mrcog sba's -2

8/18/2019 mrcog sba's -2

http://slidepdf.com/reader/full/mrcog-sbas-2 1/734

Q)

Q) Sq cell CA accounts for approxly how many

cases of vulval CA ? 90% Q) Chance of malignant transformation occurring

in premenopausal benign ovarian cysts is Mar!"#

!0%

Q) Adrenal Crisis – will present with shock syndromes in

combination with Hyponatremia, Hyperkalemia and

Hypoglycemia

Primary Mineralocorticoid Excess (Conn’s – can be d!e to

t!mor o" #ona $lomer!losa, which will ca!se Hypokalemia,

%icarbonate &etention and 'odi!m &etention,alkalosis

CAH 21-OH defcy

hyperkalemia,hyponatremia,hypoglyc,met acidosis

Addison’s Aldosterone def leads to non-anion gap hyperkalemic, hyponatremic,Hypercalcemia,uremia,eosinophilia,metabolic acidosis.

SIAH hyponatremia, lo! serumosmolarity and inapropriately high urineosmolarity.

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$ &he following combinations of bu'er system an( bo(y compartment of

ma)or action is correct* except+? A, -lasma # bicarbonate

., /.C # bicarbonate ,,ans *1b

C, 2ntracellular # protien

3, 4rine # phosphate5, /.C # 1b

o! see a )) year old lady in menopa!se clinic* +aking a history she tells yo! she gets

general aches and pains and has been worried abo!t diabetes as she is constantly thirsty*

therwise she has no signi"icant past medical history and is on no reg!lar medication* -o!

organise bloods and the res!lts are below* .hat is the likely diagnosis/ 0a 12) mmol3l

42*5 mmol3l

6r 7*8 mmol3l

Cr 59 mmol3l

E'& 1) mm3h

P+H 5: pg3ml (H;$H

H%A1C 25 mmol3mol

Ad<!sted calci!m 9*78 mol3l (H;$H

Parathyroid adenoma

'econdary hyperparathyroidism

+ertiary hyperparathyroidism

ME0 type 1

ME0 type 9

High P+H with hypercalcaemia is seen in Primary Hyperparathyroidism*Altho!gh t!mo!rs o" the parathyroid occ!r in ME0, parathyroid adenoma acco!nts "or =7>o" cases o" primary hyperparathyroidism*

High P+H with hypercalcaemia is also seen in tertiary hyperparathyroidism* +ertiary

hyperparathyroidism !s!ally "ollows a long period o" secondary hyperparathyroidism (mostcommonly d!e to renal "ail!re* +his patient has no medical history o" being !nwell or ha?inghad a long period o" renal impairment*Parathyroid

Hyperparathyroidism

Primary Hyperparathyroidism@ Excessi?e parathyroid hormone prod!ction by parathyroid adenoma*@ Ca!ses hypercalcaemia

'econdary Hyperparathyroidism@ 'econdary to hypocalcaemia

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@ P+H rises to try and correct calci!mCa!ses@ Chronic renal "ail!re@ Bitamin e"iciency (which leads to hypocalcaemia* 'e?eral ca!ses

+ertiary Hyperparathyroidism@ A"ter long periods o" excessi?e P+H secretion (i*e* long periods o" secondaryhyperparathyroidism the parathyroid gland secretes P+H a!tonomo!sly e?en i" the ca!se o"secondary hyperparathyroidism is corrected

Bitamin 4 is essential "or the synthesis o" D Bitamin A

Bitamin

Clotting "actor ;;;

Clotting "actor ;B

Protein '*ans

Bitamin 4

Bitamin 4 is a "at sol!ble ?itamin that is stored in the li?er and adipose tiss!es* ther "atsol!ble ?itamins are A, and E*

;t is essential "or the synthesis o"D Clotting "actors (F1:,(;F =, 7(B;;, 9 (;; (pne!monic 1=79D Proteins C, ' and #D steocalcin and $GA proteins

.hich one o" the "ollowing statements concerning breast cancer is correct/

A A $P with 9,):: patients will see on a?erage 9 new cases per year +his is the correctanswer % AlphaD"etoprotein is typically raised abo?e normalC '!rgery has been shown to impro?e s!r?i?al rates more than radiotherapy

+he "i?e year s!r?i?al o" all patients with breast cancer is less than ):>E +he incidence has been shown to be higher in women who ha?e had pre?io!s bilateraloophorectomy "or nonDmalignant disease

+he ann!al incidence o" breast cancer in the 64 is 1)7 per 1::,::: women (1*)7 per 1:::and a $P will see on a?erage 1: new diagnoses o" any cancer per year*AlphaD"etoprotein is raised in cancer o" the@ Gi?er @ +estis@ ?ary

@ Pancreas@ G!ng

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@ 'tomach, and@ Colon*C!rrent "ig!res s!ggest an 5:> "i?e year s!r?i?al o" all patients with breast cancer

$

Ans 3

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99*ans

27

! in !000;in !000 ,,,in !00000

5n(ometrial is !>D!00*000

Eulval is !,>D!00*000

$ (ome of bla((er from yol7 sac

#trigone from mesonephric (uct#bla((er from urogenital sinus

#ureter until collecting (uct are from ureteric bu(

# glomerulus an( tubules til the (istal convolute(

tubules are from mesonephric (uct

# urethal meatus from ecto(erm

$ &ype 2 foun( in s7in* fascia* tenson an( (entin &ype 22 foun( in cartilage

&ype 222 Freticulin foun( in s7in* bloo( vessels*

alongsi(e of type 2* embryonic (ermis*

uterus*fetus* heart an( granulation tissue*

&ype 2E foun( in .asement laminae of epithelial

an( en(othelial cells &ype E= cell surfaces hair an( placenta

! in bone (ermis ten(one

G cartilage

; fetal D car(iac D scarD synovium

H basement membrane

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&ype ! collagen ma7es "0% of total bo(y protein

H

$

$ #(ome of bla((er from yol7 sac

#trigone from mesonephric (uct

#bla((er from urogenital sinus

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#ureter until collecting (uct are from ureteric bu(

# glomerulus an( tubules til the (istal convolute(

tubules are from mesonephric (uct

# urethal meatus from ecto(erm

$ Eit A= functions for eye an( lungs ,lac7 of it

cause= night blin(ness

Eit 3= functions for bone an( teeth formation lac7

of it cause= ric7ets

Eit C=functions for gums *woun( an( also

increase immune system lac7 of it cause=

in6ammation of the tongue an( lateral margins

of the tongue an( gums that become swollen an(

re(Iscurvy

Eit5= functions for sex glan(s lac7 of it causes,

1emolysis an( sterility

Eit = functions for bloo( clotting lac7 of it cause

hameorraghe

Eit .!= functions= nervous system,lac7 = beri beri

Eit .G= functions= eye*s7in an( bloo(,lac7= slow

growth an( sore of eyes

Eit .H,functions,gums tongue ,lac7 of it ,blee(ing

$ Jhich stage of the cell cycle is a mitosis

procee(s?

Answer =K!

2n which stage cell prepare to enter into mitosis?

Answer =KG

3LA (amage chec7e( in ?

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Answer =K!

3LA histone synthesis centriole replication?

Answer = S phase

Cell become quiescent in ?

Answer =K0

Chromosomal stu(y (one in?

Answer = metaphase

$ ollowing are correctly matche( except #

AAC&1 G9 A A,,ans *;9

.prolactin !99 A A

Cgrowth hormone !9! AA

3leptin !@N AA

5none above

$

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or 1/&

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or 1/& #!" O ;0 D!00*000

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.rt oestrogen prod!ction d!ring pregnancy

AD Placental oestrogen prod!ction is independent o" "etaladrenal acti?ity%D +he placenta con?erts progesterone to oestradiol in early pregnancyCD +he placenta con?erts pregnenolone to oestradiolD +he placenta con?erts "etal HEA' to oestradiol * ansED +he addition o" a s!lphate gro!p to steroid hormonesenhances their biological acti?ity

P5S&/PK5L S5C/5&2PL

4n(er fetal control an( is a fun(amental feto#

maternal signalling mechanism

&he placenta lac7s !N#alpha hy(roxylase an( !N#

G0 (esmolase activity an( cannot convert CG!

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pro(ucts Fprogesterone D pregnenolone to C!9

pro(ucts Fan(rosten(ione D 315A

2n early pregnancy* the placenta utilises maternal

an(rogens for oestrogen pro(uction

.y G0 wee7s gestation* the ma)ority of placental

oestrogen pro(uction is from fetal 315ASulphate,

&he fetus rapi(ly sulphates steroi(s* preventing

biological activity,

&he placenta has an active sulphatase to remove

sulphate groupsetal 315A#S is converte( to oestra(iol an(

oestrone, &he placenta cannot pro(uce oestriol

from 315A#S

etal 315A#S is hy(roxylate( by the fetal liver to

!@#alpha#hy(roxy#315A#S, &his is then utilise( by

the placenta for P5S&/2PQ pro(uction, Pestriol isRrst (etectable at 9 wee7s gestation when fetal

a(renal glan( secretion of precursor begins, 2n

the absence of a normal fetal a(renal glan(*

maternal oestrogen concentrations are very low

Ffor instance* anencephaly P5S&/2PQ is the main

placental oestrogen, Pestra(iol an( oestrone are(erive( equally from maternal an( fetal

precursors

Maternal oestra32PQ levels are higher than in the

fetus

etal oes&/2PQ levels are higher than maternal

levels

-lacental aromatisation of maternal an(rogens is

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so e'ective that the fetus is protecte( from

masculinisation, 5xtremely high an(rogen levels

or non#aromatisable analogues are require( for

fetal e'ects

$ A la(y was sub)ecte( for a colposcopy in view

of her abnormal pap smear Rn(ings, &he

proce(ure is consi(ere( incomplete if which area

is not visualise(?

a, en(ocervix

b, ectocervix

c, transitional one

(, transformation one ,,ans

e, posterior fornix

;nternational ?arian +!mo!r Analysis (;+A has come

!p with a g!ideline to disting!ish benign "rom malignantt!mo!r ?ia !ltraso!nd* +he "ollowing are the "eat!res o"

benign t!mo!r on !ltraso!nd except a* !niloc!lar cyst

b* presence o" soild component 7mm

c* presence o" aco!stic shadowing

d* no blood "low

e* presence o" ascites**ans

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Q) Pap smear is a good screening tool "or cer?ical CA* +he

"ollowing are the I!alities it has, to be a good screening tool,

except a* simple,sa"e and acceptable

b* high sensiti?ity, high speci"icity with good predicti?e ?al!e

c* reprod!cible

d* ill de"ined c!t o"" le?els ans

e* cost e""ecti?e

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Q) Maternal ser!m HC$ le?els at the time o" the "irst missed

period

A 1: ;63G% 1:: ;63G *ansC ):: ;63G 1::: ;63GE 9::: ;63G

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Q)

Ans D

Q) 2) year old women attends clinic "ollowing laparotomyand !nilateral oophorectomy* +he histology shows m!cin

?ac!oles* .hat type o" t!mo!r wo!ld this be consistent with/

'ero!sM!cino!sansEndometrial

+ransitionalCear cell

Q)))Dy M is admitted to E with JtearingJ chest pain radiating

thro!gh to his back*Examn re?eals a P =8 3 min reg!lar, %P

12:35) K 9 sats D =7> on room air* A Cx& D mediastinal

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widening*A C+ shows dissection o" ascending aorta* .hat is

most s!itable initial Mx/A* ;B sodi!m nitropr!sside

%* ral ?erapamil

C* bser?e only* ;B labetalol **ans

E* '!rgical repair

Aortic (issection

type A # ascen(ing aorta # control .-F2E labetalol

I surgerytype . # (escen(ing aorta # control .-F2E

labetalol

$Mec7el8s (iverticulum is an a(ult remnant of

vitelline (uct, Jhich of foll embryonic structures

are )oine( by the vitelline (uct? A, oregut an(

yol7 sac., Mi(gut an( yol7 sac,ans

C, 1in(gut an( yol7 sac

3, oregut an( allantois 5, Mi(gut an(

allantois

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$&umor Lecrosis actor is pro(uce( by

a,&#lymphocytesans

b,. lymphocytes?

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$

Ans dDExcessi?e "l!id intake is ob?io!s, itJs not the

interpretation* 'ensory "!nction canJt be interpreted "rom

bladder diary* Lor cystitis yo! need a !rine c!lt!re* ;tJs not

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!rge incontinence as she has this only once* ;tJs o?eracti?e

bladder

.hat > age o" patients with breast CA ha?ehypercalcaemia D 1>

9D2>

)>

9:> ans

):>

)) y presents to clinic d!e to ?!l?al itch and

discolo!ration* examination re?eals pale white discolo!red

areas to the ?!l?a* A biopsy con"orms Gichen 'cleros!s (G'*

.hat is risk o" de?eloping 'CC compared to patients with

normal ?!l?al %x / :>

)>**********ans

)D1)>

9)>

1::> D histological "eat!res con"irm 'CC

Q) ;nner most layer o" testis D +!nica alb!genia

+!nica ?aginalis+!nica ?asc!losa*ans

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Q) which hormones shows di!rnal ?ariationN (t3" D a*estrogen b*progesterone

c*"sh

d*melatonin

e*cortisol**ans

Q) +he "ollowing ser!m markers inc in preg except*D +2

+OansProtein

Alkaline phosphatase*

+%$

$ Jhich ascen(ing artery can be (amage(

(uring open appen(icectomy? # a 2liolumbar

artery #

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b SuperRcial circum6ex artery

c 3eep,circum6ex artery, #ans

( Sup gluteal artery

Artery (amage( T (eep circum6ex iliac artery

Lerve (amage( T iliohypogastric nerve

$ Jhich test is most appropriate in (iagnosis

the thyroi( (ysfunction in pregnancy ? &S1

&hyroi( bin(ing globulin

Serum io(ine levelsSerum tri io(ithyronine F&;

ree thyroxine F&H ,ans

$ /obertsonian &ranslocation

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$ reciprocal &ranslocation

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$ &he ygot contain how many ceels when enter

the uterus? A, >,ans

., !@

C, ;0

3, !"0 cell

$ .rain liquifective,,,

i(ney n heart coagulative,,,

Qimb n gut gangrene,,,

at necrosis breast n pancreas

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Q) Mc ca!se o" breast l!mp in reprod!cti?e age is

A"ibro adenoma

%proli"erati?e breast diseaseans

Cd!ctal calob!lar ca

Ed!ctal papilloma

-roliferative breast (isease also 7nown as

Rbrocystic breast (isease most common cause of

breast cyst in repro(uctive age in "0 %$ Jhile performing laparoscopy the surgeon

i(entiRe( the me(ial umbilical fol(s on the (eep

surface of the anterior ab(ominal wall, &he G

me(ial umbilical fol(s represent remnants of

which of foll structures? A, 4rachus

., 2nferior epigastric vesselsC, Pbliterate( umbilical veins

3, Pbliterate( umbilical arteries,,ans

5, /oun( ligaments of the uterus

$ ollowing are the features of benign tumour

except =

a, slow growthb, presence of limiting capsule

c, aberrant mitotic formsans

(, able to function as original tissue

e, 2nability to sprea( beyon( tissue of origin

$ 1ow many telomeres are in the cell in

metaphase of mitosis? A, !

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., G

C, Hans

3, @

5, >

$ Jhich artery supplies (istal portion of roun(

ligament of uterus? ! , ovarian artery

G,ut artery

;,inf epigastric artery,,ans

$ J12C1 E5SS5QS CAL .5 -PSS2.QU 2LV4/53 2L &15 S4.C4&AL5P4S &2SS45 J15L A

&/ALSE5/S5 S4-/A-4.2C S2L 2LC2S2PL 2S

MA35? A, S4-5/2C2AQ 5-2KAS&/2Cans

., S4-5/2C2AQ C2/C4MQ5: 2QQ2AC

C, 355- C2/C4MQ5: 2QQ2AC

3, S4-5/2P/ 5-2KAS&/2C5, 2L5/2P/ 5-2KAS&/2C

Q) At what le?el o" H%A1 C the diabetic lady 'ho!ld not

concei?e D 18>

97>

25>

O1:> * ans)11>

$ Jhich of foll ligaments allows us to stan(

upright with a minimum of muscular support?A,

Sacrospinous ligament

., Sacrotuberous ligament

C, 2liolumbar ligament

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$

$ 1ow much percentage of the car(iac output

passes through the 7i(neys atterm? A, "%

., !0%

C, G"%,,,,,,,,ans

3, "0%

5, N"%

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Q) A 7 year old girl is bro!ght to see yo! by mother beca!se

girl has de?eloped breast and "ew p!bic hair *which o" the

"ollowing is best treatment "or her D Areass!rance

%ethinyl estradiolCgnrh analogans

HM$

Eexogeno!s gonadotropin

Q) +he proportion o" miscarriages that occ!r in "irst trimester

A* )D1:>

%* 1)D9:>

C* 9)D2:>

* O)D):>

E* 7)D5:>*******ans

Q)

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Q) in an a?erage pregnancy, how m!ch does cardiac o!tp!t

increase d!ring the 1st trimester/ :*)lit3min

1 lit3min

1*)lit3min *ans9 lit3min

doesnJt change

$

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$

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$

Classical bld test res!lts in Addison’s disease/

a* Hyperkalaemia, hyponatraemia, !raemia, hypercalcaemiaand basophila b* Hyperkalaemia, hyponatraemia, !raemia, hypercalcaemia

and eosinophila*ansc* Hyperkalaemia, hyponatraemia, !raemia, hypocalcaemiaand basophilad* Hyperkalaemia, hyponatraemia, !raemia, hypocalcaemiaand eosinophilae* Hypokalaemia, hypernatraemia, !raemia, hypercalcaemiaand eosinophila

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&he answer is 1yper7alaemia* hyponatraemia*

uraemia* hypercalcaemia an( eosinophila, Qac7

of mineralocorticoi(s results in re(uction of

so(ium reabsorption an( potassium excretion,

3ue to the loss of so(ium* there is associate(

water loss an( 6ui( (epletion* thus causing

uraemia an( hypercalcaemia,

$5xtremely anxious parturient requests labor

epi(ural analgesia,3uring epi(ural placement*

cerebrospinal 6ui( obtaine( in the nee(le

catheter,Jhich along spinal cor( (ose the nee(le

traverse obtaining CS lea7age from the nee(le

catheter? A, Eertebral canal

., Space between wall of vertebral canal an(

(ura mater

C, Space between arachnoi( an( (ura mater

3, Space between arachnoi( an( pia mater

5, Spinal canal

ALSJ5/ = Space between arachnoi( an( pia

mater # CS lea7age

Pption C is normal site for 5A

Q) +he blood test o" a 28DyearDold "ertility patient shows

ele?ated l!teinising hormone (GH le?els and high estradiol

le?els* .hat is the most likely ca!se o" this/

a* Hypogonadotrophic hypogonadism b* Midcycle GH s!rge**ans

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c* ?arian "ail!red* Polycystic o?ary syndromee* .eightDrelated amenorrhoea

+he answer is Midcycle GH s!rge* Polycystic o?ary syndrome

(PC' is associated with high GH le?els and !s!ally normal

estradiol le?els* ?arian "ail!re will res!lt in high GH le?els

b!t low estradiol le?els* Hypogonadotrophic hypogonadism

and weightDrelated amenorrhoea are associated with low GH

le?els and low estradiol le?els* PC' res!lts in a ratio o"

GH3LollicleDstim!lating hormone (L'H 1* +he blood testmay ha?e been taken midcycle* ;n this case we are not able to

diagnose PC' beca!se we do not ha?e a ?al!e "or L'H*

$enerally, women with PC' ha?e normal estradiol le?els*

$ Monopolar (iathermy cause coagulation e'ect

with spar7ling to stop the blee(ing vessels by

Jhich of the following proce(ures? A,

5lectrosurgical cutting

., 5lectrosurgical (esiccation

C, 5lectrosection

3, ulguration

5, Eaporiation

ALSJ5/ = ulguration

.hich hypothalamic hormone stim!lates release o" Prl /

a* opamine

b* $rowth hormone releasing hormone

c* $onadotrophinDreleasing hormone

d* 'omatostatin

e* +hyrotrophinDreleasing hormone * ans

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&he answer is &hyrotropin#releasing hormone,

&hyrotrophin#releasing hormone stimulates the

release of &S1 an( prolactin from the anterior

pituitary, 3opamine also release( from the

hypothalamus inhibits prolactin release

$ Jhen (oes the hypothamo#pituitary axis

establish in a growing fetus?a, !G wee7s

b, !@ wee7s

c, G0 wee7s,,ans

(, GH wee7s

e, G> wee7s

$Lv supply to perineal s7in 2nf rectal nerve

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$

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Q) +he physiological changes in preg are assoc with a change

in ser!m concn o" ?ario!s hormones* .hich test is most

appropriate in diagnosing the thyroid dys"!nction in

pregnancy/ A* Lree thyroxine (+O le?els *ans%* 'er!m iodine le?els

C* 'er!m triiodothyronine le?els

* +%$ le?els

E* +hyroidDstim!lating hormone

+he answer is "ree thyroxine (+O le?els*!ring pregnancy hepatic synthesis o" +%$ is increased*

+otal +O and +2 le?els are raised to compensate "or this rise*

+'H le?els "all in 1st trim as concn o" HC$ rise, howe?er they

may occasionally rise* +he le?els o" "+O are altered less in

pregnancy*

+he normal pregnancy range "or each trimester sho!ld be !sedin diagnosing or monitoring &x in cases o" thyroid disorders*

Pregnancy is assoc with a relati?e iodine de"iciency, which

has 9 m< ca!ses* Maternal iodine reI!irement increases

beca!se o" acti?e transport to "etoplacental !nit* Also there is

inc iodine excretion d!e to inc glomer!lar "iltration and dec

renal t!b!lar excretion*

Q) All o" "oll are tr!e abo!t 0+, except/

a ecrease in ALP**ans

b Polyhydramnios

c LA prophylaxis can decrease the risk o" 0+s

d +here is a O> chance o" 0+s in 9nd preg

e Can be detected by amnio centesis

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$ Jhich one of foll is rea(ily transferre( across

plac ?

A, &estosterone

., -&1

C, Eit 3ans

3, 2gM

5, Calcitonin

$ Jhich of the following pairing is not true in a

male?

a, ona glomerulosa # al(osterone

b, ona fasciculata # cortisol

c, ona reticularis # progesterone

(, ona reticularis # 315A

e, a(renal me(ulla O estrogen,,ans

$ !; w7s pregnant ;" year ol(# bhg (ecrease

# estriol (ecrease

# A- (ecrease = what u suggest the cause=

A, 3own syn(rome

., 5(war( syn(rom

C,misse( miscarriage ans

3, Lormal pregnancy

$ , .elow are the main actions of AC&1 except =

a, stimulate the synthesis an( release of

glucocorticoi(s

b, stimulate the synthesis an( release of

an(rogens

8/18/2019 mrcog sba's -2


c, stimulate the synthesis an( release of

mineralocorticoi(s,,ans*

mineralocorticoi(s are regulate( by renin#

angiotensin system

(, increase the activity of cholesterol esterase

e, facilitate the transport of cholesterol into

mitochon(ria

$ &he /CPK (eRne septic shoc7 as the

persistence of hypoperfusion (espite a(equate

6ui( replacement therapy, Jhat is the mortality

rate in patients with septic shoc7?

"%

!0%

G0%

;"%

@0%,,,,,,,,,,,ans

Q) what >age o" cardiac o!tp!t goes to kidneys at term/

A*9)>

%* ):>*********ans,2::ml3min

C* 7)>

$ followng r en(o(ermal in origin? a,heartb,spleen

c,a(renal cortex

(,(ermis

e,germ cells ans

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Q) A 18 year old girl is !nder yo!r "ollow !p in yo!r growth

and de?elopment clinic* -o! examined her breast and noted

areolar enlargement with breast b!d* .hat is her +anner

staging/ a* 1

b* 9**ans

c* 2

d* O

e* )

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Q)

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$ Jhat 7in( of cells pro(uces parathyroi(

hormone F-&1?A, Chief cells ,ans

., -arathynotic cells

C, Pxyphilic cells

3, C cells

5, ollicular cells

$ Jith regar(s to the (evelopment of the

alimentary system* which of the following is true?

a, embryonic foregut is supplie( by the coeliac

artery

b, mi(gut inclu(es the secon( part of (uo(enum

c, hin(gut incorporates the appen(ix

(, Mec7el8s (iverticulum is a remnant of the

vitelline (uct,,ans

e, gut is (erive( from meso(erm

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$Kn/1 (ecapepti(e

$ Kn/1 is =

A, -ro(uce( by anterior pituitary glan(

., -ro(uce( by the posterior pituitary glan(

C, -ro(uce( by placenta,,ans

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3, -lays important role in supporting corpus

luteum

5, Klycoprotein

$

Ans C

Q)+he release o" C&H,AC+H K cortisol "ollows a circardian

rhythm* .hen is highest peak o" those hormones/ a* at night

b* early morning**ans

c* a"ternoon

d* mid a"ternoon

e* midnight

$ &he axial Rlament of the sperm tail has whattype of arrangement of Rlaments?!I"

!IN

;I"

NI"

9IG , ans

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$ growth n maturation of ( breast at puberty is

promote( by=a,estrogen,ans

b,progesterone

c ,insulin

(,cortisol

e,pth

$ Mast cells A, -ro(uce mast cell growth factor

., 2ncrease in bloo( in allergies

C, Mature in bone marrow

3, Secrete histamine an( heparinans

5, All of the above

$ 2n thalassemia mother is at 2nc ris7 of all of

the following except # A(iabetes

.car(iomyo pathy

Chypothyroi(ism33E&

5hyperparathyroi(ism , ans

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$

Ans C,C

Q) A patient was seen in yo!r clinic and was diagnosed o"

ha?ing pit!itary adenoma* 'he was re"erred to anophthalmologist beca!se she complained o" bl!rring o" ?ision

o?er the past 2 months* .hich wo!ld be the "inding o" the

ophthalmologist/ ( blind spot is shaded pink

a* 1st image

b* 9nd image

c* 2rd image*ans,bitemp hemianopsia

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d* Oth image

e* normal "indings

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Q) +he HPB ?accine $ardasilQ is what type o" ?accine/

Gi?e atten!ated ?ir!ses

;nacti?ated ?ir!ses

+oxoid based ?accinePolysaccaride based ?accine

&ecombinant ?accine o" ?ir!sDlike particles (BGPs*ans

Q) ;n regards to an endocrine disorder, it is said to be a

a* primary disorder when the end organ is dys"!nctional

b* secondary disorder when "!nction is a""ected by de"ecti?e

pit!itary gland

c* both o" the abo?e

d* tertiary disorder when the hypothalam!s is dys"!nctional

e* all o" the abo?e**ans

Q) .hatJs the most important b!""er in interstitial space/

HC2D

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$

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$

Ans ! 3*G .*; 5

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$1-E types assoc with W rDo cx CA!@*!>*;!*;;

$ -ostoperative patient with history of 3M an(

asthma, (evelops some feeling of unwellness,

So(ium !!G m5qDQ an( other parameters were innormal range,Jhat is the (iagnosis? A, A((ison

(isease., Cushing syn(romeC, Conn8s

syn(rome3, S2A315, 3ehy(ration

Q) .hat percentage o" HPB in"ections will be cleared by the

host within 1 year/

)>9:>

):>

7:>**************ans

=:>

$ &he 7aryotype of a patient with An(rogen

2nsensitivity syn(rome is # , H@::

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,HN::U

, H":P

, H@ :U,ans

,H":U

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$ Concentration of this hormone pea7 in the Rrst

trimester an( again rise at term A, 2nhibinAans

., Action

C, 1CK

3, 1-Q

5, -rogesterone

$ Jhich one of the following is not rea(ily

transferre( across the placenta A, Aminoaci(s

., Klucose

C, &hyroxine,ans

3, 2gK

5, CAIG

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$

$ -recocious puberty is sai( to occur in a female

if pubertal changes occur before the age of = a, N

b, >ans *in males before 9

c, 9

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$ trigone of bla((er (evelops from = A,

mesonephric (uct,,ans

., urogenital sinus

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Enlarged hands and "eet, <aw prot!sion, dental

maloccl!sion, galactorrhea

Gisted abo?e are clinical "eat!re o" an endocrine disorder*How wo!ld yo! con"irm the diagnosis/

a* dexamethasone s!pression test b* corticotrophin testc* both o" the abo?ed* ?is!al "ield teste* oral gl!cose tolerance test*ans,acromegaly

$ Jhat is the fetal case mortality rate

associate( with listeria infection (uring

pregnancy?!%

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!0%

G"%,,,,,,,,,,,ans

"0%

9"%

$ -lacental hormone which is pro(uce( by the

syncytiotrophoblast but not by the

cytotrophoblast

A, 1uman chorionic gona(otropin,ans

., 1uman placental lactogen

C, 2nhibin

3, 1uman chorionic thyrotropin

5, 5striol

$ &erbutaline has a preference for stimulation of

which of the following receptors? A, Alpha

., KammaC, .eta !

3, .eta G ans

5, 3opaminergic

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3, Macrophagesans

5, Mast cells

$ !9 years ol( female presente( withammenorhea for ; months, She was previously

having normal menses, She also complaints of

hea(ache associate( with certain (egree of

vision loss, 3uring the G hours consultation* she

excuse( herself to the washroom for H times,

Jhat is the most probable (iagnosis = a,

prolactinoma

b, craniopharyngiomaans

c, acromegaly

(, A((ison8s (isease

e, Cushing8s syn(rome

menstrual (isturbance* hea(ache with vision lossan( (iabetes insipi(us are features of

craniopharyngioma, 2t is a tumour arising from

rath7e cleft Fembryogenic origin of pituitary

glan( an( most of the time benign,

$ vomiting=# meta al7alosis

(iarrhoea=# meta aci(osis

1ypo7elemia,, 1ypochloremia met al7alosisF(ue

to hypo7al in vomitings

$ Jhich of the following was a (isa(vantage of

(epoprovra

A2nc ris7 of hepatic ca.impairment of lactation

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Cprolonge( anovulation,,ans

3irreversible bone loss

5iron 3ef anemia

$

Ans A

Q) .hich o" the "ollowing is tr!e regarding PPJs

Amore e""ecti?e than in< contracepti?e

%may worsen acneans

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Cec risk o" o?arian cysts

contraindication in migraine

Emainly inhibit o?!lation

Q) Hyperplasia and hypertrophy o" al?eolar cell o" breast

d!ring pregnancy are stim!lated by which hormone

A estrone and hcg

% h!man placental lactogen and estradiol

C h!man placental lactogen and progesterone

prolactin and hplans

E prolactin and progesterone

Q) 0ormal ratio o" GHL'H/ 11

$ Jhich of these chromosomes have

centromere locate( at one si(e? A, &elocentric

chromosomeans

., Metacentric chromosome

C, 3icenteric chromosome

3, Submetacentric chromosome

5, Acrocentric chromosome

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$ Concentrations of this hormone pea7 in !st

trimester an( rise again at term? A 2nhibinA,ans

. Activin

C 1uman chorionic gona(otrophin

3 1uman placental lactogen

5 -rogesterone

At which stage o" preg are women at greatest risk o" se?ere

disease "oll H101 in"l!enRa in"ection/ A Lirst trimester

% 'econd trimester

C +hird trimester ** ans

9ODO5h postDpart!m

E OD8 weeks postDpart!m

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$ .loo( supply of the cx? A, 4t artery

ans., Eaginal a,

C, 2nternal pu(en(al a

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$ &he stan(ar( chest :#ray is equivalent to what

(uration of natural bac7groun( ra(iation # A, ;

(ays,ans

., ; wee7s

C, ; months

3, !> months

5, " years

$

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$ &rilaminar (isc forms in ;r( wee7

Anterior neurop closes at (ay G"4pper limb bu(s are forme( at (ayGG

$ Qymph no(e (rain of the upper anal canal =

A, 2nt iliac ans

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., 2nf mesentric

C, Sup inguinal

Q) Lrom what does the blastocyst hatch/ Corona radiataC!m!l!s oophor!s

Peri?itelline space

+rophectoderm

#ona Pell!cidaans

Q) +he "oll are all tr!e with regarding to labo!r EFCEP+

a Gabo!r typically occ!rs between the 27th and O9nd week

b +he 9nd stage o" labo!r is assoc with dilatation o" Cx**ans

c 2rd stge o" labo!r is inter?al betw del o" "et!s to del o" plac

d +he Cx is drawn !p into the G6'

e ;t is associated with the passage o" a m!c!s pl!g

Q) A woman is challenged with CCP, b!t does not getwithdrawal bleeding* .hich organ is most likely to be

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a""ected/ a ?eries

b 6ter!sans

c Pit!itary

d Hypothalam!se Lallopian t!bes

$ 2nci(ence of pheochromocytoma in pregnanc?

!D!000

!D!0*000

!D"0*000,,ans!D!00

X!D!*000

$ Jhat is % age change in ventilation (uring !st

trim ? G0% (ecrease

H0% (ecrease

G0% increaseH0% increase ,,ans

"0% increase

$ Jhat is overall change in airway resistance in

preg compare( to a non# pregnant woman?

3ecreases by !0%

3ecreases by "0%2ncreases by !0%

2ncreases by "0%

Lone of the above ,ans

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$ 2n regar(s to fetal circulation* which of foll has

the highest oxygen saturation? a, (uctus venosus

b, umbilical vein,ans

c, ascen(ing aorta

(, umbilical artery

e, pulmonary vein

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$&he foll (evelope( from urogenital sinus except

= a, urinary bla((er

b, prostatic urethra in male

c, genital organs

(, whole urethra in female

e, ureter ,, ans

Q) A woman comes to yo! 9 years a"ter her menopa!se

asking "or something to relie?e her PM syndromes* -o!

decide to gi?e her combined H&+* -o! explain to

her that all o" "oll are e""ects o" progesterone, except/

a 'he will ha?e preDmenstr!al like symptoms

b 'he will ha?e withdrawal bleeding e?ery month

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c Progesterone will oppose the action o" oestrogen on the

endometri!m

d Progesterone will potentiate the action o" oestrogen in

increasing HGanse Progesterone will a!gment the action o" oestrogen "or

pre?ention o" osteoporosis

$ &he mi(gut goes through rotation (uring its

(evelopment, Jhich structure provi(es the axis

for its rotation? a,ab(ominal aorta

b, coeliac artery

c, superior mesenteric artery ans

(, inferior mesenteric artery

e, pu(en(al artery

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$ A patient was seen in the M4 for a suspecte(

congenital malformation, Uou notice( that the

A- is raise(, Pn physical appearance* she loo7s

li7e she is in her late teens* multicolore( hair (ye

with multiple ear* nose an( tongue piercing, Uou

overhear( that she is a cocaine abuser, Jhat is

most probable (iagnosis of her fetus? a,

anancephaly

b, gastrochisisansc, spi(a biR(a

(, (own syn(rome

e, e(war( syn(rome

gastrochisis an( omphalocele are strongly

associate( with cocaine an( heroine abuse,

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$ A "G#y with Cushings syn(rome is referre( to

-AC prior to a E1,Jhich of foll is a feature of

Cushings syn(rome?

A 3ecrease( plasma lactate (ehy(rogenase

. 1ypoglycaemia

C 1ypo7alaemia ,,ans

3 1yponatraemia

5 Metabolic al7alo

$ Jhich of foll (rug combo shoul( be avoi(e( ?

A aspirin an( clopi(ogrel

. ethanol an( co#amoxiclav

C metformin an( chlorpromami(e

3 sil(enaRl an( isosorbi(e mononitrate

,ans

5 simvastatin an( fenoRbrate

$ Jhat is the Rnite life span of the corpus

luteum? > (ays

!0 (ays

!G (ays

!H (ays ,ans

!@ (ays

$ 2n regar(s to the (evelopment of heart* the

anterior (isplacement of the conotruncal septum

results in the occurrence of a con(ition 7nown as

tetralogy of fallot, Jhich of the following is the

feature of it? a, AS3

b, mitral stenosis

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c, pulmonary hypertension

(, pulmonary stenosis ans

e, left ventricular hypertrophy

$ Jhich of following is true of si(e e'ects ofvancomycin ?

A liable to occur with chronic liver (isease

. e'ects not seen when given orally

C unusual in el(erly

3 inclu(es irreversible vestibular (amage

ans5 inclu(es liver failure

$ An infant is born at term by LE3, Jhen the

baby is !> (ays ol(* he is brought to 53 by his

parents, 1e is E* severely (ehy(rate( an(

appears to be un(erwt, &he pae(iatricians

(iagnose a salt#wasting crisis an( are concerne(

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that he has a form of CA1,Jhat hormone

(eRciency is characteristic of this (isor(er? A

Cholesterol

. Cortisol,,ans

C 3ihy(rotestosterone

3 Pestra(iol

5 &estosterone

Me(ical (isor(ers in pregnancyG"0 Congenital

a(renal hyperplasia &his is an A/ (isor(er

a'ecting the synthesis of glu#cocorticoi(s an(

mineralocorticoi(s, 2n response to low levels of

these hormones* the pituitary glan( pro(uces

large amounts of AC&1 an( this results in

excessive pro(uction of sex steroi(s, A number of

enyme (eR ciencies can lea( to this con(ition=

the commonest is G!#hy(roxylase (eR ciency,

Many (i'erent gene mutations exist* which result

in vari#able clinical presentations,/x is

replacement with corticosteroi( IDO

6u(rocortisone, A'ecte( in(ivi(uals present in

several ways= Salt#losing crisis in neonate,

Masculiniation of female fetus Fambiguousgenitalia at birth, -recocious puberty in boy,

G 2f a couple has an a'ecte( chil(* ris7 in

subsequent pregnancies i

$ &he foll are all true with regar(s to -&Q

5:C5-&=

a &he fetus is typically (elivere( between GH an(

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Q) +otal pregnancy loss associated with CB' 1D9 >

Q) .hich o" "oll is tr!e o" common bile d!ct/ (Please select 1

option

AGies posterior to the portal ?ein

%Gies posterior to the second part o" the d!oden!m

CGies to the le"t o" the gastrod!odenal artery

Gies to the right o" the hepatic artery**ans

Epens into the third part o" the d!oden!m

Q) +he "ollowing are all risk "actors "or sho!lder dystocia

EFCEP+ a 'low progress in the "irst stage

b 'low progress in the second stagec Macrosomia

d Postmat!rity

e An !nderweight motherans

+able 1* Lactors associated with sho!lder dystocia

PreDlabo!rPre?io!s sho!lder dystocia MacrosomiaO*)kgiabetes mellit!sMaternal body mass index 2:kg3m9

;nd!ction o" labo!r

;ntrapart!mD Prolonged "irst stage o" labo!r 'econdary

arrestProlonged second stage o" labo!r xytocin

a!gmentationAssisted ?aginal deli?ery

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Q) &egarding so!lder dystocia, which is correct/

A* ;t is not assoc* with maternal M

%* Arrest occ!rs at pel?ic inlet

C* ;ncreased possibility i" epid!al anaesthesia gi?en* Most cases can be resol?ed by hyper"lexing the "etal thighs

onto the abdomen*

E* ErbJs palsy (C5D+1 is a complication*ans

Q) +ranspyloric plane passes thro!gh which ?ertebrae +11

+19

G1 **ans

G9

G2

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Q) !ring oogenesis which cell type has the greatest n!mber

o" chromatids/

ogoni!mPrimary ocyteans'econdary ocyteotid?!m

Q) 0ormal semen analysis (.H criteria 9::=@ Bol!me

1*)mG*@ Concentration 1) T 1:83mG* @ Progressi?e motility

29>*@ +otal motility O:>*

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Q)

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Q) .here does the primodial germ cell arise "rom / a* alantois

b* yolk sac * ans

c* syncytotrophoblast

d* gonadal ridge

e* paramesonephric d!ct

primordial germ cells arise "rom the cell wall o" yolk sac

d!ring second week o" de?elopment* in the 8th week, it

migrates to occ!py the gonadal ridge* Lail!re to migrates

ca!ses gonadal agenesis*

Q) ;n regards to the "ollowing, all are tr!e except a* epiblast "orms the ectoderm

b* hypoblast "orms the endoderm

c* amniotic ca?ity de?elops within hypoblastans,epiblast

d* the primary yolk sac deri?ed "rom hypoblast

e**the primary yolk sac is the main so!rce o" n!trition be"ore

the placenta takes o?er

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d* day 1:

e* day 19

Q)

which o" "oll represents the correct seI!ence which occ!rsd!ring "ertiliRation/ ; D "ormation o" Rygote

;; D "!sion o" oocyte and sperm cell membranes

;;; D completion o" meiosis in the oocyte

;B D sperm acti?ation and penetration o" corona radiata

B D attachment to Rona and penetration o" Rona pel!cida

a* ;B D BD ;; D ;;; – ;*ans b* B D ;B D ;; D ;;; D ;c* ;B D ;;; D B D ;; D ;d* B D ;B D ;; D ;;; D ;e* ;;; D ;B D B D ;; D ;

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$ &he al(osterone wor7s in= A, -C&

., 3C& ,, ans

C, Connecting (uct

+he 2rd pharyngeal arch gi?es rise to which o" "oll

str!ct!res/ +hrigeminal 0er?e

$lossopharyngeal ner?e**ans

Lacial ner?e

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Bag!s ner?e

M!scles o" mastication

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$

$ Qist of notiRable (iseases 3iseases notiRable

to local authority proper oYcers un(er the 1ealth

-rotection FLotiRcation /egulations G0!0= Acute

8/18/2019 mrcog sba's -2


encephalitis Acute infectious hepatitis Acute

meningitis Acute poliomyelitis Anthrax .otulism

.rucellosis Cholera 3iphtheria 5nteric fever

Ftyphoi( or paratyphoi( fever oo( poisoning

1aemolytic uraemic syn(rome F14S 2nfectious

bloo(y (iarrhoea 2nvasive group A streptococcal

(isease Qegionnaires (isease Qeprosy Malaria

Measles Meningococcal septicaemia Mumps

-lague /abies /ubella Severe Acute /espiratory

Syn(rome FSA/S Scarlet fever Smallpox &etanus &uberculosis &yphus Eiral haemorrhagic fever

FE1 Jhooping cough Uellow fever

$ &he inferior one#thir( of the anal canal

originates from which structure?Cloacal

membrane

5cto(erm of the procto(eum,ans

5n(o(erm of the hin( gut

5n(o(erm of the mi( gut

4rorectal septum

+he <!nction between the s!perior and in"erior part is

delineated by a pectinate line, <!st below the anal col!mns*

+he endoderm o" the hind g!t de?elops into the s!perior part

o" the anal canal*

Q)ATP produced in Ribosomes

Q) +he !rorectal sept!m is responsible in partitioning the

cloaca* .hat does the tip o" the !rorectal sept!m "orms/

a* lower 132 o" ?agina

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b* lower 932 o" ?agina

c* anal canal

d* perineal bodyans

e* external !rethral meat!s

Q)PKU in Uk 1 in 1:,::: births* inborn error o" protein

metabolism in the 64*

Q) +he "ollowing tiss!e are paired with the appropriate

primary germ cell layer except

a* mammary d!ct epitheli!m ectoderm b* epitheli!m o" the tong!e mesoderm*ans

c* pineal gland ectoderm

d* dermis o" the skin mesoderm

e* endometri!m mesoderm

$ &he axial Rlament of the sperm tail has what

type of arrangement of Rlaments? !I"

!IN

;I"

NI"

9IG ans

Q) &he intraembryonic coelom forms withinwhich structure?5n(o(erm

2nterme(iate meso(erm

Qateral plate meso(erm,,ans

Leural tube

Somites

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;n the second week o" de?elopment the lateral plate mesoderm

splits to create this ca?ity* ;t will "orm the space "or the

thoracic and abdominal ca?ity*

A 9O years old girl who is <!st recently married and not

emotionally prepared to concei?e a child* ;n order to pre?ent

pregnancy, she is taking mercilon as a contracepti?e method*

'he came to yo! today beca!se she had missed a pill "or 9O

ho!rs* .hat wo!ld yo!r ad?ice be/

a* discard this pack and start a new pack b* take the missed pill immediately and contin!e her c!rrent pack with one week pill "ree inter?al**ansc*take the missed pill immediately and contin!e her c!rrent pack with no pill "ree inter?ald* take the missed pill immediately and contin!e her c!rrent pack with 7 days additional contraception

e* contin!e this pack with no pill "ree inter?al

$ Jhat is the progestogen component in an

implant? a, (esogestrel

b, levenogestrel

c, etonogestrel,,ans

(, (rosperinone

e, norethisterone

.hat is the inner?ation to the sigmoid colon/ +)D+=

+1:311

+193G1*ans

G13G9

G93G2

8/18/2019 mrcog sba's -2


$ 1ow many oocytes are available at the time of

puberty? !G" 000

G"0 000ans*G"0*0000 to "00*000

"00 000

! million

G million

.hat happens in PE/ Metabolic acidosis

Metabolic alkalosis

&espiratory acidosis

&espiratory alkalosis**ans

Q) +here are a "ew processes or reactions that are important to

achie?e "ertiliRation* .hich o" the "ollowing is3are tr!e

a* capacitation makes the sperm capable o" penetrating the

o?!m b* acrosomal reaction release o" enRyme to "acilitate o?!m

penetration

c* Rona reaction pre?ent attachment o" any more sperm

d* cortical reaction aids the Rona reaction

e* all o" the abo?e*ans

Q) Mc organism "or s!rgical site in"ection/

A* 'taph a!re!s *ans

%* 'trepto pyogenes

A is 132 b!t % is 932

Q) .here in body is calcidiol prod!ced/ 4idneys

Gi?er ans

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Parathyroids

'kin

'pleen

Q) .ith regard to 0MU, what ca!ses a red!ction in release o"

Ach / Alc!roni!m

Aminoglycosideans

0eostigmine

'!xamethoni!m

+!boc!rarine

Q) &egarding Mg'O, the "oll statement are tr!e except

a* it acts at motor end plate and red!ces excitability o" ner?e

b* it acts on cell membrane and red!ces calci!m in"l!x into

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C 1ypotension* hyper7alaemia an(

hypernatraemia

3 1ypotension* hyper7alaemia an(

hyponatraemia ,ans

5 1ypotension* hypo7alaemia an( hyponatraemia

$ Acanthosis nigrecan most common seen in =

A, 4terian ca

., Pvarian ca

C, Stomach ca ,,ans

3, S7in ca

Lrom which germ layer does the Pancreas de?elop/

0e!ral t!be o" Ectoderm

0e!ral crest o" Ectoderm

;ntermediate Mesoderm

CoelomEndoderm**ans

$ A patient is foun( to have an en( systolic left

ventricular volume of ;0ml an( an en( (iastolic

volume of !!0ml, &he pulse rate is @"Dmin,Jhat

is the car(iac output* in litres per minute?

