1.

True for aortic malformation

A Patent ductus arteriosus
B Coarctation of aorta
C Double aortic arch
D Abnormal origin of subclavian artery
E Patent foramen ovale

2. Embryonic period is
A 4-8 weeks
B Period of organogenesis
C When major malformation to the embryo can occur due to exposure to teratogen
D Growth and differentiation of tissues
E When morphogenesis of embryo occurs

3. Klinefelter Syndrome
A Chromosome XXY pattern
B Chromosomal make up may be XXXXY
C Hypoplastic uterus
D Streak Ovaries
E oligospermia

4. A complete hydatidiform mole

A Is pregnancy without embryo
B Secrete human chorionic gonadothrophin
C Show partial development of an embryo
D Is diploid but contains only paternal chromosomes
E Main causative mechanism has been shown to be monoeprmic fertilization of an
anucleated eggs

5. 44 days (7 weeks)old human embryo

A Genital ridge appears
B Skeletal ossification begins
C Sertoli cells begin to differentiate
D Pigment appears in retina
E Elbow and toe rays appear

6. Klinefelter Syndrome
A Hypoplastic uterus
B Streak Ovaries
C Sex chromatin positive
D Increase number of X chromosome associated with mental retardation
E Female external genitalia

7. Endocardial cushion defect

A Primary type atrial septal defect
B Result of defective fusion of the septum primum with the endocardial cushion
leaving a patent foramen ovale
C A seldom seen abnormality
D Complete endocardial cushion defect is een in 20% of all Down’s Syndrome

-1-
 E Associated with dextrocardia

8. Lateral plate mesoderm gives rise to

A Serosal membrane that lines the coelom
B Septum transversum
C Somatopleuric mesoderm coating the inner surface of the body wall
D Dorsal mesentery
E The splanchnopleuric mesoderm ensheathing the gut tube

9. Complete duplicate ureters, the reasons

A Premature bifurcation of ureteric bud
B Two ureteric buds arised from mesonephric duct and penetrates the metanephric
blasterma
C Abnormality in the mechanism of mesonephric duct
D Abnormality in the Weigwert Mayer’s rule
E Defects in the interaction between ureteric bud and metanephric blasterma

10. Main cause of Potter’s syndrome

A Bilateral renal agenesis
B Oligohydramnios
C Unilateral renal agenesis
D Renal hypoplasia
E Renal dysplasia

11. Spermatogenic cells

A Sertoli cells
B Spermatogonia
C Spermatozoa
D Spermatocytes
E Spermatids

12. Fetal blood

A α feto protein is a smaller molecule than albumin
B The increased white cell count at term is due to polymorphonucleocyte
C 1◦ megaloblastic erythroblast appears at 8/52
D The liver, yolk sac, bone marrow produces 2◦ erythroblastic megaloblasts after
birth
E Bone marrow and liver produce α chains

13. The following statement is not true

A The foregut and hindgut are endodermal in origin
B The superior mesenteric artery supplies the hidgut
C The formation of peptidases in small intestines begins at 10/52
D The peristaltic movements begin at 30/52
E The acidification of stomach begins at birth

14. The following are true regarding oxytocin

A It causes ascending contraction from the cervix to the fundus
B The receptors in the uterus increase with gestation
C The amplitude and frequency of uterine contraction is not proportionate to the

-2-
 dose
D Extremely high dose may cause insufficient blood supply to the fetus
E The usage in preeclamptic patient has to be with caution

15. Prostaglandin
A Increases the uterine tone
B Is a useful abortifacient
C E2 is used for cervical ripening
D Causes cervical relaxation
E Inhibits gravid uterine contraction stimulated by oxytocin

16. Oxytocin
A Inhibits milk production
B Has vasodilator effect
C Is used in induction of labour
D Causes water retention
E Is effective in treating menorrhagia

17. Ergometrine
A Does not contract a postpartum uterus
B Has vasodilatation effect
C Inhibits emesis
D Stimulates contraction of mioepithelium of mammary glands
E Is effective in postpartum haemorrhage

