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Which one of the following infections is not screened?

A-Cytomegalovirus
B-Malaria
C- Rubella virus
D-Syphilis
E-Toxoplasmosis
Ans. B
In males, which of the following hormones facilitates the generation spermatoza?
A-Dopamine
B-Follicle-stimulating hormone (FSH)
C-Growth hormone
D-Somatostatin
E-Thyroid stimulating hormone (TSH)
Ans. B
From which of the following structures are the inferior parathyroid glands derived?
A-Mesoderm of first pharyngeal arch
B-Mesoderm of second pharyngeal arch
C-Pouch of first pharyngeal arch
D- Pouch of second pharyngeal arch
E-Pouch of third pharyngeal arch
Ans. E
A-Activates fibrinolysis
B-Increases the levels of plasminogen activators
C-Inhibits endometrial growth
D-Inhibits fibrinolysis
E-Promotes coagulation
Ans. D
Which of the following is not a known side effect of Tranexamic acid?
a-Allergic skin reactions
b-Diarrhoea
c-Pulmonary haemorrhage
d-Visual disturbances
e-Vomiting
Which one of these condition can b diagnosed using flourescent in situ hybrization?
A.duchenne muscular dystrophy
B.sickle cell disease
C.pataus syndrome
D.cystic fibrosis
E.tay sach disease
Ans. A
A 15-year-old adolescent female is brought into the pediatrician due to absence of breast development and short
stature. A karyotype is performed which reveals 46 XY. Which of the following is the most likely diagnosis?

A. Androgen insensitivity
B. Gonadal dysgenesis
C. Kallmann syndrome
D. Testicular atrophy syndrome
E-turner syndrome
Ans. B
Maternal serum inhibin A levels
a.decrease with increasing gestation age after 17 week
B.higher in women with a fetus affected by down syndrome
C.increase with increasing gestation age between 11-14 week
D.are unaffected by fetal down syndrome
E.plateau after 20 week gestation
Ans. B
double bubble of duodenal atresia. The hydramnios results from the inability of the baby to swallow. Duodenal
atresia is strongly associated with fetal Down syndrome. Gestational diabetes is associated with hydramnios
occasionally; however, duodenal atresia is not related. Rh isoimmunization can also lead to hydramnios and hydrops
but not duodenal atresia.
OGTT done at 26 weeks after 10 hrs fasting.patient is already taking metformin 850 mg TDS.
diagnosis?
Normal
GDM
Report
Fasting: 96 mg/dl
1 hr after 75g oral glucose : 176 mg/dl
2 hr glucose : 134 mg/dl
Ans. B
A child born to an HIV infected mother develops pneumonitis. Which routine rapid laboratory method is used to detect
Pneumocystis in bronchiolar lavage?
a) Direct light microscopy
b) Immunoflurescence microscopy
c) Bacterial culture
d) Detection of specific IgM
e) Quantitative molecular detection
ans. B
Case for discussion
36-year-old G1 P0 woman at 27 weeks gestation is noted to have fever, right flank tenderness, and pyuria. She is
diagnosed with pyelonephritis. A urine culture is performed. Which of the following is the most commonly isolated
etiologic agent causing pyelonephritis in pregnancy?
A. Proteus species
B. Candidal species
C. Escherichia coli

D. Klebsiella species
E . Staphylococcus
Ans. C
A 24-year-old G2 P1 woman at 39 weeks gestation presents with painful uterine contractions. She also complains of
dark, vaginal blood mixed with some mucus. Which of the following describes the most likely eti- ology of her
bleeding?
A. Placenta previa
B. Placenta abruption
C. Bloody show
D. Vasa previa
E. Cervical laceration
Ans. C
Which one of following is dangerous compilation of IUCD
A.PID
B.infection actinomysis Israeli
C.Ectopic pergnancy
D.bleeding
E.menorrhegia
Ans.c
Which class of drugs is antagonised by flumazenil
A . Antiemetics
B. Antipsychotics
C. Benzodiazepines
D. Neuroleptics
E. Opiates
Ans. C
During pergnancy which infection is associated with symmatrical IUGR?
A.CMV
B.toxoplasmosis
C.HSV
D.Rubella
E.vericella zoster
Uterine embolization is done in
a) Large fibroid
b) Multiple fibroids
c) Pedunculated fibroids
d) Submucous fibroid
A 31-year old G2 P1 woman at 39 weeks gestation complains of painful uterine contractions that are occurring every
3 to 4 minutes. Her cervix has changed from 1-cm dilation to 2-cm dilation over 3 hours. Which one of the following
management plans is most appropriate?
A.

