MRCOG PART 1 PRACTICE MCQ
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- The document discusses various topics related to embryology and fetal development including: fetal circulation patterns, fetal lung development, placental hormone production, fetal blood values at birth, and closure of fetal circulatory shunts at birth. - Key embryonic structures and their origins are outlined such as the pancreas (endoderm) and epidermis (ectoderm). Hormonal changes in pregnancy, lactation, and fetal development are also reviewed. - Lists cover topics like embryonic periods of organogenesis, fetal ultrasound milestones, hormonal markers in urine during pregnancy, blood cell counts at birth, and vitamin properties. Causes of various birth defects and clinical conditions are also mentioned.
MRCOG PART 1 PRACTICE MCQ
- 1. 1. True for aortic malformation A Patent ductus arteriosus B Coarctation of aorta C Double aortic arch D Abnormal origin of subclavian artery E Patent foramen ovale 2. Embryonic period is A 4-8 weeks B Period of organogenesis C When major malformation to the embryo can occur due to exposure to teratogen D Growth and differentiation of tissues E When morphogenesis of embryo occurs 3. Klinefelter Syndrome A Chromosome XXY pattern B Chromosomal make up may be XXXXY C Hypoplastic uterus D Streak Ovaries E oligospermia 4. A complete hydatidiform mole A Is pregnancy without embryo B Secrete human chorionic gonadothrophin C Show partial development of an embryo D Is diploid but contains only paternal chromosomes E Main causative mechanism has been shown to be monoeprmic fertilization of an anucleated eggs 5. 44 days (7 weeks)old human embryo A Genital ridge appears B Skeletal ossification begins C Sertoli cells begin to differentiate D Pigment appears in retina E Elbow and toe rays appear 6. Klinefelter Syndrome A Hypoplastic uterus B Streak Ovaries C Sex chromatin positive D Increase number of X chromosome associated with mental retardation E Female external genitalia 7. Endocardial cushion defect A Primary type atrial septal defect B Result of defective fusion of the septum primum with the endocardial cushion leaving a patent foramen ovale C A seldom seen abnormality D Complete endocardial cushion defect is een in 20% of all Down’s Syndrome -1-
- 2. E Associated with dextrocardia 8. Lateral plate mesoderm gives rise to A Serosal membrane that lines the coelom B Septum transversum C Somatopleuric mesoderm coating the inner surface of the body wall D Dorsal mesentery E The splanchnopleuric mesoderm ensheathing the gut tube 9. Complete duplicate ureters, the reasons A Premature bifurcation of ureteric bud B Two ureteric buds arised from mesonephric duct and penetrates the metanephric blasterma C Abnormality in the mechanism of mesonephric duct D Abnormality in the Weigwert Mayer’s rule E Defects in the interaction between ureteric bud and metanephric blasterma 10. Main cause of Potter’s syndrome A Bilateral renal agenesis B Oligohydramnios C Unilateral renal agenesis D Renal hypoplasia E Renal dysplasia 11. Spermatogenic cells A Sertoli cells B Spermatogonia C Spermatozoa D Spermatocytes E Spermatids 12. Fetal blood A α feto protein is a smaller molecule than albumin B The increased white cell count at term is due to polymorphonucleocyte C 1◦ megaloblastic erythroblast appears at 8/52 D The liver, yolk sac, bone marrow produces 2◦ erythroblastic megaloblasts after birth E Bone marrow and liver produce α chains 13. The following statement is not true A The foregut and hindgut are endodermal in origin B The superior mesenteric artery supplies the hidgut C The formation of peptidases in small intestines begins at 10/52 D The peristaltic movements begin at 30/52 E The acidification of stomach begins at birth 14. The following are true regarding oxytocin A It causes ascending contraction from the cervix to the fundus B The receptors in the uterus increase with gestation C The amplitude and frequency of uterine contraction is not proportionate to the -2-
