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A-Cytomegalovirus
B-Malaria
C- Rubella virus
D-Syphilis
E-Toxoplasmosis
Ans. B
In males, which of the following hormones facilitates the generation spermatoza?
A-Dopamine
B-Follicle-stimulating hormone (FSH)
C-Growth hormone
D-Somatostatin
E-Thyroid stimulating hormone (TSH)
Ans. B
From which of the following structures are the inferior parathyroid glands derived?
A-Mesoderm of first pharyngeal arch
B-Mesoderm of second pharyngeal arch
C-Pouch of first pharyngeal arch
D- Pouch of second pharyngeal arch
E-Pouch of third pharyngeal arch
Ans. E
A-Activates fibrinolysis
B-Increases the levels of plasminogen activators
C-Inhibits endometrial growth
D-Inhibits fibrinolysis
E-Promotes coagulation
Ans. D
Which of the following is not a known side effect of Tranexamic acid?
a-Allergic skin reactions
b-Diarrhoea
c-Pulmonary haemorrhage
d-Visual disturbances
e-Vomiting
Which one of these condition can b diagnosed using flourescent in situ hybrization?
A.duchenne muscular dystrophy
B.sickle cell disease
C.pataus syndrome
D.cystic fibrosis
E.tay sach disease
Ans. A
A 15-year-old adolescent female is brought into the pediatrician due to absence of breast development and short
stature. A karyotype is performed which reveals 46 XY. Which of the following is the most likely diagnosis?
A. Androgen insensitivity
B. Gonadal dysgenesis
C. Kallmann syndrome
D. Testicular atrophy syndrome
E-turner syndrome
Ans. B
Maternal serum inhibin A levels
a.decrease with increasing gestation age after 17 week
B.higher in women with a fetus affected by down syndrome
C.increase with increasing gestation age between 11-14 week
D.are unaffected by fetal down syndrome
E.plateau after 20 week gestation
Ans. B
double bubble of duodenal atresia. The hydramnios results from the inability of the baby to swallow. Duodenal
atresia is strongly associated with fetal Down syndrome. Gestational diabetes is associated with hydramnios
occasionally; however, duodenal atresia is not related. Rh isoimmunization can also lead to hydramnios and hydrops
but not duodenal atresia.
OGTT done at 26 weeks after 10 hrs fasting.patient is already taking metformin 850 mg TDS.
diagnosis?
Normal
GDM
Report
Fasting: 96 mg/dl
1 hr after 75g oral glucose : 176 mg/dl
2 hr glucose : 134 mg/dl
Ans. B
A child born to an HIV infected mother develops pneumonitis. Which routine rapid laboratory method is used to detect
Pneumocystis in bronchiolar lavage?
a) Direct light microscopy
b) Immunoflurescence microscopy
c) Bacterial culture
d) Detection of specific IgM
e) Quantitative molecular detection
ans. B
Case for discussion
36-year-old G1 P0 woman at 27 weeks gestation is noted to have fever, right flank tenderness, and pyuria. She is
diagnosed with pyelonephritis. A urine culture is performed. Which of the following is the most commonly isolated
etiologic agent causing pyelonephritis in pregnancy?
A. Proteus species
B. Candidal species
C. Escherichia coli
D. Klebsiella species
E . Staphylococcus
Ans. C
A 24-year-old G2 P1 woman at 39 weeks gestation presents with painful uterine contractions. She also complains of
dark, vaginal blood mixed with some mucus. Which of the following describes the most likely eti- ology of her
bleeding?
A. Placenta previa
B. Placenta abruption
C. Bloody show
D. Vasa previa
E. Cervical laceration
Ans. C
Which one of following is dangerous compilation of IUCD
A.PID
B.infection actinomysis Israeli
C.Ectopic pergnancy
D.bleeding
E.menorrhegia
Ans.c
Which class of drugs is antagonised by flumazenil
A . Antiemetics
B. Antipsychotics
C. Benzodiazepines
D. Neuroleptics
E. Opiates
Ans. C
During pergnancy which infection is associated with symmatrical IUGR?