Cesarean delivery
B. Intravenous oxytocin
C. Observation

D. Fetal scalp pH monitoring


E. Intranasal gonadotropin therapy
B.

Ans.c

Which one of the following options best describes the chromosome abnormality in an infant girl born with a webbed
neck, hypertension and an audible ejection systolic murmur?
A-Edwards' syndrome
B-Fragile X syndrome
C-Klinefelter's syndrome
D-Patau's syndrome
E-Turner's syndrome
Ans. E
what is the most common type of nosocomial infection in hospitals?
A. pneumonia
B. uti
C. surgical wound infection
D. bacteraemia
E. infectious diarrhea
ans. B?
a patient had hypophsectomy for pituitary tumor she has amenorrhea for 8 months ovulation induction can be done in
her by:
a)clomiphene citrate
b)pulsatile hCG
c)hMG
d)hMG followed by pulsatile hCG
ans. D
Which of the following structures of the fetal circulation becomes the ligamentum venosum after birth?
A- Ductus arteriosus
B-Ductus venosus
C-Foramen ovale
D-Umbilical arteries
E-Umbilical vein
Ans. B
How can the action of cyclizine be described?
a) 5-HT3 antagonist
b) H1 antagonist
c) H2 antagonist
d) H1 agonist
e) H2 agonist
ans. B

A 26-year-old woman completed a course of oral antibiotics for cysti- tis 1 week ago. She complains of a 1-day history
of itching, burning, and a yellowish vaginal discharge. Which of the following is the best therapy?
A. Metronidazole
B. Erythromycin
C. Fluconazole
D. Hydrocortisone
E. Clindamycin
Ans.c
which of most suggestive of placentl abruption in woman with APH at 36 week of gestation?
A.soft non tender abdomen
B
High head at term
C.painless vaginal bleeding
D.uterine contraction 8 to 10 mint
E.abnormal lie
ans. D
Which one of following is not recognized maternal complications of placenta previa
A.PPH
B.compilation of C/section
C.post partum sepsis
D.placenta accreta
E.prolonged labour
Ans. E
40-year-old woman undergoes amniocentesis for Down syndrome screening. The karyotyping was normal; however,
alphafetoprotein was found to be elevated. Which is the most likely pathology diagnosed by ultrasound scan?
a) Cleft lip
b) Congenital diaphragmatic hernia
c) Microcephaly
d) Spina bifida
e) Umbilical hernia
ans. D
Infection with which one of the following human papillomaviruses (HPVs) is associated with an increased risk of
cervical cancer?
A- 6
B-11
C-16
D-17
E-30
Ans . c
Trisomy 13 occurs in
A. 1 in 500 births
B. 1 in 1000 births
C. 1 in 2000 births

D. 1 in 5000 births
E. 1 in 20,000 birthd
Ans. D
Which of the following organisms may be isolated from a wet surface 6 hours after inoculation?
A. Candida albicans
B. Trichomonas vaginalis
C. Gardenerella species
D. Peptostreptococci
E-proteus species
Which of following test is recommended in initial assestment of women with urinary incontinence ?
A.pad test
B.fluid bridge test
C.ultrasound assment of residual volume
D.Q tip test
E.Bonney test

Which one of the following sttement regarding dysmenorrhea is correct ?


A.around 10% of women experience dysmenorrhea
B.the pain of sec dysmenorrhea typically develops 3-4 days befire the onset of periods
C.the intrauterine sys is the frst line treatment fir sec dysmenorrhea
D.Prim dysmenorrhea typically develops around 10 years after the menerche
E. Endometriosis is cause of prim dysmenorrhea
Ans. E
The legal age for prescribing a contraception to a girl or agree on a request of termination of
pregnancy (TOP) in UK is :
A. 14 yrs
B. 16 yrs
C. 18 yrs
D. 20 yrs
E. 21 yrs
Which one is absolute contraindication to combine oral contraceptive pills use ?
A.concurrent use of st john's wort
B.family history of thrmboembolic disease if first degree relative <45 years
C.immobility

