- 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.

Exam Flashcards by Alaska Burton

Pudendal nerve

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.

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Hormonal effects of prostaglandin

Paracrine

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Origin of appendicular artery

Ileocolic artery

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Estrogen produced in pre-menopausal/reproductive women

Estradiol (E2)

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Estrogen produced in menopausal years

Estrone (E1)

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Estrogen produced during pregnancy

Estriol (E3)

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Type of atom released during MRI to generate image

Hydrogen

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

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

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Step infection toxin type

Enterotoxin

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Commonest fallopian tube malignancy

Serous (Papillary serous cystadenocarcinoma)
Adenocarcinoma if serous not option

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Commonest feature of warfarin embryopathy

Nasal hypoplasia

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Max score PUQE (Pregnancy Unique Quantification of Emesis)

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

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Lung volumes decreased in pregnancy

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

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Lung volumes increased in pregnancy

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

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

Karotype 46XX
MRKH syndrome (Müllerian agenesis)

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LH half life

20 mins

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Additional risk of miscarriage with amniocentesis

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Commonest tumor in newborn

Sacrococcygeal teratoma
2nd = neuroblastoma

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Lithium associated with which anomalies:

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

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Ratio of T4:T3 in blood

14:1

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Plasmodium species causing heaviest malaria burden

Falciparum

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Frequency used in transvaginal ultrasound scans

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

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Percentage of free T3 in circulation

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Chancroid causative agent

Haemophilus ducreyi

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

Mode of inheritance for BRCA 1 & 2

Autosomal dominant

Psamomma bodies contain which ion?

Calcium

Origin of the appendix testis

Paramesonephric duct (Mullerian duct)

Where is the Ductus Arteriosus located?

Between pulmonary artery & aorta

How does clindamycin work?

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

How does Metronidazole work?

Binds covalently with DNA Damage DNA and inhibit DNA synthesis

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

15-20%

What is the test for hemolytic anaemia in babies?

Direct coombs test

Which vitamin deficiency can cause homocysteine increase?

Folic acid or Vitamin B12

Most common benign ovarian tumor

Mature teratoma

Phase before mitosis

RNA analysis is by

Northern blot

Heat stable enzyme used in PCR

Taq DNA polymeras

Largest cell in the body

Oocyte

BMI calculation

Weight (kg) / Height (m2)

Epidural anaesthesia given between which layers

Dura mater & vertebrae

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

Glutamines

Brenner tumor consists of which kind of cell

Transitional + Squamous

Which layers do the sperm pass through during fertilization?

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)

The urethral orifice is present in which space?

Superficial perineal pouch

What does methotrexate inhibit?

Dihydrofolate reductase

At term, fetus gets cholesterol from which source?

Fetal liver

which subtype of lichen planus causes the most symptoms?

Erosive

Chances of endometrial cancer with Lynch syndrome (HNPCC)?

60%

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

Squamous cell carcinoma

Most effective emergency contraception?

Copper IUD

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

Septum transversum

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

Hypercalcaemia

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

Vitamin B1 (thiamin)

Important cell of adaptive immunity

Lymphocytes

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

Subclinical hypothyroidism

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

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.

NAAT (RNA) report for chlamydia takes how long?

21 days

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

18 21 21 21 19

Fluid filled area or black area on ultrasound scan

Anechoic

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

Increase in 2,3 DPG shifts curve to the right

which organ will be affected by ACE inhibitors?

Kidney

Warfarin teratogenicity develops at which gestational age?

6-9 weeks

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

T10

What ligament resists horizontal rotation of the pelvis?

Sacrospinous ligament

Cervical screening guidelines:

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

Natural killer cells belong to?

Lymphocytes

Levonorgestrel IUS secretion in 24 hours?

20 ug

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

Anti-metabolite

Hematopoietic function starts at which gestational age?

6 weeks

Cell lysis is by which complement?

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

10%

In girls, puberty is indicated by?

Thelarchae

Normal physiological changes in pregnancy?

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

Major contribution to amniotic fluid by fetal urine from?

18 weeks

Prostaglandins are synthesized from?

Unsaturated fatty acids

Which structure divides the paramedical and para-rectal pouches?

Uterine artery

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

Nifedipine

Which most accurately describes the mode of action of Letrozole?

Aromatase inhibitor

IUD in place with discharge

Don't remove IUD, take vaginal swab and treat

Epithelium of fallopian tube

Columnar epithelium - ciliated

Hirshprung disease etiology

Abnormality in parasympathetic ganglia

Nature of heparin

Polysaccharide

Typical effective dose for CT chest

7mSv

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

Placenta percreta

Placenta attachment definitions:

Accreta: chorionic villi attached to myometrium rather than decidua basalis Increta: chorionic villi invade into the myometrium. Percreta: chorionic villi invade through the myometrium

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?

Leiomyoma

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?

Benign teratoma

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

Metabolic alkalosis

Where does vulval cancer more commonly arise?

Labia majora

What percentage of T4 is free?

0.1%

Standard CXR is equivalent to what duration of natural radiation?

10 days

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

Cabergoline

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

Chorionic cells

What is used to calculate RMI score?

ultrasound score x ca-125 x menopause score

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?

900

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

Phase 1

Zika virus is

Ss RNA

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

Dihydrotestosterone

Endometriod - USS picture and laparoscopic picture

Jan 2023 exam

Pedunculated fibroid

USS picture

Which gene is defect in 21 hydroxylase deficiency

Gene mutation 6p 21

Vulvar ca 3a latest figo calcification 2021

<=5mm

Metaplasia definition

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

Dysplasia

Pleomorphism

Phenylketonuria - where does it deposit in fetus?

