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MRCOG part 1 RECALLS

SEPTEMBER 2008

Paper 1 & 2 EMQs

In a country wide survey, 10 general practices were picked at random and 5% of patients were selected at random from each practice:

Ta) the sample of patients is a true random sample Tb) all practices had an equal chance of selection Tc) all patients had an equal chance of selection Fd) two siblings could not have been selected

Te) inferences about all patients in the country may be drawn from the sample A lady is about to deliver and you are about to give her a pudendal block..

a) ant division of ant. remi of S2-4 b) ant division of post.rami of S2-4 b)genitofemoral nerve

c) post division of ant. remi of S2-4 d) post division of post. remi of S2-4 e) sensory supply of perineal nerve f) inferior rectal nerve

g) ischial tuberosity h)ischial spine

Q1 -wht is the root value of pudendal nerve?

Q2- wht nerve supplies lower part of vagina (I think)?

Q3 –why do u give local skin infiltration before episiotomy? If we take the day of fertilization as Day’0’ then…

Day2 Day4 Day 8 Day 10 Day12 Day 14

(2)

Day 18 Day20 Day 22 Day 24 Day 26 Day 42 Day 56 Day 70

Q4-Which represents 4 cell stage ? Q5- conceptus implants completely? Q6-feable hrt pulse seen on ultrasound? Q7- vertebra form completely?

Table: on different values given for deaths due to maternal mortality with direct and indirect causes as well as # of days from delivery to the cause of death

Deaths due to

placenta previa and hypovolemia x @ e.g 20 days,10 days,8days etc suicide(with previous hx of psychiatric illness)

crash victim

diabetic neuropathy

two more causes given with values

Different numbers were given in options

Q8-the number of late maternal deaths due to indirect causes? Q9-number of maternal deaths due to direct causes?

Calculate Numbers needed to treat from a drug trial on osteoporosis: (Q frm EMQ book)

(3)

25 50 100 250 300 400 1000 others Q10-N1=10,n2=5,n3=9990,n4=9995 Q11-N1=50,N2=25,n3=9950,N4=9975 FSH Oxytocin GH Prolactin Rennin ACTH etc

Q12-which is a protein with alpha and beta subunits ?

Q13 – which stimulates mineralocorticoid activity/relsease? Q14- which hormone is produced by posterior pituatory? Folic acid

Magnesium Calcium

Vit b1-B12 given

Q15- which vitamin is required in 400mcgs at preconception?

Q16-which vitamins absorption is hampered by oxalic acid & phytates? Insulin & Glucagon excretion

Decrease decrease Increase increase Increase decrease Deacrease increase

(4)

Nochange no change Nochange increase Nochange decrease Etc

Q-17-on taking a large protein meal? Folowing are risk factors for cancer Q-18- HCC – ans Hep B

Q19- Skin cancer-ans UV radiation Q20- Cervical/uterine cancer-ans HPV Q21- Breast cancer-ans BRCA1 mutation (Repeats from march 2008)

Hormone receptors for following are located in a) protein kinase nuclease receptor

b) nucleae transcription receptor c) G-linked cell membrane receptor d) G-linked golgi apparatus receptor

e) Protein complex intra cytoplasmic receptor f) Multiligand receptor in cell membrane etc

g) Protein Tyrosine kinase activity receptor on cell membrane Q22- Insulin

Q23-PG E2 Q24-Estrogen Q25-Progesterone

Q26-A family with one kid presumed to have cystic fibrosis however cftr gene mutation was not detected. Family members willing to give samples

(5)

if needed.mother wants definite diagnosis as she is 11wks and wants to know diagnosis for her baby.parents are cousins with 1st degree relatives having cystic fibrosis. Invasive diagnostics can be applied to reach final results by?

Q27-you have Guthrie spot of their son how will u diagnose him for cystic fibrosis?

Q28- families in uk with cystic fibrosis how will u find f508? Options:

Pcr Fish test

Chromosomal linkage analysis Telomer analysis

Sum hereditary crosslinkage chromosomal option (dnt remember) Screen for some known gene mutation

Sweat test Saliva test

screening test for following Q29-alpha thalessemia Q30-folic acid deficiency Q31-iron deficiency anemia Q32-(one more i think!) options hbelectrophorisis mcv mchc MCh serum iron paul-bennel test etc

Q33-which is the commonest cause of non-dysjunction at meiosis? trisomy 21

(6)

Q-34 which defect is associated with 60-70% cleft palate and cleft palate? trisomy 13 or 18 or KF syndrome

all about cystic fibrosis

screening tests for a-thallesemia trait

iron deficiency amemia,folic acid anemia and....EMQ RECEPTORS FOR

ESTROGEN,PROGESTERONE,PROSTAGLANDIN,INSULIN ....EMQ

NERVE SUPPLYING PERIANAL SKIN,PUDENDAL NERVE ORIGIN,LA DURING EPISIOTOMY IS GIVEN FOR?????...EMQ EMQ receptors for insulin

prostaglandins estogen

progesteron

primary syphilis in early untreated period options

syphilis treponemal antibody test syphilis hemaglutination test syphilis immobilization test emq traetment of chlamedia ...bacterial vaginosis emq pre malignant conditions

emq statistics calculate n to be traetad emq diagnosis of

iron defecincy anaemia folic acid ... early untrated syphylis

(7)

emq embryology 4 cells ? day vertebra formation

mcq about DIGITALIS, cyclosporine .mitochondrial dna ,cd8 cells , the uterer(2 mcq) ,3 repeated statistics mcqs,

EMQ 36 WS PRIMI GRAVIDA had flu like sympt , the baby was born jaundiced , hepatosplenomegaly ,skIn rash , brady cardia

,,,,choose the cuase (all viruses ,bacteria,listeria,plasmodium )??????

EMQ ...why we do local infiltration + pudendal block EMQ ...cause of post operative infection ??pseudomonas

EMQ ...WHICH vit or mineral absorbtion is affected by phytate (no iron in the choices

MCQ

citric acid cycle fatty acid oxidation ???? genetic imprinting ?????stylomastoid foramen spinal cord

in smooth muscle cells /regeneration possible /actin &myosin present/lengh of fibers

repeated 2 mcqs u/s and radiation effect apoptosis

2 mcqs about hyperplasia pelvic splanchnic nerve Paper 1 & 2 EMQs

A lady is about to deliver and you are about to give her a pudendal block.. a) ant division of ant. remi of S2-4

(8)

b)genitofemoral nerve

c) post division of ant. remi of S2-4 d) post division of post. remi of S2-4 e) sensory supply of perineal nerve f) inferior rectal nerve

g) ischial tuberosity h)ischial spine

Q1 -wht is the root value of pudendal nerve?

Q2- wht nerve supplies lower part of vagina (I think)?

Q3 –why do u give local skin infiltration before episiotomy? If we take the day of fertilization as Day’0’ then…

Day2 Day4 Day 8 Day 10 Day12 Day 14 Day 18 Day20 Day 22 Day 24 Day 26 Day 42 Day 56 Day 70

Q4-Which represents 4 cell stage ? Q5- conceptus implants completely? Q6-feable hrt pulse seen on ultrasound? Q7- vertebra form completely?

Table: on different values given for deaths due to maternal mortality with direct and indirect causes as well as # of days from delivery to the cause of death

Deaths due to

placenta previa and hypovolemia x @ e.g 20 days,10 days,8days etc suicide(with previous hx of psychiatric illness)

crash victim

(9)

two more causes given with values

Different numbers were given in options

Q8-the number of late maternal deaths due to indirect causes? Q9-number of maternal deaths due to direct causes?

Calculate Numbers needed to treat from a drug trial on osteoporosis: (Q frm EMQ book) Options 25 50 100 250 300 400 1000 others Q10-N1=10,n2=5,n3=9990,n4=9995 Q11-N1=50,N2=25,n3=9950,N4=9975 FSH Oxytocin GH Prolactin Rennin ACTH etc

Q12-which is a protein with alpha and beta subunits ?

Q13 – which stimulates mineralocorticoid activity/relsease? Q14- which hormone is produced by posterior pituatory? Folic acid

Magnesium Calcium

(10)

Q15- which vitamin is required in 400mcgs at preconception?

