ABSTRACT
ADP e. One molecule of NADH produces three molecules of ATP
from ADP
52. Pyruvate a. Is the end-product of aerobic glycolysis b. Is the end-product of anaerobic glycolysis c. Is transported to mitochondria in order to enter the citric acid
cycle d. Is converted to acetyl-CoA by the pyruvate dehydrogenase
complex e. Conversion of phosphoenolpyruvate to pyruvate is the final step
in the glycolytic pathway
53. With regard to pyruvate kinase a. Is activated by fructose 6-phosphate b. Is needed for conversion of pyruvate to phosphoenolpyruvate c. Is needed in the final step in the glycolytic pathway d. Is activated by insulin e. Is activated by glucagon
54. Pyruvate kinase deficiency a. Can cause lymphopenia b. Is restricted to white blood cells c. Is restricted to red blood cells d. Can cause mild, chronic, haemolytic anaemia e. Can cause severe, chronic, haemolytic anaemia
55. Haemoglobin a. Is composed of two globin chains and three haem rings b. Haem ring in haemoglobin is synthesized in the cytoplasm c. Haem ring in haemoglobin is synthesized in the nucleus d. Iron supply is never a rate-limiting step in haem synthesis e. Globin synthesis proceeds only in the presence of sufficient haem
56. Pyruvate dehydrogenase complex a. Decarboxylates pyruvate to acetyl-CoA b. Requires five coenzymes c. Deficiency is an X-linked recessive condition d. Deficiency causes psychomotor retardation e. Is inactivated by arsenic poisoning
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b. Aerobic metabolism produces 40 ATP (glycerol 3-phosphate or
G3P shuttle) per glucose molecule c. Anaerobic metabolism produces 10 ATP per glucose molecule d. Aerobic metabolism produces 36 ATP (G3P shuttle) per glucose
molecule e. Anaerobic metabolism produces 2 ATP per glucose molecule
58. Adenosine cyclic monophosphate (cAMP) a. Is synthesized from guanosine triphosphate (GTP) b. Is activated by protein kinase A c. Is slowly degraded by cAMP phosphodiesterases d. Is rapidly degraded by cAMP phosphodiesterases e. Requires adenylyl cyclase for its synthesis
59. Factors causing K1 to move out of the cell include a. Hyperinsulinaemia b. Hypothyroidism c. Alkalosis d. Acidosis e. Severe cell damage
60. During prolonged fasting a. The brain uses more ketones than glucose b. There is decreased gluconeogenesis in the liver c. Fatty acid oxidation is increased in the muscles d. Ketone use is increased in the muscles e. Ketone use is decreased in the muscles
61. With regard to prostaglandin synthesis a. It is derived from arachidonic acid b. It is synthesized from 20-carbon fatty acid chains c. Membrane phospholipids are the source of arachidonic acid d. Cyclooxygenase converts PGE2 to PGH2 e. Isomerases convert PGH2 to PGF2a and PGE2
62. Nitric oxide a. Is produced from methionine b. Has a half-life of 5 minutes c. Is released by the endothelial cells of the blood vessels d. Mediates vasoconstriction during pregnancy e. Mediates vasodilatation during pregnancy
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c. Glutamate is oxidatively deaminated to ammonia d. The final reaction in the urea cycle requires arginase e. Most of the amino acid detoxification occurs in the kidney
64. During catecholamine synthesis a. Tyrosine is converted to 3,4-dihydroxyphenylalanine (dopa) b. Tyrosine hydroxylase converts phenylalanine to tyrosine c. Tyrosine hydroxylase is required to convert tyrosine to dopa d. Dopa is converted to dopamine by dopa decarboxylase e. Dopamine is decarboxylated to noradrenaline
65. Fats a. Contain more oxygen than carbohydrates b. Contain less oxygen than proteins c. Are composed of triacylglycerols d. Yield less energy on oxidation than from an equivalent amount
of carbohydrates e. One gram of fat yields 7 kcal of energy
66. Cervical intraepithelial neoplasia (CIN) a. Is a cytological diagnosis b. Is characterized by large abnormal nuclei and reduced cytoplasm c. Immature cells are present in the upper third of the epithelium in
CIN1 d. Immature cells are present in the lower and middle third of the
epithelium in CIN2 e. Immature cells are present in the lower third of the epithelium in
CIN3
67. The transformation zone in the cervix a. Is where the squamous and columnar epithelium meet after
puberty b. Is where native squamous epithelium changes to columnar
epithelium c. Is where most precancerous changes occur d. Contains cervical crypt openings e. Nabothian cysts can be seen in this area
68. Squamous metaplasia in the cervix a. Is a physiological process b. Always occurs before puberty c. Is preceded by reserve cell hyperplasia d. Converts squamous to columnar epithelium e. Is caused by herpes simplex virus
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c. One report of mild dyskaryosis d. One report of severe dyskaryosis e. One report of glandular neoplasia