Brain

GBS positive with a UTI?

Treat UTI and given intra-partum antibiotics

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

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

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

Folic acid 5000 mcg

Down syndrome biochemical markers?

Increased B-HCG and Inhibit, rest reduced

Most common vulval cancer

squamous cell carcinoma

Most common hyperthyroidism in pregnancy

Grave's disease

MRI not suitable to use at which gestation?

10-12 weeks

Carbimazole embryopathy causes:

Choanal atresia

Cochrane risk of thromboembolic events:

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

Mechanism of action of raltegravir:

Integrase inhibitor

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

Hypothyroidism

Pheochromocytoma signs and symptoms?

Headache, tachycardia and sweating

Obturator artery arises from

Internal iliac

Hyperaldosteronism with feminisation drug

Spiroletone

Granulosa cells produce:

Estrogen

Gonorrhoea image on Google

Granules!

Hyperemesis gravidarum, which is the best fluid?

0.9% sodium chloride

Rate of expulsion of IUD?

1/20

Risk of fibroid to change to malignancy?

1/1000

Pelvic splenic nerve is what kind?

Pre-ganglionic parasympathetic

What is obliterated in the uterine cavity prevent developing pregnancy?

decidua capsularis merges with the decidua parietalis

Anti-D doses

- 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

Muscles of scrotum?

dartos muscle and the cremasteric muscle

Half life of FSH

3-4 hours

Opsonization achieved by which compound of complement system?

C3b

Obturator artery arises from?

Anterior division of internal iliac artery

Pellagra occurs in deficiency of which vitamin?

Niacin (Vitamin B3)

Left uterine vein drains into:

Left internal iliac

Inferior rectal vein drains into:

Internal pudendal vein

HPV vaccine is:

Recombinant/ Subunit Vaccine subunit (polysaccharide)

Vaccines to be avoided in pregnancy?

Live vaccines

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

Internal iliac artery

Site of glycolysis?

Cytosol

Site of urea cycle?

Liver

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

50% - autosomal dominant

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

Ureter

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

Femoral nerve

Obturator nerve root values?

L2, L3, L4

Lateral wall of ischiorectal fossa formed by:

Obturator internus

Nd-YAG, type of laser:

Solid laser

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

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

Type of necrosis in brain?

Colliquative (Liquefactive)

E-coli urine infection in pregnancy but no symptoms?

Nitrofurantoin for 7 days

Which antibiotic should be avoided at term?

Nitrofurantoin

What is the site for filtration in kidneys?

Glomerulus

SI unit of magnetic field?

Tesla

MRI acts by:

- Aligning protons

History of old inferior MI on ECG?

Q wave in lead 2, 3, and AVF

ECG changes in N pregnancy?

T wave inversion Lead 3

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

20-25%

Increase in cardiac output in second stage of pregnancy?

50%

Antigen presenting cells in cervix?

Langerhans cells

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

Lysozymes

Standard error of mean calculation:

SD/square root of N (sample size)

What is a Type 1 error?

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

What is Type 2 error?

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

What occurs at gastrulation?

Formation of 3 germ layers

Cytotrophoblast forms on which day?

Day 8

Carbon atoms in estrogen?

Carbon atoms in testosterone?

Incidence of rhesus negative population in UK?

15%

When does hemolytic disease of newborn occur?

When father is homozygous Rhesus positive + mother is rhesus negative

What is the basis of the Kleihauer-Betke test?

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

Brunner's glands are located in?

Duodenum

What is the unit for electrosurgery?

300 Hz - 5 MHz

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

Lateral femoral cutaneous nerve/lateral cutaneous nerve of thigh

Incidence of which cancer is increased with endometriosis?

Clear cell carcinoma

Most common clinical feature of uterine fibroids?

Heavy menstrual bleeding

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

- 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.

Retinol causes teratogenicity during pregnancy due to:

Hypervitaminosis of Vitamin A

IgG passes through the placenta via:

Pinocytosis

Amino acids transferred across the placenta by which method?

Active transport

What is the co-factor for DNA synthesis?

Folic Acid

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

Until patient discharge

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

Anti-emetics + 0.9% saline

What drug is used for the treatment of herpes simplex?

Aciclovir

zidovudine belongs to which class of drug?

Nucleotide reverse transcriptase inhibitor

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

Molluscum contagiosum

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

Give her MMR vaccine after delivery.

Acute hemolytic reaction following blood transfusion occurs because of;

ABO incompatibility

Progesterone receptors are?

Nuclear transcription factor

Lacunae develops into which layer?

syncytiotrophoblast

What is the karyotype of complete mole?

46XX

What is the karotype of Turner's syndrome?

45XO

Karotype of male Edward syndrome?

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

What are the features of Turner's Syndrome?

Short stature Neck webbing Decreased fertility

Dalteparin monitored using which test?

Anti-Xa levels

Additional features of Warfarin Embryopathy?

nasal hypoplasia Slipped epiphysis IUGR

What are the consequences of fetal anticonvulsant syndrome?

- 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.

What epithelium lines the endosalpinx?

Simple columnar

Methotrexate acts in what way?

Reversible DHFR inhibitor

Arias-Stella phenomenon occurs where?