Q16-which vitamins absorption is hampered by oxalic acid & phytates? Insulin & Glucagon excretion

Decrease decrease Increase increase Increase decrease Deacrease increase Nochange no change Nochange increase Nochange decrease Etc

Q-17-on taking a large protein meal? Folowing are risk factors for cancer Q-18- HCC – ans Hep B

Q19- Skin cancer-ans UV radiation Q20- Cervical/uterine cancer-ans HPV Q21- Breast cancer-ans BRCA1 mutation (Repeats from march 2008)

Hormone receptors for following are located in a) protein kinase nuclease receptor

b) nucleae transcription receptor c) G-linked cell membrane receptor d) G-linked golgi apparatus receptor

e) Protein complex intra cytoplasmic receptor f) Multiligand receptor in cell membrane etc

g) Protein Tyrosine kinase activity receptor on cell membrane Q22- Insulin

Q23-PG E2 Q24-Estrogen Q25-Progesterone

(11)

Q26-A family with one kid presumed to have cystic fibrosis however cftr gene mutation was not detected. Family members willing to give samples if needed.mother wants definite diagnosis as she is 11wks and wants to know diagnosis for her baby.parents are cousins with 1st degree relatives having cystic fibrosis. Invasive diagnostics can be applied to reach final results by?

Q27-you have Guthrie spot of their son how will u diagnose him for cystic fibrosis?

Q28- families in uk with cystic fibrosis how will u find f508? Options:

Pcr Fish test

Chromosomal linkage analysis Telomer analysis

Sum hereditary crosslinkage chromosomal option (dnt remember) Screen for some known gene mutation

Sweat test Saliva test

EMQ 1 ST PAPER

WHICH NERVE SUPPLIES PERIANAL SKIN EMQ 2 CYSTIC FIBROSIS

a - invasive testing will be done ( she is preg 11 ws) which test b- their child blood is ready for guathri test ,which test you will do c- the relatives are willing to be tested , which test will reveal the 405 mutation for families in great braiten

any one have suggetions

more options were given for these qs karyotyping

comparative genomic hybridization flourecent ????

(12)

propranolol

smooth endoplasmic reticulum anal canal

smooth muscles (2 mcq ,paper1 ,2 ) primitive streak

fetal circulation ??microtubules digitalis

mcq ; the following are bacteria cryptococcus ,candida,histoplasmosis, mcq : the embryological origin of peritoneum,....

mcq mitosis miosis

mcq : the follwing are structral abnormalities of chromosomes mcq : ?...increase with preg

mcq : drug interaction methotrexate , sulphonamides

mcq :arterial and mean blood pressure mcq : causes of alkalosis

mcq : the folloing are types of cells with their secretion ? endothelial cells heparin

?mast cells igE ? plasma celle

(i am not sure of the exact coupling)

mcq at 20 ws gestation rbcs are made in liver lymph nodes

spleen

bone marrow

mcq about pudendal nerve mcq ischiorectal fossa mcq ureter in abdomen mcq ureter in pelvis

(13)

mcq kallman syndrome in men mcq hcg

mcq trophoplasts

mcq ? all types of cells in islets of langerhans and their products

mcq the following are premalignant conditions: paget disease ...(repeat mcq endotoxins or exotoxins ( i am not sure)

MCQ CORPUS LUTEUM mianly endothelial clls secerets inhibin

function decrease after 12 ws MCQ INHIBIN

MARCH 2008

cystic fibrosis guthic spot test receptors in apoptosis caspa arias stella reaction

blood picture in PET and in preg is inflam like 1.EMQ paclitaxel carboplatin side effects

2.EMQ complex partial seiizure gum hypertrophy,acne ,facial coarsening,vit K TO BE given..?drug used

3.EMQ oestrogen progesterone receptor site

4.EMQ on vitamins-xerophthalmia..morning sickness..macrocytic anaemia.

5.MCQ rubella incubation period,specific immunity within 15 days.. 6.EMQ HEPATOCELLULAR carcinoma,..??

7.EMQ lining epithelium of ureter,..?? 8. EMQ montoux rection..

9.MCQ ovulatory DUB

10.MCQ concerning aneurysm- 10% due 2 inflam.,syphilitic aneu,thoracic vessels,marfan recessive

(14)

if a mother has a child with cystic fibrosis ,she is preg and will do amniocentesis

a. which test to be done (every possibility mentioned)

b. all relatives will volunteer to do gutic spot test ,whichtest you will carry on the blood

-graph with hormones of the endometrial cycle -

-citric acid cycle (graph) microsatellites alleles - cd4 -nk cells -down syndrome -pulmonary embolism anal canal -vagina -ovary phenylketonuria inhibin passive transport erythropoietin renin hcg levels syphylis rubella chlamydia

hormone dependent malignancies(testicular carc._sertoli leydig-clear cellcarc.ofkidney-thyroid carc.)

pigd

missed abortion MCQ congenital heart

emq crown \heel lenghth at birth crown/rump length 6 cm =? weeks

(15)

about 10 questions statistics

plrese does anyone remember the q about ring Y chromosome q about sattellite alleles ??

passive diffussion not depend on . concenteration gradiant

molecular size

2following tissue are capable of regeneration spinal cord liver epedermis myocardium bone marrow 3

double blind trial

delliosion of HCG in the urine pregnancy test

about the q APOPTOSIS and capsase ,q methods of disinfection and BOWIE DICK test where is source to study these subjects?

q progesterone receptors q about progesterone receptors

syphilis , toxoplasma , hpv , immune responses EMQ type of hpv causing benign wart

type of hpv causing cancer cx MCQ down syndrome

associated with duodenal atresia true associated with ambig genetalia false only maternal chromosome F

(16)

only paternal chromosome F MCQ oogonia

miosis starts at puberty miosis before mitosis

during S phase chromosomes are doubled

the most diagnostic test to be done on amniocentesis gautic spot test what test you do with the blood sample emq about vitamins (hyperemesis) i wrote vit B6 and (xerophthalmia)

q about endometrial hyperplasia

q about side effect of drug (carboplatin)-(taxal) q about arias stella

if its specific in pregnancy q about chlamydia

q about varicella q about hpv ,wart

answers 16 or 18 or 6,11 q about hcg conc in pregnancy citric acid cycle diagram hormones diagram

fsh,lh,estrogen,testosteron

q about:by transvaginal u/s yolk sac apear in which week many questions in genetic about pcr,fish test

q about laser q in pathology

about totipotent cell,tumour like mass q about voiding presure

q about ca requirement in pregnancy

q about test used to diagnose folic acid deficency q about thalasthmia

q about cervical ectropion cells i choose columner cell

- mri contraindicated in early pregnancy q about stallete instability in dna

- transverse abdominus ms attached to lumbar transverse process -cut s1 lead to autonomic bladder

(17)

q about cancer which are hormone dependent -breast

-prostate -thyroid

q about guthre test

q about cystic fibrosis and diagnosis -swet test -karyotyping-fish test q about disinfection and sterelization q about complication of contraceptive pills emqs

1lining of ureter 2.erythropoeitin and renin q from john duthie 3complications of cisplatin 4 paclitaxel

5statistics -std error calculation 7 mean in a normal distribution 8occipito frontal diametr

9hcg titre at detection by tvs 10 at 3 days aftr fertilization

11crl in scan is 60mm what is gestational age 12crl at term ?

