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JMP Y2S2 > 2020 Pass S2 > Flashcards

2020 Pass S2 Flashcards

1
Q
  1. Which of the following muscles contribute to forming the levator ani?
    a. Pubococcygeus and ischiococcygeus
    b. Coccygeus and puborectalis
    c. Puborectalis and pubococcygeus
    d. Iliococcygeus and ischiococcygeus
    e. Iliococcygeus and coccygeus
A

c. Puborectalis and pubococcygeus

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2
Q 
2. Which of the following arteries is not a branch of the posterior trunk of the internal
iliac?
a. Iliolumbar
b. Lumbosacral
c. Superior gluteal
d. Lateral sacral
A

b. Lumbosacral

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3
Q
  1. What is the homologous structure to the scrotum in females?
    a. Clitoris
    b. Labia minora
    c. Labia majora
    d. Vestibule
A

c. Labia majora

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4
Q
  1. The gubernaculum in females forms which structure?
    a. Suspensory ligament
    b. Cardinal ligament
    c. Round ligament of uterus
    d. Uterosacral ligament
A

c. Round ligament of uterus

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5
Q
  1. Which of the following features is a characteristic of 46 XY Gonadal dysgenesis?
    a. Presence of internal male genitalia and external female genitalia
    b. Presence of streak gonads
    c. Presence of female external genitalia, but retained testes internally
    d. Presence of firm, pea-sized testicles
A

b. Presence of streak gonads

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6
Q
  1. FSH binding to granulosa cells causes what effect?
    a. Production of androgens
    b. Secretion of progesterone
    c. Inhibit release of inhibins
    d. Increased activity of aromatase
A

d. Increased activity of aromatase

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7
Q
  1. What is the most common cause of secondary amenorrhoea?
    a. PCOS
    b. Prolactinoma
    c. Pregnancy
    d. Primary ovarian insufficiency
A

c. Pregnancy

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8
Q
  1. During what tanner stage does menstruation usually occur?
    a. Stage 1
    b. Stage 2
    c. Stage 3
    d. Stage 4
    e. Stage 5
A

d. Stage 4

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9
Q
  1. Menstruation occurs during which days of the endometrial cycle?
    a. 0-4
    b. 5-9
    c. 10-15
    d. 25-28
A

a. 0-4

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10
Q
  1. Which of the following does the mesonephric duct not develop into?
    a. Seminal vesicles
    b. Vas deferens
    c. Prostate
    d. Epididymis
A

c. Prostate

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11
Q
  1. A 15-year-old boy presents with no dysmorphic features. He has had some learning
    difficulties and had to see a physiotherapist for his speech when he was younger. He
    is in the 95 th %ile for height. Which of the following is the likely diagnosis?
    a. Klinefelter Syndrome
    b. Turner Syndrome
    c. Edwards Syndrome
    d. Patau Syndrome
    e. Fragile X Syndrome
A

a. Klinefelter Syndrome

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12
Q

When do oestrogen levels peak?

a. Just before menstruation
b. Just after ovulation
c. Early follicular phase
d. Just before ovulation

A

d. Just before ovulation

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13
Q

Describe the function of the Sertoli cells during spermatogenesis

a. Immune surveillance
b. Main cells of gametogenesis
c. Produce testosterone
d. Secrete matrix to support sperm
e. Metabolic support and nourishment for spermatozoa

A

e. Metabolic support and nourishment for spermatozoa

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14
Q

What is the normal orientation of the uterus?

a. Anteverted anteflexed
b. Anteverted retroflexed
c. Retroverted anteflexed
d. Retroverted retroflexed

A

a. Anteverted anteflexed

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15
Q
  1. Which of the following structures forms the middle 1/3 of the vagina?
    a. Mesonephric duct
    b. Paramesonephric duct
    c. Gonad
    d. Urogenital sinus
A

d. Urogenital sinus

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16
Q

26-year-old woman sees you because she is concerned. She has been trying to fall
pregnant for the past 6 months but has been unsuccessful so far. You decide to do a
test to determine whether she is ovulating or not. What would be the best test to do?
a. Oestrogen day 7
b. Oestrogen day 21
c. Progesterone day 7
d. Progesterone day 21

A

d. Progesterone day 21

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17
Q

What constitutes a normal amount of menstruation?

a. 10mL
b. 35mL
c. 60mL
d. 100mL

A

b. 35mL

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18
Q

A young woman presents with pelvic pain occurring during her periods, with ‘deep’
pain during intercourse and pain on defecation during this time. She states that her
periods are regular with little bleeding. What is the most likely diagnosis?
a. Pelvic inflammatory disease
b. Endometriosis
c. Fibroids
d. Adenomyosis

A

b. Endometriosis

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19
Q

What type of receptors are found on theca cells?

a. Testosterone receptors
b. Progesterone receptors
c. Oestrogen receptors
d. FSH receptors
e. LH receptors

A

e. LH receptors

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20
Q 
A 52-year-old female presents to the GP concerned she has passed through the
menopause following no periods for 1 year. What is the cause of the end of the
menstrual cycle?
a. Reduced GnRH
b. Demise of ovarian follicles
c. Reduced FSH
d. Endometrial atrophy
e. Reduced oestrogen
A

b. Demise of ovarian follicles

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21
Q

Which of the following is a feature of Leydig cells in the testes?

a. Elongated in shape
b. Secrete androgen-binding protein
c. Support developing sperm during spermatogenesis
d. Form the blood-testes barrier
e. Produce testosterone

A

e. Produce testosterone

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22
Q

A 28-year-old man has sustained a non-salvageable testicular injury to his left testicle.
The surgeon decides to perform an orchiectomy and divides the left testicular artery.
From which of the following does this vessel originate?
a. Abdominal aorta
b. Anterior trunk of the internal iliac
c. Posterior trunk of the internal iliac
d. Inferior epigastric
e. Inferior vesicular
f. External iliac

A

a. Abdominal aorta

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23
Q

A 48-year-old female presents to the day surgery unit for a bilateral salpingo-
oophorectomy. The surgeon explains the procedure to her. Which of the following
ligaments would the surgeon have to open to access the ovaries and fallopian tubes?
a. Broad ligament
b. Cardinal ligament
c. Ovarian ligament
d. Round ligament
e. Uterosacral ligament

A

a. Broad ligament

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24
Q

The path of spermatozoa is Seminiferous tubules –> Rete Testis –>_______

a. Epididymis
b. Vas deferens
c. Appendix testis
d. Efferent ductules

A

d. Efferent ductules

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25
Q 
Which of the following receptors is present on the internal urethral sphincter of
males?
a. alpha1
b. alpha2
c. alpha3
d. beta1
e. beta2
f. beta3
A

a. alpha1

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26
Q

What is the normal presentation of Trichomoniasis in females?

a. Mucopurulent, bloody discharge
b. Mucopurulent, creamy discharge
c. Asymptomatic
d. Frothy green-yellow discharge
e. “cottage-cheese” discharge
f. Grey, milky discharge

A

d. Frothy green-yellow discharge

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27
Q

A 17-year-old woman comes to the office because of severe, lower abdominal
cramping for the past three days. She says that she also has purulent vaginal
discharge. She is sexually active with several males at her high school and admits to
only occasional condom use. She is not currently on oral contraceptives. For the past
month, she has been having pain and bleeding during intercourse. Physical
examination shows right lower quadrant tenderness. The abdomen is soft and bowel
sounds are diminished. A pregnancy test is negative. A Gram’s stain from a cervical
swab shows a large number of polymorphonuclear cells and diplococci. A pelvic
ultrasound shows some free fluid in the right lower quadrant. Which of the following
is the most likely diagnosis?
a. Ectopic pregnancy
b. Endometriosis
c. Ovarian Cyst
d. PID

A

d. PID

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28
Q

A 50 yo man complains of inability to obtain an erection. Has had some issues over
the last year, but now completely unable to obtain erection in the last 6 months.
Diagnosed with T2DM 3 years ago but has not been treating it. Separated from wife 3
years ago and started dating someone new 6 months ago. He is wondering if it is
because of the vasectomy he had 5 years ago. What is the most likely cause of his
erectile dysfunction?
a. Early relationship issues
b. Reduced prolactin from diabetes
c. Vascular changes from intermittent claudication
d. Middle-aged men usually have low testosterone levels
e. Side effect of vasectomy