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

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

Atypical hyperplasia

What test denotes menopausal status?

FSH

What test is for ovarian reserve?

AMH

Drugs cross across the placenta via which method?

No-ionization

The size of the uterus in pregnancy increases due to?

Hypertrophy

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

Transitional cell carcinoma

Sequence of events in wound healing

Hemostasis Inflammation Proliferation Maturation Remodelling

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

CD4 < 200

What cells are affected by HIV?

CD4 + T-cells

Plasma cells originate from?

B lymphocytes

In which site are prostaglandins inhibited?

Lungs

Discoloration of teeth due to which antibiotic?

Tetracycline

Birth weight is which type of data?

Ratio variable

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?

Trichomonas Vaginalis

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

N. Gonorrhoea

Fungal agent responsible for UTIs?

Candida

What drug causes kernicterus?

Sulfonamide

IUCD related infection with sulfur granules seen. Causative organism?

Actinomyces israelii

Mechanism of action of IUCD

Inhibits implantation/fertilization

Mechanism of action of Fluconazole?

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.

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

Parvovirus B19

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

Treponema pallidum

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

Vaginal examination PV

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

SVC, aorta, pulmonary artery

What is the screening test fr iron deficiency anaemia?

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

Pituitary microadenoma

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

Dehydration

Most common cause of hyperthyroidism?

Grave's disease

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

70%

Which HPV strains cause genital warts?

HPV strains 6 + 8 + 11

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

Normal fr 8 weeks pregnancy + repeat later

The anterior pituitary develops at:

6-7 weeks

What enzyme is used for androgen synthesis in ovary?

3β-Hydroxysteroid dehydrogenase

Most common degranulation in a fibroid?

Hyaline

What is the steroid synthesis pathway?

DHEA (Dehydroepiandrosterone)--> Androstenedione --> Testosterone

The vestibule is between?

Vagina + labia minora/ between two labia minora

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

Premature ovarian failure

Which is a second generation progesterone?

Levonorgestrel

Drospirenone has what special property compared to other synthetic progesterones?

Much higher antiandrogenic potency .

Surfactant synthesis in pneumocytes, due to which organelle?

lamellar bodies

Technique of bonding for conventional chromosomal analysis?

G-banding

GnRH chemical structure

decapeptide

Ondansetron acts as antagonist to which receptor?

5HT

What is the male equivalent of round ligament in females?

gubernaculum

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

Urogenital sinus

What is the source of fetal cholesterol in late pregnancy?

Fetal liver

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

6p21

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

Low ACTH, high cortisol, low growth hormone

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

HLA-G

Detrusor muscle receptor type?

Which muscle doesn't attach to the perineal body?

Ischiocavernosus

The hepatic phase of hematopoiesis begins at what gestational age?

6 weeks

Atropine exerts its antagonist action on which receptors?

Acetylcholine

striae gravidarum in pregnancy occur due to which hormone?

Cortisol

The Kolmogorov–Smirnov is used for?

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

What is used for delivery of head at pelvic floor?

Outlet instrumental delivery

Complications associated with retroverted uterus in pregnancy:

Incarceration of the gravid uterus

What term is used for endometrium which is thin?

Atrophic

Hyperprolactinemia in PCOS occurs due to:

Unopposed oestrogen

During fertilization, sperm penetrates which layer?

Zona Pellucida

Caput medusa due to dilation of which embryonic structure?

Umbilical vein

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

Obstetric cholestasis

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

Trimethorpim

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

Trimethoprim

What is the mechanism of action of oxytocin?

Activation of phospholipase C and increase in intracellular calcium

Most common cause of delayed puberty in males?

Constitutional

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

Thrombotic Thrombocytopenia Purpura

Which electrocautery system attaches to a ground plate?

Monopolar diathermy

HIV transmission to the baby from other is maximum during:

Delivery

what is the most common cause of secondary hyperparathyroidism?

Chronic renal failure

What releases calcitonin?

Thyroid

LDH is increased in which ovarian tumor?

Dysgerminoma

Condyloma lata seen in which stage of syphilis?

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

What is the haldane effect on facilitating exchange at placenta?

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).

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

Uterosacral/cardinal ligaments

Atosiban is:

Oxytocin antagonist

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

Cell wall synthesis

Warfarin acts where in the clotting cascade?

Vitamin K antagonist

Grade B recommendation of RCOG means?

well controlled studies but non randomized

RCOG recommendations of evidence.

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.

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

Hypoestrogenism

What type of variable is ABO Blood Group ?

Nominal

Which is a precursor of Serotonin?

Tryptophan

Wernicke-Korsakoff syndrome Deficiency disease of vitamin?

Vitamin B1

Incidence of "RARE" disease when translated into mathematics is?

1:1000- 1:10,000

Which protein is coiled in DNA?

Histones

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?

Carcinosarcoma

Which is the single mechanism of action for Mirabegron?

Selective Beta-3 antagonist

Side effect of Terbutaline:

Maternal tachycardia

In ECG which lead reflects the inferior wall of heart?

II, III, aVF

What is the embryological origin of Gartners duct cyst?

Mesonephric duct

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

Becquerel

What is the contrast dye used in MRI scans?

Gadolinium

Which hormone increases the excretion of calcium in Kidney?

Calcitonin

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

Hematogenous

What drug can be given in methotrexate toxicity?

Folinic acid

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?