13 parietal sutur is between 14kuffer cells are -phagocytic 15 estradiol receptors

16 progestrone receptors -we know that thes are intra nuclear but there were 2 confusin options with intranuclear plz refer this in depth , one option had intranuclear kinase or somethin

16anticonvulsant with description of phenytoin 17vitamin deficiency causin hyperemesis 18 - macrocytic anemia

19 -xerophtalmia

20 cystic fibrosis 3 emqs

24 citric acid cyle diagrm , enzymes were options complement causes

26 b thalasemia detection 27 folate def detection

(18)

29 basal cell ca - local malignant i think 30tumor like –hamaroma

March 2007

Copper IUD mode of action: sperm motility

microthrombi MRI:

ionising radiation?

no adverse effect on fetus? detect fetal cardiac abn? USG:

probe: array of magnets?

doppler to detect fetal heart movement? facial hair increased by:

oestrogen? testerone? spirolactone? characterics: pass thro' origin? slope = 0?

pass thro the mean?

unaffected by changing scale?

unaffected by changing dependent variable? Copper containing IUDs:

F should be changed every year

F have a high incidence of actinomycoces colonization than plastic devices

T Cause a relative increased in ectopic pregnancy

T have been implicated as a cause of fatal infection in pregnancies F do not cause menorrhagia

Comments:

Inert devices can be left in place until the menopause, but copper devices need renewal every 3-5 years, depending on the make, because of the gradual absorption of copper. Copper IUCDs produce local

(19)

concentrations of copper salts which apparently give some protection against bacterial contamination. Pelvic infection with actinomyces organisms is most likely with a plastic device that has been in situ for some years. While the rate of intrauterine pregnancy is reduced, that of ectopics is not. Hence, there is a relative increase in ectopic pregnancy after IUCD insertion. If an IUCD is left in place there is a slight risk of intrauterine infection, preterm labour and antepartum haemorrhage, but most pregnancies are uncomplicated and the device is delivered with the placenta. Increased menstrual loss may be caused by increased

fibrinolytic activity which occurs round the IUCD. The progestogen intrauterine system (IUS) reduces menstrual flow and often

dysmenorrhoea.

Which of the following is/are true concerning MRI? A It involves ionizing radiation (False)

B Has no recognised side effects on the foetus (True)

C The pregnant mother should be turned to her left side during scanning (True)

D Tissue with high hydrogen concentrations are difficult to distinguish False)

E Blood vessels appear white on scanning (False) Comments:

Water is a molecule composed of hydrogen and oxygen atoms. The nuclei of the hydrogen atoms are able to act as microscopic compass needles. When the body is exposed to a strong magnetic field, the nuclei of the hydrogen atoms are directed into order - stand "to attention". When submitted to pulses of radio waves, the energy content of the nuclei changes. After the pulse, a resonance wave is emitted when the nuclei return to their previous state. The small differences in the oscillations of the nuclei are detected. By advanced computer processing, it is possible to build up a three-dimensional image that reflects the chemical structure of the tissue, including differences in the water content and in movements of the water molecules. This results in a very detailed image of tissues and organs in the investigated area of the body. In this manner,

pathological changes can be

documented.[/color:febed2ebf4][/b:febed2ebf4]---

Many stats about sensitivity, positive predictive value, accuracy, even the linear regression

(20)

rarely symptomatic ?F

Copper IUD mode of action: ?T sperm motility

?T microthrombi

?T intervent ovary movement MRI:

ionising radiation F

no adverse effect on fetus T

detect fetal cardiac abn ?F ( I think it will be very small) USG:

probe: array of magnets? ?F

doppler to detect fetal heart movement T facial hair increased by:

oestrogen?F testerone?T

spirolactone F ( I think it is used for treating hirsutism) Mycobacteria

?T strict ?? *(nor sure which word they use ) aerobic ---

48---if a distribution of results is markedly skewed to the left(sep2000) a-the mean is same as 50th centile— f

b-the same no of values lie on either side of the median- t c-the mode is equal to the median- f

d-the students test should be used to compare this distribution with another- f

e-logrithmic transformation of the results will produce a distribution close to normal-t

-concerning the ablity of a test to predict disease

a-sensitivity is the ablity to predict those with disease correctly T b--sensitivity is the same as positive predictive value F

c-the confidence interval must cross 1 to prove significance t (NOT A MUST as CI at 1 is perfect )

d-an odds ratio of 1;3 implies the risk of 33% f e--an odds ratio of 2 indicates a halving of risk F

(21)

--- 1-SUCCESSFUL LACTATION IS

a-maintained by estrogen -- b-maintained by progesterone -- c-initiated by prolactin surge--

d-maintained by human placental lactogen e-inhibited by dopamine –

2-THE RELEASE OF CATECHOLAMINES FROM THE ADRENAL MEDULLA INCREASES

a-during sleep—

b-when the nerves to adrenal glands are stimulated— c-when the blood sugar rises—

d- immediately following a myocardial infarction— e- in the presence of pheochromocytoma—T

F-DURING ACUTE HAEMORRHAGE— 3- In the pathogenesis of thrombosis

a-prostacyclin induces platelet aggregation— b-plateletes synthesis thromboxane A2-- c-thromboxane A2 induces vasoconstriction--

d-contact with subendothelial collagen causes platelete aggregation-- e-thrombin inhibits platelete aggregation—

--4- CONVERSION OF GLUCOSE TO LACTIC ACID a-occurs in single enzymatic reaction—

b-is the only pathway for synthesis of ATP in red blood cells— C-is a reversible process in skeletal muscle

d- is inhibited by high cellular conc of ATP-

e-occurs in skeletal muscle when availability of oxygen is limited- 5-GLUCOCORTICOIDS

a- promotes hepatic gluconeogenesis- b- suppress uptake of glucose by muscle- c—promotes protein breakdown-

d—promotes fat breakdown-

e-increase glycolysis in adipose tissue- 6-Actinomycete israelii

(22)

1-Is a fungus—

2- forms yellow granules in pus – 3-is a commensal in mouth-- 4- is a commensal in vagina--

5- is usually resistant to penicillin—

7-Following substances increase the serum uric acid concentration( a-colchicine--

b-chlorothiazide-- c-allopurinol-- d-probenecid-- e-phenylbutazone—

7--THE FOLLOWING ARE INHERITED AS AUTOSOMAL RECESSIVE CONDITIONS

A. tuberous sclerosis. b-phenylketonuria-- C. ahondroplasia.-- D. sickle cell anaemia- E. Von Giek l disease.—

8-. Genes on sex chromosomes are responsible for the inheritance of ( A. glucose-&pbosphate dehydrogenase defiency.

B. defective colour vision.— C. hairy ear rims. –

D. homocystinuria. E. Hurler syndrome.

9-in human a haploid no of chromosomes is found in) a-red blood cells-

b-blastocysts- c-primary oocytes-. d-the first polar body- e-spermatozoa-

10-osteoprosis is associated with

a-an increase in uncalcified bone matrix(osteoid tissue b-prolonged oestrogen therapy—

(23)

c-a normal histological bone structure- d-bone fracture—

e-irregularity of epiphyseal plates—

11-THE FOLLOWING HAVE an anti-emetic effect a-hyoscine bromide— b-morphine sulphate— c-chlorpropamide-- d-promethazine hydrochloride— e-perphenazine— 12CLOMIFENE CITRATE a- is an antiandrogen—

b-does not stimulate ovulation directly— c-can produce visual disturbances--

d-is generally prescribed throughout the proliferative phase of the menstrual cycle—

e-in the treatment of anovulation increases the risk of multiple pregnancy—

13--if a distribution of results is markedly skewed to the left a-the mean is same as 50th centile

b-the same no of values lie on either siDe of the median c-the mode is equal to the median-

d-the students test should be used to compare this distribution with another-

e-logrithmic transformation of the results will produce a distribution close to normal-

15. when a man has hemophilia

a. 50% of his daughters would not expected to be carriers – b. 25% of his sons expected to be carriers

c. Good medical control of blood definition reduce the risk of this condition in his children

d. His new born child is likely to require an urgent blood transfusion - e. His sister has 50% probability of being a carrier

16- THE INTERSTITIAL CELL (LEYDIG) OF THE TESTIS a--secrete seminal fluid—

b-are stimulated by LH –

(24)

d-secrete fructose –

e-produce testosterone T in response to LH -- 17--CONCERNING VIRUSES

a-the core of every virus contain RNA—

b-they usually produce intracellelur toxin causing cell death c-antibodies are directed against capsular protein—

d- they can be grown in intact cells--

e-interferone are synthetic antiviral substances—

18-THE FOLLOWING ARE CYTOTOXIC ALKYLATING AGENTS( a-cyclophosphamide— b-mercaptopurine-- c-chlorambucil-- d-fluorouracil-- e-methotrexate- 19-2,3 DIPHOSPHOGLYCERATE

a-is present in higher conc in maternal erythrocytes than fetal erythrocytes--

b-binds more avidly to haemoglobin A than to haemoglobin E— c-increases the affinity of haemoglobin for oxygen—

d-is a phospholipid

e- is synthesised by the pentose phosphate pathway

18-HYPERKALEMIA IS A CHARACTERSTIC FINDING IN TINDALL

a-primary aldosteronism

b-treatment with Spironolactone- c-hyperparathyroidism-

d-ACTH secreting tumours of bronchus- e-renal failure-

19- CONCERNING INHERITABLE DISEASES

A-huntigdon ,s chorea is transmitted by a dominant gene— b-phenylketonuria is transmitted by a recessive gene— c-haemophillia ia an autosomal dominant condition-- d- Von Willebrand disease is a sex linked condition—