A.CMV
B.toxoplasmosis
C.HSV
D.Rubella
E.vericella zoster
Uterine embolization is done in
a) Large fibroid
b) Multiple fibroids
c) Pedunculated fibroids
d) Submucous fibroid
A 31-year old G2 P1 woman at 39 weeks gestation complains of painful uterine contractions that are occurring every
3 to 4 minutes. Her cervix has changed from 1-cm dilation to 2-cm dilation over 3 hours. Which one of the following
management plans is most appropriate?
A.
Cesarean delivery
B. Intravenous oxytocin
C. Observation
Ans.c
Which one of the following options best describes the chromosome abnormality in an infant girl born with a webbed
neck, hypertension and an audible ejection systolic murmur?
A-Edwards' syndrome
B-Fragile X syndrome
C-Klinefelter's syndrome
D-Patau's syndrome
E-Turner's syndrome
Ans. E
what is the most common type of nosocomial infection in hospitals?
A. pneumonia
B. uti
C. surgical wound infection
D. bacteraemia
E. infectious diarrhea
ans. B?
a patient had hypophsectomy for pituitary tumor she has amenorrhea for 8 months ovulation induction can be done in
her by:
a)clomiphene citrate
b)pulsatile hCG
c)hMG
d)hMG followed by pulsatile hCG
ans. D
Which of the following structures of the fetal circulation becomes the ligamentum venosum after birth?
A- Ductus arteriosus
B-Ductus venosus
C-Foramen ovale
D-Umbilical arteries
E-Umbilical vein
Ans. B
How can the action of cyclizine be described?
a) 5-HT3 antagonist
b) H1 antagonist
c) H2 antagonist
d) H1 agonist
e) H2 agonist
ans. B
A 26-year-old woman completed a course of oral antibiotics for cysti- tis 1 week ago. She complains of a 1-day history
of itching, burning, and a yellowish vaginal discharge. Which of the following is the best therapy?
A. Metronidazole
B. Erythromycin
C. Fluconazole
D. Hydrocortisone
E. Clindamycin
Ans.c
which of most suggestive of placentl abruption in woman with APH at 36 week of gestation?
A.soft non tender abdomen
B
High head at term
C.painless vaginal bleeding
D.uterine contraction 8 to 10 mint
E.abnormal lie
ans. D
Which one of following is not recognized maternal complications of placenta previa
A.PPH
B.compilation of C/section
C.post partum sepsis
D.placenta accreta
E.prolonged labour
Ans. E
40-year-old woman undergoes amniocentesis for Down syndrome screening. The karyotyping was normal; however,
alphafetoprotein was found to be elevated. Which is the most likely pathology diagnosed by ultrasound scan?
a) Cleft lip
b) Congenital diaphragmatic hernia
c) Microcephaly
d) Spina bifida
e) Umbilical hernia
ans. D
Infection with which one of the following human papillomaviruses (HPVs) is associated with an increased risk of
cervical cancer?
A- 6
B-11
C-16
D-17
E-30
Ans . c
Trisomy 13 occurs in
A. 1 in 500 births
B. 1 in 1000 births
C. 1 in 2000 births
D. 1 in 5000 births
E. 1 in 20,000 birthd
Ans. D
Which of the following organisms may be isolated from a wet surface 6 hours after inoculation?
A. Candida albicans
B. Trichomonas vaginalis
C. Gardenerella species
D. Peptostreptococci
E-proteus species
Which of following test is recommended in initial assestment of women with urinary incontinence ?
A.pad test
B.fluid bridge test
C.ultrasound assment of residual volume
D.Q tip test
E.Bonney test
A.day 6
B.day8
C.day 13
D. Day 16
E.day 18.
Ans. C
A pregnanat woman in her second trimester asks for advice about malaria prophylaxis which is
true ?