D.migraine with aura


E.diabties mellitus
A 36 yr G1P0 woman underwent induction for severe preeclampsia.Her antepartum was notable for
obisety &GDM.she underwent low forceps delivery for a 4Kg infant. What is her risk factor for a
puerperal hematoma :
A. Obesity
B. Large infant
C. Forceps delivery
D. Chronic HTN
Ans. C

G3P2 woman is 4 hrs postpartum from a spontaneous vag delivery complicated by 8 cm


vulvovaginal hematoma,which is incised ,evacuated &repeared.no expansion was noted.The vagina
was packed,broad spectrum AB was given.She is currently receiving 2 packed RBCs due to
hypovolemia.She developed a FEVER.Cause :
A. Preeclampsia
B. DVT
C. Infection hematoma bed
D. Transfusion reaction
E. Pneumonia
AnsImplantation completed at ?

A.day 6
B.day8
C.day 13
D. Day 16
E.day 18.
Ans. C

A pregnanat woman in her second trimester asks for advice about malaria prophylaxis which is
true ?
A.docycyclin can b used in 3rd trimester
B.chloroquine should b avoided in the first and second trimester
C.mefloquine is the anti malerial of choice in pregnanacy
D.malarone is safe in all trimesters
E.folic acid should b prescribed for pregnant patient in taking proguanil
A 20 wks pregnant woman is newly diagnosed with thyrotoxicosis .which medication will be the most
appropriate for her :
A. Carbimazole
B. Propranolol
C. Propylthiouracil
D. Radioactive iodine
E. Thyroxine

Ans. C
Which of the following is least recognised as a cause of a false positive VDRL test?
A - Pregnancy
B - SLE
C - Oral contraceptive pill
D - Tuberculosis
E HIV
Ans. C
- A woman is admitted to the antenatal ward .you have been asked to prescribe thromboprophylaxis
for her.her body weight is 101 kg. Recommended prophylactic dose of enoxaparin :
A. 20 mg
B. 40 mg
C. 60 mg
D. 80 mg
E. 100 mg
Ans. C

Down synd are at inc risk of


A.alzheimer's disease
B.Acute myeloid lukemia
C.qcute lymphoblastic leukemia
D.hypothyrodism
E.all
Ans e
A 16 year old girl presents with secondary amenorrhea she is healthy with nopast medical hx her
BMI is 17 . Initial investogation ?
A.bone mineral density
B.DHEAS measurement
C.FSH measurement
D.karyotyoe
E.thyroid function test
Ans. E

Which hormone is insensitive to NSAIDS and a potent inflammatory mediator?


A. Bradykinin
B. Leukotriens
C. Cortisol
D. Aldosterone
Ans. A
Which of the following is not a risk factor for surfactant deficiency?
A. Elective Caesarean section
B. Intrauterine growth restriction
C. Male gender
D. Prematurity
E. Sepsis
The correct answer is B.
A preterm baby is defined as a baby born prior to 37 completed weeks gestation. Intrauterine growth restriction
describes a baby that is small for its corrected gestation. Preterm babies develop respiratory disease because of
adeficiency of surfactant production by the type II pneumocytes in the lung. Surfactant is required to reduce the
surface tension within the lungs (i.e. make them less stiff).
The outcome of premature babies has been significantly improved by the production of exogenous surfactant which
can be administered directly into the lungs via an endotracheal tube.
Causes of increased incidence of surfactant deficiency:
- Prematurity
- Male gender
- Sepsis
- Maternal diabetes
- 2nd twin
- Elective Caesarean section
A reduced incidence of surfactant deficiency is associated with:
- Female gender
- Prolonged rupture of membranes
- Maternal opiate use
- Intrauterine growth restriction
- Antenatal steroids
If a pregnant woman is between 2432 weeks gestation and there is a strong likelihood of her delivering prematurely
then there is good evidence that giving the mother two doses of glucocorticoid prior to delivery will significantly
imprWhich of these drugs undergoes cytochrome p450 dependent hydroxylation ?

