Exam

Question 1

Pudendal nerve

Answer 1

• Motor supply to: EAS + EUS in females + ischiocavernosus/bulbospongiosus/levator ani
• Sensory supply to anal canal below pectinate line (bottom 1/3)
• Sensory supply to perianal skin/labia minora, vestibule, posterior aspect labia majora.

Question 2

Hormonal effects of prostaglandin

Answer 2

Paracrine

Question 3

Origin of appendicular artery

Answer 3

Ileocolic artery

Question 4

Estrogen produced in pre-menopausal/reproductive women

Answer 4

Estradiol (E2)

Question 5

Estrogen produced in menopausal years

Answer 5

Estrone (E1)

Question 6

Estrogen produced during pregnancy

Answer 6

Estriol (E3)

Question 7

Type of atom released during MRI to generate image

Answer 7

Hydrogen

Question 8

Risk of neonatal congenital CMV infection if mother contacts in pregnancy (2nd trimester)

Answer 8

30-40% in first/second trimester and 40-70% in third trimester. Affects 0.2-2.2% of all live births.

Question 9

Step infection toxin type

Answer 9

Enterotoxin

Question 10

Commonest fallopian tube malignancy

Answer 10

Serous (Papillary serous cystadenocarcinoma)
Adenocarcinoma if serous not option

Question 11

Commonest feature of warfarin embryopathy

Answer 11

Nasal hypoplasia

Question 12

Max score PUQE (Pregnancy Unique Quantification of Emesis)

Answer 12

Max score = 15
<=6 = mild
7-12 = moderate
13-15 = severe

Question 13

Lung volumes decreased in pregnancy

Answer 13

Functional residual capacity by 20%
Total lung capacity by 5%
Expiratory reserve volume by 20%
PCO2 decreases

Question 14

Lung volumes increased in pregnancy

Answer 14

Tidal volume by 50%
Minute ventilation by 50% during first trimester
PO2 increases
Oxygen consumption by 20%

Question 15

Primary amenorrhea, normal secondary sexual characteristics, normal LH/FSH/E2/TSH, absent uterus and blind-ended vagina.

Answer 15

Karotype 46XX
MRKH syndrome (Müllerian agenesis)

Question 16

LH half life

Answer 16

20 mins

Question 17

Additional risk of miscarriage with amniocentesis

Answer 17

1%

Question 18

Commonest tumor in newborn

Answer 18

Sacrococcygeal teratoma
2nd = neuroblastoma

Question 19

Lithium associated with which anomalies:

Answer 19

Overriding right atrioventricular valve
Right ventricular obstruction outlet
Ebstein anomaly (The tricuspid valve is incorrectly formed and located lower than usual in the heart)

Question 20

Ratio of T4:T3 in blood

Answer 20

14:1

Question 21

Plasmodium species causing heaviest malaria burden

Answer 21

Falciparum

Question 22

Frequency used in transvaginal ultrasound scans

Answer 22

5-10mHz (in TA 2-6 MHZ)
Often quoted as 7.5 mHz

Question 23

Percentage of free T3 in circulation

Answer 23

1%

Question 24

Chancroid causative agent

Answer 24

Haemophilus ducreyi

Question 25

If one parent is a carrier for cystic fibrosis + other parent is unknown, what is the risk of child developing cystic fibrosis?

Answer 25

1%

Question 26

Mode of inheritance for BRCA 1 & 2

Answer 26

Autosomal dominant

Question 27

Psamomma bodies contain which ion?

Answer 27

Calcium

Question 28

Origin of the appendix testis

Answer 28

Paramesonephric duct (Mullerian duct)

Question 29

Where is the Ductus Arteriosus located?

Answer 29

Between pulmonary artery & aorta

Question 30

How does clindamycin work?

Answer 30

inhibiting bacterial protein synthesis at the level of the 50S ribosome

Question 31

How does Metronidazole work?

Answer 31

Binds covalently with DNA
Damage DNA and inhibit DNA synthesis

Question 32

What is the recurrence rate of ectopic in a history of salpingectomy?

Answer 32

15-20%

Question 33

What is the test for hemolytic anaemia in babies?

Answer 33

Direct coombs test

Question 34

Which vitamin deficiency can cause homocysteine increase?

Answer 34

Folic acid or Vitamin B12

Question 35

Most common benign ovarian tumor

Answer 35

Mature teratoma

Question 36

Phase before mitosis

Answer 36

G2

Question 37

RNA analysis is by

Answer 37

Northern blot

Question 38

Heat stable enzyme used in PCR

Answer 38

Taq DNA polymeras

Question 39

Largest cell in the body

Answer 39

Oocyte

Question 40

BMI calculation

Answer 40

Weight (kg) / Height (m2)

Question 41

Epidural anaesthesia given between which layers

Answer 41

Dura mater & vertebrae

Question 42

Which enzyme in renal tubule cells is responsible for production of ammonia?

Answer 42

Glutamines

Question 43

Brenner tumor consists of which kind of cell

Answer 43

Transitional + Squamous

Question 44

Which layers do the sperm pass through during fertilization?

Answer 44

The sperm first burrow through the cells of the corona radiata. Then, upon contact with the zona pellucida, the sperm bind to receptors in the zona pellucida (acrosome reaction)

Question 45

The urethral orifice is present in which space?

Answer 45

Superficial perineal pouch

Question 46

What does methotrexate inhibit?

Answer 46

Dihydrofolate reductase

Question 47

At term, fetus gets cholesterol from which source?

Answer 47

Fetal liver

Question 48

which subtype of lichen planus causes the most symptoms?

Answer 48

Erosive

Question 49

Chances of endometrial cancer with Lynch syndrome (HNPCC)?

Answer 49

60%

Question 50

Vulval lesion on biopsy shows keratin pearls. What is likely diagnosis?

Answer 50

Squamous cell carcinoma

Question 51

Most effective emergency contraception?

Answer 51

Copper IUD

Question 52

During development of liver and biliary system, hepatic bud invaginates into which structure?

Answer 52

Septum transversum

Question 53

Lung cancer + lethargy, fatigue and polyuria + depression. Most likely disturbance?

Answer 53

Hypercalcaemia

Question 54

What vitamin supplement is given during hyperemesis/vomiting in pregnancy?

Answer 54

Vitamin B1 (thiamin)

Question 55

Important cell of adaptive immunity

Answer 55

Lymphocytes

Question 56

TSH mildly high but thyroid hormones normal, is which diagnosis?

Answer 56

Subclinical hypothyroidism

Question 57

Previous pregnancy IGG negative for CMV. Now CMV IGG +ve, cytotoxic IGG value given, IGM -ve. What is the interpretation?

Answer 57

Previously infected, primary and secondary infection status can be assessed.
- Positive CMV IgG results indicate past or recent CMV infection.
- A negative cytomegalovirus (CMV) IgM result suggests that the patient is not experiencing acute or active infection. However, a negative result does not rule-out primary CMV infection.

Question 58

NAAT (RNA) report for chlamydia takes how long?

Answer 58

21 days

Question 59

Number of carbon atoms in estrogen, progesterone, aldosterone, cortisol and androgen?

Answer 59

18 21 21 21 19

Question 60

Fluid filled area or black area on ultrasound scan

Answer 60

Anechoic

Question 61

2,3 DPG in pregnancy, what happens to O2 dissociation curve?

Answer 61

Increase in 2,3 DPG shifts curve to the right

Question 62

which organ will be affected by ACE inhibitors?

Answer 62

Kidney

Question 63

Warfarin teratogenicity develops at which gestational age?

Answer 63

6-9 weeks

Question 64

What is the level of dermatome for epidural at umbilical region?

Answer 64

T10

Question 65

What ligament resists horizontal rotation of the pelvis?

Answer 65

Sacrospinous ligament

Question 66

Cervical screening guidelines:

Answer 66

HR - HPV test

• if negative, routine recall 25-49 3 years + > 50 5 years (25-64)
• if positive –> cytology abornal at all, then for colposcopy.
• If positive –> cytology normal, then re-screen in 12 months. If HPV negaive, then routine recall. If HPV positive + cytology normaly, re-screen in 12 months. If third HPV positive + cytology normal, then return to routine re-call.
• Test for cure 6 months after treatment for any CIN.
• Women with high-grade dyskaryosis or worse are referred straight to colposcopy i.e without HR-HPV test
• For those with negative, borderline change (of squamous or endocervical type), or low-grade dyskaryosis a HR-HPV test is performed.
  If HR HPV Negative test then 3 year recall
  If HR HPV Positive referred back to colposcopy

Question 67

Natural killer cells belong to?

Answer 67

Lymphocytes

Question 68

Levonorgestrel IUS secretion in 24 hours?

Answer 68

20 ug

Question 69

What is the term used for anti-cancer agent methotrexate?

Answer 69

Anti-metabolite

Question 70

Hematopoietic function starts at which gestational age?

Answer 70

6 weeks

Question 71

Cell lysis is by which complement?

Answer 71

C5

Question 72

What is the risk of fetal loss for women who get parvovirus in first trimester?

Answer 72

10%

Question 73

In girls, puberty is indicated by?

Answer 73

Thelarchae

Question 74

Normal physiological changes in pregnancy?

Answer 74

Increase plasma volume
Decrease hematocrit
Decrease plasma protein
Increase in blood volume

Question 75

Major contribution to amniotic fluid by fetal urine from?

Answer 75

18 weeks

Question 76

Prostaglandins are synthesized from?

Answer 76

Unsaturated fatty acids

Question 77

Which structure divides the paramedical and para-rectal pouches?

Answer 77

Uterine artery

Question 78

Which anti-hypertensive should be avoided in pre-eclampsia and asthma?

Answer 78

Nifedipine

Question 79

Which most accurately describes the mode of action of Letrozole?

Answer 79

Aromatase inhibitor

Question 80

IUD in place with discharge

Answer 80

Don’t remove IUD, take vaginal swab and treat

Question 81

Epithelium of fallopian tube

Answer 81

Columnar epithelium - ciliated

Question 82

Hirshprung disease etiology

Answer 82

Abnormality in parasympathetic ganglia

Question 83

Nature of heparin

Answer 83

Polysaccharide

Question 84

Typical effective dose for CT chest

Answer 84

7mSv

Question 85

The placenta is the lower anterior in
which it invades through the myometrium up to the uterine serosa’.

Answer 85

Placenta percreta

Question 86

Placenta attachment definitions:

Answer 86

Accreta: chorionic villi attached to myometrium rather than decidua basalis

Increta: chorionic villi invade into the myometrium.

Percreta: chorionic villi invade through the myometrium

Question 87

CT scan which shows
multiple circumscribed masses in the myometrium. Hysterectomy is performed and
histopathological examination shows spindles shaped cells in whorled bundles and the
mitotic figures are scarce. The most likely diagnosis is?

Answer 87

Leiomyoma

Question 88

An 18-year-old woman has had pelvic discomfort for several months. On pelvic
examination, there is a right adnexal mass. Ultrasound picture of the right ovary shows cystic
lesion measuring 3.3x 2.5 cm with echogenic septae. What is the most likely finding?

Answer 88

Benign teratoma

Question 89

What type of acid–base disturbance results in a case of Conn’s syndrome?

Answer 89

Metabolic alkalosis

Question 90

Where does vulval cancer more commonly arise?

Answer 90

Labia majora

Question 91

What percentage of T4 is free?

Answer 91

0.1%

Question 92

Standard CXR is equivalent to what duration of natural radiation?

Answer 92

10 days

Question 93

Which of the following drugs is used to suppress lactation postpartum in mothers who
suffers from stillbirth?

Answer 93

Cabergoline

Question 94

The non-invasive, cell-free fetal DNA in maternal blood of prenatal diagnosis would best
be used on

Answer 94

Chorionic cells

Question 95

What is used to calculate RMI score?

Answer 95

ultrasound score x ca-125 x menopause score

Question 96

50 years old women with absent periods for 2years, has bilateral ovarian mass with
solid areas on scan and CA 125 of 100. What is her RMI score?

Answer 96

900

Question 97

Which drug trial phase primarily assesses the safety of a drug?

Answer 97

Phase 1

Question 98

Zika virus is

Answer 98

Ss RNA

Question 99

Which substance is indicated by the letter ‘X’ in the diagram below?

Answer 99

Dihydrotestosterone

Question 100

Endometriod - USS picture and laparoscopic picture

Answer 100

Jan 2023 exam

Question 101

Pedunculated fibroid

Answer 101

USS picture

Question 102

Which gene is defect in 21 hydroxylase deficiency

Answer 102

Gene mutation 6p 21

Question 103

Vulvar ca 3a latest figo calcification 2021

Answer 103

<=5mm

Question 104

Metaplasia definition

Answer 104

replacement of one differentiated somatic cell type with another differentiated somatic cell type in the same tissue (epithelial cells changes into other epithelial cells)

Question 105

Dysplasia

Answer 105

Pleomorphism

Question 106

Phenylketonuria - where does it deposit in fetus?