18. Prostaglandin
A E2α does not cause gravid uterine contraction
B F2α relaxes a non-gravid uterus
C Causes menorrhagia
D Is effective in the treatment of dysmenorrhoea
E F2α is synthesized plentifully in the uterus

19. The following statements are true regarding lactation

A The alveolar septum secretes milk
B The mineralocorticoid, prolactin and oxytocin are needed for maturation of the
mammary gland
C The enzyme specifier B lactalbumin is switched off by progesterone
D Lactose synthesizing enzyme is a complex of galactocyl transferase and α
lactalbumin
E Lactose is synthesized in large quantity ante- and intrapartum

20. Breast milk

A The carbohydrate content is the product of condensation of galactose and glucose
B Almost 10% of human milk is fat
C The main source of protein is casein
D The colostrum has higher immunoglobulin than full cream milk
E The electolytes content are all higher when compared with plasma

-3-
21. These methods suppress lactation
A Oestrogen
B Restricted fluid intake
C Intermittent, reducing frequencies of expressing milk
D Adequate breast support
E Bromocriptine

22. The following are true

A The milk energy content is 1000kCal/L
B The cow’s milk has equal carbohydrate but more fat than breast milk
C Milk ejection is a neuron-endocrine reflex
D Psychological stress suppresses lactation
E Lactational amenorrhoea provides contraception on in the first 3 months

23. The following are correct

A Conceptual age = ovulating age +/- 14 days
B The ovulatory age assumes fertilization at day 14 of any menstrual cycle
C Menstrual age/ gestation = ovulatory age +/- 14 days
D The trophoblast forms lacunae after the day of embedding
E The connecting stalk following retraction of 2◦ yolk sac fron chorionic cavity is
the definitive yolk sac

24. The following combinations are correct

A Epidermis & appendages – ectoderm
B Bladder & urethral epithelium – mesoderm
C Pancreas duct and islet – endoderm
D Connecting stalk – umbilical cord
E Morula – Day 4 week 1

25. Fetal pituitary gland

A Anterior pituitary – from Pouch of Rathke
B Neural tube – from anterior lobe of pituitary
C GH and prolactin – begins synthesis from second trimester
D Parapharyngeal pouch IV – superior parathyroid (dorsal)
E Pharyngeal pouch II – thyroid gland

26. The activity of the following endocrine glands are increased during pregnancy
A Thyroid
B Hypothalamus
C Adrenals
D Breasts
E Pituitary

27. The normal endocrinological change occurring in pregnancy are

A Increased ACTH
B Increased prolactin
C Increased thyroxine levels
D Increased cortisol levels
E Increased rennin levels

-4-
28. Hormone dynamics during pregnancy
A The placenta cannot synthesise oestrogen from C-21 steroids
B The placenta can utilize only C-19 steroids as precursors for oestrogen
biosynthesis
C The major of the oestrogen precursors is from the mother
D Dehydroepi-androsterone sulphate originates from fetal adrenal
E Placental sulphatase deficiency causes low oestrogen production resulting in
deleterious fetal growth

29. The following statements aabout hormonal situation in pregnancy are correct
A Maximal hCG levels are found between day 60 and 80 of pregnancy
B HPL raises maternal blood sugar
C Oestradiol accounts for 90% of oestrogen secreted in pregnancy
D Progesterone levels decrease before birth
E SP1 has an ovarian origin

30. Excretion of the following increases progressively from the 20th to 36th week
of normal pregnancy
A Oestradiol
B Pregnanediol
C Chorionic gonadotrophin
D Pregnanetriol
E Oestrone

31. The following increases in the urine during pregnancy

A Oestriol
B Progesterone
C Vaninyl mandelic acid
D Relaxin
E Pregnanediol

32. During pregnancy

A The output of maternal parathormone is increased
B The placenta secretes relaxin
C The corpus luteum begins to atrophy soon after implantation
D The placenta can convert glucose into glycogen
E There is negative nitrogen balance