H,@H,>

",0

",Gans

",H

CP < SE[ 1/ c

SE < 53E# 5SE

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!!0#;0<>0 ml

Low >0 [@"<"G00 ml<",G Q

$ &he following isDare the correctcorrespon(ents between male an( female =

a, gubernaculum < ovarian ligament

b, gubernaculum < roun( ligament

c, both of the above,ans

(, penile glans < labia ma)ora

e, scrotum < labia minora

Q) Lrom which germ layer does myenteric plex!s o" $;+

de?eloped 0e!ral crest o" Ectoderm*ans

0e!ral t!be o" Ectoderm

Mesoderm

Endoderm

0one o" the abo?eQ) A )1Dy has been re"erred by her $P "or hot "l!shes and

night sweats* Her GMP was 8 w ago* 'he is concerned that she

may be going thro!gh the VchangeV and wo!ld like to go onto

H&+, beca!se her symptoms are !nbearable*.hich o" "oll is

tr!e regarding menopa!se/

;s associated with menorrhagia;s synonymo!s with the climacteric

cc!rs later in smokers

cc!rs on a?erage at age O)*) years

'ymptoms may occ!r long be"ore menstr!ation ceases

ans

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Q) A )9Dy with C!shing’s syndrome is re"erred to the

preassessment clinic prior to a BH*.hich o" "oll is a "eat!re

o" C!shing’s synd / A ecreased plasma GH

% HypoglycaemiaC Hypokalaemia

Hyponatraemia

E Metabolic alkalo

C!shing’s syndrome is a disorder o" high ser!m cortisol, +he

most common ca!se is exogeno!s administration o" steroid

hormones* C!shing’s disease re"ers to C!shing’s syndrome

ca!sed speci"ically by a t!mo!r o" the pit!itary gland, which

secretes large amo!nts o" adrenocorticotropic hormone,

leading to high cortisol* Patients may ha?e hyperglycaemia

and ins!lin resistance, ca!sing diabetes mellit!s* All o" the

abo?e are potential "eat!res o" C!shing’s syndrome, except

"or hyponatraemia* Lindingso" hyperglycaemia and

hypokalaemia may be accompanied by hyponatraemia as a

res!lt o" increased aldosterone le?els*

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Q) A O:DyearDold woman !ndergoes amniocentesis "or own

syndrome screening* +he karyotyping was normalN howe?er,

alpha"etoprotein was "o!nd to be ele?ated* .hich is the most

likely pathology diagnosed by !ltraso!nd scan/ Cle"t lip

Congenital diaphragmatic hernia

Microcephaly

'pina bi"ida**ans

6mbilical hernia

+he answer is 'pina bi"ida* Alpha"etoprotein is a glycoprotein

synthesised by three "etal str!ct!res the g!t, li?er and yolk

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sac* ;t is may be ele?ated in a de"ect o" the anterior abdominal

wall and the ne!ral t!be* As these de"ects are not co?ered by

skin, ALP "reely enters the amniotic "l!id "rom the "etal

circ!lation, leading to ele?ation o" le?els*

$ 3uring the (evelopment of mi(gut* which of

the following is true=

a, the mi(gut rotates a total of GN0 (egrees

cloc7wise

b, physiological herniation occurs (uring the Rrst90 (egrees rotationans

c, intestinal loops re enter completely into the

ab(ominal cavity (uring the secon( 90 (egree

rotation

(, the Rrst part to re enter is the appen(ix

e, the last part to re enter is the proximal part of

)e)unum

it rotates a total o" 97: anticlockwise* the "irst part to enter is

the proximal <e<!n!m and the last part is the caecal b!d

( which then "orms the appendix

Q) .hat enRyme con?erts androstenedione to estradiol/

) alpha red!ctaseCatalyse

C-P1= aromatase*ans

+ranscriptase

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Q) $l!cagon is stim!lated by which o" "oll/;ncreased 4etoDacids

Cholecystokinin**ans

'omatostatin

&aised 6rea

;ncreased "ree "atty acids

$l!cagon 'tim!lants

@ Hypoglycemia

@ Epinephrine

@ Arginine

@ Alanine

@ Acetylcholine

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@ Cholecystokinin

$l!cagon ;nhibitors

@ 'omatostatin@ ;ns!lin

@ 6raemia

@ ;ncreased "ree "atty acids and keto acids into the blood

Q) -o! see a 29 year old women in clinic who mentions she

has been sweating and has "reI!ent headaches* n

examination yo! note her blood press!re is 1=)31:) and p!lse

rate is 11:* -o! s!spect pheochromocytoma*

Pheochromocytoma acco!nts "or what percentage o" cases o"

hypertension/ :*1>********ans

:*)>

1>

9>

1:>

@ Pheochromocytoma is rare acco!nting "or aro!nd :*1> o"

cases o" hypertension*

@ +he rate o" pheochromocytoma is I!oted at aro!nd 1 in)O,::: pregnancies

@ 9:> are "amilial

@ +he maternal mortality rate is 9> to O> i" diagnosed in the

antenatal period, rising to 1O> to 9)> i" it is diagnosed

intrapart!m or postpart!m*

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$ autograft = tissue transferre( from one part of

the bo(y to another part in the same in(ivi(ual

isograft = tissue transfer in genetically i(entical

in(ivi(uals

allograft = tissue transfer from a genetically

(i'erent but similar species

xenograft = tissue transfer between (i'erent

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species

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Ans Mixed&aised PC9 and decreased HC2 both

contrib!ting to red!ced pH

Loll statements are correct regarding oppler systemexcept D A*Can monitor "etal breathing mo?ement

%*Can monitor "etal heart mo?ement

C*Contin!es wa?e doppler ha?e an excellent resol!tion**ans

*!plex contains both contin!o!s and p!lsed wa?es

E*Can shi"t signals "rom blood ?essels to be within the a!dibleso!nd wa?es

.hat is de"inition o" p!berty in girls/ e?elopment o"

p!bic hair

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e?elopment o" secondary sex!al characteristics

&eaching stage 9 o" breast de?elopment

'tart o" menses

%ecoming capable o" sex!al reprod!ction*ans

+'H is inhibited by which hormone/ +&H

Prolactin

$rowth hormoneDreleasing hormone ($H&H

'omatostatinans

LollicleDstim!lating hormone (L'H

Q) $alactopoiesis is maintained by which hormone/ xytocin

Lollicle stim!lating hormone

H!man placental lactogen

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d* +o o""er medical inter?ention as in patient

e* none o" the abo?e

-o! re?iew a 2: year old women in clinic whoJs thyroid"!nction tests ha?e demonstrated hypothyroidism* n taking a

detailed history she reports ha?ing "elt tired "or aro!nd 8

months and noticed some weight gain b!t there are no other

symptoms and no recent illness* Examination re?eals a nonD

tender hard goitre* L!rther bloods show antiDthyroid

peroxidase (antiD+P and also antiDthyroglob!lin (antiD+g

antibodies are present* .hat is the likely diagnosis/ e

!er?ains thyroiditis

$ra?es disease

+oxic di""!se goitre

HashimotoJs**ans

Endemic goitres

Q) At o?!lation the s!rge in GH ca!ses r!pt!re o" the mat!re

oocyte ?ia action on what/

+heca interna+heca externaans$ran!losa interna

$ran!losa externaGarge l!teal cells

+he l!teiniRing hormone (GH s!rge d!ring o?!lation ca!ses

@ ;ncreases cAMP res!lting in increased progesterone and

P$L9 prod!ction

@ P$L9 ca!ses contraction o" theca externa smooth m!scle

cells res!lting in r!pt!re o" the mat!re oocyte

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?arian Endocrine L!nction

Lollic!lar 'tr!ct!re G!teal 'tr!ct!re L!nctions+heca Cells +hecal G!tein Cells

(small l!teal @ Androgen (Androstenedione prod!ction

@ +hecal G!tein cells prod!ce progesterone

$ran!losa Cells $ran!losal G!tein Cells

(large l!teal @ Con?ert androgen to estradiol ?ia aromatase

@ $ran!losa G!tein cells prod!ce progesterone

&oles o" GH and L'H

@ L'H stim!lates Aromatase prod!ction in the gran!losa cells

@ GH stim!lates Androgen prod!ction in the theca (interna

cells

@ GH also stim!lates the contraction o" the smooth m!sclecells o" the theca externa* +his increases intra"ollic!lar

press!re which res!lts in r!pt!re o" the mat!re oocyte*

Q) -o! take some preDop bloods on a patient with AddisonJs*

.hich o" "oll abnormalities is mediated primarily by

gl!cocorticoid de"iciency/ Hypogylcaemiaans

HyponatraemiaHyperkalaemia

Hypercalcaemia

Metabolic acidosis

&emember in AddisonJs both gl!cocorticoid and

mineralocorticoid hormones are de"icient*

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+he main mineralocorticoid is Aldosterone* Aldosterone

sho!ld dri?e the 0a34 p!mp in the kidney and res!lt in

sodi!m and water retention with potassi!m being excreted*

;n aldosterone de"iciency potassi!m rises (hyperkalaemia asit isnJt adeI!ately secreted whilst sodi!m and water are not

reabsorbed (leading to ?ol!me depletion K hyponatraemia*

Aldosterone sho!ld also dri?e HW secretion in exchange "or

potassi!m* ;n de"iciency HW acc!m!lates leading to acidosis*

Bol!me depletion is tho!ght to be the main ca!se o"

hypercalcaemia*

Cortisol (hydrocortisone is the main gl!cocorticoid* ;t

stim!lates gl!coneogenesis* e"iciency can there"ore res!lt in

hypoglycaemia*

Q) -o! are called to assist in an initially M. led deli?ery*

6pon deli?ering a "emale baby yo! notice the baby has partial

"!sion o" labioscrotal "olds* -o! s!spect CAH* .hich o" "oll

genes is most likely to be m!tated/elta L):5

HEL9A

C-P91A**ans

C-P11%1

%&CA1

Q).hich o" "oll statements best describes MA o"

benRodiaRepines/

a* %enRodiaRepines acti?ate $A%A%Dreceptors in spinal cord*

b* +hey inhibit $A%ADtransaminase leading to increased

le?els o" $A%A*

c* +hey block gl!tamate receptors in hierarchical ne!ronal

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pathways in the brain

d* %enRodiaRepines increase "reI o" ClDDchannels opening

which are co!pled to $A%AA receptors*ans

e* +hey are directDacting $A%A receptor agonists in the C0'*

$oll shoul( be consi(ere( in patient going for

cDs except =

a, a(minister histamine antagonist an( antaci(

b, operation table is positione( 6at,ans* the

table shoul( be tilte( !" (egress to avoi(maternal hypotension from caval compression

c, ephi(rine be given if hypotensive after regional

anaesthesia

(, antiemetics given preoperatively

e, general anaesthesia inclu(es preoxygenation*

cricoi( pressure an( rapi( sequence in(uction

Q) 1emorrhage pro(uces which of foll ? A an

increase in CP

. causes splenic contraction

C inc al(osterone secretion ans

3 vaso(ilation

5 wi(e sprea( arteriolar (ilation -o! re?iew a 9= year old women in clinic who is noted to

ha?e a raised prolactin* 'he takes the "ollowing repeat

medications Amlodipine

Ll!oxetineans

mepraRole

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Paracetamol

&amipril

-o! s!spect a dr!g ca!se* .hich o" the abo?e medicationsis most likely to be responsible "or her raised prolactin/AmlodipineLl!oxetine*ansmepraRoleParacetamol&amipril

&here are several causes of raise( -rl

Fhyperprolactinaemia=

1ypothyroi(ism

C/

Qiver (isease

-regnancy

StressQactation

Chest wall stimulation surgery

3rugs FPpiates* 1G antagonists e,g, /aniti(ine*

SS/28s e,g, luoxetine* Eerapamil* Atenolol* some

antipsychotics e,g risperi(one an( haloperi(ol*

Amitriptyline* Methyl(opa an( Pestragenconatining compoun(s

1ypothalamus tumours

-rolactinoma

Agromegaly

-CPS

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$ &he L2C5 criteria which were change( in

ebruary G0!", Accor(ing to L2C5 -K of

",@mmolDl or above an( G hour glucose of N,>

mmolDl or above is (iagnostic,

Uou really nee( to rea( the question here as you

may be as7e( for the J1P criteria where the

levels are -K < N,0 mmolDl an( G1K < !!,!

mmolDl

$actors that re(uce QSCS rate=

# partogram with H hour action line

# 2PQ beyon( H! wee7

# involvement of consultant in ma7ing (ecision

for QSCS

# fetal scalp sampling

factor increase = C&K

factor (oes not a'ect =

#wal7ing in labour

#non#supine position (uring the secon( stage of

labour#immersion in water (uring labour

#epi(ural analgesia (uring labour

# the use of rasberry leaves

# early amniotomy

# active management of labour

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.hich o" "oll is 0+ a recognised ca!se o"

hyperprolactinaemia/H9 antagonists

Hyperthyroidismans

Chest wall s!rgeryPC'

Pregnancy

Aldosterone is responsible "or approximately what

percentage o" mineralocorticoid acti?ity in the h!man body/

)>

9)>

):>

7)>

=:>**********ans

Q) .hich o" "oll wo!ld be typical o" a patients with AddisonJs

Hypertension, hypokalaemia, hypernatraemiaHypotension, hyperkalaemia, hyponatraemia*ansHypertension, hyperkalaemia, hyponatraemiaHypotension, hyperkalaemia, hypernatraemiaHypotension, hypokalaemia, hyponatraemia

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Q)

Ans C

Q) 9O years old patient who is 1: week pregnant presented

with per ?aginal bleed and passing o!t ?esic!lar like str!ct!re*

Per abdomen, !ter!s is palpable at 1O week siRe* -o!

diagnosed her with a complete molar pregnancy* Lollowing

are tr!e except a* yo! expect a snow storm appearance on !ltraso!nd

b* yo! may expect a theca l!tein cyst on !ltraso!nd

c* it is O8FF o" both paternal origin

d* ;t is O8F- o" both paternal origin

e* it is 8=FFF o" all paternal origin*ans

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Q) &egarding hormone le?els in PC' which o" the

"ollowing is typical

Ele?ated L'HEle?ated 'H%$L'HGH ratio increased typically 9GHL'H ratio increased typically 9ans 0one o" the abo?e

$

Ans A

Q) A patient is seen in clinic 8 w pp* +he pregnancy was

complicated by intrapart!m haemorrhage reI!iring "l!id

res!scitation and a 9 6 %+* M!m reports "eeling ?ery tired,

str!ggling to lose baby wt and needing to bottle "eed d!e to

?ery low ?ol!me lactation* .hat is s!spected diagnosis/

Hyperpit!itarism

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elayed trans"!sion reaction

;diopathic hypothyroidism

'heehanJs 'yndrome

M

.hich o" the "oll ca!ses a decrease in 'H%$/

CCP

Hyperthyroidism

Anorexia

Pregnancy

besity**ans

ConnJs syndrome is the res!lt o" what/

Aldosterone de"iciency

Aldosterone hypersecretion*ans

Cortisol de"iciency

Cortisol hypersecretionPregnenolone de"iciency

.hat is mc ca!se o" acromegaly/ ME0 ;

ME0 ;;

Pit!itary in"arct

Pit!itary adenocarcinoma

Pit!itary adenoma*ans

A patient de?elops hypocalcaemia as a res!lt o"

pancreatitis* .hat is the appropriate homeostatic response to

hypocalcaemia/

;ncreased P+H, ;ncreased 1,9) dihydroxycholecalci"erol K

;ncreased phosphate

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;nc P+H, ;ncreased 1,9) dihydroxycholecalci"erol K ec phosphate**ans;ncreased P+H, ecreased 1,9) dihydroxycholecalci"erol K

ecreased phosphateecreased P+H, ecreased 1,9) dihydroxycholecalci"erol K;ncreased phosphateecreased P+H, ;ncreased 1,9) dihydroxycholecalci"erol K;ncreased phosphate

Qow calcium shoul( stimulate -&1 pro(uction by

the parathyroi(s

-&1 increases hy(roxylation of vitamin 3, 2t also

increases resorption of calcium in the 7i(ney in

exchange for phosphate hence the phosphate

level (rops,

.hich o" the "ollowing changes wo!ld yo! expect in pregnancy/

;ncreased +'H, ;ncreased +otal +2 and +O;ncreased +'H ecreased +otal +2 and +Oecreased +'H ;ncreased +otal +2 and +Oansecreased +'H ecreased +otal +2 and +O

0o change +'H ;ncreased +otal +2 and +O

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$

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Q) .hat role does messenger &0A play in the synthesis o"

proteins/

A* +ranscription

%* &e?erse transcriptionC* +ranslation

* &eprod!ction

E* &eplication

A0'.E& +ranscription

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Q)

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* krebs cycle

E* xidati?e phosphorylation

Q) A !N years ol( women is re'ere( by primarycare physician for the evaluation of primary

amenorrhea , on physical examination pt has sign

of viriliation, She has also a pelvic mass , 3uring

the wor7 up of pt she is foun( to have sex

chromosome mosaicism FH"xDH@ :U

Aimmature teratoma.serous a(enocarcinoma

Csertoli ley(ig cell

3granulosa cell tumor

5gona(oblastoma,,ans

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$ &estis (etermining factor

Q)

Q) .hich pharyngeal arch is closest to the head o" the

embryo/ 1stans

9nd2rd

Oth

8th

Q) .hat process changes a spermatogoni!m into a prim

spermatocyte/Meiosis 1

Meiosis 9

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i""erentiation

Mat!ration*ans

'permosis

@ 'permatogoni!m mat!re or grow into primary

spermatocytes (this process is also called

spermatocytogenesis

@ 'permatocytes !ndergo 9 meiotic di?isions to become

spermatids (this process is also called spermatidogenesis

@ 'permatids di""erentiate into spermatoRoa (this process is

also called spermiogenesis

Q) otidogenesis re"ers to which process d!ring ogenesis/

1st Meiotic i?ision

9nd Meiotic i?ision

1st and 9nd Meiotic i?isions*ans

i""erentiation$rowth and mat!ration

@ ogoni!m become Primary ocyte ?ia $rowth3Mat!ration*

+his process is called oocytogenesis

@ Primary ocyte !ndergoes 9 meiotic di?isions to become

otids* +his process is called otidogenesis

@ otids di""erentiate into ?!m

Q) .hat process wo!ld yo! expect a secondary spermatocyte

to !ndergo d!ring spermatogenesis/ 1st Meiotc i?ision

9nd Meiotc i?ision*ans

1st Mitotic i?ision

9nd Mitotic i?isioni""erentiation

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D'econdary spermatocytes !ndergo the 9nd meiotic di?ision

Primary spermatocytes !ndergo the 1st (or primary meiotic

di?ision

0+E +he process by which sperm !ndergoes the 9 meiotic

di?isions is sometimes re"erred to as spermatidogenesis

beca!se spermatids are generated by the processS

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Q)

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!ring "ormation o" the mid, "ore and hind g!ts the initial

g!t t!be !ndegoes rotation* .hich o" the "ollowing is correct

regarding rotation o" the midg!t d!ring this process/rotates =: degrees clockwiserotates 12: degrees anticlockwiserotates 15: degrees clockwiserotates 97: degrees anticlockwise**ansrotates 97: degrees clockwise

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!ring de?elopment o" the "etal g!t the intestine mo?es

o!tside o" the embryonic abdomen herniating into the base o"the !mbilical cord* +his occ!rs at aro!nd 5 weeks gestational

age* .hen the bowel is within the !mbilical cord, the midg!t

rotates =: degrees antiDclockwise* At approximately 1: weeks

the abdomen enlarges and the intestines ret!rn to the

abdominal ca?ity* nce ret!rned to the abdomen the midg!t

rotates an additional 15: degrees antiDclockwise completing a

97: degree anticlockwise rotation* ;t then "ixes to the

retroperitone!m*

At what age does physiological g!t herniation occ!r/ 1

week 2 weeks

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) weeks

5 weeks**ans

19 weeks

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$ &estosterone .in(ing = N0% testosterone

boun( to S1.K*

G"#;0% testosterone boun( to albumin

-ercentage free testosterone can vary

signiRcantly (epen(ing on the analysis metho(

use(, &ypical laboratory reference ranges are

Male !,"#;% an( female approx !%,

Q) +he ro!nd ligament de?elops "rom which str!ct!re/

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$!bernac!l!mans6rach!sAllantois

Medial !mbilical ligamentMedian !mbilical ligament

Q) .hilst re?iewing a 2O year old patient with amenorrhoea

in clinic they tell yo! they ha?e gained o?er 1:kg in weight in

the past 5 weeks and ha?e noticed worsening acne* &o!tine

bloods taken that morning show a random gl!cose

11*1mmol3l, normal thyroid "!nction tests and negati?e pregnancy test* %P is 1853=8 mmHg*

Addisons diseaseAddisonian crisisC!shingJs syndromeansLlammer syndrome

HyperthyroidismQ) .hich pharyngeal arch gi?es rise to no m!sc!lar or

skeletal str!ct!res/ 1st

9nd

2rd

Oth

)thans

Q)%ranches B9 and B2 o" +rigeminal n? de?elop "rom which

pharyngeal arch/ 1st**ans

9nd

2rd

Oth

8th

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+he 9nd pharyngeal arch gi?es rise to which o" "oll

str!ct!res/ Bag!s 0er?e

+hyroid cardilage

M!scles o" "acial expression*ans;ntrinsic m!scles o" larynx

+rigeminal 0er?e

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A %icorn!ate !ter!s is d!e to which o" the "ollowing/

Crossed "!sed ectopiaAbnormal "!sion and reabsorption o" the paramesonephricd!ctsansP4D1 gene m!tationsM!llerian agenesis 0one o" the abo?e

A .icornuate uterus Fheart shape( is the result

of abnormal fusion an( reabsorption of the

paramesonephric (ucts (uring embryogenesis,

Mullerian agenesis typically results in failure to

form a uterus, Mullerian (uct fusion abnormalities

can cause a bicornuate malformation,

8/18/2019 mrcog sba's -2


-3#! gene abnormalities are associate( with

-CPS,

Crosse( fuse( ectopia result in 1orseshoe 7i(ney,

'omites are deri?ed "rom which germ layer/ Endoderm

Ectoderm

;ntermediate Mesoderm

Paraaxial Mesoderm**ans

Gateral Plate Mesoderm

Somites are bilaterally paire( bloc7s of paraxial

meso(erm, &hey form along the hea( to tail axis

of the (eveloping embryo as shown in the image,

8/18/2019 mrcog sba's -2


2n the (eveloping embryo* somites split to form

(ermis of the s7in F(ermatomes* s7eletal muscle

Fmyotomes* ten(ons an( cartilage Fsyn(etomes

an( bone Fsclerotomes,

.hat is pre?alence o" H;B in 64 obstetric pop!lation/

:*) per 1::: li?e births

9 per 1::: li?e birthsans

1 per 1:,::: li?e births

9 per 1:,::: li?e births

) per 1:,::: li?e births

$ what is largest immune cell foun( in placenta?

a, & cells

b, . cells

c, neutrophils

(, (en(ritic cellse, natural 7iller cells,ans

placenta is rich with specialised 04 cells* normal 04 cells

are C 18 positi?e* %!t the 04 cells in placenta are C 18

negati?e and C )8 positi?e* Acti?ation o" C)8 positi?e 04

cells ca!ses prod!ction o" cytokines,chemokines and

angiogenics "actors that "acilitate trophoblastic in?asion,instead o" destroying it*

.ith regard to the cell cycle* ;n what phase do n!clear

en?elopes "orm aro!nd da!ghter chromosomes/ Anaphase

+elophase**ans

Cytokinesis

8/18/2019 mrcog sba's -2


Metaphase

;nterphase

Mitosis is where cell (ivision occurs an( thishappens in a the following phases=

-rophase Chromatin con(enses to

chromosomes Fpaire( as chromati(s, Mitotic

spin(le forms

Metaphase Chromati(s align at the equatorial

plane AA the metaphase plate Anaphase Chromoti(s pulle( apart into G

constituent (aughter chromosomes

&elophase Lew nuclear envelopes form aroun(

each (aughter chromosome

Cyto7inesis Cells (ivi(e

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Q) ;n imm!nology, there are two wings,namely the innate and

the adapti?e imm!ne system* +he interaction between this two

wings is essential to establish an e""ecti?e imm!ne response*

.hich cell acts as a bridge "or this two wings/ a* dendriticcells

b* nat!ral killer cellsans

c* ne!trophils

d* + cells

e* % cells

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Q) .hich antibody is predominantly responsible in asecondary imm!ne response/

a* ;g $**ans

b* ;g M

c* ;g A

d* ;g

e* ;g EQ) .hich part o" an antibody determines its speci"icity/ a*

Lab ** ans

b* Lc

c* hea?y chain

d* light chain

e* all o" the abo?e

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Q) .hat is the main goal o" the complement system/a* "ormation o" antigenDantibody complex

b* "ormation o" complementD antibody complex

c* stim!late apoptosis

d* "ormation o" 0A inhibition

e* "ormation o" membrane attack complexans

all three pathways in the complement system will "inallycon?erge at the "inal lytic seI!ence ( C),C8,C7,C5,C=* +hey

seI!entially interact to "orm a membrane attack complex,

which binds to the membrane o" the target cell , "orming

transDmembrane channel thro!gh which salts and water can

"low in, res!lting in lysis o" target cell*

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$

Ans 3

Q) .hat is the ca!sati?e organism o" 'carlet Le?er/

'taphylococc!s a!re!s

'treptococc!s epidermidis

'treptococc!s pyogenes*ans

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'treptococc!s Pne!monia

Par?o?ir!s %1=

Q) .hich o" "oll best describes MA o" ndansetron/

Histamine H1Dreceptor agonist

Histamine H1Dreceptor antagonist

'erotonin )DH+2 receptor antagonistans

opamine 9 receptor agonist

opamine 9 receptor antagonist

Q) Gidocaine works by blocking which o" the "ollowing ion

channels/

slow ?oltage gated sodi!m channels

"ast ?oltage gated sodi!m channelsans

slow ?oltage gated potassi!m channels

"ast ?oltage gated potassi!m channels"ast ?oltage gated calci!m channels

Q) .hich o" the "ollowing dr!gs is most appropriate to !se to

stim!late stim!late lactation/

Cabergoline

%romocriptineomperidone*ans

'ertraline

Metoclopramide

3omperi(one an( Metocloprami(e are

recognise( galactagogues Fsubstances that

increase mil7 pro(uction, 4 Me(ical 2nformation

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F4M2 who reviewe( the evi(ence on

galactagogues a(vise that (omperi(one is the

(rug of choice,

$ A patient is having --1 an( you urgently

as7e( for bloo( pro(ucts, Uour intern rushe( to

the bloo( ban7 an( came bac7 with pac7e( cells*

cryopercipitate an( fresh froen plasma,

ollowing are the contents of cryopercipitate

except =

a, factor E222

b, factor 2

c, von willebran( factor

(, factor :222

e, factor 22,,ans

factor 22 Fthrombin is not foun( in cryo, Cryo isrich in Rbrinogen F factor 2,

$ , /obertsonian translocations result from

which of the following?

A, .rea7s at or near the centromeres of two

acrocentric chromosomes followe( by the

reciprocal exchange of bro7en partsans., A part of one chromosome becomes attache(

to a non#homologous chromosome

C, 4nequal crossing over (uring meiosis

3, &he fusion of two small chromosomes en(#to#

en( such that a (ouble centromere occurs

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.hat is the role o" HEA prod!ced by the "etal adrenal

glands/

'tim!late "ormation o" cholesterol'tim!late placenta to "orm oestragen**ans

'tim!late de?elopment o" the +hym!s

'tim!late gonadal de?elopment o" the "et!s

0one o" the abo?e

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Q) .ith regard to opioid receptors* Morphine acts primarily

as a potent/ M! receptor agonistans

M! receptor antagonist

4appa receptor agonist

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4appa receptor antgonist

elta receptor agonist

Q) .ith regard to opioid receptors* Lentanyl acts primarily asa potent/ %eta receptor agonist

elta receptor agonist

$amma receptor agonist

4appa receptor agonist

M! receptor agonistans

poids

poids may act at M!, 4appa or elta receptors*

'trong opioids commonly !sed in clinical practice i*e*

MorphineLentanyl

Methadone

are strong agonists o" the M! receptor*

.eak opioids s!ch as codeine and tramadol are also agonistso" the M! receptor b!t also act as agonists at the elta and

4appa receptors

Q) .hich o" the "ollowing best describes the mechanism o"

action o" CycliRine/

opamine 9 receptor agonistopamine 9 receptor antagonist

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'erotonin )DH+2 receptor antagonist

Histamine H1Dreceptor agonist

Histamine H1Dreceptor antagonistans

Q) .hat type o" ?ir!s is H;B&!bi?ir!s

Hepaci?ir!s

Genti?ir!s**ans

Lla?i?ir!s

Entero?ir!s

.hich o" the "ollowing is !sed in protein analysis/

0orthern %lotting

Eastern %lotting

'o!thern %lotting

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.estern %lotting**ans

'o!thwestern %lotting

-o! are asked to re?iew a 8) year old ladies legs preD

operati?ely* -o! diagnose cell!litis* .hat is the most common

ca!sati?e organism/

'taphylococc!s A!re!s

'taphylococc!s EpidermidisClostridi!m Per"ringens

'treptococc!s M!tans

'treptococc!s Pyogenes*ans

Q) .hat is the incidence o" placenta accrete (incl!ding increta

and percreta in the 64/

1*: per 1::: deli?eries9*2 per 1::: deli?eries

7 per 1::: deli?eries

1*7 per 1:,::: deli?eries * ans

17 per 1:,::: deli?eries

Q) How can the mechanism o" action o" the

imm!nos!pressi?e agent aRathioprine best be described/

A* %locking o" + cell acti?ation

%* ;nhibition o" n!cleic acid synthesis in all mitotic cells

C* ;nhibition o" + cell proli"eration

* Pre?ention o" the generation o" cytotoxic e""ector cells and

general antiDin"lammatory e""ectE* Promotion o" !nresponsi?eness in alloreacti?e + cells

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+he answer is ;nhibition o" n!cleic acid synthesis in all

mitotic cells* Corticosteroids pre?ent generation o" cytotoxic

e""ector cells and prod!ce a generalised antiDin"lammatory

response* +acrolim!s blocks + cell acti?ation*

Q) A diabetic women attends yo!r preconception clinic* -o!

ha?e checked her H%A1C* According to 0;CE g!idelines

what H%A1C le?el wo!ld prompt yo! to strongly ad?ise this

women 0+ to get pregnant d!e to the signi"iant risks it

presents/

8*)> or O5mmol3mol

7*8> or 8:mmol3mol

1:*:> or 58mmol3mol **ans

11*1> or =5mmol3mol

19*8> or 11Ommol3mol

Lentanyl is approximately how many times more potent

than morphine/ 9

)

1:

9:

1:: ans

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$

ADEFP;&A+&- &E'E&BE BG6ME

%D;0'P;&A+&- &E'E&BE BG6ME

CD+;AG BG6ME

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DB;+AG CAPAC;+-ans

ED&E';6AG BG6ME

.hich test is most sensiti?e in detecting P;/ A* Cellc!lt!re

%* Endocer?ical biopsy

C* EnRyme imm!noassay

* Microscopy

E* 0!cleic acid ampli"ication test ans

+he answer is 0!cleic acid ampli"ication test (0AA+* 0AA+(polymerase chain reaction or strand displacement

ampli"ication is more than =)> sensiti?e in detecting

Chlamydia or $onorrhoea "rom the endocer?ical specimen*

+he absence o" endocer?ical or ?aginal p!s cells on a wetD

mo!nt smear has a good negati?e predicti?e ?al!e (=)> "or a

diagnosis o" P; b!t their presence is nonDspeci"ic (poor positi?e predicti?e ?al!e*

0AA+ is more sensiti?e and speci"ic than enRyme

imm!noassay (E;A and the epartment o" Health has

ad?ised that the !se o" s!bDoptimal E;A is no longer

appropriate and has pro?ided "!nding to s!pport laboratories

mo?ing "rom E;A to 0AA+* Howe?er, no test is 1::>sensiti?e or speci"ic*

$ -atient was (iagnose( of having right ovarian

teratoma of @x>cm, /M2 score is G", -atient was

counselle( for surgery an( opte( for laparoscopic

cystectomy, Jhat is the mc nerve in)ury

associate( with this proce(ure? a, sciatic nerve

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b, femoral nerve

c, obturator nerveans

(, genitofemoral nerve

e, ilioinguinal nerve

ovarian fossa is in close relationship to the

obturator nerve, post operatively* patient will

have (iYculties in a((ucting her lower limb,

$ Uou reviewe( a H" years ol( patient in your

clinic, She is (iagnose( of having a hugesubmucosal uterine Rbroi(, She is planne( for a

total ab(ominal hysterectomy, Uou explaine( the

ris7 of blee(ing an( bloo( transfusion, urther

history reveale( that she is a Vehovah8s witness,

Jhat option you may o'er in regar(s to her

operation?a, autologous bloo( (onation preoperatively

b, intraoperative bloo( salvage

c, recombinant erythropoietin therapy

(, all of the above,ans

e, get a family member of her similar bloo( group

to (onate

$ A fetus is forme( from partial maternal an(

partial paternal genes, A fetus is* therefore*

consi(ere( foreign to the maternal8s immune

system, 1owever* the fetus escapes maternal

immunity because of a few reasons, ollowing are

the reason =

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a, cytotrophoblast has 1QA#K

b, cytotrophoblast has 1QA#5

c, cytotrophoblast has 1QA#C

(, Latural 7iller cells are negative of C3!@ but

positive for C3"@

e, All of the above,ans

Q) .hat is the main plasma Cation/ 'odi!m**ans

Chloride

Potassi!m

Calci!m

Phosphate

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Q)

Q)

Q) .hich o" "oll "actors shi"ts 9 dissociation c!r?e to Gt /

;ncreased temperat!re;ncreased partial press!re C**ans

;ncreased XHWY

;ncreased 9,2 P$

;ncreased partial press!re C9

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$ Jhich antibo(y has the highest serum

concentration? a, 2g M

b, 2g Kans* lowest concentration is 2g 5

c, 2g A

(, 2g 5

e, 2g 3

Q) .hich pathogen is mc ca!sati?e org in "emale 6+;/

Chlamydia trachomatis

'taphylococc!s A!re!s

Escherichia Coli**ans

0eisseria gonorrhoea

$ardnerella ?aginalis

Q) At birth which o" "oll circ!latory changes occ!r/

9: "old rise in l!ng blood "low

&ise in right atrial press!reAnatomical clos!re o" d!ct!s arterios!s

Anatomical clos!re o" d!ct!s ?ensos!s

Llap clos!re o" the "ora men o?ale*ans

Q)Most appropriate dr!g regimen "or empiric &x o" $m D ?e

bacilli in blood is***/ a* Ampicillin pl!s s!lbactam*

b* ARtreonam**ansc* Ce"aRolin*

d* ;mipenem pl!s cilastatin*

e* +icarcillin pl!s cla?!lanic acid*

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$ .u'ers = .loo(,,, 1.

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High le?els o" which ;g are "o!nd in breast milk/ A*

;gA**ans

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%* ;g

C* ;gE

* ;g$

E* ;gM

+he correct answer is ;gA*

$ Jhich is the most abun(ant complement

protein? a, CG

b, C;,ans

c, CH(, C"

e, C9

complement C; is the most abun(ant, cleavage

of this protein will then be followe( by activation

of the lytic sequence,

$ Jhich immunoglobulin has the highest

molecular weight? a, 2gA

b, 2g3

c, 2g5

(, 2gK

e, 2gM,ans 2gK#smallest

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Q) .hich o" the "ollowing organelles is responsible "orholding m&0A "or translation into protein 0!cle!s

0!cleol!s

$olgi Apparat!s

&ibosome*ans

'mooth E&

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Q) Librinogen is acti?ated by which o" "oll / Lactor F

Prothrombin

+hrombinansLactor Fa

+iss!e Lactor

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Q) .hat is the main biochemical b!""er in !rine/ %icarbonate

Phosphateans

AmmoniaCalci!m Carbonate

Protein

Q) .hat is main biochemical b!""er in blood/

%icarbonate*ans

Ammonia

Calci!m CarbonateProteins

Phosphate

.hich o" "oll is most appropriate "or diagnosis o" %acterial

Baginosis (%B/ AmselJs criteria**ans

LitRDH!ghDC!rtis score

$ardnerella ?aginalis wet prep c!lt!re

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$ardnerella ?aginalis PC&

'AP' ;;; score

Q) + cell cannot respond to protein antigen !nless they ha?e been processed and presented as short peptide, complexed

wtih ma<or histocompatibility (MHC molec!les,on the

s!r"ace o" an antigen presenting cells* .hich is responsible in

encoding MHC/

a* ;G 19

b* ;G 12

c* HGA **ans

d* +0L

e* ;L0 gamma

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Q) .hat biochemical process !tilises pyr!?ate to "orm A+P/

$lycolysis

$l!coneogenesis

Cal?in Cycle4rebs Cycleans

$lycogenolysis

Q) &egarding pel?ic $onorrhoea in"ection in women* .hat

percentage o" cases are asymptomatic/ )>

1)>

2:>

):>*********ans

=:>

Q) .hich o" the "ollowing is a li?e atten!ated ?accine/ a*

%C$

b* MM& c* both o" the abo?eans

d* hepatitis A

e* tetan!s

hepatitis A is killed ?accine* tetan!s is anti toxin*

Q) +he CCP ca!ses all o" "oll biochemical e""ects EFCEP+which one/ '!ppress GH

Ele?ate L'H*ans

ecreased o?arian androgen synthesis

Ele?ate 'ex Hormone %inding $lob!lin

&ed!ction in adrenal androgen secretion

8/18/2019 mrcog sba's -2


Q) Cytokines act in the "ollowing way a* a!tocrine

b* endocrine

c* paracrine

d* all o" the abo?eanse* exocrine

Q) 6ltraso!nd pict!re o" the o?ary shows cystic lesion

meas!ring 2*2x 9*) cm with echogenic septea* .hat is the

most likely "inding/

A* Hemorragic cyst

%* benign teratoma

C* o?arian carcinoma

* sero!s cystadenoma

E* Lollic!lar cyst

$ Jhich of the below (rugs* in(uce hepatic

enyme an( re(uce the eYcacy of CPC-luconaole

La valproate

Carbamaepineans

Ampicillin

Kabapentine

Q) ;n depth !nderstanding o" the imm!ne system has ca!se are?ol!tion in the de?elopment o" good ?accines* .hat is the

wanted end prod!ct "rom a ?accination/

a* promotes + cells prod!ction

b* promotes dendritic cells prod!ction

c* prod!ction o" memory % cells*ans

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Q) .hat is the maxim!m dose o" lidocaine with adrenaline/

1mg3kg2mg3kg

)mg3kg

7mg3kg*ans

1:mg3kg

Q) A 95 year old women is seen in the early pregnancy !nit*

'he has had a positi?e pregnancy test b!t is !ncertain o" her

GMP* 6ltraso!nd doesnJt ?is!alise a pregnancy* -o! per"orm a

progesterone test* +he res!lt is )= nmol3l* According to 0;CE

g!idelines what le?el is consistent with ?iable pregnancy/ )

nmol3l

1) nmol3l

9) nmol3l

8/18/2019 mrcog sba's -2


8: nmol3l

0one o" the abo?eans

Progesterone testing 0ote there is a signi"icant di""erence between what 0;CE

ad?ise and ad?ice that can be "o!nd on the &C$ website

regarding progesterone testing in Pregnancy o" !nknown

location

0;CE ad?ise do not !se ser!m progesterone meas!rements as

an ad<!nct to diagnose either ?iable intra!terine pregnancy or

ectopic pregnancy

&C$ ad?ise progesterone le?els 9:nmol3l strongly

s!ggesti?e nonD?iable pregnancy and le?els 8:nmol3l

s!ggesti?e intra!terine pregnancy

Q) .hich cell adhesion molec!les are dependent on calci!mions to "!nction/

EDselectinPDselectinCadherinsans;ntegrins

4indlinD1

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;n the "oet!s where is principle site o" ALP prod!ction

-'*+

%one Marrow

$;+*+'pleen

Gi?er**+,main,primarily

$Jhich (iabetic complication worsene( by

preg? Aneuropathy

.proliferative retinopathy,ans

Cnephropathy

3benign retinopathy

5gasteroparesis

$ 5xamination is normal for a !G#y , Microscopic

examn of (ischarge shows no eDo pseu(ohyphae*

clue cells* or trichomonas, Jhich of foll is most

8/18/2019 mrcog sba's -2


li7ely (iagnosis ? A, .E

., Can(i(a vulvovaginitis

C, -hysiologic leu7orrheaans

3, Syphilis

5, &richomoniasis

-hysiologic leu7orrhea can be seen (uring G

(i'erent perio(s of chil(hoo(, Some female

neonates (evelop a physiologic leu7orrhea

shortly after birth as maternal circulating

estrogens stimulate the newborn8s en(ocervical

glan(s an( vaginal epithelium, &he (ischarge in

these neonates is often gray an( gelatinous,

-hysiologic leu7orrhea can also be seen (uring

the months prece(ing menarche, 3uring this

time* rising estrogen levels lea( to whitish

(ischarge not assoc

with any symptoms of irritation, &his patient has

a whitish (ischarge* no other symptoms* an( she

has ha( normal pubertal (evelopment up to this

point, &he (ischarge itself has no characteristics

of infection,

&herefore* physiologic leu7orrhea is the mostli7ely (iagnosis,

.E Fchoice A is not the most li7ely (iagnosis in

this patient because the (ischarge is not

malo(orous an( there are no clue cells seen on

microscopic examination of the (ischarge,

8/18/2019 mrcog sba's -2


Can(i(a vulvovaginitis Fchoice . is not the most

li7ely (iagnosis because the (ischarge is not

thic7 an( white For \cottage#cheese\#li7e an( the

patient has no irritative symptomatology,

Syphilis Fchoice 3 most often presents with a

painless ulcer Fcalle( a chancre or is foun( with

serologic testing, A nonmalo(orous* whitish

vaginal (ischarge in a !G# y female who is not

sexually active is almost certainly not

eDo syphilis,

&richomoniasis Fchoice 5 is also highly unli7ely in

this patient an( the lac7 of trichomona(s on

microscopic examn e'ectively rules out this

(iagnosis,

Q) +he most "reI!ent ca!se o" haematosalpinx is A D'alpingitis

% D+!bal pregnancy*ans

CD Ectopic pregnancy

D Adenomyosis

ED 'treptococc!s

Q) > o" "et!ses with trisomy 91*.o!ld be wxpected to be

detected by n!ch!l transl!ency alone 1:>

9)D2:>

):D))>

7:D7)>**************ans

=:D=)>

8/18/2019 mrcog sba's -2


Q) .hich o" the "ollowing inhalational anesthetic agents is

ha?ing "astest onset o" action/ a* 0itric oxide*

b* ;so"l!rane*

c* 0itro!s oxideansd* En"l!rane*

e* 0itrogen dioxide*

$ what percentage of of ovary are bilateral?!%

"%

!0%,,,,,,,,,,,,,,,,ans!"%

G0%

.hat is the maxim!m dose o" lidocaine that sho!ld be

!sed on a 7:kg woman who is 19 weeks pregnant/

: D lidocaine is C; in pregnancy

1:ml 1> lidocaine91ml 1> lidocaineans

7:ml 1> lidocaine

1::ml 1> lidocaine

!% li(ocaine <!gD!00mQ or !0mgDmQ

Max (ose for a N07g patient is G!0mg F;mgD7g

G!mQ !% plain lignocaine

Qi(ocaine

Qi(ocaine ey -oints

8/18/2019 mrcog sba's -2


.loc7s fast voltage gate( so(ium channels

Anti#arrhythmic

1alf life G hours

Safe to use in pregnancy

1epatic metabolism

Max (ose is ;mgD7g FNmgD7g with a(renaline

$ Jhich of foll metabolic processes pro(uces

most energy nee(e( for uterine contraction

(uring parturition? A,

Aerobic glycolysis

., Anaerobic glycolysis

C, 7rebs cycle

3, Pxi(ative phosphorylation,ans

5, .eta oxi(ation

$ Jhich one of foll best (escribes thehistological type of en(ometrium soon after

ovulation? A, 3eci(ual reaction

., Atrophic en(ometrium

C, -roliferative en(ometrium

3, Secretory en(ometrium,,ans

5, Arias#Stella phenomenon

8/18/2019 mrcog sba's -2


Q)

Ans %

Q) Plasma concentration o" estrogen increases thro!gho!t pregnancy* %y O: weeks, the concentration o" estriol increased

to estradiol by who m!ch times/ A* 1:: times

%* ): times

C* 9: timesans

* 1: times

E* ) times

8/18/2019 mrcog sba's -2


Q)

Ans B

Q) An acti?e 7:Dy L is admitted to the gyn clinic "or a sling proced!re with a known h3o Paget’s disease o" bone* .hich

biochemical "indings are most likely/

&ed!ced calci!m, red!ced phosphate and ele?ated AGP

&ed!ced calci!m, ele?ated phosphate and ele?ated AGP

0ormal calci!m, normal phosphate and ele?ated AGP*ans

Ele?ated calci!m, red!ced phosphate and red!ced AGPEle?ated calci!m, ele?ated phosphate and ele?ated AGP

Q) ;denti"y which o" "oll gi?es correct pathway o" piri"ormis

m!scle*

rigin Exits pel?is ?ia ;nsertion

A* Bentral s!r"ace o" sacr!m $reater siactic notch $reater

trochanter o" "em!r**ans

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%* Bentral s!r"ace o" sacr!m Gesser siactic notch $reater

trochanter o" "em!r

C* Bentral s!r"ace o" sacr!m $reater siactic notch Gesser

trochanter o" "em!r * orsal s!r"ace o" sacr!m $reater siactic notch $reater

trochanter o" "em!r

E* orsal s!r"ace o" sacr!m Gesser siactic notch Gesser

trochanter o" "em!r

Q) Meconi!m is "o!nd in the "etal g!t "rom what gestational

age/ A* 8 weeks

%* 1: weeks * ans

C* 15 weeks

* 29 weeks

E* 2) weeks

+he answer is 1: weeks* Meconi!m is "o!nd in the "etal g!t"rom 1: weeks o" gestation b!t the passage o" meconi!m is

rare be"ore 2O weeks o" gestation*

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Q)

Ans D

Q) How can MA o" ranitidine best be described/

;t delays gastric emptying

;t hastens the gastric emptying

;t mainly has an antiemetic action

;t ne!tralises the acidic content o" the stomach;t red!ces the acid content and prod!ction by gastric parietal

cells**ans

+he answer is ;t red!ces the acid content and prod!ction by

gastric parietal cells* ;t is !sed preoperati?ely to red!ce the

risk o" aspiration pne!monia and Mendelson’s syndrome*

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$onads de?elop "rom which cell layer/ A* Endoderm

%* ;ntermediate mesoderm ** ans

C* Gateral mesoderm

* Paraxial mesodermE* '!r"ace ectoderm

+he answer is ;ntermediate mesoderm* +he gonads and

!rogenital system de?elop "rom the intermediate mesoderm*

'keletal m!scles, the skeleton, the dermis and connecti?e

tiss!e de?elop "rom paraxial mesoderm* +he lateral plate

mesoderm de?elops into the sero!s membrane o" the body*

Q)Mc organism that ca!se sepsis d!ring pregnancy /

A* $ro!p A streptococcians

%* $ro!p % sterptocooci

C* 'taph* a!re!s

* E* coliE* M&'A

in"ection, her symptoms are o"ten atypical, with extremes o"

temperat!re, !n!s!al and ?ag!e pain, and pain in the

extremities* ;maging may appear normal, b!t remo?ing a

small sample "rom the !ter!s along with a blood c!lt!re may

be a !se"!l, rapid diagnostic tool*

Q) A 1)Dy L ?isits her $P reI!esting a method o"

contraception* .hen taking her hist, yo! disco?er a personal

h3o thromboembolic e?ents* 'he has had 2 sex!al partners in )

mths* 'he also c3o dysmenorrhea* .hat 1st Dline &x wo!ld yo!

recommend "or pain"!l periods/ CCP;b!pro"en**ans

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%lood enters the right atri!m o" the "etal heart and most

passes thro!gh the "oramen o?ale into the le"t atri!m* Lrom

there it is p!mped thro!gh the aorta* +he "oramen o?ale is thema<or str!ct!re "or bypassing the "etal p!lmonary circ!lation*