70. Acetowhite epithelium may be found in association with a. Cervical intraepithelial neoplasia b. Vaginal intraepithelial neoplasia c. Human papillomavirus infection d. Immature squamous metaplasia e. Congenital transformation zone
71. Fluorescence in situ hybridization (FISH) a. Provides information about specific chromosomes studied b. Provides information about the complete karyotype c. Is used for detection of chromosomal microdeletion syndromes d. Can be performed on metaphase chromosomal preparations
of cultured lymphocytes e. Can be performed on interphase nuclei from chorionic villi
72. Examples of microdeletion syndromes a. Prader-Willi syndrome b. Fragile X syndrome c. Angelman syndrome d. DiGeorge syndrome e. Kartagener syndrome
73. Innate or non-specific immunity a. Is antigen specific b. Is not antigen specific c. Response is not antigen dependent d. Response is antigen dependent e. Lag period is present between exposure and response
74. Natural killer cells a. Resemble neutrophils in their morphology b. Are slightly larger than lymphocytes c. Are identified by the presence of CD3 cell surface marker d. Are identified by the presence of CD56 and CD16 cell surface
markers e. Are capable of killing virus-infected cells
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c. Light chains differ in each immunoglobulin d. Heavy chains are alike in all classes of immunoglobulins e. Contain a variable region and a constant region
76. The following terminologies indicate tissue necrosis a. Surgical amputation b. Postmortem examination c. Autolysis d. Gangrene e. Caseation
77. Complement a. Is a protein b. Is required for lysis of an antigen-bearing cell c. Is active in the destruction of microorganisms d. Protects against rejection of implanted tissue e. Brings about destruction of antigen-bearing cells by facilitating
phagocytosis
78. Graft rejection a. Is an immune response b. Antigen similarity increases the chance of rejection c. ‘T’-effector lymphocyte reacts with the graft tissue leading to
rejection d. Homograft rejection occurs in identical twins e. Homograft rejection occurs in non-identical twins where mixing
of the placental circulation has taken place in utero
79. The following terminologies about graft are correctly matched a. Autograft – is a tissue graft from the host’s own tissues b. Isograft – is a tissue graft from a donor to a host with different
genotypes c. Allograft – is a tissue graft from a donor to a host having the
same genotype d. Xenograft – is a tissue graft between members of different
species e. Homograft – is a tissue graft from a donor to a host with
identical genotype
80. The human major histocompatibility complex (MHC) a. Is divided into five classes b. Lies on the short arm of chromosome 6 c. Class I molecules are responsible for transplant rejection d. Class II region codes for complement protein e. Class III molecules are present on the surface of B cells
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rejection b. Class I molecules are expressed on all nucleated cells c. Type 1 diabetes mellitus occurs at a higher frequency in
individuals with the DR3/-4 haplotype d. Class I molecules are expressed on human red blood cells e. The genes of the MHC are equally inherited from each parent
82. The following statements about vaccines are true a. Haemophilus influenzae type b vaccine is 95% effective b. BCG (Bacille Calmette-Gue´rin) prevents pulmonary
tuberculosis c. MMR (measles, mumps and rubella) vaccine is a live attenuated
vaccine d. Hepatitis B vaccine is a live attenuated vaccine e. Vaccine against human papillomavirus (HPV) is a subunit
vaccine, composed of capsid protein
83. Vaccines that should be avoided in the immunocompromised patient include a. Yellow fever b. Hepatitis A c. Haemophilus influenzae type b d. Rabies e. Japanese encephalitis
84. Haemolytic disease of the newborn a. Is associated with a positive direct Coombs test in the cord
blood b. Is associated with an increased prothrombin time c. Is associated with jaundice after 24 hours d. Is associated with jaundice at birth e. Is characterized by the absence of erythroblasts in cord blood
85. Sex differentiation a. Sex-determining region on Y chromosome (SRY gene) is
responsible for the differentiation of the gonad to become a testis b. Individual with 46XY and a mutation with SRY gene will
develop ovaries c. The absence of Y chromosomes will promote an embryo to
develop into a male d. The presence of three X chromosomes and one Y chromosome
will lead to maleness e. The presence of five X chromosomes and one Y chromosome will
lead to femaleness
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c. Brings about the development of external genitalia in the male