Answer 106

Brain

Question 107

GBS positive with a UTI?

Answer 107

Treat UTI and given intra-partum antibiotics

Question 108

Congenital abnormalities and with their rate - Edward, Turner and Translocation

Answer 108

Edwards = 1/10,000
Turner = 1/3000
Translocation = 1/500

Question 109

How much folic acid should a mother have if her previous baby had anencephaly?

Answer 109

Folic acid 5000 mcg

Question 110

Down syndrome biochemical markers?

Answer 110

Increased B-HCG and Inhibit, rest reduced

Question 111

Most common vulval cancer

Answer 111

squamous cell carcinoma

Question 112

Most common hyperthyroidism in pregnancy

Answer 112

Grave’s disease

Question 113

MRI not suitable to use at which gestation?

Answer 113

10-12 weeks

Question 114

Carbimazole embryopathy causes:

Answer 114

Choanal atresia

Question 115

Cochrane risk of thromboembolic events:

Answer 115

2/100,000-6-12/100,000

Question 116

Mechanism of action of raltegravir:

Answer 116

Integrase inhibitor

Question 117

Mother has Galactorrhea. TSh 15 Fsh 20 lh 20. Cause?

Answer 117

Hypothyroidism

Question 118

Pheochromocytoma signs and symptoms?

Answer 118

Headache, tachycardia and sweating

Question 119

Obturator artery arises from

Answer 119

Internal iliac

Question 120

Hyperaldosteronism with feminisation drug

Answer 120

Spiroletone

Question 121

Granulosa cells produce:

Answer 121

Estrogen

Question 122

Gonorrhoea image on Google

Answer 122

Granules!

Question 123

Hyperemesis gravidarum, which is the best fluid?

Answer 123

0.9% sodium chloride

Question 124

Rate of expulsion of IUD?

Answer 124

1/20

Question 125

Risk of fibroid to change to malignancy?

Answer 125

1/1000

Question 126

Pelvic splenic nerve is what kind?

Answer 126

Pre-ganglionic parasympathetic

Question 127

What is obliterated in the uterine cavity prevent developing pregnancy?

Answer 127

decidua capsularis merges with the decidua parietalis

Question 128

Anti-D doses

Answer 128

• Anti-D i not required for spontaneous miscarriage before 12 gestation, unless there is instrumentation or medical evacuation of the uterus.
• In pregnancies <12 weeks , anti-D prophylaxis is only indicated following ectopic pregnancy, molar pregnancy, therapeutic termination of pregnancy and in cases of uterine bleeding where this is repeated, heavy or associated with abdominal pain.
• <20 weeks gestation = 250 IU within 72 hours
• > 20 weeks gestation = 500 IU within 72 hours

Question 129

Muscles of scrotum?

Answer 129

dartos muscle and the cremasteric muscle

Question 130

Half life of FSH

Answer 130

3-4 hours

Question 131

Opsonization achieved by which compound of complement system?

Answer 131

C3b

Question 132

Obturator artery arises from?

Answer 132

Anterior division of internal iliac artery

Question 133

Pellagra occurs in deficiency of which vitamin?

Answer 133

Niacin (Vitamin B3)

Question 134

Left uterine vein drains into:

Answer 134

Left internal iliac

Question 135

Inferior rectal vein drains into:

Answer 135

Internal pudendal vein

Question 136

HPV vaccine is:

Answer 136

Recombinant/ Subunit Vaccine
subunit (polysaccharide)

Question 137

Vaccines to be avoided in pregnancy?

Answer 137

Live vaccines

Question 138

Artery which is ligated to reduce PPH in cases of morbid adherent placenta (accreta)?

Answer 138

Internal iliac artery

Question 139

Site of glycolysis?

Answer 139

Cytosol

Question 140

Site of urea cycle?

Answer 140

Liver

Question 141

Marfan’s syndrome (mother affected, father not)?

Answer 141

50% - autosomal dominant

Question 142

X-ray image with pointer at SI joint - what structure passes anterior to it?

Answer 142

Ureter

Question 143

Image question: Ilacus muscle marked. What is nerve supply?

Answer 143

Femoral nerve

Question 144

Obturator nerve root values?

Answer 144

L2, L3, L4

Question 145

Lateral wall of ischiorectal fossa formed by:

Answer 145

Obturator internus

Question 146

Nd-YAG, type of laser:

Answer 146

Solid laser

Question 147

Power sensitivity: 90%. What is value of B?

Answer 147

Power = 1-B
0.9 = 1 - B
B = 1 - 0.9
B = 0.1 or 1/10

Question 148

Type of necrosis in brain?

Answer 148

Colliquative (Liquefactive)

Question 149

E-coli urine infection in pregnancy but no symptoms?

Answer 149

Nitrofurantoin for 7 days

Question 150

Which antibiotic should be avoided at term?

Answer 150

Nitrofurantoin

Question 151

What is the site for filtration in kidneys?

Answer 151

Glomerulus

Question 152

SI unit of magnetic field?

Answer 152

Tesla

Question 153

MRI acts by:

Answer 153

• Aligning protons

Question 154

History of old inferior MI on ECG?

Answer 154

Q wave in lead 2, 3, and AVF

Question 155

ECG changes in N pregnancy?

Answer 155

T wave inversion Lead 3

Question 156

What is blood supply to kidney in non-pregnant woman?

Answer 156

20-25%

Question 157

Increase in cardiac output in second stage of pregnancy?

Answer 157

50%

Question 158

Antigen presenting cells in cervix?

Answer 158

Langerhans cells

Question 159

Secretions attack pathogens by? conjunctival secretions protect from bacteria by secreting?

Answer 159

Lysozymes

Question 160

Standard error of mean calculation:

Answer 160

SD/square root of N (sample size)

Question 161

What is a Type 1 error?

Answer 161

• False positive
• occurs if an investigator rejects a null hypothesis that is actually true in the population

Question 162

What is Type 2 error?

Answer 162

• False negative
• investigator fails to reject a null hypothesis that is actually false in the population.

Question 163

What occurs at gastrulation?

Answer 163

Formation of 3 germ layers

Question 164

Cytotrophoblast forms on which day?

Answer 164

Day 8

Question 165

Carbon atoms in estrogen?

Answer 165

18

Question 166

Carbon atoms in testosterone?

Answer 166

19

Question 167

Incidence of rhesus negative population in UK?

Answer 167

15%

Question 168

When does hemolytic disease of newborn occur?

Answer 168

When father is homozygous Rhesus positive + mother is rhesus negative

Question 169

What is the basis of the Kleihauer-Betke test?

Answer 169

Fetal RBCs are resistant to denaturation by acid as compared to maternal RBCs (acid elution test)

Question 170

Brunner’s glands are located in?

Answer 170

Duodenum

Question 171

What is the unit for electrosurgery?

Answer 171

300 Hz - 5 MHz

Question 172

Which nerve passes below the inguinal ligament and medial to ASIS?

Answer 172

Lateral femoral cutaneous nerve/lateral cutaneous nerve of thigh

Question 173

Incidence of which cancer is increased with endometriosis?

Answer 173

Clear cell carcinoma

Question 174

Most common clinical feature of uterine fibroids?

Answer 174

Heavy menstrual bleeding

Question 175

A girl with dysmenorrhea - which treatment is not effective to treat dysmenorrhea?

Answer 175

• Progesterone from Day 21 to Day 28 of cycle.

Treatments that work:
NSAIDs
COCP Pills
GnRH analogues
Progesterone from Day 5 to Day 28 of cycle.

Question 176

Retinol causes teratogenicity during pregnancy due to:

Answer 176

Hypervitaminosis of Vitamin A

Question 177

IgG passes through the placenta via:

Answer 177

Pinocytosis

Question 178

Amino acids transferred across the placenta by which method?

Answer 178

Active transport

Question 179

What is the co-factor for DNA synthesis?

Answer 179

Folic Acid

Question 180

How long do you continue LMWH for patients with hyperemesis gravid arum?

Answer 180

Until patient discharge

Question 181

What is the treatment for patient with hyperemesis and ketonuria +++ who cannot tolerate oral fluids and feeds?

Answer 181

Anti-emetics + 0.9% saline

Question 182

What drug is used for the treatment of herpes simplex?

Answer 182

Aciclovir

Question 183

zidovudine belongs to which class of drug?

Answer 183

Nucleotide reverse transcriptase inhibitor

Question 184

Sexually active girl presents with dome shaped ulcers on her vulva and thighs. Likely diagnosis?

Answer 184

Molluscum contagiosum

Question 185

Patient at booking visit tested for rubella antibodies. IgM -ve + IgG -ve. What is the next step?

Answer 185

Give her MMR vaccine after delivery.

Question 186

Acute hemolytic reaction following blood transfusion occurs because of;

Answer 186

ABO incompatibility

Question 187

Progesterone receptors are?

Answer 187

Nuclear transcription factor

Question 188

Lacunae develops into which layer?

Answer 188

syncytiotrophoblast

Question 189

What is the karyotype of complete mole?

Answer 189

46XX

Question 190

What is the karotype of Turner’s syndrome?

Answer 190

45XO

Question 191

Karotype of male Edward syndrome?

Answer 191

47XY (also written as 47,XY,+18)

Question 192

What are the features of Turner’s Syndrome?

Answer 192

Short stature
Neck webbing
Decreased fertility

Question 193

Dalteparin monitored using which test?

Answer 193

Anti-Xa levels

Question 194

Additional features of Warfarin Embryopathy?

Answer 194

nasal hypoplasia
Slipped epiphysis
IUGR

Question 195

What are the consequences of fetal anticonvulsant syndrome?

Answer 195

• Neural tube defects (spina bifida), particularly with sodium valproate & carbamazepine.
• Congenital heart defects, particularly with phenytoin.
• Orofacial clefts.

What is not associated: hyperplasia of corpus collosum.

Question 196

What epithelium lines the endosalpinx?

Answer 196

Simple columnar

Question 197

Methotrexate acts in what way?

Answer 197

Reversible DHFR inhibitor

Question 198

Arias-Stella phenomenon occurs where?

Answer 198

Endometrium - benign change in the endometrium associated with the presence of chorionic tissue.

Question 199

What change in the endometrium poses a high risk for endometrial carcinoma?

Answer 199

Atypical hyperplasia

Question 200

What test denotes menopausal status?

Answer 200

FSH

Question 201

What test is for ovarian reserve?

Answer 201

AMH

Question 202

Drugs cross across the placenta via which method?

Answer 202

No-ionization

Question 203

The size of the uterus in pregnancy increases due to?

Answer 203

Hypertrophy

Question 204

Cystoscopy done for haematuria - papillary growth seen. What is the likely malignancy?

Answer 204

Transitional cell carcinoma

Question 205

Sequence of events in wound healing

Answer 205

Hemostasis
Inflammation
Proliferation
Maturation
Remodelling

Question 206

pneumocystis jirovecii pneumonia due to HIV. At what CD4 count is prophylaxis to be given?

Answer 206

CD4 < 200

Question 207

What cells are affected by HIV?

Answer 207

CD4 + T-cells

Question 208

Plasma cells originate from?

Answer 208

B lymphocytes

Question 209

In which site are prostaglandins inhibited?

Answer 209

Lungs

Question 210

Discoloration of teeth due to which antibiotic?

Answer 210

Tetracycline

Question 211

Birth weight is which type of data?

Answer 211

Ratio variable

Question 212

Patient complains of greenish discharge and cervix erythematous on examination. Cells under microscope show characteristic HALO around nucleus in shed cells. pH 6 What is the diagnosis?

Answer 212

Trichomonas Vaginalis

Question 213

Patient has yellow discharge and gram negative cocci seen. Diagnosis?

Answer 213

N. Gonorrhoea

Question 214

Fungal agent responsible for UTIs?

Answer 214

Candida

Question 215

What drug causes kernicterus?

Answer 215

Sulfonamide

Question 216

IUCD related infection with sulfur granules seen. Causative organism?

Answer 216

Actinomyces israelii

Question 217

Mechanism of action of IUCD

Answer 217

Inhibits implantation/fertilization

Question 218

Mechanism of action of Fluconazole?

Answer 218

Inhibits Lanosterol 14 alpha-demethylase enzyme and hence ergosterol synthesis.

interruption of the conversion of lanosterol to ergosterol via binding to fungal cytochrome P-450 and subsequent disruption of fungal membranes.