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At what gestational age do "etal breathing mo?ements

commence/ A* 19 w ans

%* 9: weeks

C* 2: weeks* 28 weeks

E* : weeks

&he answer is !G wee7s, &he movements

increase in frequency an( strength further on in

the gestational perio(, &he movements alsoincrease after maternal meals* aci(osis an( are

re(uce( by hypoxia* maternal alcohol

consumption an( se(ative (rugs,

Q) e"inition o" prolong <a!ndice in term baby /

A lasting "or o?er 79 ho!rs

% lasting "or 7 daysC lasting "or 1O days ans,Preterm 91 d

lasting "or 91 days

E lasting "or 95 days

Q) -o! re?iew a )5 year old patient in clinic* 'he asks what

the res!lts o" her recent EFA scan are* -o! note her hip

%M hip +Dscore is D1*O* -o! note she has a history o"olecranon "ract!re O years ago* .hat is her classi"ication

according to .H criteria/

0ormal bone density

steopenia**ans

'e?ere steopenia

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steoporosis

'e?ere steoporosis

$ &ill which gestational age we will Rn( Krower !

an( G 1.? !0 O !G w

$ &he thyroi( glan( is the Rrst of the bo(y8s

en(ocrine glan(s to (evelop* on approximately

the GHth (ay of gestation, &he thyroi( originatesfrom two main structures= the primitive pharynx

an( the neural crest, &he ru(imentary lateral

thyroi( (evelops from neural crest cells* while the

me(ian thyroi(* which forms the bul7 of the

glan(* arises from the primitive pharynx,

.hat is best indicator o" gest age on a dating scan in 1st

trimester/ A* %P

%* C&G ans

C* Lem!r length

* $estational sac diameter

E* Head circ!m"erence

&he answer is Crown rump length, .iparietal(iameter is appropriate after !H wee7s,

Kestational sac measurements help in early

pregnancy (iagnosis

;n the de?elopment o" the oocyte, when does the second

meiotic di?ision occ!r/ A* At birth

%* At "ertilisation ans

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C* At menarche

* At o?!lation

E* %e"ore "ertilisation

&he answer is at fertilisation, &he primary oocyte

resumes meiotic maturation in response to a

surge in luteinising hormone, &his results in a

polar bo(y an( the secon(ary oocyte, &he oocyte

is then ovulate( an( enters the secon( meiotic

cycle, 2t is arreste( in metaphase 22 an( onlycompletes meiosis after the entry of the

spermatooa at fertilisation,

$Serum levels of Qi are inc in women ta7ing this

anti #1&L ? A hy(raliine

. methyl (opa

C labetalol3 amylo(ipine

5 captoprilans

Captopril increase serum lithium level

Methyl(opa also causes lithium toxicity

Q) A )) yr old man ?isits his primary care physcian with a

complaint o" !rinary in "reI!ency* Examination "inds a 1 cm

nod!le on his prostate gland*the physcian orders P'A ser!m

test*by common standards P'A le?el O ng 3ml is considered

abnormal*!sing this standard this test has a sensiti?ity o" 5:>

and speci"icity o" =:>*a recently p!blished epidemiological

article "o!nd in a cross sectional st!dy 1:> men o" this age

ha?e prostate cancer*the res!lts on the pts P'A is 7 ng3ml*what

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is yo!r best estimate o" likelihood that this man act!ally has

prostate cancer/ A* 12>

%*9)>

C*28>*O7>***********ans

E*)5>

L*8=>

Q)

Ans C

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Q)

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Ans %

.hich part o" the o?ary is responsible "or androgen

prod!ction/ A* $ran!losa cells%* Geydig cells

C* rgan o" #!ckerkandl cells

* 'ertoli cells

E* +heca cells

+he answer is +heca cells* GH dri?es the con?ersion o"

cholesterol into androgens in the theca cells* +hese androgensare then trans"erred to the gran!losa cells "or con?ersion

(aromatisation into estrogen (estradiol !nder the in"l!ence o"

"ollicleDstim!lating hormones*

$

Ans 3

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$

$ &he chance of malignant transformation

occurring in premenopausal benign ovarian cysts

is A, 0,!%

., ;%

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pethidine and meptaRinol are opioids that can be !sed as

intrapart!m analgesic*

nitric oxide is not an opioid* ne?ertheless, it can be !sed as

intrapart!m analgesic*

Q) .hich dr!g pre?ents peripheral deiodination o" thyroxine/

CarbimaRole

;odine

Gabetalol

Potassi!m perchloratePropylthio!racilans

+he answer is Propylthio!racil* Altho!gh propylthio!rcil, like

carbimaRole, pre?ents the peroxidase oxidation o" iodide to

iodine in the thyroid gland, it also has a peripheral action*

Q) ;n the de?eloping "oetal testis, the cells that prod!cem!llerianDinhibiting s!bstance are the D

A* +estic!lar mesenchymal cells

%* ;nterstitial cells o" leydig

C* 'ertoli cells**ans

* 'permatogonia

E* Primordial germ cells

Q) &isk o" rec!rrence o" postpart!m psychosis in s!bseI!ent

pregnancy A1:>

% 1)>

C 9)>**********ans

2)>

E O:>

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A* ecreased parathyroid syndrome (P+H, increased

phosphate excretion, increased calcitriol and increased

calcitonin

%* ecreased P+H, red!ced phosphate excretion, increasedcalcitriol and increased calcitonin

C* ;ncreased P+H, increased phosphate excretion, increased

calcitriol and red!ced calcitonin

* ;ncreased P+H phosphate excretion, red!ced calcitriol and

red!ced calcitonin

E* ;ncreased P+H, red!ced phosphate excretion, increasedcalcitriol and red!ced calcitonin

+he answer is ;ncreased P+H, increased phosphate excretion,

increased calcitriol and red!ced calcitonin* Gow calci!m

le?els are detected by the parathyroid glands and P+H is

secreted* P+H acts on the kidneys to increase calci!m

absorption and also increase phosphate excretion* P+H also

increases the acti?ity o" 9)Dhydroxycholecalci"erol, which

con?erts calcidiol to calcitriol*

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Q)

Ans A

Q) A 97 y is treated "or se?ere bronchitis at 25 w* Her baby, born at O1 w , has neonatal hemolysis* .hich dr!g taken by

mother "or bronchitis is ca!se o" babyJs neonatal hemolysis/

a* amoxycillin

b* chloramphenicol

c* coDtrimoxaRoleans

d* doxycyclinee* erythromycin

.hich chromosome contains the gene that codes "or the

alpha globin chain (a constit!ent component o" Hb/

A* Chromosome )

%* Chromosome 11

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C* Chromosome 18*ans

* Chromosome 15

E* Chromosome 91

Q) 6pper ?agina s!pplied by D A!terine arteryans

%aorta

Cint iliac

ext iliac

+he ?agina recei?es its blood s!pply "rom the ?aginal arteries

and their anastomoses with branches o" the !terine, in"erior

?esical and internal p!dendal

Q) the risk o" !terine r!pt!re is )9 31:*::: in pre?io!s 1 C*s

and =9 31:*:: in pre?io!s 9 C*s

Q) .hich o" the "ollowing "orms part o" the phase 9 reactionin dr!g metabolism/ a* con<!gationans

b* cyclisation

c* hydrolysis

d* red!ction

e* oxidation

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$

Ans 3

Q) +he most common endometrial ca is**/'ero!s

the mc endometrial CA is endometroid t!pe =:> the sero!s

1:D1)>

Q)

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Q)

Ans C

Q) .hich o" the "ollowing cell types lyses cells that ha?e

been in"ected with ?ir!ses/ A* COW + cells

%* % cellsC* C5W + cells*ans

* 4iller cells

E* Macrophages

Q) .hat is the progestogen component in an implant/

a* desogestrel b* le?enogestrel

c* etonogestrelans

d* drosperinone

e* norethisterone

Q) .ith regard to electros!rgery, i" carbon is seen on the tip

o" an electrode the s!rgeon can ass!me that, at some stage in

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Q)

Ans C

$ /egar(ing MgSPH* the foll statement are trueexcept =

a, it acts at motor en( plate an( re(uces

excitability of nerve

b, it acts on cell membrane re(uces calcium

in6ux into cell

c, it is use to prevent eclampsia(, oliguria is a sign of magnesium toxicity

ans

e, Cagluconate can be given if patient (evelops

car(ioresp (epression

Magnesium sulphate is a cell membrane

stabiliser, 2t prevents in6ux of calcium into the

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cell,

mgsoH toxicity (ont cause oliguria, 2t is the other

way roun(, Pliguria causes MgSPH toxicity,

it is use( to prevent eclampsia

yes* we monitor urine output, but oliguria not

necessarily mean toxicity, oliguria coul(

percipitate toxicity as renal is the only way to

excrete mg, we monitor 4P to prevent toxicity*

not as a sign of toxicity,

$ -t ha( C#Section (evelope( SDS of -5, Most

li7ely source of embolism is? ! pelvic

veins,,ans

G femoral veins

; inf vena cava

H /t atrium$Jrt labetolol* foll statements are true except=

a, it can be given orally for patient with chr 1&L

in pregnancy

b, it is an antagonist of A! an( .! receptor

c, it is a partial antagonist of .G

receptor,,ans(, can be given intravenously in hypertensive

emergencies

e, contrain(icate( in patient with heart bloc7

it is an absolute contrain(ication in pt with heart

bloc7, labetolol is an antagonist at A! an( .! but

a partial agonist of .G, So* the net e'ect is

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re(uce peripheral resistance I re(uce heart

rate,,

$ -arrafollicular C cells is (erive( from?Leuralcrest

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$ Jhich of the following is the most e'ective in

re(ucing heavy menstrual blee(? a, tranexemic

aci(

b, CPC-

c, QLK#24Sans

(, -P-e, (anaol

Q) .hich o" "oll wo!ld yo! expect to be raised in preg/

Alb!min

AG+

AGP**ans

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&egarding transportation o" dr!gs, "oll are tr!e except

a* transcapillary mo?ement is trans"er o" dr!gs with water d!e

to hydrostatic3 osmotic press!re b* paracell!lar mo?ement occ!rs between cell <!nction

c* passi?e transport is mo?ement along a concentration

gradient

d* acti?e transportation is mo?ement against concentration

gradient and energy dependent

e* Lacilitated di""!sion is carrier mediated mo?ement along

concentration gradient and energy dependentans

"acilitated di""!sion do not reI!ire energy* C is tr!e* passi?e

di""!sion do occ!r along concentration gradient* acti?e

transportation occ!rs against concentration gradient

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Q)

Q).rt pharmacology,which o" "oll statement is3are tr!e

a* prodr!g is an inacti?e "orm o" a partic!lar dr!g

b* receptor is a cell!lar molec!le to which a dr!g binds to

initiate its e""ect

c* hal" li"e is the time taken "or the plasma concentration o"

the dr!g to red!ce by ):>

d* steady state concentration is when dr!g elimination eI!als

dr!g a?ailability

e* all o" the abo?eans

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Q)

Ans C

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Q).hat is ratio o" testosterone bo!nd to 'H%$ and alb!min

respecti?ely/

A*1> "ree,1=> alb!minDbo!nd K 5:> 'H%$Dbo!ndans%* 1:> "ree, 2:> alb!minDbo!nd and 8:> 'H%$Dbo!ndC* 2:> "ree, 1=> alb!minDbo!nd and )1> 'H%$Dbo!nd

* )> "ree, 1> alb!minDbo!nd and =O> 'H%$Dbo!ndE* )> "ree, 2:> alb!minDbo!nd and ))> 'H%$Dbo!nd+he answer is 1> "ree, 1=> alb!minDbo!nd and 5:> 'H%$D bo!nd* nly 1> is "ree b!t it is the alb!minDbo!nd "ractionthat is hormonally acti?e*

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Q) .here in body is aldosterone synthesiRed/

A* istal t!b!les

%* G!ng

C* #ona "ascic!lata* #ona retic!laris

E* #one glomer!losa

+he answer is #ona glomer!losa* &emember thatgl!cocorticoids are secreted by the Rona "ascic!late andandrogens are secreted by the Rona retic!laris*

0$H is str!ct!rally similar to Prl and HPG*

Q) &egarding tamoxi"en , all o" the "ollowing are tr!e except

a* it is a selecti?e estrogen receptor mod!lator

b* it is an estrogen antagonist on the breat

c* it is an estrogen agonist on the bone and endometri!m

d* it can ca!se endometrial hyperplasia and adenocarcinomae* it is widely !sed as a bone sparing agent*ans

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$

Ans 3

.hen !sing the M& "orm!la to calc!late $L&($lomer!lar "iltration rate which o" the "ollowing is not

"actored into the eI!ation/ Creatinine

6rea**ans

'ex

Age

Ethnic %ackgro!nd

5stimate( K/ FmlDminD!,N;mG < !>@ x FCreat D

>>,H #!,!"H x FAge#0,G0; x F0,NHG if female x

F!,G!0 if blac7

Q) .here in the kidney is the ma<ority o" 'odi!m and

$l!cose reabsorbed D%owmans Caps!le

Goop o" Henle

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Proximal +!b!le**ans

istal +!ble

Collecting !ct

/emember -C& is the main site for /eabsorptionfor all ions+

Q) An antenatal !sg demonstrates a hyperechogenic bowel*

.hich one o" the "ollowing is this "inding most associated

with/ mphalocele

PolyhydramniosM!ltiple pregnancy

$astrochisis

Cystic "ibrosisans

Hyperechogenic bowel is seen in ownJs syndrome, cystic

"ibrosis, cytomegalo ?ir!s in"ection

Q) .hat is the typical 9 cons!mption in 7)kg nonDpreg

women/ )ml3min

1)ml3min

):ml3min

1):ml3min

9):ml3min**ans+he typical xygen Cons!mption (B9 is 9):ml3min*

;n pregnancy this increases by aro!nd 9:> to 2::ml3min

.hich o" "oll is responsible "or AI!aporinD9 protein

channel openings in collecting d!ct/ Angiotensin

Angiotensin ;;

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AH**ans

Aldosterone

&enin

.hat inhibits gl!cagon releases/ A* Adrenaline

%* Exercise

C* Hypoglycaemia

* ;ncreased amino acids

E* ;ncreased "ree "atty acids ** ans

+he answer is increased "ree "atty acids* $l!cagon is secreted by the alpha cells o" the pancreas* ;t increases hepaticglycogenolysis and also glyconeogenesis* Adrenalinestim!lates gl!cagon release in times o" stress *+his stim!latesli?er glycogenolysis to ens!re maxim!m gl!cose o!tp!t to

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prepare "or ["light or "ightJ reaction* Hyperglycaemia inhibitsgl!cagon release*

Q) Aldosterone promotes water retention ?ia which o" "oll

mechs/

6pDreg!lation o" AI!aporin protein channels in collectingd!ct6pDreg!lation o" !rea transport proteins in collecting d!ctownDreg!lation o" !rea transport channels in the collectingd!ct

6pDreg!lation o" 0a34 p!mps in the distal t!b!le andC*ans'tim!lation o" Potassi!m resorption in the t!b!lar l!men

Q) .hat > age o" Hb is HbL by 8 months o" age/ 9>******ans

)D1:>

9:D9)>

):>7:D=:>

Q) &egarding blood ?ol in preg which o" "oll statements is

+&6E/

%lood ?ol!me remains constant

%lood Bol!me increases by approximately )>%lood Bol!me increases by approximately 1:D1)>%lood Bol!me increases by approximately 9:D9)>%lood Bol!me slowly increases by O:D):>********ans

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;ncreased circ!lating oestragen;ncreased circ!lating progesteroneans

A 9O years old girl who is <!st recently married and not

emotionally prepared to concei?e a child* ;n order to pre?ent

pregnancy, she is taking mercilon as a contracepti?e method*

'he came to yo! today beca!se she had missed a pill "or 9O

ho!rs* .hat wo!ld yo!r ad?ice be/

a* discard this pack and start a new pack

b* take the missed pill immediately and contin!e her c!rrent pack with one week pill "ree inter?al**ansc*take the missed pill immediately and contin!e her c!rrent pack with no pill "ree inter?ald* take the missed pill immediately and contin!e her c!rrent pack with 7 days additional contraceptione* contin!e this pack with no pill "ree inter?al

$ 2n various conversion of lactose toglucose*lactose initially goes hy(rolysis to which

substrate

Asucrose

.galactose,,ans

Cfructose

3glycerol5acetone

Q) A healthy 92yrs old woman wishes to disc!ss

contraception

A"ter a ?aginal deli?ery at term she is breast "eeding and

wishes to !se progestogen only

Pills /

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A start immediately additional contraception "or ) days

% start 91 days a"ter deli?ery

C start a"ter 8 weeks

start 8 months a"ter deli?eryE start 91 d a"ter deli?ery with additional contraception "or 7

d**ans*

Q) ;ncidence o" sho!lder dystocia D A*1>

%*:*)>

C*:*8>************ans

*:*7>

&ec!rrence 1) >

Q) An 15Dy who had !ndergone a pre? c3s, is admitted "or

acti?e labor* !ring labor, an intra!terine press!re catheter

displays normal !terine contractions e?ery 2 min!tes with

intensity !p to 8: mm Hg* Letal bradycardia ens!es* .hich o"

"oll statements is most acc!rate/

A* +he normal ;6PC display makes !terine r!pt!re !nlikely*

%* Mc sign o" !terine r!pt!re is a LH& abnormality **ans

C* ;" the patient has a !terine r!pt!re, the practitioner sho!ld

wait to see whether the heart tones ret!rn to decide on ro!te o"

deli?ery** +he ;6PC has been "o!nd to be help"!l in pre?enting

!terine r!pt!re*

Q) A 99DyearDold woman is being seen at 11 weeks’ gestation

"or an !ltraD so!nd examination* %esides the n!chal

transl!cency, which other sonographic "inding is associatedwith "etal ane!ploidy/A* Letal biparietal diameter

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%* Letal cerebellar diameter

C* Letal nasal bone**ans

* Letal crown r!mp length

?arian prec!rsors o" oestradiol incl!de a* estrone

b* Androstenedione

c* +estosterone

d* All o" the abo?e*ans

e* 0one o" the abo?e

Q) +he Ari!sD'tella reaction may be seen with all except a*Ectopic pregnancy

b* %irth control pillsans

c* Abortion

d* +rophoblastic disease

Q)Passage o" decid!al cast in cases o" ectopic !s!ally means

a* ;mpending t!bal r!pt!re

b* &eabsorption o" embryo

c* Pregnancy was intra!terine

d* eath o" embryo*ans

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$

Mc 'E with M+F therapy "or ectopic D

a* +ransient pel?ic pain 2D7 d a"ter starting &x

b* 'tomatitis

c* %one marrow s!ppressiond* $astritis

$ -renatal (iagnosis at !@ w can be performe(

using all of the foll* except= a, Amniotic 6ui(

b, Maternal bloo(

c, Chorionic villi

(, etal bloo(,,ans

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$

Ans .

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Q) A 9= y $1 at 5 w with triplet gestation presents "or

prenatal care* 'he is s!re she does not desire to ha?e in?asi?e

testing as a "irst step b!t desires \to ha?e some in"ormation]

regarding her risk "or "etal '* .hat option do yo!

recommend/ A*

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;ntegrated screen

%* 'eI!ential screen

C* !ad screen**ans

* 0!chal transl!cency only

Q)

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Q)

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Q) 22 year old women presents to clinic "or in"ertility

in?estigations* 'he has a signi"icant psychiatric history* Her

blood tests re?eal a raised Prolactin* .hich o" her medications

below is 0+ known to ca!se this D A* Amitriptyline%* #opiclone**ans

C* ChlorpromaRine

* &isperidone

E* Cocodamol

Q) 79DyearDold woman !ndergoes a total abdominal

hysterectomy* 'he has chronic obstr!cti?e p!lmonary disease*

Postoperati?ely, she is di""ic!lt to ext!bate and has a

prolonged stay on the intensi?e care !nit*.hich o" the

"ollowing is the most important direct stim!l!s to respiration/

A* ecreased arterial pH

%* ecreased arterial p:9

C* ecreased arterial pC9

* ;ncreased H concentration o" C'Lans

E* ;ncreased pC9 o" the C'L

Q) Hal" Gi"e o" heparin D A1 ho!r ans

% 9 hrs

C1 day 2 hrs

E1 week

8/18/2019 mrcog sba's -2


Q) &egarding gametogenesis, what is the end prod!ct o" one

germ cell at the end o" meiosis 9 in male and "emale/

a* male O spermatoRoa, "emale O o?!m b* male 9 spermatoRoaW9polar bodies , "emale 9 o?!mW9

polar bodies

c* male O spermatoRoa , "emale 1 o?!mW 2 polar

bodies**ans

d* male 1 spermatoRoa W 2 polar bodies, "emale O o?!m

e* male O spermatoRoa , "emale 9 o?!mW9 polar bodies

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$ ChromaYn cells pro(uce which of the

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following hormones?

A, 3opamine,ans

., Corticotropin#releasing hormone

C, Somatostatin

3, -rolactin

5, Easopressin

$ Jhich of the following is incorrectly matche(?

a, trisomy G! # (ecrease( alpha fetoprotein

b, trisomy !> # increase( L&

c, trisomy !; # mainly by meiotic non (ys)unction

(, linefelter # increase( L& ,,ans

e, linefelter # infertility

$ Jhich of the following statements regar(ing

thyroi( function testing in pregnancy is true?

A, &S1 levels increase in pregnancy., &S1 levels remain constant through the

trimesters

C, &otal &; levels (rop in pregnancy

3, ree &; levels (rop (uring

pregnancy,ans

5, &hyroi( hormone bin(ing globulin levels (rop

(uring pregnancy

$ Anti hypertensive that can cause neonatal

hypoglycemia

Amethyl (opa

.hy(ralaine

Clabetalol,ans

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3captopril

5none above

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$

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Ans .

Q)

Ans E

Q) r!g which bind to alpha 1 glycoprotein D Asalicylate

%war"arin

Cansaids

beta blocker**ans

Eall abo?e

Q) At what week in pregnancy is testing "or gestational

diabetes ($ ad?ised

A* 9OD95 weeks o" pregnancy i" past history o" $

%* 9OD95 weeks o" pregnancy i" no history o" $

C* 18D15 weeks o" pregnancy i" no history o" $

* 18D15 weeks o" pregnancy i" past history o" $ansE* At booking appointment regardless o" past history

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Q) .hich o" the "ollowing women wo!ld yo! ad?ise to take

O::mcg o" "olic acid d!ring the "irst 19 weeks o" pregnancy/

A9) year old type 1 diabetic

%98 year old recently diagnosed with coeliac disease

C21 year old taking sodi!m ?alproate

9O year old with sickle cell anaemia

E0one o" the abo?e**ans

&egarding PE in Pregnancy which o" "oll statements is

tr!e/

PE is the most common ca!se o" maternal death in the 64 PE acco!nts "or approximately 9)> o" maternal deaths in the64 PE mortality is :*7=31::,::: pregnancies in the 64 ****ans

%eing o?erweight (%M; 9)D2: does not increase B+E risk Age 2: is a positi?e risk "actor "or B+E when consideringthromboprophylaxis

Q) .ith respect to preDnatal diagnosis

A* 'creening programs "or own’s syndrome do not need to

incl!de karyotyping*ans

%* +he res!lts o" rapid preDnatal diagnosis tests are !s!allya?ailable in 7D1: days

C* 4aryotype is essential "or an e""ecti?e preDnatal diagnosis

programme

* +he res!lts o" rapid preDnatal diagnosis tests are !s!ally

a?ailable in 9D2 weeks

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E* +he res!lts o" rapid preDnatal diagnosis tests are !s!ally

a?ailable within 9Oh

Q) &egarding health risks associated with PC' which o" the"ollowing statements relating to PC' patients are tr!e (as

ad?ised by the &C$/

A* ;t is good practice to recommend treatment with gestogens

to ind!ce a withdrawal bleed at least e?ery 2 to O

months*ans

%* !e to the increased risk o" o?arian cancer patients with

PC'

reI!ire additional s!r?eillance*

C* !e to the increased risk o" breast cancer patients with

PC'

reI!ire additional s!r?eillance*

* ;ns!linDsensitising agents are licensed in the 64 "or !se in

patients witho!t diabetes

E* %ariatric s!rgery may be an option "or morbidly obese

women with PC' (%M; o" 2) kg3m9 or more or 2: kg3m9 or

more with a highDrisk obesityDrelated condition

A 21 year old patient !ndergoes an electi?e cDsection

deli?ery* -o! estimate blood loss has reached 1:::ml and yo!s!spect !terine atony is the likely ca!se* Lollowing biman!al

!terine compression what pharmacological inter?ention is

ad?ised/

AErgometrine :*)mg by intram!sc!lar in<ection

%Carboprost :*9) mg by ;M in<ection

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C'yntocinon )! by slow intra?eno!s in<ection**ans

irect intramyometrial in<ection o" carboprost :*) mg

Misoprostol 1::: micrograms rectally

Pxytocic Agents ey -oints

-rophylactic oxytocics shoul( be o'ere( routinely

in the management of the thir( stage of labour in

all women as they re(uce the ris7 of --1 by

about @0%,

Pxytocin

!st choice for prophylaxis --1 in the thir( stage

of labour,

!st choice if (elivering by caesarean section

Syntometrine

May be use( in the absence of hypertension

Ffor instance* antenatal low haemoglobin as it

re(uces the ris7 of minor --1 F"00#!000 ml

Compare( to Pxytocin " fol( increase ris7 of

si(e e'ects inc nausea* vomiting an( raise( .-

Q) A patient attends clinic with a ?aginal prolapse* n

examination the ?aginal prolapse is ?isible 1*)cm abo?e the

plane o" the hymen* According to the PP classi"ication

what grade is this prolapse/ $rade :

$rade 1*ans

$rade 9

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$rade 2

$rade O

Q) &egarding the p!bic symphysis, what type o" <oint is it

Libro!sCondyloid'yno?ialPrimary Cartilagino!s'econdary Cartilagino!sans

.hich o" "oll contracepti?es primary MA is inhibition o"o?!lation/A0orgestonQ

%CeraRetteQans

CMicronorQ

Lem!lenQ

&ra(itional -P- main mo(e of contraceptiveaction= thic7ening of cervical mucus

3esogestrel#only -P- main mo(e ofcontraceptive action is inhibition of ovulation

Ceraette] is the only 3esogestrel#only -P- in

the options above, Pther (esogestrel bran(sinclu(e= Aiea] Cerelle] Lacre]

$ Jhich of the following is with regar( to

perinatal mortality in the 4nite( ing(om?

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A, 2t is approximately N per !0000 births

., 2t is associate( with low birth weight Fless than

G," 7g babies in over @0% of cases

C, 2t is (eRne( as all stillbirths an( all (eaths in

the Rrst G> (ays after birth

3, 2t is higher in boys ,ans

5, 2t is lower in babies of mothers who are

primiparous

Q) An 15 year old patient comes to see yo! in clinic* Her %M;

is 9)*: and her %P is 19935:* 'he is a nonD smoker and there is

no personal or "amily history o" B+E or migraine* 'he wo!ld

like to start the pill "or her acne* 'he has !sed topical #ineryt

in the past b!t still has moderate acne* .hat is the most

appropriate option/

A* CeraRette (esogestrel

%* Mar?elon (Ethinylestradiol3esogestrelansC* ianette (CoDcyprindiol

* 0orimin (Ethinylestradiol30orethisterone

E* -asmin (ethinylestradiol 3 drosperinone

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Q)

Q) How many lob!les are in each testis/ 9)

9):**ans

9),:::

9):,:::

9*) million

Ans 9::D2::**** so 9):

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$

$32C # -& *A-&& 2nc* low platelets*low Rbrinogen

an( high Rbrin (egra(ation pro(ucts

.hich o" the "ollowing statements regarding the Baginal

artery is typically +&6E/

;t arises "rom the ;nternal iliac artery**ans;t arises "rom the External iliac artery;t arises "rom the Abdominal Aorta;t arises "rom the ?arian artery;t arises "rom the 6terine artery

&he Eaginal artery* li7e the 4terine artery is

typically a branch of the 2nternal 2liac artery, 2t

can sometimes arise as a branch of the 4terine

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artery so it is important to rea( the question Fif

the stem state( it CAL arise from the 4terine

artery then that woul( be true

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.here are the proximal and distal centriole located in a

spermatoRoa/

Head 0eckansMiddle Piece+ailEnd Piece

$ Jhat is the Rrst immunoglobulin to be

synthesise( by the neonate? 2gA

2gK

2gM , ans

2g3

2g5

Q) Plasma typically acco!nts "or what percentage o" body

weight/ O>*******ans1O>

9:>

O:>

5:>

Q) .hich one is not a side e""ect o" war"arin

Ap!rp!ra "!lminans%p!rple toe syndrome

Cembryopathy

skin necrosis

E'te?en Uohn sons synd*ans

Q) -o! are asked to re?iew the serology res!lts o" a 97 year

old women* 'he was noted to ha?e had deranged li?er

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"!nction tests* +he res!lts are as "ollows

Marker &es!lt

H%sAg 0egati?e

Anti H%s Positi?eAnti H%c 0egati?e

;gM Anti H%c 0egati?e

.hat does this indicate regarding her hepatitis % stat!s/

Ac!te ;n"ection

Chronic ;n"ection

;mm!ne d!e to past in"ection;mm!ne d!e to ?accination*ans

'!sceptible

+his patient has Anti H%s antibodies D this s!ggests imm!nity*

Anti H%c persists "or li"e a"ter in"ection so is a marker o" past

in"ection* ;n this case anti H%c is negati?e s!ggesting

imm!nity by ?accination rather than past in"ection* Hepatitis

% Marker escription ;nterpretation H%sAg Hepatitis %

s!r"ace Antigen ;ndicates c!rrent in"ection either ac!te or

chronic Anti H%s Hepatitis % s!r"ace Antibody ;ndicates

imm!nity either d!e to in"ection or ?accination Anti H%c

Hepatitis % core Antibody ;ndicates either c!rrent or past

in"ection ;gM Anti H%c ;gM antibody to Hepatitis % core;ndicates recent in"ection

Q) -o! are asked to re?iew the "!ll blood co!nt o" a 81 year

old patient in preDop clinic* +he res!lts are as below Hb =*:

g3l

MCB 115 "l

Platelets 1)) ^ 1: 3l

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.%C =*O ^ 1: 3l

-o! note her past medical history records a diagnosis o"

?itiligo O years ago b!t nil else*

'he takes no reg!lar medications* -o! note ro!tine bloodsdone by the $P 1 month earlier

show normal thyroid "!nction, !rea and electrolytes and

H%A1C* .hat is the likely

diagnosis/ ;ron de"iciency anaemia

$astrointestinal bleed

Endometrial bleedHashimotos

Pernicio!s anaemia*ans

Hyponatraemia is a recognised complication o" which o"

the "ollowing/

(Please select 1 option A Carbenoxolone therapy

% Cerebral cont!sion ans

C iabetes insipid!s

Poly!ric phase o" ac!te renal "ail!re

E Ma<or b!rns

Q) .hat is the additional risk o" miscarriage i" amniocentesis

is per"ormed "or genetic screening/ a* 1>*******ans

b* )>

c* 1:>

d* 9:>

e* O:>

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Q) .hen consenting a patient "or +AH("or a benign

condition what wo!ld yo! ad?ise regarding the risk/

AHaemorrhage reI!iring trans"!sion approximately 1>

%;n<!ry to 6reter or bladder approximately 1>*************ansc?erall risk o" serio!s complications 1>

Pel?ic abscess approximately 1>

E;n<!ry to %owel 1>

+he &C$ states in<!ry to bladder and3or !reter at :*7>* +his

is "or abdominal hysterectomy "or benign conditions* 0ote

abdominal hysterectomy carries higher risks when per"ormed

"or nonDbenign conditions and o?erall risk o" !reter in<!ry is

1>* Abdominal Hysterectomy According to the &C$

consent ad?ice "or abdominal hysterectomy "or benign

conditions* +he "ollowing risks are I!oted ?erall &isk

serio!s complication O> Haemorrhage reI!iring blood

trans"!sion 9*2> %ladder and3or !reter in<!ry and3or longD

term dist!rbance o" bladder "!nction :*7> &et!rn to theatre

(e*g* beca!se o" bleeding3 wo!nd dehiscence etc :*7> B+E

:*O> Pel?ic abscess3in"ection :*9> %owel in<!ry :*:O> (O

in 1: ::: &isk o" death within 8 weeks, :*:2>

+he <!xtaglomer!lar apparat!s (U$A lies within which part o" the kidney/ &enal Cortex*ans

&enal Med!lla

Minor Calyces

Ma<or Calyces

&enal Pel?is

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+he s!per"icial ing!inal ring is an apert!re in which

str!ct!re/ P!bic t!bercle

Apone!rosis external obliI!e**ans

Apone!rosis internal obliI!e

Con<oint tendon

+rans?ers!s abdomin!s

Q) ;n regards to ?aricella Roster imm!niRation, which o" the

"ollowing is correct/

a* ?accination can be gi?en d!ring pregnancy

b* in seronegati?e patient, ?accination can be gi?en

postnatally and mother can sa"ely breast"eedans

c* in seronegati?e patient, ?accination can be gi?en postnatallyand breast "eeding is contraindicated

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d* ?accination sho!ld not be gi?en d!ring prepregnancy

e* pregnant mother with ;g $ positi?e was exposed to a

comm!nity with chicken pox* she sho!ld be gi?en ;B;$*

Dmothers with ;g $ positi?e do not reI!ire ;B;$ as they are

imm!ne to B#B

D latest recommendation by &C$ is to o""er seronegati?e

mothers, ?accination d!ring prepregnancy or post natally* and

it is sa?e to breast "eed

Q) .hat testic!lar cell type secretes testosterone/ Myoid;ntersitial macrophages

'ertoli

Geydigans

$erm

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Q) Male in"ertility in a patient with cystic "ibrosis is likely to

be d!e to which condition/

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Congenital absence o" testesCongenital absence o" ?as de"erens**ansHypothalamic "ail!re

ligospermia+estic!lar "ail!re

Q) 1st meiotic di?ision occ!rs in D 'pertogoni!m

Prim spertocytes *ans

'ec spermsto?ytes

'permatids

.hich phase is best to ?is!alise chromosome/ a* prophase

b* metaphase*ans

c* $9 phase

d* $1 phase

e* ' phase

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Q)

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Q) epid!ral anesthesia is gi?en at/ G 23O

Q) +he testis recei?e inner?ation "rom which spinal segment D

+1:*ans

+19

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'1

'9

'2

Q) &egarding Ac!te P;, which o" "oll is +&6E/

a* patient presents with s!per"icial dyspare!nia b* it is strongly recommended to remo?e insit!D;6 oncediagnosed o" ha?ing P;c* the absence o" in"ection on high ?aginal swab excl!des P;

d* Absence o" p!s cell gi?e a good D?e predicti?e ?al!e *anse* the presence o" p!s cell gi?es a good positi?e predicti?e?al!e

A patient was diagnosed o" ha?ing P; and was treated

with appropriate A%ic* .hat is yo!r "!rther plan/

a* see back in 5 wks to assess adeI!ate response to &x

b* see in O weeks to repeat testing "or growth in all patientc* see back in 8 weeks to ens!re compliance o" antibiotic

d* see back in 9 w to screen and treat sex!al partner ans

e* discharge

A,C and need to be done d!ring "ollow !p***b!t within 9 to

O weeks*

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$ Lv supply to perineum

A pregnant patient who is needle phobic has her n!chal

transl!cency (0+ scan b!t re"!ses ser!m markers* -o! ad?ise

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her the Lalse Positi?e &ate o" the scan is )>* .hat wo!ld yo!

ad?ise the mother regarding the detection rate o" ' !sing 0+

alone/ O:>

):>7:>***********ans

=:>

=)>

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$ Qevator ani O p bo(y insertn

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$ /egar(ing &urner syn(rome which of the

following statements is true?

AComplete monosomy is rare accounting forX!0% of cases of &urners

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.&urner syn(rome occurs in approximately ! in

every G0*000 live female births

CPnly !% of a'ecte( fetuses will survive to

term,ans

3&urners is thought to a'ect 0,!% of all

conceptuses

5Qong Rngers are a recognise( clinical feature

&urners may be complete monosomy of the sex

chromosomes where the 7aryotype is terme( H"

: or show a mosaic pattern with variable

penetration of cell types with the single :

chromosome, Complete monosomy accounts for

"0% of cases, &urners syn(rome is common in

utero a'ecting !#G% of all conceptuses however

99% of these will miscarry an( only !% will

survive to term, &urners occurs in ! in G000 live

births, Short stature* (ysmorphism inclu(ing

short Rngers* pectus excavatum an( webbe(

nec7 are features, As are car(iac abnormalities

Fcoarctation aorta* bicuspi( aortic valve* aortic

aneurysms an( more* urogenital abnormalities

Fhorseshoes 7i(neys* (ouble collecting systeman( more an( behavioural problems,

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$

Ans C

Q) A patient arri?es on G%. she is 27 w * Her last preg ended

with deli?ery ?ia !ncomplicated G'C' O y ago* Contractions

are ) mins apart and on examn and Cx is )cm* 'he wants toknow the risk to baby o" proceeding with B%AC* .hat is

additional risk the baby will ha?e resp problems a"ter B%AC

compared to electi?e repeat CDsection (E&C'/

A* 0o di""erence

%* &isk 1 to 9> greater with B%AC

C* &isk 1 to 9> greater with E&C'ans

* &isk O to )> greater with B%AC

E* &isk O to )> greater with E&C'

Q) A 9)Dy presents with a symmetrical arthropathy a""ecting

her hands* n examn she has syno?itis o" 9nd K 2rd MCP <ts*

.hat type o" HGA allele is most assoc with this condition/

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A* HGA &2

%* HGA A2

C* HGA &O**ans rhe!matoid arthritis

* HGA &9E* HGA %97

Q)Fontanelle closure Ant by 15 months

K post by 2 months

$ .al is anti apoptosis

-"; cause apoptosis

$ Jhat cells in the spermatogenesis process can

un(ergo mitotic (ivision? -rimary spermatocytes

Secon(ary spermatocytes

Spermati(s

Spermatogonia,ans

Spermatooa

$ antigen presenting cell then langerhan

an( if it is phagocytic antigen presenting then

neutrophil

+he rect!s sheath is "ormed by which o" the "ollowing/

External obliI!e and rect!s abdomin!s apone!roses;nternal obliI!e and rect!s abdomin!s apone!roses&ect!s abdomin!s and pyramidalis apone!rosesapone!roses o" internal and external obliI!eapone!roses o" trans?ers!s abdominis, external and internalobliI!e*ans

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+he ro!nd ligament lea?es the pel?is ?ia what/ $reater

sciatic notch

Gesser sciatic notch

'!per"icial ing!inal ring

eep ing!inal ring**ansGesser sciatic notch

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$ After surgery the patient is having (iYculty in

a((uction of thigh,,,which nerve involve(,?

Pbturator

Q) A O:DyearDold woman presents at 1O weeks o" gestation*

'he opts to ha?e antenatal screening* Her blood tests show an

increase in _DhC$ and low PAPPDA* At her dating scan there

is a raised n!chal transl!cency noted* .hat is the most likelyexplanation "or these res!lts/ own syndrome

Edward’s syndrome**ans

0ormal pregnancy

Pata!Js syndrome

+win pregnancy

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Q) At what stage in the cell cycle is mitosis arrested i" there is

a chromosomal abnormality/ $9

Q) -o! ha?e been asked to per"orm a p!dendal ner?e block ona patient by yo!r cons!ltant* +he p!dendal ner?e is "ormed

"rom which spinal segments/ '1 and '9

G2,GO,G) and '1

G),'1 and '9

'9,'2 and 'O*ans

'2,'O and ')

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Q) +he post scrotal artery is a branch o" which artery/ ;nternal

P!dendal*****ans

External P!dendal

;n"erior &ectal;lioing!inal

'!perior rectal

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$ &he metabolic response to trauma causes a(ecrease in which of the following? A, Anti#

(iuretic hormone

., Klucagon secretion

C, Krowth hormone

3, 2nsulin secretion ans

5, 4rine osmolality

$ Jith regar( to the cell cycle, 2n which part of

the cycle (o Chromati(s form?A, K0

., K!

C, KG

3, Sans

5, M

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$

Ans 3

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$ Qetroole # MPA

-o! are called to see a women a"ter a prolonged labo!r

with "ailed instr!mental deli?ery con?erted to cDsection* 'he

is !nable to dorsi"lex her right "oot and complains o" pins and

needles to the "oot and lower leg* .hat is the likely

diagnosis/

&ight G) ner?e root compression&ight '1 ner?e root compression&ight 'apheno!s ner?e root compression&ight common peroneal ner?e root compression*ans&ight s!per"icial peroneal ner?e root compression

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Q) ;n the third trimester o" pregnancy what is the daily

calci!m reI!irement o" the "et!s/

): mg1:: mg9:: mg D +his is the correct answer ):: mg5:: mg D

Q) +he !reters recei?e a!tonomic s!pply "rom which spinal

segments/ +1:D19

+11DG9*ans

G1DG2

G9DG)

'1D'2

Q) &egarding the rect!s sheath which o" the "ollowing

statements are tr!e/

Abo?e the arc!ate line the internal obliI!e di?ides into twolamellae**ans%elow the arc!ate line the internal obliI!e di?ides into twolamellae%elow the arc!ate line the external obliI!e di?ides into twolamellaeAbo?e the arc!ate line the external obliI!e di?ides into twolamellae%elow the arc!ate line the trans?ers!s di?ides into two toencompass the rect!s abdomin!s

Q) Lollowing a water birth, a woman elects not to ha?e

oxytocics "or the

management o" the third stage o" labo!r* +hirty min!tes later,

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she is bro!ght to the cons!ltant !nit with a postpart!m

haemorrhage owing to an atonic !ter!s* ;" she had recei?ed

standard oxytocic management "or the third stage o" labo!r,

by what amo!nt wo!ld she ha?e red!ced her risk o" a postpart!m haemorrhage/ A* 1:>

%* 9:>

C* 2:>

* 8:>************ans

E* =:>

!) At the proximal end o" the !rethra (prostatic !rethra there

is transitional cell epitheli!m in contin!ation with the bladder*

+he epitheli!m changes to strati"ied col!mnar and then to

strati"ied sI!amo!s near the !rethral ori"ice*

;mplantation o" the embryo occ!rs at which stage/

%lastocyst*ansMor!laPron!clear phase+rophoblast#ygote

Correct

+he answer is %lastocyst* .ithin 9O ho!rs o" "ertilisation, theRygote !ndergoes clea?age* ;t then "!rther s!bdi?ides into blastomeres* %y the third day, the embryo contains 19 cells*%y the "o!rth day, it is comprised o" 18D29 cells and is called amor!la* n day ), the blastocyst hatches "rom the Rona pell!cida and implants into the endometri!m* Lor in ?itro"ertilisation, trans"er o" the embryo with blastocyst has been

8/18/2019 mrcog sba's -2


shown to be more e""ecti?e and is recommended with a singleembryo trans"er*

$ 2n earliest phase of woun( healing platelets

hel( together by ARbroblasts

.Rbrin,,ans

C-K5 !

3type ! collagen

5type G collagen

+he a?erage "!nctioning ad!lt kidney contains approxlyhow many nephrons/ 1::

1,:::

1:,:::

1::,:::

1,:::,:::*ans

$

Ans C

Q) .hich two ner?es pro?ide the primary c!taneo!s sensory

inner?ation to the labia ma<ora/ ;lioing!inal and in"erior rectal

;lioing!inal and p!dendal**ans

P!dendal and perineal

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Anterior "emoral and genito"emoral

P!dendal and iliohypogastric

Q) Letal sex di""erentiation at week – =**ans

1:

1119

Q) A baby with sho!lder dystocia s!""ers a brachial plex!s

in<!ry* +he mother asks yo! i" this will be permanent* .hat

percentage o" babies will ha?e permanent ne!rological

dys"!nction as a res!lt o" brachial plex!s in<!ry secondary to

sho!lder dystocia/1:>**************ans

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1)>

9)>

2)>

):>

$ Jhich complement protein recruits other

complement proteins to form MAC Fmembrane

attac7 complex? C;a

C;b

C;C"bans

C

;n "emales the p!dendal ner?e branches are/

;n"erior rectal, s!perior rectal and ilioing!inalPerineal, ilioing!inal and dorsal clitoral

;n"erior rectal, ilioing!inal and perinealPerineal, in"erior rectal and dorsal ner?e o" clitoris *ansPerineal, s!perior rectal and posterior ner?e o" clitoris

.hich o" "oll m!scles does 0+ recei?e inner?ation "rom

p!dendal ner?e/ ;nternal anal sphincter**ans

External anal sphincter

External !rethral sphincter %!lbospongios!s

Ge?ator ani

Q) .hat is the a?erage obliI!e diameter o" the pel?ic inlet

according to the &C$/ 7*) cm

= cm

1:*) cm

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19 cm**ans

12*) cm

Q) A 98 years old, primigra?ida who has had a pre?io!sexpos!re to B#B o!tbreak when she was 19 weeks o"

gestation* At that time, she was warded and ;B;$ was

administered* C!rrently, she is 15 weeks o" gestation and had

another expos!re to B#B* .hat wo!ld be yo!r management/

a* co!nselling and reass!rance

b* admit "or obser?ation

c* p!t her !nder isolation

d* gi?e her 9nd dose o" ;B;$*ans

e* start her on acyclo?ir

Q) .hich o" "oll m!scles is 0+ a constit!ent o" pel?ic "loor

(diaphragm/iliococcygeal

Piri"ormis**ansP!borectalis

P!bococcyge!s

Coccyge!s

+he l!mbar plex!s is deri?ed "rom which spinal segments/

+1:DG)

G9DGOG1DG2

+19DGO**ans

G1DG)

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;n male !rethra where do d!cts o" b!lbo!rethral (CowperJs

glands enter/ Posterior wall prostatic !rethralateral walls prostatic !rethra

Membrano!s !rethra*ans

'pongy !rethra

Ca?erno!s !rethra

$ Capsule of (eveloping KriYan follicles ? A

theca interna

. theca externaans

C ôna pelluci(a

3 ôna granulesa

5 lamina propria

%ladder neck clos!re and relaxation o" the bladder ismediated by/ 'ympathetic Libres G1,G9ans

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Parasympathetic Libres '9, '2,'O

'ympathetic Libres '9,'2,'O

Parasympathetic Libres +11,G1,G9

'ympathetic Libres G2,GO,G)

$ A G"#year#ol( (iabetic woman has been

morbi(ly obese for past " y,2n this patient* which

one of foll hormones woul( (ecrease the appetite

as levels increase? A, Qeptinans

., &hyroxineC, Khrelin

3, A(iponectin

5, 2nsulin

'ertoli cells contain receptors to which hormone/ ;nhibin

estradiol

+estosteroneGH

L'Hans

Q) ;nner?ation o" ?agina !pper932 by in"*hypogastric plex!s

and lower132 by p!dendal ner?e**+

Q) .hat is the a?erage AP distance o" the "emale pel?ico!tlet/ 7*) cm

= cm

1:*) cm

11*) cm

12 cmans

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Q) &egarding lymph drainage o" Cx where does the ma<ority

o" lymph drain to/ ;nternal iliac nodes

External iliac nodes**ans

ParaDaortic nodesGateral aortic nodes

;ngi!nal nodes

Q)

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$

$ Accor(ing to the !9@N Abortion Act* the foll

are all in(ications for &P- if pregnancy were to

continue 5:C5-&=

a &he woman8s life is li7ely to be en(angere(

b &he womens physical health is li7ely to be

en(angere(

c &he womens mental health is li7ely to be

en(angere(

( &he partners physical health is li7ely to be

en(angere(

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e &he chil( is li7ely to su'er a physical

han(icap,,ans

;n male !rethra where do d!cts o" b!lbo!rethral (CowperJsglands enter/ Post wall prostatic !rethra

lateral walls prostatic !rethra

Membrano!s !rethraans

'pongy !rethra

Ca?erno!s !rethra

.hich one o" "oll options best describes +$s concns in preg/ (Please select 1 option

A +he increase in triglycerides res!lts "rom decreased hepaticlipase acti?ity and decreased lipoprotein lipase acti?ity

% +he increase in triglycerides res!lts "rom decreased hepaticlipase acti?ity and increased lipoprotein lipase acti?ity

C +he inc in triglycerides res!lts "rom inc hepatic lipaseacti?ity and dec lipoprotein lipase acti?ity**ans

+he increase in triglycerides res!lts "rom increased hepaticlipase acti?ity and increased lipoprotein lipase acti?ity

E +here is no change in triglyceride concentrations

Serum total cholesterol an( triglyceri(econcentrations increase mar7e(ly (uringpregnancy, &he large increase in triglyceri(es appears to be(ue to two factors=2ncrease( hepatic lipase activity resulting in

enhance( hepatic triglyceri(e pro(uction an(

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/e(uce( lipoprotein lipase activity lea(ing tore(uce( catabolism of a(ipose tissue,

$ Jhich nerve arises near ant sup iliac spine

below inguinal ligament?