A.docycyclin can b used in 3rd trimester
B.chloroquine should b avoided in the first and second trimester
C.mefloquine is the anti malerial of choice in pregnanacy
D.malarone is safe in all trimesters
E.folic acid should b prescribed for pregnant patient in taking proguanil
A 20 wks pregnant woman is newly diagnosed with thyrotoxicosis .which medication will be the most
appropriate for her :
A. Carbimazole
B. Propranolol
C. Propylthiouracil
D. Radioactive iodine
E. Thyroxine
Ans. C
Which of the following is least recognised as a cause of a false positive VDRL test?
A - Pregnancy
B - SLE
C - Oral contraceptive pill
D - Tuberculosis
E HIV
Ans. C
- A woman is admitted to the antenatal ward .you have been asked to prescribe thromboprophylaxis
for her.her body weight is 101 kg. Recommended prophylactic dose of enoxaparin :
A. 20 mg
B. 40 mg
C. 60 mg
D. 80 mg
E. 100 mg
Ans. C
A.aspirin
B.lidocaine
C.methadone
D.procaine
E.warfarin
Puerpureium sepsis is not assosciated with ?
A.beta hemolytics streptococus
B.staphy epidermidis
C.streptococcus faecalis
D.klebsella pneumonia
E.trichomonas vaginalis
Ans . e
Foetus can recongnise foreign antigen and rejects allografts ?
A.8weeks
B.12
C.14
D.16
E.18
Ans. B
-mechanism of tranexamic acid :
A-inhibits activation of plasmin
B -inhibits activation of fibrin
C -inhibits activation of fibrinogen
D -inhibits activation of plasminogen
E -inhibits activation of thrombin
Ans. D
A 35-year-old pregnant woman is referred to you for antenatal checkup.on a liver screen the following
results are obtained:
Anti-HBs Negative
Anti-HBc Positive
Hbs ag Positive
IgM anti-HBc negative
What is the patient's hepatitis B status?
A - Probable hepatitis D infection
B - Acute hepatitis B infection
C - Previous immunisation to hepatitis B
D - Chronic hepatitis B
E - Previous hepatitis B infection, not a carrier
Ans. D
A 19-year-old woman is reviewed in the genitourinary medicine clinic. She presented with vaginal
discharge and dysuria. Microscopy of an endocervical swab showed a Gram-negative coccus that
was later identified as Neisseria gonorrhoea. This is her third episode of gonorrhoea in the past two
years. What is the most likely complication from repeated infection?
A - Lymphogranuloma venereum
B - Cervical cancer
C - Arthropathy
D - Infertility
E - Uterine abscess
Ans. D
Alkylating agents like vincristine act against
a. Cell membrane
b. Mitochondria
c. DNA
d. Tubules
Ans. D
Ans.b
A 22-year-old woman who is an immigrant from Malawi presents for review as she thinks she is
pregnant. This is confirmed with a positive pregnancy test. She is known to be HIV positive. Which
one of the following should not be part of the management plan to ensure an optimal outcome?
A - Oral zidovudine for the newborn until 6 weeks of age
B - Maternal antiretroviral therapy
C - Encourage breast feeding
D - Intrapartum zidovudine infusion
E - Elective caesarean section
Ans. C
A pregnant 34-year-old female presents with uncomplicated Falciparum malaria following a trip to
Kenya. Which one of the following is the most suitable treatment?
A - Chloroquine
B - Artemether-lumefantrine
C - Doxycycline
D - Quinine
E - Atovaquone-proguanil
Which one of following statement regarding breech presentation is incorrect ?
A.ECV should b considerd at 36weeks in prmipara
B.maternal obesity is risk factor
C.vag delivery is option for delivery
D.describe caudal end of fetus occupying the lower segment
E.occurs around 3% of babies near term
The following are synthethised by liver: (t/f)
A) glucagon
B) vit.A
C) cholesterol
D) immunoglobulins
E) prothrombin
C,d,e are true
Which one of the following congenital infections is most characteristically associated with
sensorineural deafness?