A

c. Vascular changes from intermittent claudication

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29
Q 
A 15-year-old boy is concerned because he hasn’t started puberty yet. What’s the first
sign you’d look for?
a. Increased length of penis
b. Pubic hair
c. Vocal changes
d. Acne
e. Increased testicular volume
A

e. Increased testicular volume

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30
Q

Which of the following is suggestive of an infection with Treponema pallidum?

a. Cottage cheese discharge
b. Mucopurulent discharge with blood
c. Malodourous frothy-green discharge
d. Painless chancre

A

d. Painless chancre

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31
Q

Up to what stage of oogenesis co cells develop in utero?

a. Metaphase II
b. Metaphase I
c. Prophase I
d. Prophase II
e. Anaphase II

A

c. Prophase I

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32
Q

From which of the following is the outermost layer of the spermatic cord derived?

a. Internal oblique aponeurosis
b. External oblique aponeurosis
c. Transversalis fascia
d. Rectus sheath
e. Campers fascia

A

b. External oblique aponeurosis

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33
Q

During a routine abdominal CT scan for abdominal discomfort and weight loss, a 25-
year-old gentleman is found to have enlarged para-aortic lymph nodes. What area of
the body should be checked in this gentleman for a potential malignancy, given the
CT findings?
a. Bladder
b. Glans penis
c. Prostate
d. Rectum
e. Testes

A

e. Testes

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34
Q

Which of the following is the most common reason for female infertility?

a. Ovulatory disorder such as Turner’s syndrome, PCOS, eating disorders
b. Endometriosis
c. Tubal blockage/pelvic adhesions often sequelae to PID
d. Hyperprolactinemia

A

a. Ovulatory disorder such as Turner’s syndrome, PCOS, eating disorders

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35
Q

Implantation bleeding will normally occur how many days after fertilisation?

a. 1-2
b. 4-6
c. 10-14
d. 15-20
e. 24-26

A

c. 10-14

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36
Q

At what stages of pregnancy is RhoGAM normally administered?

a. Weeks 8 and 14 and when membranes rupture
b. Weeks 14 and 20 and within 72 hours of delivery
c. Weeks 20 and 24 and within 72 hours of delivery
d. Weeks 24 and 28 and when membranes rupture
e. Weeks 28 and 32 and within 72 hours of delivery

A

e. Weeks 28 and 32 and within 72 hours of delivery

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37
Q

A cFTS screen identified as being high risk at 16 weeks would normally result in the
recommendation of what procedure being done?
a. Chorionic villus sampling
b. Non-invasive prenatal testing
c. Amniocentesis
d. Nuchal translucency screen
e. Quad Screen test

A

c. Amniocentesis

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38
Q

Capacitation of sperm normally occurs in the

a. Seminiferous tubules
b. Epididymis
c. Ductus deferens
d. Urethra
e. Uterus
f. Fallopian tube

A

f. Fallopian tube

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39
Q

The cortical reactions of the ovum occur due to which ion?

a. Na +
b. Ca 2+
c. K +
d. Mg 2+
e. Cl -

A

b. Ca 2+

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40
Q

hCG levels drops around what week of pregnancy?

a. 4
b. 6
c. 12
d. 16
e. 20

A

c. 12

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41
Q

Relaxin is principally secreted from where?

a. Placenta
b. Uterus
c. Ovaries
d. Foetus

A

c. Ovaries

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42
Q

Which of the following physiological changes would you not expect in pregnancy?

a. Blood volume increasing by up to 50%
b. Heart rate increasing by up to 20 beats
c. Increased thyroid activity
d. Increase antithrombin activity
e. Reduced gastric motility

A

d. Increase antithrombin activity

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43
Q 
Which of the following is not a contraindication to combined oral contraceptive pill
use?
a. Migraine with aura
b. Previous DVT
c. Untreated STI
d. Smoker, > 35 years old
e. Uncontrolled hypertension
f. Liver disease
A

c. Untreated STI

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44
Q

What is the hallmark of the tertiary chorionic villus?

a. Proliferation of syncytiotrophoblastic into the stroma of the uterus
b. Formation of foetal capillaries from mesenchyme
c. Extraembryonic coelom derived mesenchyme invades the villus
d. The uterine mesoderm proliferates into the villus

A

b. Formation of foetal capillaries from mesenchyme

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45
Q

What is the change in reno-vascular values in the first trimester?

a. Increase systolic BP
b. Increase diastolic BP
c. Increase haematocrit
d. Decreased GFR
e. Decreased peripheral resistance

A

e. Decreased peripheral resistance

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46
Q 
Which of the following contraceptive methods works by mainly suppressing follicular
development?
a. Copper IUD
b. Implanon
c. Progesterone-only pill
d. Mirena IUD
e. Combined OCP
A

e. Combined OCP

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47
Q

A 17-year-old female presents with primary amenorrhoea, normal external genitalia,
normal uterus, fallopian tubes and streak ovaries. What is the most likely cause?
a. 46XX Anorexia Nervosa
b. 46XX Elite Athlete
c. 46XX Congenital Adrenal Hyperplasia
d. 46XY Androgen Insensitivity
e. 46XY SRY Gene mutation

A

e. 46XY SRY Gene mutation

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48
Q 
A 35-year-old female has been diagnosed with an STI (is currently untreated). While
discussing treatment, she asks about contraception. She is a current smoker with a 10-pack-year history, and a BMI of 35. What form of contraception would you
recommend to her today?
a. Mirena
b. Progesterone only ‘mini-pill’
c. Combined OCP
d. Copper IUD
e. Implanon
A

b. Progesterone only ‘mini-pill’

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49
Q

What is the mechanism of action of mifepristone to assist with abortion?

a. Progesterone receptor antagonist
b. Progesterone receptor agonist
c. Prostaglandin receptor agonist
d. Prostaglandin receptor antagonist
e. Oestrogen receptor antagonist
f. Oestrogen receptor antagonist

A

a. Progesterone receptor antagonist

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50
Q

A 29-year-old pregnant women presents to the ED with mild vaginal bleeding. Her
cervical os is closed and ultrasound shows an intrauterine gestational sac. The foetus
has a heart rate of 160. What type of abortion is this?
a. Threatened
b. Missed
c. Incomplete
d. Complete

A

a. Threatened

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51
Q 
A 12-year-old girl has small breast growth, the areola has become continuous with the
breast, and has dark pubic and armpit hair. She has started to have a growth spurt.
What tanner stage is she in?
a. 1
b. 2
c. 3
d. 4
e. 5
A

c. 3

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52
Q

A 32-year-old male is concerned about that his couple’s infertility is because of him.
Him and his wife have been having unprotected vaginal sex for a while. His BMI is
30. What is the most appropriate next step?
a. Weight loss program
b. Check testosterone levels
c. Semen analysis
d. Screen for diabetes

A

c. Semen analysis

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53
Q

What is the correct order of progression?

a. Zygote  Morula  Blastocyst
b. Zygote  Blastocyst  Morula
c. Zygote  Trophoblast  Blastocyst
d. Blastocyst  Morula  Trophoblast

A

a. Zygote  Morula  Blastocyst

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54
Q

What would you not expect to see in a pregnant woman in 2nd trimester?

a. HR 80
b. BP 142/75
c. Fasting glucose 4.0 mmol/L
d. Bipedal oedema
e. Haemoglobin 100

A

b. BP 142/75

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55
Q

Which of the following defines infertility in a 34-year-old woman?
a. Inability to conceive after 3 months of regular intercourse without of
contraception
b. Inability to conceive after 6 months of regular intercourse without of
contraception
c. Inability to conceive after 9 months of regular intercourse without of
contraception
d. Inability to conceive after 12 months of regular intercourse without of
contraception
e. Inability to conceive after 18 months of regular intercourse without of
contraception
f. Inability to conceive after 24 months of regular intercourse without of
contraception

A

d. Inability to conceive after 12 months of regular intercourse without of
contraception

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56
Q

What % of women will experience first trimester bleeding?

a. ~10%
b. ~30%
c. ~50%
d. ~75%

A

b. ~30%

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57
Q 
What is considered average blood loss for a single baby birth for a vaginal and
caesarean section respectively?
a. 500mL and 1000mL
b. 1000mL and 500mL
c. 1000mL and 1500mL
d. 1500mL and 1000mL
e. 1500mL and 2000mL
f. 2000mL and 1500mL
A

a. 500mL and 1000mL

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58
Q

When are the APGAR tests conducted?

