has the highest
molecular weight? a. IgA
b. IgD
c. IgE
d. IgG
e. IgM.ans
IgGsmallest
Ans B
Q) Vitamin K is essential for the synthesis of : Vitamin A
Vitamin D
Clotting factor III
Clotting factor IV
Protein Sans
>60 nmol/l
None of the aboveans
Progesterone testing
Note there is a significant difference between what NICE
advise and advice that can be found on the RCOG website
regarding progesterone testing in Pregnancy of unknown
location
NICE advise do not use serum progesterone measurements as
an adjunct to diagnose either viable intrauterine pregnancy or
ectopic pregnancy
RCOG advise progesterone levels <20nmol/l strongly
suggestive non-viable pregnancy and levels >60nmol/l
suggestive intrauterine pregnancy
Q) Which cell adhesion molecules are dependent on calcium
ions to function?
E-selectin
P-selectin
Cadherinsans
Integrins
Kindlin-1
likely diagnosis ? A. BV
B. Candida vulvovaginitis
C. Physiologic leukorrheaans
D. Syphilis
E. Trichomoniasis
Physiologic leukorrhea can be seen during 2
different periods of childhood. Some female
neonates develop a physiologic leukorrhea
shortly after birth as maternal circulating
estrogens stimulate the newborn's endocervical
glands and vaginal epithelium. The discharge in
these neonates is often gray and gelatinous.
Physiologic leukorrhea can also be seen during
the months preceding menarche. During this
time, rising estrogen levels lead to whitish
discharge not assoc
with any symptoms of irritation. This patient has
a whitish discharge, no other symptoms, and she
has had normal pubertal development up to this
point. The discharge itself has no characteristics
of infection.
Therefore, physiologic leukorrhea is the most
likely diagnosis.
BV (choice A) is not the most likely diagnosis in
this patient because the discharge is not
malodorous and there are no clue cells seen on
microscopic examination of the discharge.
Q)
Ans B
Q) Plasma concentration of estrogen increases throughout
pregnancy. By 40 weeks, the concentration of estriol increased
to estradiol by who much times? A. 100 times
B. 50 times
C. 20 timesans
D. 10 times
E. 5 times
Q)
Ans B
Q) An active 70-y F is admitted to the gyn clinic for a sling
procedure with a known h/o Pagets disease of bone. Which
biochemical findings are most likely?
Reduced calcium, reduced phosphate and elevated ALP
Reduced calcium, elevated phosphate and elevated ALP
Normal calcium, normal phosphate and elevated ALP.ans
Elevated calcium, reduced phosphate and reduced ALP
Elevated calcium, elevated phosphate and elevated ALP
Q) Identify which of foll gives correct pathway of piriformis
muscle.
Origin
Exits pelvis via
Insertion
A. Ventral surface of sacrum Greater siactic notch Greater
trochanter of femur..ans
Q)
Ans D
Q) How can MOA of ranitidine best be described?
It delays gastric emptying
It hastens the gastric emptying
It mainly has an antiemetic action
It neutralises the acidic content of the stomach
It reduces the acid content and production by gastric parietal
cells..ans
The answer is It reduces the acid content and production by
gastric parietal cells. It is used preoperatively to reduce the
risk of aspiration pneumonia and Mendelsons syndrome.
Mefanamic acid
Tramadol
Tranexamic acid
As a 1st line Rx, it would be appropriate to use a Rx that
woman can purchase over counter.
Q) A 15-year-old patient visits her GP requesting a method of
contraception. When taking her history, you discover a
personal history of thromboembolic events. She has had three
sexual partners in 5 months. She also complains of
dysmenorrhea. What type of contraception would you
recommend? Barrierans
COCP
Female sterilisation
IUCD
Subdermal contraceptive implant
Q) Which structure is prim mech for shunting blood away
from fetal pulm circulation? FO..ans
Ductus Arteriosis
Arteria Umbilicalis
Ductus Venosus
Umbilical Arteries
Blood enters the right atrium of the fetal heart and most
passes through the foramen ovale into the left atrium. From
there it is pumped through the aorta. The foramen ovale is the
major structure for bypassing the fetal pulmonary circulation.
Osteoporosis
Severe Osteoporosis
C. At menarche
D. At ovulation
E. Before fertilisation
The answer is at fertilisation. The primary oocyte
resumes meiotic maturation in response to a
surge in luteinising hormone. This results in a
polar body and the secondary oocyte. The oocyte
is then ovulated and enters the second meiotic
cycle. It is arrested in metaphase II and only
completes meiosis after the entry of the
spermatozoa at fertilisation.
Q)Serum levels of Li are inc in women taking this
anti -HTN ? A hydralizine
B methyl dopa
C labetalol
D amylodipine
E captoprilans
Captopril increase serum lithium level
Methyldopa also causes lithium toxicity
Q) A 55 yr old man visits his primary care physcian with a
complaint of urinary in frequency. Examination finds a 1 cm
nodule on his prostate gland.the physcian orders PSA serum
test.by common standards PSA level > 4 ng /ml is considered
abnormal.using this standard this test has a sensitivity of 80%
and specificity of 90%.a recently published epidemiological
article found in a cross sectional study 10% men of this age
have prostate cancer.the results on the pts PSA is 7 ng/ml.what
Ans C
Q)
Ans B
Q) Which part of the ovary is responsible for androgen
production? A. Granulosa cells
B. Leydig cells
C. Organ of Zuckerkandl cells
D. Sertoli cells
E. Theca cells
The answer is Theca cells. LH drives the conversion of
cholesterol into androgens in the theca cells. These androgens
are then transferred to the granulosa cells for conversion
(aromatisation) into estrogen (estradiol) under the influence of
follicle-stimulating hormones.
Q)
Ans D
Q)
C. 10% ..ans
D. 15%
E. 25%
Q) Considering the mechanism of pain, the
following are true except : a. prostagladin
indirectly causes pain
b. bradykinin is a potent cause of pain
c. 5HT is a transmitter on inhibitory neurons
d. Adenosine has a role in regulating pain
e. Glutamate is an inhibitory amino
acid..ans
Q)The below pairing of anti-neoplastic drugs are
true except :
a. Alkylating agent - cyclophosphamide
b. Antimetabolite - 5- fluorouracil
c. platinum based paclitaxel.ans
d. Vinca alkaloids - vincristine
e. antibiotic - doxorubicin
example of platinum based are cisplastin and carboplatin.
paclitaxel is in the taxane group.
Q) Which of the foll opioids can be used as analgesia during
labour: a. pethidine
b. meptazinol
c. both of the above . ans
d. nitric oxide
e. all of the above
Q) When a drug is said to be adequate and wellcontrolled studies have failed to demonstrate a
risk to fetus in 1st trimester (and there is no e/o
risk in later trimesters). In which FDA category
does it fall? a. Aans
b. B
c. C
d. D
e. N
Q)
Ans A
Q) A 27 y is treated for severe bronchitis at 38 w. Her baby,
born at 41 w , has neonatal hemolysis. Which drug taken by
mother for bronchitis is cause of baby's neonatal hemolysis?
a. amoxycillin
b. chloramphenicol
c. co-trimoxazoleans
d. doxycycline
e. erythromycin
Q) Which chromosome contains the gene that codes for the
alpha globin chain (a constituent component of Hb)?
A. Chromosome 5
B. Chromosome 11
C. Chromosome 16.ans
D. Chromosome 18
E. Chromosome 21
Q) Upper vagina supplied by - A)uterine arteryans
B)aorta
C)int iliac
D)ext iliac
The vagina receives its blood supply from the vaginal arteries
and their anastomoses with branches of the uterine, inferior
vesical and internal pudendal
Q) the risk of uterine rupture is 52 /10.000 in previous 1 C.s
and 92 /10.00 in previous 2 C.s
Q) Which of the following forms part of the phase 2 reaction
in drug metabolism? a. conjugationans
b. cyclisation
c. hydrolysis
d. reduction
e. oxidation
Q)
Ans D
Q) The most common endometrial ca is..?Serous
the mc endometrial CA is endometroid tupe 90% the serous
10-15%
Q)
Q)
Ans C
Q) Which of the following cell types lyses cells that have
been infected with viruses? A. CD4+ T cells
B. B cells
C. CD8+ T cells.ans
D. Killer cells
E. Macrophages
Q) What is the progestogen component in an implant?
a. desogestrel
b. levenogestrel
c. etonogestrelans
d. drosperinone
e. norethisterone
Q) With regard to electrosurgery, if carbon is seen on the tip
of an electrode the surgeon can assume that, at some stage in
Q)
Ans D
Q)
Ans C
Q) Regarding MgSO4, the foll statement are true
except :
a. it acts at motor end plate and reduces
excitability of nerve
b. it acts on cell membrane & reduces calcium
influx into cell
c. it is use to prevent eclampsia
d. oliguria is a sign of magnesium toxicity
ans
e. Cagluconate can be given if patient develops
cardioresp depression
Magnesium sulphate is a cell membrane
stabiliser. It prevents influx of calcium into the
cell.
mgso4 toxicity dont cause oliguria. It is the other
way round. Oliguria causes MgSO4 toxicity.
it is used to prevent eclampsia
yes, we monitor urine output. but oliguria not
necessarily mean toxicity. oliguria could
percipitate toxicity as renal is the only way to
excrete mg. we monitor UO to prevent toxicity,
not as a sign of toxicity.
Q) Pt had C-Section developed S/S of PE. Most
likely source of embolism is? 1) pelvic
veins..ans
2) femoral veins
3) inf vena cava
4) Rt atrium
Q)Wrt labetolol, foll statements are true except:
a. it can be given orally for patient with chr HTN
in pregnancy
b. it is an antagonist of A1 and B1 receptor
c. it is a partial antagonist of B2
receptor..ans
d. can be given intravenously in hypertensive
emergencies
e. contraindicated in patient with heart block
it is an absolute contraindication in pt with heart
block. labetolol is an antagonist at A1 and B1 but
a partial agonist of B2. So, the net effect is
AST
Bilirubin
Q) Least affects bioavailability : 1) gastric emptying
2) liver impairment
3) protein binding
4) drug formulation.ans
Q)
Ans D
Q) Regarding methyldopa,foll statement is true except :
a. it is a prodrug
b. it is use to treat hypertension in pregnancy
c. it is centrally acting
d. it does not cross the placentaans
e. depression is its side effect
Q)
Q)
Ans C
Q)
Ans D
Q) When using the MDRD formula to calculate GFR
(Glomerular filtration rate) which of the following is not
factored into the equation? Creatinine
Urea..ans
Sex
Age
Ethnic Background
Estimated GFR (ml/min/1.73m2) = 186 x (Creat /
88.4) -1.154 x (Age)-0.203 x (0.742 if female) x
(1.210 if black)
Q) Where in the kidney is the majority of Sodium and
Glucose reabsorbed -Bowmans Capsule
Loop of Henle
Proximal Tubule..ans
Distal Tuble
Collecting Duct
Remember PCT is the main site for Reabsorption
for all ions!
Q) An antenatal usg demonstrates a hyperechogenic bowel.