Question 219

Patient develops rash and joint pain. USS shows fetal hydrops/fetal ascites. Likely diagnosis?

Answer 219

Parvovirus B19

Question 220

Patient had infection during pregnancy, baby delivered normal. After 1 year, developed notching of incisors + deafness. Likely diagnosis?

Answer 220

Treponema pallidum

Question 221

Patient comes in with heavy painless vaginal bleeding at 34 weeks pregnant. What should not be done immediately?

Answer 221

Vaginal examination PV

Question 222

Sequence of vessels from left to right: aorta, pulmonary artery, SVC?

Answer 222

SVC, aorta, pulmonary artery

Question 223

What is the screening test fr iron deficiency anaemia?

Answer 223

Hb

Question 224

Patient presents with irregular periods + Normal FSH/TSH + raised Prolactin (1500) + low serum progesterone. Diagnosis?

Answer 224

Pituitary microadenoma

Question 225

Patient post-op with output post-surgery 300 mld. mildly raised urea + creatinine. Diagnosis?

Answer 225

Dehydration

Question 226

Most common cause of hyperthyroidism?

Answer 226

Grave’s disease

Question 227

HPV 16 + 18 responsible for what percent of cervical cancers?

Answer 227

70%

Question 228

Which HPV strains cause genital warts?

Answer 228

HPV strains 6 + 8 + 11

Question 229

Patient presents at 8 weeks pregnant with hyperemesis. Decreased TSH + normal free T4. Diagnosis?

Answer 229

Normal fr 8 weeks pregnancy + repeat later

Question 230

The anterior pituitary develops at:

Answer 230

6-7 weeks

Question 231

What enzyme is used for androgen synthesis in ovary?

Answer 231

3β-Hydroxysteroid dehydrogenase

Question 232

Most common degranulation in a fibroid?

Answer 232

Hyaline

Question 233

What is the steroid synthesis pathway?

Answer 233

DHEA (Dehydroepiandrosterone)–> Androstenedione –> Testosterone

Question 234

The vestibule is between?

Answer 234

Vagina + labia minora/ between two labia minora

Question 235

Patient with amenorrhea + increased FSH/LH + TSH. Diagnosis?

Answer 235

Premature ovarian failure

Question 236

Which is a second generation progesterone?

Answer 236

Levonorgestrel

Question 237

Drospirenone has what special property compared to other synthetic progesterones?

Answer 237

Much higher antiandrogenic potency .

Question 238

Surfactant synthesis in pneumocytes, due to which organelle?

Answer 238

lamellar bodies

Question 239

Technique of bonding for conventional chromosomal analysis?

Answer 239

G-banding

Question 240

GnRH chemical structure

Answer 240

decapeptide

Question 241

Ondansetron acts as antagonist to which receptor?

Answer 241

5HT

Question 242

What is the male equivalent of round ligament in females?

Answer 242

gubernaculum

Question 243

The lower border (lower 2/3) of the vagina develops from:

Answer 243

Urogenital sinus

Question 244

What is the source of fetal cholesterol in late pregnancy?

Answer 244

Fetal liver

Question 245

Mutations in 21-hydroxylase (Congenital adrenal hyperplasia) involves which chromosome?

Answer 245

6p21

Question 246

In Cushing’s disease, what happens to the level of ACTH, cortisol and growth hormone?

Answer 246

Low ACTH, high cortisol, low growth hormone

Question 247

What is down-regulated in cases of recurrent pregnancy losses?

Answer 247

HLA-G

Question 248

Detrusor muscle receptor type?

Answer 248

M3

Question 249

Which muscle doesn’t attach to the perineal body?

Answer 249

Ischiocavernosus

Question 250

The hepatic phase of hematopoiesis begins at what gestational age?

Answer 250

6 weeks

Question 251

Atropine exerts its antagonist action on which receptors?

Answer 251

Acetylcholine

Question 252

striae gravidarum in pregnancy occur due to which hormone?

Answer 252

Cortisol

Question 253

The Kolmogorov–Smirnov is used for?

Answer 253

Non-parametric test used for indifferent data that is unrelated; compare two distributions to determine if they are pulling from the same underlying distribution

Question 254

What is used for delivery of head at pelvic floor?

Answer 254

Outlet instrumental delivery

Question 255

Complications associated with retroverted uterus in pregnancy:

Answer 255

Incarceration of the gravid uterus

Question 256

What term is used for endometrium which is thin?

Answer 256

Atrophic

Question 257

Hyperprolactinemia in PCOS occurs due to:

Answer 257

Unopposed oestrogen

Question 258

During fertilization, sperm penetrates which layer?

Answer 258

Zona Pellucida

Question 259

Caput medusa due to dilation of which embryonic structure?

Answer 259

Umbilical vein

Question 260

Itching in pregnancy at 37 weeks affecting palm + sole + raised AST + bile acids. Diagnosis?

Answer 260

Obstetric cholestasis

Question 261

UTI scenario: drug to be given at 8 weeks. Which to avoid in first trimester?

Answer 261

Trimethorpim

Question 262

UTI scenario: patient given Cephalexin and not responded. Which drug to be given? 37 weeks pregnant.

Answer 262

Trimethoprim

Question 263

What is the mechanism of action of oxytocin?

Answer 263

Activation of phospholipase C and increase in intracellular calcium

Question 264

Most common cause of delayed puberty in males?

Answer 264

Constitutional

Question 265

Pregnant patient at 18 weeks with HIV. Increased AST + low platelets + peripheral smear of fragmented RBCs. Diagnosis?

Answer 265

Thrombotic Thrombocytopenia Purpura

Question 266

Which electrocautery system attaches to a ground plate?

Answer 266

Monopolar diathermy

Question 267

HIV transmission to the baby from other is maximum during:

Answer 267

Delivery

Question 268

what is the most common cause of secondary hyperparathyroidism?

Answer 268

Chronic renal failure

Question 269

What releases calcitonin?

Answer 269

Thyroid

Question 270

LDH is increased in which ovarian tumor?

Answer 270

Dysgerminoma

Question 271

Condyloma lata seen in which stage of syphilis?

Answer 271

Secondary syphilis
1 = chancre
2 = condyloma lata
3 = gumma

Question 272

What is the haldane effect on facilitating exchange at placenta?

Answer 272

Carbon dioxide transfer from the fetus to the mother is facilitated by the Haldane effect (the increased capacity of deoxygenated blood to carry carbon dioxide compared with oxygenated blood).

Question 273

Previous delivery > 4kg baby. Now patient develops prolapse. Which ligament likely to be involved?

Answer 273

Uterosacral/cardinal ligaments

Question 274

Atosiban is:

Answer 274

Oxytocin antagonist

Question 275

The antibacterial action of BenzylPenicillin is due to its effect on?

Answer 275

Cell wall synthesis

Question 276

Warfarin acts where in the clotting cascade?

Answer 276

Vitamin K antagonist

Question 277

Grade B recommendation of RCOG means?

Answer 277

well controlled studies but non randomized

Question 278

RCOG recommendations of evidence.

Answer 278

A = At least one randomized controlled trial
B = well controlled studies but non randomized
C = requires evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities.

Question 279

What is the most common cause of the female urethral caruncle?

Answer 279

Hypoestrogenism

Question 280

What type of variable is ABO Blood Group ?

Answer 280

Nominal

Question 281

Which is a precursor of Serotonin?

Answer 281

Tryptophan

Question 282

Wernicke-Korsakoff syndrome Deficiency disease of vitamin?

Answer 282

Vitamin B1

Question 283

Incidence of “RARE” disease when translated into mathematics is?

Answer 283

1:1000- 1:10,000

Question 284

Which protein is coiled in DNA?

Answer 284

Histones

Question 285

A 65-year-old nulliparous women presents with vaginal spotting. A hysterectomy is
performed, and pathologic examination of the removed uterus reveals heterologous
components of a malignant tumor of the endometrial glands and metaplastic cartilage. Which
of the following is the most likely diagnosis?

Answer 285

Carcinosarcoma

Question 286

Which is the single
mechanism of action for Mirabegron?

Answer 286

Selective Beta-3 antagonist

Question 287

Side effect of Terbutaline:

Answer 287

Maternal tachycardia

Question 288

In ECG which lead reflects the inferior wall of heart?

Answer 288

II, III, aVF

Question 289

What is the embryological origin of Gartners duct cyst?

Answer 289

Mesonephric duct

Question 290

What is the SI unit for the activity of radioactive decay?

Answer 290

Becquerel

Question 291

What is the contrast dye used in MRI scans?

Answer 291

Gadolinium

Question 292

Which hormone increases the excretion of calcium in Kidney?

Answer 292

Calcitonin

Question 293

When Choriocarcinoma metastasizes, it has a predominantly spread by which route ?

Answer 293

Hematogenous

Question 294

What drug can be given in methotrexate toxicity?

Answer 294

Folinic acid

Question 295

40-year-old woman had bilateral silicone breast implants placed two years ago. Since that
time, she has noted increased firmness with slight deformity of the breast on the left. The
implants are removed, and there is evidence for leakage of the implant contents on the left.
Which of the following cell types is most likely to be most characteristic of the inflammatory
response in this situation?

Answer 295

Giant cells

Question 296

Which of the following is contraindication of the use of oxybutynin?

Answer 296

Narrow angle glaucoma

Question 297

A neoplasm of the female genital tract occurring in an 18-year-old girl whose mother was
treated with diethylstilbestrol during the pregnancy is likely to be a:

Answer 297

Clear cell carcinoma of vagina

Question 298

Active form of Vit-D is produced in which organ?

Answer 298

Kidney

Question 299

Patau syndrome karotype:

Answer 299

Trisomy 13

Question 300

Lancefield grouping of streptococci is based on the presence of ?

Answer 300

Carbohydrate antigen on cell wall

Question 301

Antihypertensive which causes postnatal depression, when used in permpartum period?

Answer 301

Methyl dopa

Question 302

Clomifene citrate mechanism of action ?

Answer 302

Selective estrogen receptor modulator

Question 303

Which Antineoplastic drug causes hemorrhagic cystitis?

Answer 303

Cyclophosphamide

Question 304

Luteinizing hormone (LH) is structurally related to what other glycoprotein hormones?

Answer 304

HCG, FSH and TSH

Question 305

Mechanism of action of ulipristal acetate ?

Answer 305

Selective progesterone receptor modulator

Question 306

Which one of the following is the termination of round ligament?

Answer 306

Labia majora

Question 307

Ductus venosus is completely obliterated after birth to form what adult
structure?

Answer 307

Ligamentum venosum

Question 308

A 60-year-old with erythematous erosive lichen planus on the vulva. What type of cancer is linked to lichen planus?

Answer 308

Squamous cell carcinoma

Question 309

Which of the following organisms Colonize copper IUD?

Answer 309

Actinomyces species

Question 310

Bacterial vaginosis is diagnosed with depletion in numbers of which
organism?

Answer 310

Lactobacillus

Question 311

The most common in Utero infection causing fetal anemia in the UK is

Answer 311

Parvovirus B19

Question 312

Sheehan syndrome affects?

Answer 312

Anterior pituitary

Question 313

A 25-year-old woman presents with right-sided pelvic pain for more than one year. An
ultrasound scan is arranged which shows a 5 cm well-defined cystic lesion in the right adnexa
with mixed echoes. There is no fluid in the cul-de-sac

Answer 313

Benign cystic teratoma

Question 314

Cori cycle

Answer 314

metabolic pathway in which lactate, produced by anaerobic glycolysis in muscles, is transported to the liver and converted to glucose, which then returns to the muscles and is cyclically metabolized back to lactate

Question 315

BMI classes:

Answer 315

Healthy weight — BMI of 18.5-24.9 kg/m2.
Overweight — BMI of 25-29.9 kg/m2.
Obesity class 1 — BMI of 30-34.9 kg/m2.
Obesity class 2 — BMI of 35-39.9 kg/m2.
Obesity class 3 — BMI of 40 kg/m2 or more.

Question 316

A 33-year-old woman is admitted with surgical wound infection after emergency
caesarean section for suspected fetal compromise. Culture of the wound demonstrates
methicillin-resistant Staphylococcus aureus (MRSA). She has no known allergies. Which is
the most appropriate treatment?

Answer 316

Clindamycin and vancomycin

Question 317

APGAR Score:

Answer 317

Activity Absent (0) Flexed limbs (1) Active (2)

Pulse Absent (0) <100 (1) >100 (2)

Grimace Floppy (0) Minimal response to stimuli (1) Prompt response to stimuli (2)

Appearance Pale/blue (0) Pink body + blue extremities (1) Pink (2)

Respiration Absent (0) Slow and irregular (1) Vigorous Cry (2)

Max score = 10

Question 318

What is affected in Horner syndrome?