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$1ysteroscopic classication of submucosal

Rbroi(s is= 0< totally in

en(ometrial cavity*

!< more than "0% protru(e in en(ometrial

cavity an(

G< less than "0% protru(e in en(ometrial cavity

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$ 1ypothal locatn (iencephalon

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Short $& interval

Qong $& intervalans

-o! ha?e been asked to re?iew an asymptomatic patient inthe early pregnancy !nit* 6ltraso!nd scan is negati?e "or

pregnancy* _hC$ le?els o?er O5 ho!rs are )): and 2):, and

ser!m progesterone le?els are 17 nmol* .hat is the most

likely "inding/ A* Ectopic pregnancy

%* Lailing pregnancy

C* High risk o" ectopic pregnancy needing inter?ention "or

treatment

* 0onD?iable pregnancy with the possibility o" spontaneo!s

resol!tion**ans

E* Biable pregnancy

.hich Ar is a direct branch o" aorta/ A* ;n"erior ?esical

%* ;nternal iliacC* ?arian **ans

* 6terian

E* Baginal

&he answer is ovarian, &he ovarian artery is a

branch of the aorta, 2t arises anterolaterally )ust

below the renal artery* running retroperitoneallyto leave the ab(omen by crossing the common or

external iliac artery in the infun(ibulopelvic fol(,

2t crosses correspon(ing ureters an( supplies

twigs to it but (oes not supply to ab(ominal

organs, &he internal iliac artery arises from the

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$

Ans 5

A 89 years old "emale presented to the emergency

department with a right neck o" "em!r "ract!re* 0o history o"

tra!ma* -o! s!spected her o" ha?ing ?itamin de"iciency*.hat blood in?estigation wo!ld yo! reI!est to s!pport yo!r

diagnosis/a* ser!m calcitriol

b* ser!m calcidiol**ans

c* 1 alpha hydroxylase enRyme

d* 9) hydroxylase enRyme

e* ser!m calci!m and phosphate le?el

it is because calci(iol is the ma)or circulatory

form for vitamin 3* thus the surrogate mar7er for

Eitamin 3 status,

.hich o" the "ollowing is responsible "or AI!aporinD9

protein channel openings in the collecting d!ct/ Angiotensin

Angiotensin ;;

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AH*ans

Aldosterone

&enin

Aldosterone promotes water retention ?ia which o" the

"ollowing mechanisms/

6pDreg!lation o" AI!aporin protein channels in the collectingd!ct6pDreg!lation o" !rea transport proteins in the collecting d!ct

ownDreg!lation o" !rea transport channels in the collectingd!ct6pDreg!lation o" sodi!m3potassi!m p!mps in distal t!b!le andcollecting d!ct*ans'tim!lation o" Potassi!m resorption in the t!b!lar l!men

%reast milk is prod!ced by the secretions o" the epithelial

cells o" the acinar* .hich o" the "ollowing is an acc!rate

estimate o" mat!re breast milk composition/

Lat O>, Protein 1>, '!gar 7>************ansLat 1:> Protein O> '!gar 9:>Lat 1:> Protein 1:> '!gar 2:>Lat 15> Protein )> '!gar )>Lat 15> Protein 1)> '!gar 1>

Q) .hich str!ct!re is the primary mechanism "or sh!nting

blood away "rom the "etal p!lmonary circ!lation/ Loramen

?ale*ans

!ct!s Arteriosis

Arteria 6mbilicalis

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!ct!s Benos!s

6mbilical Arteries

%lood enters the right atri!m o" the "etal heart and most passes thro!gh the "oramen o?ale into the le"t atri!m* Lrom

there it is p!mped thro!gh the aorta* +he "oramen o?ale is the

ma<or str!ct!re "or bypassing the "etal p!lmonary circ!lation*

'ome o" the blood in the right atri!m does enters the right

?entricle and then into the p!lmonary artery howe?er most o"

this passes thro!gh the d!ct!s arterios!s into the aorta th!s

bypassing the "etal p!lmonary circ!lation*

Q) .hich one o" the "ollowing str!ct!res is the origin o" the

renal t!b!les/(Please select 1 option A $enital t!bercle

% Mesonephric d!ct

C Metanephric blastema**ans

Paramesonephric d!ct

E 6rethral "olds

Q) .hich o" the "ollowing options describes lymph gro!p to

which the ?!l?a drains/A eep ing!inal lymph nodes

% ;nternal iliac lymph nodes

C ParaDaortic lymph nodes

'!per"icial ing!inal lymph nodesans

E '!perior mesenteric lymph nodes

+he ?!l?a

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Q) ==> o" body calci!m is in what "orm/ Calci!m

%icarbonate

Calci!m $l!conate

Calci!m Phosphate*ansCalci!m Carbonate

Calci!m Hydroxide

Q) A 1ODyearDold child presents to the adolescent gynaecology

clinic* 'he has a history o" ?irilisation a"ter !ndergoing p!bertal changes* +he karyotype re?eals O8F-* An !ltraso!nd

scan does not show the presence o" a !ter!s and o?aries*

.hich enRyme de"iciency may be associated with these

clinical "eat!res/

A* )DalphaDred!ctase de"iciency **ans%* Complete androgen insensiti?ity syndromeC* 4allmann syndrome* Polycystic o?ary syndromeE* +!rner syndrome

+he answer is )DalphaDred!ctase de"iciency* +!rner syndrome

is O) F* Polycystic o?arian syndrome has a normal "emale

karyotype* +he child described abo?e is genetically male*Howe?er, testosterone is not con?erted to dihydrotestosterone

in target tiss!es* Li?eDalphaDred!ctase de"iciency pre?ents

con?ersion o" androgen to estrogen* +he child may ha?e been

born with ambig!o!s genitalia and raised as a "emale* At

p!berty, ele?ated le?els o" androgen lead to masc!linisation

incl!ding ?irilisation* Complete androgen insensiti?ity is not

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the answer beca!se increased androgens are con?erted to

estrogen and do not show any ?irilisation* ;t in?ol?es

phenotypic "emales and an !nresponsi?eness to

androgens*4almanJs syndrome is a "orm o" hypogonadotropichypogonadism and anosmia*

$ Jhat is the action of cytochrome -H"0

enymes?

a, Always acts an isomerase

b, Always acts as a transferasec, Always a((s an alcohol group

(, Always a((s a terminal electron

e, Always catalyses hy(roxylations,,ans

$ Jhich mar7er can be use( to assess the

functional status of the fetal a(renal glan(?

a, estra(iolb, 315A

c, estrone

(, estriol,ans

e, testosterone

placenta (oes not express CU-!NA enyme which

is necessary to convert progestin toprogesterone, so it wor7s with fetal a(renal, fetal

a(renal pro(uces

!@alphahy(roxyan(rostene(ione an( through

aromatiation* estriol is pro(uce( by the

placenta, 5striol is a unique steroi( which is only

synthesie( by the placenta, &hus * estriol is a

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surrogate mar7er to assess the functional status

of the fetal a(renal glan(,

$

Ans L&C

-o! are disc!ssing radiation doses "or an abdominal C+*

+he radiation dose o" an abdominal C+ is eI!i?alent to which

o" the "ollowing/ O: Chest FDrays

1 year nat!ral backgro!nd radiation

O:: Chest FDrays*ans

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1: years nat!ral backgro!nd radiation

O: ays nat!ral backgro!nd radiation

An an(ominal C& is equivalent to H00 chest:/AUs or G,N years bac7groun( ra(iation,

$ hypervitaminosis C associate( with= !#oxalate

stone,ans

G#sensory neuropathy

;#motor neuropathy

;#iron (ef anemia

Eitamin C toxicity is a rare case as Eitamin c is

water soluble* excess amount will be excrete( via

7i(neys, .ut still there is a chance of vitamin c

toxicity an( (eath,

Anything in excess can 7ill you, for an example*

water toxicity can 7ill a person, 2f you excee( the

normal requirement of vitamin c* you are running

a ris7 of vitamin c,

&he upper limit for vitamin C inta7e is G000

mgD(ay,Common si(e#e'ects vitamin c toxicity

!, 2n(igestionsG, 3iarrhea

;, Lausea

H, Eomiting

", 1ea(ache

@, atigue

N, 3isturbe( sleep

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lipophilic and synthesiRed "rom "atty acid* How does it exerts

its action/ a* intracell!lar receptor

b* $ protein co!pled receptor**ans

c* ion channel receptor d* throxine kinase linked receptor

e* receptor with intrinsic enRyme acti?ity

altho!gh chemical property same as steroid*** prostaglandin

and steroid di""er in many ways* one o" it is their interaction

with cell!lar molec!les* steroid ?ia intracell!lar signalling,

prostagladin ?ia $ co!ple protein

other di""erence

1* steroid takes ho!rs or days to exerts its action* prostagladins

takes min!tes or seconds to exert its action

9* steroid is "rom cholesterol* Prostagladin is "rom arachidonic

acid "atty acid2* steroid responsible "or sex hormones "!nctions*

prostagladin "or initialtion o" labo!r*

Q) ++P associated with all except D A;nc %+

%ec platelets

C;nc P+*ans

shistocytes on peripheral "ilmEnone abo?e

Q) Homolog!e o" "allopian t!be D Aappendix

testes**ans

%appendix epidydimis

Cepoopheros

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prostate

Eparaoopheros

$ 5rgometrine malete#which is true?Causes an increase( central venous

pressure,,ans*causes tetanic contractn

-rostaglan(in analogue

Causes spasmo(ic contractions of uterus

Causes arterial vaso(ilation

2s a cycli oxygenase G inhibitors$ Jhich of the following is the (rug of choice for

the treatment of Chlamy(ia trachomatis infection

(uring pregnancy? A Amoxicillin ,ans

. Cephaolin

C Clin(amycin

3 Metroni(aole5 &etracycline

Chlamy(ia infection in the non_pregnant state is

usually treate( with a tetracycline

F(oxycycline!00mg .3 for N (ays* or with

aithromycin !g in a single (ose, 5rythromycin

an( o6oxacin can be use( if the Rrst linetreatments are contrain(icate(,

3uring pregnancy* tetracycline therapy is

contrain(icate( because of its incorporation into

fetal bones an( teeth, &reatment options are

therefore erthromycin or amoxicillin or

aithromycin,

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.hich o" "oll is the primary opsoniin the coplememt

system/ C2a

C2b**ans

CObC)a

C)b

Q) Calci!m is ECL 19::: times than ;CL

;n ECL it bo!nd to

Plasma proteins phosphate and bicarbonate

And O)> in ioniRed "orm and ))> bo!nd "orm

Q) &ate3 chances o" transmission o" hepatitis H%sAg positi?e

mother/

;" mother positi?e H%sAg and H%eAg percentage is 7:D=:>

;" <!st H%sA$ positi?e it is 1:>

Q) -o! answer an emergency call "or a postpart!m

haemorrhage* +he midwi"e estimates that the patient has lost

approximately 1 l o" blood* .hat sho!ld yo! be yo!r "irst

action/

A* Assess the patient’s airway, breathing and circ!lation andadminister oxygen at a rate o" 1) l3min ans%* %iman!al compression o" the !ter!sC* Catheterise the bladder* btain blood "or cross match o" O !nitsE* 'ite two large bore intra?eno!s cann!lae

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+he answer is assess the patient’s airway, breathing and

circ!lation and administer oxygen at a rate o" 1) l3min* ;n an

ac!te emergency, one sho!ld always assess the airway,

breathing and circ!lation be"ore addressing the secondarytreatment* ;n practice, this may be talking to the patient and to

see i" they respond*

Q) A primigra?id woman presents in spontaneo!s labo!r at 2=

weeks o" gestation* At 15::h, her cer?ical dilatation is 8 cm*

A "!rther ?aginal examination at 99::h re?eals that cer?ical

dilatation is still at 8 cm* At :91:h, the "et!s is in the

occipitoposterior position and !terine acti?ity is present* .hat

is the most appropriate action/

A* Amniotomy *ans%* Commence intra?eno!s oxytocin

C* Membrane sweep* &epeat ?aginal examination a"ter 9 ho!rsE* &epeat ?aginal examination a"ter O ho!rs

+he answer is amniotomy* +his case demonstrates slow3no

progression d!ring the "irst stage o" labo!r and malpositioning

o" the "et!s* +he most appropriate initial inter?ention wo!ld

be an amniotomy (arti"icial r!pt!re o" the membranes* .hat percentage o" pregnancies are comolicated by

$M / A1>

%1D)>*************ans

C1:D1)>

9:>

E9)>

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L /estriction fragment length polymorphism

characterise( by#2s use( for 3LA Rngerprinting

2s use( to i(entify (i'erence in protein

expression

/equires the use of 3LA polymerase

2s use( to i(entify (i'erence in gene expression

3oesn8t require the use of 3LA probes

+he doppler e""ect re"ers to which o" the "ollowing

+he change in wa?e direction as it passes "rom one medi!m toanother*+he "reI shi"t o" re"lected so!nd wa?es assoc with mo?emento" an ob<ect in respect to the transd!cer ans+he e""ect when so!nd wa?es are greater than the str!ct!rethey come into contact with ca!sing !ni"orm amplit!de wa?esin all directions with little or no re"lection ret!rning to the

transd!cer*Apparent bending o" wa?es aro!nd small obstacles+he decreasing intensity o" a so!nd wa?e as it passes thro!gha medi!m

$

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5xtra cellular is ""%

H0% boun( to albumin

!0 % boun( to bicarbonate* phosphate* lactate

$ Jhere in the bo(y is A&- foun(?

a, .oth intracellular an( extracellular

b, Pnly extracellular

c, Pnly intracellularans

(, Pnly within high energy output cells

e, Pnly within mitochon(ria

A&- is pro(uce( in the cytoplasm Fanaerobic an(

the mitrochon(ia Faerobic which are both

intracellular,

Q) .here in the body is calcidiol prod!ced/ 4idneys

Gi?erans

Parathyroid'kin

'pleen

Calcidol is 9) hydroxycholicalcideril which is "ormed in the

li?er by 9) hydroxylation then con?erted to 1,9) HH by 9)

hydroxylation in the kidney

Q) At what gestation does the "etal heart "irst become

detectable on !ltraso!nd/O weeks

8 weeks**ans

7 weeks

5 weeks

= weeks

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Q) .hich mediator that is responsible "or the drop o" blood

press!re in pregnancy/a* e0'ans

b* i0'

c* b0'd* prostacyclin

e* prostaglandin

endotheli!m nitric oxide synthase e **endothelial

i*** ind!cible

b*** brain woman with history o" m!ltiple interco!rse had !lcer in

cer?ix "irst line in?estigation

a pap smearans b cer?ical biopsyc ?aginal do!ch and "ellow !p a"ter O weeks

L &ransfusion of bloo( n bloo( pro(ucts=

2mmuno supression is a recognie( complication

of transfusion

Store( re( bloo( cells have a high conc of G*;

bisphosphiglycerate

Store( re( cells have lower oxygen aYnity

compare( to freshly (onate( re( bloo( cells

1ypercalcemia is recognie( complication

-lasma conc of pottasium in store( bloo( is lower

then in freshly (onate( bloo(

$ Lot transfusion transmissible infection # A

salmonella

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. brucella

C CV3

3 1ep A

5 streptococci,ans

$ Jhat is the main bu'er in urine? a, Ammonia

b, .icarbonate

c, Chlori(e

(, 1aemoglobin

e, -hosphate,ans

A 29DyearDold Asian woman presents at 28 weeks o"

gestation with abdominal discom"ort, 9W protein!ria and a

blood press!re o" 1O:3=: mmHg* 'he has blood tests in

accordance with the 0;CE g!ideline "or the management o"

hypertension in pregnancy* +he midwi"e asks yo! to re?iew

the "ollowing blood res!lts* .hat do these res!lts s!ggest/6rea 9*5 mmol3lCreatinine 87 micromol3l'odi!m 125 mmol3lPotassi!m O*9 mmol3l6rate :*27 mmol3lAlb!min 29 g3l

Alkaline phosphatase 1=5 i!3lAlanine trans"erase 22 i!3l%ilir!bin ) mmol3l

&he answer is Lormal bloo( results for ;@ wee7s

of pregnancy,

An Asian woman books in "or her third pregnancy at 19weeks o" gestation* 'he has recently mo?ed to the 64 "rom

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+hailand to be with her new h!sband* A"ter preDtest

co!nselling, with the aid o" an interpreter, she agrees to

hepatitis % ?ir!s (H%B screening* +he res!lts ret!rn as

"ollows* .hat is the signi"icance o" these res!lts/

H%sAg P';+;BEAntiDH%c P';+;BEAntiDH%c ;gM 0E$A+;BEH%eAg 0E$A+;BEAntiDH%e P';+;BE

H%B 0A 9:2 i!3ml

&he answer is Chronic infection Fimmune control

phase, 1.sAg is a mar7er of infectivity, 2ts

presence in(icates either acute or chronic 1.E

infection, Anti#1.c F2gK antibo(y to core antigen

usually remains positive for life following 1.E

infection, Anti#1.c 2gM is foun( in highconcentrations in acute infection* gra(ually

(eclining an( complementing the rise in Anti#1.c

2gK, &he presence of Anti#1.e suggests a low

viral titre an( a low (egree of infectivity, 1.E

3LA is a (ynamic parameter in chronic 1.E,

.elow G0 000 iuDmlthere is a relatively lowli7elihoo( of hepatic (amage,

A woman attends "or a preDoperati?e re?iew in preparation

"or gynaecological s!rgery* &o!tine blood tests are per"ormed,

incl!ding a "!ll blood co!nt* ne o" the clinic n!rses remarks

that the patient looks mildly <a!ndiced* Gater that day the

laboratory in"orms the "ollowing res!lts

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Haemoglobin 7*8 g3l.hite cell co!nt 9*) x 1:=3lPlatelets 97) x 1:=3l

MCB 1:= "lMCHC 2: "lHaematocrit 91>&etic!locytes 1)>

&he answer is 1aemolytic anaemia, -ernicious

anaemia is the potentially (iYcult (i'erential

(iagnosis in this situation but reticulocytes arenot generally increase( in pernicious anaemia

until treatment is commence(, Qess than G% of

circulating re( bloo( cells are reticulocytes,

Lucleate( re( bloo( cells Fnormoblasts are not

normally seen in the peripheral circulation,

Q) A healthy 2ODyearDold woman had a total abdominalhysterectomy "or cer?ical disease* &o!tine !rea and

electrolytes are meas!red one day a"ter s!rgery and are as

"ollows

'odi!m 191 (re"erence range 12)–1O) mmol3lPotassi!m O*2 (re"erence range 2*)–)*: mmol3l

6rea 9*5 (re"erence range 9*)–8*7 mmol3lCreatinine 7O (re"erence range 7:–1): micromol3l

.hat is the most likely ca!se to explain the blood test res!lts/

A* Excessi?e intra?eno!s dextrose *ans%* 0ephrogenic diabetes insipid!sC* Primary aldosteronism

8/18/2019 mrcog sba's -2


* 6ndiagnosed diabetes mellit!sE* 6reteric damage

+he answer is Excessi?e intra?eno!s dextrose*

Hypernatraemia is common a"ter excess ;B normal saline b!t

hyponatraemia can occ!r with excessi?e )> dextrose ;B*

Q) .hen do the corona radiata cells appear/

A at birth

% 19 days**ans, 19 d a"ter o?!latn

C 95 days 1 day

Q) Polyglactin s!t!res are !sed extensi?ely in s!rgical

proced!res, partic!larly to ligate ?essels* .hat are the key

"eat!res o" polyglactin s!t!res/

A* %raided, absorbable and synthetic ans%* %raided, nonDabsorbable and syntheticC* 0onDbraided, absorbable and nat!ral* 0onDbraided, absorbable and syntheticE* 0onDbraided, nonDabsorbable and nat!ral

+he answer is braided, absorbable and synthetic* Polyglactin

s!t!res are !sed to ligate pedicles and close the !ter!s d!ring

a caesarean section* +o achie?e this, the s!t!res are braided to

pre?ent the knots "rom slipping*

Q) A n!lliparo!s woman presents with spontaneo!s r!pt!re o"

membranes at O1 weeks o" gestation* At 15::h, her cer?ical

dilatation is 2 cm* A "!rther ?aginal examination at 99::h

re?eals that her cer?ical dilatation is still 2 cm* At :91:h, the

8/18/2019 mrcog sba's -2


"et!s is in the occipitoposterior position and !terine acti?ity is

present* .hat is the most appropriate action/

A* Administer prostaglandin per ?aginam%* Caesarean sectionC* Commence intra?eno!s oxytocin *ans* Membrane sweepE* &epeat ?aginal examination a"ter O ho!rs

+he answer is commence ;B oxytocin* +he membranes ha?e

r!pt!red already so amniotomy is not reI!ired* 0o

progression has been made d!ring the "irst stage o" labo!r*

+here"ore, the patient sho!ld be administered intra?eno!s

oxytocin*

which does not cross placenta / a* heparin**ans

b* morphine

c* naloxoned* war"arin

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$

Ans A

$ which antihypertensive (rug is typically

associate( with tolerance on long term use??

Qabetolol

Captopril

5napril

Methyl(opa

1y(ralaine,,ans

$ /egar(ing 2S1 which one following is correct?

2s use( to (etect mosaics

Can be use( to (etect unbalance( translocation

Can be use( to (etect gene mutation

,,ans

8/18/2019 mrcog sba's -2


1as false positive !=H000

Can be use( to (etect balance( translocation

$

or infection

irst see at 1.sAg ,,positive or negative

2f positive that means infection 2st step

Low acute or chronic

8/18/2019 mrcog sba's -2


2n acute 2gM core antibo(ies will positive

2n chronic it will be negative plus in chronic

sometimes (ata can give presence of 1ep b

3LA ,,highly in(icative of chronic infection

A 85DyearDold woman presents with two episodes o"

postmenopa!sal bleeding* 'he has a %M; o" 92 and is

otherwise healthy* An !ltraso!nd shows that her endometrial

ca?ity is O mm thick, and an endometrial pipelle sample is

taken that yields a small ?ol!me o" tiss!e* +he pathology

report s!ggests a neoplasm* .hat is the most likely diagnosis/

A* Geiomyoma%* Endometrial hyperplasiaC* Endometrial polyp* Endometrioid adenocarcinomaE* 'ero!s carcinomaans

&he answer is serous carcinoma, Serous

carcinomas are typically seen in postmenopausal

women, &he (evelopment of these carcinomas is

not associate( with a raise( .M2* (iabetes or

hypertension, &he uterine tumour can be very

small Feven in the presence of extra uterine

sprea(* an( therefore* results from an

ultrasoun( an( even hysteroscopy can appear

normal,

$ibroi( (egen 1yaline is most common

/e( (egeneration is speciRc to pregnancy

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A C+$ is per"ormed in labo!r "ollowing normal

pregnancy* +he reading has a baseline rate o" 19: bpm, a

?ariability o" ) bpm, no decelerations and no accelerations* A

"etal blood sample has been per"ormed and the pH is 7*9)*.hat is the most appropriate management/

A* eli?ery is indicated%* o not repeat the "etal blood sample !nless the C+$deteriorates ansC* ;" the C+$ remains the same repeat the "etal blood sample

in 2: min!tes* Maternal oxygen therapy and repeat the "etal blood samplein 9: min!tesE* &epeat the "etal blood sample in 2: min!tes regardless o"the C+$

&he answer is 3o not repeat the fetal bloo(

sample unless the C&K (eteriorates, &he C&K isreassuring accor(ing to L2C5 gui(elines so the

primary fetal bloo( sample F.S was not

nee(e(, &he .S result is also normal,

$ which foll (rug suppress pituitary Q1

pro(uction*hepatic S1.K pro(uction an( use to

treat 1irsutism?SpirinolectoneKn/1 Analogue

lutami(e

Kestrinone

CPC-,,ans

Q) .hich o" the "ollowing ?essels is a branch o" the anterior

tr!nk o" the internal iliac artery/ A Middle rectal artery

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% Median sacral artery

C bt!rator artery

?arian artery

E 6terine artery**ans

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Q) .hich one o" the "ollowing ner?e roots mediates the anal

re"lex/

A C), C8

% C7, C5C C5, +1

G), '1

E '2, 'O*ans

Q) !reters are deri?ed "rom/ Mesonephric d!ct

Q) .hich $L& calc!lator is recommended by 0;CE/ 'hwartRLorm!la

C4DEP; Lorm!la

M& "orm!laans

Mayo !adratic Lorm!la

PA0$ Lorm!la

e$L& is estimated $L& calc!lated by the abbre?iated M&

eI!ation 158 x (Creat 3 55*OD1*1)O x (AgeD:*9:2 x (:*7O9 i"

"emale x (1*91: i" black

Q) A midwi"e asks the obstetric registrar to re?iew a

primigra?ida in labo!r who has progressed to 8 cm dilatation

with an abnormal C+$* 'he has been monitored bycontin!o!s electric "etal monitoring beca!se o" s!spected "etal

growth restriction* +he C+$ has been normal !p to 2:

min!tes pre?io!sly*

+he registrar re?iews the patient and con"irms that the C+$

has a baseline heart rate o" 1): bpm with a baseline ?ariability

o" O "or the last 2: min!tes* +here were no accelerations b!t

8/18/2019 mrcog sba's -2


?ariable decelerations were present* .hat wo!ld be

appropriate management with these C+$ "indings/

A* +his is a normal C+$ and no inter?ention reI!ired%* +his is a s!spicio!s C+$ and reI!ires contin!ed obstetricre?iew **ansC* +his is a pathological C+$ and "etal blood sampling isreI!ired* +his is a pathological C+$ and !rgent deli?ery is reI!iredE* +his is a s!spicio!s C+$ and "etal blood sampling is

reI!ired+he answer is +his is a s!spicio!s C+$ and reI!ires

contin!ed obstetric re?iew* +his is beca!se there is <!st one

abnormal "eat!re – ?ariable decelerations* +he decreased

?ariability and lack o" accelerations ha?e only been present

"or 2: min!tes, not yet long eno!gh to classi"y as abnormal

"eat!res

$ serum lactate value in(icative of severe sepsis

` H mmolDl

$ A mi((le age( woman who is currently !G

wee7s oregnant is referre( for a routine us scan,

&he following are all commonly (etecte( at this

time except=

AnencephalyligohydramniosCystic hygroma%laddwr o!t"low obstr!ction*ans

Abdominal wall de"ects

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+he "ollowing ser!m markers increase d!ring pregnancy

except D +2

Protein

Alkaline phosphatase+Oans

+%$

$ 3uring chil(birth* anesthesia is a(ministere(

into epi(ural space of spinal column, Jhere is

the epi(ural space locate(?A, .etween supraspinous an( interspinous

ligaments

., .etw wall of vertebral cavity an( (ura

mater,ans

C, .etween arachnoi( an( (ura mater

3, .etween arachnoi( an( pia mater

5, .etween pia mater an( spinal canal

;n early pregnancy at what gestation does the Embryonic

pole become ?isible on trans?aginal !ltraso!nd/ O weeks

O weeks W 2 days

) weeks

) weeks W 2 days**ans7 weeks

$ most imp anion in urine # a, albumin

b, phosphate

c, chlori(e,,ans

(, bicarbonate

e, nitrate

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Q) .hich cells are not !sed "or P;$/

Polar body "rom oocyte

;nner cell mass **ans

+ropoectoderm cell

Polar pody "rom Rygote

%lastomere "rom clea?age stage embryo

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Q)

Q) ;n "etal circ!lation, blood passes "rom ;BC to le"t ?entriclethro!gh//

1 d!ct!s arterios!s

9 "oramen o?ale**ans

2 d!ct!s ?eno!s!s

$ Jhat ma7es (imple in gluteal region? A

ischial spine

. post sup, iliac spine ,,ans

C post inf, iliac spine

3 sacroiliac ligament

$ 2n fetal circulation* umbilical venous bloo(

before entering the inf vena cava passes throughwhich structure? ! foramen ovale

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G (uctus venousus ans

; (uctus arteriosus

Q) 4aryotype "or complete mole* D A*8=xxy%*8=xxx

C*O8xx **ans

*O8xy

Q) An M&; examination is 0+ allowed !nder any

circ!mstances when the "ollowing is present D

A* A pacemaker %* A hip3knee <oint replacement

C* An intracranial ane!rysm clip

* A metallic heart ?al?e

E* A "irstDtrimester pregnancy

Ans A,C

Q)A bsol!te C; o" H&+ is / +hrombosis **ans

"ibrocystic disease

"ibroadenoma

haemorrhage

$ Rrst heart beat seen on 4SK # (ay G0

(ay GG

(ay G>

(ay ;G , Ans

(ont confuse Rrst heart beat in embryo is on (ay

G!

Rrst heart beat (ectet( in usg is (ay ;G

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$

Ans C

$-revalence

0," hep . an( 0,;#0,N hep C 0Lollowing cross placenta, regards as teratogenic D Baricella

&!bella

H'B

+oxoplasmosis

'yphilisCMB

H&+ is help"!l in all o" the "ollowing except / ?aginal

atrophy

"l!shing

osteoporosis

coronary heart disease * Ans

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Q) %i"!rcation o" aorta at this le?el D

6ppermost edge o" iliac crest * Ans,this le?el

corresponds to G O

Anterior s!perior iliac spineAnterior in"erior iliac spine

'ciatic notch

;schial spine

Q) A registrar is asked to re?iew a primigra?ida in labo!r whohas progressed to 8 cm dilatation and has an abnormal C+$*

+he registrar re?iews the case and con"irms that the C+$ has

a baseline rate o" 1))bpm, a baseline ?ariability o" eight, no

accelerations and ?ariable decelerations* .hat is the correct

categorisation o" this C+$/

A* 0onDreass!ring C+$%* 0ormal C+$C* Pathological C+$* Pathological C+$ with reass!ring "eat!resE* '!spicio!s C+$*ans

+he answer is '!spicio!s C+$* A s!spicio!s C+$ is de"ined

as a C+$ where one o" the "eat!res is nonDreass!ring and allother "eat!res are reass!ring*

Q) $estational age o" C&G o" 2:mm D 8 weeks

5weeks

1:weeks ** ans

19weeks

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CrlWO9 daysweeks

2:WO9daysweeks

79days7weeks

1:*:9weeks1:weeks

Q) According to .H , Hb in pregnancy sho!ldnJt be less

than D5

1:**ans

=

11

12

$ 3LA (uplication occur in # K!

Sans

KG phase

$ Mc uterine immune cell # Amacrophage

.natural 7iller ,ans

C(en(ritic

3. cell

5& cell

$ all of the foll appear to (ecrease hot 6ushes in

menopausal women except ? an(rogensraloxifene ,ans

iso6avones

tibolone

&reatment of vasomotor symptoms SS/2s=

6uoxetine an( paroxetine, SL/2= venlafaxine,

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Cloni(ine FZ#agonist= once mainstay treatment*

but now shown ashaving limite( e'ect,

$

Ans C

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$ A ;@#year#ol( woman who ha( supraspinous

ligament Rxation G (ays ago complains of pain

over right mons pubis* right labia* an( the

perineum, Jhich nerve is most li7ely to be

in)ure(?A, 2liohypogastric nerve., 2lioinguinal nerve

C, Kenitofemoral nerve

3, -u(en(al nerve ,ans

5, -osterior femoral cutaneous nerve

$ potassium is absorbe( in? -C&

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$ A ;"#year#ol( marrie( woman presents to her

K-, She complains of feeling unwell with non#

speciRc )oint pains an( perianal (iscomfort, Pn

examination you note evi(ence

of wart li7e lesions on her perineum, She a(mits

to being unfaithful to her husban( for several

years, Jhat is the most li7ely (iagnosis? a

-rimary syphilis

b Secon(ary syphilis,ans* wart li7e

lesion< con(ylomata lata*at secon(ary stage ofSyphilis

c Qatent syphilis

( &ertiary syphilis

e Congenital syphilis

$ &he following statements are all true with

regar(s to labour 5:C5-&=

a 5ngagement is (eRne( as less than or equal to

two#Rfths of the fetal hea( palpable above the

pelvic brim

b 2n maximum 6exion the posterior fontanelle

can be palpate( vaginally

c 2nternal rotation involves rotation of the fetalhea( from the occipito transverse to the left

occipital transverse position

( /estitution is where the fetal hea( reverts to

the transverse position

e 3escent ten(s to occur )ust before the onset of

labour in Afro#Caribbean women,,ans

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Q) what is the ner?e s!pply to the skin o" perine!m

in" gl!teal

in" rectal**ans

s!per"icial perinealdeep perineal

obt!rator

Q) At a booking (19 w appointment a 9ODy primi complains

o" "ainting episodes and notices her hands and "eet "eel

warmer than !s!al*n examn her obser?ations are normal

(i*e*, %P and P* A!sc!ltation o" heart re?eals an E'M in 9nd

le"t ;C space*.hich o" "oll wo!ld explain these "indings/

(Please select 1 option A A rise in central ?eno!s press!re

% Cardiac o!tp!t drops in pregnancy

C Peripheral ?asoconstriction in pregnancy leads to an

increase in ?asc!lar resistance

+he p!lmonary ?asc!lar resistance increases in pregnancy

E +he stroke ?ol!me is increased in pregnancyans

Q) A 9) DyearDold woman presents to AKE* 'he is c!rrently

O1 weeks pregnant* 'he is re"erred to the obstetric registrar on

call who "eels she is a candidate "or immediate s!rgical

ind!ction o" labo!r* .hat is the most appropriate %ishop’s

score reI!ired prior to s!ch ind!ction/ a 1

b 9

c O

d )

e 7 and abo?eans

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Q) Letal hydrope is associated with* D A * toxoplasmosis

%*par?o?ir!s%1=**ans

C*&!bella

*treponema pallid!mE*CM?

Q) A patient with 9 pre? c3s presents at 2) w with a painless

?aginal blood loss o" O:: ml* 'he is [!nbooked,’ that is, she

has not presented "or any pre?io!s A0 appointments so "ar in

this pregnancy*Clinical "inding are as "ollows %P 19:37)

P!lse 75 bpm

0o clinical e3o hypo?olaemia

6rinalysis 0ormal

Examn Abdominal mass is so"t, not tender, with a +r lie

Cardiotocography (C+$ 0ormal

.hat is the most likely ca!se o" the blood loss/A* Cer?ical "ibroid degeneration%* Gikely abr!ptionC* Gikely placenta prae?ia *ans* Gikely ?asa prae?iaE* 'how

$ A GH#year#ol( woman presents to A5

following an episo(e of unprotecte( intercourse,

She complains of generalise( ab(ominal pain an(

irregular blee(ing,Speculum examination reveals

evi(ence of a (ischarge, .imanual examination

(emonstrates evi(ence of cervical excitation,

Jhat is the most li7ely aetiological cause for

such symptoms? a Leisseria gonorrhoeae,ans

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b &reponema palli(um

c Chlamy(ia trachomatis

( Kar(nerella vaginalis

e 1aemophilus in6uenae

A 71DyearDold woman has presented with recent onset o"

?omiting* 'he ?omits !p the content o" e?ery meal

approximately two ho!rs a"ter eating*n examination she has

a palpable mass to the right o" the midline in the epigastri!m*

.hich one o" the "ollowing is the most likely electrolyte

dist!rbance in this scenario/(Please select 1 option

AHigh chloride, low bicarbonate

%High potassi!m, high sodi!m, high bicarbonate

CGow chloride, low sodi!m

Gow 4, low CGD, high HC2 **ans,contraction alkalosis

EGow potassi!m, low sodi!m, low chloride, low bicarbonate

A patient who is 28 weeks pregnant comes to see yo! as

she has de?eloped tingling to the right lateral thigh o?er the

past 2 weeks* n examination there are no skin changes and

no m!scle weakness* .hat is the likely diagnosis/ bt!ratorner?e entrapment

P!dendal ner?e entrapment

Lemoral 0er?e entrapment

Meralgia Paraestheticaans

'hingles

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$ Jhich one give maximum ra(iation (uring

chec7ing tubal patency

Ans .

Q)

Ans C

Q) Crypytococ!s "alls in to which "!ngi category D A mo!ld

% yeast like

C diamorphic

tr!e yeastans

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Q) +he "ollowing are all common contraindications to the !se

o" the Mirena coil EFCEP+ a Pregnancy

b Gi?er "ail!re

c &enal "ail!re**ans,rest are all C;d Mechanical heart ?al?e

e ?arian carcinoma

$

$ 1ow many copies of AA sequence present in &/1 precursor? A,G

.,H

C,@,,ans

&/1 is synthesie( as a GHG#a a precursor

polypepti(e that contains @ copies of the

sequence #Kln#1is#-ro#Kly#* 6an7e( by Qys#Arg orArg#Arg sequences,

Q) .hich one is tr!e "or congenital hip dislocation /

A m*c in A"rican pop!lation

% m *c in "irst born "emale babies ans

C m*c in "irst born in male babies

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needs xD&ay "or con"irmation

E only s!rgically treated

Q) Epilepsy and pregnancy tr!e3 "alse

Combination o" m!ltiple low dose dr!gs recommended*L

&isk o" congenital mal"ormation is increased by 9 to 2

"old**+

Cogniti?e de"icits in older children ha?e been reported with

!se o" ?alproate in !tero*+

xcarbemeRapine is highly toxic to be !sed in pregnancy*L

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Q) Prostratic !tricle

Q) +he epithelia o" the amnion / 1* 'I!amo!s

9* C!boidal **ans2* +ransitional

O* 'imple

Q) Are the "ollowing tr!e regarding the "allopian t!be/ +r!e 3

Lalse

A Has a thick m!scle layer in the isthm!s% ;s acti?ely motile

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C ;s co?ered by peritone!m

Gies anterior to the ro!nd ligament*L

E Possesses a cilial lining

is L rest are +

$ Are the following statements about the

lymphatic (rainage of the genital tract true ? &rue

D alse

A 3rainage from the corpus uteri goes partly to

the superRcial inguinal no(es. 3rainage from the ovi(ucts is mainly via the

para#aortic no(es

C Pvarian (rainage is (irectly to the para#aortic

no(es

3 &he lymphatics of each si(e of the vulva

communicate with each other5 &he mi((le thir( of the vagina (rains to the

superRcial inguinal no(es,

A#3 are true

Githi!m and mal"ormations tr!e3"alse

Ebstein’s anomaly is the displacement o" the tric!spid ?al?etowards the apex o" the right ?entricle

;t gi?es rise to a large right atri!m

cc!rs abo!t O weeks a"ter conception

Githi!m is associate with A's and B's

+he !se o" lithi!m d!ring the last trimester is problematic

All true

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Basectomy is assoc with which one o" abo?e

complications/A An inc risk o" coronary heart disease

% An increased risk o" prostate cancer

C A 1:> risk o" de?eloping antiDsperm antibodiesL,7) > An increased risk o" epididymoDorchitisans

E A "ail!re rate o" 19:,:::

$ Jhich (rug trial phase primarily assesses the

safety of a (rug? A, -hase 2E

., -hase 222C, -hase 22

3, -hase 2 ,,ans

5, -hase 0

2E # -ost#launch safety surveillance

-hase 222 # /an(omise( control trial

-hase 22 # Assesses how well the (rug wor7s aswell as continue( safety

-hase 2 # Assesses safety

-hase 0 # irst human trial # (oes it behave in

humans as expecte(

$ A Rrst#line treatment option for a pregnant

woman at @ wee7s of gestation who has seasonalallergic rhinitis an( no history of (rug allergies or

a(verse (rug reactions is

A lorata(ine,

. chlorpheniramine,,ans

C nasal beclomethasone,

8/18/2019 mrcog sba's -2


3 oral pre(nisone,

5 all of the above,

$ Jhat has the following 2S1 analysis most

li7ely i(entiRe( F(elGG?A, Jolf harrison

syn(rome

., Angelman syn(rome

C, -ra(er willi syn(rome3, 3igeorge syn(rome,ans

5, Cri (u chat syn(rome

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Examples o" syndrome d!e to str!ct!ral chromosomalabnormalities ca!sed by deletion

.ol" harrison syndrome OI1)

Cri d! chat syndrome )I1)

igeorge syndrome 99I11

Angelman syndrome 1)I11D12 (maternal deletion

Prader willi syndrome 1)I11D12 (Paternal deletion

Q) e"iciency o" which ?itamin ca!se paresthesia

A%1

%k

C%9

%2

E%)ans

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Q) Jhich of the following bloo( clotting factors

activates Rbrinogen in common pathway?a,

actor E222

b, actor :222

c, alli7rein

(, inin

e, -rothrombinans

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$ Uour consultant has as7e( you to sen( a urea

an( electrolytes test F45 for a postoperative

woman who has un(ergone a prolonge( an(

(iYcult transcervical resection of Rbroi(s, Jhat

electrolyte (isturbance can occur after this

operation?

a, 1ypernatremia

b, 1ypo7alaemia

c, 1yponatraemia,,ans

(, 1ypovolaemia

e, 2ncrease( serum osmolality

&4/- syn(rome 2t is characterie( by

hyponatremia* hypervolumia lea(ing to cerebral

e(ema an( hypoosmolarity of serum,

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Q) A patient arri?es on labo!r ward she is 27 weeks pregnant*

Her last pregnancy ended with deli?ery ?ia !ncomplicated

lower segment CD'ection O years ago* Contractions are )

min!tes apart and on examination and the cer?ix is )cmdilated* 'he wants to know the risk to the baby o" proceeding

with ?aginal deli?ery (B%AC* .hat is the additional risk the

baby will ha?e respiratory problems a"ter B%AC compared to

electi?e repeat CDsection (E&C'/

0o di""erence&isk 1 to 9> greater with B%AC&isk 1 to 9> greater with E&C'**ans&isk O to )> greater with B%AC&isk O to )> greater with E&C'

+he $reenDtop g!idelines regarding Baginal %irth A"ter CD

section (B%AC state the "ollowing risks with B%AC

9D231:,::: additional risk o" birthDrelated perinatal death5 in 1:,::: in"ant de?eloping hypoxic ischaemic

encephalopathy

99D7O in 1:,::: &isk o" !terine r!pt!re (pre?io!s lower

segment cDsection

1> additional risk o" either blood trans"!sion or endometritis

B%AC red!ces the risk o"

&ed!ces risk the baby will ha?e respiratory problems a"ter

birth rates are 9 to 2> with planned B%AC and 2 to O> with

E&C'

Q) A primigra?ida in the "irst trimester o" pregnancy was

"o!nd to be sp!t!m positi?e "or acid "ast bacilli* +here is no

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prior history o" t!berc!losis* .hat is the treatment o" choice

"or this patient/

A* Category ; +'**ans%* Category ;; +'C* Category ;;; +'* 'tart A++ a"ter deli?ery

+ direct obser?ed therapy

Q) Min!te ?entilation in pregnancy increases d!e to which o"

the "ollowing/

E""ects o" gra?id !ter!s on diaphragmli!tional anaemia;ncreased renal excretion o" bicarbonate

;ncreased circ!lating oestragen;ncreased circ!lating progesterone*ans

&his is thought to be the result of increase(circulating progesterone, -rogesterone is 7nownto (irectly stimulate ventilation by sensitiing theCLS respiratory centres to CPG,

2ncrease( minute ventilation \blows o'\ CPG an(as a result pCPG is re(uce(, p1 homeostasis ismaintaine( via increase( renal excretion ofbicarbonate,

Q) a child born with m!ltiple congenital de"ects incl!ding

cle"t palate , ne!ral t!be de"ect , A' and microcephaly ,

which o" the "ollowing dr!g was probably !sed by mother /

8/18/2019 mrcog sba's -2


a* erythromycin b* isotretinoin**ansc* ib!pro"en

d* metronidaRoleQ)

Ans C

$ All the following therapies woul( be

appropriate for the acute treatment of migraine

in a pregnant woman except A

sumatriptan,,ans

. co(eine,

C acetaminophen,

3 propranolol,

.ith regard to cardiac cycle, what is the de"inition o"stroke ?ol!me/A* Cardiac o!tp!t3body s!r"ace area

%* End diastolic ?ol!meD end systolic ?ol!me**ans

C* End systolic ?ol!meDend diastolic ?ol!me

* End systolic ?ol!meW end diastolic ?ol!me

E* End diastolic ?ol!meW end systolic ?ol!me

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High %lood ?ol!me

&ed!ced ECL ?ol!me

Q) .hich o" "oll tests is !sed to detect antibodies orcomplement bo!nd to red blood cell antigens in ?i?o/

irect Coombs**ans

;ndirect Coombs

$!thrie

Manto!x

Hea"

irect Coombs detects antibody3complement attached to

antigens in ?i?o !sed to test &h and A% incompatibility

;ndirect Coombs detects low le?els antibody in ser!m in ?itro

!sed in cross matching

Q) /egar(ing prenatal exposure to teratogen*

choose the correct option=

A, Qarge (oses shoul( be use( for the shortest

time

., All organs are sensitive for the same perio( of

time

C, &here is no ris7 of teratogenicity after > wee7s

3, 4p to (ay !N * any teratogenic e'ect results in

miscarriage,,ans

5, nown teratogenic anticonvulsants shoul( be

stoppe( in pregnancy

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$

Ans C

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Q) which one is potassium sparing (iuretics??

.en(eo6umethiai(e

Captopril3oxaosin

8/18/2019 mrcog sba's -2


urosemi(e

&riamterene,,ans

Q) Lertilisation leads to haploid n!mber o"

chromosomesL

Q) 21D ;solated diathermy machines

AD Are earth re"erenced

generators *************************************************L

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%D perated in a "reI!ency range o" O::D8::

kHR *****************************L

CD ;solated machines are inherentlysa"er ****************************************L

D iathermy can only pass back to the generator ?ia the

patient plate*****+

ED Prod!ce !na?oidable large earth leakagec!rrents*************************L

Modern diathermy machines are isolated (!nearthed

generators as opposed to the old earth re"erenced generators*

+he old earth re"erenced generators tend to prod!ce higher"reI!ency c!rrent o?er a wider range than the narrow range o"

the isolated generators* C!rrent will only pass back to the

generator with no pathway back to earth i*e* a small area o"

skin to!ching a metal contact (eg drip stand will not res!lt in

a b!rn* ;" the plate is omitted c!rrent will not "low* +he

sophisticated electronics in the isolated generator ens!res a

considerable red!ction in earth leakage c!rrents compared to

the earth re"erenced generators*

29D 0onDdis<!nction o" chromosomes d!ring meiosis is a

ca!se o"X3!