- 3. D E dose Extremely high dose may cause insufficient blood supply to the fetus The usage in preeclamptic patient has to be with caution 15. Prostaglandin A Increases the uterine tone B Is a useful abortifacient C E2 is used for cervical ripening D Causes cervical relaxation E Inhibits gravid uterine contraction stimulated by oxytocin 16. Oxytocin A Inhibits milk production B Has vasodilator effect C Is used in induction of labour D Causes water retention E Is effective in treating menorrhagia 17. Ergometrine A Does not contract a postpartum uterus B Has vasodilatation effect C Inhibits emesis D Stimulates contraction of mioepithelium of mammary glands E Is effective in postpartum haemorrhage 18. Prostaglandin A E2α does not cause gravid uterine contraction B F2α relaxes a non-gravid uterus C Causes menorrhagia D Is effective in the treatment of dysmenorrhoea E F2α is synthesized plentifully in the uterus 19. The following statements are true regarding lactation A The alveolar septum secretes milk B The mineralocorticoid, prolactin and oxytocin are needed for maturation of the mammary gland C The enzyme specifier B lactalbumin is switched off by progesterone D Lactose synthesizing enzyme is a complex of galactocyl transferase and α lactalbumin E Lactose is synthesized in large quantity ante- and intrapartum 20. Breast milk A The carbohydrate content is the product of condensation of galactose and glucose B Almost 10% of human milk is fat C The main source of protein is casein D The colostrum has higher immunoglobulin than full cream milk E The electolytes content are all higher when compared with plasma -3-
- 4. 21. These methods suppress lactation A Oestrogen B Restricted fluid intake C Intermittent, reducing frequencies of expressing milk D Adequate breast support E Bromocriptine 22. The following are true A The milk energy content is 1000kCal/L B The cow’s milk has equal carbohydrate but more fat than breast milk C Milk ejection is a neuron-endocrine reflex D Psychological stress suppresses lactation E Lactational amenorrhoea provides contraception on in the first 3 months 23. The following are correct A Conceptual age = ovulating age +/- 14 days B The ovulatory age assumes fertilization at day 14 of any menstrual cycle C Menstrual age/ gestation = ovulatory age +/- 14 days D The trophoblast forms lacunae after the day of embedding E The connecting stalk following retraction of 2◦ yolk sac fron chorionic cavity is the definitive yolk sac 24. The following combinations are correct A Epidermis & appendages – ectoderm B Bladder & urethral epithelium – mesoderm C Pancreas duct and islet – endoderm D Connecting stalk – umbilical cord E Morula – Day 4 week 1 25. Fetal pituitary gland A Anterior pituitary – from Pouch of Rathke B Neural tube – from anterior lobe of pituitary C GH and prolactin – begins synthesis from second trimester D Parapharyngeal pouch IV – superior parathyroid (dorsal) E Pharyngeal pouch II – thyroid gland 26. The activity of the following endocrine glands are increased during pregnancy A Thyroid B Hypothalamus C Adrenals D Breasts E Pituitary 27. The normal endocrinological change occurring in pregnancy are A Increased ACTH B Increased prolactin C Increased thyroxine levels D Increased cortisol levels E Increased rennin levels -4-
- 5. 28. Hormone dynamics during pregnancy A The placenta cannot synthesise oestrogen from C-21 steroids B The placenta can utilize only C-19 steroids as precursors for oestrogen biosynthesis C The major of the oestrogen precursors is from the mother D Dehydroepi-androsterone sulphate originates from fetal adrenal E Placental sulphatase deficiency causes low oestrogen production resulting in deleterious fetal growth 29. The following statements aabout hormonal situation in pregnancy are correct A Maximal hCG levels are found between day 60 and 80 of pregnancy B HPL raises maternal blood sugar C Oestradiol accounts for 90% of oestrogen secreted in pregnancy D Progesterone levels decrease before birth E SP1 has an ovarian origin 30. Excretion of the following increases progressively from the 20th to 36th week of normal pregnancy A Oestradiol B Pregnanediol C Chorionic gonadotrophin D Pregnanetriol E Oestrone 31. The following increases in the urine during pregnancy A Oestriol B Progesterone C Vaninyl mandelic acid D Relaxin E Pregnanediol 32. During pregnancy A The output of maternal parathormone is increased B The placenta secretes relaxin C The corpus luteum begins to atrophy soon after implantation D The placenta can convert glucose into glycogen E There is negative nitrogen balance 33. In normal pregnancy A There are equal increases in the excretion of oestrone, oestradiol and oestriol B Serum hCG concentration rises to a peak at 20 weeks gestation C There is reduced aldosterone secretion D Androgen excretion is reduced E There is an increase in serum protein bound iodine 34. The following changes in the genital tract occur during pregnancy A Decrease vaginal pH B Cervical ectopy C Throphoblastic invasion of spiral arteries D The lower segment forms in the mid-trimester -5-