A.aspirin
B.lidocaine
C.methadone
D.procaine
E.warfarin
Puerpureium sepsis is not assosciated with ?
A.beta hemolytics streptococus
B.staphy epidermidis
C.streptococcus faecalis
D.klebsella pneumonia
E.trichomonas vaginalis

Ans . e
Foetus can recongnise foreign antigen and rejects allografts ?
A.8weeks
B.12
C.14
D.16
E.18
Ans. B
-mechanism of tranexamic acid :
A-inhibits activation of plasmin
B -inhibits activation of fibrin
C -inhibits activation of fibrinogen
D -inhibits activation of plasminogen
E -inhibits activation of thrombin
Ans. D

A 35-year-old pregnant woman is referred to you for antenatal checkup.on a liver screen the following
results are obtained:
Anti-HBs Negative
Anti-HBc Positive
Hbs ag Positive
IgM anti-HBc negative
What is the patient's hepatitis B status?
A - Probable hepatitis D infection
B - Acute hepatitis B infection
C - Previous immunisation to hepatitis B
D - Chronic hepatitis B
E - Previous hepatitis B infection, not a carrier
Ans. D

A 19-year-old woman is reviewed in the genitourinary medicine clinic. She presented with vaginal
discharge and dysuria. Microscopy of an endocervical swab showed a Gram-negative coccus that
was later identified as Neisseria gonorrhoea. This is her third episode of gonorrhoea in the past two
years. What is the most likely complication from repeated infection?
A - Lymphogranuloma venereum
B - Cervical cancer
C - Arthropathy
D - Infertility
E - Uterine abscess
Ans. D
Alkylating agents like vincristine act against
a. Cell membrane
b. Mitochondria

c. DNA
d. Tubules

Ans. D

At what gestation fetal breathing commences ?


A.12weeks
B.20
C.30
D.36
E.40
Ans. A
Which one of the following statement regarding PID is Incorrect ?
A.inc the risk of ectopic pregnancy
B.IUD should b removed following diagnosis
C.deep dyspurenia is typical
D.a low threshold traetment is recommended
E.Chlymadia T is the most common cause
Ans.d
A 23years old woman who is 10weeks pregnanat presents with severe vomiting she is now having
difficulty keeping down fluids and dipstick of her urine shows ketones ++ which is not associted with
inc risk of this condition ?
A.obesity
B.trophoblastic disese
C.smoking
D.nulliparity
E.carrying twins
Ans. C
You are reviewing test results. The midstream specimen of urine (MSU) from a 24-year-old woman
who is 11 weeks pregnant shows a urinary tract infection. On discussing the result with the patient
she does describe some dysuria and 'smelly urine'. What is the most appropriate management?
A - Ciprofloxacin for 7 days
B - Amoxicillin for 7 days
C - Repeat MSU
D - Trimethoprim for 3 days
E - No treatment

Ans.b
A 22-year-old woman who is an immigrant from Malawi presents for review as she thinks she is
pregnant. This is confirmed with a positive pregnancy test. She is known to be HIV positive. Which
one of the following should not be part of the management plan to ensure an optimal outcome?
A - Oral zidovudine for the newborn until 6 weeks of age
B - Maternal antiretroviral therapy
C - Encourage breast feeding
D - Intrapartum zidovudine infusion
E - Elective caesarean section
Ans. C
A pregnant 34-year-old female presents with uncomplicated Falciparum malaria following a trip to
Kenya. Which one of the following is the most suitable treatment?
A - Chloroquine
B - Artemether-lumefantrine
C - Doxycycline
D - Quinine
E - Atovaquone-proguanil
Which one of following statement regarding breech presentation is incorrect ?
A.ECV should b considerd at 36weeks in prmipara
B.maternal obesity is risk factor
C.vag delivery is option for delivery
D.describe caudal end of fetus occupying the lower segment
E.occurs around 3% of babies near term
The following are synthethised by liver: (t/f)
A) glucagon
B) vit.A
C) cholesterol
D) immunoglobulins
E) prothrombin
C,d,e are true
Which one of the following congenital infections is most characteristically associated with
sensorineural deafness?
A - Toxoplasma gondii
B - Parvovirus B19
C - Rubella
D - Treponema pallidum
E Cytomegalovirus
Ans. E
Tou are reviwieing the cervical screening results for 31 year old woman her previous smear have
been normal redults are mild dyskaryosis .sample is sent for HPV testing which is Positive what will
happen next ?
A.Offered colposcopy

B.offered course of Gardasil


C.smear repeated in 6months
D.smear repeated in 1year
E.smear pepeated in 3 years

What is the main mechanism of action of cerazette ( desogestril ) ?