AD EdwardJs

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syndrome ********************************************************************+

%D +!rnerJs

syndrome *********************************************************************L

CD Cri d! chat

syndrome ****************************************************************L

D Pata!Js

syndrome **********************************************************************+

ED Ga!renceDMoonD%iedl

syndrome ****************************************************L

0onDdys<!nction (the "ail!re o" replicated chromosomes to

segregate d!ring Anaphase ;; d!ring meiosis is responsiblemost typically "or ownJs syndrome (trisomy C91, Pata!Js

syndrome (trisomy C12, +!rnerJs syndrome (F,

4line"elterJs (FF- syndrome and Edwards syndrome

(+risomy C15* Cri d! Chat is d!e to a deletion o" a portion o"

C)*

22D Campylobacter <e<!ni

AD attack rates are highest in the

elderly ******************************************L

%D in"ections are treated with

cipro"loxacin ****************************************+

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CD is a recognised pathogen in domestic

animals ********************************+

D is readily isolated in stool

c!lt!re *************************************************L

ED ca!ses

colitis ******************************************************************************+

aD-o!ng ad!lts and children*

bDCipro and Erythromycin, b!t most are sel"Dlimiting*

cD+ransmitted to h!mans by milk or water in"ected by wild

and domestic animals and po!ltry*

dD&eI!ires special conditions O9ZC, microDaerobicatmosphere on blood agar with antimicrobials added*

eDProctocolitis and enterocolitis may be d!e to sex!ally

transmitted agents s!ch as CampylobacterEntamoeba

Gymphogran!loma ?enere!mand may be clinically

indisting!ishable "rom nonDin"ecti?e ca!ses*

2OD Mast cells

AD Contain

heparin ***********************************************************************+

%D egran!lation releases lytic enRymes and in"lammatory

mediators "rom storage gran!les ******L

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CD Are lipophilic cells in?ol?ed in in"lammatory and imm!ne

responses ***L

D CrossDlinkage o" s!r"ace ;gA molec!les by antigen may

ca!se an anaphylactic reaction*******L

ED An excess o" circ!lating mast cells ca!ses

mastocytosis *******************+

Mast cells are basophilic cells (not lipophilic in the

connecti?e and s!bc!taneo!s tiss!es, which are in?ol?ed in

in"lammatory and imm!ne responses* +hey contain storage

gran!les that contain lytic enRymes (e*g* tryptase and

in"lammatory mediators, e*g* histamine, heparin, )DH+,le!kotrienes, platelet aggregating "actor, le!cocyte

chemotactic "actor and hyal!ronidase* &elease o" these

mediators occ!rs d!ring mast cell degran!lation, which can be

triggered by tiss!e in<!ryN dr!gsN complement acti?ationN and

"oreign antigenic material* An anaphylactic reaction occ!rs

when a pre?io!sly sensitised indi?id!al is reDexposed to the

antigen* ;t is an ;gE mediated imm!ne response (not ;gA*

Mastocytosis occ!rs when excess mast cells are present in the

circ!lation or as tiss!e in"iltrates*

2)D +he "ollowing is tr!e o" diathermy sa"ety "eat!res

AD +he person who applies the diathermy plate is responsible

8/18/2019 mrcog sba's -2


"or its correct application******L

%D nly isolated diathermy machines alarm when switched on

i" the plate is not connected to the machine*********L

CD +he patient plate is applied to ens!re the c!rrent is mo?ing

away "rom the electrocardiogram electrodes*******+

D +he area !nder the plate sho!ld ha?e a good blood

s!pply*************+

ED Always sha?e the skin in contact with the diathermy

plate***************+

+he s!rgeon !sing the diathermy has o?erall responsibility "or

it and sho!ld check the alarm, wiring and plate be"ore !se*;solated and earth re"erenced monopolar diathermy machines

will alarm when switched on i" the plate is not connected to

the machine, b!t only a "ew will alarm i" the plate is not

attached to the patient* +he plate sho!ld be applied close to

the operation site with the broad side placed perpendic!lar to

a line drawn "rom the operation site to the plate* A good

s!pply is necessary to dissipate any heat generated* +he skin

sho!ld be sha?en in all patients to ens!re good contact

between the skin and the plate*

28D .hich o" the "ollowing statements regarding meiosis

is3are tr!e3"alse /

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AD ;n meiosis ;;, whole chromosomes

separate**********************************L

%D ;n spermatogenesis, meiosis begins at p!berty******************************+

CD Exchange o" paternal and maternal 0A takes place in

meiosis ;;****L

D Anaphase lag leads to n!merical chromosomeaberrations**************+

ED Pairing o" F and - chromosomes in spermatogenesis is end

to end****+

;n meiosis there is a separation o" the chromosomes andhal?ing o" karyotype to "orm germ cells* Meiosis (; and ;;

comprises two s!ccessi?e n!clear di?isions with only one

ro!nd o" 0A replication*

27D +he !rinary system

AD de?elops "rom intermediate

mesoderm ****************************************+

%D !ring intra !terine li"e 2 o?erlapping kidney systems are

"ormed ***+

CD +he mesonephros de?elops as the metanephros

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regresses **************L

D %owmanJs caps!le de?elops in the

metanephros ****************************+

ED +he glomer!l!s "orms part o" the

mesonephros *******************************L

+he !rinary system de?elops "rom the intermediate

mesoderm* !ring de?elopment o" the "et!s there are 2o?erlapping kidney systems D the pro, meso, and metanephric

systems* +he metanephros "orms the permanent kidney*

%owmanJs caps!le and the glomer!l!s de?elop as part o" the

metanephros*

25D +he !reter

AD Passes into the pel?is o?er the bi"!rcation o" the internal

iliac artery***L

%D ;s seen lying on the tips o" the trans?erse processes o" the

l!mbar ***+

CD Has the genito"emoral ner?e lying anterior to

it *******************************L

D ;s s!rro!nded by .aldeyer’s sheath as it passes thro!gh

the bladder wall *****+

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ED Gies anterior to the renal artery at the hil!m o" the

kidney ***************L

+he !reter passes ca!dally lying on the psoas m!scle andcrosses into the pel?is o?er the bi"!rcation o" the common

iliac artery* ;t is seen lying on the tips o" the trans?erse

processes o" the l!mbar ?ertebrae on an intra?eno!s !rogram*

the genito"emoral ner?e lies on psoas hence lies posterior to

the !reter* .aldeyerJs sheath is an in?estment o" m!scle

s!rro!nding the !reteral opening in the bladder wall* +he!reter lies posterior to the renal artery at the hil!m o" the

kidney

2=D +he herpes gro!p o" ?ir!ses incl!de

AD BaricellaDRoster?ir!s ********************************************************************+

%D Papilloma

?ir!s ****************************************************************************L

CD &abies

?ir!s ********************************************************************************L

D EpsteinD%arr

?ir!s ************************************************************************+

ED

Cytomegalo?ir!s ***********************************************************************

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***+

+he Herpes?iridae "amily o" ?ir!ses are ds0A ?ir!ses that

incl!de herpes simplex, ?aricella Roster, CMB and E%B* +he papilloma ?ir!s, a small ds0A ?ir!s, is a member o" the

Papo?a?i!s "amily* &abies, a ss&0A ?ir!s, is a member o" the

&habdo?ir!s "amily*

2=*+he str!ct!res at risk o" damage while cann!lating the

s!bcla?ian ?ein incl!de

AD phrenic

ner?e **************************************************************************+

%D s!bcla?ian

artery *********************************************************************+

CD ansa

cer?icalis *************************************************************************L

D anterior ram!s o" "irst thoracic

ner?e ****************************************+

ED

ple!ra *************************************************************************************+

+he s!bcla?ian artery lies in"erior to the s!cla?ian ?ein and

may be inad?ertently cann!lated in an attempt to cann!late

the s!cla?ian ?ein* +his may be o" serio!s conseI!ence as it is

8/18/2019 mrcog sba's -2


not possible to p!t press!re on the s!bcla?ian artery to arrest

bleeding gi?en its anatomical position* +he apical ple!ra is

in"erior and ca!dal to the s!bcla?ian ?ein and ple!ral

p!nct!re, with, or witho!t, pne!mothorax are recognisedconseI!ences o" s!bcla?ian ?ein cann!lation*

O:*;n ac!te allergic reaction

AD there is an increase in

bradykinins ***********************************************+

%D +Dhelper cells are

in?ol?ed **********************************************************+

CD there is an increase in the prod!cts o" the )Dlipoxygenase

pathway ****+

D the gene "or allergy is located on chromosome

19 *************************L

ED may be triggered by ac!te complement

acti?ation **************************+

c Ge!kotrines

d +he gene is located on chromosome 8

e Anaphylatoxins

O1*+he amnion arises "rom epithelial cells between the

trophoblast

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AD and ectodermal

disc ******************************************************************+

%D +he amnion has )

layers ***********************************************************+

CD the chorion has O

layers **********************************************************+

D the main layer o" the chorion is the cell!lar

layer ***********************L

ED the chorion is s!rro!nded by the

blastocyst ********************************L

+he amnion is a layer o" epithelial cells between the chorion

and the cell mass* ;t has ) layers compared to the O layer

chorion* +he chorion s!rro!nds the blastocyst*

O9*Concerning grie" reactions

AD angry o!tb!rsts are a typical "eat!re o" the nat!ral grie?ing

process ******+

%D hall!cinations o" the deceased can be a "eat!re o" the

normal grie" reaction ******+

CD grie" reactions may occ!r many years a"ter the death o" the

8/18/2019 mrcog sba's -2


person ****+

D s!icidal ideations are a common "eat!re o" a grie"

reaction *************L

ED Antidepressants is the most appropriate initial

therapy *******************L

$rie" reactions are typically mapped along the lines o" anger

denial and g!ilt* elayed grie" is said to occ!r i" itcommences two weeks a"ter berea?ement* $rie" reactions

o"ten occ!r on anni?erseries s!ch as weddings, births etc* +he

most appropriate treatment is conselling and antidepressants

sho!ld not be ro!tinely !sed* '!icidal ideations are also

abnormal*

O2*.hich o" the "ollowing are t!mo!r s!ppressor genes/

AD

p)2 *******************************************************************************************

+

%D

%&AC1 **************************************************************************************

+

CD

APC *****************************************************************************************+

8/18/2019 mrcog sba's -2


D bclD

9 ***************************************************************************************L

ED cD

myc ***************************************************************************************L

M!tations in +!mo!r s!ppressor genes ha?e been implicated

in malignancy as down reg!lation o" these genes can res!lt inthe !nrestricted growth o" cells and hence predispose to

malignancy* +hese genes incl!de BHG (?on Hippel Ginda!,

p)2, &b1(&etinblastoma, %&AC and APC (adenomato!s

polyposis coli genes* ncogenes, on the other hand are

associated with the promotion o" cell di?ision and incl!de

myc, erb, ras and ret*

OO*+rin!cleotide repeat seI!ences are seen in

AD cystic

"ibrosis *****************************************************************************L

%D !chenne m!sc!lar

dystrophy ****************************************************L

CD myotonic

dystrophy *******************************************************************+

D "ragile F

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syndrome *********************************************************************+

ED GeberJs optic

atrophy ******************************************************************L

also H!ntingtonJs chorea

;n genetics, anticipation is a phenomenon whereby the

symptoms o" a genetic disorder become apparent at an earlier

age as it is passed on to the next generation* ;n most cases, an

increase o" se?erity o" symptoms is also noted* ;t is commonin trin!cleotide repeat disorders like H!ntingtonJs disease,

myotonic dystrophy and "ragile F syndrome, where a

dynamic m!tation in 0A occ!rs* All o" these diseases ha?e

ne!rological symptoms*

O)*.hich o" the "ollowing dr!gs are teratogenic

AD

.ar"arin **********************************************************************************+

%D ral

contracepti?e *******************************************************************L

CD

Met"ormin ******************************************************************************L

D

'im?astatin ***************************************************************************+

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ED

&anitidine *******************************************************************************L

+here is no e?idence that ranitidine, met"ormin or the CP is

teratogenic altho!gh it was once belie?ed that aspirin and the

CP were, st!dies indicate otherwise* 'imilarly, met"ormin is

o"ten !sed in PCs to ind!ce "ertility thro!gh red!ction in

ins!lin resistance* .ar"arin is associated with C0' andskeletal abnormalities i" "oetal expos!re occ!rs in the "irst

trimester, pl!s "oetal haemorrhage is more likely* 'tatins also

are associated with teratogenicity*

O8*;n haemophilia A

AD dental extraction bleeding can be controlled with ABP

i" "actor B;;; concentration is 9D)> o" normal **************L

%D sons o" an a""ected man will be

normal ****************************************+

CD nly abo!t =:> ha?e bleeding be"ore one year o"

age *******************+

D hepatitis % ?ir!s is the most common ca!se o" deranged

GL+s *********L

ED there is a normal amo!nt o" "actor B;;;Drelated

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antigen *******************+

nly in mild cases ()D9:> acti?ityis bleeding controlled by

ABP*Haemophilia A is FDlinked recessi?e* 'ons o" a""ected males

will inherit a normal - chromosome, and will be !na""ected*

Hepatitis C or E wo!ld be commoner as a ca!se o" abrnomal

GL+s in these patients, as hepatitis % is more easily screened

"or*

Lactor B;;; related antigen is red!ced in ?on .illibrandJsdisease*

=:> present with bleeding by their "irst birthday* nly 2:>

present with bleeding a"ter circ!mcision*

O7*.hich o" the "ollowing are +ocolytic

AD

'alb!tamol *******************************************************************************

+

%D

'!xamethoni!m ***********************************************************************

L

CD

Propo"ol **********************************************************************************L

D

Progesterone ***************************************************************************+

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ED

$+0 *****************************************************************************************

+

+ocolytic dr!gs, inhibitors o" !terine contraction, incl!de

$+0, alcohol, magnesi!m s!lphate, ritodrine, salb!tamol,

ni"edipine and 0'A;s* Progesterone in high concentrations

also has some tocolytic acti?ity and promotes the relaxant

e""ects o" more con?entional tocolytics*

O5*MetronidaRole

AD ;nhibits dihydro"olate

red!ctase* *************************************************L

%D Has 5:> bioa?ailability i" gi?en

rectally* **************************************+

CD Has harm"!l e""ects with

alcohol* *************************************************+

D iscolo!rs the

!rine********************************************************************+

ED Ca!ses peripheral

ne!ropathy******************************************************+

&ed!ced to acti?e deri?ati?e which binds to 0A and inhibits

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acid synthesis* is!l"iram reaction with alcohol* 'ome types

o" .ar"arin* Metallic taste, hypotension, peripheral

ne!ropathy and also ca!ses a darkening o" the !rine*

O=*Polymerase chain reaction

AD takes se?eral days to

complete ****************************************************L

%D 0A or &0A can be !sed as thetemplate ************************************+

CD helps in diagnosis o"

in"ection ******************************************************+

D in diagnostic PC& the exact seI!ence at both ends o" thetarget region m!st be known *******+

ED Polymorphisms in the ?iral genome may res!lt in

ampli"ication "ail!re *****+

+he polymerase chain reaction is a rapid techniI!e which

prod!ces a res!lt in only a "ew ho!rs* ;t is there"ore extremely

!se"!l "or rapid diagnosis o" conditions s!ch as t!berc!losis

where traditional c!lt!re methods can take se?eral weeks*

0A is the standard template b!t ?iral &0A seI!ence can

also be ampli"ied i" the enRyme re?erse transcriptase is !sed*

Primers !sed in the reaction m!st be complementary to the

8/18/2019 mrcog sba's -2


n!cleic acid seI!ence s!rro!nding the region to be ampli"ied,

there"ore these seI!ences m!st be known* ;n H;B and perhaps

other ?ir!ses seI!ence polymorphism may pre?ent binding o"

primers and res!lt in "ail!re o" ampli"ication* Primers whichwere de?eloped "or ampli"ication o" the predominant clade %

strain "o!nd in E!ropeans and Americans ha?e pro?ed

!nreliable "or ampli"ication o" other H;B clades "rom A"rica

and Asia*

):*+he "ollowing are tr!e o" genes

AD +he rate o" 0A replication is directly !nder the control o"

enhancer seI!ences*************L

%D Mitochondrial genes are inherited "rom the

mother**************************+

CD +ranscription "actors are mainly made o"

&0A********************************+

D ;ntrons are the portions o" a gene which code "or

protein****************+

ED Most o" the h!man genome encodes

polypeptide*****************************L

A gene is a length o" 0A that carries in"ormation to make a

single peptide chain* Howe?er, it is estimated that only a "ew

8/18/2019 mrcog sba's -2


percent o" 0A comprising the whole h!man genome

consists o" genes encoding protein* ;ntrons are inter?ening

seI!ences o" !nknown "!nction in mammalian genes*

&eg!latory elements o" gene transcription incl!de promoters(regions o" 0A to which &0A polymerase bind and initiate

transcription, enhancer seI!ences (modi"y acti?ity o" genes

on the same chromosome and transacting proteins (modi"y

genes on both pairs o" homologo!s chromosomes* m&0A are

transcripts o" 0A, which are attached to trans"er &0A and

then translated in ribosomes to protein, which then !ndergoconsiderable postDtranslational changes* Mitochondrial

inheritance is excl!si?ely maternal, as none o" the

mitochondria "rom sperm s!r?i?es "ertiliRation*

)1*+he "ollowing mechanisms are in?ol?ed in the mediation

o" ins!lin action

AD adenylate cyclase

acti?ation ********************************************************L

%D cell membrane receptor

interaction **********************************************+

CD inhibition o" hepatic gl!cose

release *********************************************+

D receptor tyrosine kinase

acti?ity **************************************************+

ED hormone receptor 0A

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binding ****************************************************L

;ns!lin acts thro!gh a dis!l"ideDbonded heterotetrameric cells!r"ace receptor comprised o" an extracell!lar alpha s!b!nit

co!pled ?ia dis!l"ide bonds to a transmembrane and

intracell!lar beta s!b!nit* ;ns!lin inhibits gl!coneogenesis and

promotes glycogen synthesis* 'ignaling thro!gh the ins!lin

receptor occ!rs thro!gh an intracell!lar tyrosine kinase

domain and res!ltant phosphorylation o" the receptor*

)9*+he seminal ?esicles

AD Contain

spermatids *******************************************************************L

%D Contain

spermatids *****************************************************************L

CD 'ecrete acid

phosphatase *********************************************************L

D 'ecrete

"r!ctose **********************************************************************+

ED 'ecrete

prostaglandins *************************************************************+

'eminal ?esicles secrete a signi"icant proportion o" the "l!id

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that !ltimately becomes semen* Abo!t 8:> o" the seminal

"l!id in h!mans originates "rom the seminal ?esicles* +he

seminal ?esicles do not contain sperm cells* 'eminal ?esicle

secretions contain proteins, enRymes, "r!ctose, phosphorylcholine and prostaglandins*

)2*&egarding the h!man chromosomes

AD +here are 92 pairs o" a!tosomal

chromosomes*******************************L

%D +he - chromosome is larger than the F

chromosome**********************L

CD Cells containing - chromosome are not compatible with

li"e***********+

D %arr body is ca!sed by the presence o" an inacti?e F

chromosome*****+

ED %arr body is only "o!nd in people who are phenotypically

"emale********L

+here are 99 pairs o" a!tosomes, and one pair o" sex

chromosomes* +he - chromosome is smaller than the F

chromosome, no - indi?id!als ha?e been identi"ied, not

e?en aborted "oet!ses* ;t has been s!ggested that there is

8/18/2019 mrcog sba's -2


something "!ndamental on the F chromosome that is needed

"or li"e* +he %arr body is ?isible d!ring interphase and

chromosomes are too ten!o!s to be stained and seen by light

microscopy* Howe?er, a dense, stainable str!ct!re, called a%arr body (a"ter its disco?erer is seen in the interphase n!clei

o" "emale mammals* +he %arr body is one o" the F

chromosomes* ;ts compact appearance re"lects its inacti?ity*

People with FF- or FFF- karyotypes are males (beca!se o"

their - chromosome, and display the "eat!res o" 4line"elter’s

syndrome* +he phenotypic e""ects o" the extra Fchromosomes are mild beca!se, <!st as in "emales, the extra

Fs are inacti?ated and con?erted into %arr bodies

)O* +ypical ad?erse e""ects o" combined oral contracepti?e

preparations incl!de

AD

Migraine ***********************************************************************************

+

%D

Hyperprolactinaemia *****************************************************************

L

CD

epression *******************************************************************************

+

D %reast

8/18/2019 mrcog sba's -2


tenderness ********************************************************************+

ED Goss o"

libido ****************************************************************************L

Menstr!al migraine Lirst migraines associated with a

hormonal e?ent menarche, birth control pills, pregnancy,

and3or postpart!m .orse headaches occ!r near menstr!ation

%irth controls o"ten make headaches worseN discontin!ationmay bring some relie"* Headache typically occ!rs the week

o"" birth control pills, Absence o" migraine noted in second K

third trimesters o" pregnancy* Presence o" other premenstr!al

complaints mood swings, depression, "ood cra?ings, "l!id

retention and breast pain* 'ideDe""ects incl!de depression or

irritability* +he e""ect on libido is ?ariable* ;n many womenrelie" "rom "ear o" pregnancy remo?es a restraint on sex!al

acti?ity and en<oymentN in a ?ery "ew there will be a loss o"

libido* +he other side e""ects o" greatest concern with the

combined CP are ?asc!lar e?ents incl!ding B+ and stroke

(? rare*

))* +he menopa!se

AD ;mplies cessation o" menstr!al "low "or one year or

more ****************+

%D ;s synonymo!s with the

climacteric **********************************************L

8/18/2019 mrcog sba's -2


CD 'ymptoms may occ!r long be"ore menstr!ation

ceases******************+

D cc!rs on a?erage at age O)*)

years ******************************************L

ED ;s associated with

mennorhagia **************************************************L

+he menopa!se is the cessation o" normal menstr!ation*

Con?entionally a woman has to stop menstr!ating "or 19

months be"ore she is considered to be postmenopa!sal*

'trictly speaking, menopa!se is de"ined as cessation o"

menses "or a minim!m o" 8 months beca!se o" inadeI!ate

o?arian "ollic!lar de?elopment and waning oestrogen prod!ction* +he climacteric is an extended period o" grad!ally

declining o?arian "!nction o"ten beginning years be"ore and

lasting years a"ter menopa!se itsel"* +he a?erage age o"

menopa!se in the 64 is )1 years, with a large ma<ority o"

women experiencing menopa!se between the ages o" O) and

))* +he cessation o" periods, can occ!r s!ddenly or may be

preceded by light and in"reI!ent periods* +he climacteric

(rather than the menopa!se altho!gh typically associated

with light periods may be heralded by menorrhagia*

)8* +he bene"its o" adding androgen to menopa!sal hormone

replacement therapy incl!de which o" the "ollowing

8/18/2019 mrcog sba's -2


AD ;ncrease in highDdensity lipoprotein cholesterol

le?els**********************L

%D ;ncrease inlibido*************************************************************************+

CD ecrease in triglyceride

le?els******************************************************+

D ecrease in bone mineraldensity*************************************************L

ED ecreased cardio?asc!lar

risk *****************************************************L

Androgens are known to increase libido and may help to

protect bone mass* Howe?er, lipid pro"iles change when

androgens are added to H&+* +he HG "raction decreases

with androgen therapyN howe?er, triglyceride concentrations

decrease signi"icantly in patients gi?en oestrogenDandrogen

combination therapy*

)7* $rowth Hormone

AD secretion is inhibited by somatostatin

analog!es ****************************+

8/18/2019 mrcog sba's -2


%D is !sed in the treatment o" proli"erati?e

retinopathy ***********************L

CD therapy ca!ses an ele?ation o" ;$LD1

concentrations *********************+

D is appro?ed by 0;CE "or the treatment o" ad!lt

hypopit!itarism ******+

ED therapy is associated with an increased incidence o" breast

carcinoma *************L

$H therapy prod!ces an ele?ation o" ;$LD1 and therapy ismonitored thro!gh meas!ring these concentrations* $H

therapy is appro?ed "or the treatment o" ad!lt hypopit!itarism

and there is no e?idence to s!ggest that it ca!ses an oncreased

risk in any malignancy* +reatment is contraDindicated in any

acti?e malignancy and indeed proli"erati?e retinopathy* $H

secretion is s!ppressed by somatostatin analog!es D eg

octreotide, which are !sed there"ore in acromegaly*

)5* Proteolytic enRymes are released by the "ollowing

organisms

AD 0eisseria

meningitides ****************************************************************L

8/18/2019 mrcog sba's -2


%D 'almonella

typhi *************************************************************************L

CD 'treptococc!s

pyogenes *************************************************************+

D Mycobacteri!m

t!berc!losis ********************************************************L

ED Clostridi!m per"ringens

(welchii *************************************************+

Bir!lence "actors are important in the bacterial s!r?i?al in?i?o* ;n this sense bacterial extracell!lar proteolytic enRymes

can be recogniRed as the legitimate target "or this approach

since they are in?ol?ed either in direct or indirect destr!ction

o" an in"ected3coloniRed tiss!e and in dysreg!lation o" many

host de"ense pathways* +he best example o" the last is an

e""ect o" bacterial proteinases on "ibrinolytic, kallikreinDkinin

and complement cascades, as well as degradation o"

imm!noglob!lins, inacti?ation o" endogeno!s proteinase

inhibitors, and dysreg!lation o" cytokine network system*

Proteolytic enRymes are responsible "or the ?ir!lence and

acti?ity o" organisms s!ch as 'trep Pyogenes, 'taphylococc!s

a!re!s, E coli and Clostridi!m welchii enabling the necrolytic

e""ects on the skin in cell!litis and gangrene

8/18/2019 mrcog sba's -2


)=* +he thyroid gland

AD ;s stim!lated by posterior pit!itaryhormones *******************************L

%D L!nctions "rom the 19th week o" "etal

de?elopment **********************+

CD Acti?ely traps inorganic iodine "rom plasma **********************************+

D 'tores colloid o!tside epithelial

cells *********************************************+

ED Enlarges d!ring normal pregnancy ************************************************+

+hyroid hormone prod!ction is stim!lated by the anterior

pit!itary hormone +'H and secretion begins "rom

approximately the 19th week o" gestation* +2 and +O are

man!"act!red within the thyroid cells thro!gh iodination o"

tyrosine* +he synthesiRed +2 and +O are then stored within

the colloid at the centre o" the thyroid "ollicles* +he thyroid

like most other endocrine organs moderately enlarges d!ring

pregnancy*

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8:* +he h!man testis secretes

AD

Androstenedione ***********************************************************************+

%D G!teinising

hormone *******************************************************************L

CDestradiol **********************************************************************************

+

D

;nhibin ***************************************************************************************

+

ED

Lr!ctose *************************************************************************************

L

+he testis is responsible "or secreting testosterone,

androstenedione, estradiol, inhibin as well as a small amo!nt

o" progesterone* +he anterior pit!itary prod!ces GH and L'H*

Lr!ctose and prostaglandins that no!rish the spermatoRoa are

secreted by the seminal ?esicles*

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81* 'taphylococc!s epidermidis

AD is coag!lase

positi?e *****************************************************************L

%D on microscopy are $ram positi?e cocci in

chains ***********************L

CD are !s!ally sensiti?e to

penicillin ***************************************************L

D grown in blood c!lt!res are d!e to contamination and

sho!ld be ignored ***********L

ED are destroyed by po?odine

iodine ***************************************************+

'taph* epidermidis is part o" the normal skin "lora* As "or

'taph* a!re!s, $ram positi?e cocci in b!nches are seen on

microscopy*

;t is !s!ally insensiti?e to penicillin*Altho!gh it is o"ten a

contaminant in blood c!lt!res, it is associated with line

in"ections* Central ?eno!s catheters are an especially likely

site o" in"ection e?en in the absence o" o?ert exit site sepsis*

+hey sho!ld not be ignored b!t interpreted in the clinical

context, and !s!ally the blood c!lt!res sho!ld be repeated* ;n

patients with central lines, blood c!lt!res sho!ld be taken both

8/18/2019 mrcog sba's -2


peripherally and "rom the central line as semiDI!antitati?e

microbiological techniI!es are a?ailable that may point to the

central line as the principle site o" in"ection*

89* +he "ollowing hepatitis ?ir!ses are &0A ?ir!ses

AD

HAB *******************************************************************************************

+

%D

H%B ******************************************************************************************

*L

CD

HCB ******************************************************************************************+

D

HB ******************************************************************************************

+

ED

E%B ******************************************************************************************

L

Hepatitis A is an &0A ?ir!s spread ?ia the "aecalDoral ro!te*

8/18/2019 mrcog sba's -2


.hilst both H%B and HCB are transmitted thro!gh blood and

blood prod!cts, H%B is a 0A ?ir!s and Hepatitis C is an

&0A "la?i?ir!s* Hepatitis is an incomplete &0A ?ir!s,

existing only with H epatitis %, spread is with coDin"ection ors!perDin"ection with Hepatitis %* Epstein %arr Bir!s is a 0A

?ir!s, ?ery similar to the other herpes ?ir!ses* ;t is shed in

pharyngeal secretions and transmission occ!rs ?ia close oral

contact*

82* &egarding ;mm!noglob!lin

AD ;mm!noglob!lins are secreted "rom +D

lymphocytes* **********************L

%D An imm!noglob!lin $ (;g$ comprises 9 antigenDbinding

sites and a site "or the binding o" complement*********+

CD +he molec!lar str!ct!re o" ;g$ is a -

shape ***********************************+

D ;g$ constit!te approximately 9)> o" all imm!noglob!lis

in a healthy indi?id!al********L

ED ;gMs can cross the placenta to the

"oet!s****************************************L

;mm!noglob!lins (antibodies are secreted "rom %D

lymphocytes (plasma cells in response to a speci"ic antigen*

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%oth antigenDbinding sites are identical and consist o" a long

and hea?y chain* ;g$s constit!te approximately 7)> o" all

imm!noglob!lis in a healthy indi?id!al* nly ;g$s can cross

the placenta* +his is important as they pro?ide imm!ne protection "or the newborn in the "irst "ew months o" li"e*

8O* isin"ectant sol!tions may become contaminated with

AD Enterobacter

species *******************************************************************+

%D 'treptococc!s

species *****************************************************************L

CD Escherichia

coli *************************************************************************L

D Pse!domonas aer!ginosa

(pyocyanea ***************************************+

ED 'taphylococc!s

pyogenes ***********************************************************L

isin"ectant sol!tions ha?e ?ariable bactericidal and

"!ngicidal properties b!t are !s!ally b!t there are reports o"

contamination with Pse!domonas spp, Enterobacter, 'erratia,

actinomyces and L!ngi*

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"emale

AD ;mpro?es the !rethral

syndrome ***************************************************+

%D ecreases !rinary calci!m

excretion *********************************************+

CD &ed!ces the incidence o" myocardial

in"arction ******************************L

D Ca!ses an increased incidence o" endometrial

carcinoma **************+

ED Ca!se

hypertension ********************************************************************L

Gow le?els o" nat!ral oestrogen aro!nd and a"ter menopa!se

diminish the bodyJs ability to absorb calci!m and to

metaboliRe ?itamin * Gow oestrogen le?els lead to a thinning

o" trabec!lar bone and e?ent!ally osteoporosis* +his leads to

an increased risk o" "ract!res o" the hip and wrist and

compression "ract!res o" the ?ertebrae res!lting in a dowager

h!mp* &ather than the original belie" that postmenopa!sal

H&+ red!ces CB risk, st!dies like .H; and HE&' show an

increased CB mortality and morbidity associated with H&+*

0eoplasia o" the endometri!m may "ollow !nopposed

oestrogenN the risk increases with the d!ration o" !sex 2D8

a"ter "i?e years o" !se* x 1: a"ter ten years* +hat is why

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!nopposed oestrogens are no longer !sed in s!b<ects with an

intact !ter!s*

87* +he "ollowing are prec!rsors o" oestradiol

AD

Cholesterol ********************************************************************************

**+

%D'tilboestrol ********************************************************************************

**L

CD Arachidonic

acid ***************************************************************************L

D

ehydroepiandrosterone ***********************************************************

**+

ED

+estosterone *******************************************************************************

*+

+he pathways whereby oestrogens are synthesiRed in the

o?ary

Cholesterol to Pregnenolone then ?ia O pathway

Progesterone to 17Dhydroxyprogesterone (17DHP to

Androstenedione (O +estosterone to estradiolD17b (E9

8/18/2019 mrcog sba's -2


or ?ia ) pathway 17Dhydroxypregnenolone to

ehydroepiandrosterone (HA to estrone (E1

85* Prostaglandins are

AD 'ynthesiRed "rom

cholesterol ******************************************************L

%D Are small

polypeptides ***************************************************************L

CD 'ecreted by the pit!itary

gland ***************************************************L

D 'ecreted by the prostate

gland ***************************************************+

ED Associated with gastrointestinal side

e""ects **********************************+

Prostaglandins are longDchain hydroxy "atty acids deri?ed

"rom arachidonic acid, which is released "rom cell membrane

phospholipids and catalysed by the enRymes cycloDoxygenase

and endoperoxidase* Prostaglandins are prod!ced locally* +he

original so!rce was the prostate* $; side e""ects incl!de

diarrhoea and abdominal pains*

8=* +he %arr body

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AD arises "rom the -

chromosome *************************************************L

%D is present in s!b<ects with +!rnerJs

syndrome ***************************L

CD is present in 9:> o" cells in the

male ****************************************L

D appears as a dense rod close to the cell

wall *****************************L

ED is present in males with 4line"elterJs

syndrome *****************************+

+he chromatin nod!le is the second (inacti?e F chromosome*

0ormal women are thromatin positi?e* 0ormal men are

chromatin negati?e* ;n polymorphon!clear le!cocytes, a tiny

nod!le o" chromatin (the %arr body, or n!clear dr!mstick can

be seen near the n!clear membrane o" many cells in normal

"emales, b!t not in normal males* +!rnerJs F does not ha?e a

%arr body* ;n 4line"elterJs syndrome the sex chromosomal

str!ct!re is FF-, and in them a chromatin nod!le is seen*

7:* Androgens

AD Exert a "eedback inhibitory e""ect on L'H

prod!ction *********************+

8/18/2019 mrcog sba's -2


%D Prod!ce a release o" GH "rom the

o?ary ****************************************L

CD Are prod!ced in the

o?ary **********************************************************+

D Are secreted by the "emale adrenal

cortex ***********************************+

ED Are "ormed in the Geydig cells o" the

testis ************************************L

+estosterone, like oestradiol, "eeds back at the hypothalam!s 3 pit!itary to inhibit $n&H secretion and switch o"" both GH

and L'H secretion* ;n the "emale, testosterone is synthesied in

small amo!nts, probably in the adrenals, b!t a weak androgen,

androstenedione is "ormed as a step in the metabolism o"

progesterone* GH stim!lates testosterone prod!ction "rom

Geydig cells o" the testis*

71* ;gA

AD ;s in?ol?ed in m!cosal

imm!nity****************************************************+

%D Has O distinct s!bD

8/18/2019 mrcog sba's -2


gro!ps***************************************************************L

CD Acti?ates complement ?ia the classical

pathway*******************************L

D ;s man!"act!red in lymph

nodes****************************************************L

ED Crosses the

placenta* *******************************************************************L

;gA is the ma<or antibody prod!ced by plasma cells near

m!cosal s!r"aces, and is "o!nd in tears, sweat, l!ng, g!t,

!rine* ;gA a?oids digestion by the presence o" the secretory

piece which is added as it is secreted onto the m!cosa* ;t is animportant de"ence against s!r"ace binding o" microD

organisms* +here are 9 s!bDtypes, ;gA1 and ;gA9* nly ;g$ is

trans"erred across the placenta* Complement proteins

circ!late, there"ore, they rarely come into contact with ;gA*

79* Circ!lating anticoag!lants ha?e been described in

AD 'ystemic G!p!s

Erythematosis ******************************************************+

%D postD

part!m ********************************************************************************+

8/18/2019 mrcog sba's -2


CD

homocystin!ria **************************************************************************

L

D

haemophilia *******************************************************************************

+

ED the

elderly **********************************************************************************+

Circ!lating anticoag!lant, !s!ally ;g$, inter"ere with

coag!lation reactions* +he main laboratory "eat!re are

prolonged P+ and P++ which persists i" normal plasma is

added*

aD+hese are nonDspeci"ic inhibitors which prolong haemostasis by binding to phospholipids* AntiD"actor B;;; antibodies may

also be seen*

b,d and eDAntiD"actor B;;; antibodies*

cD+hrombotic tendency*

dDhaemophiliacs who ha?e had plasma trans"!sions*

72* A karyotype

AD may be prepared "rom chorionic ?illi cells o" the

placenta****************+

%D helps in the diagnosis o" chromosome

disorders*****************************+

8/18/2019 mrcog sba's -2


CD is made "rom cells arrested at telophase o"

mitosis*************************L

D "rom a Pata! syndrome patient shows an extra

chromosome 0o* 15*****L

ED helps in the identi"ication o" the Philadelphia chromosome,

in chronic myeloid le!kaemia******+

4aryotype is the chromosomal composition o" cellsD normal

karyotype is O8FF or F-* Pata! syndrome is associated with

trisomy o" Chromosome 12*

7O* .hich o" the "ollowing organelles ha?e their own sel"replicating 0A/

AD

lysosomes **********************************************************************************

*L

%D $olgi

body **********************************************************************************L

CD

mitochondria *****************************************************************************

*+

8/18/2019 mrcog sba's -2


D

n!cleol!s ***********************************************************************************

*L

ED ro!gh

E& ************************************************************************************L

Mitochondria are well recognised to contain 0A and gi?erise to maternally inherited diseases s!ch as the mitochondrial

myopathies D red ragged "ibres D ;MA syndrome,

.ol"ram disease

7O* ;mm!noglob!lin $ (;g$

AD constit!tes the nat!ral haemaggl!tinins (antiDA and antiD

% ************L

%D is the predominant imm!noglob!lin in normal bronchial

secretions ****L

CD "reely crosses the

placenta **********************************************************+

D has a molec!lar weight o" 2):,:::

daltons ***********************************L

ED bears only 9 antigenDbinding

8/18/2019 mrcog sba's -2


sites ************************************************+

a ;gM,

b ;gA,c the only ;g to do so,

d 1):,:::

7)* .hich o" the "ollowing statements regarding 0A is3are

tr!e3"alse /

AD Attached to the 9J position o" the s!gar ring is one o" "o!r

bases*******L

%D +he bases lie stacked on each other 2*O Angstroms

apart****************+

CD !ring transcription each da!ghter 0A contains one

newly synthesised strand*********L

D +he g!anine D cytosine bonds are made o" two hydrogen

bonds* *******L

ED +he 0A "rom a single cell is nearly 9 metres

long**************************+

;ndi?id!al n!cleoside !nits (bases are <oined together in a

n!cleic acid in a linear manner, thro!gh phosphate gro!ps

attached to the 2J and )J positions o" the s!gar (deoxyribose*

Hence, the "!ll repeating !nit in a n!cleic acid is a 2J,)JD

8/18/2019 mrcog sba's -2


n!cleotide*

$!anine D cytosine bonds consist o" three hydrogen bonds*

Q) Are the "ollowing tr!e or "alse regarding the de?elopmwnt

o" the !rinary system/

( +r!e 3 Lalse

A %owmanJs caps!le de?elops in the metanephros**+

% e?elops "rom intermediate mesoderm**+C ;n intra !terine li"e 2 o?erlapping kidney systems are"ormedL +he glomer!l!s "orms part o" the mesonephros+E +he mesonephros de?elops as the metanephrosregressesL

8/18/2019 mrcog sba's -2


$

###################################################

$ 1. A cone biopsy specimen of a woman who

requested that her menstrual function be preserved

8/18/2019 mrcog sba's -2


shows a carcinoma in situ with complete excision. She

should be advised to

a. Be discharged from follow up.

b. Continue to attend yearly follow up for Pap smear

tests.

c. equires hysterectomy.

d. equires !ertheim"s hysterectomy.

e. eferred for prophylactic #.

B

$. %n a pregnant lady with diabetes mellitus

a. %nsulin requirement decreases because of the fetal

pancreas.

b. &etal mortality occurs in early pregnancy.

c. Should be monitored by labstix.

d. All of the above.

e. 'one of the above.

8/18/2019 mrcog sba's -2


(.

). A positive fern test of the cervical mucus in the early

part of the menstrual cycle followed by a negative fern

test premenstrually means

a. (strogen is present.

b. Progestrogen is present.

c. *vulation has occurred.



C.

+. Cervical carcinoma is best treated by !ertheim"s

operation

a. %n the presence of 1st trimester intrauterine

pregnancy.

8/18/2019 mrcog sba's -2


b. %n the presence of P%,.

c. %n early stage %%.



C.

-. Seminar fluid

a. p is +./

b. 0olume is 1ml.

c. Contains P2($.

d. Produced mainly by seminiferous tubules.


C.

/. %n '3 basic investigation for subfertile couples

8/18/2019 mrcog sba's -2


a. Analysis of seminal fluid.

b. ormonal analysis of the male.

c. Post coitus test.



A.

4. !hat is not the advantage of early boo5ing in

pregnancy6

a. 2estational age assessment.

b. Congenital abnormalities detected.

c. (arly abortion when pregnancy is contraindicated.

d. %32 in the 1st trimester detected.

e. Pelvic pathology in pregnancy detected and treated.

,.

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7. %n a gynecological examination8 a per9rectal is done

in:

a. Carcinoma of the cervix.

b. (ndometriosis.

c. 3nmarried females.



,.

;. !hich one does not help to indicate whether the

pelvis is adequate for delivery6

a. Birth weight of last baby.

b. ,uration of previous labor.

c. <ength of last child.

d. =ethod of delivery of previous labor.

e. %ndications for previous operative deliveries.

8/18/2019 mrcog sba's -2


C.

1. #he clitoris doesn"t contain

a. (rectile tissue.

b. Corpus spongiosum.

c. %nvoluntary muscles.

d. A glans.

e. $ crura.

B.

11. !hich of the following isn"t a reason for doing avaginal examination in the 1st trimester of pregnancy6

a. #o exclude pelvic tumor.

b. #o assess si>e of uterus.

c. #o assess pelvic si>e.

8/18/2019 mrcog sba's -2


d. #o assess fetal viability.

,

1$. ,efinite signs of labor

a. <ea5age of aminotic fluid.

b. Show.

c. Painful contractions.

d. Painful contractions with cervical changes.

e. (ffaced cervix with )cm dilatation.

,.

1). !hen a women comes for labor

a. *xytocin drip is given at 1st stage labor.

b. *xytocin drip is given at $nd stage labor.

8/18/2019 mrcog sba's -2


c. *xytocin drip is given at )rd stage labor.

d. ,rip without oxytocin given at 1st stage.


(.

1+. %n normal delivery

a. *ptimal cord cutting time is ) ? / seconds.

b. *ptimal residual cord length is / ? 1cm.

c. Should mil5 as much of the cord blood into the

baby.



A

1-. =oderate uterine bleeding associated with ovulation

is

8/18/2019 mrcog sba's -2


a. #he constitutional variant of the individual.

b. 3sually seen in young women.

c. Associated with a reduction in circulating estrogen

levels.



,.

1/. !hat is not important in menstrual history6

a. 1st day of <=P.

b. ,uration.

c. Pain.

d. Color.

e. Passage of clots.

,.

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14. !hich is not found in asymmetrical growth

retardation6

a. ypoxia.

b. *ligohydramnios.

c. 'ormal @A ratio.

d. Abnormal @A ratio.

,

17. %n severe pre9eclampsia

a. #he plasma volume is reduced.

b. #he extracellular fluid is increased.

c. #here is placental insufficiency.



8/18/2019 mrcog sba's -2


,.

1;. %n polycystic ovarian syndrome8 the following is not

found in

a. !ide carrying angle.

b. irsuitism.

c. *besity.

d. aised <.


A.

$. Amenorrhoea

a. %s a feature of anterior pituitary destruction.

b. =ay occur with continuous administration of

estrogen and progesterone.

8/18/2019 mrcog sba's -2


c. =ay occur with anorexia nervosa.

d. %s always present in #urner"s syndrome.

e. All of the above.

(

$1 (clampsia management

a. Control convulsions and hypertension and deliver

immediately regardless of fetal maturity.

b. %ntubate patient to ensure airway is not obstructedand deliver by <SCS.

c. ,elivery depends on urinary output.

d. %f fetus is premature8 control fits and hypertension

and wait.


A.

8/18/2019 mrcog sba's -2


$$. !hat is the least li5ely presentation of twins6

a. Cephalic9cephalic.

b. Breech9cephalic.

c. #ransverse9transverse.

d. Breech9breech.

e. Cephalic9transverse.

C.

$). !hich of the following is not associated with twin

pregnancy6

a. Polyhydramnios.

b. Anemia.

c. Premature labor.

d. 3rinary tract infections.

e. All are associated with twin pregnancy.

(.

8/18/2019 mrcog sba's -2


$+. !hat if any are the contraindications of inductionof labor6

a. Cardiac disease in pregnancy.

b. Breech presentation.

c. Short stature 1-cm.



B.

$-. A= is mediated through

a. Prostaglandin.

b. <eu5otrienes.

8/18/2019 mrcog sba's -2


c. Prostacycline.

d. #hromboxane.


A.

$/. Pyepagus is a state of conDoined twins whereby

there is Doining of the

a. eads.

b. #horaces.

c. Abdomen.

d. <imbs.

e. Bac5 and buttoc5s.

(

$4. %ncidence of anemia is pregnancy is reduced by

8/18/2019 mrcog sba's -2


a. Spacing of children.

b. 2ive iron supplements.

c. 2ive oral contraceptives.

d. Better nutrition.


(.

$7. =aternal mortality in Singapore 1;44 ? 1;4;

a. $.- per 1.

b. 4.$ per 1 .

c. 1.+ per 18.

d. 1 per 18.

,

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$;. Choriocarcinoma presentation

a. Purplish spots in the vagina.

b. 3terine enlargement.

c. %rregular vaginal bleeding.

d. emoptysis.


(.

). Partial mole

a. Commonly associated with C'S malformation.

b. 1E of pregnancy.

c. Commonly associated with severe pre9eclampsia.



,

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)1. ,ysmaturity are infants who are

a. Post term +$@-$.

b. %nfant of diabetic mother.

c. S2A.



A.

)). =ost common etiologic factor for heart disease in

pregnancy

a. Syphilis.

b. Congenital heart disease.

c. heumatic heart disease.

d. %schaemic heart disease.


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C

)+. !hat is not seen in buffy coat film in megaloblastic

anaemia6

a. ypersegmentation of P='.

b. =acropolycytes.

c. 'ormoblasts showing abnormal hemoglobinism.

d. owell Folly bodies in BC.

e. All the above is seen.

,.

)-. !hat is not routinely done in GG for a patient

whose hemoglobin is 7.$gE6

8/18/2019 mrcog sba's -2


a. Stool for ova and cysts.

b. PB&.

c. (rythrocyte electrophoresis.

d. Bone marrow film.

e. Serum iron and #%BC.

,

)/. 'ormal pelvic dimensions are

a. Anteroposterior 1)cm.

b. #ransverse 11.-cm.

c. %nterspinous 1.-cm.



,.

)4. Physiological changes in pregnancy are

8/18/2019 mrcog sba's -2


a. %ncreased gastric secretion.

b. %ncreased small intestine mortality.

c. elaxation of the gastro9esophageal sphincter.



C.

)7. !hich is untrue6

a. *verlapping of fetal s5ull before onset of labor

supports the diagnosis of intrauterine death.

b. Buddha position in H9ray suggests hydrops fetalis.

c. !omen thought to have multiple pregnancies need

H9ray or ultrasound scan.

d. enal agenesis is associated with polyhydramnios.

e. &etal s5eleton is visible on H9ray by $th wee5.

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,.

);. #he following conditions should be present before

application of forceps except

a. =ust have no cephalopelvic disproportion.

b. ead at pelvic brim.

c. ead in occipito9anterior.

d. Cervix fully dilated.

e. Bladder and rectum emptied.

+. elevant investigations in young primigravida with

severe hypertension at )+ wee5s

a. enal creatinine clearance.

b. PB&.

c. *ptic fundoscopy.

d. 3&(=(.