Answer 318

Loss of Sympathetic supply

Question 319

What is the most common cause of cushing’s syndrome?

Answer 319

Iatrogenic Steroid Administration

Question 320

Glucocorticoids are secreted from which region of the adrenal gland?

Answer 320

Zona fasciculata

Question 321

Which cells produce mullerian-inhibiting substance in fetal testis?

Answer 321

Sertoli cells

Question 322

Which enzyme found in red blood cells which buffers blood CO2?

Answer 322

Carbonic anhydrase

Question 323

Urogram interpretation:

Answer 323

Detrusor muscle overactivity

Question 324

Calculation of maternal mortality ratio:

Answer 324

(Number of maternal deaths / Number of live births) X 100,000

Question 325

Calculation of perinatal mortality:

Answer 325

number of stillbirths (from 22 weeks) + deaths in the first week of life per 1,000 total births

Calculation: (stillbirths + neonatal deaths) / (live births + still births)

Question 326

A 67-year-old woman attends for a preoperative assessment. She has been taking
bendroflumethiazide for several years for hypertension. Her ECG shows:

Answer 326

Hypokalaemia

Question 327

A Couple with primary subfertility , who have been trying to conceive for over 12 months
, attends a reproductive medicine clinic , the male partner has already give a semen sample
for analysis which return back showing : 32 million spermatozoa , morphology >5 , vitality
>5% , live spermatozoa 63% , PH 7.2 , What is the correct interpretation of this result ?

Answer 327

Normal semen analysis

Question 328

Regarding Insulin, it gets activated by removing ?

Answer 328

C-peptide

Question 329

What represent the 2 axis of ROC curve ?

Answer 329

Sensitivity Vs 1-Specificity

Question 330

What hormone secreted by placenta leading to fetal diuresis ?

Answer 330

Vasopressinase.

Question 331

A 55 year old presents to clinic due to vulval itch and discolouration. examination reveals
pale white discoloured areas to the vulva. A biopsy shows epidermal atrophy with
subepidermal hyalinization and deeper inflammatory infiltrate. What is this characteristic of?

Answer 331

Lichen Sclerosus

Question 332

What is the Action of mRNA?

Answer 332

Transcription

Question 333

From Which structure inhibin is produced ?

Answer 333

Granulosa cells

Question 334

At what level ovarian artery arise?

Answer 334

L2

Question 335

Which of the muscles leaves the lesser pelvis through the greater sciatic foramen?

Answer 335

Piriformis

Question 336

To reduce postoperative pain after caesarean section, an obstetrician performs ilioinginaliliohypogastric
nerve block (IINB) on his 25-year-old patient. What is the nerve root of
ilioinguinal and iliohypogastric nerve?

Answer 336

L1

Question 337

What is the anatomical location of Bartholin’s gland?

Answer 337

Superficial perineal pouch

Question 338

What do the bottom and top represent on the box-and-whisker plot?

Answer 338

Lower and upper quartile

Question 339

Which hormone prevent regression of corpus luteum?

Answer 339

HCG

Question 340

A 14-year-old girl is treated with radiotherapy. Which of following tissues is most
radioresistant?

Answer 340

Cerebral nuerons

Question 341

Which pattern of endometrium do simple endometrial hyperplasia most likely resemble?

Answer 341

Proliferative endometrium

Question 342

Which class I major histocompatibility complex human leucocyte antigen (HLA) is
expressed only in extravillous trophoblast?

Answer 342

HLA-G

Question 343

Botulinum toxin is now used to treat neurogenic bladder because of its ability to

Answer 343

Inhibit the release of acetylcholine

Question 344

What is the embryonic origin of the trigone of urinary bladder?

Answer 344

Mesonephric duct

Question 345

In the development of the oocyte, when does the second meiotic division occur?

Answer 345

When sperm penetrates the zone pellucida

Question 346

A 28-year-old woman has undergone emergency hysterectomy due to obstetric
haemorrhage during her 3rd pregnancy. The previous pregnancies were both term C-section
deliveries. Examination of the uterus shows the placenta has not invaded the myometrium.
What is the most likely diagnosis?

Answer 346

Placenta accreta

Question 347

The rate of growth hormone secretion follows a circardian rhythm. When is the highest
peak of growth hormone release?

Answer 347

Deep sleep

Question 348

The most biologically active form of vitamin D is

Answer 348

1, 25-Dihydroxycholecalciferol

Question 349

Which muscles form the pelvic diaphragm?

Answer 349

Levator ani and coccygeus

Question 350

A 23-year-old woman who is six weeks by dates is referred to EPU with vaginal
spotting, which continuous today. Ultrasound shows a fetal pole with a CRL of 4 mm. There
is no fetal heart action noted. The ovaries and adnexa appear normal. What is the most likely
diagnosis?

Answer 350

Could be a viable pregnancy

Question 351

A 23-year-old woman attends the antenatal clinic in her first pregnancy. Booking bloods
reveal her Blood group O and her rhesus status to be cde/cde; her long-standing partner is
also tested at her request and his blood group A with rhesus status CDe/CDe. What is the
expected blood group of her fetus?

Answer 351

A positive or O positive

Question 352

The probability of sarcomatous change occurring in fibroid is

Answer 352

0.1%

Question 353

What part of the embryo is the origin of primordial germ cells?

Answer 353

Yolk sac endothelium

Question 354

The greater omentum is derived from which of the following embryonic structures?

Answer 354

Dorsal mesogastrium

Question 355

What electrolyte imbalance can cause paralytic ileus?

Answer 355

Hypokalemia

Question 356

Vasopressin act on increasing water re-absorption at

Answer 356

collecting duct

Question 357

Placement of cup during ventose delivery when the neck is flexed

Answer 357

Sagittal

Question 358

Schiller Duval Bodies is found in

Answer 358

endodermal sinus tumor

Question 359

Second line drugs in hyperemesis:

Answer 359

Metoclopramide, Ondansetron, Prochlorpromazine

Question 360

Most common endocrine disorder in reproductive age group

Answer 360

Polycystic Ovarian Syndrome

Question 361

Structural diagram to which carbon number base will attach? Check photo

Answer 361

1

Question 362

How much in the UK population has RH negative blood group?

Answer 362

15%

Question 363

In Horseshoe Kidney what is the structure preventing the kidney to ascend from pelvis
to abdomen?

Answer 363

inferior mesenteric a.

Question 364

Angle of the vagina with the horizontal while standing

Answer 364

60%

Question 365

Joint which resist horizontal rotation of the pelvis

Answer 365

Ileolumbar

Question 366

Two Most common dermatitis in pregnancy

Answer 366

Polymorphic (PUPP) + Obstetric Cholestasis

Question 367

Most common protozoan causes zoonotic infection(cerebral calcification, retinitis)

Answer 367

Toxoplasma

Question 368

Paroxetine is teratogenic to which organ

Answer 368

Cardiovascular system

Question 369

Which electrolyte is involved in central pontine mylenosis due to fluid overload?

Answer 369

Sodium

Question 370

Vitamin E toxicity

Answer 370

hemorrhage

Question 371

Origin of obturator artery

Answer 371

Internal Iliac

Question 372

At Term G2 wearing seat belt has car accident she has abdominal pain and consults you
for anti D

Answer 372

anti D 500iu

Question 373

Congenital conjunctivitis organism. Purulent discharge 36 hours after birth

Answer 373

Chlamydia trachomatis

Question 374

Piezoelectric used in

Answer 374

USS

Question 375

Transformation Zone

Answer 375

Squamous to glandular metaplasia

Change is: glandular epithelium replaced by squamous epithelium.

Question 376

Alternate complement pathway initiation

Answer 376

C3b

Question 377

Infertility case, Male 190 cm wt 60 kg, testicular volume 5 ml. What is the possible
karyotype

Answer 377

47xxy

Question 378

Target Hgb with oral and IV iron

Answer 378

0.8g/dl/ml

Question 379

18 y/o non penetrative intercourse, + painful ulcers in the vagina

Answer 379

Behchet’s disease

Question 380

Incomplete early miscarriage, bleeding PV, refuse surgical intervention.

Answer 380

Ergometrine

Question 381

HSG is done on what day of cycle

Answer 381

6-12

Question 382

In ECG, T wave represents

Answer 382

Ventricular repolarization

Question 383

Herpes simplex is what type of virus

Answer 383

DsDNA

Question 384

Abnormal LFTs, HbsAg -ve, HbeAg -ve, HbeAb +ve, HbsAb 3miu/hr,HbcAb +ve

Answer 384

Chronic infection ( low infectivity)

HBeAb reactive indicates your body has a high level of antibodies against the hepatitis B virus.

HbeAg It is an indicator of active viral replication; this means the person infected with Hepatitis B can likely transmit the virus on to another person.

Question 385

25 y/o first papsmear , low grade dyskaryosis, next step?

Answer 385

Repeat after 6 months

Question 386

Cauterization of large area with appearance of smoke

Answer 386

Fulguration

Question 387

Pregnancy rate with COCP if perfectly compliant and non perfectly compliant

Answer 387

0.1 perfectly compliant to 5-6 non-compliant

Question 388

INH (Isoniazid) Metabolism is by

Answer 388

Acetylation

Question 389

Risk of VTE with COCP?

Answer 389

3–9 per 10,000 people/ yr

Question 390

Muscles of internal sphincter derived from?

Answer 390

Circular Muscle

Question 391

Cardiac output after delivery

Answer 391

60-80%

Question 392

Where does the inferior rectal vein drain?

Answer 392

Internal pudendal vein

Question 393

IUD+ Pregnancy. What is the risk of Ectopic Pregnancy

Answer 393

1/20

Question 394

Cannon bell mets associated with which tumor marker?

Answer 394

HCG
cannonball metastases is classically seen in germ cell tumor, choriocarcinoma and endometrial cancer.

Question 395

Rate of miscarriage in couples with balanced translocation?

Answer 395

2-5%

Question 396

Lifelong immunity

Answer 396

Adaptive

Question 397

AMENORRHEA with raised TSH, FSH, LH - what is the cause?

Answer 397

Premature ovarian failure

Question 398

Which screening test has high negative predictive value for detection of pre-term pre-labour rupture of membranes?

Answer 398

Fetal fibronectin test

Question 399

The epithelial lining of cervix exterior to transformation zone is whcih tissue time?

Answer 399

stratified squamous non-keratinized

Question 400

Level of the gonadal artery

Answer 400

L2

Question 401

During the inflammatory phase of wound healing what is the predominant cell type
found in the wound during the first 48 hours?

Answer 401

PMNs

Question 402

Glucose transported across the placenta via?

Answer 402

Facilitated Diffusion

Question 403

Gonads are derived from which embryonic layer?

Answer 403

Intermediate Mesoderm

Question 404

Which of the following is true for a patient whose pre-transfusion blood type is group
O?

Answer 404

• AB antigen +ve Anti A and Anti B antibodies

Question 405

Which immunoglobulin is a key to passive neonatal immunity?

Answer 405

IgG

Question 406

What is the normal rate of urine output per hour?

Answer 406

0.5ml/kg/hr

Question 407

Tetanus toxoid vaccine

Answer 407

Toxoided protein

Question 408

Which clotting factors are unchanged in pregnancy?

Answer 408

Factors 11 + 13

Question 409

Which kind of cells secrete calcitonin hormone?

Answer 409

Parafollicular cells

Question 410

What type of cell is a natural killer cell?

Answer 410

Lymphocyte

Question 411

80 y/o no subjective complaints came in for pessary change then with profuse vaginal
discharge. Culture result moderate beta hemolytic streptococcus with coliform and anaerobic
bacteria .

Answer 411

Metronidazole + Clindamycin p.o. X 7 days

Question 412

Why ramifentanyl used in patient controlled analgesia?

Answer 412

Short acting easily metabolized by serum esterase
191.

Question 413

Patient Hypertensive, Gravida 2 in labor 4cm dilated, membranes ruptured
spontaneously clear liquor, CTG showed Baseline FHR 120-130 bpm, good beat to beat
variability, no acceleration, no deceleration. She was on Oxytocin. After 2 hours, Baseline

Answer 413

FBS

Question 414

Diagonal conjugate is the only diameter that can be measured clinically. How is it
measured ?

Answer 414

From Lower border of Symphsis pubis to sacral promontory.

Question 415

During which phase DNA synthesis and chromosome duplication take place

Answer 415

S phase

Question 416

Endometrial tissue found within the myometrium is

Answer 416

Adenomyosis

Question 417

Which of the following depression screening questionnaire are frequently used during
pregnancy?