Giant cells

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

Narrow angle glaucoma

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:

Clear cell carcinoma of vagina

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

Kidney

Patau syndrome karotype:

Trisomy 13

Lancefield grouping of streptococci is based on the presence of ?

Carbohydrate antigen on cell wall

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

Methyl dopa

Clomifene citrate mechanism of action ?

Selective estrogen receptor modulator

Which Antineoplastic drug causes hemorrhagic cystitis?

Cyclophosphamide

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

HCG, FSH and TSH

Mechanism of action of ulipristal acetate ?

Selective progesterone receptor modulator

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

Labia majora

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

Ligamentum venosum

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

Squamous cell carcinoma

Which of the following organisms Colonize copper IUD?

Actinomyces species

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

Lactobacillus

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

Parvovirus B19

Sheehan syndrome affects?

Anterior pituitary

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

Benign cystic teratoma

Cori cycle

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

BMI classes:

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.

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?

Clindamycin and vancomycin

APGAR Score:

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

What is affected in Horner syndrome?

Loss of Sympathetic supply

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

Iatrogenic Steroid Administration

Glucocorticoids are secreted from which region of the adrenal gland?

Zona fasciculata

Which cells produce mullerian-inhibiting substance in fetal testis?

Sertoli cells

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

Carbonic anhydrase

Urogram interpretation:

Detrusor muscle overactivity

Calculation of maternal mortality ratio:

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

Calculation of perinatal mortality:

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)

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

Hypokalaemia

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 ?

Normal semen analysis

Regarding Insulin, it gets activated by removing ?

C-peptide

What represent the 2 axis of ROC curve ?

Sensitivity Vs 1-Specificity

What hormone secreted by placenta leading to fetal diuresis ?

Vasopressinase.

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?

Lichen Sclerosus

What is the Action of mRNA?

Transcription

From Which structure inhibin is produced ?

Granulosa cells

At what level ovarian artery arise?

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

Piriformis

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?

What is the anatomical location of Bartholin’s gland?

Superficial perineal pouch

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

Lower and upper quartile

Which hormone prevent regression of corpus luteum?

HCG

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

Cerebral nuerons

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

Proliferative endometrium

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

HLA-G

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

Inhibit the release of acetylcholine

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

Mesonephric duct

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

When sperm penetrates the zone pellucida

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?

Placenta accreta

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

Deep sleep

The most biologically active form of vitamin D is

1, 25-Dihydroxycholecalciferol

Which muscles form the pelvic diaphragm?

Levator ani and coccygeus

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?

Could be a viable pregnancy

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?

A positive or O positive

The probability of sarcomatous change occurring in fibroid is

0.1%

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

Yolk sac endothelium

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

Dorsal mesogastrium

What electrolyte imbalance can cause paralytic ileus?

Hypokalemia

Vasopressin act on increasing water re-absorption at

collecting duct

Placement of cup during ventose delivery when the neck is flexed

Sagittal

Schiller Duval Bodies is found in

endodermal sinus tumor

Second line drugs in hyperemesis:

Metoclopramide, Ondansetron, Prochlorpromazine

Most common endocrine disorder in reproductive age group

Polycystic Ovarian Syndrome

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

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

15%

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

inferior mesenteric a.

Angle of the vagina with the horizontal while standing

60%

Joint which resist horizontal rotation of the pelvis

Ileolumbar

Two Most common dermatitis in pregnancy

Polymorphic (PUPP) + Obstetric Cholestasis

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

Toxoplasma

Paroxetine is teratogenic to which organ

Cardiovascular system

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

Sodium

Vitamin E toxicity

hemorrhage

Origin of obturator artery

Internal Iliac

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

anti D 500iu

Congenital conjunctivitis organism. Purulent discharge 36 hours after birth

Chlamydia trachomatis

Piezoelectric used in

USS

Transformation Zone

Squamous to glandular metaplasia Change is: glandular epithelium replaced by squamous epithelium.

Alternate complement pathway initiation

C3b

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

47xxy

Target Hgb with oral and IV iron

0.8g/dl/ml

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

Behchet's disease

Incomplete early miscarriage, bleeding PV, refuse surgical intervention.

Ergometrine

HSG is done on what day of cycle

6-12

In ECG, T wave represents

Ventricular repolarization

Herpes simplex is what type of virus

DsDNA

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

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.

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

Repeat after 6 months

Cauterization of large area with appearance of smoke

Fulguration

Pregnancy rate with COCP if perfectly compliant and non perfectly compliant

0.1 perfectly compliant to 5-6 non-compliant

INH (Isoniazid) Metabolism is by

Acetylation

Risk of VTE with COCP?

3–9 per 10,000 people/ yr

Muscles of internal sphincter derived from?

Circular Muscle

Cardiac output after delivery

60-80%

Where does the inferior rectal vein drain?

Internal pudendal vein

IUD+ Pregnancy. What is the risk of Ectopic Pregnancy

1/20

Cannon bell mets associated with which tumor marker?

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

Rate of miscarriage in couples with balanced translocation?

2-5%

Lifelong immunity

Adaptive

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

Premature ovarian failure

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

Fetal fibronectin test

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

stratified squamous non-keratinized

Level of the gonadal artery

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

PMNs

Glucose transported across the placenta via?

Facilitated Diffusion

Gonads are derived from which embryonic layer?

Intermediate Mesoderm

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

- AB antigen +ve Anti A and Anti B antibodies

Which immunoglobulin is a key to passive neonatal immunity?

IgG

What is the normal rate of urine output per hour?

