PJE Spotter Qs & EoW Qs (also copied to qs) Flashcards
1
Q
This is a photograph of the lower back of a one day old baby who is still in hospital. What is the most likely cause of this lesion?
- Child abuse
- Blood coagulation defect
- Meningicoccal septicaemia
- Strawberry haemangioma
- Mongolian blue spot
A
This is a photograph of the lower back of a one day old baby who is still in hospital. What is the most likely cause of this lesion?
- Child abuse
- Blood coagulation defect
- Meningicoccal septicaemia
- Strawberry haemangioma
5. Mongolian blue spot
Dermal melanocytosis is the name of a kind of birthmark that is flat, blue, or blue-gray. They appear at birth or in the first few weeks of life. Dermal melanocytosis was formerly called Mongolian blue spots
2
Q
This centile chart shows the weight of a newborn baby plotted against gestation. The baby is
- extremely low birthweight
- small for gestational age
- normal birthweight
- low birthweight
- very low birthweight
A
This centile chart shows the weight of a newborn baby plotted against gestation. The baby is
- extremely low birthweight
- small for gestational age
- normal birthweight
4. low birthweight - very low birthweight
3
Q
a. greater vestibular (Bartholin’s) gland
b. perineal body
c. Cowper’s gland
d. crus of clitoris
e. bulbospongiosus
A
a. greater vestibular (Bartholin’s) gland
b. perineal body
c. Cowper’s gland
d. crus of clitoris
e. bulbospongiosus
4
Q
This photograph is of a new born with hydrocele. This occurs as a result of
a. patent processus vaginalis
b. cryptorchidism
c. androgen insufficiency
d. ectopic testes
e. patent ductus arteriosus
A
This photograph is of a new born with hydrocele. This occurs as a result of
a. patent processus vaginalis
b. cryptorchidism
c. androgen insufficiency
d. ectopic testes
e. patent ductus arteriosus
5
Q
This girl had difficulty swallowing. The arrow indicates a/an
- inflamed palatine tonsil
- inflamed adenoid
- normal adenoid
- normal palatine tonsil
- inflamed uvula
- normal uvula
- inflamed appendix
A
This girl had difficulty swallowing. The arrow indicates a/an
1. inflamed palatine tonsil
2. inflamed adenoid
3. normal adenoid
4. normal palatine tonsil
5. inflamed uvula
6. normal uvula
7. inflamed appendix
6
Q
What is structure Z?
a. yolk sac
b. polar body
c. extraembryonic mesoderm
d. amnion
e. chorionic villi
A
What is structure Z?
a. yolk sac
b. polar body
c. extraembryonic mesoderm
d. amnion
e. chorionic villi
7
Q
This diagram is the anterior view of the cervix and uterus. The supports of the cervix indicated are
- cardinal ligaments
- levator ani muscle
- round ligaments
- ovarian ligaments
A
This diagram is the anterior view of the cervix and uterus. The supports of the cervix indicated are
1. cardinal ligaments
2. levator ani muscle
3. round ligaments
4. ovarian ligaments
8
Q
A baby was born at 27/40. She was given three doses of surfactant and ventilated. On day 4, a chest x-ray showed ‘solid’ lungs. The photomicrograph shows
- hyaline membrane disease
- normal lung for this age
- pneumonia
- pneumothorax
- pneumopericardium
- intraventricular haemmorhage
A
A baby was born at 27/40. She was given three doses of surfactant and ventilated. On day 4, a chest x-ray showed ‘solid’ lungs. The photomicrograph shows
1. hyaline membrane disease
2. normal lung for this age
3. pneumonia
4. pneumothorax
5. pneumopericardium
6. intraventricular haemmorhage
9
Q
This diagram shows the inguinal canal of a 3-week old baby. What abnormality is shown?
- Hydrocoele
- Complete inguinal hernia
- Ectopic testis
- Intra-abdominal testis
- Teratoma
A
This diagram shows the inguinal canal of a 3-week old baby. What abnormality is shown?
- Hydrocoele
2. Complete inguinal hernia - Ectopic testis
- Intra-abdominal testis
- Teratoma
10
Q
A 2-year-old girl is vomiting, refuses to eat and has a fever. She has a non-blanching haemorhagic rash. She is up to date with all her vaccinations. Which infective agent is
most likely to be associated with her condition?
- Haemophilus influenza
- Herpes simplex virus
- Mycobacterium tuberculosis
- Neisseria meningitides
- Streptococcus pyogenes
A
A 2-year-old girl is vomiting, refuses to eat and has a fever. She has a non-blanching haemorhagic rash. She is up to date with all her vaccinations. Which infective agent is
most likely to be associated with her condition?
- Haemophilus influenza
- Herpes simplex virus
- Mycobacterium tuberculosis
4. Neisseria meningitides - Streptococcus pyogenes
11
Q
The photo shows
- syringomyelia
- exomphalos
- Meckel-Gruber syndrome
- sirenomelia
- amniotic band disruption
- gastroschisis
A
The photo shows
- syringomyelia
2. exomphalos - Meckel-Gruber syndrome
- sirenomelia
- amniotic band disruption
- gastroschisis
12
Q
The photo shows
- syringomyelia
- exomphalos
- Meckel-Gruber syndrome
- sirenomelia
- amniotic band disruption
- gastroschisis
A
The photo shows
- syringomyelia
- exomphalos
- Meckel-Gruber syndrome
- sirenomelia
- amniotic band disruption
6. gastroschisis
13
Q
The photomicrograph shows
- normal prostate
- prostatic adenocarcinoma
- normal testis
- papillary serous tumour of the testis
- transitional cell carcinoma
A
The photomicrograph shows
1. normal prostate
2. prostatic adenocarcinoma
3. normal testis
4. papillary serous tumour of the testis
5. transitional cell carcinoma
14
Q
A 24 year old man presented to his GP complaining of a lump in the right testis. The patient was referred to his local urology department and underwent a right orchidectomy. In
this histopathology specimen of the tissue, the arrow indicates
- seminomatous tumour cells
- non-seminomatous tumour cells
- lymphocytes
- papillary serous carcinoma
- Sertoli cell tumour cells
A
A 24 year old man presented to his GP complaining of a lump in the right testis. The patient was referred to his local urology department and underwent a right orchidectomy. In
this histopathology specimen of the tissue, the arrow indicates
1. seminomatous tumour cells
2. non-seminomatous tumour cells
3. lymphocytes
4. papillary serous carcinoma
5. Sertoli cell tumour cells
15
Q
State each type of testicular cancer shown [3]
A
The large images show a general histology pattern of a seminoma (upper panel)
**undifferentiated embryonal carcinoma (middle panel) **
teratoma: a tumor displaying differentiation into various somatic tissues (bottom panel).
16
Q
This ovarian tumour is a/an
- adenocarcinoma
- teratoma
- dysgerminoma
- granulosa cell tumour
- choriocarcinoma
- seminoma
A
This ovarian tumour is a/an
- adenocarcinoma
- teratoma
- dysgerminoma
- granulosa cell tumour
- choriocarcinoma
- seminoma
17
Q
- Human papilloma virus
- Herpes simplex virus
- Tricomonas vaginalis
- Neisseria gonorrhoea
- Chlamydia trachomatis
A
1. Human papilloma virus
2. Herpes simplex virus
3. Tricomonas vaginalis
4. Neisseria gonorrhoea
5. Chlamydia trachomatis
18
Q
A caudal epidural would
1. anaesthetise the lower pelvic viscera, but would leave the legs unaffected.
2. anaesthetise the lower pelvic viscera and the legs.
3. anaesthetise the pudendal nerve.
4. anaesthetise just the perineum and the lower quarter of the vagina.
5. anaesthetise the area below the waist
A
A caudal epidural would
1. anaesthetise the lower pelvic viscera, but would leave the legs unaffected.
2. anaesthetise the lower pelvic viscera and the legs.
3. anaesthetise the pudendal nerve.
4. anaesthetise just the perineum and the lower quarter of the vagina.
5. anaesthetise the area below the waist
19
Q
A
20
Q
What is the most likely syndrome that this baby has?
A. Amniotic band syndrome
B. Angelman syndrome
C. Down syndrome
D.Edwards syndrome
E. Prader-Willi syndrome
A
What is the most likely syndrome that this baby has?
A. Amniotic band syndrome
B. Angelman syndrome
C. Down syndrome
D.Edwards syndrome
E. Prader-Willi syndrome
21
Q
What structure is A pointing to in this photomicrograph of an ovary?
A Corpus albicans
B. Corpus luteum
C. Primordial follicle
D. Primary follicle
E. Oocyte
A
What structure is A pointing to in this photomicrograph of an ovary?