Which one of the following is this finding most associated
with? Omphalocele
Polyhydramnios
Multiple pregnancy
Gastrochisis
Cystic fibrosisans
Hyperechogenic bowel is seen in Down's syndrome, cystic
fibrosis, cytomegalo virus infection
Q) What is the typical O2 consumption in 75kg non-preg
women? 5ml/min
15ml/min
50ml/min
150ml/min
250ml/min..ans
The typical Oxygen Consumption (VO2) is 250ml/min.
In pregnancy this increases by around 20% to 300ml/min
Q) Which of foll is responsible for Aquaporin-2 protein
channel openings in collecting duct? Angiotensin
Angiotensin II
ADH..ans
Aldosterone
Renin
Q)
Ans C
Q) Progestron have higher affinity to bind to : A.
SHBG
B. CBGans
Progesterone: 2% unbound, 80% bound to albumin, 18%
bound to cortisol binding globulin and < 1% bound to SHBG
Q) Dilatation of the uterine cervix at parturition is primarily
achieved by:
Muscle relaxation under the influence of oestriol
Prostaglandin E1 mediated Interleukin release
Constriction of cervical small vessels
Macrophage mediated collagen degradation
Degradation of type I collagen by interstitial
collagenaseans
Q) Minute ventilation in pregnancy increases due to which of
the following?
Effects of gravid uterus on diaphragm
Dliutional anaemia
Increased renal excretion of bicarbonate
Q)
Q)Mc SE with MTX therapy for ectopic a. Transient pelvic pain 3-7 d after starting Rx
b. Stomatitis
c. Bone marrow suppression
d. Gastritis
Q) Prenatal diagnosis at 16 w can be performed
using all of the foll, except: a. Amniotic fluid
b. Maternal blood
c. Chorionic villi
d. Fetal blood..ans
Q)
Ans B
Integrated screen
B. Sequential screen
C. Quad screen..ans
D. Nuchal translucency only
Q)
Q)
following hormones?
A. Dopamine.ans
B. Corticotropin-releasing hormone
C. Somatostatin
D. Prolactin
E. Vasopressin
Q) Which of the following is incorrectly matched?
a. trisomy 21 - decreased alpha fetoprotein
b. trisomy 18 - increased NT
c. trisomy 13 - mainly by meiotic non dysjunction
d. Klinefelter - increased NT ..ans
e. Klinefelter - infertility
Q) Which of the following statements regarding
thyroid function testing in pregnancy is true?
A. TSH levels increase in pregnancy
B. TSH levels remain constant through the
trimesters
C. Total T3 levels drop in pregnancy
D. Free T3 levels drop during
pregnancy.ans
E. Thyroid hormone binding globulin levels drop
during pregnancy
Q) Anti hypertensive that can cause neonatal
hypoglycemia
A)methyl dopa
B)hydralazine
C)labetalol.ans
D)captopril
E)none above
Q)
Q)
Ans B
Q)
Ans E
Q) Drug which bind to alpha 1 glycoprotein - A)salicylate
B)warfarin
C)ansaids
D)beta blocker..ans
E)all above
Q) At what week in pregnancy is testing for gestational
diabetes (GD) advised
A. 24-28 weeks of pregnancy if past history of GD
B. 24-28 weeks of pregnancy if no history of GD
C. 16-18 weeks of pregnancy if no history of GD
D. 16-18 weeks of pregnancy if past history of GDans
E. At booking appointment regardless of past history
Grade 3
Grade 4
Q) Regarding the pubic symphysis, what type of joint is it
Fibrous
Condyloid
Synovial
Primary Cartilaginous
Secondary Cartilaginousans
Q) Which of foll contraceptives primary MOA is inhibition of
ovulation?A)Norgeston
B)Cerazetteans
C)Micronor
D)Femulen
Traditional POP main mode of contraceptive
action: thickening of cervical mucus
Desogestrel-only POP main mode of
contraceptive action is inhibition of ovulation
Cerazette is the only Desogestrel-only POP in
the options above. Other desogestrel brands
include:
Aizea
Cerelle
Nacrez
Q) Which of the following is with regard to
perinatal mortality in the United Kingdom?
Q)
Q)
Q)
WBC 9.4 * 10 /l
You note her past medical history records a diagnosis of
vitiligo 4 years ago but nil else.
She takes no regular medications. You note routine bloods
done by the GP 1 month earlier
show normal thyroid function, urea and electrolytes and
HBA1C. What is the likely
diagnosis? Iron deficiency anaemia
Gastrointestinal bleed
Endometrial bleed
Hashimotos
Pernicious anaemia.ans
Q) Hyponatraemia is a recognised complication of which of
the following?
(Please select 1 option) A) Carbenoxolone therapy
B) Cerebral contusion ans
C) Diabetes insipidus
D) Polyuric phase of acute renal failure
E) Major burns
Q) What is the additional risk of miscarriage if amniocentesis
is performed for genetic screening? a. 1%.......ans
b. 5%
c. 10%
d. 20%
e. 40%
Q)
S1
S2
S3
Q) Regarding Acute PID, which of foll is TRUE?
a. patient presents with superficial dyspareunia
b. it is strongly recommended to remove insitu-IUD once
diagnosed of having PID
c. the absence of infection on high vaginal swab excludes PID
d. Absence of pus cell give a good -ve predictive value .ans
e. the presence of pus cell gives a good positive predictive
value
Q) A patient was diagnosed of having PID and was treated
with appropriate ABic. What is your further plan?
a. see back in 8 wks to assess adequate response to Rx
b. see in 4 weeks to repeat testing for growth in all patient
c. see back in 6 weeks to ensure compliance of antibiotic
d. see back in 2 w to screen and treat sexual partner ans
e. discharge
A,C and D need to be done during follow up...but within 2 to
4 weeks.
Q) Nv supply to perineum
her the False Positive Rate of the scan is 5%. What would you
advise the mother regarding the detection rate of DS using NT
alone? 40%
50%
70%...........ans
90%
95%
Q)
Ans C
Q) A patient arrives on LBW she is 37 w . Her last preg ended
with delivery via uncomplicated LSCS 4 y ago. Contractions
are 5 mins apart and on examn and Cx is 5cm. She wants to
know the risk to baby of proceeding with VBAC. What is
additional risk the baby will have resp problems after VBAC
compared to elective repeat C-section (ERCS)?
A. No difference
B. Risk 1 to 2% greater with VBAC
C. Risk 1 to 2% greater with ERCSans
D. Risk 4 to 5% greater with VBAC
E. Risk 4 to 5% greater with ERCS
A. HLA DR3
B. HLA A3
C. HLA DR4..ans rheumatoid arthritis
D. HLA DR2
E. HLA B27
Q)Fontanelle closure - Ant by 18 months
& post by 3 months
Q) Bal is anti apoptosis
P53 cause apoptosis
Q) What cells in the spermatogenesis process can
undergo mitotic division? Primary spermatocytes
Secondary spermatocytes
Spermatids
Spermatogonia.ans
Spermatozoa
Q) antigen presenting cell then langerhan
and if it is phagocytic antigen presenting then
neutrophil
Q) The rectus sheath is formed by which of the following?
External oblique and rectus abdominus aponeuroses
Internal oblique and rectus abdominus aponeuroses
Rectus abdominus and pyramidalis aponeuroses
aponeuroses of internal and external oblique
aponeuroses of transversus abdominis, external and internal
oblique.ans
Q)
Ans D
Q) Letrozole - MOA
Ans C
Q) Which two nerves provide the primary cutaneous sensory
innervation to the labia majora? Ilioinguinal and inferior rectal
Ilioinguinal and pudendal..ans
Pudendal and perineal
15%
25%
35%
50%
Q) Which complement protein recruits other
complement proteins to form MAC (membrane
attack complex)? C3a
C3b
C3
C5bans
C
Q) In females the pudendal nerve branches are?
Inferior rectal, superior rectal and ilioinguinal
Perineal, ilioinguinal and dorsal clitoral
Inferior rectal, ilioinguinal and perineal
Perineal, inferior rectal and dorsal nerve of clitoris .ans
Perineal, superior rectal and posterior nerve of clitoris
Q) Which of foll muscles does NOT receive innervation from
pudendal nerve? Internal anal sphincter..ans
External anal sphincter
External urethral sphincter
Bulbospongiosus
Levator ani
Q) What is the average oblique diameter of the pelvic inlet
according to the RCOG? 7.5 cm
9 cm
10.5 cm
12 cm..ans
13.5 cm
Q) A 26 years old, primigravida who has had a previous
exposure to VZV outbreak when she was 12 weeks of
gestation. At that time, she was warded and IVIG was
administered. Currently, she is 18 weeks of gestation and had
another exposure to VZV. What would be your management?
a. counselling and reassurance
b. admit for observation
c. put her under isolation
d. give her 2nd dose of IVIG.ans
e. start her on acyclovir
Q) Which of foll muscles is NOT a constituent of pelvic floor
(diaphragm)?iliococcygeal
Piriformis..ans
Puborectalis
Pubococcygeus
Coccygeus
Q) The lumbar plexus is derived from which spinal segments?
T10-L5
L2-L4
L1-L3
T12-L4..ans
L1-L5
Q)
Q)
Q)
Short QT interval
Long QT intervalans
Q) You have been asked to review an asymptomatic patient in
the early pregnancy unit. Ultrasound scan is negative for
pregnancy. hCG levels over 48 hours are 550 and 350, and
serum progesterone levels are 17 nmol. What is the most
likely finding? A. Ectopic pregnancy
B. Failing pregnancy
C. High risk of ectopic pregnancy needing intervention for
treatment
D. Non-viable pregnancy with the possibility of spontaneous
resolution..ans
E. Viable pregnancy
Q) Which Ar is a direct branch of aorta? A. Inferior vesical
B. Internal iliac
C. Ovarian ..ans
D. Uterian
E. Vaginal
The answer is ovarian. The ovarian artery is a
branch of the aorta. It arises anterolaterally just
below the renal artery, running retroperitoneally
to leave the abdomen by crossing the common or
external iliac artery in the infundibulopelvic fold.
It crosses corresponding ureters and supplies
twigs to it but does not supply to abdominal
organs. The internal iliac artery arises from the
Q)
Ans E
Q) A 62 years old female presented to the emergency
department with a right neck of femur fracture. No history of
trauma. You suspected her of having vitamin D deficiency.
What blood investigation would you request to support your
diagnosis?a. serum calcitriol
b. serum calcidiol..ans
c. 1 alpha hydroxylase enzyme
d. 25 hydroxylase enzyme
e. serum calcium and phosphate level
it is because calcidiol is the major circulatory
form for vitamin D, thus the surrogate marker for
Vitamin D status.
Q) Which of the following is responsible for Aquaporin-2
protein channel openings in the collecting duct? Angiotensin
Angiotensin II
ADH.ans
Aldosterone
Renin
Q) Aldosterone promotes water retention via which of the
following mechanisms?
Up-regulation of Aquaporin protein channels in the collecting
duct
Up-regulation of urea transport proteins in the collecting duct
Down-regulation of urea transport channels in the collecting
duct
Up-regulation of sodium/potassium pumps in distal tubule and
collecting duct.ans
Stimulation of Potassium resorption in the tubular lumen
Q) Breast milk is produced by the secretions of the epithelial
cells of the acinar. Which of the following is an accurate
estimate of mature breast milk composition?