a. 1 minute and 5 minutes after birth
b. 1 minute and 10 minutes after birth
c. 5 minutes and 10 minutes after birth
d. 10 minutes and 30 minutes after birth

A

a. 1 minute and 5 minutes after birth

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59
Q

Which of the following is the antibody that is most predominant in colostrum?

a. IgA
b. IgG
c. IgM
d. IgE

A

a. IgA

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60
Q 
A woman is in the middle of labour. Her cervix is currently at 10cm dilation. In which
stage of labour is she?
a. Ending Stage 1 – latent
b. Beginning stage 1 – active
c. At the end of 1-active
d. At the beginning of stage 2
e. Beginning stage 3
A

d. At the beginning of stage 2

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61
Q

Which of the following is the most common reason for dystocia?

a. Macrosomia
b. Cephalopelvic disproportion
c. Psychological stressors
d. Insufficient uterine contractility

A

d. Insufficient uterine contractility

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62
Q

A patient with a 3 rd degree perineal tear will most likely develop what complication?

a. Vaginal-rectal fistula
b. Urinary incontinence
c. Faecal incontinence
d. Mild inflammation

A

c. Faecal incontinence

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63
Q

What does the puerperium period encompass?

a. 2 hours post-partum
b. 48 hours post-partum
c. 10 days post-partum
d. 4 weeks post-partum
e. 6-8 weeks post-partum

A

e. 6-8 weeks post-partum

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64
Q

Which of the following would represent a pathology in a newborn?

a. Acrocyanosis 24 hours postpartum
b. Neonatal jaundice 7 days postpartum
c. 6% weight loss in the first week
d. Not passing meconium in the first 24 hours
e. Not urinating for 48 hours

A

e. Not urinating for 48 hours

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65
Q

Which of the following is the longest stage of labour?

a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4

A

a. Stage 1

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66
Q

How does lactation lead to amenorrhoea?

a. Reduced oestrogen production
b. Inhibits LH release
c. Reduces GnRH release
d. Reduced progesterone release

A

c. Reduces GnRH release

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67
Q

Which of the following foetal shunts functionally closes with the first breath?

a. Foramen ovale
b. Ductus arteriosus
c. Ductus venosus
d. Umbilical artery

A

a. Foramen ovale

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68
Q

A cleft palate or defect in the palate of a newborn most likely results from a
teratogenic insult at which stage of gestation?
a. Weeks 3-4
b. Weeks 7-8
c. Weeks 16-18
d. Weeks 26-28
e. Weeks 34-36

A

b. Weeks 7-8

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69
Q

A 32-year-old female is rushed to the hospital at 31 weeks’ gestation due to the onset
of labour. She is currently in the first stage and physicians are looking at using a
tocolytic to try preventing the delivery. Which of the following would be used?
a. Misoprostol
b. Dexamethasone
c. Betamethasone Valerate
d. Nifedipine
e. Magnesium Sulphate

A

d. Nifedipine

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70
Q

What is a common side effect that occurs in most general anaesthesia?

a. Irritation of upper respiratory airways
b. Malignant hyperthermia
c. Decreased urine output
d. Cardiovascular depression

A

d. Cardiovascular depression

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71
Q

What is a component tested in the APGAR score?

a. Blood pH
b. Colour of body
c. Respiratory rate
d. Oxygen saturation
e. Temperature

A

b. Colour of body

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72
Q

Cardiotocography is used during labour. What does it monitor?

a. Foetal wellbeing; foetal HR and movements
b. Foetal wellbeing; foetal HR and maternal uterine contractions
c. Maternal wellbeing; Foetal HR and maternal uterine contractions
d. Maternal wellbeing; foetal HR and movements

A

b. Foetal wellbeing; foetal HR and maternal uterine contractions

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73
Q

What is true about the placenta?

a. The umbilical cord attaches in the centre
b. It is thinnest in the middle
c. Placental lacunae contain foetal blood
d. A placenta will on average weight 1-1.2kg

A

a. The umbilical cord attaches in the centre

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74
Q

The ductus venosus allows bypassing of which organ?

a. Lungs
b. Liver
c. Lower limb
d. Pelvic organs

A

b. Liver

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75
Q

What causes the initiation of labour?

a. Withdrawal of prolactin
b. Withdrawal of progesterone with the placenta
c. Withdrawal of progesterone reducing inhibition on uterus
d. Withdrawal of oestrogen reducing inhibition on the uterus

A

c. Withdrawal of progesterone reducing inhibition on uterus

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76
Q

What level perineal tear does an episiotomy give?

a. 1 st degree
b. 2 nd degree
c. 3 rd degree
d. 4 th degree

A

b. 2 nd degree

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77
Q

Which of the following physiological changes occurs as a direct result of the first
breath after birth?
a. Constriction of umbilical vessels
b. Expression of enzymes for bile production
c. Functional closure of the foramen ovale
d. Increased lung surfactant production
e. Replacement of foetal haemoglobin subunit with adult subunit

A

c. Functional closure of the foramen ovale

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78
Q

What is the most common cause of post-partum haemorrhage?

a. Retained products of conception
b. Uterine atony
c. Perineal tear
d. Placental abruption

A

b. Uterine atony

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79
Q

Which of the following pathogens is a teratogen in pregnancy?

a. E. Coli
b. Rubella
c. Group B Strep
d. Salmonella

A

b. Rubella

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80
Q

A 26-year-old man presents with a dental abscess which needs to be surgically
drained under local anaesthetic. What would impact the effectiveness of the local
anaesthetic?
a. Nutritional status of the patient
b. pH elevation in local tissues
c. Injury to local nerves
d. Previous effects of local anaesthetics
e. Extent of inflammation

A

e. Extent of inflammation

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81
Q

Which of the following is included in the Newborn Screening Test?

a. Congenital Adrenal Hypoplasia
b. Cystic Fibrosis
c. Down Syndrome
d. Cerebral Palsy
e. Coeliac disease

A

b. Cystic Fibrosis

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82
Q

A 3-year-old presents with recurrent otitis media and only speaks a disjointed word or

two. What is the best test for ruling out sensorineural hearing loss?
a. Audiogram
b. CT
c. Otoscopy
d. Tympanogram
e. Auditory Brainstem Response (ABR) Audiometry

A

a. Audiogram

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83
Q

Some people with a colorectal cancer mutation (APC – Familial Adenomatous
Polyposis) on one allele will develop colorectal cancer, while others will not. How
would you describe this in genetics?
a. Normal variation
b. Autosomal recessive
c. Variable expressivity
d. Incomplete penetrance

A

d. Incomplete penetrance

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84
Q

How long does passive immunisation conferred from the mother last after birth?

a. 2 weeks
b. 6 weeks
c. 6 months
d. 12 months
e. 18 months

A

c. 6 months

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85
Q

What vaccination is given to a baby at birth, prior to discharge?

a. DTP
b. MMR
c. Hepatitis B
d. Polio
e. Varicella

A

c. Hepatitis B

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86
Q

A 16-year-old boy has a one-day history of pain in the right ear. He swims every
morning. The right ear canal is swollen and red. He has pain when the auricle is
pulled, or the tragus is pushed. Which of the following is the most likely diagnosis?
a. Acute otitis media
b. Chronic otitis media
c. External otitis
d. Mastoiditis

A

c. External otitis

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87
Q

Which of the following is given as a live attenuated vaccine?

a. Polio
b. Influenza
c. Hep A
d. Hep B
e. MMR

A

e. MMR

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88
Q

What is most true about a conjugated vaccine?

a. The inactivated pathogen is bound to polysaccharide
b. The inactivated pathogen is bound to protein
c. The immune inducing part of the pathogen is bound to polysaccharide
d. The immune inducing part of the pathogen is bound to protein

A

c. The immune inducing part of the pathogen is bound to polysaccharide
AND ALSO
d. The immune inducing part of the pathogen is bound to protein

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89
Q

Which of the following layers of the adrenal gland does aldosterone come from?

a. Zone glomerulosa
b. Zona Fasciculata
c. Zona reticularis
d. Adrenal Medulla

A

a. Zone glomerulosa

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90
Q

A 42-year-old woman has a microadenoma of the pituitary leading to excess
production of ACTH. What clinical presentation would you expect to see?
a. Bone formation and increased density
b. Obesity and hypertension
c. Sodium and fluid retention
d. Tachycardia and tremors

A

b. Obesity and hypertension

91
Q

Small cell lung cancers often exhibit a paraneoplastic effect – resulting in ectopic
ADH secretion. What effect would this have on the body?
a. Low osmolality urine
b. Increased sodium reabsorption
c. Increased serum sodium
d. Increased fluid in the extracellular space