0.5ml/kg/hr

Tetanus toxoid vaccine

Toxoided protein

Which clotting factors are unchanged in pregnancy?

Factors 11 + 13

Which kind of cells secrete calcitonin hormone?

Parafollicular cells

What type of cell is a natural killer cell?

Lymphocyte

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 .

Metronidazole + Clindamycin p.o. X 7 days

Why ramifentanyl used in patient controlled analgesia?

Short acting easily metabolized by serum esterase 191.

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

FBS

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

From Lower border of Symphsis pubis to sacral promontory.

During which phase DNA synthesis and chromosome duplication take place

S phase

Endometrial tissue found within the myometrium is

Adenomyosis

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

Edinburgh Postnatal Depression Scale

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

T10

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

primary oocyte

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

Diarrhea

Terbutaline has the following mechanism of action

Beta 2 agonist

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

Mesonephric duct

Allantois embryonic origin

Endoderm

Which of the following antibodies is found as a dimer?

IgA

Magnesium excretion

Excreted Unchanged in urine

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

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

Klinefelter's Syndrome karotype

47,XXY

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

Kallman's Syndrome

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)?

Amoxicillin

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

Touch

What is the mechanism of action of Dibagatran?

Thrombin inhibitor

Warfarin acts where in the clotting cascade

factor V precursor

Pyramidalis is supplied by which nerve?

Subcostal nerve

The pathway of piriformis muscle??

Pelvic surface of sacrum,greater sciatic notch,greater trochanter

Which hormone has a structure similar to Prolactin?

Growth Hormone

Reciprocal translocation

occur when part of one chromosome is exchanged with another.

Robertsonian translocation

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

Coronal suture is located in?

between frontal and parietal

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?

It is low risk for down's syndrome

LDH elevates in which type of ovarian ca ?

Dysgerminoma

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

HPV 33

Which group of viruses cause molluscum contagiosum?

Pox virus

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

Aromatase

Where in body is androgen produced?

Zona reticularis

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

50%

Aspirin and ibuprofen what is the difference in action?

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

Grade A recommendation of RCOG means

at least one randomized controlled trial

Sigmoid Colon - arterial supply + lymph drainage

Inf Mesenteric AND pre aortic LN

Drugs readily cross the placenta because of which quality?

High lipid solubility

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

Category 3 CS with IV Zidovudine

Macrophages are derived from what type of cell?

Monocytes

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

GIT

What type of variable is BMI ?

Continuous

Categorical variable

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.

Discrete variable

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.

Continuous variables

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.

Half life of Mifepristone?

25 to 30 hours

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

30 to 50%

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

Pelvic splanchnic

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

superior vesical

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

idiopathic

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?

5-alpha reductase

The enzyme involve in the final oxidation of uric acid?

xanthine oxidase

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

mitochondria

Which is precursor of dopamine/catecholamines? .

Tyrosine.

What is the most common cause of postmenopausal bleeding?

Atrophic vaginitis and endometritis

What is the function of DNA polymerase?

DNA repair

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

Dermoid cyst

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

Ovarian Endometrioma

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

after delivery

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

late secretory

Sympathetic supply of bladder largely comes from which nerve?

Hypogastric +Inferior gluteal nerve

Which structure in female is homologus to male prostate?

Skenes gland

Rate limiting step in the synthesis of catecholamines?

tyrosine hydroxyla

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

between internal oblique and transversus abdominis

What is the chemical structure of Renin?

Protein

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

Amplitude

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

reflection

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

Inferior epigastric artery

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?

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..

Ovarian CA associated with mutation of mismatch repair genes

endometriod CA

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

Coagulative necrosis

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

estrogen fails to produce positive feedback on pituitary

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?

Brachytherapy

Where is prolactin produced that is not under dopaminergic control?

maternal decidua

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?

Polymorphic Eruption of Pregnancy

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?

Amniotic fluid embolism

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

Staphylococcus aureus

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

Group A Streptococcus

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

Stap aureus

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?

Lateral - NAVY - medial

Most important complement in opsonization

C3b

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'?

Epithelial cells

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?

Theca lutein cyst

What is the most common cause of acromegaly?

Pituitary adenoma

Labetalol is:

Non selective beta blocker

What is the mechanism of action of hydralazine?

Direct acting smooth muscle relaxant

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

prostaglandin F2

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?

Basal layer of endometrium

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?

Placenta increta

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

Placental Trophoblast

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

Gubernaculum ovarii , ant surface of uterine cornua, labia majus

The most common site of endometriosis is?

ovary

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

Small cell lung carcinoma

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

Sertoli cells

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

450ml/kg

Which kind of cell produce parathyroid hormone?

chief cells

Which chromosomes are capable of robertsonian translocations?

13, 14, 15, 21, 22

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

Aldosterone

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

Respiratory alkalosis

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

Metabolic alkalosis

Trichomonas Vaginalis is what kind of protozoa?

flagelated protozoan

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

No need for treatment only hydration and mobilization

VIN3 is caused by which organism ?

HPV 16

Zika virus is

Ss RNA

Thrombosis in protein C deficiency is due to

Factor 5 and 8a

Transport of iodide in the cells is associated with

Sodium

Renal Calculus referred pain

Lumbar region

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

11b- hydroxylase

Embryonic origin of oocytes

primordial germ cell

Definition of Tidal Volume

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

What type of compound is Histones?