Fat 4%, Protein 1%, Sugar 7%............ans
Fat 10% Protein 4% Sugar 20%
Fat 10% Protein 10% Sugar 30%
Fat 18% Protein 5% Sugar 5%
Fat 18% Protein 15% Sugar 1%
Ductus Venosus
Umbilical Arteries
Blood enters the right atrium of the fetal heart and most
passes through the foramen ovale into the left atrium. From
there it is pumped through the aorta. The foramen ovale is the
major structure for bypassing the fetal pulmonary circulation.
Some of the blood in the right atrium does enters the right
ventricle and then into the pulmonary artery however most of
this passes through the ductus arteriosus into the aorta thus
bypassing the fetal pulmonary circulation.
Q) Which one of the following structures is the origin of the
renal tubules?(Please select 1 option) A) Genital tubercle
B) Mesonephric duct
C) Metanephric blastema..ans
D) Paramesonephric duct
E) Urethral folds
Ans FRC
Q) You are discussing radiation doses for an abdominal CT.
The radiation dose of an abdominal CT is equivalent to which
of the following? 40 Chest X-rays
1 year natural background radiation
400 Chest X-rays.ans
Indigestions
Diarrhea
Nausea
Vomiting
Headache
Fatigue
Disturbed sleep
8. Skin rashes
Possible side-effects of vitamin toxicity
1. Iron poisoning as vitamin c enhances the
absorption of iron.
2. Heamochromatosis
3. Heamolytic anemia can be precipitated if the
patient is enzyme glucose-6-phosphate
dehydrogenase (G6PD) deficient one.
4. Kidney stone
5. May precipitate abortions
Q) Which of the following is a branch of the
femoral artery?
A Peroneal artery
B The ascending genicular artery
C The deep epigastric artery This is the correct
answer
D The deep external pudendal artery
E The inferior gluteal artery
Q) About octreotide one is false - A)is somatostatin analogue
B)used v treatment of carcinoid syndrome
C)used in treatment of esophageal varices
D)can cause biliary calculi
E)none aboveans
Q) Steroid is lipophilic. It exerts its action by free access into
cell and binds to intracellular receptor. Prostagladin is also
D)prostate
E)paraoopheros
Q) Ergometrine malete-which is true?
Causes an increased central venous
pressure..ans,causes tetanic contractn
Prostaglandin analogue
Causes spasmodic contractions of uterus
Causes arterial vasodilation
Is a cycli oxygenase 2 inhibitors
Q) Which of the following is the drug of choice for
the treatment of Chlamydia trachomatis infection
during pregnancy? A Amoxicillin .ans
B Cephazolin
C Clindamycin
D Metronidazole
E Tetracycline
Chlamydia infection in the nonpregnant state is
usually treated with a tetracycline
(doxycycline100mg BD for 7 days), or with
azithromycin 1g in a single dose. Erythromycin
and ofloxacin can be used if the first line
treatments are contraindicated.
During pregnancy, tetracycline therapy is
contraindicated because of its incorporation into
fetal bones and teeth. Treatment options are
therefore erthromycin or amoxicillin or
azithromycin.
B) brucella
C) CJD
D) Hep A
E) streptococci.ans
Q) What is the main buffer in urine? a. Ammonia
b. Bicarbonate
c. Chloride
d. Haemoglobin
e. Phosphate.ans
Q) A 32-year-old Asian woman presents at 36 weeks of
gestation with abdominal discomfort, 2+ proteinuria and a
blood pressure of 140/90 mmHg. She has blood tests in
accordance with the NICE guideline for the management of
hypertension in pregnancy. The midwife asks you to review
the following blood results. What do these results suggest?
Urea 2.8 mmol/l
Creatinine 67 micromol/l
Sodium 138 mmol/l
Potassium 4.2 mmol/l
Urate 0.37 mmol/l
Albumin 32 g/l
Alkaline phosphatase 198 iu/l
Alanine transferase 33 iu/l
Bilirubin 5 mmol/l
The answer is Normal blood results for 36 weeks
of pregnancy.
Q) An Asian woman books in for her third pregnancy at 12
weeks of gestation. She has recently moved to the UK from
Q)
Ans A
Q) which antihypertensive drug is typically
associated with tolerance on long term use??
Labetolol
Captopril
Enapril
Methyldopa
Hydralazine..ans
Q) Regarding FISH which one following is correct?
Is used to detect mosaics
Can be used to detect unbalanced translocation
Can be used to detect gene mutation
..ans
For infection
First see at HBsAg ..positive or negative
If positive that means infection Ist step
Now acute or chronic
Q)
Q)
Ans C
Q)Prevalence 0.5 hep B and 0.3-0.7 hep C
N)Following cross placenta, regards as teratogenic :- Varicella
Rubella
HSV
Toxoplasmosis
Syphilis
CMV
Q) HRT is helpful in all of the following except ? vaginal
atrophy
flushing
osteoporosis
coronary heart disease . Ans
Q) Bifurcation of aorta at this level Uppermost edge of iliac crest . Ans,this level
corresponds to L 4
Anterior superior iliac spine
Anterior inferior iliac spine
Sciatic notch
Ischial spine
Crl+42 days=weeks
30+42days=weeks
72days7=weeks
10.02weeks=10weeks
Q) According to WHO , Hb in pregnancy shouldn't be less
than -8
10..ans
9
11
13
Q) DNA duplication occur in - G1
Sans
G2 phase
Q) Mc uterine immune cell - A)macrophage
B)natural killer .ans
C)dendritic
D)B cell
E)T cell
Q) all of the foll appear to decrease hot flushes in
menopausal women except ? androgens
raloxifene .ans
isoflavones
tibolone
Treatment of vasomotor symptoms SSRIs:
fluoxetine and paroxetine. SNRI: venlafaxine.
Ans C
b Treponema pallidum
c Chlamydia trachomatis
d Gardnerella vaginalis
e Haemophilus influenzae
Q) A 71-year-old woman has presented with recent onset of
vomiting. She vomits up the content of every meal
approximately two hours after eating.On examination she has
a palpable mass to the right of the midline in the epigastrium.
Which one of the following is the most likely electrolyte
disturbance in this scenario?(Please select 1 option)
A)High chloride, low bicarbonate
B)High potassium, high sodium, high bicarbonate
C)Low chloride, low sodium
D)Low K, low CL-, high HCO3 ..ans,contraction alkalosis
E)Low potassium, low sodium, low chloride, low bicarbonate
Q) A patient who is 36 weeks pregnant comes to see you as
she has developed tingling to the right lateral thigh over the
past 3 weeks. On examination there are no skin changes and
no muscle weakness. What is the likely diagnosis? Obturator
nerve entrapment
Pudendal nerve entrapment
Femoral Nerve entrapment
Meralgia Paraestheticaans
Shingles
Ans B
Q)
Ans C
Q) Crypytococus falls in to which fungi category - A) mould
B) yeast like
C) diamorphic
D) true yeastans
Q) Prostratic utricle
C) Is covered by peritoneum
D) Lies anterior to the round ligament.F
E) Possesses a cilial lining
D is F rest are T
Q) Are the following statements about the
lymphatic drainage of the genital tract true ? True
/ False
A) Drainage from the corpus uteri goes partly to
the superficial inguinal nodes
B) Drainage from the oviducts is mainly via the
para-aortic nodes
C) Ovarian drainage is directly to the para-aortic
nodes
D) The lymphatics of each side of the vulva
communicate with each other
E) The middle third of the vagina drains to the
superficial inguinal nodes.F
A-D are true
Q) Lithium and malformations true/false
Ebsteins anomaly is the displacement of the tricuspid valve
towards the apex of the right ventricle
It gives rise to a large right atrium
Occurs about 4 weeks after conception
Lithium is associate with ASDs and VSDs
The use of lithium during the last trimester is problematic
All true
D) oral prednisone.
E) all of the above.
a. erythromycin
b. isotretinoin..ans
c. ibuprofen
d. metronidazole
Q)
Ans C
Q) All the following therapies would be
appropriate for the acute treatment of migraine
in a pregnant woman except
A)
sumatriptan..ans
B) codeine.
C) acetaminophen.
D) propranolol.
Q) With regard to cardiac cycle, what is the definition of
stroke volume?A. Cardiac output/body surface area
B. End diastolic volume- end systolic volume..ans
C. End systolic volume-end diastolic volume
D. End systolic volume+ end diastolic volume
E. End diastolic volume+ end systolic volume
Q)
Ans C
Furosemide
Triamterene..ans
syndrome ....................................................................T
B- Turner's
syndrome .....................................................................F
C- Cri du chat
syndrome ................................................................F
D- Patau's
syndrome ......................................................................T
E- Laurence-Moon-Biedl
syndrome ....................................................F
Non-dysjunction (the failure of replicated chromosomes to
segregate during Anaphase II) during meiosis is responsible
most typically for Down's syndrome (trisomy C21), Patau's
syndrome (trisomy C13), Turner's syndrome (XO),
Klinefelter's (XXY) syndrome and Edwards syndrome
(Trisomy C18). Cri du Chat is due to a deletion of a portion of
C5.
33- Campylobacter jejuni:
A- attack rates are highest in the
elderly ..........................................F
B- infections are treated with
ciprofloxacin ........................................T
regresses ..............F
D- Bowman's capsule develops in the
metanephros ............................T
E- The glomerulus forms part of the
mesonephros ...............................F
The urinary system develops from the intermediate
mesoderm. During development of the fetus there are 3
overlapping kidney systems - the pro, meso, and metanephric
systems. The metanephros forms the permanent kidney.
Bowman's capsule and the glomerulus develop as part of the
metanephros.
38- The ureter:
A- Passes into the pelvis over the bifurcation of the internal
iliac artery...F
B- Is seen lying on the tips of the transverse processes of the
lumbar ...T
C- Has the genitofemoral nerve lying anterior to
it ...............................F
D- Is surrounded by Waldeyers sheath as it passes through
the bladder wall .....T
...T
The Herpesviridae family of viruses are dsDNA viruses that
include herpes simplex, varicella zoster, CMV and EBV. The
papilloma virus, a small dsDNA virus, is a member of the
Papovavius family. Rabies, a ssRNA virus, is a member of the
Rhabdovirus family.
39.The structures at risk of damage while cannulating the
subclavian vein include:
A- phrenic
nerve ..........................................................................T
B- subclavian
artery .....................................................................T
C- ansa
cervicalis .........................................................................F
D- anterior ramus of first thoracic
nerve ........................................T
Epleura .....................................................................................T
The subclavian artery lies inferior to the suclavian vein and
may be inadvertently cannulated in an attempt to cannulate
the suclavian vein. This may be of serious consequence as it is
A- and ectodermal
disc ..................................................................T
B- The amnion has 5
layers ...........................................................T
C- the chorion has 4
layers ..........................................................T
D- the main layer of the chorion is the cellular
layer .......................F
E- the chorion is surrounded by the
blastocyst ................................F
person ....T
D- suicidal ideations are a common feature of a grief
reaction .............F
E- Antidepressants is the most appropriate initial
therapy ...................F
Grief reactions are typically mapped along the lines of anger
denial and guilt. Delayed grief is said to occur if it
commences two weeks after bereavement. Grief reactions
often occur on anniverseries such as weddings, births etc. The
most appropriate treatment is conselling and antidepressants
should not be routinely used. Suicidal ideations are also
abnormal.