Answer 417

Edinburgh Postnatal Depression Scale

Question 418

Pain due to ovarian irritation is felt through which spinal segment ?

Answer 418

T10

Question 419

In which phase of oocyte development does zona pellucida apear around ovum ?

Answer 419

primary oocyte

Question 420

Which adverse reaction is common and usually dose related in patients taking misoprostol?

Answer 420

Diarrhea

Question 421

Terbutaline has the following mechanism of action

Answer 421

Beta 2 agonist

Question 422

The ureteric buds is derived from which of the following structures ?

Answer 422

Mesonephric duct

Question 423

Allantois embryonic origin

Answer 423

Endoderm

Question 424

Which of the following antibodies is found as a dimer?

Answer 424

IgA

Question 425

Magnesium excretion

Answer 425

Excreted Unchanged in urine

Question 426

Vitamin A has 2 diet sources. Plant source is carotene and the animal source is…

Answer 426

vitamin A is found as retinol, the ‘active’ form of vitamin A. Liver, including fish liver, is a very good source.

Question 427

Klinefelter’s Syndrome karotype

Answer 427

47,XXY

Question 428

Case of a male with azoospermia and loss of smell(anosmia) diagnosis?

Answer 428

Kallman’s Syndrome

Question 429

A 30 year old women comes to see you and advises she has felt a little unwell with
diarrhoea and flu like symptoms. She is 28 weeks pregnant. A blood culture confirms listeria
infection. What is the appropriate treatment (she has no known dug allergies)?

Answer 429

Amoxicillin

Question 430

CNS is the most affected during teratogenesis. What is the first sensation developed in the
fetus?

Answer 430

Touch

Question 431

What is the mechanism of action of Dibagatran?

Answer 431

Thrombin inhibitor

Question 432

Warfarin acts where in the clotting cascade

Answer 432

factor V precursor

Question 433

Pyramidalis is supplied by which nerve?

Answer 433

Subcostal nerve

Question 434

The pathway of piriformis muscle??

Answer 434

Pelvic surface of sacrum,greater sciatic notch,greater trochanter

Question 435

Which hormone has a structure similar to Prolactin?

Answer 435

Growth Hormone

Question 436

Reciprocal translocation

Answer 436

occur when part of one chromosome is exchanged with another.

Question 437

Robertsonian translocation

Answer 437

one in which, effectively, the whole of a chromosome is joined end to end with another. This type of translocation involves only chromosomes 13, 14, 15, 21 and 22

Question 438

Coronal suture is located in?

Answer 438

between frontal and parietal

Question 439

A pregnant woman desires screening test for down’s syndrome and the following report is
obtained :
Age related risk; 1:1000MoM
AFP; 1.05MoM
β-hCG; 0.85
Test risk; 1:10000
What will you counsel this woman?

Answer 439

It is low risk for down’s syndrome

Question 440

LDH elevates in which type of ovarian ca ?

Answer 440

Dysgerminoma

Question 441

Infection with which one of the following human papillomaviruses (HPVs) is associated with
an increased risk of cervical cancer?

Answer 441

HPV 33

Question 442

Which group of viruses cause molluscum contagiosum?

Answer 442

Pox virus

Question 443

Which enzyme is present in granulosa cells but not in theca cells?

Answer 443

Aromatase

Question 444

Where in body is androgen produced?

Answer 444

Zona reticularis

Question 445

Mother has sickle cell disease married to sickle cell trait husband chance of baby to
having disease?

Answer 445

50%

Question 446

Aspirin and ibuprofen what is the difference in action?

Answer 446

Aspirin Irreversibly inhibit COX 1 and is more selective towards COX 1 than ibuprofen

Question 447

Grade A recommendation of RCOG means

Answer 447

at least one randomized controlled trial

Question 448

Sigmoid Colon - arterial supply + lymph drainage

Answer 448

Inf Mesenteric AND pre aortic LN

Question 449

Drugs readily cross the placenta because of which quality?

Answer 449

High lipid solubility

Question 450

HIV positive patient came with ruptured membranes 38 weeks. Already on HAART. Viral
copies 1450. Management?

Answer 450

Category 3 CS with IV Zidovudine

Question 451

Macrophages are derived from what type of cell?

Answer 451

Monocytes

Question 452

From which organ / system does the Krukenberg tumor of the ovaries originate from?

Answer 452

GIT

Question 453

What type of variable is BMI ?

Answer 453

Continuous

Question 454

Categorical variable

Answer 454

Categorical variable
Categorical variables contain a finite number of categories or distinct groups. Categorical data might not have a logical order. For example, categorical predictors include gender, material type, and payment method.

Question 455

Discrete variable

Answer 455

Discrete variables are numeric variables that have a countable number of values between any two values. A discrete variable is always numeric. For example, the number of customer complaints or the number of flaws or defects.

Question 456

Continuous variables

Answer 456

Continuous variables are numeric variables that have an infinite number of values between any two values. A continuous variable can be numeric or date/time. For example, the length of a part or BMI.

Question 457

Half life of Mifepristone?

Answer 457

25 to 30 hours

Question 458

In pregnancy, what is the total percentage increase in plasma volume by term compared to
a non-pregnant woman?

Answer 458

30 to 50%

Question 459

Motor fibers to detrusor muscle of the urinary bladder are derived from which of the
following nerves?

Answer 459

Pelvic splanchnic

Question 460

During laparoscopy, the remnant of theumbilical artery could be identified sometimes the
it is patent. In the adult the patent segment supplies which vessel?

Answer 460

superior vesical

Question 461

Which is the most common cause of the premature ovarian failure?

Answer 461

idiopathic

Question 462

A male came for infertility check up who was taking Finasteride for treatment of his male
pattern baldness. Finasteride exert its action by inhibition of which enzyme?

Answer 462

5-alpha reductase

Question 463

The enzyme involve in the final oxidation of uric acid?

Answer 463

xanthine oxidase

Question 464

Most enzymes that take part in Kreb’s cycle are located in?

Answer 464

mitochondria

Question 465

Which is precursor of dopamine/catecholamines? .

Answer 465

Tyrosine.

Question 466

What is the most common cause of postmenopausal bleeding?

Answer 466

Atrophic vaginitis and endometritis

Question 467

What is the function of DNA polymerase?

Answer 467

DNA repair

Question 468

Which of the following ovarian Cysts most prone to undergo Torsion ?

Answer 468

Dermoid cyst

Question 469

Patient came in with abdominal pain with history of heavy and painful periods. Exlap was
done which revealed the following:

Answer 469

Ovarian Endometrioma

Question 470

Telogen Effluvium (hair loss) is more pronounced in what stage of pregnancy?

Answer 470

after delivery

Question 471

Natural Killer Cells(NK) is increased significantly at which stage of menstrual cycle?

Answer 471

late secretory

Question 472

Sympathetic supply of bladder largely comes from which nerve?

Answer 472

Hypogastric +Inferior gluteal nerve

Question 473

Which structure in female is homologus to male prostate?

Answer 473

Skenes gland

Question 474

Rate limiting step in the synthesis of catecholamines?

Answer 474

tyrosine hydroxyla

Question 475

The anesthesiologist wanted to anesthesize the anterior andomen using TAP block. In this
procedure where are the nerves mostly located?

Answer 475

between internal oblique and transversus abdominis

Question 476

What is the chemical structure of Renin?

Answer 476

Protein

Question 477

The difference between the peak and the throughs of ultrasound wave is called?

Answer 477

Amplitude

Question 478

There are 3 components of interaction of ultrasound with the tissue medium: absorption,
scattering, and the third one is…

Answer 478

reflection

Question 479

Blood supply to the medial part of the anterior abdominal wall below the umbilicus?

Answer 479

Inferior epigastric artery

Question 480

A primigravida at 22 weeks is scared to have vaginal delivery. On examination she had
absent clitoris and normal labia majora. What type of genital mutilation is it?

Answer 480

Type 1 = (clitoridectomy) – removing part or all of the clitoris
Type 2 = (excision) – removing part or all of the clitoris and the inner labia (the lips that surround the vagina), with or without removal of the labia majora (the larger outer lips)

Type 3 = (infibulation) – narrowing the vaginal opening by creating a seal, formed by cutting and repositioning the labia

Type IV – Other

.All other harmful procedures to the female genitalia for non-medical purposes, eg, pricking, piercing, incising, scraping and cauterising (burning) the genital area..

Question 481

Ovarian CA associated with mutation of mismatch repair genes

Answer 481

endometriod CA

Question 482

What type of necrosis is seen in the heart after an acute myocardial infarction?

Answer 482

Coagulative necrosis

Question 483

Physiological variation in menstrual cycle between 21 to 35 days due to

Answer 483

estrogen fails to produce positive feedback on pituitary

Question 484

A 60-year-old woman with stage IIB cervical cancer is currently undergoing radiotherapy
by impact of gamma-emitting isotopes containing Casieum 137 on her vagina. This type of
therapy is best described by which of the following terms?

Answer 484

Brachytherapy

Question 485

Where is prolactin produced that is not under dopaminergic control?

Answer 485

maternal decidua

Question 486

You see a patient who is 35 weeks pregnant in your day assessment unit. She presents
with itching… more on the area of the abdominal striae. Lab results given which showed
normal ALP, normal bilirubin levels. Diagnosis?

Answer 486

Polymorphic Eruption of Pregnancy

Question 487

27-year-old woman after normal vaginal birth develops shortness of birth and seizures.
Despite resuscitation she died. At autopsy squamous cells and fetal hair are found in lungs.
What is the most likely cause of death?

Answer 487

Amniotic fluid embolism

Question 488

Which one of the following bacteria produces an exotoxin causing ‘toxic shock
syndrome’?

Answer 488

Staphylococcus aureus

Question 489

Which organism is the most common cause of sepsis in pregnancy?

Answer 489

Group A Streptococcus

Question 490

A lady was injured while walking in the garden barefoot. After that she developed
cellulitis.. What’s the possible cause?

Answer 490

Stap aureus

Question 491

There is difficulty in extracting blood in the upper arm, the intern decided to extract
from the femoral vein. What is the relation of the femoral vein to the artery and nerve from
lateral to medial?

Answer 491

Lateral - NAVY - medial

Question 492

Most important complement in opsonization

Answer 492

C3b

Question 493

23-year-old woman presents with fishy foul smelling vaginal odour. ‘Clue cells’ are found
in the smear. Which of the following cell types is belong to ‘Clue cells’?

Answer 493

Epithelial cells

Question 494

A 28-year-old woman with complete hydatidiform mole is found to have
bilateral multiple tiny ovarian cysts along with an enlarged uterus at 12 weeks’ gestational
age. The quantitative β-hCG level of 300,000 mIU/mL.What is the most likely type of these
ovarian cysts?

Answer 494

Theca lutein cyst

Question 495

What is the most common cause of acromegaly?

Answer 495

Pituitary adenoma

Question 496

Labetalol is:

Answer 496

Non selective beta blocker

Question 497

What is the mechanism of action of hydralazine?

Answer 497

Direct acting smooth muscle relaxant

Question 498

A woman experiences a postpartum hemorrhage after delivery and is administrated
carboprost to promote uterine contraction. What type of drug is carboprost?

Answer 498

prostaglandin F2

Question 499

Patient has heavy menstrual bleeding. She desires an endometrial ablation to stop
bleeding after failure of medical treatment. Which part of the uterus is destructed to stop
bleeding?

Answer 499

Basal layer of endometrium

Question 500

A 28-year-old woman has undergone emergency hysterectomy due to obstetric
haemorrhage during her 3rd pregnancy. The previous pregnancies were both term Csection
deliveries. Examination of the uterus shows the placenta had invaded through
the full thickness of the myometrium. What is the most likely diagnosis?

Answer 500

Placenta increta

Question 501

What is the new non invasive prenatal diagnostic test of cell-free fetal DNA of maternal
blood derived from?

Answer 501

Placental Trophoblast

Question 502

Which of the option correctly identified the embryological origin beginning and ending of
the round ligament of the uterus?

Answer 502

Gubernaculum ovarii , ant surface of uterine cornua, labia majus

Question 503

The most common site of endometriosis is?

Answer 503

ovary

Question 504

Which neoplasm is characteristically associated with paraneoplastic syndrome of
inappropriate antidiuretic hormone (SIADH)?

Answer 504

Small cell lung carcinoma

Question 505

Which types of cells are phagocytic for residual bodies left over from the process of
spermiogenesis?

Answer 505

Sertoli cells

Question 506

Insensible loss of water from sweat and lungs in 70 yr old healthy woman is

Answer 506

450ml/kg

Question 507

Which kind of cell produce parathyroid hormone?

Answer 507

chief cells

Question 508

Which chromosomes are capable of robertsonian translocations?