A - Toxoplasma gondii
B - Parvovirus B19
C - Rubella
D - Treponema pallidum
E Cytomegalovirus
Ans. E
Tou are reviwieing the cervical screening results for 31 year old woman her previous smear have
been normal redults are mild dyskaryosis .sample is sent for HPV testing which is Positive what will
happen next ?
A.Offered colposcopy
A 29-year-old woman presents to the genitourinary medicine clinic for treatment of recurrent genital
warts. Which one the following viruses are most likely to be responsible?
A - Human papilloma virus 16 & 18
B - Human papilloma virus 13 & 17
C - Human papilloma virus 6 & 11
D - Human papilloma virus 12 & 14
E - Human papilloma virus 15 & 21
Ans. C
Which one of the following organisms is most contagious?
A - Varicella zoster virus
B - Epstein Barr virus
C - Rotavirus
D - Herpes simplex virus
E - Haemophilus influenza
Ans. A
A 22-year-old female presents with an offensive vaginal discharge. History and examination findings
are consistent with a diagnosis of bacterial vaginosis. What is the most appropriate initial
management?
A - Oral azithromycin
B - Topical hydrocortisone
C - Oral metronidazole
D - Clotrimazole pessary
E - Advice regarding hygiene and cotton underwear
Ans. C
A 31-year-old woman who is known to be HIV positive presents following a positive pregnancy test.
Her last menstrual period was 6 weeks ago. The last CD4 count was 420 * 106/l and she does not
take any antiretroviral therapy. What is the most appropriate management with regards to
antiretroviral therapy?
A - Check CD4 at 12 weeks and initiate antiretroviral therapy if CD4 count is less than 350 * 106/l
B - Do not give antiretroviral therapy
C - Start antiretroviral therapy at 20-32 weeks
D - Start antiretroviral therapy at 10-12 weeks
E - Start antiretroviral therapy immediately
Ans. C
ans. C
c. immunoreactive trypsinogen
d. karyotyping
Ans. B
Expected T score in a 90 yr old female
a. 2.5
b. +1
c. 0
d. -1
e. -2.5
Ans. E
A 35-year-old homosexual man is referred to the local genitourinary clinic following the development
of a solitary painless penile ulcer associated with painful inguinal lymphadenopathy. He has recently
developed rectal pain and tenesmus. What is the most likely diagnosis?
A - Herpes simplex infection
B - Syphilis
C - Granuloma inguinale
D - Chancroid
E - Lymphogranuloma venereum
Ans. E
Below is a list of genetic conditions.
Which of the following has an autosomal dominant inheritance pattern?
A. Haemophilia A
B. Incontinentia pigmenti
C. Klinefelters syndrome
D. Oculocutaneous albinism
E. Tuberous sclerosis
Ans. E
The inheritance of disorders is a relatively common exam question and needs to be memorized. Knowing the
inheritance of certain disorders is important for counselling parents regarding the risk of future children being affected.
Inheritance patterns:
Chromosomal abnormalities
Trisomy 21 (Downs)
Trisomy 13 (Patau)
Trisomy 18 (Edwards)
Turner (45XO)
Fragile-X syndrome
Klinefelters syndrome (47 XXY)
Autosomal dominant inheritance
Achondroplasia
Tuberous sclerosis
EhlersDanlos
Familial hypercholesterolaemia
Huntingtons disease
Marfan syndrome
Neurofibromatosis
Noonan syndrome
Osteogenesis imperfecta
Polyposis coli
Autosomal recessive inheritance
Congenital adrenal hyperplasia
Cystic fibrosis
Friedreichs ataxia
Galactosaemia
Haemochromatosis
Oculocutaneous albinism
Sickle cell disease
TaySachs
Thalassaemia
X-linked recessive inheritance
Redgreen colour blindness
Duchenne muscular dystrophy
Haemophilia A & B
Glucose-6-phosphate
dehydrogenase deficiency
X-linked dominant inheritance
Vitamin D resistant rickets
Incontinentia pigmenti
A 25-year-old woman has an early transvaginal ultrasound scan due to some per vagina brown
spotting with a positive pregnancy test. The scan showed no intrauterine pregnancy. She had two
hCG serum tests taken, the first on the day of her scan showed a result of 653 and the second 48
hours later had a result of 623. What is the most likely diagnosis?