A.thick cervical mucus
B.inhibit ovulation
C.causes endometrial thining
D.inhibit implantation
E. Toxic to sperm
Ans. A
31 year old with history of epilepsy consult you following an uneventful pregnanacy . Which one of
the following drug would it be safe during breast feeding ??
A.phenytoin
B.carbamezapime
C.lamptrigine
D.sodium valporate
E.all
Ans. B
A 30-year-old woman presents with a white, malodorous vaginal discharge. There is no associated
itch or dyspareunia. A diagnosis of bacterial vaginosis is suspected. Overgrowth of which one of the
following organisms is most likely to cause this presentation?
A - Lactobacilli
B - Trichomonas
C - Candida
D - Mycoplasma hominis
E Gardnerella
Ans. E
Foetus can recongnise foreign antigen and rejects allografts ?
A.8weeks
B.12
C.14
D.16
E.18
Ans. B
What is youngest age that a child in Uk may be legally able to consent to sexual activity ?
A.12
B.13
C.14
D.15
E.16

Which one of the following sttement regarding dysmenorrhea is correct ?


A.around 10% of women experience dysmenorrhea
B.the pain of sec dysmenorrhea typically develops 3-4 days befire the onset of periods
C.the intrauterine sys is the frst line treatment fir sec dysmenorrhea
D.Prim dysmenorrhea typically develops around 10 years after the menerche
E. Endometriosis is cause of prim dysmenorrhea
Ans. B
A new mother who is 4 weeks post partum presents fir warm red tender patch on the rite side just
lateral to areola this has been getting worse in last three days and feeding is now painful she saw a
midwife yeaterday helps with positioning but it is not improved on examination has mastitis of rt brest
no obvious absess what is most appropriate managment ?
A.co amxiclav, continue breast feeding
B.flucloxacillon, continue Bf
C.flucolxacillin, stop feeding
D.co amociclav , stop feeding
E. Metronodazole , continue feeding
Ans. B
Which ovarian tumor is difficult to distinguish from endometriosis ?
A.chorioacarcinoma
B.mature cyst teratoma
C.yolk sac tumor
D.mucinous tumor
E.serous teratoma
Ans. B
The yolk sac rapidly degenerates before birth.In rare cases it may persist to develop into which
condition :
A. Gastroschiasis
B. Meckel's diverticulum
C. Umbilical hernia
D. Vermiform appendix
E. Volvulus
Ans. B
The 2 oncogenes HPV 16 and HPV 18 are responsible for this percentage of cervical cancer.
a. 20%
b. 30%
c. 50%
d. 70%
e. 100%
ans. D

A 29-year-old woman presents to the genitourinary medicine clinic for treatment of recurrent genital
warts. Which one the following viruses are most likely to be responsible?
A - Human papilloma virus 16 & 18
B - Human papilloma virus 13 & 17
C - Human papilloma virus 6 & 11
D - Human papilloma virus 12 & 14
E - Human papilloma virus 15 & 21
Ans. C
Which one of the following organisms is most contagious?
A - Varicella zoster virus
B - Epstein Barr virus
C - Rotavirus
D - Herpes simplex virus
E - Haemophilus influenza
Ans. A
A 22-year-old female presents with an offensive vaginal discharge. History and examination findings
are consistent with a diagnosis of bacterial vaginosis. What is the most appropriate initial
management?
A - Oral azithromycin
B - Topical hydrocortisone
C - Oral metronidazole
D - Clotrimazole pessary
E - Advice regarding hygiene and cotton underwear
Ans. C
A 31-year-old woman who is known to be HIV positive presents following a positive pregnancy test.
Her last menstrual period was 6 weeks ago. The last CD4 count was 420 * 106/l and she does not
take any antiretroviral therapy. What is the most appropriate management with regards to
antiretroviral therapy?
A - Check CD4 at 12 weeks and initiate antiretroviral therapy if CD4 count is less than 350 * 106/l
B - Do not give antiretroviral therapy
C - Start antiretroviral therapy at 20-32 weeks
D - Start antiretroviral therapy at 10-12 weeks
E - Start antiretroviral therapy immediately
Ans. C

ans. C

Immunologic factor involved in the pathophysiology of polycystic ovarian


syndrome:
a. Complement
b. IL 8
c. VEGF
d. IL2
e. TNF
Ans. C
alpha fetoprotein is low in
1 NTD
2 Renal disease
3 Downs syndrome
4 VWD
ans. C
What is total blood volume thats risese in normal pregnanacy ?
A.5ml/kg
B.10
C.25
D.50
E.100
Ans. D
WHICH OF THE FOLLOWING TEST IS THE BEST FOR DETECTING TRISOMY 21
1 Serum test : hCG + PPAP-A
2 Triple test = hcg . feto protein, unconjugated E3
3 Quadruple test = hcg . feto protein, unconjugated E3, Inhibin A
4 Combined test: NT + hCG + PPAP-A
Ans.4