- 6. E Hyperplasia and hypertrophy of myometrial fibres occur 35. The following biochemical changes occur in normal pregnancy A Decrease in serum albumin B Decrease in serum IgG C Decrease in blood urea D Decrease in iron binding capacity E Decrease in total haemoglobin 36. In early pregnancy A The chorion leave is the precursor of the true placenta B The uterine cavity is obliterated when the decidua capsularis comes in contact with the decidua vera C The syncytiotrophoblast is in contact with maternal blood D Both vitelline veins will become umbilical veins E The zygote begins to embed in the uterus at the age of 3 days 37. During pregnancy there is an increase in the size of A Uterine muscle cells B Uterine fibrous and elastic tissues C Uterine blood vessels D Frankenhauser’s ganglion E Pituitary gland 38. Lactation A is initiated by a postpartum prolactin surge B Requires the presence of adequate circulating growth hormone C Is controlled by oxytocin D Inhibits ovulation in 50% of nursing mothers E Occurs inappropriately in the Budd-Chiari Syndrome 39. During pregnancy A Glycosuria is an effective test of carbohydrate intolerance B Fasting plasma glucose concentration is decreased C Fasting plasma insulin concentration is decreased D The oral glucose tolerance test alters with advancing gestation E Two hours after an oral glucose load, plasma insulin concentration should have returned to fasting levels 40. The following hormone shelp to maintain established lactation A Prolactin B Human placental lactogen C Corticosteroids D Oestrogen E Growth hormone 41. The following statements relate to the total oestrogen excretion in pregnancy A 30% of urinary oestrogens are conjugates of oestradiol B In defining the normal range of excretion, biological and assay variations are additive -6-
- 7. C D E Oestrogen excretion increases with parity Oestrogen excretion is higher in mothers with female fetuses A falling pattern of Oestrogen excretion within the normal range, is a reliable guide to fetal prognosis 42. Falling levels of total oestrogen in maternal urine during pregnancy may often indicate A Antepartum haemorrhage B Impending fetal death C Fetal adrenal hyperplasia D Fetal abnormality E Tobacco smoking 43. At birth A The foramen ovale closes immediately B The ductus arteriosus constricts in response to hypoxia C The pulmonary vasculature constricts vigorously in response to acidosis D Output from the left ventricle increases E Pressure falls in the right ventricle and pulmonary atery 44. The following are normal peripheral blood values at birth A Mean Hb of 12g/dl B Fetal Hb of 25% on electrophoresis C White cell count of 15,000 – 20,000 cu. Mm D Lymphocyte count of 90% of total white cell count E Serum bilirubin of up to 100 mmol/l 45. In the fetal circulation A The two umbilical veins carry blood from the fetus to the placenta for gaseous exchange B The oxygen content is higher in the umbilical artery than the carotid artery C Under normal circumstances, blood from the superior vena cava is minimally shunted through the foramen ovale D Ductus venosus is the first shunt for the oxygenated blood coming from the placenta E The circulation in the umbilical arteries and the placenta has lower resistance 46. Lack of surfactatnt in the infant lungs A Tends to be more marked the more prematurely is the infant born B Increases the tendency of the lungs to remain expanded despite the infant’s expiratory efforts C Leads to poor oxygenation of the blood before birth D Does not change the overall work of breathing E Prevents the delivery of fetus in pre-eclampsia at 34 weeks 47. Fetal respiratory movements in utero A Are normally present for 80% of a 24 hour period B Occur at a frequency of 2 per minute C Are increased in diabetic pregnancies D Are reduced by maternal hyperventilation -7-