D- bcl2 .......................................................................................F
E- cmyc .......................................................................................F
Mutations in Tumour suppressor genes have been implicated
in malignancy as down regulation of these genes can result in
the unrestricted growth of cells and hence predispose to
malignancy. These genes include VHL (von Hippel Lindau),
p53, Rb1(Retinblastoma), BRAC and APC (adenomatous
polyposis coli) genes. Oncogenes, on the other hand are
associated with the promotion of cell division and include
myc, erb, ras and ret.
44.Trinucleotide repeat sequences are seen in
A- cystic
fibrosis .............................................................................F
B- Duchenne muscular
dystrophy ....................................................F
C- myotonic
dystrophy ...................................................................T
D- fragile X
syndrome .....................................................................T
E- Leber's optic
atrophy ..................................................................F
also Huntington's chorea
In genetics, anticipation is a phenomenon whereby the
symptoms of a genetic disorder become apparent at an earlier
age as it is passed on to the next generation. In most cases, an
increase of severity of symptoms is also noted. It is common
in trinucleotide repeat disorders like Huntington's disease,
myotonic dystrophy and fragile X syndrome, where a
dynamic mutation in DNA occurs. All of these diseases have
neurological symptoms.
45.Which of the following drugs are teratogenic
AWarfarin ..................................................................................T
B- Oral
contraceptive ...................................................................F
CMetformin ..............................................................................F
DSimvastatin ...........................................................................T
ERanitidine ...............................................................................F
antigen ...................T
Only in mild cases (5-20% activity)is bleeding controlled by
DDAVP.
Haemophilia A is X-linked recessive. Sons of affected males
will inherit a normal Y chromosome, and will be unaffected.
Hepatitis C or E would be commoner as a cause of abrnomal
LFTs in these patients, as hepatitis B is more easily screened
for.
Factor VIII related antigen is reduced in von Willibrand's
disease.
90% present with bleeding by their first birthday. Only 30%
present with bleeding after circumcision.
47.Which of the following are Tocolytic:
ASalbutamol ...............................................................................
T
BSuxamethonium .......................................................................
F
CPropofol ..................................................................................F
DProgesterone ...........................................................................T
EGTN .........................................................................................
T
Tocolytic drugs, inhibitors of uterine contraction, include
GTN, alcohol, magnesium sulphate, ritodrine, salbutamol,
nifedipine and NSAIDs. Progesterone in high concentrations
also has some tocolytic activity and promotes the relaxant
effects of more conventional tocolytics.
48.Metronidazole:
A- Inhibits dihydrofolate
reductase. .................................................F
B- Has 80% bioavailability if given
rectally. ......................................T
C- Has harmful effects with
alcohol. .................................................T
D- Discolours the
urine....................................................................T
E- Causes peripheral
neuropathy......................................................T
Reduced to active derivative which binds to DNA and inhibits
binding ....................................................F
tenderness ....................................................................T
E- Loss of
libido ............................................................................F
B- Salmonella
typhi .........................................................................F
C- Streptococcus
pyogenes .............................................................T
D- Mycobacterium
tuberculosis ........................................................F
E- Clostridium perfringens
(welchii) .................................................T
Whilst both HBV and HCV are transmitted through blood and
blood products, HBV is a DNA virus and Hepatitis C is an
RNA flavivirus. Hepatitis D is an incomplete RNA virus,
existing only with H epatitis B, spread is with co-infection or
super-infection with Hepatitis B. Epstein Barr Virus is a DNA
virus, very similar to the other herpes viruses. It is shed in
pharyngeal secretions and transmission occurs via close oral
contact.
63. Regarding Immunoglobulin:
A- Immunoglobulins are secreted from Tlymphocytes. ......................F
B- An immunoglobulin G (IgG) comprises 2 antigen-binding
sites and a site for the binding of complement.........T
C- The molecular structure of IgG is a Y
shape ...................................T
D- IgG constitute approximately 25% of all immunoglobulis
in a healthy individual........F
E- IgMs can cross the placenta to the
foetus........................................F
Immunoglobulins (antibodies) are secreted from Blymphocytes (plasma cells) in response to a specific antigen.
The risks of some cancers are associated with use of the OCP.
In particular, it appears that breast cancer risk is increased
and, use of the OCP for more than 5 years is associated with
increased risk of cervical carcinoma. Hepatoma risk may also
be increased with use of the OCP. Use may be protective for
ovarian carcinoma.
66.Unopposed oestrogen therapy for the postmenopausal
female
A- Improves the urethral
syndrome ...................................................T
B- Decreases urinary calcium
excretion .............................................T
C- Reduces the incidence of myocardial
infarction ..............................F
D- Causes an increased incidence of endometrial
carcinoma ..............T
E- Cause
hypertension ....................................................................F
Low levels of natural oestrogen around and after menopause
diminish the body's ability to absorb calcium and to
metabolize vitamin D. Low oestrogen levels lead to a thinning
of trabecular bone and eventually osteoporosis. This leads to
an increased risk of fractures of the hip and wrist and
compression fractures of the vertebrae resulting in a dowager
hump. Rather than the original belief that postmenopausal
HRT reduces CV risk, studies like WHI and HERS show an
increased CV mortality and morbidity associated with HRT.
Neoplasia of the endometrium may follow unopposed
oestrogen; the risk increases with the duration of use:x 3-6
after five years of use. x 10 after ten years. That is why
groups...............................................................F
C- Activates complement via the classical
pathway...............................F
D- Is manufactured in lymph
nodes....................................................F
E- Crosses the
placenta. ...................................................................F
Chomocystinuria ..........................................................................
F
Dhaemophilia ...............................................................................
T
E- the
elderly ..................................................................................T
Circulating anticoagulant, usually IgG, interfere with
coagulation reactions. The main laboratory feature are
prolonged PT and PTT which persists if normal plasma is
added.
a-These are non-specific inhibitors which prolong haemostasis
by binding to phospholipids. Anti-factor VIII antibodies may
also be seen.
b,d and e-Anti-factor VIII antibodies.
c-Thrombotic tendency.
d-haemophiliacs who have had plasma transfusions.
73. A karyotype
A- may be prepared from chorionic villi cells of the
placenta................T
B- helps in the diagnosis of chromosome
disorders.............................T
Dnucleolus ...................................................................................
.F
E- rough
ER ....................................................................................F
sites ................................................T
a) IgM,
b) IgA,
c) the only Ig to do so,
d) 150,000
75. Which of the following statements regarding DNA is/are
true/false ?
A- Attached to the 2' position of the sugar ring is one of four
bases.......F
B- The bases lie stacked on each other 3.4 Angstroms
apart................T
C- During transcription each daughter DNA contains one
newly synthesised strand.........F
D- The guanine - cytosine bonds are made of two hydrogen
bonds. .......F
E- The DNA from a single cell is nearly 2 metres
long..........................T
Individual nucleoside units (bases) are joined together in a
nucleic acid in a linear manner, through phosphate groups
attached to the 3' and 5' positions of the sugar (deoxyribose).
Hence, the full repeating unit in a nucleic acid is a 3',5'-
nucleotide.
Guanine - cytosine bonds consist of three hydrogen bonds.
--------------------------------------------------------Q) Are the following true or false regarding the developmwnt
of the urinary system?
( True / False)
A) Bowman's capsule develops in the metanephros..T
B) Develops from intermediate mesoderm..T
C) In intra uterine life 3 overlapping kidney systems are
formedF
D) The glomerulus forms part of the mesonephrosT
E) The mesonephros develops as the metanephros
regressesF
Q)
--------------------------------------------------Q) 1.
A cone biopsy specimen of a woman who
requested that her menstrual function be preserved
a.
Requires hysterectomy.
d.
e.
2.
c.
d.
e.
E.
a.
Estrogen is present.
b.
Progestrogen is present.
c.
d.
e.
C.
b.
c.
d.
e.
C.
5.
Seminar fluid
a.
pH is 4.6
b.
Volume is 10ml.
c.
Contains PGE2.
d.
e.
C.
6.
a.
b.
c.
d.
e.
A.
a.
b.
c.
d.
e.
D.
a.
b.
Endometriosis.
c.
Unmarried females.
d.
e.
D.
a.
b.
c.
d.
e.
C.
a.
Erectile tissue.
b.
Corpus spongiosum.
c.
Involuntary muscles.
d.
A glans.
e.
2 crura.
B.
a.
b.
c.
d.
a.
b.
Show.
c.
Painful contractions.
d.
e.
D.
a.
b.
c.
d.
e.
E.
a.
b.
e.
a.
b.
e.
D.
a.
b.
Duration.
c.
Pain.
d.
Color.
e.
Passage of clots.
D.
a.
Hypoxia.
b.
Oligohydramnios.
c.
d.
a.
b.
c.
d.
e.
D.
a.
b.
Hirsuitism.
c.
Obesity.
d.
Raised LH.
e.
A.
20. Amenorrhoea
a.
c.
d.
e.
21 Eclampsia management
A.
a.
Cephalic-cephalic.
b.
Breech-cephalic.
c.
Transverse-transverse.
d.
Breech-breech.
e.
Cephalic-transverse.
C.
a.
Polyhydramnios.
b.
Anemia.
c.
Premature labor.
d.
e.
E.
a.
b.
Breech presentation.
c.
d.
e.
B.
a.
Prostaglandin.
b.
Leukotrienes.
c.
Prostacycline.
d.
Thromboxane.
e.
A.
a.
Heads.
b.
Thoraces.
c.
Abdomen.
d.
Limbs.
e.
a.
Spacing of children.
b.
c.
d.
Better nutrition.
e.
E.
a.
b.
c.
d.
10 per 100,000.
a.
b.
Uterine enlargement.
c.
d.
Hemoptysis.
e.
E.
a.
b.
c.
d.
e.
a.
b.
c.
SGA.
d.
e.
A.
a.
Syphilis.
b.
c.
d.
e.
a.
Hypersegmentation of PMN.
b.
Macropolycytes.
c.
d.
e.
D.
a.
b.
PBF.
c.
Erythrocyte electrophoresis.
d.
e.
a.
Anteroposterior 13cm.
b.
Transverse 11.5cm.
c.
Interspinous 10.5cm.
d.
e.
D.
a.
b.
c.
d.
e.
C.
e.
D.
a.
b.
c.
Head in occipito-anterior.
d.
e.
a.
b.
PBF.
c.
Optic fundoscopy.
d.
UFEME.
e.
a.
b.
c.
Obstructed labor.
d.
e.
B.
a.
Intravenous dextrose.
b.
Intravenous oxytocin.
c.
Delivery by vacuum.
d.
LSCS.
e.
Controlled anaesthesia.
D.
a.
Oral contraceptives.
b.
Sheehans syndrome.
c.
Genital tuberculosis.
d.
Hypothyroidism.
e.
Ginari-rommech syndrome.