during intrauterine life d. Deficiency of the enzyme required for its formation results in the
development of male internal genitalia (testis) e. Deficiency of the enzyme required for its formation results in the
development of female external genitalia
87. Genetic basis of hydatidiform mole a. Triploidy is seen in a partial mole b. Chromosomes are solely of maternal origin in a partial mole c. Fertilization of an ovum by two sperm results in a complete mole d. A partial mole occurs by fertilization of an empty ovum by two
sperm e. Chromosomes are purely of paternal origin in a complete mole
88. Sex chromatin a. Is derived from the Y chromosome b. Stains lightly with basic dyes c. Is seen in the metaphase cells d. Is seen in the interphase cells e. Is also called the Barr body
89. Lyon hypothesis (the principle of X chromosome inactivation) a. Only one X chromosome is active in the somatic cells of
mammals b. Inactivation of X chromosomes occurs in adult life c. Inactivated X chromosome is mainly of paternal origin d. Inactivated X chromosome is mainly of maternal origin e. Males do not have a sex chromatin or Barr body
90. During anaphase of mitosis a. Chromosomes move towards the equator of the spindle b. Cytoplasmic division begins by infolding of the cell at the
equator c. Two new chromosomes move apart, one towards each pole of
the cell d. Nucleoli disintegrate and disappear e. The nuclear membrane reappears
91. A mutational change in gene can be induced by a. X-rays b. Mustard gas c. Nitrous acid d. Formaldehyde e. Gamma rays from radium
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b. Sickle cell trait (HbAS) c. G6PD deficiency d. FyFy genotype in the Duffy blood group e. Sickle cell disease (HbSS)
93. In a standard 12-lead ECG a. Lead III is the signal between the aVL electrode on the left arm
and the aVF electrode on the left leg b. Lead aVF has the positive electrode on the left leg. The negative
electrode is on the left arm c. Lead V1 is placed in the fourth intercostal space (between ribs
4 and 5) to the left of the sternum d. A P-R interval of over 100milliseconds (ms) may indicate a first-
degree heart block e. The normal electrical axis lies between –308 and þ908
94. In obstetric ultrasound a. The abdominal probe most commonly used operates at a
frequency of 6-7.5MHz b. Lateral resolution is mediated by the beam width c. Increasing the frequency of the probe increases the field of view d. The transvaginal probe typically operates with a higher-
frequency probe than the abdominal probe e. The wavelength determines the axial resolution
95. As regards ultrasound and Doppler scanning a. Continuous-wave Doppler scanning is more commonly used in
obstetrics than pulsed-wave Doppler scanning b. Red colour denotes flow away from the transducer and blue
colour denotes flow towards the transducer in colour Doppler imaging
c. Aliasing is a technical artefact seen during use of pulsed-wave Doppler scanning
d. Doppler frequency is determined only by angle of insonation e. MI (mechanical Index), TIS (soft-tissue thermal index) and TIB
(thermal index for bone) indicate safety indices in the use of Doppler scanning
96. In urodynamics a. The rectal pressure probe measures the intra-abdominal pressure b. The bladder pressure probe measures the intravesical pressure c. Free uroflowmetry measures how fast the patient can empty their
bladder d. A cough or Valsalva manouvre can be performed to confirm
genuine stress incontinence e. Cystometry alone can demonstrate the reasons for voiding
difficulties
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b. Skin burns are more common with unipolar diathermy c. Options to cut, coagulate, desiccate or fulgurate rely on changes
in power and the electrical waveform d. To minimize the effects of muscle and neural stimulation, a
return pad is used for unipolar diathermy e. With unipolar diathermy the electric current preferentially runs
through the blood vessels
98. In radiotherapy a. b-Rays are composed of electrons b. Intracavitary radiotherapy (brachytherapy) works by the release
of particles that have high penetrating power c. Necrosis within tumours reduces sensitivity to radiotherapy d. Less differentiated tumours are more sensitive to radiotherapy e. Squamous cell carcinoma of the cervix is generally less sensitive
to radiotherapy than adenocarcinoma of the cervix
99. Imaging a. The dose of radiation used in an abdominal CT is approximately
ten times the dose of a plain chest radiograph b. No effects of MRI on the fetus have been demonstrated c. Ventilation-perfusion scan (V
. /Q . scan) performed during
pregnancy has less risk to the fetus than CT pulmonary angiogram in the diagnosis of a pulmonary embolus