- 8. E Are increased during labour 48. Fetal pulmonary maturity A Is delayed in diabetic pregnancies B Normally occurs before the 36th week of gestation C Is influenced by maternal corticosteroid levels D Is controlled by α fetoprotein E Is delayed in anencephaly 49. The following are Gram positive bacteria A Clostridium welchii B Mycobacterium tuberculosis C Neisseria meningitis D Bacillus anthracis E Vibrio cholera 50. The following blood coagulation factors are increased during pregnancy A Factor I B Factor VII C Platelets D Factor XIII E Factor X 51. The purine bases nucleic acids include A Adenine B Cytosine C Uracil D Guanine E Thymine 52. The following vitamins are fat soluble A Vitamin A B Vitamin B2 C Vitamin D D Vitamin K E Vitamin C 53. In normal thyroid physiology A The mammary gland can trap iodide B T4 is released from TBG by proteolysis C Thyroxine binding protein is a beta globulin D TBG has 3 times greater affinity for triiodothyronine E The normal range of protein bound iodine in the blood is 4-8 mcg per 100ml 54. The posterior relation of the ovary include A Ureter B Internal iliac artery C Ovarian artery D External iliac artery E Ovarian ligament -8-
- 9. 55. Transplacental transfer of blood constituents may cause neonatal disease, when the mother is suffering from A Hyperparathyroidism B Tuberosclerosis C Idiopathic thrombocytopenic purpura D SLE E Rheumatoid arthritis 56. The following are transported across the placenta A IgA B IgG C Calcium D Insulin E Pethidine 57. The rate of maternal-to-fetal oxygen flux across the placenta depends on A Uterine blood flow rate B Fetal oxygen consumption rate C The oxygen gradient across the placenta D Carbon dioxide transfer E Fetal haemoglobin 58. Normal urodynamic study A First sensation of micturition at 300ml B Residual urine 0-10ml C Maximum urine flow rate 100-150 ml/s D Voiding volume 200-300 ml E Bladder capacity >600ml 59. Which of the following have a dominant inheritance A Marfan’s Syndrome B Tuberous sclerosis C Spherocytosis D Sturge-Weber Syndrome E Blue/ green colour blindness 60. Human placental lactogen A Has a molecular weight of 21 600 B Has a half life of 15 minutes C Has no carbohydrate residues D Has two chains of amino acids E Is excreted in the urine 61. the following examples of teratogenic agents and their effects are correct A Phenytoin – nasal hypoplasia B Lithium – cleft palate, spina bifida C Irradiation – leukaemia D Quinine – optic nerve hypoplasia E Warfarin – cleft palate -9-
- 10. 62. The following description are correct A Chi- squared test – the standard test for comparing the difference between two means B F-test – the standard method for comparing the size of variances C Correlation – the relation between 2 variables D Mean – the most frequently occurring value E Standard deviation – the square of variance 63. the following features of Actinonyces Israeli are true A Gram positive B Aerobic C Mouth commensal D Causes unilateral salpingitis E Associated with ‘Dalkon Shield’ 64. The cardiovascular changes in pregnancy are A Increase stroke volume B Increase heart rate C All heart sounds are louder D First heart sound is split E A diastolic murmur is normal 65. The ECG done during pregnancy may show A High voltage QRS complexes B Deep Q waves C Inversion of T waves D ST depression E Ventricular extrasystoles 66. The vagina A Has 3 layers of cells B pH is normally acidic C Vaginal fluid has a higher potassium level D Vaginal fluid has a higher sodium level E Vaginal fluid may act as pheromones 67. The following associations are correct A Genital folds – labia majora B Genital swelling – Bartholin’s glands C Mullerian duct – ovary, fallopian tubes and uterus D Genital swelling – Bulbouethral glands E Genital tubercle – clitoris 68. The following nerve originates from the lumbar plexus A Superior gluteal B Genitofemoral C Pedendal D Obturator E Femoral - 10 -
- 11. 69. Addison’s syndrome A Hyponatraemia B Vomiting C Muscle wasting D Hypokalaemia E Metabolic acidosis 70. Pineal gland A Innervated by parasympathetic neurons B Secrete melatonin C Innervated by sympathetic pathways D Present in the roof of third ventricle E Vestigial gland in humans 71. Glucagon A Secreted by alpha cells of islets of langerhans B Single chain polypeptide C Secretion increases during exercise and stress D Glycogenolytic hormone E Ketogenic hormone 72. Human Chorionic Gonadotrophin A Has alpha and beta chain B Has molecular weight of 28000 C UPT detects urine B HCG D Similar to luteinising hormone E Secreted by corpus luteum in pregnancy 73. Amniotic fluid A Is alkalotic B Contains fetal epithelial cells C Is the transudate from fetal intracellular cells D Is acidic E Volume increases as pregnancy advances 74. Structures passing through the Greater Sciatic Notch below the piriformis A Internal pudendal neurovascular bundle B Posterior cutaneous nerve of the thigh C Tendon of obturator internus D Superior gluteal nerve E Inferior gluteal neurovascular bundle 75. Which of the following hormones promotes hypoglycaemia? A Epinephrine B Norepinephrine C Insulin D Glucagon E Glucocorticoids - 11 -