(25)

20-Early blood borne dissemination is a characteristic feature of: a) carcinoma of the endometrium –

b) osteosarcoma –

c) basal cell carcinoma – d) carcinoma of the cervix- e) choriocarcinoma-

21- in tissue pigmentation the following are associated a-kernicterus and conjugated billirubin

b-addison disease and increased cutaneous melanin c-melanosis coli and bile pigments-

d—wilson disease and copper deposition in the cornea- e-corpus leuteum and carotenoids-

22-acquired diverticular disease of the colon

a-is present in at least 15% of Caucasian over the age of 50 years- b-is due to congenital abnormality of the bowel wall

c-is associated with increased intraluminal pressure— d-is associated with muscular thickening—

e-may result in intestinal obstruction—

23 stored blood which is to be used for transfusion— a-kept at -4 degree

b-must be used in 1 week –

c-is tested for compliment content before transfusion -- d-may be used for platelet replacement –

e-contains an acid anticoagulant –

24- in uncomplicated homozygous beta thalasemia there is a-hypochromasia--

b-a reduction in haemoglobin A— c-an increase in haemoglobin F— d- RED CELL SICKLING

e-presence of megaloblasts in bone marrow-

32-The following are capable of cellular regeneration a)spinal cord

b)liver parenchyma – c)gut epithelium – d)kidney ???

(26)

e)bone marrow—

33-during the development of female reproductive system a-primordial germ cells arise in yolk sac--

b-ovarian development is dependent upon oestrogen activity-- c-the paramesonephric duct give rise to the cervix--

d-the greater vestibular glands arise from the urogenital sinus--

e-differentiation of external genitalia is dependent upon ovarian activity-- 36- IN CONGENITAL ADRENAL CORTICAL HYPERPLASIA

a-commonest deficiency is C21 b- plasma cortisol conc is raised –

c-there may be excessive secretion of 17 hydroxy progesterone-- d- sodium retension is characterstic –

e-blood catecholamine conc are increased – 37-- SCHISTOSOMA HAEMATOBIUM a- is a snail –

b- is prevalent in china—

c- infestation may affect the uterine cervix d- give rise to chronic granulomatous lesions-- e- infestation predisposes to carcinoma— 38- KETONE BODIES

.

a-can be utilised by theadult brain—. B-Include acetone -

c-are water soluble --

d- are synthesised in skeletal muscles— e-can be utilised during starvation— 39-IRON IONS

a-diffuse passively into erythropoitic cells- b-bind to transferin-

c-are taken up by hepatocytes-

d- are necessary for cytochrome synthesis- e-are absorbed predominantly by the ileum- 40-- --the conjugation of billirubin

(27)

a-takes place in hepatocytes-

b-is catalysed by UDP glucuronyl transferase- c-is inhibited by phenobarbitone-

d-renders it water soluble-

e-is impaired in acute billiary obstruction- 41- in radiotherapy(

a-1Gray is eq to 1joule per kg

b- the skin usually recieve a greater dose of radiation than underlying tissue-

c-the major effect of radiation energy is to damage the cytoplasm of the cell-

d-cells in tissue which are hypoxic are more vulnerable to radiation- e-radiation induced changes in tissues may take 6 weeks to develop- -42--osteomalacia is characterised by

a-mineralization of the periostium – b-deposition of uncalcifiedbone matrix -- c-normal osteobastic activity --

d-increase capillary fragility - e-normal calcification of bone— 43-progesterone

a-is a C21 compound

b-synthesised by the ovary before ovulation- c-increases ventilation-

d- raises BMR-

e-binds to corticotrophin –binding globulin- 44-EPIDERMAL GROWTH FACTOR A- is mitogenic-.

b- synthesis is stimulated by oestradiol- c-is a steroid molecule-F ...

d- is found in endometrium--

e- binds to receptor on the nuclear membrane-

45-the following are structural aberrations of chromosomes: a. deletions --

(28)

c. aneuploidy – d. . polyploidy- e translocations— 46-- Messenger RNA

a-Synthesis is dependent on RNA polymerase – b-is an exact copy of sense DNA—

c-Contains exons –

d-Is measured by Western blotting – e-translation occurs in the nucleus

47-- BETA SYMPATHOMIMETIC DRUGS MAY— A- caue bronchospasm—

b-reduce frequency of uterine contraction— c-cause heart block—

d-reduce diastolic blood pressure— e- increase blood glucose conc

48- The following statistical statements are correct-

a-in the normal distribution,the value of mode is 1.73 times the median – b-in a distribution skew to the right,the mean lies to the left of median- c-in the series- 2;7;5;2;3;2;5;8, the mode is 2 -

d-student’s ‘t’ test is designed to correct for skew distribution –

e-the chi squared testmay be used when data are not normally distributed--

50-Contraindicated in breast feeding— A-POPs

B-Bromocriptine- C-chloroqunine- d-??

e-warfarine—F

51-Contraindicated with kidney impairment A-Dopamine -

B-Gentamycine – C-Cephahexin D-Cis platin

(29)

A-Apoptosis… -- B-Phagocytosis—… C-Pyknosis… -- D-Poikilocytosis…

E-Release of phospholipids—

52- the following are characters of hypoxic cell death: A-Apoptosis… -- B-endocytosis C-Pyknosis… -- D-Poikilocytosis… E-koliosytosis prostagladins- a-lipooxygenase pathway

b-thromboxane causes vasoconstriction c-increased in the myometruim

d-? e-?

linear regression: a-starts from the origin b-passes thru the mean- c-values vary

d-ranking is done???

following test r used to compare 2 drugs a and b a-student t test

b-meta analysis

c-wiloxone paired test withney u paired test e?

toxic shock syndrome

associated with the use of tampoons b-due to toxigenic starinsof strep

c-infrequently reported outside n america

d-a consequence of previous antibioitic therapy e-confined to seualy active women

(30)

a-kidneyepitheluim? b-pheriheral axons- c-liver parenchyme d-bone marrow e-bone radiation sensitive a-bone b-bone marrow c-epith of gut d-skin e-? Mycobacteruim

a- are alchochol acid fast b-does not form spores c-d-a facultative anaerobes d-responsible for leprosy

e-pathogenic inhumans all strains

the germination of tetanus spores in a wound is inhibited by a-tissue trauma

b-oxygen

c-inject of toxoid d-injection of antitoxin

e-removal of devitalised tissue Aldosterone

a-reduces Na resorption in PCT

b-reduces Na absorption in descen loop of henle c-Increase Na absortion in DCT

Increase K loss from the tubule

e increases Na absortion in collecting tubules

the following r conclusive evidence of pregnancy in uterine cureetings???? can, t remmber

a-decidua compacta-

b-Arias -stella changes in endometrail glad- c-spiral arterioles

d-plasma cell infiltration e chorionic villi

(31)

White cell migration from the bld vessels in areas of inflammation involves--- march 1997/2 21

a-call migration between the endothelial cells b-a pssive loss of fluid bld elements

c-cell migration independeant of endothelial cell motion d-initail emigration of polymorhs neutrophils

e-more polymorphs than monocytes after 2 day= the vulva is supplied by

a-ant cutaneu erve of the thigh b-femoral br/o genito femoral nerve c-?

d? e?

glucocorticoids

a-promote hepatic gluconeogenesis b-suppress uptake of glucose by muscles c-promote protein break down

d-promote fat reakdown e-increase glycolysis

halothane(refer sept 1997)42 a-cardic arrythmias

b-explosive mixtures with air c-liver damage

53- U/S: A-Pulstile

B-Increase body temp 1 degree after 15 min scanning.. C-High frequency penetrates deeper TISSUE,-

D-Can distinguish between 2 points closer than 0.5 mm

E-Best echoes are produded by beam at right angle to the structures. 54-Disinfectant solutions may become contaminated with:

1-Enterobacter species – 2-Streptococcus species - 3-Escherichia coli -

4-Pseudomonas aeruginosa - 5-Staphyloccus pyogenes-

(32)

55-Nitric oxide

a) is synthesised in the endothelium – b) has a short half life --

c) causes smooth muscle contraction d) increases during pregnancy -

e) combines with oxygen to produce L-arginine— but few question got modifications eg;

nitrous oxide synthesised by macrophages naloxone antiemitic effect

drugs contraindicated in breast feeding drugs causing renal impairment

ultasound mri

statistics quit difficult all definitions rna

pre implantation diagnosis 1 ( FIBRINOGEN 2) HEPATOGLOGIN 3) FERRITIN 4) ...

predominantly produced by UG system - is a kind of lukotriene

- is phospholipid

which reactant protein will increase in injury

--- 1) FIBRINOGEN 2) HEPATOGLOGIN 3) FERRITIN 4) albumin 5) ? Cell cycle -prophase I and II

(33)

-mitosis I and II Vulva nerve supply

Urinary bladder - lining/embrology vagina - embrology

Fetal testis IL I

MCH I

Function of Neutrophil polymorphs Fetal HbF

PG

Umblical cord – embrology prostaglandins

half lifa 30 min f il1

produced by macrophages

whartons jelly originate from extra embryonic endodem detrusor muscle is of mesodermal origin

acute phase proteins are transferrin alfa feto protein

(34)

possible 2 detect the sex of the embryo uses pcr 4 chromosomal deletions

can be used 4 detection of single gene disoderes facial hair causes

testosterone mestranol spironolactone real time bias length time bias

negative predictive value

fibrocystic disease of thr breast...in paper 2 , breast anatomy and breast from endocrine function (in paper 1..)...ie 3 qs we about the breast levator ani its attachnment and its coverings

endometrial carcinoma adenomyosis

about measuring the arterial blood pressure and its methods interleukin 2

prenatal implantation genetic diagnosis menstural cycle in paper 1 and 2

MARCH 2006

The germination of tetanus spores in a wound is inhibited by a)tissue trauma

b)oxygen

c)injection of anti-toxin d)injection of toxoid

e)removal of devitalised tissue

The following values fall within the normal range for the adult female bladder

a)residual volume of 100ml b)voiding capacity of 250ml c)bladder capacity of 900ml

d)intravesical pressure rise of less than 10cm H2O during early filling e)maximum urine flow rate of 60ml per second

(35)

In the small intestine, the following substances are absorbed by active processes a)water b)sodium c)vitamin K d)amino acids e)chloride

White cell migration from blood vessels in areas of inflammation involves

a)cell migration occurring between endothelial cells b)a passive loss of fluid blood elements

c)cell migration independent of endothelial cell motion d)initial emigration of polymorphonuclear neutrophils e)more polymorphs that monocytes after 2 days

Antibodies (!!)

a)are soluble proteins

b)are formed in the fetus before 12 weeks of intrauterine life c)have an average molecular weight of around 10000 daltons d)of the rhesus type are genetically transmitted

e)are produced by the ribosomes of plasma cells In DNA

a)a codon is a sequence of three bases b)all codons have an identified function

c)there is a greater variety of amino acids than there are different codons d)replication can be initiated at several different points along a

chromosome

e)complementary pairing precedes messenger mRNA synthesis The inferior vena cava

a)is formed at the level of the fifth lumbar vertebra b)commences posterior to the right external iliac artery c)receives the left ovarian vein

d)receives the right ovarian vein

e)pierces the central tendon of the diaphragm In the normal human pelvis

a)the promontory of the sacrum is in the upper anterior border of the first sacral vertebra

(36)

c)the joint between the two pubic bones is a synovial joint

d)the acetabular fossa is wholly formed from parts of the pubic and ischial bones

e)the transverse diameter of the brim is greater than the anteroposterior diameter

Arginine vasopressin

a)reduces the glomerular filtration rate

b)controls water loss in the proximal renal tubule c)is synthesised by the posterior pituitary gland

d)is released in response to a rise in plasma osmolality

e)is released in response to a fall in circulating plasma volume Concerning ovarian function

a)progesterone is the major steroid of the developing follicle b)granulosa cells secrete oestradiol

c)oestradiol is derived from androgen precursors

d)insulin-like growth factor (IGF-1) is not secreted by the ovary e)circulating inhibin concentrations are a marker of granulosa cell function

Actinomyces israelii a)is a rickettsia

b)forms yellow granules in pus c)is a commensal in the mouth d)is a commensal in the vagina e)is usually resistant to penicillin Halothane produces

a)cardiac arrhythmias

b)explosive mixtures with air c)liver damage if given repeatedly d)myometrial relaxation

e)bronchial irritation

The therapeutic effect of the first drug is enhanced by the second drug a)phenytoin: ethinyloestradiol b)bromocryptine: metoclopramide c)penicillin: probenicid d)ritodrine: dexamethasone e)warfarin: phenobarbitone Potassium

(37)

a)is mainly intracellular

b)plasma levels vary in proportion to intracellular levels c)plasma levels are decreased in Addison’s disease d)plasma levels are increased in diabetic ketoacidosis e)deficiency occurs with prolonged vomiting

Concerning carbohydrates

a)sucrose is a disaccharide of glucose and fructose b)cereal grains contain less than 40% starch

c)cellulose is a fructose polysaccharide

d)a normal diet contains less than 60g of carbohydrate daily

e)dietary carbohydrate is oxidised in the body to carbon dioxide and water

Steroid hormones

a)all contain 20 carbon atoms

b)can be produced by structures of urogenital ridge origin c)are mostly activated in the liver

d)are predominantly excreted unchanged in the urine e)mainly circulate unbound to carrier proteins

Ventilation is increased due to stimulation of central receptors by a)nikethamide b)hypoxia c)doxapram d)phenobarbitone e)salbutamol Tetrahydrofolic acid

a)is involved in purine synthesis b)is a precursor of folic acid

c)is a coenzyme in amino acid synthesis

d)catalyses the conversion of glucose to glucose-6-phosphate e)activity is inhibited by Methotrexate

Mitochondrial DNA a)is located in the nucleus b)inheritance is patrilineal

c)is present in two copies per cell d)mutation causes cystic fibrosis

e)is involved in the control of oxidative phosphorylation The following conditions may lead to hydronephrosis

(38)

a)mercury poisoning b)cervical carcinoma c)renal calculi

d)renal vein thrombosis e)posterior urethral valves

In uncomplicated homozygous beta thalassaemia there is a)hypochromasia

b)a reduction in haemoglobin A2 c)an increase in haemoglobin F d)no depletion of iron stores

e)the presence of megaloblasts in bone marrow

The following statements relate to lung function in normal pregnancy a)vital capacity is increased by about 50%

b)tidal volume is increased c)the subcostal angle increases d)the residual volume is reduced e)the respiratory rate is increased

In normal pregnancy, uterine blood flow a)is about 50ml/minute at term

b)is maintained throughout the cardiac cycle to the choriodecidual space c)is reduced by prostacyclin

d)is increased during uterine contractions

e)represents about 10% of the cardiac output by the end of the first trimester

During normal pregnancy a)arterial pCO2 decreases

b)the blood hydrogen ion concentration decreases c)plasma bicarbonate concentrations decrease d)urine pH falls

e)lactic acid production is increased The anal canal

a)has an upper part which is innervated by the inferior hypogastric plexus b)has a lower part which is supplied by the superior rectal artery

c)drains lymph to the superficial inguinal nodes from its upper part d)has its internal sphincter innervated by the inferior rectal nerve e)has a superficial part of its external sphincter attached to the coccyx. Human placental lactogen

(39)

a)is a single chain polypeptide

b)reaches the same concentration in fetal and maternal blood at term c)may be secreted by the decidua

d)is detectable only after the 25th week of pregnancy e)is an insulin antagonist

Human chorionic gonadotrophin !! a)is a glycoprotein

b)is detectable 48 hours after fertilisation occurs c)secretion peaks at 20 weeks of gestation

d)is synthesised by the corpus luteum of pregnancy e)binds to luteinizing hormone receptors

Cholecalciferol (vitamin D) a)promotes the absorption

b)is 25-hydroxylated in the liver c)is synthesised in the SKIN d)is 1-hydroxylated in the kidney

e)is most active in the 1,25-dihydroxyl form Unconjugated bilirubin !!

a)is normally present in the plasma in lower concentration than conjugated bilirubin

b)circulates in the plasma bound to albumin c)is not excreted in the urine

d)does not cross the blood-brain barrier e)crosses the placenta

The following are capable of cellular regeneration: a)spinal cord

b)liver c)epidermis d)myocardium e)bone marrow

The Leydig cells of the testis !! a)secrete seminal fluid

b)are stimulated by luteinising hormone c)are active in intrauterine life

d)secrete fructose

e)produce androstenedione Angiotensin II !!