Protein

Most important function of Vitamin C

collagen formation

Indirect Inguinal Hernia is lateral to which arteries?

inferior epigastric arteries

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

10-15%

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

Pituitary adenoma

Trophoblast cells that invade the lumen of spiral arteries

endovascular trophoblast

HPV proliferate in?

Basal Cell of endometrium

Regarding Influenza vaccine , what type of vaccine?

Organism Subunit vaccine + inactivated

Which drug antagonises the action of oxytocin?

Atosiban

Misoprostol is analogue of which?

PGE1

Urea transfer from fetal circulation to maternal circulation?

Passive diffusion

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

IgA

which Immunoglobin is a pentamer?

IgM

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

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

Erythromycin 500 QDS

Which anti-emetic drug has extrapyramidal side effect?

Metoclopramide

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

5% dextrose

Mechanism of action of ondansetrone?

Seretonin HT3

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?

Check Partner Blood group & Rh

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?

Lobular hyperplasia

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

X-linked Recessive

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

12 hours

Remifentanil is an ideal controlled analgesia during labour because

It is rapidly metabolized by tissue estrases

Lancefield grouping of streptococci is based on the presence of ?

Carbohydrate antigen on cell wall

Mechanism of action of Neostigmine is

Anticholinesterase

Coumarin drug antagonise which vitamin?

Vitamin K

Which structures passes through the lesser sciatic foramen?

Tendon of obturator internus muscle

Which Antineoplastic drugs causing hemorrhagic cystitis?

Cyclophosphamide

Mechanism of action of ulipristal acetate ?

Selective progesterone receptor modulator

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?

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

The following image from ICSI procedure .

First polar body.

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

Vestibulocochlear nerve ( 8th)

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

10 cm

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

Parvovirus B19

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

Choloroquine

The Lowest acceptable Hb in second trimester?

10.5 g/dl

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

Melasma

Mechanism of Action of Indomethacin?

Cyclo-oxygenase Inhibitor

Which of the following regions is represented by the arrows ?

Amniotic cavity

What is Evidence based medicine?

Using current guidelines for treating individual patients.

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

Medial Umbilical ligament

What is the source for premenopausal Oestrogen secretion?

Granulosa cells

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

Hypothyroidism

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

Uretheral caruncle

which clotting factor does not rise in pregnancy?

XI & XIII

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

She is not immune to Chicken pox

Which cells secrete histamine and serotonin?

Basophils

Which Type of Ovarian cancer occurs which BRCA 1 mutation ?

papillary serous cystadenocarinoma.

Regarding Varicella Zoster , What its infectivity period?

2 days before rash until the crust appear.

Gestation age is which type of data?

Interval

Which type of electrosurgical circuits is safest in theatres?

Patient is Attached to pad

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

External iliac artery

Glucocorticoids are secreted from which region of the adrenal gland?

Zona fasciculate

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

α-Linoliec acid

Cervical cancer incidence in UK ?

1/3000

What is the mechanism of action of Trimethoprim ?

Inhibit dihydrofolate reductase enzyme Acts on nucleic acid

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

High frequency current focused on small area.

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

11cm

What is the site of production of Thromboxane A2 ?

Platelets.

What is the site where Urea cycle occurs ?

Liver.

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

Obturator nerve.

The Umbilical artery is branch of ?

Anterior division of internal iliac artery.

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

Immuno-histochemistry

Regarding OOCYTE , when the second meiotic division is completed ?

fertilization

Regarding Wound healing process , what is the first stage ?

Hemostasis.

Regarding inferior vesical artery , where does it come from ?

Anterior division of internal iliac artery.

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.

Sickle cell trait

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

10%

describe Tidal volume ?

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

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 ?

Pelvic splanchnic nerve.

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

Adenomyosis

From what structure does ligamentum Arteriosus come from?

Ductus arteriosus

What is the incidence of pregnancies complicating by cancer ?

1/1000

Which enzymes used in Transcription ?

RNA Polymerase.

What is the Direct arterial blood supply of decidua ?

Spiral arteries.

What is the component of Placental barrier at term pregnancy?

Syncitiotrophoblast and Endothelium

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

6 weeks

Which of the following is male homologous of bartholin gland ?

Bulbouretheral gland ( Cowper’s gland )

What hormone secreted by placenta leading to fetal diuresis ?

Vasopressinase.

Which of the following neurotransmitters secreted onto adrenal medulla?

Acetylcholine

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

Pubococcygeus.

What is the site of production of Ammonia ?

Kidneys

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?

Lichen Sclerosus

What is the most common solid benign tumour of ovary ?

Benign teratoma

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 ?

Pelvic brim

What is the Action of mRNA ?

Transcription

From Which structure inhibin is produced ?

Granulosa cells

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

Lymphocytes

Which Immunoglobulin is a Dimer ?

IgA

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

See picture!

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

superficial epigastric vein

Superior vesical artery is a direct branch from:

Umbilical artery (branch from anterior division internal iliac)

Which artery is most commonly absent?

Middle rectal artery

At what point is the aortic bifurcation?

Highest point on iliac crests

Ventouse is applied to which suture?

Sagittal suture

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

1:1

What is the embryological origin of the bladder trigone?

mesoderm derived wolffian ducts

At 4 weeks, germ cells are present where?

Yolk sac

Which cells invade spiral arteries?

Extravillous trophoblasts

What is PCR used for?

DNA amplification

What is northern blot used for?

Identify RNA sequences

What is southern blot used for?

Identify DNA sequences

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

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

Where does paracrine action occur?