A Corpus albicans
B. Corpus luteum
C. Primordial follicle
D. Primary follicle
E. Oocyte
22
Q
What is the blue arrow pointing at?
A. posterior vaginal fornix
B. broad ligament
C. rectouterine pouch (of Douglas)
D. rectovesical pouch
E. vesicouterine
A
What is the blue arrow pointing at?
A. posterior vaginal fornix
B. broad ligament
C. rectouterine pouch (of Douglas)
D. rectovesical pouch
E. vesicouterine
23
Q
The arrow is pointing to what structure in the breast?
A Lactiferous sinus
B. Lactiferous duct
C. Areola
D. Smooth muscle cells
E. Suspensory ligament
A
The arrow is pointing to what structure in the breast?
A Lactiferous sinus
B. Lactiferous duct
C. Areola
D. Smooth muscle cells
E. Suspensory ligament
24
Q
This diagram shows the changes that occur after fertilisation and before implantation.
Name structure (e).
A. zygote
B. morula
C.blastocyst
D. embryo
E. fetus
A
This diagram shows the changes that occur after fertilisation and before implantation.
Name structure (e).
A. zygote
B. morula
C.blastocyst
D. embryo
E. fetus
25
A baby who is described as small for gestational age is one whose weight at birth
falls below which centile for their gestational age?
A. 3rd centile
B. 15th centile
C. 10th centile
D. 5th centile
E. 20th centile
A baby who is described as small for gestational age is one whose weight at birth
falls below which centile for their gestational age?
A. 3rd centile
B. 15th centile
**C. 10th centile**
D. 5th centile
E. 20th centile
26
What structure is labelled A in this photomicrograph of seminiferous tubules?
A. Primary
spermatocytes
B. Secondary
spermatocytes
C. Spermatogonia
D. Spermatids
E. Spermatozoa
What structure is labelled A in this photomicrograph of seminiferous tubules?
A. Primary
spermatocytes
B. Secondary
spermatocytes
C. Spermatogonia
D. Spermatids
**E. Spermatozoa**
27
What cells do you see in this photomicrograph of a cervical smear?
A. Chondrocytes
B. Epithelial cells
C. Fibroblasts
D. Lymphocytes
E. Myocytes
What cells do you see in this photomicrograph of a cervical smear?
A. Chondrocytes
**B. Epithelial cells**
C. Fibroblasts
D. Lymphocytes
E. Myocytes
28
What hormone is responsible for stimulating uterine contractions, production of
placental prostaglandin
A. Gonadotrophin-releasing hormone
B. Luteinising hormone
C.Oxytocin
D. Prolactin
E. Progesterone
What hormone is responsible for stimulating uterine contractions, production of
placental prostaglandin
A. Gonadotrophin-releasing hormone
B. Luteinising hormone
**C.Oxytocin**
D. Prolactin
E. Progesterone
29
What is structure X?
A. Corpus luteum
B. Primary oocyte
C. Secondary oocyte
D.Graafian follicle
E. Corpus albicans
What is structure X?
A. Corpus luteum
B. Primary oocyte
C. Secondary oocyte
**D.Graafian follicle**
E. Corpus albicans
30
What is the most likely syndrome that images in this photograph suggest?
A. Amniotic band syndrome
B. Angelman syndrome
C. Down syndrome
D. Edwards syndrome
E. Prader- Willi syndrome
What is the most likely syndrome that images in this photograph suggest?
A. **Amniotic band syndrome**
B. Angelman syndrome
C. Down syndrome
D. Edwards syndrome
E. Prader- Willi syndrome
31
What is the congenital heart defect shown in this diagram?
A. Critical pulmonary stenosis
B. Coarctation of the aorta
C. Pulmonary valve atresia
D. Ventricular septal defect
E. Tetralogy of Fallot
What is the congenital heart defect shown in this diagram?
A. Critical pulmonary stenosis
B. Coarctation of the aorta
C. Pulmonary valve atresia
D. Ventricular septal defect
**E. Tetralogy of Fallot**
32
Identify this neural tube defect.
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
Identify this neural tube defect.
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
**D. Myelomeningocoele**
E. Anencephaly
33
Identify this neural tube defect.
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
Identify this neural tube defect.
A. Encephalocoele
**B. Meningocoele **
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
34
Identify this neural tube defect.
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
Identify this neural tube defect.
**A. Encephalocoele**
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
35
In this photograph of a baby with meningococcus septicaemia what is the most likely
cause?
A. Haemophilus influenzae
B.Neisseria meningitidis
C. Pseudomonas sp.
D. Staphylococcus sp.
E. Streptococcus pneumoniae
In this photograph of a baby with meningococcus septicaemia what is the most likely
cause?
A. Haemophilus influenzae
**B.Neisseria meningitidis**
C. Pseudomonas sp.
D. Staphylococcus sp.
E. Streptococcus pneumoniae
36
The diagram shows a sagital section of an embryo at about day 16. Idnetify A
A. definative yolk sac
B. extraembryonic mesoderm
C. chorionic cavity
D. hypobalst 0%
E. amniotic cavity
The diagram shows a sagital section of an embryo at about day 16. Idnetify A
**A. definative yolk sac**
B. extraembryonic mesoderm
C. chorionic cavity
D. hypobalst 0%
E. amniotic cavity
37
What type of follicle is labelled A in this photomicrograph of an ovary?
A. Antral
B. Graafian
C. Primary
D. Primordial
E. Secondary
(Growing)
What type of follicle is labelled A in this photomicrograph of an ovary?
A. Antral
B. Graafian
C. Primary
**D. Primordial **
E. Secondary
(Growing)
38
What structure in this photomicrograph of the male reproductive system is labelled
A?
A. Ductus (vas) deferens
B. Epididymis
C. Penis
D. Prostate gland
E. Seminiferous tubules
A. Ductus (vas) deferens
**B. Epididymis**
C. Penis
D. Prostate gland
E. Seminiferous tubules
39
These graphs show hormonal changes throughout the menstrual cycle. In pregnancy,
which hormone maintains the corpus luteum and the production of hormone A until
the placenta produces hormone A.
A. Oestradiol
B. Human chorionic gonadotrophin
C. Progesterone
D. Insulin-like growth factor
E. Gonadotrophin-
releasing hormone
These graphs show hormonal changes throughout the menstrual cycle. In pregnancy,
which hormone maintains the corpus luteum and the production of hormone A until
the placenta produces hormone A.
A. Oestradiol
**B. Human chorionic gonadotrophin**
C. Progesterone
D. Insulin-like growth factor
E. Gonadotrophin-
releasing hormone
40
This picture shows brain calcification in an infant. What is the most likely condition?
A. Chronic renal failure
B. Toxoplasmosis
C. Congenital cytomegalovirus
D. Intracerebral haemorrhage
E. Cavernous angioma
A. Chronic renal failure
B. Toxoplasmosis
**C. Congenital cytomegalovirus**
D. Intracerebral haemorrhage
E. Cavernous angioma
41
From what cells of the ovary did this tumour originate?
A. Epithelial cells
B. Germ cells
C. Sex cord stromal cells
D. Smooth muscle cells
E. Mixture of A, B and C
From what cells of the ovary did this tumour originate?
A. Epithelial cells
**B. Germ cells**
C. Sex cord stromal cells
D. Smooth muscle cells
E. Mixture of A, B and C
42
This graph shows hormonal changes throughout pregnancy. Hormone C is measured
as part of the 1st and 2nd trimester screening tests for Down's syndrome. What is
hormone C?
gonadotrophin-
releasing hormone
Insulin-like
growth factor
Progesterone
human
chorionic
gonadotrophin
Oestradiol
This graph shows hormonal changes throughout pregnancy. Hormone C is measured
as part of the 1st and 2nd trimester screening tests for Down's syndrome. What is
hormone C?
gonadotrophin-
releasing hormone
Insulin-like
growth factor
Progesterone
**human
chorionic
gonadotrophin**
Oestradiol
43
On the diagram of the female perineum, identify A
A. Cowper's
gland
B. perineal
body
C. crura of
clitoris
D.
Bartholin's
gland
E. bulb of
vestibule
On the diagram of the female perineum, identify A
A. Cowper's
gland
B. perineal
body
C. crura of
clitoris
D.
**Bartholin's
gland**
E. bulb of
vestibule
44
The definition of antepartum haemorrhage is?
1. significant bleeding from the
birth canal after the 24th week
of pregnancy
2. significant bleeding from the
birth canal after 32nd week of
pregnancy
3. significant bleeding from the
birth canal before the 24th
week of pregnancy
The definition of antepartum haemorrhage is?