- 12. 76. Which of the following hormones stimulates gluconeogenesis? A Progesterone B Glucagon C Aldosterone D Epinephrine E Thyroxine 77. The citric acid cycle is inhibited by which of the following? A Fluoroacetate B Fluorouracil C Aerobic conditions D Arsenic E Malic acid 78. Which one of the following enzymes catalyses high-energy phosphorylation of substrates during glycolysis? A Pyruvate kinase B Phosphoglycerate kinase C Triose phosphate isomerase D Aldolase E Glyceraldehydes-3-phosphate dehydrogenase 79. Which are the ketogenic amino acids? A Leucine B Isoleucine C Phenylalanine D Tyrosine E Alanine 80. Tricarboxylic cycle (Krebs Cycle) A Occurs in aerobic B Occurs in the mitochondria C Net production of 2 ATPs D End product is carbon dioxide and water E Occurs in both aerobic and anaerobic conditions 81. The following are true A Human parvovirus B19 is associated with hydrops fetalis B Intrauterine infection occurs as a result of maternal herpes zoster C CMV is excreted in breast milk D Coxsackie A virus causes neonatal myocarditis E Hepatitis B virus is frequently transmitted to fetus during vaginal delivery 82. Lymphocytes in health A Form 2% of white cell count B Play an essential role in cell-medicated immunity C Can change into plasma cells D Have proportionately more nuclear material than cytoplasm E Have a life span of about 30 days - 12 -
- 13. 83. Common aetiological agents of salpingitis A Neisseria gonorrhoea B Bacteroides fragilis C E Coli D Chlamydia trachomatis E Salmonella sp. 84. The following are frequently associated with postpartum infection A Group B streptococcus B Staphylococcus aureus C Pseudomonas aeruginosa D Bacteroides fragilis E Eischerichia coli 85. Chlamydia trachomatis is associated with A Low sperm counts in men B Chronic pelvic pain in women C Asymptomatic endometritis D Recurrent salphingitis E Prostatic hypertrophy 86. Morphine A Is detoxified by oxidation to gentisic acid B Increases biliary tract pressure C Is eliminated mainly in conjugated state via glomerular filtrate D Is secreted in bile E Alters the threshold or responsivity of nerve endingd to noxious stimuli 87. In 28 days old embryo A Ureteric bud present B Otic vesicle and lens placode C Neural fold begins to fuse D Myocardium forms and hearts begins to pump E Spinal nerve begins to sprout 88. Which of these derived from derived from hypoblast A Extraembryonic endoderm B Amniotic membrane C Exocoelomic membrane D Heuser’s membrane E Extraembryonic endoderm 89. Wilm’s tumour A Is a nephroblastoma that contain mixed layer of cells and tissues B Is one of the most frequent neoplasm in children C Arised from abnormal gonadal agenesis D Is a type of benign tumour found in teenagers E Is associated with VAGR syndrome - 13 -
- 14. 90. Collagen A Has double helical structure B Shows regular banding pattern on electronic microscopy C Not found normally in absence of ascorbic acid D Is not found within basement membrane E Synthesis imhibited by glucocorticoids 91. High alpha fetoprotein is associated with A Seminoma B Hepatoblastoma C Embryonal carcinoma D Choriocarcinoma E Breast carcinoma 92. Extrabasal cells are commonly seen in smears of A Normal reproductive women B Postnatal period C Postmenopausal period D Pregnancy E Impending abortion 93. Features of secretory phase endometrium include A Supranuclear vacuolation of epithelium B Decidual change in stroma C Pseudostratification of columnar epithelium D Stromal oedema E Saw-tooth appearance of glands 94. Features of hydropic swelling in a cell are due to A Accumulation of fluid in cytoplasm B Dilatation of endoplasmic reticulum C Mitochondrial swelling D Swelling of nuclei E Disruption of Golgi apparatus 95. Examples of metaplasia include A Leukoplakia of vulva B Development of cystitis glandularis of urinary bladder C Intestinalisation of gastric epithelium D Development of carcinoma in situ in cervical epithelium E Ossification of scar tissue 96. In acute disseminated intravascular coagulation A PT and PTT are prolonged B There is presence of fragmented RBCs in peripheral blood film C Important part of management is treatment of the cause D Heparin may be useful E Thrombin time is not prolonged - 14 -