(40)

a)is the most potent vasoconstrictor b)reduces aldosterone production c)is mainly found in the lungs d)is a decapeptide

e)is produced when the extracellular fluid volume is reduced Cyproterone acetate

a)is an oestrogen

b)is used for the treatment of amenorrhoea c)binds to androgen receptors

d)increases libido

e)inhibits spermatogenesis

Lignocaine used as a local anaesthetic !!

a)causes tachycardia if given as a systemic injection b)has a longer lasting action than bupivicaine

c)is used in combination with adrenaline for ring block d)causes vasoconstriction

e)is a weak base

Plasma osmolarity in the human

a)is normally about 290 milliosmoles per kg in the nonpregnant state b)increases during the first trimester of pregnancy

c)is closely controlled by plasma protein concentration d)is regulated by arginine vasopressin

e)regulates the sensation of thirst

In the statistical analysis of any group of numerical observations a)the mean is always less than the mode

b)the median value always lies at the mid-point of the range

c)standard deviation is always greater than the standard error of the mean d)the standard error of the mean is independent of the total number of observations

e)there are the same number of observations greater than and less than the median value

The pelvic splanchnic nerves

a)are derived from the posterior rami of the sacral spinal nerves b)supply afferent fibres

c)mix with branches of the sympathetic pelvic plexus d)supply the ascending colon with motor fibres

(41)

Exotoxins

a)are derived from gram-negative bacteria b)have specific action

c)are more toxic than endotoxins

d)are neutralised by their homologous antitoxin e)can be converted to toxoid

Candida albicans a)is gram positive

b)is an anaerobic organism

c)is associated with diabetes mellitus d)is motile

e)is inhibited by oral tetracycline therapy

Transferrin

a)is one third saturated with iron b)is increased in pregnancy c)binds to 10mg of iron per gram d)levels in the neonate are low e)is actively transported

In Crohn’s disease there is

a) non casesous granuloma formation b) formation of deep fissures

c) formation of crypt abscesses d) the presence of mucosal polyps

e) a recognised association with occurence in the vulva The rectum

a) usually commences at the level of S3 b) has a mesentery in its proximal third c) drains lymph to the pre-aortic nodes

d) has a parasympathetic nerve supply derived entirely form the S3 spinal segment

e) is about 25cm in length The female urethra (!!)

a) traverses the perineal membrane b) is lined throughout by urothelium

c) has a muscle layer continuous with that of the bladder d) has an external sphincter supplied by the obturator nerve

(42)

e) corresponds developmentally to the membranous urethra in the male During menstruation, endometrial haemostasis depends upon

a) a platelet and fibrin plug formation after the first 20 hours of bleeding b) oestrogen mediated vasoconstriction

c) prostaglandin mediated spiral vessel constriction

d) production of plasminogen activating factor by the glandular epithelial cells

In HIV, seroconversion illness after a needlestick injury a)occurs within 1 to 4 weeks following exposure

b)infectivity decreases after seroconversion c)the CD4 count is a useful adjunct in diagnosis

d)measurement of HIV RNA viral load is most useful in diagnosis The following tumours arise in the ovary:

a) nephroblastoma b) cystadenoma

c) granulosa cell tumour d) neuroblastoma

e) teratoma

Early blood borne dissemination is a characteristic feature of: a) carcinoma of the endometrium

b) osteosarcoma

c) basal cell carcinoma d) carcinoma of the cervix e) choriocarcinoma

Breast milk compared to cow's milk (!!) a) has more protein

b) has more sodium

c) contains more carbohydrate d) has more casein

e) contains more calories

The following are consequences of pulmonary embolism: a) pulmonary infarction

b) fibrinous pleurisy

c) right ventricular hypertrophy d) sudden death

(43)

In a country wide survey, 10 general practices were picked at random and 5% of patients were selected at random from each practice:

a) the sample of patients is a true random sample b) all practices had an equal chance of selection c) all patients had an equal chance of selection d) two siblings could not have been selected

e) inferences about all patients in the country may be drawn from the sample

Nitric oxide

a) is synthesised in the endothelium b) has a short half life

c) causes smooth muscle contraction d) increases during pregnancy

e) combines with oxygen to produce L-arginine Carbohydrates

a) yield 17kj/g of energy

b) are a major source of energy for the brain c) are a a major component of the diet

d) give a higher energy yield compared to fats

Head mesenchyme gives rise to the following skull bones a)Parietal

b)Mandible c)Maxillary d)Frontal e)Ethmoid

Pre-implantation genetic diagnosis

a) can be used to identify single gene defects b) is used in ICSI only

c) testing for trisomy 21 should be offered in a case of ovum donation with a 45 year old recipient and 23 year old donor

d) is routinely used in IVF in selection of embryos

e) is governed by the regulations of the Human, Embryology and Fertilisation Authority

The following are gram positive organisms a)Brucella

b)Listeria

c)Staphylococcus d)Vibrio cholera

(44)

Endometriotic deposits a) only occur in the pelvis

b) consist of deposits of endometrial stromal tissue without glands c) do not occur in postmenopausal women

d) are hormone sensitive Amyloidosis

a)Can be inherited

b)Is associated with bronchiectasis c)Is a cause of cardiomyopathy Phenylketonuria

a)can only be diagnosed in the adult

b)is diagnosed by high levels of phenylpyruvate in the urine c)treatment is with diet restriction

DUB (Dysfunctional uterine bleeding) a) is common at the extremes of life

b) may be caused by coagulation disorders Chylomicrons

a) are not normally present in the fasting state

b) after hydrolysis of lipoproteins, mainly consist of phospholipid Other questions that I cannot remember in such detail were about: Insulin (*half life of 30min)

Pituitary gland Anatomy (*contains pars tuberalis)

Many Pathology questions (equivalents ie *ovarian dysgerminoma = seminoma?, *endodermal sinus tumour = yolk sac tumour?)

Embryology (notochord, primitive streak, mesonephros derivatives) Ionising radiation (radiosensitivity ie *liver /intestinal epithelium - which is more radiosensitive; *is radiation exposure of dental x-ray equivalent to 1/5 that from a transatlantic flight)

difference b/w human milk and cows milk casien lactose sodium ascorbic acid water phenyl ketoneuria

(45)

inherited disorder

cause by defficiency of phenyl alanine dietry restriction of tyrosine helpful

diagnosed by measuring phenyl ketone level in urine essential amino acids

are not synthesized by body sufficiently all ketogenic

can produce energy dont remember exact wording radiation

mostly harmful in 8-12 wks gestation xrays r ionizing radiation

contraindicated in pregnancy

transatlantic flight hv higher dose of radiation than xray MRI

repeat q from sept paper chylomicrins

responsible for turbulence of plsma?dont remem metabolized in adipose tissue -true 80% 20% in liver after hydrolysis by lipoprotien mainly phospholipids r absorbed form intestinal luminal cells to ----? ovarian tumors

dysgerminoma and endodermal sinus tumor hv same origin choriocharcinoma can arise

cocp increase risk of ovarian cancers -this qs repeated again in other qs with different wording

b cells

arise from plasma cells

in pregnancy humoral immunity is depressed early in pregnany tumor necrotic factor alpha raised in parturition

pulmonary embolism cause s sudden death fibrinous plurisy rt ventricular hypertrohy haemoptysis

repeated from sept 05 transferrin -

endo metrium hiv seroconversion carbohydrate

preimplantation diagnosis repeat from march 2005 progesteron

(46)

basal body temp progesterone

LH--PLZ SOME ONE ADD I DONT REMEMBER NOTOCHORD

R SOLID CELLS

GIVE RISE TO brain --?