Answer 508

13, 14, 15, 21, 22

Question 509

Which signaling molecule that stimulate the renin-angiotensin system to regulate the
sodium concentration?

Answer 509

Aldosterone

Question 510

Woman climbed up the hill with her friends suddenly felt breathless plus parasthesia in
her hands. What is the acid-base imbalance ?

Answer 510

Respiratory alkalosis

Question 511

What type of acid–base disturbance result in a case of Conn’s syndrome?

Answer 511

Metabolic alkalosis

Question 512

Trichomonas Vaginalis is what kind of protozoa?

Answer 512

flagelated protozoan

Question 513

174.25 y/o had lscs at term for breech presentation with spinal anesthesia After what time
you start low dose molecular heparin(LMWH)

Answer 513

No need for treatment only hydration and mobilization

Question 514

VIN3 is caused by which organism ?

Answer 514

HPV 16

Question 515

Zika virus is

Answer 515

Ss RNA

Question 516

Thrombosis in protein C deficiency is due to

Answer 516

Factor 5 and 8a

Question 517

Transport of iodide in the cells is associated with

Answer 517

Sodium

Question 518

Renal Calculus referred pain

Answer 518

Lumbar region

Question 519

CAH is caused by 21 hydroxylase the remaining is due to?

Answer 519

11b- hydroxylase

Question 520

Embryonic origin of oocytes

Answer 520

primordial germ cell

Question 521

Definition of Tidal Volume

Answer 521

amount of air that goes in and out of the lungs during normal respiration

Question 522

What type of compound is Histones?

Answer 522

Protein

Question 523

Most important function of Vitamin C

Answer 523

collagen formation

Question 524

Indirect Inguinal Hernia is lateral to which arteries?

Answer 524

inferior epigastric arteries

Question 525

Cells in the body produce hormones among them how many are lactotrophs?

Answer 525

10-15%

Question 526

What is the most common cause of endogenous Cushing’s syndrome?

Answer 526

Pituitary adenoma

Question 527

Trophoblast cells that invade the lumen of spiral arteries

Answer 527

endovascular trophoblast

Question 528

HPV proliferate in?

Answer 528

Basal Cell of endometrium

Question 529

Regarding Influenza vaccine , what type of vaccine?

Answer 529

Organism Subunit vaccine + inactivated

Question 530

Which drug antagonises the action of oxytocin?

Answer 530

Atosiban

Question 531

Misoprostol is analogue of which?

Answer 531

PGE1

Question 532

Urea transfer from fetal circulation to maternal circulation?

Answer 532

Passive diffusion

Question 533

Which class of immunoglobulin is primarily secreted in breast milk and protects the infant’s intestinal mucosa from infection?

Answer 533

IgA

Question 534

which Immunoglobin is a pentamer?

Answer 534

IgM

Question 535

What day of a regular 25-day menstrual cycle is a woman likely to ovulate?

Answer 535

11

Question 536

A 32-year-old woman 7 weeks pregnant. Her Chlamydia swab is positive. Which is the single most appropriate treatment?

Answer 536

Erythromycin 500 QDS

Question 537

Which anti-emetic drug has extrapyramidal side effect?

Answer 537

Metoclopramide

Question 538

Pregnant women with Nausea and vomiting. Which fluid should not be given?

Answer 538

5% dextrose

Question 539

Mechanism of action of ondansetrone?

Answer 539

Seretonin HT3

Question 540

A Doctor is making a discharge summary for a women who underwent a laparoscopic saplingo-oophorectomy for Ectopic pregnancy after 4days. You realise that her blood group is O-. What is the best course of action?

Answer 540

Check Partner Blood group & Rh

Question 541

A 19-year-old woman gives birth to her first child. She begins breast feeding the infant. She continues breast feeding for almost a year with no difficulties and no complications. Which of the following cellular processes that occurred in the breast during pregnancy allowed her to nurse the infant for this period of time?

Answer 541

Lobular hyperplasia

Question 542

What is the mode of inheritance of Duchenne muscular dystrophy (DMD)?

Answer 542

X-linked Recessive

Question 542

When should the prophylactic dose of low molecular weight heparin (LMWH) be given post-c-section?

Answer 542

12 hours

Question 543

Remifentanil is an ideal controlled analgesia during labour because

Answer 543

It is rapidly metabolized by tissue estrases

Question 544

Lancefield grouping of streptococci is based on the presence of ?

Answer 544

Carbohydrate antigen on cell wall

Question 545

Mechanism of action of Neostigmine is

Answer 545

Anticholinesterase

Question 546

Coumarin drug antagonise which vitamin?

Answer 546

Vitamin K

Question 547

Which structures passes through the lesser sciatic foramen?

Answer 547

Tendon of obturator internus muscle

Question 548

Which Antineoplastic drugs causing hemorrhagic cystitis?

Answer 548

Cyclophosphamide

Question 549

Mechanism of action of ulipristal acetate ?

Answer 549

Selective progesterone receptor modulator

Question 550

A girl presented to your clinic requesting emergency contraception. LMP 20days ago. h/o unprotected intercourse 7days ago for which she took levonorgestrel. The couple had regular intercourse since then and last night the condom had breeched. What is the best course for action?

Answer 550

No need for additional contraception as levonorgestrel already inhibited ovulation this cycle

Question 551

The following image from ICSI procedure .

Answer 551

First polar body.

Question 552

Side effect of Aminoglycosides is mainly by affection of which of the following nerves?

Answer 552

Vestibulocochlear nerve ( 8th)

Question 553

Regarding Breech presentation, What is the Bi-trochanteric diameter?

Answer 553

10 cm

Question 554

The most common in Utero infection causing fetal anemia in the UK is

Answer 554

Parvovirus B19

Question 555

A 20 week GA women with h/o recent travel to India, presents with fever, chills. Blood test falciparum Vivax +VE. Best treatment?

Answer 555

Choloroquine

Question 556

The Lowest acceptable Hb in second trimester?

Answer 556

10.5 g/dl

Question 557

Pregnant women when exposed to sun, get pigmentation on cheeks & face?

Answer 557

Melasma

Question 558

Mechanism of Action of Indomethacin?

Answer 558

Cyclo-oxygenase Inhibitor

Question 559

Which of the following regions is represented by the arrows ?

Answer 559

Amniotic cavity

Question 560

What is Evidence based medicine?

Answer 560

Using current guidelines for treating individual patients.

Question 561

During laparoscopy you visualize medial umbilical folds. what structure it contains?

Answer 561

Medial Umbilical ligament

Question 562

What is the source for premenopausal Oestrogen secretion?

Answer 562

Granulosa cells

Question 563

41 years old women presents to clinic Complaining of galactorrhea. Labs show: FSH, LH and TSH raised.

Answer 563

Hypothyroidism

Question 564

80 years old women presents to clinic with dysuria, on Examination you notice a growth at urethral orifice exophytic with well circumscribed edges?

Answer 564

Uretheral caruncle

Question 565

which clotting factor does not rise in pregnancy?

Answer 565

XI & XIII

Question 566

You see a patient in antenatal clinic who is 14 week pregnant and is worried. Her 3 year old son has chicken pox. she does not remember if she had chicken pox in past? her lab reports are as follows: Varicella IgG negative Varicella IgM negative

Answer 566

She is not immune to Chicken pox

Question 567

Which cells secrete histamine and serotonin?

Answer 567

Basophils

Question 568

Which Type of Ovarian cancer occurs which BRCA 1 mutation ?

Answer 568

papillary serous cystadenocarinoma.

Question 569

Regarding Varicella Zoster , What its infectivity period?

Answer 569

2 days before rash until the crust appear.

Question 570

Gestation age is which type of data?

Answer 570

Interval

Question 571

Which type of electrosurgical circuits is safest in theatres?

Answer 571

Patient is Attached to pad

Question 572

The deep circumflex iliac artery is a branch of which artery?

Answer 572

External iliac artery

Question 573

Glucocorticoids are secreted from which region of the adrenal gland?

Answer 573

Zona fasciculate

Question 574

Which of the following essential amino acids not found in OMEGA 3 and should be taken from dietry intake ?

Answer 574

α-Linoliec acid

Question 575

Cervical cancer incidence in UK ?

Answer 575

1/3000

Question 576

What is the mechanism of action of Trimethoprim ?

Answer 576

Inhibit dihydrofolate reductase enzyme
Acts on nucleic acid

Question 577

Post-operatively , the nurse noticed an area of burn near attached diathermy plate , what is the mechanism of injury ?

Answer 577

High frequency current focused on small area.

Question 578

What is the measurement of Anteroposterior diameter of pelvic inlet in Engagement ?

Answer 578

11cm

Question 579

What is the site of production of Thromboxane A2 ?

Answer 579

Platelets.

Question 580

What is the site where Urea cycle occurs ?

Answer 580

Liver.

Question 581

What is the Nerve that most commonly injured during Gynecological laparotomy ?

Answer 581

Obturator nerve.

Question 582

The Umbilical artery is branch of ?

Answer 582

Anterior division of internal iliac artery.

Question 583

What is the best investigation to detect receptor status in breast cancer?

Answer 583

Immuno-histochemistry

Question 584

Regarding OOCYTE , when the second meiotic division is completed ?

Answer 584

fertilization

Question 585

Regarding Wound healing process , what is the first stage ?

Answer 585

Hemostasis.

Question 586

Regarding inferior vesical artery , where does it come from ?

Answer 586

Anterior division of internal iliac artery.

Question 587

A 22-year-old primiparous woman books her pregnancy at 11 weeks’ gestation. Her booking blood tests reveal a haemoglobin level of 10.1 g/dL. Electrophoresis reveals haemoglobin karyotype HbAS.

Answer 587

Sickle cell trait

Question 588

A study design is made with a Power sensitivity 90% and P = 0.05 .
What is the chance of type 2 error ?

Answer 588

10%

Question 589

describe Tidal volume ?

Answer 589

The normal volume of air displaced between normal inhalation and exhalation(in and out ) when extra effort is not applied

Question 590

A 28 years old women undergoing a D&C for a missed abortion , develop pain on cervical dilatation , what is the nerve supply of cervix ?

Answer 590

Pelvic splanchnic nerve.

Question 591

A condition where the uterus is bulky and endometrial glands are in myometrium is called ?

Answer 591

Adenomyosis

Question 592

From what structure does ligamentum Arteriosus come from?

Answer 592

Ductus arteriosus

Question 593

What is the incidence of pregnancies complicating by cancer ?

Answer 593

1/1000

Question 594

Which enzymes used in Transcription ?

Answer 594

RNA Polymerase.

Question 595

What is the Direct arterial blood supply of decidua ?

Answer 595

Spiral arteries.

Question 596

What is the component of Placental barrier at term pregnancy?

Answer 596

Syncitiotrophoblast and Endothelium

Question 597

Regarding sex differentiation , at what gestational age does the External genitalia of male and female is Identical/ remain undifferentiated?

Answer 597

6 weeks

Question 598

Which of the following is male homologous of bartholin gland ?

Answer 598

Bulbouretheral gland ( Cowper’s gland )

Question 599

What hormone secreted by placenta leading to fetal diuresis ?

Answer 599

Vasopressinase.

Question 600

Which of the following neurotransmitters secreted onto adrenal medulla?

Answer 600

Acetylcholine

Question 601

A Multiparous women with prolapse , which muscle is most likely to be injured ?

Answer 601

Pubococcygeus.

Question 602

What is the site of production of Ammonia ?

Answer 602

Kidneys

Question 603

55 year old presents to clinic due to vulval itch and discolouration. examination reveals pale white discoloured areas to the vulva.
A biopsy shows epidermal atrophy with subepidermal hyalinization and deeper inflammatory infiltrate.
What is this characteristic of?

Answer 603

Lichen Sclerosus

Question 604

What is the most common solid benign tumour of ovary ?

Answer 604

Benign teratoma

Question 605

A Patient come complaining of a groin pain , a ureteric stone is suspected and Xray is requested , at what level you would expect to see the stone ?

Answer 605

Pelvic brim

Question 606

What is the Action of mRNA ?

Answer 606

Transcription

Question 607

From Which structure inhibin is produced ?

Answer 607

Granulosa cells

Question 608

Which of the following cells is considered the basis for the adaptive immune system?

Answer 608

Lymphocytes

Question 609

Which Immunoglobulin is a Dimer ?

Answer 609

IgA

Question 610

Diagram order of structures - inferior epigastric/medial umbilical/ median umbilical

Answer 610

See picture!

Question 611

What vein arises from the femoral vein and can get injured in subcutaneous tissue during suprapubic insertion?