80. Diagnostic test for cystic fibrosis in blood


a. FISH
b. sweat test

c. immunoreactive trypsinogen
d. karyotyping
Ans. B
Expected T score in a 90 yr old female
a. 2.5
b. +1
c. 0
d. -1
e. -2.5
Ans. E
A 35-year-old homosexual man is referred to the local genitourinary clinic following the development
of a solitary painless penile ulcer associated with painful inguinal lymphadenopathy. He has recently
developed rectal pain and tenesmus. What is the most likely diagnosis?
A - Herpes simplex infection
B - Syphilis
C - Granuloma inguinale
D - Chancroid
E - Lymphogranuloma venereum
Ans. E
Below is a list of genetic conditions.
Which of the following has an autosomal dominant inheritance pattern?
A. Haemophilia A
B. Incontinentia pigmenti
C. Klinefelters syndrome
D. Oculocutaneous albinism
E. Tuberous sclerosis
Ans. E
The inheritance of disorders is a relatively common exam question and needs to be memorized. Knowing the
inheritance of certain disorders is important for counselling parents regarding the risk of future children being affected.
Inheritance patterns:
Chromosomal abnormalities
Trisomy 21 (Downs)
Trisomy 13 (Patau)
Trisomy 18 (Edwards)
Turner (45XO)
Fragile-X syndrome
Klinefelters syndrome (47 XXY)
Autosomal dominant inheritance
Achondroplasia
Tuberous sclerosis
EhlersDanlos
Familial hypercholesterolaemia
Huntingtons disease
Marfan syndrome
Neurofibromatosis

Noonan syndrome
Osteogenesis imperfecta
Polyposis coli
Autosomal recessive inheritance
Congenital adrenal hyperplasia
Cystic fibrosis
Friedreichs ataxia
Galactosaemia
Haemochromatosis
Oculocutaneous albinism
Sickle cell disease
TaySachs
Thalassaemia
X-linked recessive inheritance
Redgreen colour blindness
Duchenne muscular dystrophy
Haemophilia A & B
Glucose-6-phosphate
dehydrogenase deficiency
X-linked dominant inheritance
Vitamin D resistant rickets
Incontinentia pigmenti

A 25-year-old woman has an early transvaginal ultrasound scan due to some per vagina brown
spotting with a positive pregnancy test. The scan showed no intrauterine pregnancy. She had two
hCG serum tests taken, the first on the day of her scan showed a result of 653 and the second 48
hours later had a result of 623. What is the most likely diagnosis?
A. Early intrauterine pregnancy
B. Ectopic pregnancy
C. Inevitable miscarriage
D. Missed miscarriage
E. Threatened miscarriage
Ans. B
Which one of the following uterine fibroid is incorrect ?
A. Bengin smooth muscle tumor of uterus
B.urinary symptoms
C.Undergo malignanay changes 1:200
D.occur in around 20% of white woman
E.more common in black woman
Ans. C

Ans. C

A newborn baby has a heel-prick blood test taken for Guthrie card screening.
Which of the following is not screened for on the newborn Guthrie card?
A. Congenital hypothyroidism
B. Cystic fibrosis

C. Diabetes mellitus
D. Phenylketonuria
E. Sickle cell disease
Ans. C
The national newborn screening programme was introduced in 1969 for phenylketonuria
(PKU) and in 1981 congenital hypothyroidism (CHT) was added.
Currently all babies in the UK will have a Guthrie card to screen for:
- PKU
- CHT
- Cystic fibrosis
- Sickle cell disease and thalassaemia
Medium Chain Acetyl Co-A Dehydrogenase Deficiency (MCADD an inborn error of metabolism where fat cannot be
broken down, resulting in low energy and hypoglycaemic episodes) screening has now also been approved and will
hopefully soon be nationalized.
The Wilson criteria describe the features of a good screening tool:
- The condition should be an important health problem
- The natural history should be understood
- There should be a recognizable latent or early symptomatic stage
- There should be an accepted treatment recognized for the disease
- Treatment should be more effective if started early
- There should be a policy on who should be treated
- Diagnosis and treatment should be cost-effective
The test/tool should be:
- Easy to perform and interpret
- Acceptable
- Accurate, reliable, sensitive and specific
- Case-finding shThis phagocytic antigen presenting cell present in the cervix:(not sure about the