- 15. 97. Bromocriptine A Suppresses LH production B Causes headache C Is teratogenic D Causes postural hypotension E Is antiestrogenic 98. The effects of clomiphene include A Hot flushes B Transient blurring of vision C Abortion D Ovarian enlargement E Hirsutism 99. Combined oral contraceptives A Prevent menstruation if given continuously B Are contraindicated in pregnancy C Act mainly by preventing implantation of fertilised ovum D Depress secretion of anterior pituitary hormones E Increase body weight 100. Bacteriosis A Is due to Gram negative organisms B May be effectively treated with penicillin C May occur as transplacental infection D May be sexually transmitted E Presents in adults as a flu-like illness 101. The following structures are likely to be injured in submandibulectomy A Cervical branch of the facial nerve B Otic ganglion C Hypoglossal nerve D Lingual nerve E Retromandibular vein 102. The following statements are true of perianal suppuration A It arises from anal glands B It travels to ischiorectal fossa via the external sphincter C It passes intersphincterically to the perianal skin D Is found in ulcerative colitis E The surgical drainage leads to perianal fistula 103. The following are true of hypercalcaemia A It can present as an acute pancreatitits B Is commonly caused by metastatic lesion in the bones C Is lowered by calcitonin D There is a U wave in ECG E It can cause cardiac arrest - 15 -
- 16. 104. Regarding ambiguous genitalia A Palpable gonads with chromatin – True haemophradite (XX/XY) B Gonad not palpable with positive chromatin – CAH C Commonest cause of ambiguous genitalia – CAH D Incomplete 46XY gonadal dysgenesis – normal gonad E Klinefelter’s – 46XY/ 45XO 105. Regarding prescribing in pregnancy A Tetracycline is not contraindicated B Cotrimoxazole causes Grey Syndrome C Heparin crosses the placenta D Nitrofurantoin is harmful to the fetus E Warfarin causes chondrodysplasia 106. Regarding the gene A Unit of genetic information which is a Mendel’s factor B The protein polypeptide chains of gene is synthesized in the nucleus C Only riboxine and mRNA necessary for polypeptide synthesis D TATA box aids in mRNA polymerase II to the correct initiation site for transcription E Hybridization is not part of DNA diagnosis 107. These combinations are true A Autosomal dominant – Huntington’s disease B Autosomal recessive – Tuberous sclerosis C Autosomal recessive – monozygote carriers D Autosomal recessive – Albinism E Sex linked – father to son transmission 108. Regarding bacteria A Transition of losing the capsule is a R S transition B As the refractive index is less than H2O it is difficult to be visualized C The basis of typing in GMN is the Thecoic acid D The B lactamase is found in plasmic spaces E The hydrophobic nature of mycobacterium confers the acid fastness characteristics 109. Regarding fat A The density of fat is proportionate to protein content B Complexes composed of triglycerides and phospholipids C HDL transports the main bulk of plasma cholesterol D The synthesis of LDL is in the liver E HDL contains 50% protein mainly A1, A2 110. In the adult human A Plasma albumin is synthesized in the liver B Elevated serum lactate dehydrogenase (LDH) activity is a good indicator of liver damage C There are about 76g of protein per litre of plasma D Plasma fibrinogen is synthesized in the liver - 16 -
- 17. E An alpha 2 globulin synthesized in the liver is a substrate for renin 111. Coagulation of blood may me impaired A When factor VIII is deficient B When factor IX is deficient C When vitamin A is deficient D Immediately on administration of coumarin anticoagulants E By heparin which promotes inhibition of thrombin synthesis 112. Coagulation of blood A Is inhibited by plasmin B Is promoted by urokinase C Is inhibited by ancrod, a thrombin-like enzyme D Is inhibited by aminocaproic acid E May be promoted by aprotinin 113. In the skeletal muscle A Tetrodotoxin blocks membrane calcium channel B Thiocyanate ions lower the threshold for mechanical activation C Caffeine potentiates contraction by inhibition of phosphodiesterase D Beta 2 selective adrenoceptor agonists increase twitch tension in fast contracting fibres E Excessive circulating thyroid hormones cause tremors 114. D tubocurarine (Curare) A Is a competitive neuromuscular blocker B Causes a blockade which is intensified by neostigmine C Does not affect transmission in autonomic ganglia D Causes paralysis preceded