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+1. A $9year9old primigravida in established labor for$+ hours. <abor is slow8 cervix remains half dilated over

/ hours8 no cephalopelvic disproportion. Patient has

severe sacral pain and some tenderness over lower

segment. esting tone of uterus is high. She is li5ely to

be having

a. ypotonic uterine inertia.

b. ypertonic uterine inertia.

c. *bstructed labor.

d. All of the above.e. 'one of the above.

B.

+$. &ollowing treatment should be given for the above

condition

a. %ntravenous dextrose.

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b. %ntravenous oxytocin.

c. ,elivery by vacuum.

d. <SCS.

e. Controlled anaesthesia.

,.

+). Secondary amenorrhoea is not associated with

a. *ral contraceptives.

b. Sheehan"s syndrome.

c. 2enital tuberculosis.

d. ypothyroidism.

e. 2inari9rommech syndrome.

(.

++. !hich of the following statements about

choriocarcinoma is not true6

8/18/2019 mrcog sba's -2


a. Always preceded by mole.

b. 3rinary gonadotrophin raised.

c. Cytotoxic drugs give increased survival.

d. Secondary deposits in the liver.

e. =ay be heralded by onset of hemoptysis.

A

+-. !hich is usually not associated with failure to

conceive6 a. Cervical incompetence.

b. Sperm count of - million @ ml.

c. #uberculosis salpingitis.

d. Adrenogenital syndrome.

e. Stein9<eventhal syndrome.

A.

+/. !hich statement is wrong6

a. %nfertility may be associated with acute gonorrhoea.

b. Cryptomenorrhoea may be associated with acute

retention of urine.

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c. 'egative pregnancy test always excludes ruptured

ectopic pregnancy.

d. Presence of chorionic villi in curetting excludeectopic pregnancy.

e. Sterili>ation by tubal ligation is regarded as

irreversible.

B.

+4. !hich statement about genital prolapse is wrong6

a. #ransverse ligaments ta5e part in supporting

vaginal vault.

b. Post9natal exercises are of no value.

c. Cervix is often elongated.

d. ectocoele may cause intestinal colic.

e. *verflow incontinence is a common syndrome of

urethrocoele.

B

+7. !hich of the following statements about carcinoma

of the cervix is untrue6

a. Anaemia is a common terminal event.

b. is5 of carcinoma cervix is related to parity.

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c. Post9coital bleeding is a common symptom.

d. istologically usually adenocarcinoma.

e. Common site for mets are obturator nodes.

,.

+;. !hich of the coupled signs and diseases are

wrong6 a. Ascites and ovarian carcinoma.

b. #hic5ened uterosacral ligament and carcinoma of

the corpus uteri.

c. ,iscrete white patches on vagina and monilia.

d. (nlarged inguinal nodes and Bartholin"s abscess.

e. #hic5ened uterosacral ligament and endometriosis.

B.

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-. Congenital abnormalities of the uterus are

associated with the following except

a. abitual abortion.

b. 'ormal reproductive ability.

c. enal abnormalities.

d. Polycystic 5idneys.

e. Cryptomenorrhoea.

,.

-1. ight ureter lies in relation to the following:

a. Bifurcation of common iliac vessels.

b. %nfundibular pelvic ligaments.

c. %nferior mesenteric artery.

d. 3terine artery.

e. Paracervical tissue.

A

-$. Ioung girls may get vaginal discharge due to the

following except

8/18/2019 mrcog sba's -2


a. =onilia.

b. *varian dysgerminoma.

c. 2onorrhoea.

d. (ctopic ureters.

e. Sarcoma.

B.

-). -9year9old woman having irregular periods is first

managed by

a. ormones.

b. *ral &e and ergometrine.

c. , J C.

d. ysterectomy.

e. %nducing menopause with radium.

C.

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-+. Absolute contraindication to use of oralcontraceptives

a. Cervical erosions.

b. Carcinoma of breast.

c. Cholecystitis.

d. yperemesis gravidarum.

e. P#B.

B.

-/. Post menopausal bleeding is caused by the

following except

a. Cervical prolapse.

b. Senile vaginitis.

c. (ctopic pregnancy.

d. Stilboesterol.

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e. (ndometrial carcinoma.

C.

-7. AP2A score assess the state of the following

systems in the newborn except

a. espiration.

b. <ocomotor.

c. Cardiovascular system.

d. Central nervous system.

e. All.

(

-;. K!itches mil5L results from

a. Prolonged breast feeding.

8/18/2019 mrcog sba's -2


b. (xcessive endogenous stimulation in female infants

by estrogen.

c. %ncreased levels of placental hormones in fetalplasma.

d. Abnormal lactation.

/. espiratory quotient in a newborn is

a. 1..

b. .4.

c. 1.$.

d. .7.

C

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/1. =econium is composed of the following except

a. =ucopolysaccharides.

b. 0ernix.

c. 3pper respiratory epithelium.

d. Bilirubin.

e. =ucoprotein.

C

/$. <abor is said to be established when contractions

a. Are painful.

b. *ccur 1 in ) minutes.

c. *ccur 1 in - minutes.

d. #here is a show and lea5ing liquor.

C.

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/). #ubal insufflation is contraindicated under the

following conditions

a. Fust before mid9cycle.

b. At onset of menstruation.

c. ,ay after coitus.

d. 2ross chronic cervicitis.

/+. !hich of the following sperm counts are abnormal6

a. $- million @ ml.

b. / million @ ml.

c. $ million @ ml.

d. 1 million @ ml.

,

/-. (ndometrial carcinoma stage 1 must be treated by

8/18/2019 mrcog sba's -2


a. %ncreased dosage of progesterone therapy.

b. Cytotoxic drugs.

c. #otal hysterectomy.

d. Cobalt therapy.

e. Combined radiotherapy and surgery.

C.

//. %mmunotherapy must be employed in

a. #reatment of h immuni>ed pregnancy.

b. Prevention of h isoimmuni>ation.

c. #reatment of Bart"s disease.

d. As an adDunct to chemotherapy in choriocarcinoma.

B.

/4. #he ovaries may not be conserved during

hysterectomy under the following circumstances

8/18/2019 mrcog sba's -2


a. M )7 years.

b. &or pelvic endometriosis.

c. &or persistent P%,.

d. (xtensive fibroids.

B.

/7. %n the normal menstrual cycle8 estrogen is produced

from the

a. *vum.

b. *varian stroma.

c. 2raafian follicle.

d. (ndometrium.

e. Corpus luteum.

C.

8/18/2019 mrcog sba's -2


/;. Complications of %3C, include

a. Placenta praevia.

b. Perforation of the uterus.

c. P%,.

d. Chronic cervicitis.

e. #hrombophlebitis.

B.

4. Bleeding may be caused by vaginal examination

when there is

a. &ibroid prolapse.

b. Cervical carcinoma.

c. Adenomyosis.

d. 3rethral carbuncle.

e. *varian carcinoma.

B.

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41. Ioung girls may develop vaginal discharge due to

a. =oniliasis.

b. Presence of foreign body.

c. #hreadworms.

d. *varian dysgerminoma.

e. (ctopic pregnancy.

,.

4$. Secondary dysmenorrhoea

a. =eans painful menstruation in those who have hadat least 1 child.

b. =ay precede menstrual period.

c. %s relieved by antispasmodics.

d. 3sually associated with organic disease.

e. %s often improved by dilatation of the cervix.

8/18/2019 mrcog sba's -2


B.

4). eavy irregular periods in a female aged -$ may be

correctly managed by

a. ormonal therapy.

b. #a5ing a cervical smear.

c. %nducing the menopause with radium.

d. Administration of oral iron and ergometrine.

e. ,JC.

(.

4+. =ost common cause of early abortions

a. Physical trauma.

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b. 3terine retroversion.

c. Abnormality of conceptus.

d. %ncompetent cervix.

C.

4-. *varian artery runs through

a. Parametrium.

b. *varian ligaments.

c. %nfudibulopelvic ligament.

d. ound ligament.

e. 3rachus.

C.

4/. #urner"s syndrome is characteri>ed by all except

a. !ebbed nec5.

8/18/2019 mrcog sba's -2


b. Short stature.

c. Primary amenorrhoea.

d. Chromosome haplotype H*.

e. 0aginal atresia.

(

44. ydatiform mole have all but the following

a. 3terine si>e M period of amenorrhoea.

b. #hreatened abortion.

c. Produce C2.

d. 3sually have a fetus.

B

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47. ydatiform mole have all but the following

a. 3terine si>e M period of amenorrhoea.

b. &eatures of missed abortion.

c. Produce normal C2 titres.

d. %rregular vaginal bleeding.

e. #heca lutein cyst of ovaries.

C.

4;. !hich of the following is commonly associated with

cervical carcinoma6

a. ,yspareunia.

b. ,ysmenorrhoea.

c. Post coital bleeding.

d. 2%# symptoms.

e. Prolapse.

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C.

7. !hich of the following is not associated with failure

to conceive

a. Cervix incompetence.

b. Sperm count of 1 million @ ml.

c. #B salpingitis.

d. &ibroid.

e. Bicornuate uterus.

A.

71. Complications of abdominal hysterectomy with

conservation of ovaries may be any of the following

except:

8/18/2019 mrcog sba's -2


a. Apareunia.

b. 0aginal discharge.

c. (xcessive weight gain.

d. irsutism.

e. 3rinary incontinence.

,.

7$. Post9menopausal bleeding is not caused by:

a. Cervical polyp.

b. (ctopic pregnancy.

c. Cervical carcinoma.

d. (ndometrium carcinoma.

e. Senile vaginitis.

B.

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7). Cystic swelling of the anterior vaginal wall may be

due to the following except:

a. 2anter"s duct cyst.

b. 3rethrocoele.

c. 3rethral diverticulae.

d. 3reterocoele.

e. Cystocoele.

,.

7+. Stress incontinence is characteri>ed by:

a. <oss of posterior urethro9vesical angle.

b. ecurrent urinary tract infection.

c. 3tero9vaginal prolapse.



A

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7-. =ethod of preventing conception must consider:

a. #ime of ovulation.

b. Availability of unfertili>ed ovum.

c. 0iability of sperm.



,.

7/. (C0 is contraindicated when all of the following

conditions are present except:

a. AP.

b. ypertension.

c. 2rossly contracted pelvis.

d. Previous <SCS scar.

e. Polyhydramnios @ oligohydramnios.

8/18/2019 mrcog sba's -2


B.

74. ecogni>ed complications of term pregnancy

include:

a. =alpresentation.

b. Anemia.

c. Premature labor.

d. ,iabetes mellitus.

e. ydramnios.

C.

77. %n physiological anemia of pregnancy8 there is:

a. &all in total BC mass.

b. %ncrease in blood volume.

c. &all in the serum iron levels.

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d. %ncreased plasma volume.

e. &all in hemoglobin volume.

,.

7;. Placental insufficiency can be suspected in all of the

following except:

a. &alling estriol level.

b. &etal movements are not vigorous.

c. Amnioscopy shows clear liquor.

d. 3terus less than dates.

e. istory of bleeding in early pregnancy.

C.

;. Pruritus vulvae is a feature of the following except:

8/18/2019 mrcog sba's -2


a. ,iabetes mellitus.

b. 0aricose veins of the vulvae.

c. ound worm infestation of the gut.

d. <eu5opla5ia vulvae.

e. 0ulval carcinoma.

C.

;1. Second stage of labor begins when:

a. Cervix is effaced.

b. =embranes ruptured.

c. Caput distending the perineum.

d. Cervix is fully dilated.

e. 3terine cavity and vagina form a continuouscylindrical tube.

,.

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;$. =anagement of patient in labor with fetus in

transverse lie:

a. Caesarean section if cervix is not fully dilated.

b. 3terine version and breech extraction if cervix is

half dilated.

c. Anticipated spontaneous delivery.

d. upture membrane8 set oxytocin drip.

e. Perform decapitation operation if fetus is absent.

A.

;). ecurrent early trimester abortion due to

incompetent os is best treated by:

a. Cervical suture.

b. Progesterone therapy.

c. Stilbesterol.

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d. ,ia>epam.

e. %soxupurine.

A.

;+. Gru5enburg tumor is ovarian tumor which:

a. %s primary to the ovary.

b. Secondary to any gastrointestinal tract cancer.

c. Shows characteristic mucinous epithelial changes.

d. %n association with ascites.


B.

;-. *varian blood supply comes principally from:

a. 3terine artery.

b. *varian artery.

8/18/2019 mrcog sba's -2


c. <ong artery of ishaelis.

d. %nternal iliac artery.

e. Common iliac artery.

B.

;/. *C pill is contraindicated in:

a. Ca breast.

b. Past history of Daundice.

c. Past history of thrombosis.



,.

;4. %mperforate hymen may present with:

8/18/2019 mrcog sba's -2


a. Acute retention of urine.

b. Primary amenorrhoea.

c. Suprapubic pain.



,.

;7. #reatment of choice for Bartholin cyst:

a. %ncision and drainage.

b. (xcision of gland.

c. =arsupialisation.

d. Antibiotics.

e. 2lycerol magnesium sulphate.

C.

;;. All are true of missed abortions except:

8/18/2019 mrcog sba's -2


a. Clotting defect sets in after missed abortion.

b. equires urgent evacuation of uterus.

c. 3terus usually greater than period of amenorhroea.

d. Pregnancy test is negative.

e. is5 of infection is higher in missed abortions.

C.

1.&etal distress is characteri>ed by:

a. &etal heart beat type %% dips and scalp blood p

4.1-.

b. Passage of meconium stained liquor.

c. &etal bradycardia or tachycardia.

d. 'one of the above.


(.

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11.Commonest post9op compliactions of <SCS in:

a. ,eep vein thrombosis.

b. Pneumonia.

c. 3rinary tract infections.

d. upture of scar.

e. aemorrhage.

(.

1$.#he smallest diameter of fetal s5ull is:

a. BP,.

b. Bregma diameter.

c. *ccipitomental diameter.

d. Suboccipitofrontal diameter.

e. Subparietal diameter.

8/18/2019 mrcog sba's -2


A.

1).%ron deficiency anemia in pregnancy is

characteri>ed by all except:

a. =icrocytic hypochromic BC.

b. Serum folate iron is - ug@1ml.

c. ypersegmented nucleus in white blood cell.

d. #%BC of - up@1ml.

e. %ncreased incidence of multiple pregnancy.

C.

1-.#he following radiological findings indicate fetal

death except:

a. aloes area on fetal s5ull.

b. Absence of femoral epiphysis.

8/18/2019 mrcog sba's -2


c. Spalding sign.

d. 2as bubbles in heart vessels.

e. Ball sign.

(.

1/.#he normal sequelae of events in acute P%, is:

a. Abscess formation.

b. ydrosalpinx.

c. Atrophy of ovary.

d. Pseudocyst formation.

e. esolution.

14.!hat is the method of choice in the termination of1/ wee5 pregnancy6 a. ysterectomy.

b. 0acuum aspiration followed by uterine curretage.

c. %ntra9amniotic prostaglandins.

d. Buccal oxytocin.

C.

17.%n a -+ year old woman with vaginal prolapse8 the

treatment of choice is:

a. 0aginal hysterectomy with pelvic floor repair.

b. Perineal exercises.

8/18/2019 mrcog sba's -2


c. <efort"s operation.

d. ing pessary.

A.

11.Prophylactic forceps delivery should be ruled out in:

a. Cardiac disease.

b. Previous caesarean section.

c. #oxaemia of pregnancy.

d. 'one of the above.


,.

##############################################################

+he "ollowing radiological "indings indicate "etal death

excepta* Haloes area on "etal sk!ll*

b* Absence o" "emoral epiphysis*

c* 'palding sign*

d* $as b!bbles in heart ?essels*

e* %all signans

conseI!ence o" maternal !se o" cocaine is /

a* hydrops b* sacral agenesisc* cerebral in"arction*ansd* hypertrichosis

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M!scle relaxation !nder the in"l!ence o" oestriolProstaglandin E1 mediated ;nterle!kin releaseConstriction o" cer?ical small ?essels

Macrophage mediated collagen degradationegradation o" type ; collagen by interstitialcollagenaseans

Cervical ripening refers to the softening of thecervix prior to labour, 2t is a complex process thatinvolves the following processes Fthe 7ey point istype ! collagen brea7(own by collegenase=

2ncrease( activity of metalloproteinases G 9that (egra(e extracellular matrix proteins,Cervical collagenase an( elastase also increasean( (egra(ation of collagen increases* lea(ing to(ecrease( collagen content in the cervix,2ncrease( oestrogen lea(s to increase(

collagenase activity # 2ncrease CP:G causingincrease( prostaglan(in 5G F-K5G in the cervix-K5G lea(s to=2ncrease in collagen (egra(ation2ncrease in hyaluronic aci(2ncrease in chemotaxis for leu7ocytes* whichcauses increase( collagen (egra(ation

2ncrease in stimulation of interleu7in F2Q> release-rostaglan(in G#alpha is also involve( in theprocess via its ability to stimulate an increase inglycosaminoglycans,

&egarding blood ?ol!me in pregnancy which o" the

"ollowing statements is +&6E/

8/18/2019 mrcog sba's -2


%lood ?ol!me remains constant%lood Bol!me increases by approximately )>%lood Bol!me increases by approximately 1:D1)>

%lood Bol!me increases by approximately 9:D9)>%lood Bol!me slowly increases by O:D):>**************ans

Q) &egarding the !se o" Erythropoietin

(recombinant h!man erythropoietin A4A rH!EP in

pregnancy which o" the "ollowing statements is correct/

rH!EP has been shown to be ha?e ad?erse maternal e""ectswhen !sed antenatallyrH!EP has been shown to be ha?e ad?erse "etal e""ects when!sed antenatallyrH!EP has been shown to be ha?e ad?erse neonatal e""ectswhen !sed antenatally+he !se o" rH!EP is only recommended "or nonDendDstagerenal anaemia

0one o" the abo?e**ans

+he $reen +op $!idelines state the "ollowing

&ecombinant h!man erythropoietin (rH!EP is mostly !sed

in the anaemia o" endDstage renal disease* rH!EP has been

!sed both antenatally and postpart!m in women witho!t endD

stage renal disease witho!t any ad?erse maternal, "etal or

neonatal e""ects*

6se rH!EP in clinical practice "or nonDendDstage renal

anaemia is still to be established and sho!ld only be !sed in

the context o" a controlled clinical trial*

8/18/2019 mrcog sba's -2


;mportant Points on Erythropoietin

C!rrently sho!ld be !sed in endDstage renal anaemia only

0o e?idence to s!ggest harm"!l to mother, "oet!s or neonateHowe?er, ;t is 0+ established "or !se in nonDendDstage renal

anaemia and there"ore sho!ldnJt be !sed in these patients

o!tside o" a controlled trial

Q) 6preg!lation o" !rea mo?ement thro!gh !rea transport

proteins in the collecting d!ct is an e""ect o" which o" the

"ollowing Angiotensin

Angiotensin ;;

Aldosterone

&enin

Basopressinans

Q) A 29 years old woman is admitted to postnatal ward 1:days a"ter emergency cesarean section with a pain"!l swollen

cal"* Her obser?ations are stable* Her %M; is 27* -o! want to

r!le o!t a deep ?ein thrombosis* .hich o" the "ollowing

clotting "actors are increased in normal pregnancy/ A* Lactor

B;;

%* B;;, B;;;C* B;;, B;;;,Fans

* B;;, B;;;, F , F;

E* B;;, B;;;, F ,F; , F;;;

Q) .hat is the typical oxygen cons!mption in a 7)kg nonD

pregnant women/

8/18/2019 mrcog sba's -2


)ml3min1)ml3min):ml3min

1):ml3min9):ml3minans

+he typical xygen Cons!mption (B9 is 9):ml3min*

;n pregnancy this increases by aro!nd 9:> to 2::ml3min

Q) Contraindications 64MEC 23O to !se depot "or

contraception//

+reated %reast Ca with no rec!rrence a"ter 1: yearsans

Age 27 smoking 2D) ciger per day

Personal history o" B+

%M; O) kg3m9

19 weeks post partam breast"eeding

antimalarial dr!g to be a?oided in pregnancy /

a* chloroI!ine

b* I!inine

c* primaI!ine**ans

d* antiD"olates

e*tetracyclines .hatJs the earliest gestational age at which the "etal

endocrine system is thi!ght to be "!lly "!nctional/ 8weeks

1:weeksans

18weeks

9Oweeks

2:weeks

8/18/2019 mrcog sba's -2


.hich str!ct!re is the primary mechanism "or sh!nting

blood away "rom the "etal p!lmonary circ!lation/

Loramen ?ale*ans

!ct!s ArteriosisArteria 6mbilicalis

!ct!s Benos!s

6mbilical Arteries

.loo( enters the right atrium of the fetal heart

an( most passes through the foramen ovale intothe left atrium, rom there it is pumpe( through

the aorta, &he foramen ovale is the ma)or

structure for bypassing the fetal pulmonary

circulation,

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&he fracture history here is irrelevant especially

consi(ering neither are fragility fractures,

&#score 0 to #! Lormal bone (ensity

&#score #! to #G," Psteopenia

&#score #G," or less Psteoporosis

!ring wo!nd healing collagen alignment along tension

lines is part o" which phase/

Haemostasis;n"lammation$ran!lationProli"eration&emodelling**ans

/ealignmnet of collagen is part of the remo(eling

phase, /emo(eling is usually un(erway by wee7;, Maximum tensile woun( strength is typicallyachieve( by wee7 !G,

a pregnant mother is treated with oral anticoag!lant * the

likely congenital mal"ormation that may res!lt in the "et!s is /

a* long bones limb de"ect

b* cranial mal"ormationc* cardio?asc!lar mal"ormation

d* chondrodysplasia p!nctate**ans

Q) HPB proteins associated with ca* risk/ a* E9 and E2

b* EO E)

c* E8 E7**ans

d* E1 E9

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Q) ==> o" body calci!m is in what "orm/ Calci!m

%icarbonate

Calci!m $l!conate

Calci!m PhosphateansCalci!m Carbonate

Calci!m Hydroxide

Q) .hich o" the "ollowing options describes the lymph gro!p

to which the ?!l?a drains/

A eep ing!inal lymph nodes

% ;nternal iliac lymph nodes

C ParaDaortic lymph nodes

'!per"icial ing!inal lymph nodes**ans

E '!perior mesenteric lymph nodes

+he ?!l?a

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Q) +he haemorrhage considered the 8th ca!se maternal

mortility+

Mat mortalioty ca!ses 'epsis

Preeclamsia and eclampsiaBte

Amniotic "l!id embolism

Ectopic

Haemorrage

Anaesthesia

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.hich o" "oll statements regarding placenta and "etoD

maternal circ!lation are LAG'E/

eoxygenated "etal blood arri?es at the placenta ?ia 9!mbilical arteriesxygenated blood ret!rns to the "et!s ?ia a single !mbilical?ein+here is no direct mixing o" "etal and maternal blood at the placentaAt term the placenta recei?es 7:> o" !terine blood

"low**ans;n the !mbilical ?ein the press!re is approximately 9: mmHg

At term the placenta receives aroun( 90% ofuterine bloo( 6ow

Para!rethral glands skenes present in

'!per"icial perineal po!cheep perineal po!ch

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Min!te ?entilation in pregnancy increases d!e to which o"

the "ollowing/E""ects o" gra?id !ter!s on diaphragm

li!tional anaemia;ncreased renal excretion o" bicarbonate

;ncreased circ!lating oestragen

;ncreased circ!lating progesterone**ans

&his is thought to be the result of increase(

circulating progesterone, -rogesterone is 7nown

to (irectly stimulate ventilation by sensitiing theCLS respiratory centres to CPG,

2ncrease( minute ventilation \blows o'\ CPG an(

as a result pCPG is re(uce(, p1 homeostasis is

maintaine( via increase( renal excretion of

bicarbonate,

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!ring pregnancy the $L& changes as "ollows

$L& remains the same

$L& decreases by 1)>$L& increases by 1)>$L& decreases by O:>$L& increases by O:>********ans ,inc by O:D): >

A 87 years old woman is admitted to hospital with"reI!ently o" !rination and extreme thirst* Her blood tests

re?eal deranged !rea and electrolytes* Pro?isional diagnosis is

diabetes insipid!s* .hich hormone acts in nephron, to

increase the permeability o" the collecting d!cts to water/

A* Aldosterone

%* AngiotensinC* Atrial natri!retic peptide

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* Parathyroid hormone

E* Basopressin**ans

$ Jhich one is a type of chromosomeheteromorphism?

.alance( translocation

Lon (ys)unction

Kene (eletion

4nbalance( translocation

ragile sites,,ansQ) .hich o" "oll hormones inhibits $alactopoiesis and

Gactogenesis postpart!m/xytocin

Progesterone

opamineans

hPG

Prolactin

At what stage o" "etal de?elopment does "etal haemoglobin

(HbL replace embryonic haemoglobin (HbE as the primary

"orm o" haemoglobin/OD8 weeks

1:D19 weeksans

9:D9O weeks

29D28 weeksAt %irth

$ A G; years ol( woman (evelop a fever an( has

o'ensive (ischarge an( ab(ominal pain, Uou are

concerne( that she is septic an( wish to

a(minister intravenous antibiotics, -rior to

a(ministration you wish to calculate her

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estimate( K/ in or(er to (ose her appropriately,

Jhich of the following factors is inclu(e( when

calculating eK/? A, Creatinine

.,3iabetic status

C,1eight

3,Me(ication

5,Jeight

.hat is the typical peak change in oxygen cons!mption in

a pregnant ?s a nonDpregnant women/ )>

9:>**********ans

8:>

1::>

19:>

+he typical xygen Cons!mption (B9 is 9):ml3min*

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;n pregnancy this increases by aro!nd 9:> (or ):ml3min to

2::ml3min

Q) -o! re?iew a patient who is 2O weeks pregnant* 'hecomplains o" grad!ally worsening itching o?er the past 8

weeks partic!larly to the hands and "eet which is worse at

night* -o! order some bloods* .hich o" the "ollowing wo!ld

yo! normally expect to increase in the 2rd trimester/ AG+

AGP**ans

%ilir!bin

Alb!min

Calci!m

Q) A woman with schiRophrenia presents with galactorrea

**the ca!se o" hyperprolactinemia is mostly d!e to

Hypothyroidism

MacroprolactinomaMicroprolactinoma

&enal "ali!re

6se o" phenothiaRine**ans

79 y is !ndergoing l!ng "!nction tests prior to abdominal

s!rgery* .hich o" "oll gi?es the correct l!ng ?ol!me eI!ation/

A* L!nctional resid!al capacity resid!al ?ol!meW tidal?ol!me%* ;nspiratory capacity tidal ?ol!meW expiratory reser?e?ol!meC* ;nspiratory capacityinspiratory reser?e ?ol!meW tidal?ol!me**ans

* +otal l!ng capacityinspiratory capacityW resid!al ?ol!me

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E* Bital capacityinspiratory capacityWexpiratory reser?e?ol!me

Q) Mc ca!se o" secondary dysmenorrhea/Endometrioses

Q) Menarche be"ore 1: years o" age is considered precocio!s

p!berty

Q) !ring wo!nd healing the clotting cascade is acti?ated*

.hich o" the "ollowing acti?ates the extrinsic pathway/

amaged endotheli!m

+hromboxane A9

Prostaglandin E9

+iss!e Lactorans

Librin

+he clotting cascade can be acti?ated either by damaged

endotheli!m (;ntrinsic pathway or +iss!e Lactor (Extrinsic pathway

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Q) .hich o" the "ollowing ca!se a shi"t o" oxygen

dissociation c!r?e to the le"t/

A* ecreased hemoglobin%* ecreased 9,2D P$*ansC* ;ncreased acidity* ;ncreased carbon dioxideE* ;ncreased temperat!re

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.hat is the a?erage ?ol!me o" blood loss d!ring the

menstr!al cycle

2)DO:ml*ans8:D8)ml5:D5)ml1):D9::ml2):DO::ml

average ;"#H0 mlmax >0#>" ml

.hich o" "oll prolongs Prothrombin time/ Lactor B

de"iciency

Bon .illebrand disease*ans

Hemophilia

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Aspirin therapy

Protein C e"iciency

Ca!ses o" prolonged Prothrombin time (P+ and also ;0&(;0& is a ratio o" P+

Lactor B de"iciency

.ar"arin therapy

Gi?er Lail!re

;C

.hat is the a?erage li"espan o" a platelet/ 2DO days)D= daysans

1OD91 days

2: days

=: days

%lood Cell Gi"espans

&ed %lood Cells 19: days

Platelets )D= days

.hite blood cells 9D) days

0e!trophils (!p to ) days

%asophils (9 to 2 daysEosinophls (9 to ) days

Monocytes (1 to ) days

Gymphocytes (?ariable

Gactogenesis at term is stim!lated by which hormone/

xytocinhPG

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Progesterone

Prolactin*ans

opamine

$ which following (rug suppress pituitary Q1

pro(uction*hepatic S1.K pro(uction an( use to

treat 1irsutism? Spirinolactone

Kn/1 Analogue

lutami(e

KestrinoneCPC-ans

$ Pn &Es H#" wee7 gestational sac visible

" wee7 yol7 sac

"#@ embryo

Q) .hich one is tr!e "or congenital hip dislocation /

A m*c in A"rican pop!lation% m *c in "irst born "emale babies **ans

C m*c in "irst born in male babies

needs xD&ay "or con"irmation

E only s!rgically treated

Q)Cardinal si"ns o# in#lamm

r!borDredness

calorDheat

dolorDpain

t!morD swelling

"!nctiolessaD loss o" "!nctions

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Q)Anal canal epit$elium % +hey 2 types

;nner col!mnarer

!ter di?ided by white line nonDkeratanaiRed st*sI and

below the line keratinaiRed st*sI

Q)

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$ 2ssue in pre#pregnancy counseling of women

with heart (isease ??

A, /is7 of 24K/

., /is7 of maternal (eath

C, Maternal an( fetal monitoring (uring labour

3, /e(uction in maternal life expectancy

5, Lee( for frequent hospital atten(ance an(

possible a(mission,,ans

$ Assuming normal renal function *by how many

(ays post -artum will 1. start to increase ?

A (ay !

. (ay ; ,,ans

C (ay N

3 (ay !0

5 (ay !H

$ 2n precocious puberty=which is false

A, &reatment is (own regulation of pituitary with

Kn/1 analogues

., -ubertal changes occur earlier than normal

C, Mostly i(iopathic

3, Sequence of events that occur there after

mimics normal puberty,,

5, Jhen investigating chil(ren the exclusion of a

serious tumor is very important

A 95 year old women is seen in the early pregnancy !nit*

'he has had a positi?e pregnancy test b!t is !ncertain o" her

GMP* 6ltraso!nd doesnJt ?is!alise a pregnancy* -o! per"orm a

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progesterone test* +he res!lt is )= nmol3l* According to 0;CE

g!idelines what le?el is consistent with ?iable pregnancy/ )

nmol3l

1) nmol3l9) nmol3l

8: nmol3l

0one o" the abo?e**ans

L2C5 state progesterone levels shoul(n8t be use(

to (iagnose viable or ectopic pregnancy,

/CPK suggest levels `@0 are consistent with

viable pregnancy an( you may get a

progesterone level in a clinical scenario but not

usually without serial hCK measurements,

&his may seem li7e a tric7 question but highlights

that if you get a question on pregnancy of

un7nown location then the clinical picture is of

primary importance followe( by hCK

measurements,

$ Kastrochisis is (ue to un(evelopemnt of

Ab( wall

A 18years old "emale presents to yo!r clinic with per

?aginal discharge* !pt is negati?e* yo! took a swab and it

re?ealed microscopic image as below* what wo!ld be yo!r

"irst line treatment "or her/ a* aRithromycin 1g once only

b* doxycycline 1::mg bd W metronidaRole O::mg tds "or 7

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days

c* doxycycline 1::mg bd "or 1Odays W metronidaRole O::mg

tds "or 7 days

d* metronidaRole O::mg tds "or ) days**anse* tinidaRole 9g once only

it is trichomoniasis, it is an anaerobic infection,

&ini(aole can also be given but after failure of

metroni(aole, therefore* !st line is

metroni(aole,$Qabia M) nv supply ant !D; by illioinguinal

nerve

post GD; by perineal (ivision of pu(en(al nerve,

$ anterior part of labia ma)ora supplie( by which

nerve?1ypogastric

Q) .hich one is noti"iable disease /

A clostridi!m di""icle

% measles *ans

C M&'A

pne!mococcal pne!monia

E rhe!matic "e?er

$ -lease conRrm accor(ing to last gui(eline

Mc (irect maternal (eath is sepsis& * FSepsis

5clampsia E&5

An( in(irect is car(iac (isease,&

.hat is the lymphatic drainage o" the o?aries/ A* Common

iliac nodes

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%* External iliac and s!per"icial iliac nodes ?ia the ro!nd

ligament

C* External iliac nodes

* ;nternal iliac nodesE* Gateral aortic and preaortic nodesans

&he answer is lateral aortic an( pre#aortic no(es,

2t is useful to remember the following= the

bla((er (rains to the external iliac no(es the

urethra (rains to the internal iliac no(es thefallopian tubes an( fun(us uteri (rain to the

external iliac an( superRcial iliac no(es via the

roun( ligament an( the cervix (rains to the

external an( internal iliac* rectal an( sacral

no(es an( occasionally obturator no(es,

$ inci(ence of asymptomatic bacteuria inpregnant females? G# N%

Q) At which cell cycle checkpoint is the cell cycle halted i"

the cellJs 0A is damaged/

a $1 – '**ans

b ' D $9

c $9 D M

d $: D $1

Q)

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ORIGIN

Perineal body and midline rapheover corpus spongiosum in male

INSERTION

Superficial perineal membrane anddorsal penile@clitoral aponeurosis

ACTION

=ale:aids emptying of urine andeDaculate from urethra. &emale:

closes vaginal introitusNERVE

Perineal branch of pudendal nerveS$8 )8 +

Q) 4A is associated with

HypokalemiaQ) a patient had hypophsectomy "or pit!itary t!mor she has

amenorrhea "or 5 months o?!lation ind!ction can be done in

her by

aclomiphene citrate

bp!lsatile hC$

chM$dhM$ "ollowed by p!lsatile hC$*ans

Q)

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Ans D

$ /egar(ing varicella oster virus* S.A

! it is a single#strain herpes virus,,ans

G,it contains single stran(e( 3LA

;,the incubation perio( lasts one wee7

H,infections are preventable by a 7ille( vaccine

&!bella ?ir!s, '%A 1 Contains do!ble stranded 0A

9has inc!bation period o" 12D9: days*ans

2 has killed ?accine

O is treated with anti?irals

$ /egar(ing Meningococcus= S.A!it is not part of the normal 6ora in human

Ginfecte( people (evelop a slow sprea(ing

petechial rash

;people with meningitis typically have

coexisting septicemia

Hthe cerebrospinal 6ui( glucose concentration is

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increase(

"treatment is with penicillinans

$!thrie test was done on a newborn and it was positi?e*.hat is the mode o" inheritance o" this disease/ a* a!tosomal

dominant

b* a!tosomal recessi?e*ans

c* x linked dominant

d* x linked recessi?e

e* none o" the abo!e

phenylketon!ria gi?es g!thrie test positi?e d!e to

acc!m!lation o" phenylalanine in blood* it is inherited as A&*

Bitamin !ndergoes a "ew process o" acti?ation* .here

does the "inal acti?ation step predominantly occ!rs/ a*

<!xtaglomer!l!s apparat!s

b* distal con?ol!ted t!b!le

c* hepatocyte

d* proximal con?ol!ted t!b!le**ans

e* loop o" henle

Q) Calcitriol is important to maintain a good calci!m

homeostasis* what is the e""ect o" its "!nction/ a* increaseser!m ca, increase ser!m phosphate

b* increase bone "ormation

c* both abo?eans

d* increase ser!m ca, decrease ser!m phosphate

e* red!ce kidney reabsorption o" phosphate

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Q)

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Ans

Q) .hich statement is "alse regarding non herpetic genital

!lcers

1 lymphogran!lom ?ener!m is ca!sed by speci"ic sero?ars o" chlamydia trachomatis

9lymphogran!loma ?ener!m ca!ses se?ere proctocolitis

2chancroid is an in"ection ca!sed by klebsiellagran!lomatis*ans

Ochancroid ca!ses in"lamed lymph nodes to weep thro!ghskin

)gran!loma ing!inale ca!ses elephantiasis

Q) e"ecti?e "eedback control o" calci!m hemostasis may

lead to secondary hyperparathyroidism* ;t is !s!ally

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associated with D a* parathyroid gland t!mo!r

b* chronic li?er disease

c* thyroid carcinoma

d* chronic kidney disease*anse* ';AH

$ A ;!#year#ol( woman who is 7nown to be 12E

positive presents following a positive pregnancy

test, 1er last menstrual perio( was @ wee7s ago, &he last C3H count was HG0 !0@Dl an( she (oes

not ta7e any antiretroviral therapy, Jhat is the

most appropriate management with regar(s to

antiretroviral therapy?

A # Chec7 C3H at !G wee7s an( initiate

antiretroviral therapy if C3H count is less than;"0 !0@Dl

. # 3o not give antiretroviral therapy

C # Start antiretroviral therapy at G0#;G

wee7sans

3 # Start antiretroviral therapy at !0#!G wee7s

5 # Start antiretroviral therapy imme(iately

+reatment with a single antiDretro?iral dr!g (Rido?!dine may

be considered i" yo!r ?iral load is less than 1::::, yo!r CO

co!nt is more than 2): and yo! are prepared to ha?e a

caesarean section*-o!r doctor will !s!ally recommend that

yo! start the treatment between 1O and 9O weeks o" yo!r

pregnancy and contin!e !ntil yo!r baby is born*

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-o! sho!ld be able to ha?e a ?aginal deli?ery, e?en i" yo!

ha?e had a caesarean section be"ore, i" yo! are taking

HAA&+, ha?e a ?iral load less than ): and a CO co!nt morethan 2):*

;" yo! are taking HAA&+ and yo!r ?iral load is between ):

and 2==, yo!r doctors may recommend a caesarean section,

!s!ally at 25 weeks* +his will depend on the pattern o" yo!r

?iral load, how long yo! ha?e been on treatment and yo!rwishes*@ -o! will be ad?ised to ha?e a caesarean section,

!s!ally at 25 weeks, i" yo! are taking HAA&+ and ha?e a

?iral load o" O:: or more yo! are taking Rido?!dine

alone hepatitis C ?ir!s is detected in yo!r blood*

-o! sho!ld be prescribed Rido?!dine thro!gh a drip, whichwill be started a "ew ho!rs be"ore yo!r caesarean section* ;t

sho!ld contin!e !ntil yo!r baby is born and the !mbilical cord

has been clamped*

;n which phase o" the cell cycle is 0A replicated/

a $1 phase

b ' phase*ans

c $9 phase

d M phase

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$ A new mother who is H wee7s post partum

presents Rr warm re( ten(er patch on the rite

si(e )ust lateral to areola this has been getting

worse in last three (ays an( fee(ing is now

painful she saw a mi(wife yeater(ay helps with

positioning but it is not improve( on examination

has mastitis of rt brest no obvious absess what is

most appropriate managment ?

A,co amxiclav* continue breast fee(ing

.,6ucloxacillon* continue .f ,ansC,6ucolxacillin* stop fee(ing

3,co amociclav * stop fee(ing

5, Metrono(aole * continue fee(ing

$ main supply of levator ani muscle is = S!

SG

S;

SH,,ans

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$

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$ 2ncubation perio( for varicella infection

"#N(ays

N#!0(ays

!0#!H (ays

!0#G0 (ays,,ans

!H#G! (ays

Basectomy is associated with which one o" the abo?e

complications/

A An increased risk o" coronary heart disease% An increased risk o" prostate cancer C A 1:> risk o" de?eloping antiDsperm antibodies An increased risk o" epididymoDorchitis**ansE A "ail!re rate o" 19:,:::

Complications of vasectomy

! Qocal Anaesthetic complications -ain* .lee(ing* 2nfection 2schaemic necrosis # rarelyG Surgical complications 2ntraoperative blee(ing 5arly post operative # 2nfection Fwoun(*epi(y(imytis* Scrotal haematoma* -ostoperative pain Qate post operative # Chronic testicular pain*Anti sperm antibo(ies O nearly N"% will (evelopantibo(ies ailure of metho( O rate is ! in G*000

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$

Ans C$ M/SA infections may respon( to which

antibiotics

,Augmentin

,carbapenams

,cephalosporins

,clin(amycin,vancomycin,ans

Q) 1= year old !ni?ersity st!dent is concerned that she might

ha?e Chlamydia in"ection*

.hich one o" the abo?e is not a sign 3 symptom o" Chlamydia

in"ection/

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A ;ntermenstr!al bleeding% Uoint painsC Cer?ical excitation

Exophytic Cer?ical mass**ansE M!c!p!r!lent ?aginal discharge

7:> o" women are asymptomatic* ;" symptoms are present,

they incl!de Gower abdominal pain, yspare!nia,

Abnormal ?aginal bleeding e*g* postcoital bleeding,

intermenstr!al bleeding, Abnormal ?aginal or cer?ical

discharge*May be m!c!p!r!lent* ys!ria*

&arely, patients can present with right !pper I!adrant pain

(periDhepatitis and <oint pains (reacti?e arthritis*

'igns +he "ollowing may be present Pyrexia, Gower

abdominal tenderness, Cer?ical excitation, Contact bleeding

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$

Ans C

$ Jhich ovarian tumor is (iYcult to (istinguish

from en(ometriosis ?

A,chorioacarcinoma

.,mature cyst teratoma,,ans

C,yol7 sac tumor

3,mucinous tumor5,serous teratoma

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$

Ans 5*theca pro(uce an(rogens

Q) .hich one o" abo?e is not a C; to the !se o" depoD

medroxyprogesterone acetate/

A History o" stroke% Acti?e ?iral hepatitis

C '!spicio!s ?aginal bleeding Healthy 25 year old smokeransE iabetic retinopathy

ProgesteroneDonly in<ectables Contraindications

64MEC 2 – risks o!tweighs the bene"its o" !sing the method*

@ M!ltiple risk "actors "or arterial cardio?asc!lar risk e*g*

older age, diabetes, hypertension, smoking*@ Basc!lar disease

@ C!rrent or history o" ;H* n anticoag!lants*

@ C!rrent or history o" stroke

@ Past history o" breast cancer K 0 e?idence o" c!rrent

disease "or ) yrs

@ 6nexplained ?aginal bleeding or s!spicio!s be"ore

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in?estigations

@ &etinopathy, nephropathy, ne!ropathy or diabetes 9: yrs

d!ration

@ Acti?e ?iral hepatitis64MEC O – !nacceptable health risks or absol!te

contraindications

@ C!rrent breast cancer – 64MEC O

Q) A 22 year old woman has been diagnosed with o?arian

hyperstim!lation syndrome* .hich one o" the abo?e "eat!res

wo!ld s!ggest se?ere H''/

A Haematocrit O)>***************ans% 6ltraso!nd e?idence o" ascitesC ?arian siRe o" 5 – 19 cm 6rine o!tp!t o" 8): mls o?er 9O hrsE Mild abdominal pain

'e?ere H''

@ Clinical ascites W3D hydrothorax

@ lig!ria

@ Haemoconcentration (haematocrit O)>

@ HypoDproteinaemia

@ ?arian siRe !s!ally 19cm$ Characteristics of common organisms inclu(e

all except

ALeisseria gonococcus is non motile

.Mycobacteria are gram Ive

C.acillus anthracis is anaerobic,,ans*both

aerobic an( anerobic,.acillus species is aerobic

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35coli is motile

5Kar(nerella vaginalis is gram #vegm

variable can be Ive or #ve

.hich one o" abo?e statements is tr!e/

A Cer?ical ectropion is a pathological process res!lting "rome?ersion o" the lower cer?ical canal% Cer?ical ectropion is a risk "actor "or de?eloping C;0C Cer?ical ectropion in early pregnancy is an indication "ortermination Cer?ical ectropion is assoc with adolescence*ansE Cer?ical ectropion is pre malignant

'!nlight plays a ma<or role in ?itamin prod!ction* ;n

certain co!ntry, d!ring winter, day is shorter than night*

People in those co!ntry prod!ce ?itamin d!ring s!mmer

and store them "or !sage d!ring winter* where is the ?itamin

being storeda* adipocyte**ans

b* hepatocyte

c* red blood cell

d* adrenal

e* dermis

$ Anencephaly inclu(eAhigh A- an( 2nc estriol

.low A- an( normal estriol

Clow A- an( low estriol

3high A- an( low estriol

5high A- an( normal estriol

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$ 3iagnostic test for cystic Rbrosis in bloo(

a, 2S1

b, sweat test

C ,immunoreactive trypsinogenans

(, 7aryotyping

.loo( ` immunoreactive trypsinogen

Sputum *throat swab ` 2S1

Sweat ` sweat test

Q) Jith respect to pre term births*which is true??