**1. significant bleeding from the
birth canal after the 24th week
of pregnancy**
2. significant bleeding from the
birth canal after 32nd week of
pregnancy
3. significant bleeding from the
birth canal before the 24th
week of pregnancy
45
Which of the following is not a pre-requisite for the
use of these obstetric instruments?
1. The greatest diameter of the fetal
head must have passed the
pelvic brim
2. The cervix must be fully dilated
3. The membranes must have
ruptured
4. The bladder must be empty
5. The patient must have adequate
analgesia
6. The pregnancy must be 37+
weeks
Which of the following is not a pre-requisite for the
use of these obstetric instruments?
1. The greatest diameter of the fetal
head must have passed the
pelvic brim
2. The cervix must be fully dilated
3. The membranes must have
ruptured
4. The bladder must be empty
5. The patient must have adequate
analgesia
**6. The pregnancy must be 37+
weeks**
46
Which of the following is not a risk factor for
intrauterine growth retardation?
1. Pre-eclampsia
2. Congenital
abnormalities
3. Infections
4. Placental
insufficiency
5. First pregnancy
Which of the following is not a risk factor for
intrauterine growth retardation?
1. Pre-eclampsia
2. Congenital
abnormalities
3. Infections
4. Placental
insufficiency
**5. First pregnancy**
47
Dizygotic twinning is more likely to occur.......
1. in younger women
2. as a result of fertility
treatments
3. parity <5
4. by chance
Dizygotic twinning is more likely to occur.......
1. in younger women
**2. as a result of fertility
treatments**
3. parity <5
4. by chance
48
The puerperium is the period which......
1. Begins with the
delivery of the baby
and ends 6 weeks later
2. Begins with the
delivery of the placenta
and ends 6 weeks later
3. Begins with the
delivery of the baby
and ends 6 months
later
The puerperium is the period which......
1. Begins with the
delivery of the baby
and ends 6 weeks later
**2. Begins with the
delivery of the placenta
and ends 6 weeks later**
3. Begins with the
delivery of the baby
and ends 6 months
later
49
This is not a cause of recurrent
miscarriage...........
1. autoimmune disease
2. chromosomal
abnormalities
3. endometriosis
4. cervical incompetence
5. infection
6. hormonal disturbances
This is not a cause of recurrent
miscarriage...........
1. autoimmune disease
2. chromosomal
abnormalities
**3. endometriosis**
4. cervical incompetence
5. infection
6. hormonal disturbances
50
Light & painless PV bleeding with a closed cervical os
& the uterus is size expected from dates is termed.....
1. A threatened
miscarriage
2. A complete
miscarriage
3. A missed miscarriage
4. Ongoing miscarriage
Light & painless PV bleeding with a closed cervical os
& the uterus is size expected from dates is termed.....
1. **A threatened
miscarriage**
2. A complete
miscarriage
3. A missed miscarriage
4. Ongoing miscarriage
51
What is the potential impact on the unborn
fetus of Toxoplasma gondii?
1. Stillbirth
2. Premature delivery
3. physical damage,eg
eye disorders
4. Neurological disorders
leading to learning
difficulties
5. None of the above
6. All of the above
**6. All of the above**
52
Administration of live vaccines (such as MMR) is often delayed until
after one year of age. Which of the following factors may interfere
with live vaccines in babies under 6 months of age?
1. Lactoferrin in breastmilk
2. Immunoglobulin G
acquired before birth
3. Neutrophil immaturity
4. Absence of an adjuvant in
the vaccine
5. Immunological naivety
Administration of live vaccines (such as MMR) is often delayed until
after one year of age. Which of the following factors may interfere
with live vaccines in babies under 6 months of age?
1. Lactoferrin in breastmilk
**2. Immunoglobulin G
acquired before birth**
3. Neutrophil immaturity
4. Absence of an adjuvant in
the vaccine
5. Immunological naivety
53
Which of the following factors are most important in
preventing collapse of aerated alveoli in the newborn baby?
1. The first gasp
2. Hepatic glycogen
3. Pulmonary surfactant
4. Closure of the ductus
arteriosus
5. Bradykinin
Which of the following factors are most important in
preventing collapse of aerated alveoli in the newborn baby?
1. The first gasp
2. Hepatic glycogen
**3. Pulmonary surfactant**
4. Closure of the ductus
arteriosus
5. Bradykinin
54
The 5 components of the Apgar score are:
1. Colour, respiratory
effort, muscle tone,
reflex irritability, heart
rate
2. Appearance, breathing
rate, grimace, pulse,
activity
3. complexion,
respiration, floppiness,
cry, pulse rate
The 5 components of the Apgar score are:
**1. Colour, respiratory
effort, muscle tone,
reflex irritability, heart
rate**
2. Appearance, breathing
rate, grimace, pulse,
activity
3. complexion,
respiration, floppiness,
cry, pulse rate
55
Common neonatal problems:
Which of the following is a cause of jaundice in the
first 24 hours of life?
1. Hepatitis B
2. Biliary atresia
3. Physiological
jaundice
4. ABO immune
haemolysis
5. Breastmilk jaundice
**4. ABO immune
haemolysis**
56
Problems of prematurity: Respiratory Distress
Syndrome (RDS) is caused by:
1. Lack of brown fat
2. Surfactant deficiency
3. Lack of alveolar
development
4. Pulmonary hypoplasia
5. High surface area-to-
volume ratio
Problems of prematurity: Respiratory Distress
Syndrome (RDS) is caused by:
1. Lack of brown fat
**2. Surfactant deficiency**
3. Lack of alveolar
development
4. Pulmonary hypoplasia
5. High surface area-to-
volume ratio
57
This lesion, found on the lower
back of a newborn baby, arises from abnormal
development of which embryonic structure(s)?
1. Frontonasal process
2. Endoderm
3. Angiogenic cells
4. Yolk sac
5. Neural folds
This lesion, found on the lower
back of a newborn baby, arises from abnormal
development of which embryonic structure(s)?
1. Frontonasal process
2. Endoderm
3. Angiogenic cells
4. Yolk sac
**5. Neural folds**
58
Congenital Heart Disease: Which of the
following is not a feature of Tetralogy of Fallot?
1. Atrial septal defect
2. Pulmonary stenosis
3. Right ventricular
hypertrophy
4. Ventricular septal
defect
5. Over-riding aorta
Congenital Heart Disease: Which of the
following is not a feature of Tetralogy of Fallot?
**1. Atrial septal defect**
2. Pulmonary stenosis
3. Right ventricular
hypertrophy
4. Ventricular septal
defect
5. Over-riding aorta
59
Select the statement below which best describes
Low Birth Weight (LBW) babies
3. 1. All premature babies are LBW
2. Conditions related to immaturity are
the leading cause of neonatal death
in the UK
3. 8% of births in Yemen are Low Birth
Weight
4. In the UK, LBW babies have the same
survival as normal birth weight
babies
5. If a baby is small-for-gestational age
they will also be LBW
1. All premature babies are LBW
**2. Conditions related to immaturity are
the leading cause of neonatal death
in the UK**
3. 8% of births in Yemen are Low Birth
Weight
4. In the UK, LBW babies have the same
survival as normal birth weight
babies
5. If a baby is small-for-gestational age
they will also be LBW
60
Which congenital infection causes fetal anaemia,
heart failure and hydrops fetalis?
1. Rubella
2. Cytomegalovirus
3. Toxoplasmosis
4. Parvovirus B19
5. Varicella
Which congenital infection causes fetal anaemia,
heart failure and hydrops fetalis?
1. Rubella
2. Cytomegalovirus
3. Toxoplasmosis
**4. Parvovirus B19**
5. Varicella
61
Genetic disease in childhood:
A polymorphic genetic marker is:
1. Responsible for a number of
different inherited diseases
2. Gives rise to several
alternative phenotypes
3. Present at a frequency of >1%
in the normal population
4. A series of linked alleles
5. A genetic tag that is unique to
a particular person
Genetic disease in childhood:
A polymorphic genetic marker is:
1. Responsible for a number of
different inherited diseases
2. Gives rise to several
alternative phenotypes
**Present at a frequency of >1%
in the normal population**
4. A series of linked alleles
5. A genetic tag that is unique to
a particular person
62
Developmental delay and disability: Which of the
following will be most helpful for a pre-school child
with uncomplicated learning disabilities?
1. Physiotherapy
2. Portage service
3. Acute Paediatrician
4. Intensive care unit
5. The AA
Developmental delay and disability: Which of the
following will be most helpful for a pre-school child
with uncomplicated learning disabilities?
1. Physiotherapy
**2. Portage service**
3. Acute Paediatrician
4. Intensive care unit
5. The AA
63
Which of the following statements about wheezing
in infancy is incorrect?