SKULL MESENCHYME GIVE RISE TEMPORAL BONE

FRONTAL PARIETAL

Q-Disinfectant solutions may become contaminated with: 1-Enterobacter species

2-Streptococcus species 3-Escherichia coli

4-Pseudomonas aeruginosa 5-Staphyloccus pyogenes

Q-Examples of active transport across a membrane include the passage of:

1-Potassium ions into the neurons

2-Water into the proximal renal tubular cell 3-Glucose from the proximal renal tubular cell 4-Fatty acids into the mucosal cells of the intestine 5-Hydrogen ions from the gastric oxyntic cells. ENDOMETRIOSIS

has endometrial tissue with no glands not occurs after menopause

The following values fall within the normal range for the adult female bladder

Fa)residual volume of 100ml Tb)voiding capacity of 250ml Fc)bladder capacity of 900ml

Td)intravesical pressure rise of less than 10cm H2O during early filling Fe)maximum urine flow rate of 60ml per second

(47)

The germination of tetanus spores in a wound is inhibited by Fa)tissue trauma

Tb)oxygen

Fc)injection of anti-toxin Td)injection of toxoid

Te)removal of devitalised tissue In DNA

Ta)a codon is a sequence of three bases Tb)all codons have an identified function

Fc)there is a greater variety of amino acids than there are different codons Td)replication can be initiated at several different points along a

chromosome

Fe)complementary pairing precedes messenger mRNA synthesis Concerning ovarian function

Fa)progesterone is the major steroid of the developing follicle Tb)granulosa cells secrete oestradiol

Tc)oestradiol is derived from androgen precursors

Td)insulin-like growth factor (IGF-1) is not secreted by the ovary Fe)circulating inhibin concentrations are a marker of granulosa cell function

Actinomyces israelii Fa)is a rickettsia

Tb)forms yellow granules in pus Tc)is a commensal in the mouth Fd)is a commensal in the vagina Fe)is usually resistant to penicillin

In the small intestine, the following substances are absorbed by active processes F a)water T b)sodium F c)vitamin K T d)amino acids T e)chloride

White cell migration from blood vessels in areas of inflammation involves

T a)cell migration occurring between endothelial cells F b)a passive loss of fluid blood elements

(48)

T c)cell migration independent of endothelial cell motion T d)initial emigration of polymorphonuclear neutrophils F e)more polymorphs that monocytes after 2 days

Which are formed from intramembranous ossification? T Temporal , occipital, parietal

F. Sphenoid, Ethmoid Antibodies (!!)

Ta)are soluble proteins -- Ab are glycoprotein. Are they soluble? not sure [color=red:c2901df9c1][b:c2901df9c1]F[/b:c2901df9c1][/color:c2901df9 c1]b)are formed in the fetus before 12 weeks of intrauterine life

Fc)have an average molecular weight of around 10000 daltons Fd)of the rhesus type are genetically transmitted

Te)are produced by the ribosomes of plasma cells Correction

The germination of tetanus spores in a wound is inhibited by Fa)tissue trauma

Tb)oxygen

[color=red:1e03073b8c][b:1e03073b8c]T[/b:1e03073b8c][/color:1e0307 3b8c]c)injection of anti-toxin

Td)injection of toxoid

Te)removal of devitalised tissue Insulin (*half life of 30min) F

Pituitary gland Anatomy (*contains pars tuberalis)F Q-Disinfectant solutions may become contaminated with: T1-Enterobacter species

F2-Streptococcus species F3-Escherichia coli

T4-Pseudomonas aeruginosa F5-Staphyloccus pyogenes The inferior vena cava

Ta)is formed at the level of the fifth lumbar vertebra Fb)commences posterior to the right external iliac artery Fc)receives the left ovarian vein

(49)

Td)receives the right ovarian vein

Te)pierces the central tendon of the diaphragm In the normal human pelvis

Ta)the promontory of the sacrum is in the upper anterior border of the first sacral vertebra

Fb)the anterior surface of the sacrum has five paired foramina Fc)the joint between the two pubic bones is a synovial joint

[b:715c81bcd5]d)the acetabular fossa is wholly formed from parts of the pubic and ischial bones [/b:715c81bcd5]

Te)the transverse diameter of the brim is greater than the anteroposterior diameter

Arginine vasopressin

Fa)reduces the glomerular filtration rate

Fb)controls water loss in the proximal renal tubule Fc)is synthesised by the posterior pituitary gland

Td)is released in response to a rise in plasma osmolality

Te)is released in response to a fall in circulating plasma volume Concerning ovarian function

Fa)progesterone is the major steroid of the developing follicle Tb)granulosa cells secrete oestradiol

Tc)oestradiol is derived from androgen precursors

Td)insulin-like growth factor (IGF-1) is not secreted by the ovary Fe)circulating inhibin concentrations are a marker of granulosa cell function

Actinomyces israelii Fa)is a rickettsia

Tb)forms yellow granules in pus Tc)is a commensal in the mouth Fd)is a commensal in the vagina Fe)is usually resistant to penicillin Halothane produces

(50)

Fb)explosive mixtures with air Tc)liver damage if given repeatedly Td)myometrial relaxation

Fe)bronchial irritation

The therapeutic effect of the first drug is enhanced by the second drug Fa)phenytoin: ethinyloestradiol Fb)bromocryptine: metoclopramide Tc)penicillin: probenicid Td)ritodrine: dexamethasone Fe)warfarin: phenobarbitone Potassium

Ta)is mainly intracellular

Fb)plasma levels vary in proportion to intracellular levels Fc)plasma levels are decreased in Addison’s disease Td)plasma levels are increased in diabetic ketoacidosis Te)deficiency occurs with prolonged vomiting

Concerning carbohydrates

Ta)sucrose is a disaccharide of glucose and fructose

[color=red:715c81bcd5][b:715c81bcd5]F[/b:715c81bcd5][/color:715c81b cd5]b)cereal grains contain less than 40% starch

[color=red:715c81bcd5][b:715c81bcd5]F[/b:715c81bcd5][/color:715c81b cd5]c)cellulose is a fructose polysaccharide

Fd)a normal diet contains less than 60g of carbohydrate daily

Te)dietary carbohydrate is oxidised in the body to carbon dioxide and water

Steroid hormones

Fa)all contain 20 carbon atoms

Tb)can be produced by structures of urogenital ridge origin Fc)are mostly activated in the liver

Fd)are predominantly excreted unchanged in the urine Fe)mainly circulate unbound to carrier proteins

(51)

Ta)nikethamide Tb)hypoxia Tc)doxapram Fd)phenobarbitone Fe)salbutamol Tetrahydrofolic acid

Ta)is involved in purine synthesis Fb)is a precursor of folic acid

Fc)is a coenzyme in amino acid synthesis

Fd)catalyses the conversion of glucose to glucose-6-phosphate Te)activity is inhibited by Methotrexate

Mitochondrial DNA

Ta)is located in the nucleus Fb)inheritance is patrilineal

Fc)is present in two copies per cell Fd)mutation causes cystic fibrosis

Te)is involved in the control of oxidative phosphorylation The following conditions may lead to hydronephrosis ?Fa)mercury poisoning

Tb)cervical carcinoma Tc)renal calculi

?Fd)renal vein thrombosis Te)posterior urethral valves

In uncomplicated homozygous beta thalassaemia there is Ta)hypochromasia

Fb)a reduction in haemoglobin A2 Tc)an increase in haemoglobin F Td)no depletion of iron stores

Fe)the presence of megaloblasts in bone marrow

The following statements relate to lung function in normal pregnancy Fa)vital capacity is increased by about 50% (ans from busyspr)

(52)

Tc)the subcostal angle increases Td)the residual volume is reduced Fe)the respiratory rate is increased

[color=darkblue:715c81bcd5]In normal pregnancy, uterine blood flow Fa)is about 50ml/minute at term

Tb)is maintained throughout the cardiac cycle to the choriodecidual space Fc)is reduced by prostacyclin

Fd)is increased during uterine contractions

Te)represents about 10% of the cardiac output by the end of the first trimester [/color:715c81bcd5]

P.200 sep 2001 paper 2 Q 46 During normal pregnancy Ta)arterial pCO2 decreases

Fb)the blood hydrogen ion concentration decreases Tc)plasma bicarbonate concentrations decrease Fd)urine pH falls