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

Which protein forms gap junctions?

Connexins

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

Niacin (B3) deficiency?

Which enzyme works in the urea cycle?

Carbamoyl phosphate synthetase

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

Increase in intracellular calcium

Which cells are involved in wound remodeling?

Myofibroblasts

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

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'

What kind of damage does pre-eclampsia cause?

Vascular endothelial damage

What is the epithelium outside of the cervical transformation zone?

Stratified squamous epithelium

When is the peak GFR in pregnancy?

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

When does HCG peak?

12 weeks

When does HPL plateau?

35 weeks (3rd trimester)

What is the major Hb at 32 weeks?

HbF

When does adult Hb production start?

28 weeks

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

40-50%

What are the causative agents of bacterial vaginosis?

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

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

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.

When is the test for cure in gonorrhea?

14 days

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

Listerosis

Trichomonas in pregnancy should be treated with what?

Metronidazole

What type of bacteria is chlamydia?

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

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

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.

Peptide chains in IGG?

2, 4

Antigen-antibody complexes are formed in which pathway?

classical pathway

Image of direct coombs test

Antibodies are on RBCs

What is the function of parathyroid hormone?

Decrease excretion of calcium

What is the immediate pre-cursor of testosterone?

Androstenedione (+ Cholesterol)

how many sequences do the TRH precursors have?

Where is HPL produced?

Synctiotrophoblast

What has direct action on aldosterone?

Angiotensin 2

What is the main regulator of sodium?

Aldosterone

Where is ADH + oxytocin synthesized?

Supraoptic + paraventricular nucleus of hypothalamus

Main tumor causing hyperprolactinemia?

Adenoma

Where is prolactin produced?

Maternal decidua

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

Pancreas

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

1:10,000

Oxybutynin side effects include:

Dry mouth, dry eyes, hypohidrosis

Nature of Mifepristone:

Anti-progesterone

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

No contraception effective

Missed single dose COCP - advice?

Take missed pill + continue rest of pack

Method of action of the POP?

Thickens cervical mucus

Method of action of the IUD/copper IUD?

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

What is dinoprostone?

PGE2 analogue

What is the method of action of botox?

Inhibits release of acetylcholine at neuromuscular junction.

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

24 hours

Recreational drug use causing placental abruption?

Cocaine

Tocolytic which prevents calcium influx?

Nifedipine

Hepatitis C advice for breastfeeding

Can breastfeed but pump if nipples cracked/bleeding

Diagnosis of diabetes in pregnancy?

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

Chicken pox + rash management

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.

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

Acquired varicella infection

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

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)

Intraoperative cell salvage during CS blood loss?

20% blood loss

Patient on anti-epileptics and contraception of choice?

IUS

Ductus venosus connects:

umbilical vein + inferior vena cava

PCOS biochemistry includes:

Insulin increases Estradiol decreases SHBG decreases Leptin decreases

Incidence of 45XO + its mosaicism?

1:3000

Mode of inheritance for blood groups?

Co-dominant

Which receptor does nicotine bind to that affects neurotransmitter in foetus

Acetylcholine

Function of BRCA

Tumour suppressor gene

Coagulation factors that increase during pregnancy

Factor VII, VIII, IX, X, plasminogen

Structure lateral to internal iliac artery

Ureter

Ovary originates from:

Mesoderm

Cleft palate results from:

Failure of development of 1st pharyngeal arch

Derivatives of 2nd pharyngeal arch:

stapedial artery, epiglottis, facial nerve

Proximal internal carotid artery derived from :

3rd pharyngeal arch

Phosphate excreted by:

Kidneys

Site where active form of Vit D produced :

Kidney

Nerve supply to structure below umbilicus :

Inferior hypogastric nerve

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

7 days

Source of Vit K1 :

Leafy green vegetables

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

Up regulation of nitric oxide and PG

Screening test for iron deficiency anaemia :

Serum iron

40% of pt with PCOS have hyperprolactinemia because?

Estradiol excess leading to hyperprolactinemia

Pregnancy 3 fold increase cortisol. Mechanism :

Cortisol increased by increased unopposed oestrogens

Prolactin levels in pregnancy compared to pre-pregnancy :

50 fold increase (20-50 folds)

Structure passing through deep inguinal ring visualised easily on laparoscopy :

Round ligament

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

Cardinal ligament

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

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

Main blood supply of transverse colon :

Middle colic artery

Sutures enclosing largest fontanelle :

Frontal, coronal, saggital

Diameter(s) widest in mid pelvis :

AP, oblique, transverse

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

CN VII

Alcohol group attached to which carbon atom of prostaglandin structure :

C 20/ C15 (best answer)

Name the structure (picture)

Colle’s fascia

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

Type I error

Major estrogen produced by placenta :

Estriol

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

Decreased insulin, increased glucagon

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

Brachytherapy

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

Monopolar diathermy

USG phase with best resolution :

Axial

USG process causing lysis of cell and damage :

Heating/cavitation

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

Vit B12 deficiency

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

Hypocalcemia

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

Hepatitis B

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

Vitamin D deficiency

Best sample for dx of chlamydia :

Endocervical swab

Features of neonatal herpes :

pneumonitis + mucous membrane vesicles

Dx criteria in Amsel’s criteria :

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

Absolute contratindication in pt with hx of pulmonary embolism :

COCP

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

Ca-125 LDH AFP HCG

Origin of Ca 125 :