1. It is mainly triggered by viral
infections
2. The wheeze occurs in the expiratory
phase of respiration
3. Most children with wheezing in
infancy will develop allergic asthma
in later life
4. Maternal smoking is a risk factor for
wheezing in infancy
5. The airways tend to narrow during
the expiratory phase of respiration
Which of the following statements about wheezing
in infancy is incorrect?
1. It is mainly triggered by viral
infections
2. The wheeze occurs in the expiratory
phase of respiration
**3. Most children with wheezing in
infancy will develop allergic asthma
in later life**
4. Maternal smoking is a risk factor for
wheezing in infancy
5. The airways tend to narrow during
the expiratory phase of respiration
64
Child Psychiatry: which of the following
is a feature of autism?
1. Impaired
communication
2. Bed wetting
3. Criminal behaviour
4. Hallucinations
5. Truancy
Child Psychiatry: which of the following
is a feature of autism?
**1. Impaired
communication**
2. Bed wetting
3. Criminal behaviour
4. Hallucinations
5. Truancy
65
Childhood infections: This 4-year
old boy has a fever and a
vesicular rash. What is the most
likely cause?
1. Smallpox
2. Measles
3. Meningococcal disease
4. Tuberculosis
5. Chickenpox
Childhood infections: This 4-year
old boy has a fever and a
vesicular rash. What is the most
likely cause?
1. Smallpox
2. Measles
3. Meningococcal disease
4. Tuberculosis
**5. Chickenpox**
66
Malignant disease in children: Which of the
following malignancies is not seen in childhood:
1. Retinoblastoma
2. Teratoma
3. Wilm’s tumour
4. Bronchial
carcinoma
5. Acute leukemia
Malignant disease in children: Which of the
following malignancies is not seen in childhood:
1. Retinoblastoma
2. Teratoma
3. Wilm’s tumour
**4. Bronchial
carcinoma**
5. Acute leukemia
67
The majority of patients referred with short
stature have the following.....
1. Constitutional
growth delay
2. Endocrine disorders
3. Chronic diseases
4. Psychosocial
deprivation
5. Dysmorphic
syndromes
6. Variation of normal
growth
The majority of patients referred with short
stature have the following.....
1. Constitutional
growth delay
2. Endocrine disorders
3. Chronic diseases
4. Psychosocial
deprivation
5. Dysmorphic
syndromes
**6. Variation of normal
growth**
68
Red circle is
1. pterion
2. inion
3. asterion
4. nasion
5. glabella
**pterion**
69
A indicates
1. transition zone of the prostate gland
2. peripheral zone of the prostate gland
3. central zone of the prostate gland
4. seminal vescicle
5. bladder
A indicates
1. transition zone of the prostate gland
**2. peripheral zone of the prostate gland**
3. central zone of the prostate gland
4. seminal vescicle
5. bladder
70
A baby was born at 27/40. She was given three doses doses of surfactant and ventilated.
On day 4, a chest x-ray showed 'solid' lungs. The photomicrograph shows
1. hyaline membrane disease
2. normal lung for this age
3. pneumonia
4. pneumothorax
5. pneumopericardium
6. intraventricular haemmorhage
**1. hyaline membrane disease**
71
Characteristics depicted suggest
1. Kleinfelter syndrome
2. Cushing syndrome
3. Turner syndrome
4. Acromegaly
5. Congenital adrenal hyperplasia
Characteristics depicted suggest
**1. Kleinfelter syndrome**
2. Cushing syndrome
3. Turner syndrome
4. Acromegaly
5. Congenital adrenal hyperplasia
72
This diagram shows the inguinal canal of a 3-week old baby. What abnormality is shown?
1. Hydrocoele
2. Complete inguinal hernia
3. Ectopic testis
4. Intra-abdominal testis
5. Teratoma
2. Complete inguinal hernia
73
A 2-year-old girl is vomiting, refuses to eat and has a fever. She has a non-blanching haemorhagic rash. She is up to date with all her vaccinations. Which infective agent is
most likely to be associated with her condition?
1. Haemophilus influenza
2. Herpes simplex virus
3. Mycobacterium tuberculosis
4. Neisseria meningitides
5. Streptococcus pyogenes
A 2-year-old girl is vomiting, refuses to eat and has a fever. She has a non-blanching haemorhagic rash. She is up to date with all her vaccinations. Which infective agent is
most likely to be associated with her condition?
1. Haemophilus influenza
2. Herpes simplex virus
3. Mycobacterium tuberculosis
**4. Neisseria meningitides**
5. Streptococcus pyogenes
74
This is the nose of a newborn baby. This appearance is characteristic of:
1. staphylococcal infection
2. acne
3. eczema
4. milia
5. erythema toxicum
4. milia
75
The photo shows
1. syringomyelia
2. exomphalos
3. Meckel-Gruber syndrome
4. sirenomelia
5. amniotic band disruption
6. gastroschisis
The photo shows
1. syringomyelia
**2. exomphalos**
3. Meckel-Gruber syndrome
4. sirenomelia
5. amniotic band disruption
6. gastroschisis
76
A 24 year old man presented to his GP complaining of a lump in the right testis. The patient was referred to his local urology department and underwent a right orchidectomy. In
this histopathology specimen of the tissue, the arrow indicates
1. seminomatous tumour cells
2. non-seminomatous tumour cells
3. lymphocytes
4. papillary serous carcinoma
5. Sertoli cell tumour cells
A 24 year old man presented to his GP complaining of a lump in the right testis. The patient was referred to his local urology department and underwent a right orchidectomy. In
this histopathology specimen of the tissue, the arrow indicates
**1. seminomatous tumour cells**
2. non-seminomatous tumour cells
3. lymphocytes
4. papillary serous carcinoma
5. Sertoli cell tumour cells
77
A represents
a. ischial tuberosity
b. ischial spine
c. ramus of ischium
d. pubic tubercle
e. pubis
A represents
**a. ischial tuberosity**
b. ischial spine
c. ramus of ischium
d. pubic tubercle
e. pubis
78
What is the most likely syndrome that this baby has?
A. Amniotic
band
syndrome
B. Angelman
syndrome
C. Down
syndrome
D. Edwards
syndrome
E. Prader-
Willi
syndrome
What is the most likely syndrome that this baby has?
A. Amniotic
band
syndrome
B. Angelman
syndrome
C. Down
syndrome
**D. Edwards
syndrome**
E. Prader-
Willi
syndrome
79
A. Corpus
albicans
B. Corpus
luteum
C. Primordial
follicle
D. Primary
follicle
E. Oocyte
**A. Corpus
albicans**
80
A. posterior
vaginal
fornix
B. broad
ligament
C.
rectouterine
pouch (of
Douglas)
D. rectovesical
pouch
E. vesicouterine
**C.
rectouterine
pouch (of
Douglas)**
81
Name structure (e).
A. zygote
B. morula
C. blastocyst
D. embryo
E. fetus
**C. blastocyst**
82
A. bladder
B. posterior fornix
C. vaginal canal
D. cervix
E. fundus ofuterus
A. bladder
B. posterior fornix
C. vaginal canal
**D. cervix**
E. fundus ofuterus
83
What structure is labelled A in this photomicrograph of seminiferous tubules?
A. Primary
spermatocytes
B. Secondary
spermatocytes
C. Spermatogonia
D. Spermatids
E. Spermatozoa
What structure is labelled A in this photomicrograph of seminiferous tubules?
A. Primary
spermatocytes
B. Secondary
spermatocytes
C. Spermatogonia
D. Spermatids
**E. Spermatozoa**
84
What hormone is responsible for stimulating uterine contractions, production of
placental prostaglandin and is missing in this diagram?
A. Gonadotrophin-releasing hormone
B. Luteinising hormone
C. Oxytocin
D. Prolactin
E. Progesterone
What hormone is responsible for stimulating uterine contractions, production of
placental prostaglandin and is missing in this diagram?
A. Gonadotrophin-releasing hormone
B. Luteinising hormone
**C. Oxytocin**
D. Prolactin
E. Progesterone
85
A. Corpus
luteum
B. Primary
oocyte
C. Secondary
oocyte
D.
Graafian
follicle
E. Corpus
albicans
A. Corpus
luteum
B. Primary
oocyte
C. Secondary
oocyte
**D.
Graafian
follicle**
E. Corpus
albicans
86
A. Amniotic
band
syndrome
B.
Angelman
syndrome
C. Down
syndrome
D. Edwards
syndrome
E. Prader-
Willi syndrome
**A. Amniotic
band
syndrome**
B.