d. V . /Q . scan performed during pregnancy has less risk to the
mother than CT pulmonary angiogram in the diagnosis of a pulmonary embolus
e. MRI has less movement artefact than CT
100. The risks involved in amniocentesis include a. Fetal puncture b. Amnionitis c. Amniotic fluid leakage d. Amniotic fluid embolism e. Miscarriage
101. Chorionic villus biopsy (CVS) a. Is associated with limb defect when performed after 9 weeks b. Is associated with miscarriage in 1-2% of the cases c. Is used as a screening test for Down syndrome d. Is associated with vaginal bleeding e. Is always done under ultrasound guidance
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gestational age b. Measurement of the biparietal diameter to determine exact
gestational age c. Measurement of the femur length to determine exact gestational
age d. Detection of gross fetal malformations, e.g. anencephaly e. Perform nuchal translucency scan to determine risk of Down
syndrome
103. The following abnormalities can be detected by ultrasonography a. Duodenal atresia b. Diaphragmatic hernia c. Renal agenesis d. Encephalocele e. Omphalocele
104. Clinical syndromes caused by chromosomal (autosomal) aberrations include a. Cri-du-chat syndrome b. Turner syndrome c. Edwards syndrome d. Klinefelter syndrome e. Patau syndrome
105. Klinefelter syndrome and cytogenetics a. Individuals with the condition are phenotypically male and show
absence of sex chromatin b. The error during gametogenesis can occur during the first
meiotic division c. The error during gametogenesis can occur during the second
meiotic division d. The error during gametogenesis is paternal in 90% of the cases e. Of all patients with this syndrome 80-90% have the karyotype
46XY/47XXY
106. The features of Turner syndrome include a. Epicanthic folds b. Coarctation of the aorta c. High-arched palate d. Short metatarsals e. Single palmar crease
107. The following are due to inborn errors of carbohydrate metabolism a. Pompe disease b. McArdle disease c. Lesch-Nyam syndrome d. Galactosaemia e. Tay-Sachs disease
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c. Is associated with cherry-red spot on the macula d. Is characterized by severe learning disability e. Is associated with deficiency of the enzyme sphingomyelinase
109. Wilson disease a. Is an autosomal dominant condition b. Can lead to cirrhosis of liver c. Can cause deposition of copper in the basal ganglia d. Is associated with an increase in the serum ceruloplasmin levels e. Kayser-Fleischer ring is seen in the retina
110. With regard to sickle cell haemoglobulin (HbS) in RBCs a. Low oxygen tension promotes sickling of these RBCs b. High oxygen tension promotes sickling of these RBCs c. Acidosis and dehydration promote sickling of these RBCs d. HbS is diagnosed by haemoglobin electrophoresis e. HbS differs from normal haemoglobin (HbA) in the a-chain
component
111. The following are true with regard to different variants of haemoglobin a. Haemoglobin Bart is made of four b-chains b. Haemoglobin H is made of four g-chains c. In haemoglobin C, glutamic acid is replaced by lysine at the sixth
amino acid position from the N-terminal end in the a-chain d. Haemoglobin S is made of two a-and two b-chains e. Haemoglobin A is made of two a-and two b-chains
112. Thalassaemia a. Is associated with characteristic facies due to hyperplasia of the
bone marrow in facial and skull bones b. Is associated with accumulation of only b-chains in the red cell
precursors c. Is associated with accumulation of only a-chains in the red cell
precursors d. Is associated with hypoplasia of the bone marrow, leading to
severe anaemia e. Is characterized by target cell appearance of red cells on
peripheral blood smear
113. With respect to ECG changes during pregnancy a. There is a left axis deviation b. May show high-voltage QRS complexes c. Ventricular systoles are common d. May show depression of the ST segment e. May show low-voltage QRS complexes
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b. Phenylketonuria c. Galactosaemia d. Cystinuria e. Histidinaemia
115. The following results of detection tests are correctly matched with X-linked disorders a. Increased serum creatine kinase – Becker muscular dystrophy b. Reduced G6PD in erythrocytes – maple syrup disease c. Reduced serum factor VIII – haemophilia B d. Increased serum phosphorus – vitamin D-resistant rickets e. Reduced steroid sulphatase – X-linked ichthyosis
116. Red blood cells a. Utilize glucose as a fuel b. Cannot survive without glucose c. Generate ATP by aerobic glycolysis d. Generate ATP by anaerobic glycolysis e. Generate ATP by fatty acid oxidation
117. Calcitonin a. Is a peptide that binds to osteoclasts b. Can be given by the oral route c. Can be given by the nasal route d. Promotes bone absorption e. Causes hot flushes and diarrhoea