Answer 611

superficial epigastric vein

Question 612

Superior vesical artery is a direct branch from:

Answer 612

Umbilical artery (branch from anterior division internal iliac)

Question 613

Which artery is most commonly absent?

Answer 613

Middle rectal artery

Question 614

At what point is the aortic bifurcation?

Answer 614

Highest point on iliac crests

Question 615

Ventouse is applied to which suture?

Answer 615

Sagittal suture

Question 616

What is the post-menopausal uterine body:cervical ratio?

Answer 616

1:1

Question 617

What is the embryological origin of the bladder trigone?

Answer 617

mesoderm derived wolffian ducts

Question 618

At 4 weeks, germ cells are present where?

Answer 618

Yolk sac

Question 619

Which cells invade spiral arteries?

Answer 619

Extravillous trophoblasts

Question 620

What is PCR used for?

Answer 620

DNA amplification

Question 621

What is northern blot used for?

Answer 621

Identify RNA sequences

Question 622

What is southern blot used for?

Answer 622

Identify DNA sequences

Question 623

Acute hyperventilation of the mother can cause what sort of fetal acid-base disturbance?

Answer 623

may lead to the development of fetal metabolic acidosis because it induces uterine vasoconstriction

Question 624

Where does paracrine action occur?

Answer 624

Adjacent cells : Paracrine signaling in which cells communicate over relatively short distances by the release (secretion) of small signaling molecules onto nearby cells

Question 625

Which protein forms gap junctions?

Answer 625

Connexins

Question 626

What causes pellagra (dermatitis, diarrhoea, and mental disturbance/dementia)?

Answer 626

Niacin (B3) deficiency?

Question 627

Which enzyme works in the urea cycle?

Answer 627

Carbamoyl phosphate synthetase

Question 628

What is the mechanism of action behind oxytocin causes uterine contractions?

Answer 628

Increase in intracellular calcium

Question 629

Which cells are involved in wound remodeling?

Answer 629

Myofibroblasts

Question 630

postmenopausal woman with ovarian cyst of 5cm - what tumor markers?

Answer 630

None needed - Women with simple ovarian cysts of 50-70 mm in diameter should have yearly ultrasound follow-up and those with larger simple cysts should be considered for either further imaging (MRI) or surgical intervention’

Question 631

What kind of damage does pre-eclampsia cause?

Answer 631

Vascular endothelial damage

Question 632

What is the epithelium outside of the cervical transformation zone?

Answer 632

Stratified squamous epithelium

Question 633

When is the peak GFR in pregnancy?

Answer 633

13 weeks (Renal plasma flow increases by 50-70% in pregnancy), urea + creatinine levels are decreased

Question 634

When does HCG peak?

Answer 634

12 weeks

Question 635

When does HPL plateau?

Answer 635

35 weeks (3rd trimester)

Question 636

What is the major Hb at 32 weeks?

Answer 636

HbF

Question 637

When does adult Hb production start?

Answer 637

28 weeks

Question 638

What is the increase in total/minute ventilation during pregnancy?

Answer 638

40-50%

Question 639

What are the causative agents of bacterial vaginosis?

Answer 639

Gardenella Vaginalis, Mycoplasma genitalium, (third one except trichomonalis)

Question 640

Syphilis patient with positive EIA + TPPA and VDRL test with titre 1:2 (initial titre 1:120). What does this mean?

Answer 640

VDRL used to monitor for re-infection of syphilis or inadequate treatment, but patients might have low levels and not have condition. VDRL do not detect antibodies specific for
syphilis. This is likely past infection that was well treated.

Question 641

When is the test for cure in gonorrhea?

Answer 641

14 days

Question 642

Flu like symptoms in the mother and then baby has rash, hepatosplenomegaly and jaundice. condition?

Answer 642

Listerosis

Question 643

Trichomonas in pregnancy should be treated with what?

Answer 643

Metronidazole

Question 644

What type of bacteria is chlamydia?

Answer 644

gram-negative, anaerobic, intracellular obligates that replicate within eukaryotic cells

Question 645

HBsAG -ve
HbsAB +ve
HBcAB +ve
HbeAB +ve
Diagnosis?

Answer 645

Previous infection

HbsAG = current infection acute or chronic
HbsAB (anti HBS) = immunity due to infection/vaccination
HBcAB (anti HBC) = indicates current or past infection
HBeAB = indicates your body has a high level of antibodies against the hepatitis B virus.

Question 646

Peptide chains in IGG?

Answer 646

2, 4

Question 647

Antigen-antibody complexes are formed in which pathway?

Answer 647

classical pathway

Question 648

Image of direct coombs test

Answer 648

Antibodies are on RBCs

Question 649

What is the function of parathyroid hormone?

Answer 649

Decrease excretion of calcium

Question 650

What is the immediate pre-cursor of testosterone?

Answer 650

Androstenedione (+ Cholesterol)

Question 651

how many sequences do the TRH precursors have?

Answer 651

6

Question 652

Where is HPL produced?

Answer 652

Synctiotrophoblast

Question 653

What has direct action on aldosterone?

Answer 653

Angiotensin 2

Question 654

What is the main regulator of sodium?

Answer 654

Aldosterone

Question 655

Where is ADH + oxytocin synthesized?

Answer 655

Supraoptic + paraventricular nucleus of hypothalamus

Question 656

Main tumor causing hyperprolactinemia?

Answer 656

Adenoma

Question 657

Where is prolactin produced?

Answer 657

Maternal decidua

Question 658

Other than breast and ovary, what cancer is associated with the BRCA gene?

Answer 658

Pancreas

Question 659

What is a low risk screening for down’s syndrome?

Answer 659

1:10,000

Question 660

Oxybutynin side effects include:

Answer 660

Dry mouth, dry eyes, hypohidrosis

Question 661

Nature of Mifepristone:

Answer 661

Anti-progesterone

Question 662

Patient came 8 days after UPSI on Day 16 of her cycle. Which emergency contraception can she use?

Answer 662

No contraception effective

Question 663

Missed single dose COCP - advice?

Answer 663

Take missed pill + continue rest of pack

Question 664

Method of action of the POP?

Answer 664

Thickens cervical mucus

Question 665

Method of action of the IUD/copper IUD?

Answer 665

Inhibits implantation by altering endometrium + inhibition of sperm entry/ inhibits fertilization

Question 666

What is dinoprostone?

Answer 666

PGE2 analogue

Question 667

What is the method of action of botox?

Answer 667

Inhibits release of acetylcholine at neuromuscular junction.

Question 668

Therapeutic dose of LMWH - after how many hours is anesthesia safe?

Answer 668

24 hours

Question 669

Recreational drug use causing placental abruption?

Answer 669

Cocaine

Question 670

Tocolytic which prevents calcium influx?

Answer 670

Nifedipine

Question 671

Hepatitis C advice for breastfeeding

Answer 671

Can breastfeed but pump if nipples cracked/bleeding

Question 672

Diagnosis of diabetes in pregnancy?

Answer 672

FBS = 5.6 or above
2-hour post prandial sugar = 7.8 or above

Question 673

Chicken pox + rash management

Answer 673

STAT Aciclovir

Oral aciclovir should be prescribed for pregnant women with chickenpox if they present within 24 hours of the onset of the rash and if they are 20+0 weeks of gestation or beyond. Use of aciclovir before 20+0 weeks should also be considered
VZIG has no therapeutic benefit once chickenpox has developed and should therefore not be used in pregnant women who have developed a chickenpox rash.

Question 674

If varicella IgG negative and IgM positive, what does this mean?

Answer 674

Acquired varicella infection

Question 675

LMP 1st march with 35 day cycle. what is EDD?

Answer 675

15 december

Calculate due date: first day of LMP then subtract 3 months + add 1 year and 7 days + add difference from 28 day cycle (35- 28 = additional 7 days)

Question 676

Intraoperative cell salvage during CS blood loss?

Answer 676

20% blood loss

Question 677

Patient on anti-epileptics and contraception of choice?

Answer 677

IUS

Question 678

Ductus venosus connects:

Answer 678

umbilical vein + inferior vena cava

Question 679

PCOS biochemistry includes:

Answer 679

Insulin increases
Estradiol decreases
SHBG decreases
Leptin decreases

Question 680

Incidence of 45XO + its mosaicism?

Answer 680

1:3000

Question 681

Mode of inheritance for blood groups?

Answer 681

Co-dominant

Question 682

Which receptor does nicotine bind to that affects neurotransmitter in foetus

Answer 682

Acetylcholine

Question 683

Function of BRCA

Answer 683

Tumour suppressor gene

Question 684

Coagulation factors that increase during pregnancy

Answer 684

Factor VII, VIII, IX, X, plasminogen

Question 685

Structure lateral to internal iliac artery

Answer 685

Ureter

Question 686

Ovary originates from:

Answer 686

Mesoderm

Question 687

Cleft palate results from:

Answer 687

Failure of development of 1st pharyngeal arch

Question 688

Derivatives of 2nd pharyngeal arch:

Answer 688

stapedial artery, epiglottis, facial nerve

Question 689

Proximal internal carotid artery derived from :

Answer 689

3rd pharyngeal arch

Question 690

Phosphate excreted by:

Answer 690

Kidneys

Question 691

Site where active form of Vit D produced :

Answer 691

Kidney

Question 692

Nerve supply to structure below umbilicus :

Answer 692

Inferior hypogastric nerve

Question 693

You intend to prescribe COCP to 4 wks postpartum woman, not breastfeeding. How long should additional contraception be used:

Answer 693

7 days

Question 694

Source of Vit K1 :

Answer 694

Leafy green vegetables

Question 695

Pt came with fever, abdominal pain, hypotension, tachycardia. Worsening of sepsis and inflammation in pregnancy due to :

Answer 695

Up regulation of nitric oxide and PG

Question 696

Screening test for iron deficiency anaemia :

Answer 696

Serum iron

Question 697

40% of pt with PCOS have hyperprolactinemia because?

Answer 697

Estradiol excess leading to hyperprolactinemia

Question 698

Pregnancy 3 fold increase cortisol. Mechanism :

Answer 698

Cortisol increased by increased unopposed oestrogens

Question 699

Prolactin levels in pregnancy compared to pre-pregnancy :

Answer 699

50 fold increase (20-50 folds)

Question 700

Structure passing through deep inguinal ring visualised easily on laparoscopy :

Answer 700

Round ligament

Question 701

Ligament arising from lateral border of cervix and attached to endopelvic fascia :

Answer 701

Cardinal ligament

Question 702

Structure supplying majority of midgut branches from aorta at which level?

Answer 702

L1

Question 703

Structure supplying majority of hindgut branches from aorta at which level?

Answer 703

L3

Question 704

Main blood supply of transverse colon :

Answer 704

Middle colic artery

Question 705

Sutures enclosing largest fontanelle :

Answer 705

Frontal, coronal, saggital

Question 706

Diameter(s) widest in mid pelvis :

Answer 706

AP, oblique, transverse

Question 707

Foetus born with absence of mastoid process. Which structure is at increased risk of damage during delivery :

Answer 707

CN VII

Question 708

Alcohol group attached to which carbon atom of prostaglandin structure :

Answer 708

C 20/ C15 (best answer)

Question 709

Name the structure (picture)

Answer 709

Colle’s fascia

Question 710

Term for condition in which statistical difference occurs purely by chance :

Answer 710

Type I error

Question 711

Major estrogen produced by placenta :

Answer 711

Estriol

Question 712

Healthy normal adult, what is the response to a fall in blood glucose :

Answer 712

Decreased insulin, increased glucagon

Question 713

Type of treatment where a device is inserted into vagina to deliver radioactive substance :

Answer 713

Brachytherapy

Question 714

Type of electrosurgery used in laparoscopy where a pad is placed on patient :

Answer 714

Monopolar diathermy

Question 715

USG phase with best resolution :

Answer 715

Axial

Question 716

USG process causing lysis of cell and damage :

Answer 716

Heating/cavitation

Question 717

Pt with underlying Chron’s disease presented with had numbness. Had hx of bowel resection. Hb 10.5, MCV 122. Likely cause of symptoms :

Answer 717

Vit B12 deficiency

Question 718

Pt complained of perioral numbness and spasm over upper limbs. *Diagram showed pic of ECG : Prolonged QT interval. Likely electrolyte abnormality :

Answer 718

Hypocalcemia

Question 719

Hepadnavirus containing DNA, can be transmitted via needle sharing, blood transfusion :

Answer 719

Hepatitis B

Question 720

Lady with generalised fatigue. Non-pregnant. Done LFT
ALP 230 ( raised ). ALT, GGT, Alb, Bili within normal range. Possible dx :

Answer 720

Vitamin D deficiency

Question 721

Best sample for dx of chlamydia :

Answer 721

Endocervical swab

Question 722

Features of neonatal herpes :

Answer 722

pneumonitis + mucous membrane vesicles

Question 723

Dx criteria in Amsel’s criteria :

Answer 723

clue cells on wet mount, vaginal pH >4.5, amine odor when vaginal fluid is exposed to 10% potassium hydroxide, and abnormal vaginal discharge.