A

d. Increased fluid in the extracellular space

92
Q

A benign tumour in the pituitary will most likely result in which symptom?

a. Acromegaly
b. Goitre
c. Addison’s disease
d. T2DM

A

a. Acromegaly

93
Q

Which of the following describes the moro reflex?
a. When the roof of mouth is touched  baby will begin to suck
b. When stimulated suddenly, arms and legs are thrown out
c. When object placed in hand, infant will flex hand around
object
d. Movement of trunk and hips when placed in ventral
suspension

A

b. When stimulated suddenly, arms and legs are thrown out

94
Q 
Which of the following body organs has a reduction in absolute and relative perfusion
during moderate exercise?
a. Muscles
b. Skin
c. Kidneys
d. Heart
e. Brain
A

c. Kidneys

95
Q

As part of a healthy routine work-up, a 22-year-old patient’s neurological exam
reveals bilateral reduced knee jerk reflex. What do you think is causing this?
a. Lesion in the DCML
b. Lesion in the motor cortex
c. Metabolic disturbance e.g. hyperthyroidism
d. Voluntary inhibition of reflex

A

d. Voluntary inhibition of reflex

96
Q 
A 67-year-old man with severe COPD is on many medications. He presents with
dysphonia and has white plaques on his tongue and parapharyngeal area. Which of his
medications could have caused this?
a. LAMA
b. LABA
c. SAMA
d. SABA
e. ICS
A

e. ICS

97
Q

A 30-year-old male presents to the hospital and endoscopy reveals a peptic ulcer.
Post-op, what would make you most concerned that he now has a severe GIT bleed?
a. Bradycardia
b. Haematemesis
c. Epigastric pain
d. Melaena
e. Slow capillary refill

A

e. Slow capillary refill

98
Q 
A patient is started on an infusion of plain tap water at a rapid rate. What would this
cause?
a. No effect
b. High efflux of water
c. High influx of sodium
d. Shrinkage and cretination
e. Swelling and haemolysis
A

e. Swelling and haemolysis

99
Q

Loperamide is an opioid more potent than morphine. However, it is available as an
OTC medication for diarrhoea. Why does it have a limited effect on the CNS?
a. Converted to a lipid soluble metabolite
b. Efficiently transported by P-glycoprotein
c. Low affinity for CYP450 enzymes
d. Rapid uptake by enterocytes

A

b. Efficiently transported by P-glycoprotein

100
Q 
Which of the following tests would be most useful for testing the dorsal column
pathways?
a. Blunt/sharp pain
b. Touch
c. Vibration
d. Temperature
A

c. Vibration

101
Q

Which of the following investigations is a screening tool used for bowel cancer?

a. Full Blood Count
b. Iron studies
c. Stool microscopy for blood
d. Faecal Occult Blood Test
e. Patient history for blood in stool

A

d. Faecal Occult Blood Test

102
Q

A woman presents after performing a self-examination on her breast and she is
referred onwards for a mammogram. Which of the following is most correct about
screening programs?
a. They must be rapid
b. Screening tests are used to identify disease in symptomatic individuals
c. A screening test should be 90% sensitive
d. They are cost effective

A

d. They are cost effective

103
Q

Which hormone causes contraction of the myoepithelium in breast duct tissue?

a. Oxytocin
b. Prolactin
c. Oestrogen
d. Progesterone

A

a. Oxytocin

104
Q

Which of the following correctly describes the histology of the cervix?
a. Stratified squamous non-keratinised epithelium of the endocervix and simple
columnar epithelium of the ectocervix
b. Stratified squamous non-keratinised epithelium of the ectocervix and simple
columnar epithelium of the endocervix
c. Stratified squamous keratinised epithelium of the ectocervix and simple
columnar epithelium of the endocervix.
d. Stratified squamous keratinised epithelium of the endocervix and simple
columnar epithelium of the ectocervix.

A

b. Stratified squamous non-keratinised epithelium of the ectocervix and simple
columnar epithelium of the endocervix

105
Q

How many lobules in a human mammary gland?

a. 15-20
b. 20-50
c. 50-100
d. 100-500

A

a. 15-20

106
Q

Which of the following most accurately represents the two primary arteries that
supply the breast (ie: off of which the mammary branches descend), as well as where
they themselves branch from?
a. Lateral thoracic artery, branching off the Subclavian artery;
Internal thoracic artery, branching off the Axillary artery
b. Medial thoracic artery, branching off the Subclavian artery;
External thoracic artery, branching off the Axillary artery
c. Lateral thoracic artery, branching off the Axillary artery;
Internal thoracic artery, branching off the Subclavian artery
d. Medial thoracic artery, branching off the Axillary artery;
External thoracic artery, branching off the Subclavian artery

A

c. Lateral thoracic artery, branching off the Axillary artery;
Internal thoracic artery, branching off the Subclavian artery

107
Q 
Which subtypes of HPV are most likely to cause several cancers, including SCC of
the cervix and ano-genital region?
a) 1, 2, 4, 7
b) 6, 11
c) 5, 15
d) 16, 18
a. 12, 14
A

d) 16, 18

108
Q

Anti-Mullerian Hormone is used to measure ovarian reserve. What is its physiological
role in the female body?
a. Induce regression of the Mullerian ducts
b. Promote ovulation in tandem with LH
c. Prevent follicular recruitment
d. Induces the selection of a dominant follicle in folliculogenesis
e. Cause luteinisation of granulosa cells

A

c. Prevent follicular recruitment

109
Q

Which of the following is a trait of a malignant breast lesion?

a. Discharge green/yellow
b. Painless
c. Mobile
d. Firm
e. Absence of skin dimpling

A

b. Painless

110
Q

What is the hormone profile of the majority of breast carcinomas?

a. Triple negative
b. HER2 positive, ER positive
c. HER2 positive, ER negative
d. ER positive, HER2 negative

A

d. ER positive, HER2 negative

111
Q 
The hormone involved in contraction of the myoepithelial cells in the breast is
released from where?
a. Ovaries
b. Pars nervosa
c. Pars tuberalis
d. Pars distalis
e. Hypothalamus
f. Pars intermedia
A

b. Pars nervosa

112
Q

Through which mechanism are lipids secreted in mammary glands?

a. Merocrine
b. Apocrine
c. Autocrine
d. Endocrine

A

b. Apocrine

113
Q

Which of the following is not a risk factor for breast cancer?

a. Nulliparity
b. Early menopause
c. Early menarche
d. Liver disease
e. Smoking

A

b. Early menopause

114
Q

What is the most common breast tumour type observed in BRCA1?

a. Oestrogen receptor positive, HER2 positive
b. Oestrogen receptor negative, HER2 positive
c. Oestrogen receptor positive, HER2 positive, Progesterone receptor positive
d. Oestrogen receptor negative, HER2 negative, Progesterone receptor negative

A

d. Oestrogen receptor negative, HER2 negative, Progesterone receptor negative

115
Q

How often is a screening mammogram recommended?

a. Every.year
b. Every 2 years
c. Every 3 years
d. Every 5 years

A

b. Every 2 years

116
Q

A female with a PMHx of DVT is taking Warfarin. She decides to start a new diet
with leafy green smoothies and juices. What are you most concerned about?
a. Cognitive dysfunction
b. Increased risk of cerebral haemorrhage
c. Nausea and vomiting
d. Increased bruising
e. Increased risk of DVT

A

e. Increased risk of DVT

117
Q

Which of the following would be consistent with a clotting factor disorder?

a. Urinary tract bleeding
b. Menorrhagia
c. Epistaxis
d. Haemarthroses
e. Oral bleeding

A

d. Haemarthroses

118
Q

A patient presents to the ED with a high energy trauma to the humerus. A surgeon
explores the cubital fossa for signs of damage and see a damaged median nerve.
Which of the following functions would not be affected?
a. Pincer grip
b. Opposition
c. Thumb adduction
d. Thumb flexion
e. Thumb abduction

A

c. Thumb adduction

119
Q

A 15-year old boy presents to the GP complaining of hearing loss following his
school swimming carnival a few days ago. When you perform a Rinne test, air
conduction > bone conduction for both ears. On Weber test, he says the sound is
louder on the right. What do you suspect?
a. Left conductive hearing loss
b. Left sensorineural hearing loss
c. Right conductive hearing loss
d. Right sensorineural hearing loss