118. Selective oestrogen receptor modulator (SERM) a. Reduces the occurrence of vertebral fractures by 30-50% b. Reduces occurrence of non-vertebral fractures by 50% c. Decreases the incidence of breast cancer d. Does not have any effect on endometrium e. Reduces the risk of coronary heart disease
119. The following antibiotics are correctly matched with their mode of action a. Clavulanic acid – inhibitor of b-lactamases b. Gentamicin – damages cytoplasmic membranes c. Tetracyclines – inhibit translation (protein synthesis) d. Cephalosporins – inhibit steps in cell wall (peptidoglycan)
synthesis e. Clindamycin – inhibits translation (protein synthesis)
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b. Boiling c. Autoclave d. Pasteurization e. Irradiation
121. Concerning meticillin-resistant Staphylococcus aureus (MRSA) infection a. Transmission can be prevented by appropriate hand hygiene b. Community-acquired MRSA strains display enhanced virulence
compared with hospital-acquired strains c. Includes strains of the bacterium that are resistant to meticillin,
but sensitive to cephalosporins d. MRSA and vancomycin-resistant enterococci (VREs) are the
most commonly encountered multiple drug-resistant organisms in patients residing in non-hospital health-care facilities
e. MRSA is sensitive to vancomycin and fusidic acid
122. Concerning hepatitis B virus (HBV) infection a. HBV surface antigen is detectable in the bloodstream 3-5 days
after infection b. The presence of HBV surface and envelope antigens in the blood
may indicate chronic infection c. The presence of HBV surface antigen is the best marker for
infectivity d. The antibody to HBV core antigen is the first antibody to appear e. The presence of antibody to the HBV envelope antigen (HBeAg)
increases the risk of transmission to the fetus
123. The following are important in the principles of DNA cloning a. Isolation of DNA sequence of interest b. Obtaining multiples of RNA from DNA c. Obtaining multiples of DNA from an organism such as a
bacterium d. Isolation of pure DNA in large quantities e. Isolation of pure RNA from DNA
124. The following are used as vectors in the DNA-cloning process a. Cosmids b. Bacteriophages c. Plasmids d. Nucleocapsid e. Yeast artificial chromosomes
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b. DNA polymerase is required for DNA replication c. Only a small quantity of DNA sequence of interest is enough to
produce millions of copies d. It gives large quantities of impure DNA e. The first step in the PCR process is denaturation of the genomic
DNA by heating at a high temperature to form single-stranded DNA
126. The following are true of ribonucleic acid (RNA) a. It is composed of two polynucleotide chains b. It is synthesized on a DNA template by transcription c. RNA polymerase enzyme is required for transcription d. Messenger RNA (mRNA) is produced in the cytoplasm e. Messenger RNA and transfer RNA (tRNA) are both involved in
protein synthesis
127. NHS cervical cancer screening: a. Women aged 20-64 should be screened every 2 years b. Women aged 25-49 should be screened every 3 years c. Women aged 50-64 should be screened every 5 years d. Women under the age of 25 should not be screened unless
already included in the screening programme e. Women over the age of 65 should be screened only if they have
not been screened since the age of 50
128. With regard to human papillomavirus a. HPV type depends on RNA homology b. Polymerase chain reaction (PCR) is used for its diagnosis c. HPV6 and -11 cause genital warts d. HPV33 and -35 are oncogenic e. HPV16 and -18 cause most cases of cervical cancer
129. Severe dyskaryosis a. Is caused by exposure to human papillomavirus b. Is characterized by large hyperchromatic nuclei on cytology c. Is characterized by pyknotic nuclei d. Is best treated by radical trachelectomy e. Is best treated by total hysterectomy
130. The following are advantages of liquid-based cytology (LBC) a. It dramatically increases the number of inadequate smears b. It reduces the workload for primary care trusts c. It reduces the workload for cytology laboratories d. The same sample can be used for chlamydia testing e. The same sample can be used for testing HPV
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c. Satisfactory colposcopy with HPV changes d. Suspicion of a glandular lesion e. Microinvasive disease
132. Complications of the knife cone cervical biopsy procedure include a. Secondary haemorrhage b. Premature rupture of the membranes c. Infection d. Preterm delivery e. Pre-eclampsia
133. Routine antenatal booking investigations in low-risk women include a. ELISA test for hepatitis B b. Blood group and antibody levels c. Biophysical profile d. Cordocentesis e. Fetal echocardiogram