A,&he ma)ority of preterm are (ue tospontaneous pre term labour

.,About a thir( of preterm births are (ue to

multiple pregnanciesans

C,Pver N"% preterm births (ue to infection

3,About "0% are 2atrogenic

5,4&2 most common cause of preterm births

8/18/2019 mrcog sba's -2


'P0+A0E6' P&E+E&M 2:>

M6G+;PGE P&E$0A0C;E' 2:>

$E0;+D6&;0A&- ;0LEC+;0,P&M 9:D9)>

EGEC+;BE 1:D1)>

which are the "ollowing is correctly matched/

a* chylomicron D transports +A$ "rom li?er to tiss!es b* BGG D transports +A$ "rom intestine to li?er c* GG D transport cholestrol "rom intestines to tiss!es

d* HGD transport cholestrol "or storagee* none o" the abo?e*ans

chylo transport &AK from intestine to tissues

vl(l transport tag from liver to tissue

l(l transpost cholestrol from liver to tissue

h(l transport cholestrol for excretion

A diabetic women attends yo!r preconception clinic* -o!




presents/

8*)> or O5mmol3mol7*8> or 8:mmol3mol1:*:> or 58mmol3mol**ans11*1> or =5mmol3mol19*8> or 11Ommol3mol

$ /ibosomes are locate( in which part of the

cell? A, Kolgi complex

., Qysosomes

8/18/2019 mrcog sba's -2


C, Mitochon(ria

3, /ough en(oplasmic reticulum

5, Smooth en(oplasmic reticulum

&he answer is /ough en(oplasmic reticulum,

/ibosomes 8rea(8 the messenger /LA create(

from the nuclear 3LA an( translate it to create

proteins via transfer /LA, &here are free

ribosomes in the cytoplasm of cells but they are

in abun(ance in the rough en(oplasmic reticulum

Q) .hich part o" the cell cycle is noted "or sister chromatids

separating and mo?ing to opposite sides o" the cell/ A*

Anaphase *ans

%* Metaphase

C* Prophase

* 'ynthesis phase

E* +elophase+he answer is Anaphase* .ithin the cell cycle 0A

replication occ!rs in the synthesis phase be"ore entering the

$ap 9 phase* Mitosis starts with chromosomes condensing

(prophase "ollow by chromatids aligning (metaphase,

"ollowing by sister chromatids separating and mo?ing

(anaphase* Linally the cell membrane di?ides in telophase

Q) .hich o" the "ollowing amino acid bases is not contained

in &0A/

A* Adenine

%* Cytosine

C* $!anine

* +hymine

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E* 6racil

+he answer is +hymine* ;n &0A the thymine is replaced by

!racil* +he other bases (adenine, cystosine and g!anineremain the same*

.hich o" the "ollowing molec!les generates weak "orces

that can attract ne!trophils to cell walls/ A* Cadhedins

%* Eicosanoids

C* Hemidesmosomes

* ;ntegrins

E* 'electinsans

'electins are molec!les that are expressed in endometrial cell

walls and also le!cocytes* +hey generate weak attraction

"orces* ;n"lammatory processes ?ia interle!kins increase the

amo!nt o" selectins present and hence, attract more le!cocytes

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$ Causes of 32C inclu(e all except

Aamniotic 6ui( embolism

.hep 5

Cmassive bloo( loss3acute fatty liver of pregnancy

5none aboveans

$ Lotochor( from =

!,meso(erm ,,ans

G,en(o(erm

;,ecto(erm

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Q) .hich hormone is made in o?arian gran!losa cells be"ore

o?!lation occ!r

Atestosterone

%progesterone

Cantim!llerian hormoneans

alpha "etoproteinEaldosterone

Q) Lrom which o" the "ollowing str!ct!res are the in"erior

parathyroid glands deri?ed/

ADMesoderm o" "irst pharyngeal arch

%DMesoderm o" second pharyngeal arch

CDPo!ch o" "irst pharyngeal archD Po!ch o" second pharyngeal arch

EDPo!ch o" third pharyngeal arch**ans

$ Pptimum pressure range for primary trocar

insertion at laproscopy

A !0#!"mmhg

. G0#G"mmhg,ans

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C G0#G" mm water

3 !0#!" mm water

5 !"#!>mmhg

$

Ans C

Heprin and war"rin is gi?e "or 2 to ) day combine then heprin

withdraw*

Q) &%C no mitochondria,energy needs met by anerobis

respiration

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Q) where in the body ketone bodies prod!ced d!ring

star?ation//

%rain'keletal m!scle

Cardiac m!scle

Gi?er**ans

Heart

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Q) A 2:DyearDold woman, who is 5 weeks pregnant, presentsto accident and emergency with PB bleeding and crampy

abdominal pain* 'he has a past medical history o" a rightD

sided deep ?ein thrombosis and two pre?io!s miscarriages*

'he is sent to the early pregnancy assessment !nit, where

!ltraso!nd con"irms miscarriage* .hat is the most likely

!nderlying diagnosis/ A* &he!matoid arthritis

%* AntiDphospholipid syndromeans

C* '<fgren’s syndrome

* iscoid l!p!s

E* 'ystemic l!p!s erythematos!s ('GE

Q) A team wish to a!dit their departmental res!lts on the !se

o" anticoag!lation in patients with obstetric thromboembolic

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disease*.hich one o" the "ollowing options is the most

appropriate next step in the a!dit cycle/(Please select 1

option

A ata analysis

% ata collection

C ;denti"y standards

;mplement change

E 0eeds assessment

$ Jhich one is notiRable (isease ? A clostri(ium

(iYcle

. measles ,ans

C M/SA

3 pneumococcal pneumonia5 rheumatic fever

Q) A diabetic women attends yo!r preconception clinic* -o!




presents/

8*)> or O5mmol3mol7*8> or 8:mmol3mol1:*:> or 58mmol3molans11*1> or =5mmol3mol19*8> or 11Ommol3mol

8/18/2019 mrcog sba's -2


Patients with H%A1C o" 1:*:> or greater sho!ld be strongly

ad?ised to !se contraception and impro?e glycemic control

prior to getting pregnant*

iabetes ;n Pregnancy

0;CE !pdated its g!idance on management o" diabetes in

pregnancy in 9:1)* +he c!rrent g!idelines ad?ise the

"ollowing regarding management incl!ding new H%A1C

targets

Ad?ise women with diabetes who are planning to become

pregnant to aim to keep their HbA1c le?el below O5

mmol3mol (8*)>, i" this is achie?able witho!t ca!sing

problematic hypoglycaemia*

&eass!re women that any red!ction in HbA1c le?el towards

the target o" O5 mmol3mol (8*)> is likely to red!ce the risk

o" congenital mal"ormations in the baby*

'trongly ad?ise women with diabetes whose HbA1c le?el is

abo?e 58 mmol3mol (1:> not to get pregnant beca!se o" the

associated risks*

Q)

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Q)

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Q) .hich artery is a direct branch o" the aorta/

A* ;n"erior ?esical%* ;nternal iliac

C* ?arian *ans* 6terianE* Baginal

&he ovarian artery is a branch of the aorta, 2t

arises anterolaterally )ust below the renal artery*

running retroperitoneally to leave the ab(omen

by crossing the common or external iliac artery in

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the infun(ibulopelvic fol(, 2t crosses

correspon(ing ureters an( supplies twigs to it but

(oes not supply to ab(ominal organs, &he

internal iliac artery arises from the common iliac

an( its inferior branch further supplies to the

pelvis,

$ &he ris7 of vertical transmission of 12E with no

intervention?

!, !0#G0

G, "#!0

;, !"#G"

H, G"#H0

", More than "0ans

Pre implantation genetic diagnosis is /

A* ;s one in early stage o" h!man Rygote embryode?elopment*ans%* Carried o!t at 1: week o" gestation*C* 'ho!ld be o""er at all women** ;s done so that termination can be o""ered to co!ple timely** Carries a small risk o" miscarriage*

A 25 year old woman attends her $P at 1: weeks gestation*'he is complaining o" "e?er and has pains in her <oints* 'he

de?eloped a rash yesterday* n examination, she has at

temperat!re o" 25, posta!ric!lar lymphadenopathy and a

mac!lopap!lar rash o?er her torso*

what is the most likely "etal abnormality to occ!r as a res!lt o"

this ac!te in"ection/

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c* ins!lin**ans

d* diabetes

e* gl!cagon

7ey c, the rest stimulates the hormone sensitivelipase F1SQ to brea7 &AK to fatty aci(

$ which organism is responsible for the

occurance of the (iagram below? a, trichomonas

vaginalis

b, chlamy(ia trachomatisc, neisseiria gonorrhea

(, gar(renella vaginalisans

e, hemophilus (ucreyi

bacteria vaginosis presents with high ph

(ischarge (ue to re(uction of lactobacilli, they

have o'ensive Rshy o(or (ischarge an( presenceof clue cells on histology

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Q) .hat is the blood "low to the !ter!s in a term pregnancy/

A* ):: ml3min

%* 8::

C* 7::**ans

* 5::

&he uterus receive H00mlDmin from the extra

!"00 ml * so those calculate( it from the total

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Q) .hich artery pro?ides main blood s!pply to breast /

A axillary artery

% internal mammary artery**ansC lateral thoracic artery

s!perior thoracic artery

E thoracoacromial artery

Q) .hich o" the "ollowing is not a risk "actor "or s!r"actant

de"iciency/

A* Electi?e Caesarean section%* ;ntra!terine growth restriction*ans

C* Male gender

* Premat!rity

E* 'epsis

$ luorescent insitu hybri(iation F2S1 analysis

is useful in all the following situations* except

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! 3etermination of sex in cases of ambiguous

genitalia

FG 3etermination of uniparental (isomy

ans,

F; /api( (iagnosis of trisomies

FH 2(entiRcation of submicroscopic (eletions

$ 1ypophosphatemia shifts the curve Qeft

$ 2n spermatogenesis* at which stage (o the sex

chromosomes segregate?F! Meiosis 22* primary

spermatocyte

FG Meiosis 2* primary spermatocyteans

F; Meiosis 22* secon(ary spermatocyte

FH Meiosis 2* secon(ary spermatocyte

$ A number of cytogenetic metho( can beemploye( in prenatal genetic screening,which

screening metho(s examines 2L&5/-1AS5

C1/PMPSPM5?

Agarose gel electrophoresis

2uroscent 2n situ hybri(isation ,ans

Multiplex ligation (epen(ent probe ampliRcation

-C/

^#3LA 2solation an( ampliRcation

$ 2n men* the lower part of gubernaculum

becomes the scrotal ligament* with the upper

part (egenerating* 2n women* the upper part

becomes the suspensory ligament of the ovary*

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whilst the lower part become the roun( ligament,

&he wolYan (uct (egenerates in females but

contributes to the suspensory ligaments,

&he mullerian (ucts fuse to form the uterus*

cervix an( vagina,

&he bla((er is forme( from the cloaca* whilst the

urachus forms the me(ian umbilical ligament,

$

Ans C

!,Chloroquine 3A Category C

can be use( Causiously F.eneRts `harms,

G,1ep A can be given

;,&(ap is recommen(e( to be given specially late

trimester

H,MM/ is live attenuate( vaccine So

Contrain(icate(,

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$

Ans .

$ Alcoholic pregnant la(y with obstetric

cholestasis what you will give #a vitamin C

b vitamin ,ans

c vitamin .!( vitamin .@

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Q)

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$

$-lanne( E.AC is associate( with an

approximately how much % ris7 of uterine

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rupture # !%,,,,,,,ans

G%

;%

!0%

Q) .hat proportion o" cytomegalo?ir!s (CMB in"ections is

asymptomatic in imm!neDcompetent patients/aD 1:>

bD O:>

cD 8:>

dD 5:>

eD =:>***********ans

+he answer is =:>* CMB in"ection in ad!lts is asymptomatic

in =:> o" cases* ;" primary in"ection occ!rs in pregnancy,

then there is a O:–):> risk o" "etal transmission* %etween

99> and 25> o" the in"ected "et!ses will de?elop symptoms*

Q) .hich o" "oll enRymes, which may rise in hepatitis and

myocardial in"arction, is present in the li?er cell cytosol, brain

and myocardi!m/

A Alkaline phosphatase (AGP

% Aspartate aminotrans"erase (A'+ ans

C $ammaDgl!tamyl transpeptidase ($$+ Alanine aminotrans"erase (AG+

E 'er!m bilir!bin

Q) .hich o" the "ollowing is a ca!se o" hyponatraemia/

A Cirrhosisans

% ConnJs syndrome

C C!shingJs syndrome

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$ 24 pregnancy at N wee7s what woul( be

expecte( .hcg levels ?

A "00024,ans

. ;00*00024

C !G024

3 "024

5 ;0024

$ -lasma -1 is neutral N,H Frange N,;"#N,H"

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$ &he localiation of a genetic locus to a

particular chromosomal region using lin7age or

molecular analysis is 7nown as ! Kene mapping

FG Kene cloningans

F; Kene isolation

FH Kene splicing

$ Aci(osis is associate( with hyper7alaemia an(

al7alosis with hypo7alemia ,,&

$ A !@#year#ol( a(olescent is seen in your clinic,Pn physical examination* you note that he has

small testis for his state( age an( has poorly

(evelope( secon(ary sexual characteristics, 2n

a((ition* on physical examination* there is

notable gynaecomastia, 1e is rather tall* with

abnormally long upper an( lower limbs, A buccalsmear is obtaine( an( examine( microscopically,

1ow many chromatin positive inclusion bo(ies

are seen?

F! 0

FG !,ans

F; G

FH ;

$ All of foll are stone formation inhibitors except

A magnesium

. syprophosphate

C calciumans

8/18/2019 mrcog sba's -2


$ &he stan(ar( 7aryotype is performe( by

photomicroscopy of cells at which mitotic stage?

F! 2nterphase

FG -rophase

F; Metaphase,ans

FH Anaphase

$ &he mc cause of learning (isability

ragile x syn(rome

3own syn(romeans

Q) 'B inc by D a*):>

b*7:>

c*9:>**********ans

Hormones synthesised by kidney incl!de which o" "oll/

A 1,9) dihydroxycholecalci"erol *ans

% Aldosterone

C Angiotensin ;

Angiotensin ;;

E Cortisol

-o!r 9)Dy preg at 28 w* 'he has an ac!te 6+;* .hich o"

"oll medications is contraindicated in &x o" 6+; in this

patient/ a* Ampicillin

b* 0itro"!rantoin**ans, C; in 2rd trimester %ecoR

haemolytic anaemia in new born

c* +rimethoprim3s!l"amethoxaRole

8/18/2019 mrcog sba's -2


d* Cephalexin

e* Amoxicillin3cla?!lanate

Q)9:Dy D ro!tine wellDwoman examn* 'he has a h3o acne, "orwhich she takes minocycline and isotretinoin on daily basis*

'he also has a h3o epilepsy that is well controlled on ?alproic

acid* 'he also takes a CCP containing norethindrone acetate

and EE* 'he is a nonsmoker b!t drinks alcohol on daily basis*

'he is concerned abo!t e""ecti?eness o" her birth control pill,

gi?en all medications that she takes* 'he is partic!larly

worried abo!t the e""ects o" her medications on a de?eloping

"et!s in e?ent o" !nintended preg* .hich o" "oll dr!gs has

lowest potential to ca!se birth de"ects/a* Alcohol

b* ;sotretinoin (Acc!tane

c* +etracyclines

d* Progesterone*ans

e* Balproic acid (epakote

Q) bilir!bin is bo!nd to alb!min in circ!lation**+

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Q) 0at!ral killer cells belong to which cell type/A %asophils

% Eosinophils

C Gymphocytes*ans

Monocytes

E 0e!trophils

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Q) A 17DyearDold primigra?ida complains o" constipation andarthralgia at 95 weeks gestation*A n!mber o" biochemical

in?estigations are per"ormed, b!t which o" these is clinically

signi"icant/ (Please select 1 option

A etectable !rinary h!man chorionic gonadotrophin

% Lree thyroxine 5*= pmol3G (=D99

C Prolactin o" 1::: m63G (O):

'er!m alkaline phosphatase o" 2): ;63G ():D11:

E 'er!m corrected calci!m 9*5= mmol3G (9*9D9*8*ans

A patient presents "or prenatal care in the second trimester*

'he was born o!tside the 6nited 'tates and has ne?er had any

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ro!tine ?accinations* .hich o" the "ollowing ?accines is

contraindicated in pregnancy/

a* Hepatitis A

b* +etan!sc* +yphoid

d* Hepatitis %

e* Measles*ans

$ 3eci(ual reaction occur at = 3ay >,,ans

3ay!G

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Q)

.hich imm!noglob!lin is key to passi?e neonatal

imm!nity/ ;g

;gE

;gM;gA

;g$*ans

Myasthenia $ra?is is an example o" what type o"

hypersensiti?ity reaction/ +ype ;

+ype ;;+ype ;;;

+ype ;B

+ype Bans

Myasthenia gra?is and $ra?esJ disease as well* +hese are also

classi"ied as type 9 in the older classi"ication

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Q) Lollic!logenesis 27) d

8/18/2019 mrcog sba's -2


Q) CrossDo?er occ!re in which stage o" prophase 1 in

meiosis/

A*'tage 1

%*9

C*2**ans

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*O

E*)

A 22 year old women presents to clinic "or in"ertility

in?estigations* 'he has a signi"icant psychiatric history* Her

8/18/2019 mrcog sba's -2


blood tests re?eal a raised Prolactin* .hich o" her medications

below is 0+ known to ca!se this Amitriptyline

#opicloneans

ChlorpromaRine&isperidone

Cocodamol

r!g Ca!se o" Hyperprolactinaemia incl!de

Atypical antipsychotics eg risperidone

PhenothiaRines eg chlorpromaRine

%!tyrophenones eg haloperidol

+hioxanthenes

Metoclopramide

opamine synthesis inhibitors eg DMethyldopa

Catecholamine depletors eg &eserpine

piates eg Codeine

H9 antagonists eg Cimetidine, &anitidine

Amitriptyline

''&;Js eg Ll!oxetine

Calci!m channel blockers eg Berapamil

estrogens

+&H

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$

8/18/2019 mrcog sba's -2


Q)

Q) CP is contraindicated in

%ronchial asthma

Hyperthyroidism

8/18/2019 mrcog sba's -2


.ol" Parkinson white disease

'ystemic l!p!s erythematos!s**ans

8/18/2019 mrcog sba's -2


Q) &egarding the ProgesteroneDnnly Pill (PP which o" the

"ollowing statements regarding its mechanism o" action is

LAG'E/

A* .ith esogestrelDonly pills the primary mode o" action is?ia inhibition o" o?!lation

%* All types o" PP thicken cer?ical m!c!s

C* 6p to =7> o" cycles in women !sing a le?onorgestrelDonly

pill are ano?!latory**ans

* %lood press!re and weight sho!ld be meas!red prior to

prescribing a PP

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E* +he only 64MEC O criteria "or PP prescription is %reast

Cancer within the past ) years

$ 3uring normal pregnancy which one is

correct ?

A G0% increase in plasma volume by ;G wee7s

gestation

. 3ecrease in J.C count

C inc in proportion of . to & lymphocytes,,ans

3 increase in antithrombin ;

5 lupus anticoagulant in circulation

$

Ans C

$ A baby ha( bra(ycar(ia an( was (elivere( by

ventouse,&he umbilical artery p1 wa(N,0"* base

excess #H* while the umbilical vein p1 was N,G"*

base excess #G,", Jhat will you tell the

pe(iatrician about the test = Lormal bloo(

8/18/2019 mrcog sba's -2


testans

&he baby ha( an acute episo(e of hypoxia before

(elivery

&he baby ha( chronic episo(e of hypoxia before

(elivery

1ere -h N,0"F re(uce( base excess #H F normal

So acute hypoxia

Qiste( below are normal values in an umbilical

arterial sample in a term newborn=

-1= N,!> O N,;>

-CPG= ;G O @@ Fmm1g

1CP;= !N O GN FmmolDQ

-PG= @ O ;! Fmm1g

.ase excess= #> O 0 FmmolDQ F.ase (eRcit= 0 O >

$

Ans C

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$ Angle of Qouis O & H

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$ Content of spermatic cor( inclu(e all except =

Avas (eferns

.genital branch of genito femoral nerve

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Ccremasteric artery

3inferior epigastric arteryans

5illio inguinal nerve

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Q)

Ans C

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Q) &enal artery passes behind Aaorta

%in" ?ena ca?aans

C!reter

diaphragmEpsoas m!scle

Q) progesterone only pills (PP

+ypes o" PP

1* +raditional (eg Lem!lenQ, MicronorQ, 0orgestonQ

Main mode o" acton thickening cer?ical m!c!s pre?enting

sperm entry at neck o" womb

May also ca!se ano?!lation b!t this e""ect ?ariable and!nreliable

9* esogestrel (eg CeraRetteQ

Main mode o" action inhibition o" o?!lation*

Also ca!se thickening o" cer?ical m!c!s

64MEC Conditions

8/18/2019 mrcog sba's -2


64MEC 1 A condition "or which there is no restriction "or

the !se o" the contracepti?e

64MEC 9 A condition "or which the ad?antages o" !sing the

contracepti?e method o!tweigh the risks64MEC2 A condition where the theoretical or pro?en risks

!s!ally o!tweigh the ad?antages o" !sing the method

64MEC O A condition which represents an !nacceptable

health risk i" the contracepti?e is !sed

0ote the 64MEC conditions ?ary between CCP and PP

*

Q) Cystic "ibrosis is diagnosed in ser!m by 'weat test

;mm!noreacti?e trypsinans

Chloride test

A is con"irmatory test

8/18/2019 mrcog sba's -2


% is screening test

%!t A is not done in ser!m itJs done on skin

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$

Ans C

$ &he G most commonly use( 31/ inhibitorsare=

&rimethoprim

Methotrexate,

Some antimalarials are also 31/ inhibitors,

A patient is on the ward with a mechanical mitral ?al?e*

+here is no history o" B+E* .hat is the target ;0&/ 1*) D 9*)

9*: D 2*:

9*) D 2*:

9*) D 2*)**ans

2*: D O*:

Jith regar( to warfarin therapy there are only ;

target ranges that are commonly use(=

G,0 # ;,0 Most common use( for 3E&*-5 tissue

valve replacement treatment

G," # ;," 4se( in mechanical mitral valve

replacement some aortic mech,valve

8/18/2019 mrcog sba's -2


replacements

;,0 # H,0 4se( in mechanical valve replacement

where -5 has occurre( (espite anticoagulation at

lower range

$ 1yperthyroi(ism

1yperthyroi(ism in pregnancy occurs in G in

!*000 pregnancies in the 4

Management Pptions

Antithyroi( 3rugs !st Qine

-ropylthiouracil crosses !st Choice as crosses

placenta less rea(ily than carbimaole

Carbimaole

/a(ioio(ine is contra#in(icate(

.eta#.loc7ers

May be use( but use shoul( be limite( to a few

wee7s as may a(versely a'ect fetus

Surgery

Pnly when absolutely necessary, -atient nee(s to

be euthyroi( prior to surgery

Q) Pharmacokinetics in Pregnancy

Maternal physiology changes d!ring pregnancy incl!de

;ncreased maternal "at and total body water

ecreased plasma protein concentrations

;ncreased maternal blood ?ol!me, cardiac o!tp!t, renal blood

"low and !teroplacental !nit, and decreased blood press!re*

il!tinal anaemia

;ncreased tidal ?ol!me

8/18/2019 mrcog sba's -2


elayed gastric emptying and gastrointestinal motility

Altered acti?ity o" hepatic dr!g metaboliRing enRymes

Q)

Q)Pearl inde&

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-o! are called to re?iew a baby with cyanosis when

"eeding immediately a"ter birth* '!bseI!ent in?estigation and

imaging re?eals choanal atresia* 6pon I!estioning the mother

re?eals she had been getting repeat prescriptions "rom her $Pin Poland witho!t her 64 $PsJ or yo!r knowledge* .hich o"

the "ollowing medication was most likely to ca!se this/

CarbimaRole*ans&amipril&anitidine

.ar"arin'ertraline

$S prea( of malignancy from pelvic viscera to

vertebral venous plexis system via

Alateral sacral vesselsans

.vertebral vein

Clumber vein

3inf mesenteric vein

5post intercostal vein

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$

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$

A patient is stated on .ar"arin d!e to a P!lmonary

Embolism* .hat is the target ;0&/ 1*)D1*=

9*:D9*)

9*:D2*:**ans9*)D2*)

2*:DO*:

Jith regar( to warfarin therapy there are only ;

target ranges that are commonly use(=

G,0 # ;,0 Most common use( for 3E&*-5 tissue

valve replacement treatment

8/18/2019 mrcog sba's -2


G," # ;," 4se( in mechanical mitral valve

replacement some aortic mech,valve

replacements

;,0 # H,0 4se( in mechanical valve replacement

where -5 has occurre( (espite anticoagulation at

lower range

8/18/2019 mrcog sba's -2


$

-o! see a patient who ga?e birth earlier in the day* 'he was

taken o"" war"arin d!ring pregnancy and is c!rrently on

GM.H* 'he intends to breast"eed "or the "irst 8D5 weeks and

8/18/2019 mrcog sba's -2


wants ad?ice regarding restarting war"arin* .hich o" the

"ollowing is appropriate/

&ecommence war"arin on stopping breast"eeding&ecommence war"arin immediately

&ecommence war"arin in 8 weeks regardless o" breast"eeding

stat!s

&ecommence war"arin in )D7 daysans

&ecommence war"arin O5 ho!rs a"ter breast"eeding has

stopped

&here are G pieces of 7nowle(ge that will help

you answer this question, irstly Jarfarin is safe

to use when breastfee(ing so breastfee(ing has

no bearing on when to restart warfarin, &he main

concern is postpartum haemorrhage an( because

of this the a(vise is to wait "#N (ays after givingbirth before restarting,

8/18/2019 mrcog sba's -2


$

Q) bstetric con<!gate A 1:*) cm

%19cm

C12cm

12*) cm

Enone abo?e

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Q)

Ans b

8/18/2019 mrcog sba's -2


A 98DyearDold second gra?id who is work in a n!rsery

school attends the $P’s s!rgery as she noticed ?esic!lar rash

on her back and abdomen* 'he is 9) weeks pregnant* Her $P

con"irms the diagnosis o" chickenpox* .hat is the most

appropriate action/

A* &eass!rance

%* $i?e a single dose o" ?aricella Roster imm!noglob!lin

C* Ad?ise serial !ltraso!nd scans

* Commence oral acyclo?irans

E* Commence intra?eno!s acyclo?ir

$ Sure sign for sacral hiatus

Asacral cornu,ans

.sacral promontory

CcN spine

3ishial tuberosity

5ischial spine

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$ 4terus pierce

Auterosacral ligament

.broa( ligaments

Clevator ani3pubocervical ligament

5none above,,ans

$ Jarfarin

/CPK up(ate( its Kreentop gui(elines on

thromboprophylaxis in G0!",

ey -oints -eople on warfarin shoul( be converte( to

QMJ1 (uring pregnancy

Eery few exceptions to above, Mechanical heart

valves main one

Jarfarin causes a characteristic warfarin

embryopathy in "% of foetuses expose( to

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0o treatment*ans

;B Clindamycin =:: mg 5 ho!rly

;B Cipro"loxacin 7):mg 19 ho!rly

;B Clarithromycin )::mg 19 ho!rlyral doxycycline 9::mg 19 ho!rly

Antibiotic prophylaxis for K.S is not require( for

women un(ergoing planne( caesarean section in

the absence of labour an( with intact

membranes,

2f 2ntrapartum antibiotics for K.S are in(icate(

;g .enylpenicillin shoul( be a(ministere( as

soon as possible after the onset of labour an(

!,"g H hourly until (elivery,

Clin(amycin 900mg shoul( be a(ministere( to

those women allergic to

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$

Ans A

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$

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$ Jhich paire( structure contain the uterian

arteries an( veins?

!, .roa( lig

G, Car(inal lig ,,ans

;, -ubocervical lig

H, /oun( lig

", 4terosacral lig

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Q)

'ertoli cells ser?e a n!mber o" "!nctions d!ring

spermatogenesis, they s!pport the de?eloping gametes in the

"ollowing ways

Maintain the en?ironment necessary "or de?elopment andmat!ration, ?ia the bloodDtestis barrier

'ecrete s!bstances initiating meiosis

'ecrete s!pporting testic!lar "l!id

'ecrete androgenDbinding protein (A%P, which concentrates

testosterone in close proximity to the de?eloping gametes

+estosterone is needed in ?ery high I!antities "or maintenanceo" the reprod!cti?e tract, and A%P allows a m!ch higher le?el

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o" "ertility

'ecrete hormones a""ecting pit!itary gland control o"

spermatogenesis, partic!larly the polypeptide hormone,

inhibinPhagocytose resid!al cytoplasm le"t o?er "rom spermiogenesis

'ecretion o" antiDMllerian hormone ca!ses deterioration o"

the Mllerian d!ctX11Y

Protect spermatids "rom the imm!ne system o" the male, ?ia

the bloodDtestis barrier

Q)

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Q)

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&!bella*ans

Baricella #oster

CMB

i" only sensorine!ral hearing loss DD CMB

sensorine!ral hearing loss W bl!eberry m!""in rashDD &!bella

$

Ans C

$

Ans ? 5

$ Jhich v the following is not a (erivative of

vitelline vein

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Ainferior mesenteric vein,ans

.superior mesenteric vein

Chepatic vein

3portal vein

5lower inferior vena cava

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$

Ans 5

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$ Jhich antiretrovial (rug cause lactic

aci(osis??

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$

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$ /egar(ing shoul(er (ystocia which one is

true ?

A# recurrence is "0%

. half of all (ystocia cases occur when babies

have normal birth weight ans

C# macrosomia can be reliably pre(icate(

antenatally

3 early 2PQ in suspecte( cases has been shown

to re(uce ris7 of (ystocia

5 sie of pelvic outlet in association withperineum contributes to mechanism of (ystocia

$

Ans C

Q) .hat percentage o" in"ants with congenital CMB in"ection

are symptomatic/==>

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):>

1:>*************ans

1D9>

1>

Q)'ta"es o# s(p$ilis %

$

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$ chic7en pox an( rubella both got same

incubation perio( of aroun( !H (ays ,,,

$ &he 1!n! virus = 2s in6uena b ,,ans

&ransmitte( from pigs to human4n(ergo antigenic shift

3oesnt go antigenic shift

2nfection (oesnt pro(uce antibo(ies

$ which (oesnt cross placenta? 2gK!

igKG,ans

igK;2gKH

-o! are asked to re?iew a 8) year old ladies legs preD

operati?ely* -o! diagnose cell!litis* .hat is the most common

ca!sati?e organism/

'taphylococc!s A!re!s'taphylococc!s Epidermidis

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Clostridi!m Per"ringens

'treptococc!s M!tans

'treptococc!s Pyogenes**ans

$ro!p A streptococc!s A4A 'treptococc!s Pyogenes is the

most common ca!se o" cell!litis*

'taph* a!re!s is the second most common

'taph* epidermis can "orm bio"ilms on catheters3implants

Clostridia Per"ringens ca!ses gas gangrene

'trep* M!tans ca!ses tooth decay and dental ca?ities

$ro!p A 'treptococc!s can also ca!se +onsillitis

(strep*throat, 'carlet "e?er and &he!matic "e?er*

Candidates sho!ld also be "amiliar with $ro!p %

'treptococc!s A4A 'treptococc!s Agalactiae which can ca!se

neonatal sepsis*

A patient is seen in the sex!al health clinic* 'pec!l!m

examination re?eals a "irm 19mm !lcerated lesion with

smooth edges to the cer?ix* +he patient denies any pain* .hat

is the likely ca!se/Herpes 'implex +ype 1

Herpes 'implex +ype 9

0eisseria gonorrhoeae

Chlamydia +rachomatis D4

+reponema pallid!mans

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A 97 year old patient is maintained on war"arin d!ring

pregnancy d!e to a mechanical mitral ?al?e* 'he has read

abo!t war"arin embryopathy* .hich o" the "ollowing is a

typical "eat!re/ Aplasia c!tis'tippled epiphyses**ans

totoxicity

&enal dysgenesis

mphalocoele

A 2) year old lady is seen in clinic "or ;BL co!nselling*

'he reports ha?ing bloody watery diarrhoea "or the past )

days and a "e?er !p to 2=oC* A day or two earlier she had

takeaway chicken that tasted V"!nnyV* .hich gram negati?e

rod is likely to be responsible/

'almonella

Helicobacter Gisteria

Camplylobacter**ans

Escherichia coli

$ Jhich one is not associate( with cor( prolapse

?

A pre term (elivery

. fetal abnormality

C P& positionans

3 internal po(alic version

5 A/M

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$

Ans C

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$ assuming normal renal function *after how

many wee7s plasma volume return to normal ?

Q) smolarity o" the blood is more or !rine *L

Q) .hich white blood cell type is ele?ated in an ac!te

cytomegalo?ir!s in"ection/

0e!trophils

Monocytes

Gymphocytes**ans

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Eosinophils

%asophils

$ Jhich of the following is best explanation forbreast (evelopment in apatient with an(rogen

insensitivity?

A , gona(al pro(uction of estrogen,

. , a(renal pro(uction of estrogen,

C,.reast tissue sensitivity to progesterone,

3 , peripheral conversion of an(rogen, ,ans ?5 , autonomous pro(uction of breast speciRc

estrogen,

$ Surface mar7er of & cell #A,C3;,ans

.,2g

C,C3H

3,C3>

& cell C3 H for helper

C3 > for cytotoxic

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$ Mc trisomy in miscarrie( fetuses ? & !@

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Compatible is G!

Lon compatible is !@

.hat is the inc!bation period o" 'carlet Le?er (in days/1D7*ans

2D11

7D1O

1OD91

1OD95

.hat is the mode o" action o" Me"enamic acid/

;nhibits Prostaglandin 'ynthesisans

Acti?ates Antithrombin ;;;

;nacti?ates "actor Fa

;nhibits "ibrin

;nhibits Plasminogen Acti?ation

$ Quteoplacental shift occurre( in =

!, !G w7s

G, !@ w7s

;, > w7s ans*@#> wH, G0 w7s

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$ si(e e'ects of AC5 inhibitor an( A/.Fangiotensin 22 receptor bloc7er use in pregnancy

# 24K/ an( renal (ysgenesis

$ .loo(y (iarrhea without foo( poisoning 》

salmonella ,,,.loo(y (iarrhea with foo(

poisoning》 camphylobacter

Q) All o" the "ollowing are stone "ormation inhibitors except

A magnesi!m

% syprophosphate

C calci!m*ans

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Q) A 9O year old patient who is 1O weeks pregnant has her

!rine dipped d!ring an antenatal ?isit* +his shows le!cocytes

WW and nitrites WW* -o! s!spect a 6+; and send a !rine sample

"or c!lt!re* According to 0;CE g!idance which o" the

"ollowing is most appropriate treatment option/

0o treatment !ntil c!lt!re res!lt recei?ed+rimethoprim 9::mg % "or 2 days

+rimethoprim 9::mg % "or 7 days

0itro"!rantoin ):mg ' "or 7 days*ans

Amoxicillin )::mg +' "or 7 days

0;CE g!idance on 6+; in pregnancy was !pdated in U!ly

9:1)

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+he "ollowing is ad?ised

'end !rine "or c!lt!re and sensiti?ity "rom all women inwhom 6+; is s!spected be"ore starting empirical antibiotics

and 7 days a"ter antibiotic treatment is completed*

Prescribe an antibiotic to all women with s!spected 6+;

(awaiting c!lt!re res!lt is not ad?ised

Altho!gh local antibiotic resistance needs to be taken into

acco!nt the "ollowing is ad?ised in terms o" antibioticselection

1* 0itro"!rantoin ): mg ' (or 1:: mg M& % "or 7 days*

9* +rimethoprim 9:: mg twice daily, "or 7 days

$i?e "olic acid ) mg i" it is the 1st trimester

o not gi?e trimethoprim i" the woman is "olate de"icient,taking a "olate antagonist, or has been treated with

trimethoprim in the past year*

2* Ce"alexin ):: mg % (or 9): mg 8Ids "or 7 days

Q) .hich l!ng ?ol!me is decrease in pregnancy /

A peak "low rate

% tidal ?ol!meC ?ital capacity

"!nctional resid!al capacity ans

E Lorced expiratory ?ol!me

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Q) +here are di""erent types o" "etal haemoglobin prod!ced

thro!gho!t the gestational period* .hat is the primaryhaemoglobin type at 29 weeks o" gestation/ ADHb A

%DHb L *ans

CDHb $ower 1

DHb $ower 9

EDHb Portland

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Q) 0er?e root o" ilioing!inal and iliohypogastric ner?e /A +19

% +19 and G1 *ans

C G1

G9

E G1 and G9

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$ Aci(osis is associate( with hyper7alaemia an(

al7alosis with hypo7alemia ,&

Mneumonic = Al7 Qow I

'ympathetic s!pply to the bladder is deri?ed "rom whichl!mbar segments/ AD G1 and G9

%DG9 and G2

CDG2 and GO

DGO and G)

ED'9 , '2 and 'O

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Changes in the n!cleotide seI!ence o" 0A which aren’t

passed to o""spring occ!r in****/ A* Eggs K sperm cells

%* 0onDsex!al cellsans

C* iploid and haploid cells

* All o" the abo?e

a woman seek to concei?e, she had history o" treatment"rom Chlamydia be"ore 9 months, now she complain o" right

iliac "osse pain * !3s report was empty normal siRe !ter!s

Omm in thickness in !pper corner there is 1)2TOT cm (not

s!re abo!t n!mber,normal o?aries ,little "l!id in right

adenexia* iagnosis is******sep9:12

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aDright hydrosalpinx **ans

bD o?arian cyst

cDectopic pregnancy

dD!terine carcinomaeDappendicitis

;n the process o" "ertilisation, what is the correct seI!ence

"or sperm penetration into the oocyte/

AD Corona radiata, Rona pell!cida, peri?itelline space, plasma

membrane**ans%D Corona radiata, Rona pell!cida, plasma membrane,

peri?itelline space

CD#ona pell!cida, corona radiata, plasma membrane,

peri?itelline space

D #ona pell!cida, peri?itelline space, corona radiata,

peri?itelline spaceED#ona pell!cida, peri?itelline space, plasma membrane,

corona radiata

8/18/2019 mrcog sba's -2


$ aposi sarcoma is cause( by= 1SE!

1SE G

1SE H

1SE >ans

$ Jhich bo(y fat has a ma)or role in gene

transcription

A eicosanoi(s

. fatty aci(sans

C membrane phospholipi(s

3 phospholipi(s

5 triglyceri(es

$ Klan(ular fever is cause( by = 1SE !

1SE G

1SE H,ans * 5.E is 1SE H *Klan(ular fever is

the same Finfectious mononucleosis1SE >

8/18/2019 mrcog sba's -2


$ Jith regar( to oxygen (issociation curve

which factor shift the curve to left ? A al7alosis

,ans

. anemia

C heat

3 hypercapnia

5 hypoxia

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Q) 95 year old lady P2W9 presented to the clinic with history

o" irreg!lar menstr!al cycle "or 9 months, no history o" postD

coital bleeding* 'he had pap smear which showed high grade

sI!amo!s cell intraepithelial lesion (C;0 ;;* +he propermanagement is/

A* Lollow !p K repeat pap smear aer 8 months*

%* Gaser cone biopsyans

C* Examination !nder anesthesia K (KC

* Colposcopic assessment K pel?ic biopsy*

E* Cryotherapy K antibiotic

Q) $ro!p % 'trep* was "o!nd in high ?aginal swap in 98 week

primi, what is next action /

D Antibiotic "or 1 week

D Ad?ice antibiotics perinataly to pre?ent neonatal septicemia

D A"ter birth ;B A% "or 1 week

D &epeat swap at 27 weeksans

$ A ;@#year#ol( woman un(erwent a total

ab(ominal hysterectomy for uterine Rbroi(s,

-ostoperatively she complains of loss of 6exion of her left hip an( numbness over her left anterior

an( me(ial thigh, &he compression of which

nerve is li7ely to be responsible? A, Common

peroneal nerve

., emoral nerve,,ans

C, 2lioinguinal nerve

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3, Pbturator nerve

5, -u(en(al nerve

.hen does ocytogenesis complete/ 8 weeks gestation15 weeks gestation

%irth*ans

P!berty

?!lation

8/18/2019 mrcog sba's -2


.hat is the inner?ation to the Oth part o" d!oden!m/ +)D

+=

+1:3+11*ans

+193G1

G93G2

G23GO

foregut ##` &"#&9

mi(gut ##` &!0 # &!!

hin(gut ##` &!G#Q!$ 1yponatremia is a recognie( complication of

which of the following,,

Carbenoxolone therapy

Cereberal contusion,ans

3iabetes insipi(us

8/18/2019 mrcog sba's -2


-olyuric phase of acute renal faulure

Mahor burns

$

Ans .

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$

Ans A

-o! are asked to re?iew a patient* +hey ha?e attended "or a

scan at 12 weeks "ollowing a positi?e pregnancy test* +he

patient has had 9 pre?io!s pregnancies "or which she opted "or

termination on both occasions* +he scan shows no identi"iable

"etal tiss!e or gestational sac and yo! note the radiologist hasreported a Jb!nch o" grapes signJ* .hat is the likely diagnosis/

Missed miscarriage

;ncomplete miscarriage

Partial molar pregnancy

Complete molar pregnancy*ans

Choriocarcinoma

8/18/2019 mrcog sba's -2


6ltraso!nd "eat!res o"

complete hydatidi"orm mole

D'olid collection o" echoes with n!mero!s small anechoic

spaces (snowstorm or gran!lar appearance*D%!nch o" grapes sign which represents swelling o"

trophoblastic ?illi*

D0ormal inter"ace between abnormal trophoblastic tiss!e and

myometri!m*

D0o identi"iable "etal tiss!e or gestational sac*

6ltraso!nd Leat!res o" Partial Hydatid"orm mole

DEnlarged placenta with m!ltiple di""!se anechoic lesions

DLet!s with se?ere str!ct!ral abnormalities or growth

restriction

Dligohydramnios or de"ormed gestational sac

A co!ple ha?e been re"erred to the in"ertility clinic* +he

male partner ;s 9) and has CL, his semen analysis shows

aRoospermia* .hat is the likely !nderlying ca!se/

Epididymal obstr!ction by thickened secretions d!e to

chloride channel dys"!nction

ligospermiaCongenital absence o" ?as de"erens**ans

bstr!ction o" ?as de"erens by thick secretions d!e to chloride

channel dys"!nction

Congenital absence o" epididymal tail

2n C the thic7ene( intraluminal secretions lea(

to progressive obstruction an( (estruction of the

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vas (eferens in utero lea(ing to congenital

absence of the vas (eferens in most cases,

2n treating such patients for infertility sperm can

be retrieve( from the epi(i(ymis,

.hich o" the "ollowing plays an important role in the

adapti?e imm!ne system/%asophils

endritic cells

Macrophages

0at!ral 4iller Cells

COW + cell*ans

.hich type o" o?arian cancer is responsible "or the

ma<ority o" cases o" o?arian cancer in the 64 and also the

most cancer deaths/ Epithelial o?arian cancers

$erm cell t!mo!rs%orderline o?arian t!mo!rs

+eratoma

ysgerminoma

Malignant primary ovarian tumours can be

broa(ly classiRe( into ; types=

!, 5pithelialG, Kerm Cell

;, Sex Cor( an( Stromal

5pithelial Pvarian Cancers F5PCs are the most

common type with high gra(e serous ovarian

carcinomas the most common subtype, 5PCs

8/18/2019 mrcog sba's -2


comprise=Serous F@>%

Clear cell F!;%

5n(ometrioi( F9%

Mucinous F;%

" year survival is H;%

Qifetime ris7 is ! in N0

Kerm cell tumours account for !#G% of ovarian

cancers

Sex Cor( an( stromal cancers are rare,

$ ollowing are 3LA viruses ? A hep A

. hep .