Angelman
syndrome
C. Down
syndrome
D. Edwards
syndrome
E. Prader-
Willi syndrome
87
A. obturator internus
B. coccygeus
C. levator ani
D. piriformis
E. illiacus
A. obturator internus
B. coccygeus
**C. levator ani**
D. piriformis
E. illiacus
88
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
**D. Myelomeningocoele**
E. Anencephaly
89
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
**D. Myelomeningocoele**
E. Anencephaly
90
A. definative yolk sac
B. extraembryonic mesoderm
C. chorionic cavity
D. hypobalst
E. amniotic cavity
**A. definative yolk sac**
B. extraembryonic mesoderm
C. chorionic cavity
D. hypobalst
E. amniotic cavity
91
These graphs show hormonal changes throughout the menstrual cycle. In pregnancy,
which hormone maintains the corpus luteum and the production of hormone A until
the placenta produces hormone A.
A. Oestradiol
B. Human chorionic gonadotrophin
C. Progesterone
D. Insulin-like growth factor
E. Gonadotrophin-releasing hormone
These graphs show hormonal changes throughout the menstrual cycle. In pregnancy,
which hormone maintains the corpus luteum and the production of hormone A until
the placenta produces hormone A.
A. Oestradiol
**B. Human chorionic gonadotrophin**
C. Progesterone
D. Insulin-like growth factor
E. Gonadotrophin-releasing hormone
92
This picture shows brain calcification in an infant. What is the most likely condition?
A. Chronic renal failure
B. Toxoplasmosis
C.Congenital cytomegalovirus
D. Intracerebral haemorrhage
E. Cavernous angioma
This picture shows brain calcification in an infant. What is the most likely condition?
A. Chronic renal failure
B. Toxoplasmosis
**C.Congenital cytomegalovirus**
D. Intracerebral haemorrhage
E. Cavernous angioma
93
This graph shows hormonal changes throughout pregnancy. Hormone C is measured
as part of the 1st and 2nd trimester screening tests for Down's syndrome. What is
hormone C?
A. Oestradiol
B. Human chorionic gonadotrophin
C. Progesterone
D. Insulin-like growth factor
E. Gonadotrophin-releasing hormone
This graph shows hormonal changes throughout pregnancy. Hormone C is measured
as part of the 1st and 2nd trimester screening tests for Down's syndrome. What is
hormone C?
A. Oestradiol
**B. Human chorionic gonadotrophin**
C. Progesterone
D. Insulin-like growth factor
E. Gonadotrophin-releasing hormone
94
This picture shows one of the major causes of death in a pre-term baby. What is this
condition?
Waterhouse-Friderichsen syndrome
Meningitis
Periventricular haemorrhage
Hyaline membrane disease
Neonatal sepsis
This picture shows one of the major causes of death in a pre-term baby. What is this
condition?
Waterhouse-Friderichsen syndrome
Meningitis
**Periventricular haemorrhage**
Hyaline membrane disease
Neonatal sepsis
95
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
**E. Anencephaly**
96
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
**D. Myelomeningocoele**
E. Anencephaly
97
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
A. Encephalocoele
B. Meningocoele
**C. Spina bifida occulta**
D. Myelomeningocoele
E. Anencephaly
98
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
**D. Myelomeningocoele**
E. Anencephaly
99
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
A. Encephalocoele
**B. Meningocoele**
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
100
Red circle is
1. pterion
2. inion
3. asterion
4. nasion
5. glabella
**pterion**
101
A indicates
1. transition zone of the prostate gland
2. peripheral zone of the prostate gland
3. central zone of the prostate gland
4. seminal vescicle
5. bladder
A indicates
1. transition zone of the prostate gland
**2. peripheral zone of the prostate gland**
3. central zone of the prostate gland
4. seminal vescicle
5. bladder
102
A baby was born at 27/40. She was given three doses doses of surfactant and ventilated.
On day 4, a chest x-ray showed 'solid' lungs. The photomicrograph shows
1. hyaline membrane disease
2. normal lung for this age
3. pneumonia
4. pneumothorax
5. pneumopericardium
6. intraventricular haemmorhage
**1. hyaline membrane disease**
103
Characteristics depicted suggest
1. Kleinfelter syndrome
2. Cushing syndrome
3. Turner syndrome
4. Acromegaly
5. Congenital adrenal hyperplasia
Characteristics depicted suggest
**1. Kleinfelter syndrome**
2. Cushing syndrome
3. Turner syndrome
4. Acromegaly
5. Congenital adrenal hyperplasia
104
This diagram shows the inguinal canal of a 3-week old baby. What abnormality is shown?
1. Hydrocoele
2. Complete inguinal hernia
3. Ectopic testis
4. Intra-abdominal testis
5. Teratoma
2. Complete inguinal hernia
105
A 2-year-old girl is vomiting, refuses to eat and has a fever. She has a non-blanching haemorhagic rash. She is up to date with all her vaccinations. Which infective agent is
most likely to be associated with her condition?
1. Haemophilus influenza
2. Herpes simplex virus
3. Mycobacterium tuberculosis
4. Neisseria meningitides
5. Streptococcus pyogenes
A 2-year-old girl is vomiting, refuses to eat and has a fever. She has a non-blanching haemorhagic rash. She is up to date with all her vaccinations. Which infective agent is
most likely to be associated with her condition?
1. Haemophilus influenza
2. Herpes simplex virus
3. Mycobacterium tuberculosis
**4. Neisseria meningitides**
5. Streptococcus pyogenes
106
This is the nose of a newborn baby. This appearance is characteristic of:
1. staphylococcal infection
2. acne
3. eczema
4. milia
5. erythema toxicum
4. milia
107
The photo shows
1. syringomyelia
2. exomphalos
3. Meckel-Gruber syndrome
4. sirenomelia
5. amniotic band disruption
6. gastroschisis
The photo shows
1. syringomyelia
**2. exomphalos**
3. Meckel-Gruber syndrome
4. sirenomelia
5. amniotic band disruption
6. gastroschisis
108
A 24 year old man presented to his GP complaining of a lump in the right testis. The patient was referred to his local urology department and underwent a right orchidectomy. In
this histopathology specimen of the tissue, the arrow indicates
1. seminomatous tumour cells
2. non-seminomatous tumour cells
3. lymphocytes
4. papillary serous carcinoma
5. Sertoli cell tumour cells
A 24 year old man presented to his GP complaining of a lump in the right testis. The patient was referred to his local urology department and underwent a right orchidectomy. In
this histopathology specimen of the tissue, the arrow indicates
**1. seminomatous tumour cells**
2. non-seminomatous tumour cells
3. lymphocytes
4. papillary serous carcinoma
5. Sertoli cell tumour cells
109
A represents
a. ischial tuberosity
b. ischial spine
c. ramus of ischium
d. pubic tubercle
e. pubis
A represents
**a. ischial tuberosity**
b. ischial spine
c. ramus of ischium
d. pubic tubercle
e. pubis
110
What is the most likely syndrome that this baby has?
A. Amniotic
band
syndrome
B. Angelman
syndrome
C. Down
syndrome
D. Edwards
syndrome
E. Prader-
Willi
syndrome
What is the most likely syndrome that this baby has?
A. Amniotic
band
syndrome
B. Angelman
syndrome
C. Down
syndrome
**D. Edwards
syndrome**
E. Prader-
Willi
syndrome
111
A. Corpus
albicans
B. Corpus
luteum
C. Primordial
follicle
D. Primary
follicle
E. Oocyte
**A. Corpus
albicans**
112
A. posterior
vaginal
fornix
B. broad
ligament
C.
rectouterine
pouch (of
Douglas)
D. rectovesical
pouch
E. vesicouterine
**C.
rectouterine
pouch (of
Douglas)**
113
Name structure (e).
A. zygote
B. morula
C. blastocyst
D. embryo
E. fetus
**C. blastocyst**
114
A. bladder
B. posterior fornix
C. vaginal canal
D. cervix
E. fundus ofuterus
A. bladder
B. posterior fornix
C. vaginal canal
**D. cervix**
E. fundus ofuterus
115
What structure is labelled A in this photomicrograph of seminiferous tubules?
A. Primary
spermatocytes
B. Secondary
spermatocytes
C. Spermatogonia
D. Spermatids
E. Spermatozoa
What structure is labelled A in this photomicrograph of seminiferous tubules?
A. Primary
spermatocytes
B. Secondary
spermatocytes
C. Spermatogonia
D. Spermatids
**E. Spermatozoa**
116
What hormone is responsible for stimulating uterine contractions, production of
placental prostaglandin and is missing in this diagram?