134. With regard to antepartum haemorrhage (APH) a. It is per vaginal bleeding after 24 weeks of pregnancy but before
delivery of the baby b. Abruption is the cause when per vaginal bleeding occurs before
24 weeks of pregnancy c. Cervical cancer could be a cause of APH d. Vasa praevia is one of the recognized causes of APH e. Anti-D should be given to all women presenting with APH
135. Pre-eclampsia a. Is synonymous with proteinuric pregnancy-induced
hypertension b. Is due to inadequate invasion of the trophoblasts into the spiral
arteries c. Is associated with fetal macrosomia d. Is associated with hydrops fetalis e. Is associated with systemic lupus erythematosus (SLE)
136. The findings on obstetric ultrasound scan in fetuses with IUGR due to placental insufficiency include a. Increased liquor volume b. Increased weight of the baby c. Increased resistance index in the umbilical artery d. Absent end-diastolic flow e. Reversal of end-diastolic flow
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c. Position of the uterus d. Consistency of the cervix e. Station of the presenting part in relation to ischial tuberosity
138. The following fetal and placental factors are proposed for onset of labour a. Maturation of the fetal hypothalamic-pituitary-adrenal axis b. Secretion of adrenocorticotrophic hormone (ACTH) by the fetal
pituitary c. Secretion of cortisol by the fetal adrenal gland in response to
ACTH d. Secretion of corticotrophin-releasing hormone (CRH) by the
placenta, resulting in stimulation of the fetal adrenal gland e. Secretion of the hormone progesterone by the placenta
139. With regard to oxytocin receptors in the uterus a. The majority of these receptors are in the upper uterine segment b. They form the link between oxytocin in the fetal circulation and
the myometrial cells c. The sensitivity of the myometrial cells is dependent on the
receptor density rather than on just the increased output of oxytocin
d. The sensitivity of the myometrial cells is dependent on the increased output of oxytocin rather than on oxytocin receptors
e. Increased concentration of progesterone promotes formation of the oxytocin receptors
140. Physiology of myometrial contraction a. Oxytocin is responsible for the release of calcium in myometrial
cells b. The interaction between actin and myosin is triggered by the
release of calcium c. The interaction between actin and myosin promotes production
of the energy (ATP) required to initiate uterine contraction d. The contractions are stronger in the lower segment than in the
upper segment e. The contractions are initiated at the cornua of the uterus and are
strongest in the upper segment
141. Oxytocin a. Is produced in the hypothalamus b. Is stored in the anterior lobe of the pituitary gland until required c. Acts as a hormone as well as a neurotransmitter d. Is secreted continuously from the pituitary in late pregnancy e. Secretion is increased by the Ferguson reflex in labour
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c. Irregular menstrual cycles d. Type 1 diabetes mellitus e. Increase in sex hormone-binding globulin (SHBG)
143. In the UK, the following statements are true with regard to heavy menstrual bleeding (menorrhagia) a. Ninety per cent of women receive medical treatment before
referral to a specialist by a GP b. One in 20 women aged 30-49 consults a GP for menorrhagia c. It is the main presenting problem in at least 80% of those who
go on to have a hysterectomy d. At least half of all women who have a hysterectomy for
menorrhagia have a normal uterus e. According to NICE guidelines, menorrhagia is defined as
excessive menstrual loss that interferes with the quality of life
144. The following are recognized treatments of menorrhagia due to dysfunctional uterine bleeding (DUB) a. Tranexamic acid b. Myomectomy c. Uterine artery embolization d. Endometrial ablative procedures e. Mirena intrauterine system (IUS)
145. The causes of menorrhagia include a. Adenomyosis b. Copper intrauterine contraceptive device (IUD) c. Hyperthyroidism d. Von Willebrand factor deficiency e. Subserous fibroids
146. The causes of thrombocytopenia in pregnancy include a. Systemic lupus erythematosus b. Haemolytic-uraemic syndrome c. HELLP syndrome d. Disseminated intravascular coagulation e. Haemophilia
147. The laboratory diagnosis of disseminated intravascular coagulation (DIC) is made by findings of a. Decrease in fibrinogen b. Decrease in fibrin degradation products (FDPs) c. Increase in thrombin time (TT) d. Decrease in prothrombin time (PT) e. Increase in activated partial thromboplastin time (APTT)
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c. Bleeding time is prolonged d. APTT may be prolonged e. Factor VIII levels fall rapidly during the postpartum period