A

b. Left sensorineural hearing loss

120
Q

Which antineoplastic drug is most likely to cause myelosuppression?

a. Alkylating agents
b. Immunotherapy
c. Monoclonal antibodies
d. Kinase inhibitor

A

a. Alkylating agents

121
Q

Which of the following features is a characteristic of 46 XY Gonadal dysgenesis?

a. Presence of internal male genitalia and external female genitalia
b. Presence of streak gonads
c. Presence of female external genitalia, but retained testes internally
d. Presence of firm, pea-sized testicles

A

b. Presence of streak gonads

122
Q

Where do most prostate carcinomas arise?

a. Peripheral zone
b. Periurethral zone
c. Transitional zone
d. Central zone

A

a. Peripheral zone

123
Q

17-year-old male presents to the ED with an extremely painful testicle that has
worsened since its onset 1 hour ago. There is no Hx of trauma. No recent new sexual
partners, and no change in urinary habits. On inspection, the testicle is swollen, very
painful and seems to be lying horizontally. What is the pathology?
a. UTI
b. Epididymo-orchitis
c. Testicular torsion
d. Varicocele

A

c. Testicular torsion

124
Q

From which of the following is the outermost layer of the spermatic cord derived?

a. Internal oblique aponeurosis
b. External oblique aponeurosis
c. Transversalis fascia
d. Rectus sheath
e. Campers fascia

A

b. External oblique aponeurosis

125
Q

What is the mechanism of action of mifepristone to assist with abortion?

a. Progesterone receptor antagonist
b. Progesterone receptor agonist
c. Prostaglandin receptor agonist
d. Prostaglandin receptor antagonist
e. Oestrogen receptor antagonist
f. Oestrogen receptor antagonist

A

a. Progesterone receptor antagonist

126
Q

What is the hallmark of the tertiary chorionic villus?

a. Proliferation of syncytiotrophoblastic into the stroma of the uterus
b. Formation of foetal capillaries from mesenchyme
c. Extraembryonic coelom derived mesenchyme invades the villus
d. The uterine mesoderm proliferates into the villus

A

b. Formation of foetal capillaries from mesenchyme

127
Q 
What is considered average blood loss for a single baby birth for a vaginal and
caesarean section respectively?
a. 500mL and 1000mL
b. 1000mL and 500mL
c. 1000mL and 1500mL
d. 1500mL and 1000mL
e. 1500mL and 2000mL
f. 2000mL and 1500mL
A

a. 500mL and 1000mL

128
Q 
A woman is in the middle of labour. Her cervix is currently at 5cm dilation. In which
stage of labour is she?
a. Ending Stage 1 – latent
b. Beginning stage 1 – active
c. At the end of 1-active
d. At the beginning of stage 2
e. Beginning stage 3
A

b. Beginning stage 1 – active

129
Q

Cardiotocography is used during labour. What does it monitor?

a. Foetal wellbeing; foetal HR and movements
b. Foetal wellbeing; foetal HR and maternal uterine contractions
c. Maternal wellbeing; Foetal HR and maternal uterine contractions
d. Maternal wellbeing; foetal HR and movements

A

b. Foetal wellbeing; foetal HR and maternal uterine contractions

130
Q

Which of the following pathogens is a teratogen in pregnancy?

a. E. Coli
b. Group B Strep
c. Salmonella
d. Syphilis

A

d. Syphilis

131
Q

Where is the suprachiasmatic nucleus located?

a. Pineal gland
b. Thalamus
c. Hypothalamus
d. Midbrain
e. Reticular Activating System
f. Ventral Tegmentum

A

c. Hypothalamus

132
Q

Correctly match the types of EEG wave, their frequency and when they would be
seen
a. Delta – 4-7 Hz – deep sleep
b. Alpha – 15-30 Hz – awake, resting
c. Delta < 4 Hz – some sleep and waking states
d. Beta – 4-7 Hz – quiet, waking state
e. Theta < 4 Hz – deep sleep
f. Beta – 15-30 Hz – activated or attentive

A

f. Beta – 15-30 Hz – activated or attentive

133
Q

Which of the following is characteristic of Non-REM sleep regarding characteristics of
the functional states?
a. EEG: Low voltage, fast; Sensation: dull or absent
b. Thought: Logical, progressive; Movement: occasional and involuntary
c. EEG: High voltage, slow, Thought: logical, repetitive
d. Movement: Muscle paralysis; REM – often
e. EEG: Low voltage, fast; Sensation: vivid, internally generated
f. Thought: Vivid, illogical, bizarre; EEG: low voltage, fast

A

c. EEG: High voltage, slow, Thought: logical, repetitive

134
Q 
According to Erikson’s stages of psychosocial development, what stage is a person
who’s middle aged (40-65) in?
a. Guilt
b. Inferiority
c. Role confusion
d. Isolation
e. Stagnation
f. Despair
g. Shame and doubt
A

e. Stagnation

135
Q

The serotonergic nuclei of the brain is the

a. Midbrain
b. Pons
c. Lateral hypothalamus
d. Raphe nuclei
e. Locus coeruleus
f. Basal forebrain

A

d. Raphe nuclei

136
Q

What two neurotransmitters play a key role in secure attachment?

a. Serotonin and dopamine
b. Oxytocin and serotonin
c. Noradrenaline and dopamine
d. Oxytocin and dopamine
e. Oxytocin and acetylcholine
f. Acetylcholine and serotonin

A

d. Oxytocin and dopamine

137
Q

Which of the following describes the role of the anterior insula in regard to
resilience?
a. Emotion and self-awareness
b. Pleasure centre
c. Fear
d. Planning, decision-making, emotional regulation
e. Learning, memory and regulating stress response

A

a. Emotion and self-awareness

138
Q

Which of the following adjectives best describes the concept of a “good enough”
mother?
a. Almost always anticipating the needs of the baby
b. Attempts to teach emotional regulation to the infant
c. Shows average care for the infant
d. Adhering to a strict routine as best as possible
e. Sometimes delaying soothing a crying baby

A

e. Sometimes delaying soothing a crying baby

139
Q

What is true about sleep in young adults?

a. REM occurs 4-6 times at night
b. REM predominates in the first 1/3 of the night
c. Slow wave sleep predominates for the last 1/3 of the night
d. Wakefulness accounts for 10% of sleep

A

a. REM occurs 4-6 times at night

140
Q

What neurotransmitter is implicated in social affiliation?

a. Dopamine
b. Serotonin
c. Oxytocin
d. Noradrenaline
e. Prolactin

A

c. Oxytocin

141
Q

What brain structure controls circadian rhythms?

a. Locus coeruleus
b. Pineal gland
c. Suprachiasmatic nucleus
d. Mammillary body

A

c. Suprachiasmatic nucleus

142
Q

What pharmacological agent causes uterine relaxation?

a. Ergometrine
b. Nifedipine
c. Syntocinon
d. Nifedipine
e. Misoprostol

A

d. Nifedipine

143
Q

What brain structure is involved in emotional regulation?

a. Anterior pituitary
b. Caudate nucleus
c. Mamillary body
d. Prefrontal cortex

A

d. Prefrontal cortex

144
Q

A 47-year-old man recently prescribed a ‘sleeping pill’ was found to be acting out
bizarre behaviours whilst he was asleep. Video footage found him to taking his bins
out, and binge eating in the fridge while sleeping. Which of the following
medications is the most likely culprit?
a. Diazepam
b. Zolpidem
c. Melatonin
d. Valerian

A

b. Zolpidem

145
Q

Which of the following is not a sleep promoting factor?

a. IL-1
b. Melatonin
c. Adenosine
d. NO
e. Noradrenaline

A

e. Noradrenaline

146
Q

A 12-year-old child has been abused in his life and is now exposed to a frightening

experience. Which of the following best represents his body’s response?
a. Decreased activity of the medial temporal lobe
b. Decreased activity of the prefrontal cortex
c. Overactivity of the cortisol stress response
d. Reduced activity of the amygdala response

A

c. Overactivity of the cortisol stress response

147
Q

A young woman joins a political group and is rude and dismissive to other people
who don’t share the same beliefs as her. What would be evidence for a personality
disorder?
a. Her beliefs don’t align with the majority of society
b. Her behaviours changed upon joining the political group
c. She has always been rude and dismissive even before joining the political
group
d. Being rude and submissive is a recent change, but not related to the political
party

A

c. She has always been rude and dismissive even before joining the political
group