A. Gonadotrophin-releasing hormone
B. Luteinising hormone
C. Oxytocin
D. Prolactin
E. Progesterone
What hormone is responsible for stimulating uterine contractions, production of
placental prostaglandin and is missing in this diagram?
A. Gonadotrophin-releasing hormone
B. Luteinising hormone
**C. Oxytocin**
D. Prolactin
E. Progesterone
117
A. Corpus
luteum
B. Primary
oocyte
C. Secondary
oocyte
D.
Graafian
follicle
E. Corpus
albicans
A. Corpus
luteum
B. Primary
oocyte
C. Secondary
oocyte
**D.
Graafian
follicle**
E. Corpus
albicans
118
A. Amniotic
band
syndrome
B.
Angelman
syndrome
C. Down
syndrome
D. Edwards
syndrome
E. Prader-
Willi syndrome
**A. Amniotic
band
syndrome**
B.
Angelman
syndrome
C. Down
syndrome
D. Edwards
syndrome
E. Prader-
Willi syndrome
119
A. obturator internus
B. coccygeus
C. levator ani
D. piriformis
E. illiacus
A. obturator internus
B. coccygeus
**C. levator ani**
D. piriformis
E. illiacus
120
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
**D. Myelomeningocoele**
E. Anencephaly
121
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
**D. Myelomeningocoele**
E. Anencephaly
122
A. definative yolk sac
B. extraembryonic mesoderm
C. chorionic cavity
D. hypobalst
E. amniotic cavity
**A. definative yolk sac**
B. extraembryonic mesoderm
C. chorionic cavity
D. hypobalst
E. amniotic cavity
123
These graphs show hormonal changes throughout the menstrual cycle. In pregnancy,
which hormone maintains the corpus luteum and the production of hormone A until
the placenta produces hormone A.
A. Oestradiol
B. Human chorionic gonadotrophin
C. Progesterone
D. Insulin-like growth factor
E. Gonadotrophin-releasing hormone
These graphs show hormonal changes throughout the menstrual cycle. In pregnancy,
which hormone maintains the corpus luteum and the production of hormone A until
the placenta produces hormone A.
A. Oestradiol
**B. Human chorionic gonadotrophin**
C. Progesterone
D. Insulin-like growth factor
E. Gonadotrophin-releasing hormone
124
This picture shows brain calcification in an infant. What is the most likely condition?
A. Chronic renal failure
B. Toxoplasmosis
C.Congenital cytomegalovirus
D. Intracerebral haemorrhage
E. Cavernous angioma
This picture shows brain calcification in an infant. What is the most likely condition?
A. Chronic renal failure
B. Toxoplasmosis
**C.Congenital cytomegalovirus**
D. Intracerebral haemorrhage
E. Cavernous angioma
125
This graph shows hormonal changes throughout pregnancy. Hormone C is measured
as part of the 1st and 2nd trimester screening tests for Down's syndrome. What is
hormone C?
A. Oestradiol
B. Human chorionic gonadotrophin
C. Progesterone
D. Insulin-like growth factor
E. Gonadotrophin-releasing hormone
This graph shows hormonal changes throughout pregnancy. Hormone C is measured
as part of the 1st and 2nd trimester screening tests for Down's syndrome. What is
hormone C?
A. Oestradiol
**B. Human chorionic gonadotrophin**
C. Progesterone
D. Insulin-like growth factor
E. Gonadotrophin-releasing hormone
126
This picture shows one of the major causes of death in a pre-term baby. What is this
condition?
Waterhouse-Friderichsen syndrome
Meningitis
Periventricular haemorrhage
Hyaline membrane disease
Neonatal sepsis
This picture shows one of the major causes of death in a pre-term baby. What is this
condition?
Waterhouse-Friderichsen syndrome
Meningitis
**Periventricular haemorrhage**
Hyaline membrane disease
Neonatal sepsis
127
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
**E. Anencephaly**
128
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
**D. Myelomeningocoele**
E. Anencephaly
129
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
A. Encephalocoele
B. Meningocoele
**C. Spina bifida occulta**
D. Myelomeningocoele
E. Anencephaly
130
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
**D. Myelomeningocoele**
E. Anencephaly
131
A. Encephalocoele
B. Meningocoele
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
A. Encephalocoele
**B. Meningocoele**
C. Spina bifida occulta
D. Myelomeningocoele
E. Anencephaly
132
A 30 year old women is pregnant with her 3rd baby. She is now 31+2 weeks. She was concerned that the fetus seemed to have decreased movement and was referred for a umbilical cord and MCA Doppler. (she had an umbilical cord and MCA Doppler at the same stage of gestation for one of her previous pregnancies the normal umbilical cord Doppler is shown at the top). Her present umbilical cord Doppler is shown at the bottom.
**Explain the blood flow pattern seen in the normal ultrasound**
At the **end of the diastolic filling of the atria**, there is **still flow going through the umbilical cord**; so there is still depth to it.
Flow **never stops flowing** all the way through **even if the fetal heart stops beating** !
133
A 30 year old women is pregnant with her 3rd baby. She is now 31+2 weeks. She was concerned that the fetus seemed to have decreased movement and was referred for a umbilical cord and MCA Doppler. (she had an umbilical cord and MCA Doppler at the same stage of gestation for one of her previous pregnancies the normal umbilical cord Doppler is shown at the top). Her present umbilical cord Doppler is shown at the bottom.
**What is the pattern shown in the present Doppler and what could be the consequence of this flow pattern?** [2]
**Absent flow** throughout the **diastole phase**; blood is **only flowing through systole**
**IUGR**
134
A 30 year old women is pregnant with her 3rd baby. She is now 31+2 weeks. She was concerned that the fetus seemed to have decreased movement and was referred for a umbilical cord and MCA Doppler. (she had an umbilical cord and MCA Doppler at the same stage of gestation for one of her previous pregnancies the normal umbilical cord Doppler is shown at the top). Her present umbilical cord Doppler is shown at the bottom.
**Explain why the pattern shown in the present Doppler is occurring** [2]
(Absent flow in diastole) as blood is bein diverted to the MCA; vasoconstriction of the umbilical cord vessels is occuring
135
A 30 year old women is pregnant with her 3rd baby. She is now 31+2 weeks. She was concerned that the fetus seemed to have decreased movement and was referred for a umbilical cord and MCA Doppler. (she had an umbilical cord and MCA Doppler at the same stage of gestation for one of her previous pregnancies the **normal MCA Doppler is shown at the top**). **Her present MCA is shown at the bottom**.
What specific type of IUGR is shown here if you compare the umbilical cord and the MCA?
Explain how you can tell form the diagram
Asymmetric IUGR with brain sparing
**There is no low point in the diastole phase in the MCA** (due to vasodilation)
136
A baby is born by spontaneous vaginal delivery at 34 weeks to a mother who had tested positive for Covid-19. The baby boy weighed 2,065g. The neonate was admitted to the NICU, he was breathing room air without tachypnea and was started on feeds of expressed milk supplemented with formulae when breast milk was not available. 15 hrs after delivery they developed tachypnea and at 20 hrs they developed a fever, at 25 hrs they developed feed intolerance. An x-ray was taken at 30 hrs and repeated at 36 hrs. They tested positive for Covid-19 at 48 hrs after delivery.
What is the most likely diagnosis?
**Necrotizing** **enterocolitis**
137
Necrotising fasciitis in children may follow [] infection
Varicella-zoster infection
Herpes simplex virus
Cytomegalovirus
T. gondii
HIV
Necrotising fasciitis in children may follow [] infection
**Varicella-zoster infection**
Herpes simplex virus
Cytomegalovirus
T. gondii
HIV
138
Necrotising fasciitis in children may be caused by infection from which pathogen, aftern an initial infection from VZV? [1]
Group A streptococcus (GAS): e.g. Streptococcus pyogenes
139
140
This picture is from an autopsy. What is the pathology?
exomphalos
omphalocele
necrotising enterocolitis
peritonitits
This picture is from an autopsy. What is the pathology?
exomphalos
omphalocele
**necrotising enterocolitis**
peritonitits
141
An 8 year old child presents to her local A&E department with a 5 day history of progressively worsening fever, cough, nasal congestion and conjunctivitis. A rash started to appear on their face the day before. On examination of the oral mucosa small white spots are observed opposite the 1st and 2nd molars. Their vaccination status is unknown.
What is the most likely diagnosis?
Covid 19
Measles
Mumps
Rubella
Streptococcal scarlet fever
An 8 year old child presents to her local A&E department with a 5 day history of progressively worsening fever, cough, nasal congestion and conjunctivitis. A rash started to appear on their face the day before. **On examination of the oral mucosa small white spots are observed opposite the 1st and 2nd molars.** Their vaccination status is unknown.