E.
a.
b.
c.
d.
e.
A
45. Which is usually not associated with failure to
conceive? a. Cervical incompetence.
b.
c.
Tuberculosis salpingitis.
d.
Adrenogenital syndrome.
e.
Stein-Leventhal syndrome.
A.
46. Which statement is wrong?
a.
B.
c.
d.
b.
c.
d.
e.
D.
d.
e.
B.
a.
Habitual abortion.
b.
c.
Renal abnormalities.
d.
Polycystic kidneys.
e.
Cryptomenorrhoea.
D.
51. Right ureter lies in relation to the following:
a.
b.
c.
d.
Uterine artery.
e.
Paracervical tissue.
a.
Monilia.
b.
Ovarian dysgerminoma.
c.
Gonorrhoea.
d.
Ectopic ureters.
e.
Sarcoma.
B.
a.
Hormones.
b.
c.
D & C.
d.
Hysterectomy.
e.
C.
a.
Cervical erosions.
b.
Carcinoma of breast.
c.
Cholecystitis.
d.
Hyperemesis gravidarum.
e.
PTB.
B.
a.
Cervical prolapse.
b.
Senile vaginitis.
c.
Ectopic pregnancy.
d.
Stilboesterol.
e.
Endometrial carcinoma.
C.
a.
Respiration.
b.
Locomotor.
c.
Cardiovascular system.
d.
e.
All.
a.
Abnormal lactation.
a.
1.0.
b.
0.7.
c.
1.2.
d.
0.8.
a.
Mucopolysaccharides.
b.
Vernix.
c.
d.
Bilirubin.
e.
Mucoprotein.
a.
Are painful.
b.
Occur 1 in 30 minutes.
c.
Occur 1 in 5 minutes.
d.
C.
a.
b.
At onset of menstruation.
c.
d.
a.
b.
60 million / ml.
c.
20 million / ml.
d.
1 million / ml.
a.
b.
Cytotoxic drugs.
c.
Total hysterectomy.
d.
Cobalt therapy.
e.
C.
a.
b.
Prevention of Rh isoimmunization.
c.
d.
B.
a.
> 38 years.
b.
c.
d.
Extensive fibroids.
B.
a.
Ovum.
b.
Ovarian stroma.
c.
Graafian follicle.
d.
Endometrium.
e.
Corpus luteum.
C.
a.
Placenta praevia.
b.
c.
PID.
d.
Chronic cervicitis.
e.
Thrombophlebitis.
B.
a.
Fibroid prolapse.
b.
Cervical carcinoma.
c.
Adenomyosis.
d.
Urethral carbuncle.
e.
Ovarian carcinoma.
B.
a.
Moniliasis.
b.
c.
Threadworms.
d.
Ovarian dysgerminoma.
e.
Ectopic pregnancy.
D.
c.
Is relieved by antispasmodics.
d.
e.
B.
a.
Hormonal therapy.
b.
c.
d.
e.
D&C.
E.
a.
Physical trauma.
b.
Uterine retroversion.
c.
Abnormality of conceptus.
d.
Incompetent cervix.
C.
a.
Parametrium.
b.
Ovarian ligaments.
c.
Infudibulopelvic ligament.
d.
Round ligament.
e.
Urachus.
C.
a.
Webbed neck.
b.
Short stature.
c.
Primary amenorrhoea.
d.
e.
Vaginal atresia.
a.
b.
Threatened abortion.
c.
Produce HCG.
d.
a.
b.
c.
d.
e.
C.
a.
Dyspareunia.
b.
Dysmenorrhoea.
c.
d.
GIT symptoms.
e.
Prolapse.
C.
a.
Cervix incompetence.
b.
c.
TB salpingitis.
d.
Fibroid.
e.
Bicornuate uterus.
A.
a.
Apareunia.
b.
Vaginal discharge.
c.
d.
Hirsutism.
e.
Urinary incontinence.
D.
a.
Cervical polyp.
b.
Ectopic pregnancy.
c.
Cervical carcinoma.
d.
Endometrium carcinoma.
e.
Senile vaginitis.
B.
a.
b.
Urethrocoele.
c.
Urethral diverticulae.
d.
Ureterocoele.
e.
Cystocoele.
D.
a.
b.
c.
Utero-vaginal prolapse.
d.
e.
a.
Time of ovulation.
b.
c.
Viability of sperm.
d.
e.
D.
a.
APH.
b.
Hypertension.
c.
d.
e.
Polyhydramnios / oligohydramnios.
B.
a.
Malpresentation.
b.
Anemia.
c.
Premature labor.
d.
Diabetes mellitus.
e.
Hydramnios.
C.
a.
b.
c.
d.
e.
D.
a.
b.
c.
d.
e.
C.
a.
Diabetes mellitus.
b.
c.
d.
Leukoplakia vulvae.
e.
Vulval carcinoma.
C.
a.
Cervix is effaced.
b.
Membranes ruptured.
c.
d.
D.
a.
d.
e.
A.
a.
Cervical suture.
b.
Progesterone therapy.
c.
Stilbesterol.
d.
Diazepam.
e.
Isoxupurine.
A.
a.
b.
c.
d.
e.
B.
a.
Uterine artery.
b.
Ovarian artery.
c.
d.
e.
B.
a.
Ca breast.
b.
c.
d.
e.
D.
a.
b.
Primary amenorrhoea.
c.
Suprapubic pain.
d.
e.
D.
a.
b.
Excision of gland.
c.
Marsupialisation.
d.
Antibiotics.
e.
C.
a.
b.
c.
d.
e.
C.
c.
d.
e.
E.
a.
b.
Pneumonia.
c.
d.
Rupture of scar.
e.
Haemorrhage.
E.
a.
BPD.
b.
Bregma diameter.
c.
Occipitomental diameter.
d.
Suboccipitofrontal diameter.
e.
Subparietal diameter.
A.
a.
b.
c.
d.
e.
C.
a.
b.
c.
Spalding sign.
d.
e.
Ball sign.
E.
106.The normal sequelae of events in acute PID is:
a. Abscess formation.
b.
Hydrosalpinx.
c.
Atrophy of ovary.
d.
Pseudocyst formation.
e.
Resolution.
c.
Intra-amniotic prostaglandins.
d.
Buccal oxytocin.
C.
108.In a 54 year old woman with vaginal prolapse, the
treatment of choice is:
a.
b.
Perineal exercises.
c.
Leforts operation.
d.
Ring pessary.
A.
110. Prophylactic forceps delivery should be ruled out in:
a.
Cardiac disease.
b.
c.
Toxaemia of pregnancy.
d.
e.
D.
-------------------------------------------------------------Q) The following radiological findings indicate fetal death
except:a. Haloes area on fetal skull.
b. Absence of femoral epiphysis.
c. Spalding sign.
d. Gas bubbles in heart vessels.
e. Ball signans
Q) consequence of maternal use of cocaine is ?
a. hydrops
b. sacral agenesis
c. cerebral infarction.ans
d. hypertrichosis
5ml/min
15ml/min
50ml/min
150ml/min
250ml/minans
The typical Oxygen Consumption (VO2) is 250ml/min.
In pregnancy this increases by around 20% to 300ml/min
Q) Contraindications UKMEC 3/4 to use depot for
contraception??
Treated Breast Ca with no recurrence after 10 yearsans
Age 37 smoking 3-5 ciger per day
Personal history of DVT
BMI 45 kg/m2
12 weeks post partam breastfeeding
Q) antimalarial drug to be avoided in pregnancy ?
a. chloroquine
b. quinine
c. primaquine..ans
d. anti-folates
e.tetracyclines
Q) What's the earliest gestational age at which the fetal
endocrine system is thiught to be fully functional? 6weeks
10weeksans
16weeks
24weeks
30weeks
Q) Which of foll statements regarding placenta and fetomaternal circulation are FALSE?
Deoxygenated fetal blood arrives at the placenta via 2
umbilical arteries
Oxygenated blood returns to the fetus via a single umbilical
vein
There is no direct mixing of fetal and maternal blood at the
placenta
At term the placenta receives 70% of uterine blood
flow..ans
In the umbilical vein the pressure is approximately 20 mmHg
At term the placenta receives around 90% of
uterine blood flow
Q) Paraurethral glands skenes present in:
Superficial perineal pouch
Deep perineal pouch
D. Parathyroid hormone
E. Vasopressin..ans
Q) Which one is a type of chromosome
heteromorphism?
Balanced translocation
Non dysjunction
Gene deletion
Unbalanced translocation
Fragile sites..ans
Q) Which of foll hormones inhibits Galactopoiesis and
Lactogenesis postpartum?Oxytocin
Progesterone
Dopamineans
hPL
Prolactin
Q) At what stage of fetal development does fetal haemoglobin
(HbF) replace embryonic haemoglobin (HbE) as the primary
form of haemoglobin?4-6 weeks
10-12 weeksans
20-24 weeks
32-36 weeks
At Birth
Q) A 23 years old woman develop a fever and has
offensive discharge and abdominal pain. You are
concerned that she is septic and wish to
administer intravenous antibiotics. Prior to
administration you wish to calculate her
Aspirin therapy
Protein C Deficiency
Causes of prolonged Prothrombin time (PT) and also INR
(INR is a ratio of PT):
Factor V deficiency
Warfarin therapy
Liver Failure
DIC
Q) What is the average lifespan of a platelet? 3-4 days
5-9 daysans
14-21 days
30 days
90 days
Blood Cell Lifespans
Red Blood Cells 120 days
Platelets 5-9 days
White blood cells 2-5 days
Neutrophils (up to 5 days)
Basophils (2 to 3 days)
Eosinophls (2 to 5 days)
Monocytes (1 to 5 days)
Lymphocytes (variable)
Q) Lactogenesis at term is stimulated by which hormone?
Oxytocin
hPL
Progesterone
Prolactin.ans
Dopamine
Q) which following drug suppress pituitary LH
production,hepatic SHBG production and use to
treat Hirsutism? Spirinolactone
GnRH Analogue
Flutamide
Gestrinone
COCPans
Q) On TVs 4-5 week gestational sac visible
5 week yolk sac
5-6 embryo
Q) Which one is true for congenital hip dislocation ?
A m.c in African population
B m .c in first born female babies ..ans
C m.c in first born in male babies
D needs x-Ray for confirmation
E only surgically treated
Q)Cardinal signs of inflamm
rubor-redness
calor-heat
dolor-pain
tumor- swelling
functiolessa- loss of functions
days
c. doxycycline 100mg bd for 14days + metronidazole 400mg
tds for 7 days
d. metronidazole 400mg tds for 5 days..ans
e. tinidazole 2g once only
it is trichomoniasis. it is an anaerobic infection.
Tinidazole can also be given but after failure of
metronidazole. therefore, 1st line is
metronidazole.
Q)Labia Mj nv supply ant 1/3 by illioinguinal
nerve
post 2/3 by perineal division of pudendal nerve.
Q) anterior part of labia majora supplied by which
nerve?Hypogastric
Q) Which one is notifiable disease ?