148
Q

In regard to sleep cycles and consciousness, where is the centre for arousal located?

a. Brain stem
b. Motor cortex
c. Cerebellum
d. Prefrontal Cortex
e. Basal ganglia

A

a. Brain stem

149
Q

A 19-year-old male presents to the GP with reports of new sleep onset-latency
insomnia. History reveals that the patient works in IT and then plays video games at
night and drinks 2 coffees and a red bull per day. Which of the following describes
the next best step in the management of this patient?
a. Short-course prescription of benzodiazepines
b. Follow-up in 4 weeks
c. Referral to a Sleep and Respiratory physician
d. Referral to a psychiatrist
e. Sleep hygiene recommendations and follow-up

A

e. Sleep hygiene recommendations and follow-up

150
Q

Which of the following is true about the cervix?

a. The junction between the ectocervix and endocervix occurs at the internal os
b. The vagina has tall columnar cells
c. The endocervical canal connects the uterine cavity to the vulva
d. The endocervical canal has tall columnar cells that secrete mucous

A

d. The endocervical canal has tall columnar cells that secrete mucous

151
Q 
Which of the following is the most common mental health problem found in patients
over the age of 65?
a. Alzheimer’s disease
b. Delirium
c. Late-onset schizophrenia
d. Mood disorders
e. Vascular dementia
A

d. Mood disorders

152
Q

Monoamines are believed to be important in regulating emotional processes. Which
of the following medicines affect the monoamine levels in the brain as a major
effect?
a. Diazepam
b. Sertraline
c. Thyroxine
d. Valproate

A

b. Sertraline

153
Q 
Which alteration in neurotransmission is responsible for the anxiolytic action of
diazepam?
a. Increased 5-hydroxytryptamine
b. Increased gamma-aminobutyric acid
c. Increased glutamate
d. Decreased gamma-aminobutyric acid
e. Decreased 5-hydroxytryptamine
A

b. Increased gamma-aminobutyric acid

154
Q

What is chronic mild depression known as?

a. Dysthymia
b. Bipolar depression
c. Melancholia
d. Depressive personality
e. Major depression

A

a. Dysthymia

155
Q

A 47-year-old man is driving his car. All of a sudden, he becomes diaphoretic and
loses control of the steering wheel while driving. What would provide reassurance
that the man is having a panic attack?
a. Just before this he had a flashback to a previous car crash
b. He was thinking about being embarrassed about his recent singing
performance while driving
c. The symptoms subside within 10 mins
d. He reported paraesthesia and weakness on the left side of his body

A

c. The symptoms subside within 10 mins

156
Q

You are determining the suicide risk of a young, emotionally distressed man. Which
of the following is true regarding assessment of suicide risk?
a. Asking about suicide increases the risk of suicide
b. You only need to ask about suicidal thoughts if you think he may be
depressed
c. Those who have suicidal thought almost never act on them
d. He is unlikely to tell you
e. You can ask him directly about his suicidal thoughts

A

e. You can ask him directly about his suicidal thoughts

157
Q

A 35-year-old woman presents with treatment resistant depression that has not
reported to several individual drug trials. Which of the following is most likely
true regarding giving her a MAOI combined with an SSRI?
a. Hypertension from inadequate tyramine metabolism
b. Combined medications have better efficacy for treatment resistant
depression
c. This has an increased risk of resulting in serotonin syndrome
d. Synapse remodelling will be accelerated, and improvement will be faster

A

c. This has an increased risk of resulting in serotonin syndrome

158
Q

A 32-year-old female is invited out to dinner with some friends. She was recently
diagnosed with atypical depression. She hesitates as she is on a medication that
restricts her diet. What is the drug she is taking?
a. Phenelzine
b. Sertraline
c. Venlafaxine
d. Amitriptyline

A

a. Phenelzine

159
Q

Which of the following conditions is lithium carbonate most widely used for?

a. Major Depressive Disorder
b. Generalised Anxiety Disorder
c. Bipolar Affective Disorder
d. Post-Traumatic Stress Disorder

A

c. Bipolar Affective Disorder

160
Q

A 37-year-old male presents to the GP with symptoms suggestive of depression. He
reports that his mood seems okay, but that he has difficulty concentrating, he is
unable to sleep very well, he doesn’t feel like eating, has lost interest in things he
used to enjoy doing, and even reports passive suicidal ideation. Which of the
previous mentioned presenting factors most strongly supports a diagnosis of Major
Depressive Disorder?
a. Suicidality
b. Insomnia
c. Anorexia
d. Anhedonia
e. Concentration deficit

A

d. Anhedonia

161
Q

Which of the following is required for a diagnosis of bipolar affective disorder?

a. A single manic episode
b. At least two manic episodes, and at least one depressive episode
c. At least two depressive episodes and at least one manic episode
d. A single depressive episode

A

a. A single manic episode

162
Q

Which of the following differentiates PTSD from acute stress disorder?

a. Severity
b. Hallucinations
c. Timeline
d. Instigating stimulus

A

c. Timeline

163
Q

What is the leading cause of death in Australia in people aged 12-24?

a. Accidental drug overdose
b. Anorexia nervosa
c. Cancer
d. Road traffic accidents
e. Suicide

A

e. Suicide

164
Q 
Psychomimetic drugs that cause hallucinations act on which of the following
receptors?
a. Adrenergic beta2
b. Dopaminergic
c. Serotonergic-2A
d. Muscarinic M3
A

c. Serotonergic-2A

165
Q

A 25-year-old male presents to the ED. He has been out partying at a nightclub. He
appears agitated and tremulous. On history, he reports that the security guards were
out to get him, and that they were following him home. These statements appear to
be false. Ingestion of which of the following drugs most likely correlates with these
symptoms?
a. Marijuana
b. LSD
c. Amphetamine
d. Benzodiazepine
e. Opioids

A

c. Amphetamine

166
Q

A 55-year-old patient known to the hospital presents to the emergency department
with confusion. He is unable to balance properly and has obvious gait ataxia. He has
a known substantial Hx of EtOH. Which of the following additional symptoms/signs
would complete the classic triad for Wernicke’s Encephalopathy?
a. Dysmetria
b. Dysdiadochokinesia
c. Nystagmus
d. Vertigo
e. Trigeminal neuralgia

A

c. Nystagmus

167
Q

A 37-year-old female has been alcohol abstinent for the last 5 months. She attends a
birthday party and has a slice of cake, asking her friend “what’s the secret to this
recipe?”. Her friend tells her that it is rum. She leaves the party concerned, and then
later on develops flushing, headaches and profound nausea. Which medication is she
taking?
a. Acamprosate
b. Varenicline
c. Diazepam
d. Disulfiram

A

d. Disulfiram

168
Q

A 54-year-old male presents to the ED due to a FOOSH. Imaging reveals that he has
sustained a distal radius fracture (Colles). He undergoes open reduction internal
fixation. 18 hours post-op, the nurses call you to examine him because they are
concerned. He appears agitated and tremulous, and O/E he is sweaty with a HR of
88, temp 37.4 and SaO2 97%. What is the most likely diagnosis?
a. Alcohol withdrawal
b. Opiate overdose
c. Haemorrhaging
d. Septic
e. Hypoglycaemia

A

a. Alcohol withdrawal

169
Q

A 36-year-old female presents to the GP with dysphoria, lack of motivation and poor
concentration after giving birth 6 weeks ago. She has a PMHx of depression in her
early 20s, which was successfully treated with SSRIs. What is the most likely
diagnosis?
a. Adjustment disorder
b. Postpartum psychosis
c. Baby Blues
d. Postpartum depression

A

d. Postpartum depression

170
Q

A 22-year-old male presents to the GP wanting some help quitting smoking. He is
prescribed something to help with it. He returns 2 weeks later reporting weird,
abnormal dreams. What medication was he most likely prescribed?
a. Bupropion
b. Nicotine Replacement Therapy
c. Buprenorphine
d. Varenicline

A

d. Varenicline

171
Q

You are a GP seeing a patient diagnosed with schizophrenia. They are an identical twin. What
is the risk of the other twin developing schizophrenia?
a. 20%
b. 30-75%
c. 95%
d. No more risk than in non-twin siblings.
e. No more risk than any the general population