149. Thrombotic thrombocytopenic purpura is characterized by a. Aplastic anaemia b. Microangiopathic haemolytic anaemia c. Neurological symptoms d. Hypertension e. Thrombocytopenia
150. Malaria in pregnancy a. Can be caused by Plasmodium falciparum b. Can be caused by Plasmodium vivax c. Decreases the risk of premature labour d. Increases the birth weight of the baby e. Can result in congenital malaria by transplacental spread
151. Hyperemesis gravidarum a. Is a diagnosis of exclusion b. Is associated with deranged renal function tests c. May be associated with abnormal thyroid function tests d. Can lead to Mallory-Weiss tear in cases of prolonged vomiting e. Can be associated with Wernicke encephalopathy in severe cases
152. The following are physiological changes that occur during pregnancy a. Increase in oxygen consumption by 20% b. Increase in metabolic rate by 50% c. Decrease in functional residual capacity due to diaphragmatic
elevation in late pregnancy d. Increase in resting minute ventilation by 40-50% e. There is rise in arterial PCO2 and fall in arterial PO2
153. Risk factors for venous thromboembolism during pregnancy include a. Paraplegia b. Sickle cell disease c. Antithrombin III deficiency d. Long-haul travel e. Body mass index (BMI) more than 30
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b. Atelectasis c. Pericardial effusion d. Cardiomegaly e. Areas of translucency in under-perfused lung
155. The imaging studies that are used to make a diagnosis of pulmonary embolism during pregnancy include a. Ventilation-perfusion scan b. Computed tomography (CT) scan of the abdomen c. CT pulmonary angiography (CTPA) d. Venogram of both legs e. Duplex Doppler ultrasound scans of femoral and iliac vessels
156. The following statements are true with regard to antibodies in systemic lupus erythematosus (SLE) a. The most common autoantibody is anti-Rho antibody b. Antibodies against double-stranded DNA and anti-Smith
(anti-Sm) antibody are non-specific antibodies c. Anti-Rho and anti-La antibodies do not cross the placenta d. Glomerulonephritis occurs less frequently in women with
antibodies to double-stranded DNA e. Antinuclear antibody is seen in only 50% of the cases
157. The causes of seizures in pregnancy include a. Thrombotic thrombocytopenic purpura b. Intracerebral haemorrhage c. Cerebral vein thrombosis d. Withdrawal of recreational drugs e. Eclampsia
158. Myasthenia gravis a. Is caused by IgM antibodies directed against the nicotinic
acetylcholine receptor on the motor end-plate b. Is associated with weakness and fatigue of smooth muscle c. Is associated with diplopia and ptosis of the eyelid d. May rarely cause arthrogryposis multiplex congenita in fetus e. Diagnosis is made by administration of suxamethonium
159. Pemphigoid gestationis a. Is an autoimmune disease b. Is common during pregnancy c. Is a self-limiting condition d. Usually occurs in the third trimester e. Is associated with lesions around the umbilicus, unlike
polymorphic eruption of pregnancy
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c. Haemolytic-uraemic syndrome d. Massive abruption e. Puerperal sepsis
161. With regard to primary maternal cytomegalovirus (CMV) infection a. Most women are usually symptomatic b. It occurs in 10-20% of pregnant women c. The vertical transmission rate to the fetus is around 40% d. The fetal damage occurs in 90% of infected fetuses e. Recurrent CMV is always associated with fetal damage
162. The following viral infections are associated with high maternal mortality in pregnant women a. Hepatitis A b. Hepatitis B c. Hepatitis E d. Varicella-zoster e. Japanese B encephalitis
163. The following are true regarding maternal hepatitis C infection a. Caesarean section prevents the risk of transmission to the fetus b. Caesarean section reduces the risk of transmission to the fetus c. Caesarean section increases the risk of transmission to the fetus d. If acute maternal infection occurs in the third trimester, infection
is not transmitted to the fetus e. If the mother is positive for hepatitis C viral RNA, the risk of
neonatal infection is around 5-10%
164. With regard to Listeria monocytogenes a. It is a motile Gram-negative rod b. It can multiply at low temperatures c. It can cause meningitis in adults d. Of the healthy population 90% carry this organism in their
bowel e. Histological examination of the placenta shows miliary
granulomas and necrosis, when infection occurs during pregnancy
165. Mumps a. Is an adenovirus b. Is highly infectious c. Has an incubation period of 7 days d. Manifests mainly as meningitis e. Can be prevented by vaccination