A clostridium difficle
B measles .ans
C MRSA
D pneumococcal pneumonia
E rheumatic fever
Q) Please confirm according to last guideline
Mc direct maternal death is sepsisT , (Sepsis
Eclampsia VTE)
And indirect is cardiac disease.T
Q) What is the lymphatic drainage of the ovaries? A. Common
iliac nodes
Q)
ORIGIN
Perineal body (and midline raphe
over corpus spongiosum in male)
INSERTION
Superficial perineal membrane and
dorsal penile/clitoral aponeurosis
ACTION
Male:aids emptying of urine and
ejaculate from urethra. Female:
closes vaginal introitus
NERVE
Perineal branch of pudendal nerve
(S2, 3, 4)
Ans D
Q) Regarding varicella zoster virus, SBA
1) it is a single-strain herpes virus..ans
2.it contains single stranded DNA
3.the incubation period lasts one week
4.infections are preventable by a killed vaccine
Q) Rubella virus, SBA : 1) Contains double stranded DNA
2)has incubation period of 13-20 days.ans
3) has killed vaccine
4) is treated with antivirals
Q) Regarding Meningococcus: SBA
1)it is not part of the normal flora in human
2)infected people develop a slow spreading
petechial rash
3)people with meningitis typically have
coexisting septicemia
4)the cerebrospinal fluid glucose concentration is
increased
5)treatment is with penicillinans
Q) Guthrie test was done on a newborn and it was positive.
What is the mode of inheritance of this disease? a. autosomal
dominant
b. autosomal recessive.ans
c. x linked dominant
d. x linked recessive
e. none of the aboue
phenylketonuria gives guthrie test positive due to
accumulation of phenylalanine in blood. it is inherited as AR.
Q) Vitamin D undergoes a few process of activation. Where
does the final activation step predominantly occurs? a.
juxtaglomerulus apparatus
b. distal convoluted tubule
c. hepatocyte
d. proximal convoluted tubule..ans
e. loop of henle
Q) Calcitriol is important to maintain a good calcium
homeostasis. what is the effect of its function? a. increase
serum ca, increase serum phosphate
b. increase bone formation
c. both aboveans
d. increase serum ca, decrease serum phosphate
e. reduce kidney reabsorption of phosphate
Q)
Ans D
Q) Which statement is false regarding non herpetic genital
ulcers
1) lymphogranulom venerum is caused by specific serovars of
chlamydia trachomatis
2)lymphogranuloma venerum causes severe proctocolitis
3)chancroid is an infection caused by klebsiella
granulomatis.ans
4)chancroid causes inflamed lymph nodes to weep through
skin
5)granuloma inguinale causes elephantiasis
Q)
Q)
Ans C
Q) MRSA infections may respond to which
antibiotics
.Augmentin
.carbapenams
.cephalosporins
.clindamycin
.vancomycin.ans
Q) 19 year old university student is concerned that she might
have Chlamydia infection.
Which one of the above is not a sign / symptom of Chlamydia
infection?
A Intermenstrual bleeding
B Joint pains
C Cervical excitation
D Exophytic Cervical mass..ans
E Mucupurulent vaginal discharge
70% of women are asymptomatic. If symptoms are present,
they include: Lower abdominal pain, Dyspareunia,
Abnormal vaginal bleeding e.g. postcoital bleeding,
intermenstrual bleeding, Abnormal vaginal or cervical
discharge.
May be mucupurulent. Dysuria.
Rarely, patients can present with right upper quadrant pain
(peri-hepatitis) and joint pains (reactive arthritis).
Signs: The following may be present: Pyrexia, Lower
abdominal tenderness, Cervical excitation, Contact bleeding
Q)
Ans C
Q) Which ovarian tumor is difficult to distinguish
from endometriosis ?
A.chorioacarcinoma
B.mature cyst teratoma..ans
C.yolk sac tumor
D.mucinous tumor
E.serous teratoma
Q)
investigations
Retinopathy, nephropathy, neuropathy or diabetes > 20 yrs
duration
Active viral hepatitis
UKMEC 4 unacceptable health risks or absolute
contraindications
Current breast cancer UKMEC 4
Q) A 33 year old woman has been diagnosed with ovarian
hyperstimulation syndrome. Which one of the above features
would suggest severe OHSS?
A Haematocrit > 45%...............ans
B Ultrasound evidence of ascites
C Ovarian size of 8 12 cm
D Urine output of 650 mls over 24 hrs
E Mild abdominal pain
Severe OHSS
Clinical ascites +/- hydrothorax
Oliguria
Haemoconcentration (haematocrit > 45%)
Hypo-proteinaemia
Ovarian size usually > 12cm
Q) Characteristics of common organisms include
all except
A)Neisseria gonococcus is non motile
B)Mycobacteria are gram +ve
C)Bacillus anthracis is anaerobic..ans,both
aerobic and anerobic.Bacillus species is aerobic
D)Ecoli is motile
E)Gardnerella vaginalis is gram -vegm
variable can be +ve or -ve
Q) Which one of above statements is true?
A Cervical ectropion is a pathological process resulting from
eversion of the lower cervical canal
B Cervical ectropion is a risk factor for developing CIN
C Cervical ectropion in early pregnancy is an indication for
termination
D Cervical ectropion is assoc with adolescence.ans
E Cervical ectropion is pre malignant
Q) Sunlight plays a major role in vitamin D production. In
certain country, during winter, day is shorter than night.
People in those country produce vitamin D during summer
and store them for usage during winter. where is the vitamin D
being storeda. adipocyte..ans
b. hepatocyte
c. red blood cell
d. adrenal
e. dermis
Q) Anencephaly include
A)high AFP and Inc estriol
B)low AFP and normal estriol
C)low AFP and low estriol
D)high AFP and low estriol
E)high AFP and normal estriol
C. Mitochondria
D. Rough endoplasmic reticulum
E. Smooth endoplasmic reticulum
The answer is Rough endoplasmic reticulum.
Ribosomes 'read' the messenger RNA created
from the nuclear DNA and translate it to create
proteins via transfer RNA. There are free
ribosomes in the cytoplasm of cells but they are
in abundance in the rough endoplasmic reticulum
Q) Which part of the cell cycle is noted for sister chromatids
separating and moving to opposite sides of the cell? A.
Anaphase .ans
B. Metaphase
C. Prophase
D. Synthesis phase
E. Telophase
The answer is Anaphase. Within the cell cycle DNA
replication occurs in the synthesis phase before entering the
Gap 2 phase. Mitosis starts with chromosomes condensing
(prophase) follow by chromatids aligning (metaphase),
following by sister chromatids separating and moving
(anaphase). Finally the cell membrane divides in telophase
Q) Which of the following amino acid bases is not contained
in RNA?
A. Adenine
B. Cytosine
C. Guanine
D. Thymine
E. Uracil
:
The answer is Thymine. In RNA the thymine is replaced by
uracil. The other bases (adenine, cystosine and guanine)
remain the same.
Q) Which of the following molecules generates weak forces
that can attract neutrophils to cell walls? A. Cadhedins
B. Eicosanoids
C. Hemidesmosomes
D. Integrins
E. Selectinsans
Selectins are molecules that are expressed in endometrial cell
walls and also leucocytes. They generate weak attraction
forces. Inflammatory processes via interleukins increase the
amount of selectins present and hence, attract more leucocytes
C) 20-25 mm water
D) 10-15 mm water
E) 15-18mmhg
Q)
Ans C
Heprin and warfrin is give for 3 to 5 day combine then heprin
withdraw.
Q) RBC no mitochondria,energy needs met by anerobis
respiration
Q)
a. cerebral palsy
b. failure to thrive
c. limb hypoplasia
d. microcephaly
e. sensorineural hearing lossans
pt is having rubella infection. arthalgia, fever ,
rash and lyphadenopathy is highly likely to be
rubella.
arthalgia is a prominent clinical feature due to
deposition of antigen antibody complex on the
synovial membrane.
rubella infection causes 80% hearing loss, 60%
heart defects , 30 % cataract.
limb hypoplasia is associated with varicella zoster
microcepaly associated with cytomegalovirus
c. insulin..ans
d. diabetes
e. glucagon
key c. the rest stimulates the hormone sensitive
lipase (HSL) to break TAG to fatty acid
Q) which organism is responsible for the
occurance of the diagram below? a. trichomonas
vaginalis
b. chlamydia trachomatis
c. neisseiria gonorrhea
d. gardrenella vaginalisans
e. hemophilus ducreyi
bacteria vaginosis presents with high ph
discharge due to reduction of lactobacilli. they
have offensive fishy odor discharge and presence
of clue cells on histology
Ans C
1.Chloroquine FDA Category C
can be used Causiously (Benefits >harms).
2.Hep A can be given
3.Tdap is recommended to be given specially late
trimester
4.MMR is live attenuated vaccine So
Contraindicated.
Q)
Ans B
Q) Alcoholic pregnant lady with obstetric
cholestasis what you will give -a) vitamin C
b) vitamin K.ans
c) vitamin B1
d) vitamin B6
Q)
Q)
rupture - 1%.......ans
2%
3%
10%
Q) What proportion of cytomegalovirus (CMV) infections is
asymptomatic in immune-competent patients?a- 10%
b- 40%
c- 60%
d- 80%
e- 90%...........ans
The answer is 90%. CMV infection in adults is asymptomatic
in 90% of cases. If primary infection occurs in pregnancy,
then there is a 4050% risk of fetal transmission. Between
22% and 38% of the infected fetuses will develop symptoms.
Q) Which of foll enzymes, which may rise in hepatitis and
myocardial infarction, is present in the liver cell cytosol, brain
and myocardium?
A) Alkaline phosphatase (ALP)
B) Aspartate aminotransferase (AST) ans
C) Gamma-glutamyl transpeptidase (GGT)
D) Alanine aminotransferase (ALT)
E) Serum bilirubin
Q) Which of the following is a cause of hyponatraemia?
A) Cirrhosisans
B) Conn's syndrome
C) Cushing's syndrome
D) Diabetes insipidus
E) Hypertonic saline
Q) Of the SGA infants missed by conventional measurements
of SFH, more than half would
have been picked up using customised assessment of
SFHF
Q)
d. Cephalexin
e. Amoxicillin/clavulanate
Q)20-y - routine well-woman examn. She has a h/o acne, for
which she takes minocycline and isotretinoin on daily basis.
She also has a h/o epilepsy that is well controlled on valproic
acid. She also takes a COCP containing norethindrone acetate
and EE. She is a nonsmoker but drinks alcohol on daily basis.
She is concerned about effectiveness of her birth control pill,
given all medications that she takes. She is particularly
worried about the effects of her medications on a developing
fetus in event of unintended preg. Which of foll drugs has
lowest potential to cause birth defects?a. Alcohol
b. Isotretinoin (Accutane)
c. Tetracyclines
d. Progesterone.ans
e. Valproic acid (Depakote)
Q) bilirubin is bound to albumin in circulation..T
Q)
Q) Folliculogenesis 375 d
D.4
E.5
Q)
Q)
Ans C
Q) A baby had bradycardia and was delivered by
ventouse.The umbilical artery pH wad7.05, base
excess -4, while the umbilical vein pH was 7.25,
base excess -2.5. What will you tell the
pediatrician about the test : Normal blood
testans
The baby had an acute episode of hypoxia before
delivery
The baby had chronic episode of hypoxia before
delivery
Here Ph 7.05( reduced )base excess -4 ( normal)
So acute hypoxia
Listed below are normal values in an umbilical
arterial sample in a term newborn:
PH: 7.18 7.38
PCO2: 32 66 (mmHg)
HCO3: 17 27 (mmol/L)
PO2: 6 31 (mmHg)
Base excess: -8 0 (mmol/L); (Base deficit: 0 8)
Q)
Ans C
Q) Angle of Louis T 4
C)cremasteric artery
D)inferior epigastric arteryans
E)illio inguinal nerve
Q)
Ans C
.