by fasciculations of skeletal muscles E Produces a block at the motor end plate that is antagonized by potassium chloride 115. Cardiac sympathetic nerves A Have preganglionic axons arising from the lumbar segments of the spinal cord B Have postganglionic axons in three bilateral nerve trunks C Innervate cardiac pacemaker and contractile tissue only D Contain both afferent and efferent axons E Have postganglionic cell bodies entirely within the stellate ganglion 116. In an normal resting man, a bradycardia would be expected to occur following A Increased carotid sinus pressure B Increased right atrial pressure C Application of pressure to the eyeball D Intravenous administration of a large dose of atropine E inspiration 117. Angina pectoris may be ameliorated by A An effect of glyceryl trinitrate on coronary arterial perfusion of ischaemic myocardium B B adrenoceptor antagonist, such as propranolol C Administration of hyperbaric oxygen - 17 -
- 18. D E Oral administration of Verapamil Intravenous administration of Dobutamine 118. Essential aminoacids for adults include A Leucine B Phenylalanine C Histidine D Valine E Lysine 119. The following hormones are increased during pregnancy A Insulin B Parathyroid hormones C Calcitonin D Cortisol E Growth hormones 120. The following associations are correct A Chloramphenicol – Grey syndrome B Tetracycline – hypoplasia of primary teeth C Novobiocin – neonatal jaundice D Rifampicin – spina bifida E Chlorothiazide - thrombocytopenia 121. Spinbarkeit activity A Pertains to the arborisation phenomenon B Peaks following ovulation C Increases in activity in the proliferative phase D Is caused by the progesterone effect E Is taken in consideration in the Billing’s method 122. The early menstrual cycles in a woman reproductive life are usually A Anovulatory B Painful C Irregular D Has longer luteal phase E Before breast enlargement occurs 123. These are examples of primary chronic inflammation A Unresolving lobar pneumonia B Sarcoidosis C Appendiceal abscess mass D Tuberculosis E Leprosy 124. The following substances are recognized chemical mediators of inflammation A Histamine B Prostaglandin C Dopamine D Amiodarone - 18 -
- 19. E Kallidin 125. Benign, rather than malignant neoplasms are characterized by the following features A Increased numbers of mitotic figures B Microinvasion C Nuclear pleomorphism D Orderly maturation E Ability to metastasize 126. The following tumours are correctly matched A Burkitt’s lymphoma – a t-cell lymphoma common in Europe B Kaposi’s sarcoma – a vascular neoplasm associated with AIDS C Wilm’s tumour – an embryonal tumour of the kidney D Grawitz tumour – adrenocortical carcinoma E Ewing’s tumour – a malignant tumour of bone of uncertain histogenesis 127. Which of the following is NOT associated with thrombosis A Bleeding B Activation of the coagulation mechanism C Endothelial damage D Formation of platelet aggregates E Thrombocytopenia 128. In a patient with the following results: pH = 7.34, PCO2 = 29 mmHg, bicarbonate = 15 mmol/L Na = 134 mmol/L, Cl- = 90mmol/L, K+ = 4 mmol/L A B C D E The patient is hyperventilating The patient has respiratory alkalosis It could be at a compensated stage The anion gap is reduced In this patient, formation of ammonia in the kidneys will be increased 129. Concerning acid-base balance A The proteins are quantitatively most important buffers in the body B The renal H+ secretion mechanism depends on tubular acidity C The urine may be acidic during chronic vomiting D The chloride concentration will increase in chronic vomiting E The body K+ concentration will increase in chronic diabetic ketosis 130. The plasma concentration of HCO3- is low in A Compensated metabolic acidosis B Uncompensated respiratory acidosis C Compensated respiratory acidosis D Uncompensated respiratory alkalosis E Compensated respiratory alkalosis - 19 -