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c. Can be obtained from fetal bone marrow d. Can be obtained from fetal liver e. Can be obtained from fetal neural tissue
167. The following are advantages of cord (umbilical) blood banking a. Cord blood is a rich source of haematopoietic stem cells b. Cord blood requires stricter criteria for tissue type matching
between potential recipient and donor than required for bone marrow donors
c. Cord blood recipients have more severe graft-versus-host disease than bone marrow recipients
d. Cord blood can be used for bone marrow disorders such as leukaemia
e. Cord blood can be used in metabolic disorders such as Hurler syndrome
168. With regard to the amniotic fluid during the second half of pregnancy a. Most of the fluid is obtained from active sodium and potassium
transport across the amniotic membrane b. Most of the fluid is obtained from active sodium and potassium
transport across fetal skin c. Only a minor amount is obtained from the respiratory tract d. Most of the fluid is obtained from the gastrointestinal tract e. Only a minor amount is obtained from fetal micturition
169. Active management of the third stage of labour is associated with a. Increase in the duration of the third stage of labour b. Decrease in the duration of the third stage of labour c. Increase in the proportion of women with blood loss of 500 mL
or more d. Decrease in the proportion of women with nausea and vomiting e. Increase in the proportion of women with nausea and vomiting
170. Antiphospholipid antibody syndrome (APS) during pregnancy a. Is associated with recurrent early pregnancy loss b. Can be associated with thrombotic events or a past history
of thromboembolism c. Is diagnosed by a blood test showing moderate-to-high titres
of IgG anticardiolipin antibodies d. Is associated with abnormal placental function, resulting in
fetal loss e. May be associated with placental changes of infarction, necrosis
and thrombosis in women with fetal loss
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not by the underlying condition or disease b. Near miss – a medical error that does not result in an injury c. Adverse event – the use of the wrong management plan to
achieve an aim or failure of an action to be completed as intended
d. Preventable adverse event – an adverse event caused by medical error
e. Serious untoward incident – an incident occurring within health service premises or in relation to the health service provided, resulting in serious injury to the staff or public or causing major permanent harm or an unexpected death of a patient
172. The following are the pillars of clinical governance a. Clinical audit b. Risk management c. Education and training d. Clinical effectiveness and research e. Patient and public involvement
173. With regard to the principles of the risk management process a. It is a process meant to improve patient safety and outcome b. It involves strategies to optimize the outcome of patient care c. It involves strategies to prevent or decrease risks that can lead to
potential harm to health and safety of patients d. The first step in the risk management process is risk identification e. Risk or incident reporting and monitoring of reporting also form
part of the risk management process
174. Clinical Negligence Scheme for Trusts (CNST) a. Is a management programme started in 1990 b. Provides indemnity cover for NHS bodies in England c. Is administered by the NHS litigation authority (NHSLA) d. Provides NHS trusts with a set of risk management standards
for maternity services e. Contributions are significantly lower than the equivalent
commercial premiums
175. With regard to pituitary prolactinomas a. Prolactinomas account for nearly 30% of the pituitary
adenomas causing tumoral hyperprolactinaemia b. Pituitary microadenomas are found in 10-20% of the normal
population as per autopsy studies c. Microprolactinomas are typically associated with prolactin
values .5000 mU/L d. Macroprolactinomas can cause visual field defect and cranial
nerve palsies e. Surgical treatment is the first-line management in cases of
microprolactinomas
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1a. True 1b. True 1c. True 1d. False 1e. True
Note Endoplasmic reticulum (ER) is of two types: (1) smooth ER, (2) rough ER. Rough ER is studded with ribosomes, which account for the basophilic granularity, and is responsible for peptide formation. Smooth ER is responsible for metabolism of small molecules, e.g. detoxification of drugs and poisons. They are present abundantly in hepatocytes where they also help in the synthesis of cholesterol and bile acid. Rough ER helps in the production of hormones and enzymes to be secreted outside the cell, as well as lysosomal enzymes for the digestion of phagocytosed particles.