A

b. 30-75%

172
Q

A 22-year-old male presents to the emergency department in an episode of acute
psychosis, complaining that the government is out to get him and reporting visual and
auditory hallucinations. History of a family member reveals this has been going on for 7
months. Further history reveals that he has been sleeping poorly, had a reduced appetite,
social withdrawal, reduced energy for the last year, and attempted suicide 9 months ago.
Which of the following is the most appropriate diagnosis?
a. Brief psychotic disorder
b. Schizophreniform disorder
c. Schizophrenia disorder
d. Bipolar with psychotic features
e. Major depressive disorder with psychotic features
f. Schizoaffective disorder

A

e. Major depressive disorder with psychotic features

173
Q

A 65-year-old male presents to the GP clinic complaining of shortness of breath, chest
palpitations and diaphoresis. History reveals he was a soldier in the Vietnam War, and
when he goes out in public, he scans the exits for an escape from the crowd. Which of
the following terms describes this?
a. Flashback
b. Agoraphobia
c. Hypervigilance
d. Terrors

A

c. Hypervigilance

174
Q

Which of the following medications is a typical antipsychotic?

a. Sulpuride
b. Fluphenazine
c. Risperidone
d. Clozapine
e. Olanzapine
f. Quetiapine
g. Aripiprazole

A

c. Risperidone

175
Q

A patient presents to the GP clinic complaining of 45 kilograms of weight gain in the
last 18 months. She was diagnosed with schizophrenia 2 years ago and was commenced
on a medication. Which of the following medications was she started on?
a. Fluphenazine
b. Haloperidol
c. Chlorpromazine
d. Thioridazine
e. Olanzapine

A

e. Olanzapine

176
Q

Which of the following medications is least likely to cause tardive dyskinesia?

a. Olanzapine
b. Aripiprazole
c. Clozapine
d. Sulpuride
e. Haloperidol
f. Chlorpromazine

A

c. Clozapine

177
Q 
Which of the following features helps differentiate between neuroleptic malignant
syndrome and serotonin syndrome?
a. Diaphoresis
b. Hyperthermia
c. Tachycardia
d. Rigidity
e. Hypertension
A

d. Rigidity

178
Q 
A patient commenced on an oral antidiabetic agent presents with recurrent bouts of
dysuria, frequency, urgency and nocturia. Which of the following medications is most
implicated?
a. Biguanide
b. GLP1
c. DPP4i
d. SGLT2i
e. Sulfonylureas
f. Alpha-glucosidase inhibitor
g. TZD
A

d. SGLT2i

179
Q

Which of the following is the diagnostic cut-off for HbA1C for diabetes?

a. 5%
b. 5.5%
c. 6%
d. 6.5%
e. 7
f. 7.5%

A

d. 6.5%

180
Q

A 19-year-old man is brought in by his family. They tell you he has become withdrawn
and not left the house for several months and has been acting strangely. They think he is
hearing voices and he often refuses to eat as he claims the food it is poisoned. Given the
likely diagnosis, what would be the most appropriate first-line treatment?
a. Clozapine
b. Olanzapine
c. Sertraline
d. Sodium valproate
e. Pregabalin

A

b. Olanzapine

181
Q

A 19-year-old woman is being assessed by a psychiatrist due to her eating habits. She
admits to binge eating followed by self-induced vomiting for the past 6 months. On
physical examination, her body mass index (BMI) is 20 kg/m² and she has enamel
erosion.Which of the following acid-base and electrolyte abnormalities is most likely
associated with her eating disorder?
a. Metabolic alkalosis, hypochloraemia, hyperkalaemia
b. Metabolic alkalosis, hyperchloraemia, hypokalaemia
c. Metabolic alkalosis, hypochloraemia, hypokalaemia
d. Metabolic acidosis, hypochloraemia, hypokalaemia
e. Metabolic acidosis, hyperchloraemia, hyperkalaemia

A

c. Metabolic alkalosis, hypochloraemia, hypokalaemia

182
Q

What would indicate a diagnosis of diabetes?

a. A fasting glucose of 6.9mmol/L and 5.8mm/l 48 hours apart
b. Blood glucose of 7.1 mmol/L 2 hours after an oral glucose of 75mg
c. Random glucose of 12.1mmol/L
d. Single fasting glucose of 6.8 mmol/L

A

c. Random glucose of 12.1mmol/L

183
Q

What is the most common eating disorder in Australia?

a. PICA
b. Bulimia Nervosa
c. Binge Eating Disorder
d. Anorexia Nervosa

A

c. Binge Eating Disorder

184
Q

What finding is most commonly found in Anorexia Nervosa?

a. Heat intolerance
b. Hyperkalaemia
c. Hypernatraemia
d. Hypotension
e. Tachycardia

A

d. Hypotension

185
Q

A patient is recently prescribed a new oral anti-diabetic medication. She reports
episodes of hypoglycaemia which prompts the GP to review the medication. Which
medication was she most likely prescribed?
a. Metformin
b. SLGT2i
c. GLP-1
d. Sulfonylurea

A

d. Sulfonylurea

186
Q

A 23-year-old male is recently started on risperidone for schizophrenia. Shortly after
starting the medication he notices that his breasts have enlarged and there is some
discharge. He also admits to a reduced libido and erectile dysfunction.
He is diagnosed with hyperprolactinaemia secondary to anti-psychotic use.
Which dopaminergic pathway is inhibited to cause this presentation?
a. Nigro-striatal pathway
b. Tuberoinfundibular pathway
c. Mesolimbic pathway
d. Mesocortical pathway
e. Corticospinal tract

A

b. Tuberoinfundibular pathway

187
Q 
The positive symptoms found in schizophrenia are attributable to increased activity in
which pathway?
a. Mesolimbic
b. Mesocortical
c. Nigrostriatal
d. Tuberoinfundibular
A

a. Mesolimbic

188
Q

What is the defining characteristic of Anorexia Nervosa?

a. Preoccupation with weight
b. Loss of appetite
c. Social isolation
d. No disruption in the family
e. Menorrhagia

A

a. Preoccupation with weight

189
Q

What do you see on MRIimaging in schizophrenia?

a. Decreased hippocampal volume
b. Basal ganglia decreased volume
c. Decreases size of ventricles
d. Increase in neocortex volume
e. Increased thalamic volume

A

a. Decreased hippocampal volume

190
Q

A patient presents to the GP clinic complaining of the inability to stop moving,
grimacing movements in their face and a pill-rolling tremor. The GP presents them on
a new medication and these symptoms resolve. Which of the following explains the
improvement in symptoms, wrt to the MoA of the new drug?
a. D2 inhibition
b. D2 agonism
c. H1 antagonism
d. M1 antagonism
e. 5HT 3A antagonism
f. 5HT 1A agonism
g. 5HT 2A antagonism

A

g. 5HT 2A antagonism

191
Q

A patient with a known, long-standing history of alcohol misuse presents to the emergency department after her friend became worried that she was confused. She is unable to recall what she has done over the past few days and explains how she arrived at the emergency department, which the paramedics confirm to be untrue. It is also challenging to take a history from her as she cannot recall any of her past medical

histories. What vitamin deficiency is this patient suffering from?
a. Folate
b. Thiamine
c. Vitamin D
d. Vitamin K
e. Vitamin B12

A

b. Thiamine

192
Q

A 28-year-old patient with schizophrenia presents to the general practice. On two
occasions he has noticed discharge on his shirt, when inspecting he noticed a milky
fluid was coming from his nipples. He remembers the psychiatrist mentioning
something similar to this could occur with his medication. Which of the following is
the most likely cause of his discharge?
a. Clozapine
b. Risperidone
c. Fluoxetine
d. Olanzapine
e. Quetiapine

A

b. Risperidone

193
Q

Why are patients with Type 2 Diabetes Mellitus less likely to get DKA?

a. Blood glucose levels do not get high enough
b. Hormone sensitive lipase is still inhibited
c. Extrahepatic lipolysis is increased
d. Pancreatic amylase is insufficient

A

b. Hormone sensitive lipase is still inhibited

194
Q

A 55-year-old man sees his GP for follow up of his type 2 diabetes mellitus, which he
has had for 10 years. His HbA1c has risen from 7%-9.9% over the past year despite
increasing his oral gliclazide and metformin to maximum doses. He is very frustrated
because he insists that he is adherent to his medications, eats well and exercises 30
minutes a day. Which of the following is the most likely explanation of his worsening
control?
a. Autonomic neuropathy
b. Declining beta-cell function
c. Diabetic gastroparesis
d. Diabetic nephropathy
e. Increasing insulin resistance