- 20. 131. Normal micturition A Depends on the integrity of a sacral spinal reflex arc B Is prevented by sectioning of the ensory nerves supplying the bladder C May occur with spinal transaction in the thoracic region D Relaxation of sphincters followed by detrusor contraction E Is under voluntary control in healthy young adults 132. The following are correct embryological associations A Germ cells – wall of the yolk sac B Mullerian duct – female genital tract C Mullerian duct – Garner’s cyst D Genital tubercle – clitoris E Metanephros - kidneys 133. Regarding puberty A Pubarche – onset of pubic hair B Adrenarche – elevation of DHA and DHAS C Menarche – before breast growth D Ovulation – after menarche E Pubertal growth – 45% of final adult height 134. Regarding the menstrual cycle A Corpus luteum regulates the constant postovulatory interval B LH stimulates follicular development C The mean duration of LH surge is 24 hours D The preceded increase of progesterone initiates LH surge E The raised level of progesterone 36 hours after LH surge indicates ovulation 135. Regarding the menopause A Climacteric is the first year of menopause B Average age of menopause in Asian women is 50.7 years C High levels of FSH result in the loss of follicular reserve D Sole primary phenomenon is decrease in ovulatory follicle production of oestrogen E There is a primary increase of FSH 136. Regarding mycology A The fungus is dimorphic B The yeast is a non-facultative organism C Biopsies are not useful for laboratory investigations D Tricophytons causes subcutaneous infection E Phyconicosis is a systemic infection related with immune suppressed patient 137. The following condition causes a rise in prolactin level A Exercise B Pain C Puerperium D Naloxone E Renal failure - 20 -
- 21. 138. In left ventricular heart failure A There is often peripheral vasodilatation B Salt and water retention is common C There is a tendency towards oedema in the feet and legs when standing D Cardiac glycosides may produce a diuresis E Left ventricular end diastolic pressure is reduced 139. In the process of blood coagulation A Prothrombin II is converted to thrombin IIa by platelet factor 3 B The role of thrombin is confined to the conversion of fibrinogen I to fibrin Ia C The initiating stimulus activates factor XII D The initiating stimulus may elevate plasma factor III levels E Defects in the final stages may be assessed by addition of thrombin to plasma 140. The following tissues are likely to regenerate following damage: A Cereberal cortex B Myocardium C Bone D Liver E Spinal cord 141. Granulation tissue A Contains fibroblasts B Always contain granulomas C Often occurs after acute short-lived injury to the liver D Contains thin-walled capillaries E Actively contracts 142. The following factors will delay healing of a bony fracture A Stabilisation B Infection C Malalignment D Interposed soft tissue E Paget’s disease of bone 143. In cell death by apoptosis A Cell membrane integrity is lost B Death of contiguous cell groups occurs C An inflammatory response is usual D There is energy-dependant fragmentation of DNA by endogenous endonucleases E Lysosome leak lytic enzymes 144. Phenylketonuria A May be detected using the Guthrie test B Is due to a deficiency of phenylalanine hydroxylase C Is characterized by hyperpigmentation of the skin D Occurs in 1:1000 infants in Britain E Is characterized by mental retardation - 21 -
- 22. 145. Dystrophic calcification A May occur in the absence of any derangement of calcium metabolism B May result in the formation of psammoma bodies C Is associated with hyperparathyroidism D Is associated with the ingestion of large amounts of milk E May lead to heterotopic bone formation 146. The following organisms characterictically induce a granulomatous inflammatory response A Mycobacterium tuberculosis B Staphylococcus Aureus C Treponema pallidum D Mycobacterium leprae E Streptococcus pneumoniae 147. Examples of aneuploidy are seen in patients suffering from: A Klinefelter’s syndrome B Cystic fibrosis C Edward’s syndrome D Huntington’s chorea E G6PD deficiency 148. The following statements is/ are true of carbohydrate metabolism A There is an increased rate of absorption of glucose in pregnancy B During mid and late pregnancy there is progressive rise in plasma insulin C The production of lactate from glucose or glycogen is dependent upon the presence of oxygen D Muscle glycogen is the main source of blood glucose E The fasting blood glucose concentration in pregnancy is greater than in the nonpregnant state 149. Chylomicrons A Are the lightest of the lipoproteins B Are not present in fasting plasma in a normal individual C Are rich in triacylglycerol D Are metabolized in the liver E Impart milkiness to the plasma if present in large numbers 150. Regarding glucose A Main organ of glucogenolysis in the muscles B Is not found in plants C The hexokinase is important for gluconeogenesis D Fructose-1,6-PIP is only found in the liver E Insulin inhibits lipolysis of adipose tissue - 22 -