Question 724

Absolute contratindication in pt with hx of pulmonary embolism :

Answer 724

COCP

Question 725

20 y/o, had large complex ovarian cyst 30cm. Suggested tumour markers :

Answer 725

Ca-125
LDH
AFP
HCG

Question 726

Origin of Ca 125 :

Answer 726

Coelomic epithelial structures

Question 727

Ig that crosses placenta from mother to foetus :

Answer 727

IgG

Question 728

Likely test to give biological false +ve for syphilis :

Answer 728

VDRL

Question 729

Pt 22 y/o presented with prolonged heavy menses. Had heavy menses since menarche. Pt is otherwise well. Took CBC. Additional investigations :

Answer 729

Coagulation

Question 730

Rheumatoid arthritis less frequently flare up in pregnancy. Which mechanism contributes to this?

Answer 730

Suppression of T helper 1

Question 731

MoA nifedipine :

Answer 731

Decrease PVR

Question 732

E. coli belongs to :

Answer 732

Enterobacteriaceae

Question 733

Action of antibiotics that renders bacteria inactive, but does not kill bacteria :

Answer 733

Bacteriostatic

Question 734

Group of abx treatment for syphilis infection :

Answer 734

Penicillin

Question 735

Foetal head at level of pelvic floor, requires operative delivery. Type of delivery :

Answer 735

Outlet delivery

Question 736

% or Brenner tumour with malignant change :

Answer 736

5%

Question 737

Pt no known medical illness, not on meds. Has red papules over bilateral labia majora 20mm, 10mm until natal area. + lesions at umbilicus. Speculum examination normal. Hair, skin, nails normal. Likely dx :

Answer 737

Eczema

Question 738

Pt day 1 post hysterectomy. Na 123. K, Urea, Creat normal range. Possible cause :

Answer 738

Excessive IV dextrose

Question 739

Pt amenorrhea 5 wks. UPT strongly +ve. USG sac-like structure 2mm, eccentric location, ectopic pregnancy cannot be ruled out. Likely BHCG levels that correspond to the findings :

Answer 739

1200

Question 740

Anterior pelvic compartment prolapse. Pt underwent op, done sling via transabdominal route. Most important ligament for the procedure :

Answer 740

Iliopectineal

Question 741

HLA types that down-regulated in pregnancy

Answer 741

HLA-A + HLA-B

Question 742

PG with highest level pre-menstruation :

Answer 742

PGE2

Question 743

Advantage of PGE 2 vs PGE 1 analogue :

Answer 743

More effective at cervical ripening

Question 744

Defective structure in thalassemia :

Answer 744

Globin

Question 745

Baby with extra chromosome 18 with limb abnormalities :

Answer 745

Edward syndrome

Question 746

Rett syndrome associated with profound neurological impairment. Mode of inheritance :

Answer 746

X-linked dominant

Question 747

In males, FSH secreted by :

Answer 747

Sertoli cells

Question 748

Enzyme for androgen synthesis in ovary :

Answer 748

Aromatase

Question 749

Pt with primary amenorrhoea, scant pubic and axillary hair. Hx of bilateral inguinal hernia in her childhood. Dx :

Answer 749

Androgen insensitivity syndrome

Question 750

Treatment for central precocious puberty :

Answer 750

GnRH analogue

Question 751

Class of drugs associated with hyperprolactinemia :

Answer 751

Antiemetics

Question 752

Types of bile acid :

Answer 752

Cholic and chenodeoxycholic acid

Question 753

Methods that reduce risk of SSI during C-sec according to RCOG :

Answer 753

Antibiotics before skin incision

Question 754

Pt presents with hyperemesis, 8 wks amenorrhoea. T4 0.04 (↓), TSH 18 (N). Interpretation :

Answer 754

Normal findings for 8 wks pregnancy

Question 755

Pt experiencing PPH. Given oxytocin. Onset of action of oxytocin :

Answer 755

5 mins

Question 756

Pt presents with amenorrhoea, diagnosed with anorexia nervosa. BMI 18 dropped to
16. Likely cause of amenorrhoea :

Answer 756

Hypogonadism

Question 757

Structure on HIV allowing it to enter cells :

Answer 757

Glycoprotein

Question 758

What is the best way to perform intermittent auscultation during 1st stage of labour :

Answer 758

Immediately after contraction, for at least 1 minute, every 30 mins

Question 759

Minimum amount of sperm concentration per mL of ejaculate :

Answer 759

15 000 000

Question 760

Agent that cannot be used as tocolytic :

Answer 760

Prostacyclin

Question 761

Pain score is what type of variable :

Answer 761

Ordinal

Question 762

Measured blood loss type of variable :

Answer 762

Ordinal

Question 763

Adverse effect of COCP

Answer 763

Irregular bleeding

Question 764

In what active disease is COC contraindicated

Answer 764

SLE

Question 765

Rotterdam criteria requires biochemical evidence of :

Answer 765

Hyperandrogenism

Rotterdam criteria for PCOS:
oligo‐anovulation, hyperandrogenism and polycystic ovaries (≥ 12 follicles measuring 2‐9 mm in diameter and/or an ovarian volume > 10 mL in at least one ovary).

Question 766

Gestation at which differentiation of external genitalia occurs :

Answer 766

9-11 wks

Question 767

What substance is secreted by granulosa cells :

Answer 767

Oestrogen

Question 768

Erythrocytes formed from :

Answer 768

Pluripotent haematopoetic stem cells

Question 769

Percentage of non-epithelial ovarian Ca :

Answer 769

10%

Question 770

βHCG is a tumour marker for :

Answer 770

Choriocarcinoma

Question 771

Identify structure: umbilical artery/vein

Answer 771

Umbilical vein

Question 772

True statement regarding inheritance of achondroplasia :

Answer 772

Roughly equal number of males and females affected

Question 773

Non-ergot agent used to supress lactation postpartum :

Answer 773

Quinagolide

Question 774

Enzyme for conversion of testosterone to DHT :

Answer 774

5 alpha-reductase

Question 775

Histamine released from :

Answer 775

Mast cell, eosinophil, basophil

Question 776

Oxytocin cannot be given orally because :

Answer 776

Destroyed by gastric juice

Question 777

15 y/o British came to see you for contraceptive advice, does not wish to let parents know. Which guideline will you follow?

Answer 777

Fraser guideline

Question 778

Pt underwent surgery for ovarian mass. Histology showed benign spindle shaped cells. Dx :

Answer 778

Fibroma

Question 779

From what arch does the ligamentum arteriosum come?

Answer 779

6th arch

Question 780

What amount of hormone released from Mirena/24 hours?

Answer 780

20mcg/24 hours

Question 781

Patient has increased FSH, LH + TSH =

Answer 781

premature ovarian failure

Question 782

Patient complaining of cold intolerance + increase TSH

Answer 782

Hashimoto’s

Question 783

Type of ovarian cancer with association of mismatch repair?

Answer 783

Endometroid Ca

Question 784

Likelihood of pneumonitis with chicken pox?

Answer 784

1/400 = .25%

Question 785

HIV Pregnancy guidelines

Answer 785

• Viral load should be checked at 36 weeks then delivery planned as follows:
• < 50 HIV RNA copies/mL = vaginal delivery
• 50–399 = PLCS considered
• ≥400 HIV = PLCS

Zidovudine Infusion

• Indicated for women with a viral load of >1000 HIV RNA copies/mL who present in labour or with ruptured membranes or who are admitted for planned CS
• Indicated for women presenting in labour or with ruptured membranes in whom the current viral load is not known
• Women taking zidovudine monotherapy

nfant Antiretroviral therapy(ART)

Very low risk =
Mother has been on cART for longer than 10 weeks and
Two documented maternal HIV viral loads <50 HIV RNA copies/mL during pregnancy
at least 4 weeks apart and
Maternal HIV viral load <50 HIV RNA copies/mL at or after 36 weeks
2 weeks zidovudine monotherapy

Low risk
maternal viral load <50 HIV RNA copies/mL at 36 weeks or
maternal viral load <50 HIV RNA at time of delivery if born prematurely
4 weeks zidovudine monotherapy

High risk = Combination PEP

Question 786

Post-menopausal woman had one episode of vaginal bleeding. ET 1.2mm

Answer 786

No further action + return if bleeding continues

Question 787

Post CS, absorbable sutures, nodule at stitch line, cells for inflammation

Answer 787

Neutrophils

Question 788

HIV patient with viral load > 16000, when should anti-viral HAART be started?

Answer 788

ASAP after 16 weeks

Question 789

Anti-epileptic affected by increased renal flow?

Answer 789

Lamotrigine

Question 790

Magnesium excreted by?

Answer 790

Excreted unchanged by kidneys

Question 791

Chlamydia transmittion from mother to her foetus via :

Answer 791

Direct contact

Question 792

Pseudomonas appear on macconey agar :

Answer 792

colourless

Question 793

Prophlaxis of malaria during pregnancy :

Answer 793

Mefloquin in 2nd and 3rd trimester

Question 794

Exotoxins:

Answer 794

Heat labile
Secreted by gram positive
Susceptible to antibodies
Higher toxicity

Endotoxins = gram negative

Question 795

Preg. With flu like symptoms & backache ,baby Delivered with resp. depression,jaundice & hepatosplenomegaly :

Answer 795

Listeria

Question 796

Treatment of vulvovaginal atrophy includes :

Answer 796

estriol and phytoestrogens

Question 797

Most common non-epithelial vaginal cancer:

Answer 797

Rhabdomyosarcoma

Question 798

SI unit of diathermy power

Answer 798

Watt

Question 799

Cutoff of fibronectin level in screen of preterm labour

Answer 799

50ng

Question 800

Rate of recurrence of pre eclampsia

Answer 800

16%-20%

Question 801

Rate of CMV to be symptomatic for the baby:

Answer 801

10-15%

Question 802

Pendrin protein used in thyroid synthesis , which ion is exchanged for iodine:

Answer 802

Cl−/HCO3−

Question 803

Definition of minor PPH:

Answer 803

500-1000 loss without shock

Question 804

70 kg ptn,Maximum safest dose of lidocaine:

Answer 804

49 with adrenaline

Question 805

Doxazosin MOA

Answer 805

Alpha-1 antagonist

Question 806

Complement system , initial cascade that end by cell lysis

Answer 806

C3 complement

Question 807

Six differentiation is due to gene on:

Answer 807

Short am of y chromosome

Question 808

False and true data variable:

Answer 808

Nominal (binary)

Question 809

In sexual arousal engorgement of bulb of vestibule is dt:

Answer 809

Dorsal nerve of clitoris OR labial branch of perineal nerve.

Question 810

In male most of ejaculate come from:

Answer 810

Seminal vesicles

Question 811

Nerve supply of area over femoral triangle?

Answer 811

Genitofemoral nerve

Question 812

Percentage of DM type 2 after GDM

Answer 812

40-60%

Question 813

Dose of radiation to breast tissue used in CTPA

Answer 813

20

Question 814

Oncogenes in Lynch Syndrome:

Answer 814

MSH2/methylation MLH1/MSH6

Question 815

N.s of internal anal sphincter?

Answer 815

Sympathetic L5, parasympathetic S2, 3, 4

Question 816

USS has the best resolution in which plane?

Answer 816

Axial

Question 817

Semen analysis all normal except morphology 3%

Answer 817

Morphology > 4% = normal but morphology very unreliable measurement
Normal

Which numbers should we focus on?
Sperm concentration should be >20million <5: difficult to conceive naturally

Total motility should be >40%
< 20: difficult to conceive naturally

Question 818

What kind of junctions in the uterus?

Answer 818

Gap junctions

Question 819

GNRH secreted where other than hypothalamus?

Answer 819

Liver

Question 820

Painless ulcer & enlarged LN & diagnosed by serology

Answer 820

treponema pallidum

Question 821

Lower 2/3 of vagina developed from:

Answer 821

sinovaginal bulbs (derived from the pelvic part of the urogenital sinus)

Question 822

Non penetrative intercourse , shallow painful genital ulcer

Answer 822

Behçet disease

Question 823

Fetal hemolysis detected by:

Answer 823

direct Coombs’ test is the test usually used to identify hemolytic anemia. [The indirect Coombs’ test is used only in prenatal testing of pregnant women and in testing blood prior to a transfusion.]