A

e. Increasing insulin resistance

195
Q 
Which of the following would you not expect to see in a patient with diagnosed end-
stage renal disease/CKD?
a. Osteoporosis
b. Anaemia
c. Metabolic acidosis
d. Hypokalaemia
e. Hypertension
A

d. Hypokalaemia

196
Q 
A patient with chronic kidney disease has a hypertension and mild hyperkalaemia.
Which of the following anti-hypertensives has the added bonus of reducing
potassium?
a. Labetalol
b. Ramipril
c. Spironolactone
d. Hydrochlorothiazide
e. Nifedipine
A

d. Hydrochlorothiazide

197
Q

A 56-year-old male presents to the rheumatology clinic with ongoing pain for his
rheumatoid arthritis, he is initiated on ibuprofen for pain control. What effect does
this have on the kidneys?
a. Afferent arteriole dilation
b. Afferent arteriole constriction
c. Efferent arteriole constriction
d. Efferent arteriole dilation

A

b. Afferent arteriole constriction

198
Q

A 52-year-old woman presents complaining of progressive weakness over a period of
several months. She reports tripping over her toes while walking and has dropped a
cup of coffee on one occasion because she felt too weak to keep holding it. A LMN
disorder is suspected. Which of the following would you expect to find, except?
a. Decreased tone
b. Distal greater than proximal weakness
c. Fasciculations
d. Increased tendon reflexes
e. Severe muscle atrophy

A

d. Increased tendon reflexes

199
Q 
A patient presents with numbness over the palmar surface of their thumb, index and
middle finger. They also have a weak pincer grip, wrist flexion and pronation. Which
nerve is affected?
a. Radial
b. Ulnar
c. Musculocutaneous
d. Median
e. Axillary
A

d. Median

200
Q

A person suffers an injury and subsequently loses cutaneous sensation to the space
between the great toe and the 2 nd toe. What nerve has been damaged?
a. Superficial fibular
b. Deep fibular
c. Sural
d. Saphenous
e. Tibial

A

b. Deep fibular

201
Q

A patient suffers a freak accident and resultingly acquires a lesion isolated to the
foramen rotundum. Which of the following will describe the acquired deficit?
a. Inability to lift the eyelid
b. Inability to chew
c. Inability to feel along the angle of the mandible
d. Inability to feel along the upper cheek
e. Absent corneal reflex

A

d. Inability to feel along the upper cheek

V2 damaged

202
Q 
The corticospinal fibres progress through the midbrain into the \_\_\_\_\_\_\_ in the
midbrain
a. Substantia nigra
b. Dorsal column
c. Cerebral peduncle
d. Lateral leminiscus
A

c. Cerebral peduncle

203
Q

What is the structure that divides the lateral ventricles?

a. Thalamus
b. Corpus callosum
c. Septum pellucidum
d. Caudate nucleus

A

Septum pellucidum

204
Q

Which of the following ventricular systems is at the level of the midbrain?

a. Obex
b. Cerebral aqueduct
c. Interventricular foramen (of Monroe)
d. 4 th ventricle
e. Third ventricle
f. Lateral ventricles

A

b. Cerebral aqueduct

205
Q

A patient presents to the ED with stigmata of a subarachnoid haemorrhage. The pupil
is also fixed in the down and out position and is dilated and non-reactive to light. A
berry aneurysm of which of the following vessels would likely lead to this
presentation?
a. AICA Aneurysm
b. SCA Aneurysm
c. MCA Aneurysm
d. Posterior Communicating Aneurysm
e. ACA Aneurysm
f. Anterior communicating Aneurysm

A

d. Posterior Communicating Aneurysm

206
Q

Which of the following is not a nerve root for the long thoracic nerve?

a. C5
b. C6
c. C7
d. C8

A

d. C8

207
Q

A 45-year-old male presents to the GP with a recent shoulder injury. He describes a
sensation of not being able to initiate lifting his up into abduction, but once assisted,
can complete abduction. Which of the following muscles has likely been injured?
a. Deltoid
b. Infraspinatus
c. Teres Major
d. Supraspinatus
e. Teres Minor
f. Subscapularis

A

d. Supraspinatus

208
Q

A 25-year-old footballer presents to the GP with a recent sporting injury. On
examination, she has 3/5 strength on right hip flexion. Given injury to the iliopsoas
muscle, which of the following other muscles can assist in hip flexion?
a. Vastus intermedius
b. Vastus medius
c. Vastus lateralis
d. Gracilis
e. Rectus Femoris

A

e. Rectus Femoris

209
Q 
Which of the following muscles in the posterior thigh is not innervated by the tibial
component of the sciatic nerve?
a. Semimembranosus
b. Semitendinosus
c. Long head of biceps femoris
d. Short head of biceps femoris
A

d. Short head of biceps femoris

210
Q 
A 75-year-old female presents to the ED with a recent FOOSH. AP and Lateral Xrays
reveal a surgical neck of humerus fracture. Which of the following nerves is most
likely to be damaged?
a. Musculocutaneous
b. Radial
c. Median
d. Ulnar
e. Axillary
A

e. Axillary

211
Q

The nuclei of the 2nd order neuron in the spinothalamic tract is in the

a. Dorsal root ganglion
b. Dorsal horn of spinal cord
c. Medulla
d. Thalamus

A

b. Dorsal horn of spinal cord

212
Q

Only one of the cranial nerves come off the dorsal brainstem, while the rest come off

ventrally. Damage to this cranial nerve will result in which deficit?
a. Reduced visual acuity
b. Inability to shrug against resistance
c. Loss of taste in the posterior 1/3 of the tongue
d. Inability to chew
e. Inability to intort the eye

A

e. Inability to intort the eye

213
Q

The facial nerve exists the skull via which structure?

a. Foramen lacerum
b. Internal acoustic meatus
c. Stylomastoid foramen
d. Jugular foramen
e. Foramen ovale

A

c. Stylomastoid foramen

214
Q

Which of the following innervates the Parotid gland?

a. CN VII
b. CN VIII
c. CN IX
d. CN X
e. CN XI

A

c. CN IX (glossopharyngeal)

215
Q 
A 65-year-old diabetic male presents to the GP with impaired gait. On examination,
he has right-sided foot drop. Which of the following nerve roots would describe this
pathology?
a. L1, L2
b. L3, L4
c. L4, L5
d. L5, S1
e. S1, S2
A

c. L4, L5

216
Q

Which of the following is not innervated solely by the femoral nerve?

a. Rectus femoris
b. Vastus medialis
c. Sartorius
d. Iliopsoas
e. Vastus lateralis

A

d. Iliopsoas

217
Q

Which of the following is a muscle of the superficial posterior leg?

a. Semimembranosus
b. Tibialis anterior
c. Rectus femoris
d. Popliteus
e. Plantaris

A

e. Plantaris

218
Q 
Which of the following structures passes through the tarsal tunnel most
anteriorly/superiorly?
a. Posterior tibial artery
b. Tibial nerve
c. Posterior tibial vein
d. Flexor hallucis longus
e. Flexor digitorum longus
f. tibialis posterior
A

f. tibialis posterior

219
Q 
7. Which of the following describes the nerve roots of the nerve that innervates the short
head of biceps femoris?
a. L1-L3
b. L2-L4
c. L4-S2
d. L4-S3
A

c. L4-S2

220
Q

Which of the following muscles is not innervated by the median nerve?

a. Pronator teres
b. Flexor digitorum superficialis
c. Flexor pollicis longus
d. Adductor pollicis
e. Opponens pollicis

A

d. Adductor pollicis

221
Q

Hemineglect would be associated with what stroke syndrome (in majority of

patients) ?
a. Left ACA
b. Right ACA
c. Left MCA
d. Right MCA
e. Left PCA
f. Right PCA

A

d. Right MCA

222
Q

The conus medullaris is around what vertebral level in most people?

a. T12-L1
b. L1-L2
c. L2-L3
d. L3-L4

A

b. L1-L2

223
Q 
A 45-year-old female presents to the ED concerned she is having a stroke. On cranial
nerve examination, you notice she has a left homonymous hemianopia. Where is the
lesion likely located?
a. Left optic nerve
b. Right optic nerve
c. Optic chiasm
d. Left optic tract
e. Right optic tract
A

e. Right optic tract

224
Q

The middle meningeal artery arises from which artery?

a. Inferior alveolar artery
b. Superficial temporal artery
c. Internal carotid artery
d. Facial artery
e. Maxillary artery

A

e. Maxillary artery

JMP Y2S2 (6 decks)

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