A. Early intrauterine pregnancy
B. Ectopic pregnancy
C. Inevitable miscarriage
D. Missed miscarriage
E. Threatened miscarriage
Ans. B
Which one of the following uterine fibroid is incorrect ?
A. Bengin smooth muscle tumor of uterus
B.urinary symptoms
C.Undergo malignanay changes 1:200
D.occur in around 20% of white woman
E.more common in black woman
Ans. C
Ans. C
A newborn baby has a heel-prick blood test taken for Guthrie card screening.
Which of the following is not screened for on the newborn Guthrie card?
A. Congenital hypothyroidism
B. Cystic fibrosis
C. Diabetes mellitus
D. Phenylketonuria
E. Sickle cell disease
Ans. C
The national newborn screening programme was introduced in 1969 for phenylketonuria
(PKU) and in 1981 congenital hypothyroidism (CHT) was added.
Currently all babies in the UK will have a Guthrie card to screen for:
- PKU
- CHT
- Cystic fibrosis
- Sickle cell disease and thalassaemia
Medium Chain Acetyl Co-A Dehydrogenase Deficiency (MCADD an inborn error of metabolism where fat cannot be
broken down, resulting in low energy and hypoglycaemic episodes) screening has now also been approved and will
hopefully soon be nationalized.
The Wilson criteria describe the features of a good screening tool:
- The condition should be an important health problem
- The natural history should be understood
- There should be a recognizable latent or early symptomatic stage
- There should be an accepted treatment recognized for the disease
- Treatment should be more effective if started early
- There should be a policy on who should be treated
- Diagnosis and treatment should be cost-effective
The test/tool should be:
- Easy to perform and interpret
- Acceptable
- Accurate, reliable, sensitive and specific
- Case-finding shThis phagocytic antigen presenting cell present in the cervix:(not sure about the
answer)
g. Hofbauer
h. T-lymphocyte
i. Plasma cell
j. Kuppfer cell
k. Neutrophilould be a continuous process
.A urinary catheter is vigorously inflated in the urethra at the time of caesarean section. Urine leaks
from the rupture into which anatomical space?
a.Into the anterior abdominal wall and mons pubis
b.Into the lesser pelvis
c.Into the peritoneal cavity
d.Into the vagina
e.Laterally to the femoral triangles
ans. A
Ans. B
103. All the following are the about management of hypercalcemia except:
A. Iv saline
B. Frusemide 40mg iv
C. Prednisolone po
A 34-year-old diabetic woman attends your hypertension clinic to discuss her blood pressure control.
She is currently following lifestyle advice and has started to lose weight and maintain good glycaemic
control. Her blood pressure was 155/93 mmHg at her last clinic appointment and is now 150/90
mmHg. She informs you she has recently become pregnant, which was planned, and intends to keep
the baby.
The most appropriate first-line therapy is:
A. ACE-inhibitor
B. Angiotensin II receptor blocker
C. Calcium channel blocker
D. Diuretics
E. -blocker
Ans. C
A calcium channel blocker is first-line therapy in a female who intends to/or has become pregnant, as well as in
patients who are of African-Caribbean descent (with an ACE inhibitor). In a normal patient following lifestyle therapy
ACE inhibitors are first line, calcium channel blockers are second line followed by a combination of diuretics and
calcium channel blockers. -blockers are used if despite the aforementioned therapy target blood pressure is not met.
If there are any contraindications or poor compliance with ACE inhibitors, angiotensin II receptor blockers are used
instead.
95% CI = 80 2 x 5
95% CI = 70-90 kg