What is the most likely diagnosis?
Covid 19
**Measles**
Mumps
Rubella
Streptococcal scarlet fever
142
An 7 year old boy is referred to an educational psychologist by the school because of concerns over their impaired communication development. During the assessment this behaviour is noted
What is the most likely diagnosis?
Attention deficit hyperactivity disorder
Autistic spectrum disorder
Conduct disorder
Obsessive compulsive disorder
Schizophrenia
**Autistic spectrum disorder**:
Not playing ‘pretend’ games (e.g. feeding a doll with play food)
Not smiling back when you smile at them
Not playing social games like ‘peek-a-boo’
Being over-sensitive or reacting strangely to some tastes, smells or sounds
Not pointing at interesting objects or looking when you point
Being very late starting to ‘babble’ and talk, not talking as much as other children or being able to say fewer than ten words at age 2 years old
Repetitive movements, for example rocking their body, flicking their fingers or hand-flapping
Repeating the same phrases over and over.
143
An individual is diagnosed with attention deficit hyperactivity disorder. When reviewing the mothers antenatal history what would be the most likely behaviour or condition that the mother had during her pregnancy?
Continued to drink alcohol
Continued to smoke
Had gestational diabetes
Had pre-eclampsia
Was obese
An individual is diagnosed with attention deficit hyperactivity disorder. When reviewing the mothers antenatal history what would be the most likely behaviour or condition that the mother had during her pregnancy?
Continued to drink alcohol
**Continued to smoke**
Had gestational diabetes
Had pre-eclampsia
Was obese
144
A female child was diagnosed with Turner syndrome at age of 4 years. She was given oxandrolone and her height was within target height. She was referred for further assessment at 7 year 10 months because of vaginal bleeding. On assessment she was assessed as Tanner stage 3.
How would this be best managed?
Counselling
Do nothing
Give GnRH analogues
Give growth hormone
Stop oxandrolone
A female child was diagnosed with Turner syndrome at age of 4 years. She was given oxandrolone and her height was within target height. She was referred for further assessment at 7 year 10 months because of vaginal bleeding. On assessment she was assessed as Tanner stage 3.
How would this be best managed?
**Counselling**
Do nothing
Give GnRH analogues - can't do this because stage 3.
Give growth hormone
Stop oxandrolone
145
A baby is born at 36 weeks
Their length and weight are assessed at 8 weeks when they have their 1st set of vaccinations.
What is their gestationally corrected age?
40 weeks - 36 weeks = **4 weeks preterm**
Start the plot at plotted at **4 week not 8 weeks**
146
A 75 year old man has an open prostatectomy because of longstanding urinary problems that have not been managed by medication.
What is the most likely diagnosis?
Benign prostate hyperplasia
Embryonal carcinoma
Prostate cancer
Prostatis
Testicular cancer
A 75 year old man has an open prostatectomy because of longstanding urinary problems that have not been managed by medication.
What is the most likely diagnosis?
**Benign prostate hyperplasia**
Embryonal carcinoma
Prostate cancer
Prostatis
Testicular cancer
147
A 75 year old man has an open prostatectomy because of longstanding urinary problems that have not been managed by medication.
What is the most likely diagnosis?
Benign prostate hyperplasia
Embryonal carcinoma
Prostate cancer
Prostatis
Testicular cancer
A 75 year old man has an open prostatectomy because of longstanding urinary problems that have not been managed by medication.
What is the most likely diagnosis?
Benign prostate hyperplasia
Embryonal carcinoma
**Prostate cancer**
Prostatis
Testicular cancer
148
A 20 year old male goes to their GP concerned that their left testis / scrotum looks like a bag of worms. What anatomical issue means that the left side is predominately at risk?
There are no valves on the left side
The pampiniform plexus is more complex on the left
The left testicular vein is longer and drains to left renal vein at a right angle
The left testicular vein is shorter and drains into the IVC
Left renal has a longer course to reach the IVC
A 20 year old male goes to their GP concerned that their left testis / scrotum looks like a bag of worms. What anatomical issue means that the left side is predominately at risk?
There are no valves on the left side
The pampiniform plexus is more complex on the left
**The left testicular vein is longer and drains to left renal vein at a right angle**
The left testicular vein is shorter and drains into the IVC
Left renal has a longer course to reach the IVC
149
This 30 year old male has both a direct and indirect inguinal hernia. What structure is the yellow arrow pointing to?
Superficial ring
Deep ring
Hesselbach’s triangle
Linea alba
Aponeurosis of internal, external oblique and transversus abdominis muscles
This 30 year old male has both a direct and indirect inguinal hernia. What structure is the yellow arrow pointing to?
Superficial ring
**Deep ring**
Hesselbach’s triangle
Linea alba
Aponeurosis of internal, external oblique and transversus abdominis muscles
150
Which structure in this image helps you determine if a hernia is direct or indirect? [1]
Inferior epigastric vessels
151
Label A-C
A: Vas deferens
B: IEV
C: gonadal vessels
152
Is the hernia labelled at A a direct or indirect hernia?
Indirect
153
Which of the following is the vas deferens?
A
B
C
D
E
Which of the following is the vas deferens?
A
B
C
**D**
E
154
Which of the following is the inferior epigastric vessels?
A
B
C
D
E
Which of the following is the inferior epigastric vessels?
A
**B**
C
D
E
155
Which of the following is the gonadal vessels?
A
B
C
D
E
Which of the following is the gonodal vessels?
A
B
C
D
**E**
156
Is this a direct or indirect hernia?
Indirect
157
A 30 year old woman has a routine PAP smear and on investigation the pathologist notes these large glassy inclusions. What infectious pathogen is most likely to have caused these?
Chlamydia trachomatis
Neisseria gonorrhoeae
Herpes simplex virus type I
Human papilloma virus type 16
Treponema pallidum
**Chlamydia trachomatis**
158
Which of the following is leiomyoma, leiomyosarcoma and normal?
A: **normal**
B: **fibroids**
C: a **malignant leiomyosarcoma** is hypercellular and less fascicular, and consists of **atypical smooth-muscle cells with hyperchromatic, enlarged nuclei**. Increased mitotic figures and necrosis are frequent histological findings in leiomyosarcomas
159
A 30 year old woman has a routine PAP smear and on investigation the pathologist notes these abnormalities. What infectious pathogen is most likely to have caused these?
Chlamydia trachomatis
Neisseria gonorrhoeae
Herpes simplex virus type I
Human papilloma virus type 16
Treponema pallidum
A 30 year old woman has a routine PAP smear and on investigation the pathologist notes these abnormalities. What infectious pathogen is most likely to have caused these?
Chlamydia trachomatis
**Neisseria gonorrhoeae**
Herpes simplex virus type I
Human papilloma virus type 16
Treponema pallidum
160
A 30 year old woman has a routine PAP smear and on investigation the pathologist isolates the pathogen. What is the most likely pathogen? [1]
A 30 year old woman has a routine PAP smear and on investigation the pathologist isolates the pathogen. What is the most likely pathogen?
**syphilis**
161
During a routine ultrasound the image below was generated the largest depth of amniotic fluid was measured at 10 cm? What is this condition called?
Oligohydramnios
Normal amniotic volume
Polyhydramnios
During a routine ultrasound the image below was generated the largest depth of amniotic fluid was measured at 10 cm? What is this condition called?
Oligohydramnios
Normal amniotic volume
**Polyhydramnios**
162
A mother gives birth to a baby with chorioretintitis, hydrocephalus and intracranial atherosclerosis. A biopsy of the mothers muscle is shown below. What is the causative pathogen?
Toxoplasma gondii
Treponema pallidum
Parvovirus B19
Chlamydia trachomatis
Neisseria gonorrhoeae
A mother gives birth to a baby with chorioretintitis, hydrocephalus and intracranial atherosclerosis. A biopsy of the mothers muscle is shown below. What is the causative pathogen?
**Toxoplasma gondii**
Treponema pallidum
Parvovirus B19
Chlamydia trachomatis
Neisseria gonorrhoeae
163
A mother gives birth to a baby who lafter a couple of weeks looks like this. What is he infected with?
Toxoplasma gondii
Treponema pallidum
Parvovirus B19
Chlamydia trachomatis
Neisseria gonorrhoeae
Parvovirus B19: slapped cheeks
164
At the routine 24 week antenatal visit the BP is measured at 142/92mmHg for the second time after the 1st reading was also 145/95mmHg 4 hrs previously. There is protein detected in her urine as well. What is the most likely diagnosis?