?Te)lactic acid production is increased The anal canal

Ta)has an upper part which is innervated by the inferior hypogastric plexus

Fb)has a lower part which is supplied by the superior rectal artery Fc)drains lymph to the superficial inguinal nodes from its upper part Fd)has its internal sphincter innervated by the inferior rectal nerve Te)has a superficial part of its external sphincter attached to the coccyx. Human placental lactogen

?T[b:715c81bcd5]a)is a single chain polypeptide [/b:715c81bcd5] Fb)reaches the same concentration in fetal and maternal blood at term Tc)may be secreted by the decidua

?F[b:715c81bcd5]d)is detectable only after the 25th week of pregnancy[/b:715c81bcd5]

(53)

Human chorionic gonadotrophin !! Ta)is a glycoprotein

?T[b:715c81bcd5]b)is detectable 48 hours after fertilisation occurs [/b:715c81bcd5]

Fc)secretion peaks at 20 weeks of gestation

Fd)is synthesised by the corpus luteum of pregnancy Te)binds to luteinizing hormone receptors

Cholecalciferol (vitamin D) Ta)promotes the absorption

Tb)is 25-hydroxylated in the liver Tc)is synthesised in the SKIN Td)is 1-hydroxylated in the kidney

Te)is most active in the 1,25-dihydroxyl form Unconjugated bilirubin !!

?Fa)is normally present in the plasma in lower concentration than conjugated bilirubin

?Tb)circulates in the plasma bound to albumin Fc)is not excreted in the urine

Fd)does not cross the blood-brain barrier ?Te)crosses the placenta

The following are capable of cellular regeneration: Fa)spinal cord

Tb)liver Tc)epidermis Fd)myocardium Te)bone marrow

The Leydig cells of the testis !! Fa)secrete seminal fluid

Tb)are stimulated by luteinising hormone Tc)are active in intrauterine life

Fd)secrete fructose

(54)

Angiotensin II !!

Ta)is the most potent vasoconstrictor Fb)reduces aldosterone production Tc)is mainly found in the lungs

Fd)is a decapeptide -- angiotensin I is a decapeptide

Te)is produced when the extracellular fluid volume is reduced Cyproterone acetate

Fa)is an oestrogen [color=blue:715c81bcd5]--is an antiandrogenic progesterone[/color:715c81bcd5]

Fb)is used for the treatment of amenorrhoea [color=blue:715c81bcd5]-- treat hirsutism [/color:715c81bcd5]

Tc)binds to androgen receptors Fd)increases libido

Te)inhibits spermatogenesis

Lignocaine used as a local anaesthetic

Ta)causes tachycardia if given as a systemic injection Fb)has a longer lasting action than bupivicaine

Fc)is used in combination with adrenaline for ring block Fd)causes vasoconstriction

Te)is a weak base

Plasma osmolarity in the human

Ta)is normally about 290 milliosmoles per kg in the nonpregnant state Fb)increases during the first trimester of pregnancy

?Fc)is closely controlled by plasma protein concentration Td)is regulated by arginine vasopressin

Te)regulates the sensation of thirst

In the statistical analysis of any group of numerical observations Fa)the mean is always less than the mode

Tb)the median value always lies at the mid-point of the range

Tc)standard deviation is always greater than the standard error of the mean

Fd)the standard error of the mean is independent of the total number of observations

(55)

Te)there are the same number of observations greater than and less than the median value

The pelvic splanchnic nerves

Fa)are derived from the posterior rami of the sacral spinal nerves Fb)supply afferent fibres

Tc)mix with branches of the sympathetic pelvic plexus Fd)supply the ascending colon with motor fibres

Te)supply the uterus with parasympathetic fibres Exotoxins

Ta)are derived from gram-negative bacteria

[color=red:715c81bcd5][b:715c81bcd5]T[/b:715c81bcd5][/color:715c81 bcd5]b)have specific action

Tc)are more toxic than endotoxins

Td)are neutralised by their homologous antitoxin Te)can be converted to toxoid

Candida albicans Ta)is gram positive

Fb)is an anaerobic organism

Tc)is associated with diabetes mellitus Fd)is motile

Fe)is inhibited by oral tetracycline therapy T treat with miconazole

T commonsal in intestine

Transferrin

Ta)is one third saturated with iron c)binds to 10mg of iron per gram d)levels in the neonate are low e)is actively transported

(56)

In Crohn’s disease there is

?Ta) non casesous granuloma formation Tb) formation of deep fissures

Tc) formation of crypt abscesses Td) the presence of mucosal polyps

e) a recognised association with occurence in the vulva The rectum

Ta) usually commences at the level of S3 Fb) has a mesentery in its proximal third

[b:715c81bcd5][color=red:715c81bcd5]T[/color:715c81bcd5][/b:715c81 bcd5]c) drains lymph to the pre-aortic nodes

[color=red:715c81bcd5][b:715c81bcd5]T[/b:715c81bcd5][/color:715c81 bcd5]d) has a parasympathetic nerve supply derived entirely form the S3 spinal segment

[color=red:715c81bcd5][b:715c81bcd5]F[/b:715c81bcd5][/color:715c81b cd5]e) is about 25cm in length

[b:715c81bcd5]The female urethra (!!) a) traverses the perineal membrane b) is lined throughout by urothelium

c) has a muscle layer continuous with that of the bladder d) has an external sphincter supplied by the obturator nerve

e) corresponds developmentally to the membranous urethra in the male [/b:715c81bcd5]

[b:715c81bcd5]During menstruation, endometrial haemostasis depends upon

a) a platelet and fibrin plug formation after the first 20 hours of bleeding b) oestrogen mediated vasoconstriction

Tc) prostaglandin mediated spiral vessel constriction

d) production of plasminogen activating factor by the glandular epithelial cells [/b:715c81bcd5]

During menstruation endometrial hemostasis depends upon Platelet and fibrin plug formation after first 20 hrs of bleeding Production of PAF by glandular epithelial cells

(57)

Estrogen mediated hemostasis PG mediated hemostasis

In HIV, seroconversion illness after a needlestick injury Ta)occurs within 1 to 4 weeks following exposure

[color=darkblue:715c81bcd5][b:715c81bcd5]?T[/b:715c81bcd5][/color:7 15c81bcd5]b)infectivity decreases after seroconversion

Tc)the CD4 count is a useful adjunct in diagnosis

Td)measurement of HIV RNA viral load is most useful in diagnosis HIV seroconversion

Illness occurs witin 1-4 wks...T...SEROCONVERSION OCCURS IN FIRST FEW WEEKS...FOLLOWED BY SIGNS OF ILLNESS After illness infectivity decreases

...[b:715c81bcd5][color=darkblue:715c81bcd5].F...[/color:715c81 bcd5][/b:715c81bcd5]I THINK SO BECAUSE THOUGH ITS A

LATENT PHASE AND NO OVERT SYMPTOMS OCCUR WHILE THE VIRUS MULTIPLIES, I THINK INFECTIVITY REMAINS JUST THE SAME...

The best available diagnostic test is HIV viral load

assay...[color=red:715c81bcd5][b:715c81bcd5]T[/b:715c81bcd5][/col or:715c81bcd5]...FROM AN OBSTETRIC POINT OF

VIEW...VIRAL LOAD IS THE ONLY USEFUL WAY OF

PREDICTING DISEASE...BECAUSE SEROLOGY IS UNRELIABLE IN ITS RESULTS DUE TO MATERNAL ANTIBODIES...WHICH MIGHT TAKE UPTO 18MONTHS TO DIE DOWN...

Without any intervention during pregnancy the mother to child transmission rate is 80%

...[color=red:715c81bcd5][b:715c81bcd5]F[/b:715c81bcd5][/color:71 5c81bcd5]...ITS 15-45%...LATTER IN UNTREATED CASES... Mode of delivery by LSCS decreases the transmission to

baby...[color=red:715c81bcd5][b:715c81bcd5]T[/b:715c81bcd5][/color :715c81bcd5]...CAN BRING THE TRANSMISS DOWN TO 2% Short course of anti viral Rx during labor decreases transmission to

baby...[b:715c81bcd5][color=red:715c81bcd5]T[/color:715c81bcd5][/ b:715c81bcd5]

References

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