Coelomic epithelial structures

Ig that crosses placenta from mother to foetus :

IgG

Likely test to give biological false +ve for syphilis :

VDRL

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

Coagulation

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

Suppression of T helper 1

MoA nifedipine :

Decrease PVR

E. coli belongs to :

Enterobacteriaceae

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

Bacteriostatic

Group of abx treatment for syphilis infection :

Penicillin

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

Outlet delivery

% or Brenner tumour with malignant change :

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 :

Eczema

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

Excessive IV dextrose

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 :

1200

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

Iliopectineal

HLA types that down-regulated in pregnancy

HLA-A + HLA-B

PG with highest level pre-menstruation :

PGE2

Advantage of PGE 2 vs PGE 1 analogue :

More effective at cervical ripening

Defective structure in thalassemia :

Globin

Baby with extra chromosome 18 with limb abnormalities :

Edward syndrome

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

X-linked dominant

In males, FSH secreted by :

Sertoli cells

Enzyme for androgen synthesis in ovary :

Aromatase

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

Androgen insensitivity syndrome

Treatment for central precocious puberty :

GnRH analogue

Class of drugs associated with hyperprolactinemia :

Antiemetics

Types of bile acid :

Cholic and chenodeoxycholic acid

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

Antibiotics before skin incision

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

Normal findings for 8 wks pregnancy

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

5 mins

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

Hypogonadism

Structure on HIV allowing it to enter cells :

Glycoprotein

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

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

Minimum amount of sperm concentration per mL of ejaculate :

15 000 000

Agent that cannot be used as tocolytic :

Prostacyclin

Pain score is what type of variable :

Ordinal

Measured blood loss type of variable :

Ordinal

Adverse effect of COCP

Irregular bleeding

In what active disease is COC contraindicated

SLE

Rotterdam criteria requires biochemical evidence of :

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).

Gestation at which differentiation of external genitalia occurs :

9-11 wks

What substance is secreted by granulosa cells :

Oestrogen

Erythrocytes formed from :

Pluripotent haematopoetic stem cells

Percentage of non-epithelial ovarian Ca :

10%

βHCG is a tumour marker for :

Choriocarcinoma

Identify structure: umbilical artery/vein

Umbilical vein

True statement regarding inheritance of achondroplasia :

Roughly equal number of males and females affected

Non-ergot agent used to supress lactation postpartum :

Quinagolide

Enzyme for conversion of testosterone to DHT :

5 alpha-reductase

Histamine released from :

Mast cell, eosinophil, basophil

Oxytocin cannot be given orally because :

Destroyed by gastric juice

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

Fraser guideline

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

Fibroma

From what arch does the ligamentum arteriosum come?

6th arch

What amount of hormone released from Mirena/24 hours?

20mcg/24 hours

Patient has increased FSH, LH + TSH =

premature ovarian failure

Patient complaining of cold intolerance + increase TSH

Hashimoto's

Type of ovarian cancer with association of mismatch repair?

Endometroid Ca

Likelihood of pneumonitis with chicken pox?

1/400 = .25%

HIV Pregnancy guidelines

* 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

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

No further action + return if bleeding continues

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

Neutrophils

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

ASAP after 16 weeks

Anti-epileptic affected by increased renal flow?

Lamotrigine

Magnesium excreted by?

Excreted unchanged by kidneys

Chlamydia transmittion from mother to her foetus via :

Direct contact

Pseudomonas appear on macconey agar :

colourless

Prophlaxis of malaria during pregnancy :

Mefloquin in 2nd and 3rd trimester

Exotoxins:

Heat labile Secreted by gram positive Susceptible to antibodies Higher toxicity Endotoxins = gram negative

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

Listeria

Treatment of vulvovaginal atrophy includes :

estriol and phytoestrogens

Most common non-epithelial vaginal cancer:

Rhabdomyosarcoma

SI unit of diathermy power

Watt

Cutoff of fibronectin level in screen of preterm labour

50ng

Rate of recurrence of pre eclampsia

16%-20%

Rate of CMV to be symptomatic for the baby:

10-15%

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

Cl−/HCO3−

Definition of minor PPH:

500-1000 loss without shock

70 kg ptn,Maximum safest dose of lidocaine:

49 with adrenaline

Doxazosin MOA

Alpha-1 antagonist

Complement system , initial cascade that end by cell lysis

C3 complement

Six differentiation is due to gene on:

Short am of y chromosome

False and true data variable:

Nominal (binary)

In sexual arousal engorgement of bulb of vestibule is dt:

Dorsal nerve of clitoris OR labial branch of perineal nerve.

In male most of ejaculate come from:

Seminal vesicles

Nerve supply of area over femoral triangle?

Genitofemoral nerve

Percentage of DM type 2 after GDM

40-60%

Dose of radiation to breast tissue used in CTPA

Oncogenes in Lynch Syndrome:

MSH2/methylation MLH1/MSH6

N.s of internal anal sphincter?

Sympathetic L5, parasympathetic S2, 3, 4

USS has the best resolution in which plane?

Axial

Semen analysis all normal except morphology 3%

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

What kind of junctions in the uterus?

Gap junctions

GNRH secreted where other than hypothalamus?

Liver

Painless ulcer & enlarged LN & diagnosed by serology

treponema pallidum

Lower 2/3 of vagina developed from:

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

Non penetrative intercourse , shallow painful genital ulcer

Behçet disease

Fetal hemolysis detected by:

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.]