Gestational diabetes
Placental abruption
Placental praevia
Pre-eclampsia
Chronic hypertension of pregnancy
At the routine 24 week antenatal visit the BP is measured at 142/92mmHg for the second time after the 1st reading was also 145/95mmHg 4 hrs previously. There is protein detected in her urine as well. What is the most likely diagnosis?
Gestational diabetes
Placental abruption
Placental praevia
**Pre-eclampsia**
Chronic hypertension of pregnancy
165
At the routine 18 week antenatal visit the BP is measured at 142/92mmHg for the second time after the 1st reading was also 145/95mmHg 4 hrs previously. There is protein detected in her urine as well. What is the most likely diagnosis?
Gestational diabetes
Placental abruption
Placental praevia
Pre-eclampsia
Chronic hypertension of pregnancy
At the routine 18 week antenatal visit the BP is measured at 142/92mmHg for the second time after the 1st reading was also 145/95mmHg 4 hrs previously. There is protein detected in her urine as well. What is the most likely diagnosis?
Gestational diabetes
Placental abruption
Placental praevia
Pre-eclampsia
**Chronic hypertension of pregnancy**: up to week 20
166
An ultrasound is taken at 28 weeks showing the head (H) of the fetus is engaged with the internal os (white arrow). The red Doppler shows the umbilical vessels. What is the name of this issue?
Placenta previa
Placental abruption
Vasa previa
Placenta increta
Placenta accreta
**Vasa previa** - **umbilical vessels** connecting the **placenta** to the baby are **covering the internal os**
167
A 27 year old in her 3rd pregnancy is having a routine ultrasound which is shown below. The uterus is to the left hand side of the image and the bladder is at the bottom of the image. What is the problem shown?
Complete molar pregnancy
Incompetent cervix
Placental abruption
Placenta previa
Vasa praevia
**Placenta previa**: The US shows that the placenta is covering the OS opening completely
168
This is an ultrasound from a 16 week pregnant woman with heavy vaginal bleeding on examination the cervical os is dilated. The arrows are indicating the significant detachment of the placenta with hemorrahge. What is the type of miscarriage shown?
Complete
Incomplete
Inevitable
Missed
Threatened
**Inevitable**
The arrows are pointing to bleeding between the sac and the uterine wall. From the symptoms reported this would be inevitable miscarriage. The difference to a threatened miscarriage is that the cervical os is open compared to closed in a threatened
169
What is the aroow pointing at
urethra
vagina
rectum
ureter
anal canal
**urethra**
170
These images show a childhood respiratory condition. They show
congenital lobar emphysema
a bronchogenic cyst
asthma
pneumonia
tuberculosis
**congenital lobar emphysema**
171
Corpus luteum
172
what is the principal venous drainage of the anal cancl above the line indicated here?
superior rectal vein to internal iliac vein
middle rectal vein to inferior mesenteric vein
middle rectal ven to internal iliac vein
superior rectal vein to inferior mesenteric vein
inferior rectal vein to inferior mesenteric vein
superior rectal vein to inferior mesenteric vein
173
Which nerve loops around the ligament highlight here? [1]
pudendal nerve
174
The inguinal ligament runs from the ASIS to the pubic tubercle. What structure is located at its mid-point? [1]
**femoral artery**
175
The structure highlighted in this cross section of the prostate gland serves what function?
passage of ejaculant from seminal vesciles and vas deferens
entrance of prostatic fluid into urethra
vestigal / remnant uterus
prevent retrograde ejaculation
opening of bulbourethral glands
The structure highlighted in this cross section of the prostate gland serves what function?
passage of ejaculant from seminal vesciles and vas deferens
entrance of prostatic fluid into urethra
**vestigal / remnant uterus**
prevent retrograde ejaculation
opening of bulbourethral glands
176
A collection of striated muscle fibres are highlighted in this picture of the testes and spermatic cord. From which abdominal layer are these fibres derived?
external obliique
internal oblique
transversalis fascia
transversalis abdominus
parietal peritoneum
A collection of striated muscle fibres are highlighted in this picture of the testes and spermatic cord. From which abdominal layer are these fibres derived?
external obliique
**internal oblique**
transversalis fascia
transversalis abdominus
parietal peritoneum
177
The left testicular artery is hihglighted here. From where is this vessel derived
abdominal aorta T12
external iliac
internal iliac
abdominal aorta L2
pudendal artery
The left testicular artery is hihglighted here. From where is this vessel derived
abdominal aorta T12
external iliac
internal iliac
**abdominal aorta L2**
pudendal artery
178
what is A? [1]
**obturator artery**
179
What is A
iliacus
obturator internus
obturator externus
leavtor ani
coccygeus
What is A
**iliacus**
obturator internus
obturator externus
leavtor ani
coccygeus
180
A nine month old girl died after a sudden illness. Her adrenal gland is shown in her photograph. What most likekly caused her illness?
reye's syndrome
meningoccocal septicaemia
neonate herpes virus infection
congenital adrenal hyperplasia
A nine month old girl died after a sudden illness. Her adrenal gland is shown in her photograph. What most likekly caused her illness?
reye's syndrome
**meningoccocal septicaemia**
neonate herpes virus infection
congenital adrenal hyperplasia
181
The prostate gland has zones that are associated with higher prevalence of different conditions. Choose the option for the zone indicated by the arrow the condition most commonly associated with this zone
transitional zone - benign prostatc hyperplasia
peripheral zone - prostate cancer
transitional zone - prostate cancer
peripheral zone - benign prostatc hyperplasia
The prostate gland has zones that are associated with higher prevalence of different conditions. Choose the option for the zone indicated by the arrow the condition most commonly associated with this zone
**transitional zone - benign prostatc hyperplasia**
peripheral zone - prostate cancer
transitional zone - prostate cancer
peripheral zone - benign prostatc hyperplasia
182
The prostate gland has zones that are associated with higher prevalence of different conditions. Choose the option for the zone indicated by the arrow the condition most commonly associated with this zone
transitional zone - benign prostatc hyperplasia
peripheral zone - prostate cancer
transitional zone - prostate cancer
peripheral zone - benign prostatc hyperplasia
The prostate gland has zones that are associated with higher prevalence of different conditions. Choose the option for the zone indicated by the arrow the condition most commonly associated with this zone
transitional zone - benign prostatc hyperplasia
**peripheral zone - prostate cancer**
transitional zone - prostate cancer
peripheral zone - benign prostatc hyperplasia
183
adenocarcinoma of the prostate, Gleeson Grade 5
adenocarcinoma of the prostate, Gleeson Grade 1
transitional cell carcinoma
BPE
stratified squamous carcinoma
**adenocarcinoma of the prostate, Gleeson Grade 5**
184
dysgerminoma
serous adenocarcinoma
mucinous adenocarcnoma
teratoma
granulosa cell tumour
**dysgerminoma**
serous adenocarcinoma
mucinous adenocarcnoma
teratoma
granulosa cell tumour
185
leimyosarcoma
leimyoma
fibroadenoma
adenocarcinoma of the breast
normal breast tissue
fibrosarcoma
leimyosarcoma
leimyoma
fibroadenoma
**adenocarcinoma of the breast**
normal breast tissue
fibrosarcoma
186
Name a cause of encephalitis that is reverisble with acyclovir [1]
Herpes Simplex Virus
187
Depicted is a brain abscess. Which is the most common cause of bacterial caused brain abscess?
Streptococcus agalactiae
Streptococcus mutans
Streptococcus pneumoniae
Neisseria meningitidis
Staphylococcus aureus
Staphylococcus aureus
188
In the UK, the most common cause of bacterial meningitis is infection with
Streptococcus agalactiae
Streptococcus mutans
Streptococcus pneumoniae
Neisseria meningitidis
Staphylococcus aureus
In the UK, the most common cause of bacterial meningitis is infection with
Streptococcus agalactiae
Streptococcus mutans
Streptococcus pneumoniae
**Neisseria meningitidis**
Staphylococcus aureus
189
Meningococcal bacteria are divided into distinct serogroups, according to their polysaccharide outer capsule. The most common serogroups that cause disease worldwide are groups B, C, A, Y and W.
However, the number of cases caused by serogroup [] has significantly reduced in the UK since routine vaccination was introduced in 1999 in those age groups targeted for vaccination
meningococcal group B (MenB)
meningococcal group C (MenC)
meningococcal group A (MenA)
meningococcal group Y (MenY)
meningococcal group W (MenW)
**meningococcal group C (MenC)**
190
Which serotype of meningococcal disease accounts for the vast majority of meningococcal disease in the UK?
meningococcal group B (MenB)
meningococcal group C (MenC)
meningococcal group A (MenA)
meningococcal group Y (MenY)
meningococcal group W (MenW)
**meningococcal group B (MenB)**