C 12E

3 1/E >

5 EÊ Ans .35*rest are /LA

$ Cabergolin= 1as long half life,ans

2s an e'ective antiemetic

2s use( (uring pregnancy

May cause par7insonian S5

$ Cell cycle = S is the nucleic aci( synthesis

S is the (na replication &he apoptotic cell is remove( from macrophages

Apotosis is (ownregulate( by p";

.ax family promotes apoptosisans

.ax family promotes apoptosis,,

.cl G family inhibits,,

8/18/2019 mrcog sba's -2


Catecholamines "rom adrenal med!lla increase when

Aprox 1 hr "ollowing a M;

!ring sleep

Lollowing increase in blood s!gar

.hen ner?es to adrenal gland are stim!lated *ans

Lollowing episode o" hypertension

4rebs cycle Prod!ce 1 9 A+P 8 0AH 9 LAH9 9 A+P, 5 0AH, O LAH*ans

2 O A+P, 5 0AH, 9 LAH

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$

Ans C, glycogenolysis, gl!coneogenesis and ketone

generation

8/18/2019 mrcog sba's -2


.hich o" "oll is a $m D?e obligate anaerobe/

%acteroidesans

Clostridia

ChlamydiaEscherichia coli

'almonella

5xamples of obligately anaerobic bacterial

genera inclu(e Actinomyces* Bacteroides*

Clostridium* Fusobacterium* Peptostreptococcus*

Porphyromonas* Prevotella an( Veillonella,

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.hich complement protein is the prod!ct o" all 2

acti?ation pathwaysDDC9:

C7

C2bansC1a

C9a

https://en.wikipedia.org/wiki/Bacteria

https://en.wikipedia.org/wiki/Genus

https://en.wikipedia.org/wiki/Actinomyces

https://en.wikipedia.org/wiki/Bacteroides

https://en.wikipedia.org/wiki/Clostridium

https://en.wikipedia.org/wiki/Fusobacterium

https://en.wikipedia.org/wiki/Peptostreptococcus

https://en.wikipedia.org/wiki/Porphyromonas

https://en.wikipedia.org/wiki/Prevotella

https://en.wikipedia.org/wiki/Veillonella

8/18/2019 mrcog sba's -2


$

Ans A

Pvulation occurs ;@ h after LH surge ans !@OG@ h

after peak of Q1

$

1* $ Miscarriage

1* Letal loss be"ore 9: weeks $estational age

9* Early 'tillbirth

1* Letal loss between 9:D97 weeks $estational age (or"etal weight 2): grams or less

2* Gate 'tillbirth

1* Letal loss between 95D28 weeks $estational age

O* +erm 'tillbirth

1* Letal loss between 27DO: weeks $estational age

Q) .hat epitheli!m cell type lines the endometri!m/

Col!mnarans

C!boidal

8/18/2019 mrcog sba's -2


'trati"ied 'I!amo!s

Pse!dostrati"ied 'I!amo!s

+ransitional

Q)

Ans c

Q) Letal l!ng mat!ration takes place in Astage one

%stage two

Cstage three

stage "o!ransEstage "i?e

) stages o" l!ng de?elopment 1st embryonic with early

b!ds,second pse!dogland!lar !pto 17 weeks, third canalic!lar

!pto 9) weeks s!r"actant prod!ction starts,"o!rth sacc!lar

!pto 28 weeks s!r"actant present mat!re str!ct!re o" l!ngs,last

al?eolar it contin!es to birth and in early childhood

http://www.fpnotebook.com/OB/Bleed/FrstTrmstrBldng.htm

http://www.fpnotebook.com/NICU/Premature/PrtrmInfnt.htm




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Q) Chromosome 91 which one is tr!e / AD9nd largest

chromosome

%D is s!bmetacenteric

8/18/2019 mrcog sba's -2


C carries gene "or growth hormone

incl!des in gro!p % o" chromosomes

E has a n!clear organiRer*ans

Kenes for human growth hormone* 7nown as

growth hormone ! Fsomatotropin an( growth

hormone G* are localie( in the qGG#GH region of

chromosome !N

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https://en.wikipedia.org/wiki/Growth_hormone_1



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Q)

$ Jhich of the following is in (irect contact with

maternal bloo( in lacunae of the placenta?

a, Cells of the cytotrophoblast

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b, 5xtraembryonic meso(erm

c, etal bloo( vessels

(, Cells of the syncytiotrophoblast,,ans

e,Amniotic cells

2n the (eveloping fetus* the maternal bloo( is in

(irect contact with the syncytiotrophoblast,

3uring implantation* the syncytiotrophoblast

inva(es the en(ometrium an( ero(es the

maternal bloo( vessels, Maternal bloo( an(

nutrient glan(ular secretions Rll the lacunae an(

bathe the pro)ections of syncytiotrophoblast,

-rimary villi consist of syncytiotrophoblast with a

core of cytotrophoblast cells, 2n secon(ary villi*

the cytotrophoblast core is inva(e( by meso(erm

an( subsequently by umbilical bloo( vessels in

tertiary villi,

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$ A baby ha( bra(ycar(ia an( was (elivere( by

ventouse,&he umbilical artery p1 wa(N,0"* base

excess #H* while the umbilical vein p1 was N,G"*

base excess #G,", Jhat will you tell the

pe(iatrician about the test,Lormal bloo( test

&he baby ha( an acute episo(e of hypoxia before

(elivery

&he baby ha( chronic episo(e of hypoxia before

(elivery,ans

$ Lerve pierce /ectus sheath?Subcostal

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$

Ans C*avoi( in !st trim

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A 9= year old women wants to speak to yo! regarding

in"ections in pregnancy* Her two year old son has

sensorine!ral dea"ness as a res!lt o" in"ection in her pre?io!s

pregnancy* 'he tells yo! he was born with a Vbl!eberrym!""inV rash* .hat was the most likely in"ection/

+oxoplasmosisPar?o?ir!s %1=&!bella**ansBaricella #oster

CMB

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+he yolk sac reaches its maxim!m diameter at what week

o" gestation/8 weeks

1: weeks**ans

18 weeks

9O weeks

25 weeks

Macrophages are deri?ed "rom what type o" white bloodcell/ 0at!ral 4iller Cells

+Dcells

%DCells

Monocytesans

0e!trphils

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Q) 'GE is an example o" what type o" hypersensiti?ity

reaction/ 2

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Q) -o! see a patient in antenatal clinic who is concerned thatshe has ne?er had chicken pox and may catch it d!ring

pregnancy* -o! check her Baricella stat!s and she is nonD

imm!ne* 'he asks yo! abo!t ?accination* .hat type o"

?accine is the ?aricella ?accine/

Atten!ated**ans

;nacti?ated'!b!nitPolysaccaride+oxoid

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$ An M/2 examination is LP& allowe( un(er any

circumstances when the following is present

A, A pacema7er,,ans

., A hipD7nee )oint replacement

C, An intracranial aneurysm clip

3, A metallic heart valve5, A Rrst#trimester pregnancy

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$

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Q) endometri!m D"rom endoderm

myometri!mD "rom paramesonephric d!ct

Myometri!m, !ter!s and t!bes are "ormed o" ;ntermediate

mesoderm D paramesonepheric d!cts

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Q) +-PE' L L;%&; E$E0E&A+;0

Libroids degeneration occ!rs when "ibroids o?ergrow their

blood s!pply and slowly die a"terwards* +hese degenerati?echanges o" the "ibroids tiss!e are common conseI!ence o" therapid growth, pregnancy, tra!ma, and postmenopa!salatrophy*

1* Hyaline Libroids egeneration

Hyaline degeneration is the most common type o" "ibroids

degeneration that can occ!r in 8:> o" all "ibroids cases* +hemost common change is replacement o" the "ibro!s andm!scle "ibroid tiss!es with the hyaline tiss!e (type o"connecti?e tiss!e* $rad!al decrease^^ in the blood s!pply tothe "ibroids can ca!se this type o" "ibroids degeneration*

Altho!gh, hyaline "ibroids degeneration is witho!t symptoms,it can ca!se central necrosis^^ (death o" the cells and tiss!esand lea?e cystic spaces at the center* ;n this way, cystic"ibroids degeneration starts*9* Cystic Libroids egeneration

Cystic degeneration is not so common type o" "ibroidsdegenerationN it a""ects only O> o" all "ibroids and !s!allyocc!rs a"ter menopa!se^^* As already mentioned, hyaline

degeneration o"ten precedes cystic degeneration*ecreased blood s!pply to the "ibroids may in"l!enceliI!e"action o" hyaliniRed areas that are seen as cystic changeson the !ltraso!nd* +hey resemble \honeycomb pattern], andsometimes can be misleading, especially with the s!bm!co!stype o" "ibroids* +hey are o"ten misdiagnosed as othergestational abnormalities, s!ch as missed abortion, blightedo?!m, and hydatidi"orm mole*

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2* Myxoid Libroids egeneration

+his type o" "ibroids degeneration is not as common, tho!ghsome doctors think that myxoid degeneration is present in, asm!ch as, ):> o" all "ibroids*

O* &ed (carneo!s Libroids egeneration

+his type o" "ibroids degeneration is common d!ring pregnancy or a"ter pregnancy^^^* ;t is a wellDknowncomplication especially d!ring pregnancy* &ed degeneration

occ!rs in 5> o" "ibroids complicating pregnancy, altho!gh the pre?alence is abo!t 2> o" all !terine leiomyoma*

&ed "ibroids degeneration is the hemorrhagic in"raction o"!terine "ibroids*^^ +he exact mechanism o" red degenerationis not completely !nderstood, b!t scientists belie?e that it begins with the ?eno!s obstr!ction at the periphery o" thelesion, which leads to hemorrhagic in"arction and extensi?e

necrosis that in?ol?es the entire lesion*

&ed "ibroids degeneration a""ects hal" o" the "ibroids d!ring pregnancyN it’s I!ite common* Libroids d!ring pregnancyha?e the tendency to rapidly grow, beca!se o" the higherle?els o" estrogen* +hey soon o?ergrow their blood s!pply andstart to decay*

+he symptoms characteristic "or the red "ibroids degenerationmay incl!de abdominal pain, tenderness localiRed to the!ter!s associated with mild pyrexia and increased white bloodcells co!nt (le!kocytosis*

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Q)

$ CME is most commonly transmitte( by which

route?.reast fee(ing$

Ans 3

A co!ple come to see yo! in clinic* +he male partner

re?eals he has cystic "ibrosis and wants to know what his

likelihood o" being in"ertile is* .hat is the male in"ertility rate

in CL patients/ =5>**********ans

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=:>

7)>

O:>

15>

A 98 year old patient who is c!rrently 9O weeks pregnant

presents with ?aginal discharge* 'wabs show Chlamydia

+rachomatis detected* .hich o" the "ollowing is the most

appropriate treatment regime/ oxycycline 1::mg bd "or 7

days

Erythromycin ):: mg twice a day "or 1O days

ARithromycin 1gm orally in a single dose

"loxacin 9::mg bd "or 7 days

"loxacin O::mg once a day "or 7 days

the "ollowing treatment regimes are recommended "or the

treatment o" Chlamydia in P&E$0A0C-

Erythromycin )::mg "o!r times a day "or 7 days or

Erythromycin ):: mg twice a day "or 1O days or

Amoxicillin ):: mg three times a day "or 7 days or

ARithromycin 1 gm stat (only i" no alternati?e, sa"ety in

pregnancy not "!lly assessed

+he "ollowing treatment regimes are recommended "or the

treatment o" Chlamydia in 00DP&E$0A0+ patients

oxycycline 1::mg bd "or 7 days &

ARithromycin 1gm orally in a single dose

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Patent d!ct!s arterios!s

;n preterm in"ants clos!re can be achie?ed by 0'A;s

typically indomethacin b!t ib!pro"en co!ld be !sed*;n term in"ants s!rgical clos!re is indicated* Prostaglandinin"!sion may be !sed in this sit!ation b!t this is to keep theA patent !ntil s!rgery*

$ :#ray= which is incorrect

A* are a form of electromagnetic ra(iation

.* are longer than gamma rays

C* are measure( in can(elaans

3* are very energy ineYcient to pro(uce

5*are forme( by acceleration of electrons

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C= Measure( by millira(

Pne session < !000 millira(

C& scan from H0#H00 millira(

M/2 = no ra(iation

Q)

Ans A

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Q) &egarding M&; which statement is incorrect

Pro?ides high contrast between di""erent so"t tiss!es

Prod!ces the same amo!nt o" ioniRing radiation as C+

scan**ansA""ects all protons in the body

.orks by emitting a radio "reI!ency p!lse as protons mo?e

between magnetic "ields

;s !sed to characteriRe pathological tiss!e

$oll substances can be reabsorbe( from renaltubule ? A insulin

. sucrose

C creatine

3 mannitol

5 urea,,ans

$ &rue regar(ing Pbturator Lerve?5marge from lateral bor(er of psoas ma)or

1as branch separate( by A((uctor

.revis,,ans

2s forme( by post (evision of Qumber nerves

Qies me(ial to the ureter

Supplies lateral 7nee )oint A 2: year old women who is 9O weeks pregnant attends

EP6 d!e to s!prap!bic pain* 6ltraso!nd shows a ?iable "oet!s

and also a "ibroid with a cystic "l!id "illed centre* .hat is the

likely diagnosis/ Adenomyosis

Geiomyosarcoma

Cystic degeneration o" "ibroid

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&ed degeneration o" "ibroidans

Appendicitis

/e( (egeneration of Rbroi(s is one of " metho(sof Rbroi( (egeneration,

Although uncommon outsi(e pregnancy it is

thought to be the most common form of Rbroi(

(egeneration (uring pregnancy an( typically

occurs in the Gn( trimester,

2t is thought to arise from the Rbroi( outgrowing

its bloo( supply an( haemorrhagic infarction

occurs, 4ltrasoun( will typically show a localise(

6ui( collection Fbloo( within the Rbroi(,

$ ollowing is an action of cortisol ? A#analgesia. (ec glycogenesis

C Sec, Catabolism of proteins

3 (ec gastric aci( pro(uction

5 increase gluconeogenesis,ans

$ Jhat type of aci(Obase (isturbance result in a

case of Conn8s syn(rome?A, Metabolic aci(osis

., Metabolic al7alosis ,,ans

C, Lo e'ect

3, /espiratory aci(osis

5, /espiratory al7alosis

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$ Jhich 1QA type is expresse( only in extra

villous trophoblast?A1QA A

b1QA .

C1QA C

31QA

51QA K,ans

$ Complete heart bloc7 in newborns is

associate( with maternal?

A, Cyanotic heart (isease,

., 5n(emic goitre,

C, SQ5,ans

3, Myasthenia gravis,

5, 3iabetes mellitus,

SQ5 causes neonatal cutaneous lupus in "% of

cases an( complete heart bloc7 in !#G% of casesin pts with anti /o la antibo(ies

8= year old lady has a stroke on the ward O days a"ter

hysterectomy* .hat type o" necrosis typically occ!rs in

cerebral in"arction/ Lat necrosis

Coag!lati?e necrosis

Caseo!s necrosis$ran!lomato!s

GiI!e"acti?e necrosisans

Clos!re o" a patent d!ct!s arterios!s in a term in"ant

sho!ld be ?ia/ ;ndomethacin administration

;b!pro"en administration

Prostaglandin in"!sion

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xytocin in"!sion

'!rgical clos!re**ans

&egarding gestational diabetes which o" the "ollowing is 0+ a recognised risk "actor 'moking

besity

Hispanic3Gatino ethnic origin

Pre?io!s !nexplained stillbirth

High poly!nsat!rated "at intake**ans

A )) year old presents to clinic d!e to ?!l?al itch anddiscolo!ration* examination re?eals pale white discolo!red

areas to the ?!l?a* A biopsy shows epidermal atrophy with

s!bDepidermal hyaliniRation and deeper in"lammatory

in"iltrate* .hat is this characteristic o"/

Gichen 'implex Chronic!sB!l?al intraepithelial neoplasiaBitiligoExtramammary PagetsGichen 'cleros!s**ans

A patient comes to see yo! as she is considering pregnancy

and wants ad?ice regarding B+E prophylaxis* 'he has

!ndergone pri?ate thrombophilia screening as her "ather was"o!nd to ha?e the "actor B Geiden* Her PC& has shown she is

homoRygo!s "or the "actor B Geiden m!tation* .hat is her

relati?e risk o" thrombosis compared to the general

pop!lation/ 1*)

9

O

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5

5:*ans

A co!ple present to the "ertility clinic a"ter "ailing toconcei?e despite trying "or 9*) years* +he semen analysis

shows aRoospermia*-o! per"orm a "!ll examination o" the

male partner which re?eals Height 1=:cm, %M; 9:*:, small

testes and scant p!bic hair* .hat is the likely diagnosis/

Cystic Librosis

A!toimm!ne orchitis

4line"elters 'yndrome*ans

Mar"ans

iabetic ind!ced hypogonadsm

&egarding prostaglandins 10!mber o" do!ble bonds is

indicated by s!bscript n!merical a"ter the letter pg

9thromboxanes are prod!ced "rom placenta, membranes anddecid!a

2 platelate cox is 9: times sensati?e to antiprostaglandin s!ch

as aspirin as ?essel wall enRyme

Olabetalol enhances the prostacycline to thromboxane ratio

)Pg can maintain "etal pattern o" circ!lation

All tr!e

&egarding Beno!s +homboembolism (B+E in pregnancy

which o" the "ollowing statements are +&6E/ A* besity

increases B+ risk by 9 times

%* besity increases B+ risk by O to ) times*ans

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C* ;nherited thrombophilia is present is present in 2D)> o"cases o" pregnancy associated B+E

* ;nherited thrombophilia is present is present in 1:D1)> o"cases o" pregnancy associated B+EE* 2:DO:> o" B+Es in pregnancy are P!lmonary Emboli

A co!ple ha?e been re"erred to the in"ertility clinic* +he

male partner ;s 9) and has CL, his semen analysis shows

aRoospermia* .hat is the likely !nderlying ca!se/

Epididymal obstr!ction by thickened secretions d!e tochloride channel dys"!nctionligospermiaCongenital absence o" ?as de"erens**ansbstr!ction o" ?as de"erens by thick secretions d!e to chloridechannel dys"!nction

Congenital absence o" epididymal tail

2n C the thic7ene( intraluminal secretions lea(

to progressive obstruction an( (estruction of the

vas (eferens in utero lea(ing to congenital

absence of the vas (eferens in most cases,

2n treating such patients for infertility sperm canbe retrieve( from the epi(i(ymis,

$ &o which group of lymph no(e (oes lymph

from rectum Rrst pass

a (eep inguinal

b inferior mesentric

c internal iliac

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( para aortic

e superfecisl inguinal

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$

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$

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$ which on of the following is true regar(ing

-u(en(al nerve?

Arises from S;*H*"

5nter perinium through obturator canal

leaves the pelvis through greater sciatic foramen

lies me(ial to ischial spine

lies on sacrospinous ligaments,ans

$ Septum secun(um (evelops from = Aatrial

wall fol(ingans

.from septum primum

Cventricular wall infol(ing

3fossa ovalis

5none

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&egarding prostaglandins which is tr!e **/

10!mber o" do!ble bonds is indicated by s!bscript n!merical

a"ter the letter pg

9thromboxanes are prod!ced "rom placenta, membranes anddecid!a

2 platelate cox is 9: times sensati?e to antiprostaglandin s!ch

as aspirin as ?essel wall enRyme

Olabetalol enhances the prostacycline to thromboxane ratio

)Pg can maintain "etal pattern o" circ!lation

All tr!e

$

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Ans .

$ ;@yrs ol( la(y -K at !H wee7s of gestation

*following serum screening *pregnancy is foun( tohave an increase( ris7 of trisomy G!*she wishes

to conRrm if fetus is a'ecte( 2n view of her

gestation what8s most appropriate (iagnostic test

? A#amniocentesis

. #cell free fetal 3LA sampling

C# CES ,,ans

3#cor(ocentesis

5 L& imaging

` !" w amnio

.hich o" the "ollowing statements regarding

phenylketon!ria is tr!e/ +ype 1

"ollows a mitochondrial inheritance patternPhenylalanine blood assay m!st be per"ormed O5 hrs a"ter

birth

+reatment reI!ires dietary s!pplemention with phenylalanine

'!""erers ha?e low plasma phenylpyr!?ic acid and

phenylethylamine le?els

64 ;ncidence is 1 in 1O,:::**ans

A 2) y has a pel?ic !ltraso!nd scan showing m!ltiple

"ibroids* .hat is the mc "orm o" "ibroid degeneration/

&ed degeneration

Hyaline degeneration*ans

Carneo!s degeneration

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Myxoid degeneration

Cystic degeneration

A O9 year old smoker attends clinic d!e to ?!l?al sorenessand shows yo! a n!mber o" ?!l?al l!mps* %iopsy is taken and

reported as showing epithelial n!clear atypia, loss o" s!r"ace

di""erentiation and increased mitosis* .hat is the diagnosis/

Gichen 'cleros!s

Chronic atrophic ?!l?itis

B!l?al intraepithelial neoplasia (B;0ans

Extramammary PagetJs disease

Gichen 'implex

$ A ;" year ol( women atten(s clinic following

laparotomy an( unilateral oophorectomy, &he

histology shows -sammoma bo(ies, Jhat type of

tumour woul( this be consistent with?'ero!sans

M!cino!s

Endometrial

+ransitional

Clear cell

$ Jhich of the following is non essential AA? A#arginine

.#leucine

C#methionine

3 tryptophan

5 tyrosine,ans

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Q) .hich type o" o?arian cancer is responsible "or the

ma<ority o" cases o" o?arian cancer in the 64 and also the

most cancer deaths/ Epithelial o?arian cancersans

$erm cell t!mo!rs

%orderline o?arian t!mo!rs

+eratoma

ysgerminoma

Malignant primary o?arian t!mo!rs can be broadly classi"ied

into 2 types 1* Epithelial

9* $erm Cell

2* 'ex Cord and 'tromal

Epithelial ?arian Cancers (ECs are the most common type

with high grade sero!s o?arian carcinomas the most common

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s!btype* ECs comprise

'ero!s (85>

Clear cell (12>

Endometrioid (=>M!cino!s (2>

) year s!r?i?al is O2>

Gi"etime risk is 1 in 7:

$erm cell t!mo!rs acco!nt "or 1D9> o" o?arian cancers'ex Cord and stromal cancers are rare*

Q) C&G at which "etal heart so!nd can be seen !sing

!ltraso!nd machine

A9mmans%2mm

COmm

8mm

Enone abo?e

Q) * Fetal Circulation % +(po"astric arteries

Letal blood is ret!rned to the !mbilical arteries and the placenta thro!gh the

a Hypogastric arteries b !ct!s ?enos!sc Portal ?eind ;n"erior ?ena ca?ae Loramen o?ale

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Correct Anser% a) +(po"astric arteries* xygenated%lood "rom the placenta is carried to the "et!s by the!mbilical ?ein* eoxygenated %lood mo?es "rom the aorta

thro!gh the internal iliac arteries to the !mbilical arteries, andreDenters the placenta* ;n the "et!s, the internal iliac artery istwice as large as the external iliac, and is the directcontin!ation o" the common iliac*;t ascends along the side o" the bladder, and r!ns !pward onthe back o" the anterior wall o" the abdomen to the !mbilic!s,con?erging toward its "ellow o" the opposite side*

Ha?ing passed thro!gh the !mbilical opening, the twoarteries, now termed !mbilical, enter the !mbilical cord,where they are coiled aro!nd the !mbilical ?ein, and!ltimately rami"y in the placenta*At birth, when the placental circ!lation ceases, the pel?ic portion only o" the !mbilical artery remains patent gi?es riseto the s!perior ?esical artery (or arteries o" the ad!ltN theremainder o" the ?essel is con?erted into a solid "ibro!s cord,the medial !mbilical ligament (otherwise known as theobliterated hypogastric artery which extends "rom the pel?isto the !mbilic!s*

-* .$ic$ o# t$e #olloin" statements is true o# t$e #etal

circulation/

a 1::> o" the cardiac o!tp!t goes to the l!ngs ?ia the p!lmonary artery* b +he arterial d!ct (d!ct!s arterios!s helps send oxygenated blood to the brain*c %lood sh!nts across the d!ct [le"t to right’ ("rom the aortato the p!lmonary artery*d +he "oramen o?ale typically closes by 28 weeks’ gestation*e +he !mbilical ?ein carries wellDoxygenated blood*

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Correct Anser% e) T$e umbilical 0ein carries o&("enated

blood #rom t$e placenta to t$e 12C 0ia t$e ductus 0enosus*

Gess than 1:> o" the cardiac o!tp!t goes to the "etal l!ng*

&elati?ely deoxygenated blood is p!mped "rom the right?entricle, !p the p!lmonary artery and across the d!ct where it <oins the aorta a"ter the carotid ?essels, di?erting this bloodaway "rom the brain* ;n the "et!s the p!lmonary ?asc!larresistance is high and the systemic ?asc!lar resistance is low,so blood sh!nts right to le"t* +he "oramen o?ale sends wellDoxygenated blood across to the le"t atri!m and only closes

a"ter birth*3* A#ter birt$, all o# t$e #olloin" #etal 0essels constrict

E4CEPT%

a !ct!s arterios!s* b 6mbilical arteries*c !ct!s ?enos!s*

d Hepatic portal ?ein*e 6mbilical ?ein*

Correct Anser% d) +epatic portal 0ein* At birth, placental blood "low ceases and l!ng respiration begins* +he s!ddendrop in right atrial press!re p!shes the sept!m prim!m againstthe sept!m sec!nd!m, closing the "oramen o?ale* +he d!ct!sarterios!s begins to close almost immediately, and may bekept open by the administration o" prostaglandins* therembryonic circ!latory ?essels are slowly obliterated andremain in the ad!lt only as "ibro!s remnants*Letal 'tr!ct!re Ad!lt &emnant1 Loramen o?ale Lossa o?alis o" the heart9 !ct!s arterios!s Gigament!m arterios!m2 Ge"t !mbilical ?ein –

a* ExtraDhepatic Gigament!m teres

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b* ;ntraDhepatic (d!ct!s ?enos!s Gigament!m ?enos!mO Ge"t and right !mbilical arteriesa* Proximal portions 6mbilical br*o" int iliac art

b* istal portions Medial !mbilical ligaments5* Fetal Circulation % 6&("enated Blood

;n the "et!s, the most well oxygenated blood is allowed intothe systemic circ!lation by the

a !ct!s arterios!s*

b Loramen o?ale*c &t* Bentricle*d Gigament!m teres*e Gigament!m ?enos!m

Correct Anser% 7e#t 2entricle 0ia 8 Eustac$ian 0al0e 8 b)

Foramen o0ale 8 le#t atrium 8 aorta* Letal cardio?asc!larsystem is designed in s!ch a way that the most highly

oxygenated blood is deli?ered to the myocardi!m and brain*;n the "et!s, deoxygenated blood arri?es at the placenta ?ia the!mbilical arteries and is ret!rned to the "et!s in the !mbilical?ein* +he partial press!re o" oxygen in the !mbilical ?ein isaro!nd O*7 kPa and "etal blood is 5:–=:> sat!rated* %etween):–8:> o" this placental ?eno!s "low bypasses the hepaticcirc!lation ?ia the d!ct!s ?enos!s (B to enter the in"erior

?ena ca?a (;BC* ;n the ;BC, the better oxygenated blood"low "rom the B tends to stream separately "rom theextremely desat!rated systemic ?eno!s blood, which isret!rning "rom the lower portions o" the body with an Lorm!lao" aro!nd 9)–O:>* At the <!nction o" the ;BC and the rightatri!m (&A is a tiss!e "lap known as the E!stachian ?al?e*+his "lap tends to direct the more highly oxygenated blood,

streaming along the dorsal aspect o" the ;BC, across the"oramen o?ale (L and into the le"t atri!m (GA* ;n the GA,

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the oxygen sat!ration o" "etal blood is 8)>*1 +his betteroxygenated blood enters the le"t ?entricle (GB and is e<ectedinto the ascending aorta* +he ma<ority o" the GB blood is

deli?ered to the brain and coronary circ!lation th!s ens!ringthat blood with the highest possible oxygen concentration isdeli?ered to these ?ital str!ct!res*

Q) * T$e main blood suppl( o# t$e 0ul0a is% 9(necolo"(

:CQ

a ;n"erior hemorrhoidal artery*

b P!dendal artery*c ;lioing!inal artery*d Lemoral artery*e ;n"eriorHypogastricartery*

Correct Anser% b) Pudendal arter(* %lood s!pply to theexternal genitalia is mainly "rom the p!dendal artery* +helateral aspects o" the external genitalia recei?e their blood

s!pply "rom the external p!dendal artery, a branch o" the"emoral artery* +he mons p!bis is s!pplied by the in"eriorepigastric artery, a branch o" the external iliac artery*

-* T$e principle supports o# t$e uterus are % 9(necolo"(

:CQ

a ;liosacral ligaments b Pyri"ormis m!sclec +rans?erse cer?ical ligamentsd ;n"!ndib!lar ligamentse 6terosacral ligaments

Correct Anser% c and e* +he principle s!pports o" the!ter!s are the trans?erse cer?ical ligaments (cardinal

ligaments and !terosacral ligaments* +he in"!ndib!lopel?ic

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ligament is a "old o" peritone!m that extends o!t "rom theo?ary to the wall o" the pel?is*

3* T$e e&ternal iliac arter( is crossed b(% ;'elect FA7'E)

a +he corresponding ?ein b +he o?arian ?esselsc +he genital branch o" the genital "emoral ner?ed +he ro!nd ligamente +he !reter

Correct Anser% a) T$e correspondin" 0ein is FA7'E* %oth external iliac ?eins are accompanied along their co!rse by external iliac arteries* Posteriorly, the artery comes inrelation with its ?ein in the !pper portion o" its co!rse* ;n thelower part o" its co!rse the ?ein lies medial to it*

5* T$e uterine arter(% ;'elect FA7'E) % 9(necolo"( :CQ

a ;s a branch o" the anterior di?ision o" the internal iliacartery b &!ns in "ront o" the !reter c $i?es a branch to the ?aginad May anastomose with the obt!rator arterye i?ides into arc!ate arteries

Correct Anser% d) :a( anastomose it$ t$e obturator

arter( is FA7'E* it anastomoses with the t!bal branches o"o?arian artery*

<* T$e o0arian arteries % 9(necolo"( :CQ

a Arise <!st abo?e the renal artery b Are crossed by the !reters

c n the right cross the in"erior ?ena ca?ad n the le"t cross the le"t colic artery

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e &each the o?ary thro!gh the o?arian ligament

Correct Anser% c) 6n t$e ri"$t cross t$e in#erior 0ena

ca0a* Corrected FA7'E statements% a) Arise =ust belo t$e

renal arter(

b 6reters crosses o?arian ?esselsd n the le"t does not cross the le"t colic arterye A"ter emerging "rom the aorta, the artery tra?els down thein"!ndib!lopel?ic ligament (s!spensory ligament o" theo?ary, enters the meso?ari!m, and may anastamose with the!terine artery in the broad ligament*

>* T$e most common beni"n neoplasm o# t$e cer0i& ?

endocer0i& a Polyp*

b Hematoma*c 0abothain cyst*d Cer?ical hood*e $artner’s d!ct cyst*

Correct Anser% a) Pol(p* +hese are the most common benign neoplasms o" the cer?ix ("o!nd in O> o" thegynaecological pop!lation* +hese may be endocer?ical orcer?ical*

@* .$ic$ "rp o# ner0es all constitute branc$es o# pudendal

ner0e/a ;nternal p!dendal n?, perineal n?, dorsal clitoral n? b Mid rectal ner?e, dostal clitoral ner?e, perineal ner?ec Perineal ner?e and posterior clitoral ner?ed Perineal ner?e, dorsal clitoral ner?e, in"erior rectal ner?ee Perineal ner?e, in"erior clitoral ner?e, mid rectal ner?e

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Correct Anser% d) Perineal ner0e, dorsal clitoral ner0e

and in#erior rectal ner0e* +hese are the three important branches o" the p!dendal ner?e*

* Pel0ic Diap$ra"m % 9(necolo"( :CQ

+he pel?ic diaphragm is composed o" all o" the "ollowingm!scles EFCEP+ Da ;liococcyge!s

b P!borectalisc +rans?ers!s perinei

d P!bococcyge!sCorrect Anser% c) Trans0ersus perinei*

+he m!scles o" the pelic diaphragm primarily pro?ide pel?ics!pport* +hese m!scles "orm a basin or co?ering o" the pel?ico!tlet and are o"ten gro!ped together as the le?ator ani* +hemost medial portion o" the pel?ic diaphragm is "ormed by the p!borectalis* Lorming the b!lk o" the pel?ic diaphragm, the

P!bococcyge!s and ;liococcyge!s m!scles co?er the posterior and lateral portion o" the pel?ic o!tlet* +rans?ers!s perineam!scle is the part o" !rogenital diaphragm*

* 1n a sa"ittal cross section o# t$e pel0is

a 6rethra lies anterior to the !pper third o" the ?agina b 6rethra lies anterior to the lower third o" the ?aginac %ladder when empty lies below and anterior to the !terine bodyd %ladder when empty lies parallel and anterior to !terine bodye &ect!m lies posterior to the body o" the !ter!s

Correct Anser% b,c,e* +he !rethra is only 2*) cm long and is

anterior to the lower third o" the ?agina* +he bladder when

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empty lies below the !tero?esical "old which arises "rom the <!nction between the !terine body and the cer?ix*

* Bart$olins abscess % 9(necolo"( :CQ

9:Dy woman presents with %artholin’s abscess* .hich one o""oll glands is in?ol?ed/a %!lbo!rethral glands (Cowper’s b $lands o" skinic $reater ?estib!lar glandd Gesser ?estib!lar glande 'eminal ?escicle

Correct Anser% c) 9reater 0estibular ;Bart$olins) "land*

+hese are small paired glands located in the s!per"icial perineal po!ch* +hey are partially co?ered by posterior portions o" the b!lb o" the ?estib!le and the b!lbospongio!s!sm!scles* +he d!ct opens into the ?estib!le between the hymenand the labi!m min!s* +hese glands pro?ide l!brication at theintroit!s* %artholin’s abscess may occ!r d!e to in"ection and blockage o" these glands*

* .$ic$ arter( is a direct branc$ o# t$e aorta/

a ;n"erior ?esical b ;nternal iliacc ?arian

d 6teriane Baginal

Correct Anser% c) 60arian* +he o?arian artery is a brancho" the aorta* ;t arises anterolaterally <!st below the renalartery, r!nning retroperitoneally to lea?e the abdomen bycrossing the common or external iliac artery in thein"!ndib!lopel?ic "old* ;t crosses corresponding !reters and

s!pplies twigs to it b!t does not s!pply to abdominal organs*

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+he internal iliac artery arises "rom the common iliac and itsin"erior branch "!rther s!pplies to the pel?is*

-* .$at is t$e l(mp$atic draina"e o# t$e o0aries/

a Common iliac nodes b External iliac and s!per"icial iliac nodes ?ia the ro!ndligamentc External iliac nodesd ;nternal iliac nodese Gateral aortic and preaortic nodes

Correct Anser% e) 7ateral aortic and preaortic nodes* ;tis !se"!l to remember the "ollowing the bladder drains to theexternal iliac nodesN the !rethra drains to the internal iliacnodesN the "allopian t!bes and "!nd!s !teri drain to theexternal iliac and s!per"icial iliac nodes ?ia the ro!ndligamentN and the cer?ix drains to the external and internaliliac, rectal and sacral nodes and occasionally obt!rator nodes*

3* .$ic$ o# t$e #olloin" structures lie it$in t$e broad

li"ament/a +he "allopian t!be b +he !reter c +he !terine arteryd +he o?arian arterye +he s!perior ?esical artery

Correct Anser%a and c*+he broad ligament is made o" twolayers o" peritone!m that co?ers the "allopian t!be, ro!ndligament, and down the sides o" the !ter!s to the cer?ix*+he !reter, s!perior ?esical artery and the o?arian artery areall retroperitoneal*+he !terine artery r!ns between the lea?es o" the broadligament along the lateral wall o" the !ter!s* ;t also containso?arian ligament and ro!nd ligament*

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5* Pudendal ner0e does not suppl( % 9(necolo"( :CQ

a Gabia Minora b ;schioca?ernos!sc Posterior Lornix o" Baginad 6rethral 'phincter

Correct Anser% c) Posterior Forni& o# 2a"ina* +he p!dendal ner?e is a mixed motor and sensory ner?e, and doesnot carry parasympathetic "ibres* +he ner?e has 2 branchesthe clitoral, perineal, and in"erior hemorrhoidal* ;t s!pplies

1 Clitoris*9 %!lbospongios!s, ;schioca?ernos!s m!scles and+ranse?ers!s perinei m!scles* Also to the skin o" the inner portions o" labia ma<ora, labia minora and ?estib!le* +heexternal !rethral sphincter is controlled by the deep perineal branch o" the p!dendal ner?e*2 External anal sphincter and perineal skin*

!pper ?agina – parasympathetic "ibres "rom pel?ic splanchnicner?es ('9D'Olower 9D2cm ?agina – p!dendal ner?e

<* Trans0erse 0a"inal sulcus corresponds to

a U!nction o" !rethra and bladder b U!nction o" cer?ix and ?agina

c Gower limit o" rect!md 6pper limit o" bladder

Correct Anser% a) unction o# uret$ra and bladder* ninspection o" ?agina, 2 groo?es can be disting!ished in theanterior ?aginal wall 1 '!bmeatal s!lc!s, 9 +rans?erse?aginal s!lc!s corresponds to the !pper border o" post!rethralligament and 2 %ladder s!lc!s* %ladder s!lc!s indicates the

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!pper limit o" the relation o" the bladder to the anterior?aginal wall*

>* .$ic$ o# t$e #olloin" structures lies posterior to t$e

isc$ial spine/ a P!dendal ner?e3 ?essels b 'ciatic ner?ec Hypogastric ?eno!s plex!sd ;n"erior gl!teal ?essels

Correct Anser% a) Pudendal ner0e 0essels* +he sciaticner?e lies s!perior and lateral to the sacrospino!s ligament*

'!perior to the ligament lies the in"erior gl!teal ?essels andthe hypogastric ?eno!s plex!s*+he p!dendal ner?e passes between the piri"ormis m!scle and ischiococcyge!s m!sclesand lea?es the pel?is thro!gh the lower part o" the greatersciatic "oramen* ;t then enters the gl!teal region, crossing o?er the sacrospino!s ligament near to where it attaches to theischial spine* &eDentering the pel?is thro!gh the lesser sciatic

"oramen, it accompanies the internal p!dendal ?essels!pwards and "orwards along the lateral wall o" the ischiorectal"ossa, being contained in a sheath o" the obt!rator "asciatermed the p!dendal canal (Alcock’s canal, along with theinternal p!dendal blood ?essels*

@* 7ocation o# 9artners c(st % 9(necolo"( :CQ

a Hymen b Baginac Cer?ixd Gabia ma<orae %road ligament

Correct Anser% b) 2a"ina

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A $artner’s d!ct cyst is a benign ?aginal cystic lesion thatarises "rom the ?estigial remnant o" a mesonephric d!ct or$artner’s d!ct* +hey are typically small asymptomatic cysts

that occ!r along the lateral walls o" the ?agina, "ollowing theco!rse o" the d!ct* +hey can, howe?er, enlarge to s!bstantial proportions and be mistaken "or !rethral di?ertic!l!m or other str!ct!res*

* :cCalls Culdoplast( % 9(necolo"( :CQ

.hich o" the "ollowing str!ct!res is at risk "or in<!ry d!ring a

McCall’s c!ldoplasty/a 'ciatic ner?e

b &ect!mc ;nternal iliac ?eind P!dendal ner?ee 6rinary bladder

Correct Anser% b) Rectum* Most common complication o"

McCall’s c!ldoplasty is laceration o" bowel or rect!m as perirectal "ascia is incorporated into the s!t!res*

* T$e loer t$ird o# t$e 0a"ina $as l(mp$atic draina"e

to $ic$ nodes/ a Common iliac nodes b External iliac nodesc ;nternal iliac nodes

d '!per"icial ing!inal nodese ParaDaortic nodes

Correct Anser% d) super#icial in"uinal nodes* &ememberthe embryological di""erence between the lower oneDthird o"the ?agina and the !pper twoDthirds* +he !pper part is deri?ed"rom the "!sed mesonephric d!cts, and the lower oneDthird"rom canalisation o" the ectodermal thickening* +he !pper

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twoDthirds o" the ?agina drain to the internal and externalnodes*

-* :otor #unction o# t$e uterus occurs 0ia s(mpat$etic

and paras(mpat$etic ner0es*Loll sentences +3L*1 ;ntact ner?e s!pply is essential to initiate normal labo!r*9 0ormal labor occ!rs in patients with a transected spinalcord*

Correct Anser% ) False, -) True* 6terine contractions arein?ol!ntary and "or the most part, indepependent o"

extra!terine control* Myometrial contractions in paraplegicwomen are normal, tho!gh painless, as in women with bilateral l!mbar sympathectomy*

-* T$e canal o# !uck is associated it$ $at/

a %road ligament b ;ng!inal ligament

c ;schiorectal "ossad &o!nd ligamente 6rogenital diaphragm

Correct Anser% d) Round li"ament* +he ro!nd ligamentarises "rom the body o" the !ter!s antero in"erior to thecorn!e* ;t passes thro!gh the layers o" broad ligaments across

the psoas and external iliac ?essels* ;t then passes thro!gh thedeep ing!inal ring and the ing!inal canal to the labi!m ma<!s*;n the "et!s, the ro!nd ligament is s!rro!nded by a peritone!m, process!s ?aginalis, which is obliterated at birth b!t may remain patent as the canal o" 0!ck*

--* Urinar( Cat$eter % 9(necolo"( :CQ

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A !rinary catheter is ?igoro!sly in"lated in the !rethra at thetime o" cesarean section* 6rine leaks "rom the r!pt!re intowhich anatomical space/

a ;nto the anterior abdominal wall and mons p!bis b ;nto the lesser pel?isc ;nto the peritoneal ca?ityd ;nto the ?aginae Gaterally to the "emoral triangles

Correct Anser% a) 1nto t$e anterior abdominal all and

mons pubis* +his is the only ro!te possible d!e to theanatomy o" the !rethra*

$ An obstetrician performs a me(iolateral

episiotomy to expan( the birth canal (uring achil( birth, Jhich of the following muscles is

typically incise( (uring this

proce(ure?

A, .ulbospongiosus an( superRcial transverse

perineal muscles,ans

., .ulbospongiosus an( (eep transverse perinealmuscles

C, .ulbospongiosus an( ischiocavernosu muscles

3, 2schiocavernosus an( levator ani muscles

5, .ulbospongiosus an( levator ani muscles

$ /egar(ing urinary tract infections* which

micro#organism is most li7ely to be associate(

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with bla((er catheterisation? A, .acteroi(es

., 5scherichia coli

C, -roteus mirabilis

3, -seu(omonas aeruginosa ,ans

5, Staphylococcus saprophyticus

$ Acute retention of urine in women may be (ue

to all of the following except # -reoperative

anxiety

Eulva herps

Multiple sclerosis ,ans

4trine prolapse

/etroverte( uterus in pregnancy

$ Qong term consequences very ra(iotherapy

inclu(e all except # AEAK2LAQ

L5C/PS2S,,ans.EE

CEAK2LAQ S&5LPS2S

3/E

5/5C&AQ S&/2C&4/5

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how to calc!late cardiac o!tp!t o" "etal heart

a* "oramen o?ale W le"t ?entricleans

b* Gt ?entricle alone

c* !ct!s arterios!s W aorta

Antiphospholipid syndrome associated with EFCEP+

a* ;6$&*

b* Preterm deli?ery*

c* Miscarriage

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d* iabetesans

.hich o" "ollowing prod!ce se?ere hyperkaleamia in

combination D Aspirin n allop!rinolL!rosemide n amiloride

Gisinopril n "!rosemide

Gosartan n amilorideans

Propranol n?erapamil

$which one of foll is the termination of roun(

ligament? 3eep 2nguinal ringQabia ma)ora,,ans

Qabia minora

SuperRcial 2nguinal ring

Qateral vaginal wall

.hich o" the "ollowing wo!ld yo! expect to see red!ce in

pregnancy/ LibrinogenE'&

0e!trophil co!nt

Lactor B;;

Platelet co!nt**ans

Adenocanthoma o" endometri!m a* adenocarcinoma W benign sI!am!s*ans

b* %enign W malignant sI!am!s*

c* adenocarcinoma W papillary "ormation*

d* $land!lar W sI!am!s

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$

Ans .

$

Ans .

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$ oll substances can be reabsorbe( from renal

tubule ?

A insulin

. sucrose

C creatine

3 mannitol

5 urea,,ans

$ Jhich ascen(ing artery can be (amage(

(uring open appen(icectomy?#2liolumbar artery

#SuperRcial circum6ex artery

#3eep,circum6ex artery,,ans

#Sup gluteal artery

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$ :#ray= which is incorrect

A* are a form of electromagnetic ra(iation

.* are longer than gamma rays

C* are measure( in can(ela,,ans

3* are very energy ineYcient to pro(uce

5*are forme( by acceleration of electrons

Measure( by millira(

Pne session < !000 millira(

C& scan from H0#H00 millira(

M/2 = no ra(iation

$

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$ 3i'usion of gases thro placental membrane

which one is true ? A#mean -PG in mother is

approx ;0mmgh

.#mean -PG in fetus is "0mmgh

C#only way fetus can excrete CPG thro placenta

ans

3# coG crosses placenta Co of higher conc

5# coG (i'uses through placental membrane "

times quic7er than PG

Q)

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-o! are re?iewing a patient who is complaining o" pain

and n!mbness to the proximal medial thigh "ollowing

abdominal hysterectomy* -o! s!spect genito"emoral ner?e

in<!ry* .hat spinal segment(s is the genito"emoral ner?ederi?ed "rom/+19,G1

+19

G1,G9ans

G9DGO

+19DGO

$ After (isinfection which organism survive?

ungi

5nteribacter

Actinomytes

Serratia

-su(omonas An( Spores

.hat is the a?erage obliI!e diameter o" the pel?ic inlet

according to the &C$/ 7*) cm

= cm

1:*) cm

19 cmans

12*) cm

At what age does physiological g!t herniation occ!r /

1 week

2 weeks

) weeks

5 weeks**ans

19 weeks

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otidogenesis re"ers to which process d!ring ogenesis/

1st Meiotic i?ision

9nd Meiotic i?ision

1st and 9nd Meiotic i?isions*ansi""erentiation

$rowth and mat!ration

$ Mc organism of chorioamniotis in prematurelabour is? K.S

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$

Ans .

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;" the omphalomesenteric d!ct (-' stalk "ails to close

properly a MeckelJs di?ertic!l!m may "orm in the small

intestine* .hat percentage o" the pop!lation are e""ected/

:*1>:*)>9>******************ans)>9)>

Mec7els follows the rule of Gs

G% of the population

G inches long

G feet from the ileocecal valve

GD;r(s have ectopic mucosa

G types of ectopic tissue F gastric an( pancreatic

an( G% become symptomatic

$ what percentage of female with malignancy

have hypercalcemia?!%

G%

"%

!0%G0%,,,,,,,,,,,,,,,,ans

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$

Ans 5

$ &he mc anomalies with 233M is car(iac

anomalies F>,; for !00 live birth specially

transposition of great arteries an( SE3 an(

neurological anomalies is Gn( common anomalies

F",G for !00 live birth an( the cau(al regression

is the most speciRc anomalies with 233M FG00

times more frequent than other healthy infants

$ # @0 y * smo7er patient in war( for preop prep

for &A1 to en(ometrial CA, Jhich investi of foll

you (ont require? #Chest : ray

#Complete bloo( Rlm

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#Coagulation proRleans

# .loo( for cross match an( saving

#5CK

$ 34. can be (ue to all except #

A2nc -K5G D-KG ratio

.3ec -K2GD&:AG ratioans* inc -K2GD&:AG

ratio

C2nc Rbrinolysis

33ec en(othelin

5platelet (eactivation

Q)

Ans A

Q)

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!ring oogenesis which cell type has the greatest n!mber

o" chromatids/ogoni!m

Primary ocyteans

'econdary ocyteotid

?!m

$ /egar(ing electrosurgery* what is the right

answer=

!the electric current use( in monopolar(iathermy has a lower frequency than the current

of the main supply

Glow frequency currents have no e'ect on cells

;high frequency currents (irectly pro(uce heat

H bipolar (iathermy (oes not allow

cuttingans

$ .est site for giving Anti#3 ? 3eltoi(

$ Jhat mechanism is require( for myometrial

contraction?

#5lectron transport an( n A&- generation

#Pxi(ation*

Citric aci( cycle*5lecrtron transport chain,,ans

$ -rolonge( an( excessive blee(ing at irregular

intervals

Ametrohagia

.Meno metrorhagia,,ans

Cmenorrhagia

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3poly menorrhoea

5oligo menorrhoea

$ GNyrs ol( -K has failure to progress in Rrststage of labour an( is starte( on synto infusion

Mi(wife calls reg Co of suspicious C&K the

woman is @cm (ilate( an( reg performs bloo(

sampling *-1 came as N,!" *what shoul( be

course of action?

A C#section ,,ans

. instrumental (elivery

C reassure that all is well an( cont with labour

3 repeat .S in one hour

5 repeat .S in two hours

N,G" N,H normal

N,G0 N,GH suspecious.elow N,G0 mean aci(o(is nee( intervention

$ 4ltrasoun( can not be use( for the following=

A* fetal therapy,ans

.* to (etermine the nature of a tissue

C* to assess the movement of tissues

3* to measure bloo( 6ow5* to measure structure

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$

Answer 3, /est (epen(s on KQ4&!

$ At what stage in the cell cycle is mitosis

arreste( if there is a chromosomal abnormality?K

G chec7 point

$ Joman atten(s 4SS in early pregnancy* fetal

poles seen but heartbeat not visible, Jhat is theli7ely KA? " w

+he "ollowing may be !sed sa"ely to accelerate labor,

except;ntra?eno!s oxytocin

Ergometrine**ans

Prostaglandin&!pt!re o" membranes

'tim!lation o" the nipples

'ertoli cells contain receptors to which hormone/ ;nhibin

estradiol

+estosterone

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GH

L'H**ans

'!mmary points o" the two key testic!lar cell types

'ertoli Cells 'ecrete ;nhibin* Lorms bloodDtestis barrier*

Ha?e L'H receptors

Geydig Cells 'ecrete testosterone* Ha?e GH receptors

;n s!rgical in"ection, which o" "oll is tr!e/

A A%ics are only ad?ised once a septic "oc!s has been drained% Primary re"ers to a planned s!rgical tra!maC +here is rarely a "oc!s +iss!e necrosis is rarely an associationE +iss!e necrosis res!lts in in"lammation*ans

$ An anxious ;>y pregnant un(ergoes a

combine( test for 3own syn(rome *ris7 comes as

!D!000,whats appropriate course of action?

A#a(vise that (iagnostic test are not in(icate(

,ans *low ris7

.#amniocentesis

C#CES

3#inform that baby (oesn8t have 3own syn(rome

5 termination of pregnancy

+r!e statements abo!t P;H incl!de which o" "oll/

a* +he incidence ?aries little aro!nd the world

b* .omen who ha?e had hypertension o" pregnancy once ha?ea 1:> chance o" de?eloping it in a later pregnancy

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c* Ele?ations in systolic or diastolic blood press!res do not become diagnostically signi"icant !ntil blood press!re ?al!esreach 1O:3=: mmHg

d* -o!ng primiparo!s women ha?e the lowest incidence

e* Ha?ing a baby by a di""erent "ather increases the risk o" preeclampsia in a m!ltigra?id woman*ans

$ Jhat is 7ey histologic (iagnostic feature of

chorioCA ? a# An increase in

Cytotrophoplast

b# 3ecrease in syncytial trophoplast

c# Absence of cellular anaplasia

(# Absence of villous pattern,,ans

$ Jhats in bo(y secretions e,g cervicalsecretions attac7 the bacterial lipoprotien?

#2mmunoglobulin

#Qysoyme,ans

2rd pharyngeal arch gi?es rise to which o" "oll str!ct!res/

+hrigeminal 0er?e

$lossopharyngeal ner?eansLacial ner?e

Bag!s ner?e

M!scles o" mastication

!st Arch < &rigeminal EG E; FCL E

Gn( Arch < acial FCL E22

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;r( Arch < Klossopharyngeal FCL 2:

Hth an( @th Arches < Eagus FCL :

$ 1-E #Aconsists of " group. low ris7 inclu(e subtype @ an( !!

Chigh ris7 inclu(e subtype !@ an( !>

3only infect epithelial cells

5 /LA virus,ans

Q) Approximately how many oocytes are present in the

o?aries at birth/1,:::1:,:::

1::,:::

1 million**ans

1: million

Q)&x o" choice in a patient with a cystocele d!ring preg is

Anterior repair operation in the "irst trimester

&epair 9 weeks a"ter deli?ery

Anterior repair operation in the second trimester

;mmediate repair a"ter deli?ery o" the placenta

&eDe?al!ation 8 w a"ter deli?ery*ans

8/18/2019 mrcog sba's -2


$

Ans 35

$ &he half life of the (rug will be increase( by=

A#increase( volume of (istribution,ans

.#increase( rate of clearance,

C#increase( age*for (rugs eliminate( mainly by

the 7i(ney,

3#pregnancy for (rugs metabolie( in the liver,

.hen a women comes "or labor

a* xytocin drip is gi?en at 1st stage labor*

b* xytocin drip is gi?en at 9nd stage labor*

c* xytocin drip is gi?en at 2rd stage labor*d* rip witho!t oxytocin gi?en at 1st stage*

e* 0one o" the abo?eans

All o" "oll are possible indications "or classical c3s , except

Carcinoma o" the cer?ix

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;mpacted sho!lder presentationans

'e?ere adhesions in G6'

Garge cer?ical "ibroid

Posterior placenta pre?ia grade ;;

.hich pharyngeal arch is closest to head o" embryo D

1st **ans

9nd

2rdOth

8th

&he arches are numbere( accor(ing to theirproximity to the hea( i,e the !st is the closest tothe hea( en( of the embryo an( the @th closest

to the tail en( ,,

8/18/2019 mrcog sba's -2


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