Q) Cystic fibrosis is diagnosed in serum by : Sweat test
Immunoreactive trypsinans
Chloride test
A is confirmatory test
B is screening test
But A is not done in serum it's done on skin
Q)
Ans C
Q) The 2 most commonly used DHFR inhibitors
are:
Trimethoprim
Methotrexate.
Some antimalarials are also DHFR inhibitors.
Q) A patient is on the ward with a mechanical mitral valve.
There is no history of VTE. What is the target INR? 1.5 - 2.5
2.0 - 3.0
2.5 - 3.0
2.5 - 3.5..ans
3.0 - 4.0
replacements
3.0 - 4.0 Used in mechanical valve replacement
where PE has occurred despite anticoagulation at
lower range
Q) Hyperthyroidism
Hyperthyroidism in pregnancy occurs in 2 in
1,000 pregnancies in the UK
Management Options
Antithyroid Drugs 1st Line
Propylthiouracil crosses 1st Choice as crosses
placenta less readily than carbimazole
Carbimazole
Radioiodine is contra-indicated
Beta-Blockers
May be used but use should be limited to a few
weeks as may adversely affect fetus
Surgery
Only when absolutely necessary. Patient needs to
be euthyroid prior to surgery
Q) Pharmacokinetics in Pregnancy
Maternal physiology changes during pregnancy include:
Increased maternal fat and total body water
Decreased plasma protein concentrations
Increased maternal blood volume, cardiac output, renal blood
flow and uteroplacental unit, and decreased blood pressure.
Dilutinal anaemia
Increased tidal volume
Q)Pearl index
Q)
Q)
Q)
Q) You see a patient who gave birth earlier in the day. She was
taken off warfarin during pregnancy and is currently on
LMWH. She intends to breastfeed for the first 6-8 weeks and
Q)
Q)
Ans b
Q) Uterus pierce
A)uterosacral ligament
B)broad ligaments
C)levator ani
D)pubocervical ligament
E)none above..ans
Q) Warfarin
RCOG updated its Greentop guidelines on
thromboprophylaxis in 2015.
Key Points
* People on warfarin should be converted to
LMWH during pregnancy
* Very few exceptions to above. Mechanical heart
valves main one
* Warfarin causes a characteristic warfarin
embryopathy in 5% of foetuses exposed to
No treatment.ans
IV Clindamycin 900 mg 8 hourly
IV Ciprofloxacin 750mg 12 hourly
IV Clarithromycin 500mg 12 hourly
Oral doxycycline 200mg 12 hourly
Antibiotic prophylaxis for GBS is not required for
women undergoing planned caesarean section in
the absence of labour and with intact
membranes.
If Intrapartum antibiotics for GBS are indicated
3g Benzylpenicillin should be administered as
soon as possible after the onset of labour and
1.5g 4 hourly until delivery.
Clindamycin 900mg should be administered to
those women allergic to
Q)
Ans A
Q)
Q)
of fertility
Secrete hormones affecting pituitary gland control of
spermatogenesis, particularly the polypeptide hormone,
inhibin
Phagocytose residual cytoplasm left over from spermiogenesis
Secretion of anti-Mllerian hormone causes deterioration of
the Mllerian duct[11]
Protect spermatids from the immune system of the male, via
the blood-testis barrier
Q)
Q)
Q) Herpes,chancroid =painful
Syphilis (chancre)=painless
Q) What is the incubation period of Rubella (in days)? 2-5
4-11
7-14
12-23.ans
21-28
Rubella.ans
Varicella Zoster
CMV
if only sensorineural hearing loss --> CMV
sensorineural hearing loss + blueberry muffin rash--> Rubella
Q)
Ans C
Q)
Ans ? E
Q) Which v the following is not a derivative of
vitelline vein
Q)
Ans E
Q)
Ans C
Q) What percentage of infants with congenital CMV infection
are symptomatic?>99%
50%
10%.............ans
1-2%
<1%
Q)Stages of syphilis :
Q)
Clostridium Perfringens
Streptococcus Mutans
Streptococcus Pyogenes..ans
Group A streptococcus AKA Streptococcus Pyogenes is the
most common cause of cellulitis.
Staph. aureus is the second most common
Staph. epidermis can form biofilms on catheters/implants
Clostridia Perfringens causes gas gangrene
Strep. Mutans causes tooth decay and dental cavities
Group A Streptococcus can also cause Tonsillitis
(strep.throat), Scarlet fever and Rheumatic fever.
Candidates should also be familiar with Group B
Streptococcus AKA Streptococcus Agalactiae which can cause
neonatal sepsis.
Q) A patient is seen in the sexual health clinic. Speculum
examination reveals a firm 12mm ulcerated lesion with
smooth edges to the cervix. The patient denies any pain. What
is the likely cause?
Herpes Simplex Type 1
Herpes Simplex Type 2
Neisseria gonorrhoeae
Chlamydia Trachomatis D-K
Treponema pallidumans
Q)
Ans C
Eosinophils
Basophils
Q) Which of the following is best explanation for
breast development in apatient with androgen
insensitivity?
A . gonadal production of estrogen.
B . adrenal production of estrogen.
C.Breast tissue sensitivity to progesterone.
D . peripheral conversion of androgen. .ans ?
E . autonomous production of breast specific
estrogen.
Q) Surface marker of T cell -A.CD3.ans
B.Ig
C.CD4
D.CD8
T cell CD 4 for helper
CD 8 for cytotoxic
Compatible is 21
Non compatible is 16
Q) What is the incubation period of Scarlet Fever (in days)?
1-7.ans
3-11
7-14
14-21
14-28
Q) What is the mode of action of Mefenamic acid?
Inhibits Prostaglandin Synthesisans
Activates Antithrombin III
Inactivates factor Xa
Inhibits fibrin
Inhibits Plasminogen Activation
D. Obturator nerve
E. Pudendal nerve
Q) When does Oocytogenesis complete? 6 weeks gestation
18 weeks gestation
Birth.ans
Puberty
Ovulation
Ans B
Q)
Ans A
Q) You are asked to review a patient. They have attended for a
scan at 13 weeks following a positive pregnancy test. The
patient has had 2 previous pregnancies for which she opted for
termination on both occasions. The scan shows no identifiable
fetal tissue or gestational sac and you note the radiologist has
reported a 'bunch of grapes sign'. What is the likely diagnosis?
Missed miscarriage
Incomplete miscarriage
Partial molar pregnancy
Complete molar pregnancy.ans
Choriocarcinoma
Ultrasound features of :
complete hydatidiform mole:
-Solid collection of echoes with numerous small anechoic
spaces (snowstorm or granular appearance).
-Bunch of grapes sign which represents swelling of
trophoblastic villi.
-Normal interface between abnormal trophoblastic tissue and
myometrium.
-No identifiable fetal tissue or gestational sac.
Ultrasound Features of Partial Hydatidform mole:
-Enlarged placenta with multiple diffuse anechoic lesions
-Fetus with severe structural abnormalities or growth
restriction
-Oligohydramnios or deformed gestational sac
Q) A couple have been referred to the infertility clinic. The
male partner Is 25 and has CF, his semen analysis shows
azoospermia. What is the likely underlying cause?
Epididymal obstruction by thickened secretions due to
chloride channel dysfunction
Oligospermia
Congenital absence of vas deferens..ans
Obstruction of vas deferens by thick secretions due to chloride
channel dysfunction
Congenital absence of epididymal tail
In CF the thickened intraluminal secretions lead
to progressive obstruction and destruction of the
comprise:Serous (68%)
Clear cell (13%)
Endometrioid (9%)
Mucinous (3%)
5 year survival is 43%
Lifetime risk is 1 in 70
Germ cell tumours account for 1-2% of ovarian
cancers
Sex Cord and stromal cancers are rare.
Q) Following are DNA viruses ? A hep A
B hep B
C HIV
D HRV 8
E VZV
Ans BDE,rest are RNA
Q) Cabergolin: Has long half life.ans
Is an effective antiemetic
Is used during pregnancy
May cause parkinsonian SE
Q) Cell cycle : S is the nucleic acid synthesis
S is the dna replication
The apoptotic cell is removed from macrophages
Apotosis is downregulated by p53
Bax family promotes apoptosisans
Bax family promotes apoptosis..
Bcl 2 family inhibits..
Q)
Q)
Ans A
Ovulation occurs 36 h after LH surge ans 1626 h
after peak of LH
Q)
1. Q) Miscarriage
1. Fetal loss before 20 weeks Gestational age
2. Early Stillbirth
1. Fetal loss between 20-27 weeks Gestational age (or
fetal weight 350 grams or less)
3. Late Stillbirth
1. Fetal loss between 28-36 weeks Gestational age
4. Term Stillbirth
1. Fetal loss between 37-40 weeks Gestational age
Stratified Squamous
Pseudostratified Squamous
Transitional
Q)
Ans c
Q) Fetal lung maturation takes place in A)stage one
B)stage two
C)stage three
D)stage fourans
E)stage five
5 stages of lung development 1st embryonic with early
buds,second pseudoglandular upto 17 weeks, third canalicular
upto 25 weeks surfactant production starts,fourth saccular
upto 36 weeks surfactant present mature structure of lungs,last
alveolar it continues to birth and in early childhood
Q)
b. Extraembryonic mesoderm
c. Fetal blood vessels
d. Cells of the syncytiotrophoblast..ans
e.Amniotic cells
In the developing fetus, the maternal blood is in
direct contact with the syncytiotrophoblast.
During implantation, the syncytiotrophoblast
invades the endometrium and erodes the
maternal blood vessels. Maternal blood and
nutrient glandular secretions fill the lacunae and
bathe the projections of syncytiotrophoblast.
Primary villi consist of syncytiotrophoblast with a
core of cytotrophoblast cells. In secondary villi,
the cytotrophoblast core is invaded by mesoderm
and subsequently by umbilical blood vessels in
tertiary villi.