answer)
g. Hofbauer
h. T-lymphocyte
i. Plasma cell
j. Kuppfer cell
k. Neutrophilould be a continuous process
.A urinary catheter is vigorously inflated in the urethra at the time of caesarean section. Urine leaks
from the rupture into which anatomical space?
a.Into the anterior abdominal wall and mons pubis
b.Into the lesser pelvis
c.Into the peritoneal cavity
d.Into the vagina
e.Laterally to the femoral triangles
ans. A

what about ABO blood group?


a. parametric nominal

b. non parametric nominal


c. parametric ordinal
d. non parametric ordinal
ans. B

Ans. B

pregnant with clamydia inf,what is the best choice ?


1 erythromycin
2 azithromycin
3 ampicillin
4 cefuroxime
hemoglobin contain 2 alpha chains and two gamma chains
a. hb A
b. hbF
c. hb A1
d. bart
ans. B
Not recognized cause of imminent eclampsia
a. Headache
b. Epigastric pain
c. Blurred vision
d. Decreased fetal movement
e. Hypertension
Ans. D
Father has cystic fibrosis, and the mother is normal. What is the probability of having an affected
child?
A. 0
B. 25%
C. 50%
D. 75%
Ans. A

103. All the following are the about management of hypercalcemia except:
A. Iv saline
B. Frusemide 40mg iv
C. Prednisolone po

D. Oral thiazide diuretics


E. S.C calcitonin

mitochondrial chromosome(Single best answer)


a. exclusively present in the erythrocytes
b. round chromosome
c. inherited maternally only
d. occur in each generation
e. exclusively present in all body tissue
ans. C
What is the Lymphatic drainage of cervix and upper vagina?
A. Internal iliac LN
B. External iliac LN
C. Aortic LN
D. External iliac + internal iliac + common iliac + aortic LNs
E. External iliac + internal iliac + obturator + sacral LNs
Ans. D
Which is most suitable treatment in CIN ii ?
A-cryosurgery
B-laser ablation
C-cone biopsy
D-large loop excision of tranformation zone (LLETz)
Ans. B
A 30-year-old woman, who is 8 weeks pregnant, presents to accident and emergency with PV
bleeding and crampy abdominal pain. She has a past medical history of a right-sided deep vein
thrombosis and two previous miscarriages. She is sent to the early pregnancy assessment unit,
where ultrasound confirms miscarriage. What is the most likely underlying diagnosis?
A. Rheumatoid arthritis
B. Anti-phospholipid syndrome
C. Sjgrens syndrome
D. Discoid lupus
E. Systemic lupus erythematosus (SLE
Ans. B

Ideal contraception for a women with epilepsy :


A. Barrier method
B.IUCD
C. COCP
D. POP
E. Implanon
Ans. B

A 34-year-old diabetic woman attends your hypertension clinic to discuss her blood pressure control.
She is currently following lifestyle advice and has started to lose weight and maintain good glycaemic
control. Her blood pressure was 155/93 mmHg at her last clinic appointment and is now 150/90
mmHg. She informs you she has recently become pregnant, which was planned, and intends to keep
the baby.
The most appropriate first-line therapy is:
A. ACE-inhibitor
B. Angiotensin II receptor blocker
C. Calcium channel blocker
D. Diuretics
E. -blocker
Ans. C
A calcium channel blocker is first-line therapy in a female who intends to/or has become pregnant, as well as in
patients who are of African-Caribbean descent (with an ACE inhibitor). In a normal patient following lifestyle therapy
ACE inhibitors are first line, calcium channel blockers are second line followed by a combination of diuretics and
calcium channel blockers. -blockers are used if despite the aforementioned therapy target blood pressure is not met.
If there are any contraindications or poor compliance with ACE inhibitors, angiotensin II receptor blockers are used
instead.

Clomiphene citrate is ...?