Q)
Q)
Q)
Ans D
Q) A couple come to see you in clinic. The male partner
reveals he has cystic fibrosis and wants to know what his
likelihood of being infertile is. What is the male infertility rate
in CF patients? 98%..........ans
90%
75%
40%
18%
Q) A 26 year old patient who is currently 24 weeks pregnant
presents with vaginal discharge. Swabs show Chlamydia
Trachomatis detected. Which of the following is the most
appropriate treatment regime? Doxycycline 100mg bd for 7
days
Erythromycin 500 mg twice a day for 14 days
Azithromycin 1gm orally in a single dose
Ofloxacin 200mg bd for 7 days
Ofloxacin 400mg once a day for 7 days
the following treatment regimes are recommended for the
treatment of Chlamydia in PREGNANCY:
Erythromycin 500mg four times a day for 7 days or
Erythromycin 500 mg twice a day for 14 days or
Amoxicillin 500 mg three times a day for 7 days or
Azithromycin 1 gm stat (only if no alternative, safety in
pregnancy not fully assessed)
The following treatment regimes are recommended for the
treatment of Chlamydia in NON-PREGNANT patients:
Doxycycline 100mg bd for 7 days OR
Azithromycin 1gm orally in a single dose
C: Measured by millirad
One session = 1000 millirad
CT scan from 40-400 millirad
MRI : no radiation
Q)
Ans A
Oxytocin infusion
Surgical closure..ans
Q) Regarding gestational diabetes which of the following is
NOT a recognised risk factor
Smoking
Obesity
Hispanic/Latino ethnic origin
Previous unexplained stillbirth
High polyunsaturated fat intake..ans
Q) A 55 year old presents to clinic due to vulval itch and
discolouration. examination reveals pale white discoloured
areas to the vulva. A biopsy shows epidermal atrophy with
sub-epidermal hyalinization and deeper inflammatory
infiltrate. What is this characteristic of?
Lichen Simplex Chronicus
Vulval intraepithelial neoplasia
Vitiligo
Extramammary Pagets
Lichen Sclerosus..ans
Q) A patient comes to see you as she is considering pregnancy
and wants advice regarding VTE prophylaxis. She has
undergone private thrombophilia screening as her father was
found to have the factor V Leiden. Her PCR has shown she is
homozygous for the factor V Leiden mutation. What is her
relative risk of thrombosis compared to the general
population? 1.5
2
4
8
80.ans
Q) A couple present to the fertility clinic after failing to
conceive despite trying for 2.5 years. The semen analysis
shows azoospermia.You perform a full examination of the
male partner which reveals Height 190cm, BMI 20.0, small
testes and scant pubic hair. What is the likely diagnosis?
Cystic Fibrosis
Autoimmune orchitis
Klinefelters Syndrome.ans
Marfans
Diabetic induced hypogonadsm
Q) Regarding prostaglandins : 1)Number of double bonds is
indicated by subscript numerical after the letter pg
2)thromboxanes are produced from placenta, membranes and
decidua
3) platelate cox is 20 times sensative to antiprostaglandin such
as aspirin as vessel wall enzyme
4)labetalol enhances the prostacycline to thromboxane ratio
5)Pg can maintain fetal pattern of circulation
All true
Q) Regarding Venous Thomboembolism (VTE) in pregnancy
which of the following statements are TRUE? A. Obesity
increases DVT risk by 2 times
B. Obesity increases DVT risk by 4 to 5 times.ans
d para aortic
e superfecisl inguinal
Q)
Q)
Ans D
Q)
Ans B
Q) 36yrs old lady PG at 14 weeks of gestation
,following serum screening ,pregnancy is found to
have an increased risk of trisomy 21,she wishes
to confirm if fetus is affected In view of her
gestation what's most appropriate diagnostic test
? A-amniocentesis
B -cell free fetal DNA sampling
C- CVS ..ans
D-cordocentesis
E NT imaging
> 15 w amnio
Q) Which of the following statements regarding
phenylketonuria is true?
Type 1
follows a mitochondrial inheritance pattern
Phenylalanine blood assay must be performed >48 hrs after
birth
Treatment requires dietary supplemention with phenylalanine
Sufferers have low plasma phenylpyruvic acid and
phenylethylamine levels
UK Incidence is 1 in 14,000..ans
Q) A 35 y has a pelvic ultrasound scan showing multiple
fibroids. What is the mc form of fibroid degeneration?
Red degeneration
Hyaline degeneration.ans
Carneous degeneration
Myxoid degeneration
Cystic degeneration
Q) A 42 year old smoker attends clinic due to vulval soreness
and shows you a number of vulval lumps. Biopsy is taken and
reported as showing epithelial nuclear atypia, loss of surface
differentiation and increased mitosis. What is the diagnosis?
Lichen Sclerosus
Chronic atrophic vulvitis
Vulval intraepithelial neoplasia (VIN)ans
Extramammary Paget's disease
Lichen Simplex
Q) A 35 year old women attends clinic following
laparotomy and unilateral oophorectomy. The
histology shows Psammoma bodies. What type of
tumour would this be consistent with?
Serousans
Mucinous
Endometrial
Transitional
Clear cell
Q) Which of the following is non essential AA? Aarginine
B-leucine
C-methionine
D tryptophan
E tyrosine.ans
empty lies below the uterovesical fold which arises from the
junction between the uterine body and the cervix.
10. Bartholins abscess : Gynecology MCQ
20-y woman presents with Bartholins abscess. Which one of
foll glands is involved?a) Bulbourethral glands (Cowpers)
b) Glands of skini
c) Greater vestibular gland
d) Lesser vestibular gland
e) Seminal vescicle
Correct Answer: c) Greater vestibular (Bartholins) gland.
These are small paired glands located in the superficial
perineal pouch. They are partially covered by posterior
portions of the bulb of the vestibule and the bulbospongiousus
muscles. The duct opens into the vestibule between the hymen
and the labium minus. These glands provide lubrication at the
introitus. Bartholins abscess may occur due to infection and
blockage of these glands.
11. Which artery is a direct branch of the aorta?
a) Inferior vesical
b) Internal iliac
c) Ovarian
d) Uterian
e) Vaginal
Correct Answer: c) Ovarian. The ovarian artery is a branch
of the aorta. It arises anterolaterally just below the renal
artery, running retroperitoneally to leave the abdomen by
crossing the common or external iliac artery in the
infundibulopelvic fold. It crosses corresponding ureters and
supplies twigs to it but does not supply to abdominal organs.
The internal iliac artery arises from the common iliac and its
inferior branch further supplies to the pelvis.
12. What is the lymphatic drainage of the ovaries?
a) Common iliac nodes
b) External iliac and superficial iliac nodes via the round
ligament
c) External iliac nodes
d) Internal iliac nodes
e) Lateral aortic and preaortic nodes
Correct Answer: e) Lateral aortic and pre-aortic nodes. It
is useful to remember the following: the bladder drains to the
external iliac nodes; the urethra drains to the internal iliac
nodes; the fallopian tubes and fundus uteri drain to the
external iliac and superficial iliac nodes via the round
ligament; and the cervix drains to the external and internal
iliac, rectal and sacral nodes and occasionally obturator nodes.
13. Which of the following structures lie within the broad
ligament?a) The fallopian tube
b) The ureter
c) The uterine artery
d) The ovarian artery
e) The superior vesical artery
Correct Answer:a and c.The broad ligament is made of two
layers of peritoneum that covers the fallopian tube, round
ligament, and down the sides of the uterus to the cervix.
The ureter, superior vesical artery and the ovarian artery are
all retroperitoneal.
The uterine artery runs between the leaves of the broad
ligament along the lateral wall of the uterus. It also contains
ovarian ligament and round ligament.
d. Diabetesans
Q) Which of following produce severe hyperkaleamia in
combination - Aspirin n allopurinol
Furosemide n amiloride
Lisinopril n furosemide
Losartan n amilorideans
Propranol nverapamil
Q)which one of foll is the termination of round
ligament? Deep Inguinal ring
Labia majora..ans
Labia minora
Superficial Inguinal ring
Lateral vaginal wall
Q) Which of the following would you expect to see reduce in
pregnancy? Fibrinogen
ESR
Neutrophil count
Factor VII
Platelet count..ans
Q) Adenocanthoma of endometrium :
a. adenocarcinoma + benign squamus.ans
b. Benign + malignant squamus.
c. adenocarcinoma + papillary formation.
d. Glandular + squamus
Q)
Ans B
Q)
Ans B
Q)
Q)
Ans B
Ans C
Q)
Ans E
Q) The mc anomalies with IDDM is cardiac
anomalies (8.3 for 100 live birth) specially
transposition of great arteries and SVD and
neurological anomalies is 2nd common anomalies
(5.2 for 100 live birth )and the caudal regression
is the most specific anomalies with IDDM (200
times more frequent than other healthy infants)
Q) - 60 y F, smoker patient in ward for preop prep
for TAH to endometrial CA. Which investi of foll
you dont require?
-Chest X ray
-Complete blood film
-Coagulation profileans
- Blood for cross match and saving
-ECG
Q) DUB can be due to all except A)Inc PGE2 /PGF2@ ratio
B)Dec PGI2/TXA2 ratioans, inc PGI2/TXA2
ratio
C)Inc fibrinolysis
D)Dec endothelin
E)platelet deactivation
Q)
Ans A
Q)
Q)
D)poly menorrhoea
E)oligo menorrhoea
Q) 27yrs old PG has failure to progress in first
stage of labour and is started on synto infusion
Midwife calls reg Coz of suspicious CTG the
woman is 6cm dilated and reg performs blood
sampling ,PH came as 7.15 ,what should be
course of action?
A C-section ..ans
B instrumental delivery
C reassure that all is well and cont with labour
D repeat FBS in one hour
E repeat FBS in two hours
7.25_ 7.4 normal
7.20_ 7.24 suspecious
Below 7.20 mean acidodis & need intervention
Q) Ultrasound can not be used for the following:
A, fetal therapy.ans
B, to determine the nature of a tissue
C, to assess the movement of tissues
D, to measure blood flow
E, to measure structure
Q)
LH
FSH..ans
Summary points of the two key testicular cell types:
Sertoli Cells = Secrete Inhibin. Forms blood-testis barrier.
Have FSH receptors
Leydig Cells = Secrete testosterone. Have LH receptors
Q) In surgical infection, which of foll is true?
A ABics are only advised once a septic focus has been drained
B Primary refers to a planned surgical trauma
C There is rarely a focus
D Tissue necrosis is rarely an association
E Tissue necrosis results in inflammation.ans
Q) An anxious 38y pregnant undergoes a
combined test for Down syndrome ,risk comes as
1/1000.whats appropriate course of action?
A-advise that diagnostic test are not indicated
.ans ,low risk
B-amniocentesis
C-CVS
D-inform that baby doesn't have Down syndrome
E termination of pregnancy
Q) True statements about PIH include which of foll?
a. The incidence varies little around the world
b. Women who have had hypertension of pregnancy once have
a 10% chance of developing it in a later pregnancy
Q)
Ans D&E
Q) The half life of the drug will be increased by:
A-increased volume of distribution.ans
B-increased rate of clearance.
C-increased age,for drugs eliminated mainly by
the kidney.
D-pregnancy for drugs metabolized in the liver.
Q) When a women comes for labor
a. Oxytocin drip is given at 1st stage labor.
b. Oxytocin drip is given at 2nd stage labor.
c. Oxytocin drip is given at 3rd stage labor.
d. Drip without oxytocin given at 1st stage.
e. None of the aboveans
Q) All of foll are possible indications for classical c/s , except:
Carcinoma of the cervix
Q)
Q)
Ans A
Q) ADH increases permeability of which part of the nephron?
Proximal convoluted tubule
Distal convoluted tubule
Collecting duct.ans
Descending loop of Henle
Ascending loop of Henle