A. Gonadotropin analogue
B. Androgenic steroid
C. Estrogenic steroid
D. Progestogenic steroid
E. Selective estrogen receptor modulator
B. Ans. E

What organ removes old red blood cells?


A. liver
B. Spleen
C. lungs
D. Bones marrow
E. Lymphnods
Ans. B

Which statistical test requires a normal population distribution?


A. Chi-squared test
B. Mann-Whitney U test
C. Spearmans rank correlation
D. Analysis of variance
E. Wilcoxon rank-sum test
The answer is Chi-squared test
In appraising a study, it is important to assess the suitability of the research, design and methods
used in the context of a clinical condition. Which study will provide the best evidence for a diagnostic
test?
A. Randomised controlled trial
B. Cross-sectional study
C. Cohort study
D. Case reports
E. Cost-benefit study
The answer is cross-sectional study.
A researcher is looking at different types of kettles to find out which type of material is better in terms
of achieving a quick boiling temperature. The factors affecting the outcome are: the volume of water,
the type of material, the electric resistance and the shape of kettle. Which one of the following will be
the independent variable for the researcher's first research question?
A. Time to boil
B. Volume
C. Kettle material
D. Starting temperature
E. Shape of the kettle
The answer is the kettle material. B, D and E are the control variables and should be kept constant.
In order to make a valid test, A is the dependent or output variable. Therefore, C is the independent
or input variable.
You wish to investigate the time it takes to perform a caesarean section on women with and without
pre-eclampsia. At the end of the study you have two groups of women with the duration of caesarean
sections recorded for each. It can't be assumed that these are normally distributed. Which nonparametric statistic test would you use?
A. Chi-squared test
B. Linear regression analysis
C. Mann-Whitney U test
D. Pearsons R test
E. Students t-test
The answer is the Mann-Whitney U test. The first three options are suitable for normally distributed
data. The Chi-squared test is suitable for two-way tables. Since one of the two variables you wish to
look at (time of caesarean section) is continuous, a Chi-squared test is not suitable.
If TP = true positive and FP = false positive, what is represented by the equation TP / (TP + FP)?
A. Likelihood ratio

B. Negative predictive value


C. Positive predictive value
D. Sensitivity
E. Specificity
The answer is Positive predictive value. Positive predictive value is is the proportion of positive test
results that are true positives.
Diagnostic studies frequently use a receiver operating characteristic curve. What do the two axes of
the curve represent?
A. Accuracy versus 1/sensitivity
B. Positive likelihood ratio versus negative likelihood ratio
C. Positive predictive value versus negative predictive value
D. Sensitivity versus 1 - specificity
E. Sensitivity versus positive predictive value
The answer is Sensitivity versus 1/specificity. This is required to measure the area under the curve. It
is an extremely useful tool to assess a diagnostic or screening trial.
What are the three leading three causes of maternal death in the UK from the 2003-2005
Confidential Enquiry into Maternal and Child Health (CEMACH) report?
A. Infection, pre-eclampsia and ectopic pregnancy
B. Pre-eclampsia, haemorrhage and infection
C. Thrombosis, haemorrhage and fatty liver
D. Thrombosis, pre-eclampsia and amniotic fluid embolism
E. Thrombosis, pre-eclampsia and infection
Incorrect:
The answer is Thrombosis, pre-eclampsia and infection. The rates of maternal deaths are often
quoted per 100,000 maternities. The maternal mortality rates for the top three cause were;
thrombosis 1.94, pre-eclampsia 0.85 and infection 0.85. Interestingly, haemorrhage had a rate of
0.66, fatty liver 0.05 and ectopic pregnancy 0.47.
Lewis G (editor). The Confidential Enquiry into Maternal and Child Health (CEMACH). Saving
Mothers Lives: Reviewing Maternal Deaths to Make Motherhood Safer 2003-2005. The Seventh
Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. London: CEMACH;
2007.
If the mean booking weight of an antenatal population of 125 women was 80 kg and the standard
error of the mean was 5 kg, what is the 95% confidence interval?
A. 40-120 kg
B. 60-100 kg
C. 65-95 kg
D. 70-90 kg
E. 75-85 kg
Incorrect:
The answer is 70-90 kg. The 95% confidence interval (CI) is 2 multiplied by the standard error of
the mean.
95% CI = mean 2 x SEM

95% CI = 80 2 x 5
95% CI = 70-90 kg