33. In normal pregnancy

A There are equal increases in the excretion of oestrone, oestradiol and oestriol
B Serum hCG concentration rises to a peak at 20 weeks gestation
C There is reduced aldosterone secretion
D Androgen excretion is reduced
E There is an increase in serum protein bound iodine

34. The following changes in the genital tract occur during pregnancy
A Decrease vaginal pH
B Cervical ectopy
C Throphoblastic invasion of spiral arteries
D The lower segment forms in the mid-trimester

-5-
 E Hyperplasia and hypertrophy of myometrial fibres occur

35. The following biochemical changes occur in normal pregnancy

A Decrease in serum albumin
B Decrease in serum IgG
C Decrease in blood urea
D Decrease in iron binding capacity
E Decrease in total haemoglobin

36. In early pregnancy

A The chorion leave is the precursor of the true placenta
B The uterine cavity is obliterated when the decidua capsularis comes in contact
with the decidua vera
C The syncytiotrophoblast is in contact with maternal blood
D Both vitelline veins will become umbilical veins
E The zygote begins to embed in the uterus at the age of 3 days

37. During pregnancy there is an increase in the size of

A Uterine muscle cells
B Uterine fibrous and elastic tissues
C Uterine blood vessels
D Frankenhauser’s ganglion
E Pituitary gland

38. Lactation
A is initiated by a postpartum prolactin surge
B Requires the presence of adequate circulating growth hormone
C Is controlled by oxytocin
D Inhibits ovulation in 50% of nursing mothers
E Occurs inappropriately in the Budd-Chiari Syndrome

39. During pregnancy

A Glycosuria is an effective test of carbohydrate intolerance
B Fasting plasma glucose concentration is decreased
C Fasting plasma insulin concentration is decreased
D The oral glucose tolerance test alters with advancing gestation
E Two hours after an oral glucose load, plasma insulin concentration should have
returned to fasting levels

40. The following hormone shelp to maintain established lactation

A Prolactin
B Human placental lactogen
C Corticosteroids
D Oestrogen
E Growth hormone

41. The following statements relate to the total oestrogen excretion in pregnancy
A 30% of urinary oestrogens are conjugates of oestradiol
B In defining the normal range of excretion, biological and assay variations are
additive

-6-
 C Oestrogen excretion increases with parity
D Oestrogen excretion is higher in mothers with female fetuses
E A falling pattern of Oestrogen excretion within the normal range, is a reliable
guide to fetal prognosis

42. Falling levels of total oestrogen in maternal urine during pregnancy may often
indicate
A Antepartum haemorrhage
B Impending fetal death
C Fetal adrenal hyperplasia
D Fetal abnormality
E Tobacco smoking

43. At birth
A The foramen ovale closes immediately
B The ductus arteriosus constricts in response to hypoxia
C The pulmonary vasculature constricts vigorously in response to acidosis
D Output from the left ventricle increases
E Pressure falls in the right ventricle and pulmonary atery

44. The following are normal peripheral blood values at birth

A Mean Hb of 12g/dl
B Fetal Hb of 25% on electrophoresis
C White cell count of 15,000 – 20,000 cu. Mm
D Lymphocyte count of 90% of total white cell count
E Serum bilirubin of up to 100 mmol/l

45. In the fetal circulation

A The two umbilical veins carry blood from the fetus to the placenta for gaseous
exchange
B The oxygen content is higher in the umbilical artery than the carotid artery
C Under normal circumstances, blood from the superior vena cava is minimally
shunted through the foramen ovale
D Ductus venosus is the first shunt for the oxygenated blood coming from the
placenta
E The circulation in the umbilical arteries and the placenta has lower resistance

46. Lack of surfactatnt in the infant lungs

A Tends to be more marked the more prematurely is the infant born
B Increases the tendency of the lungs to remain expanded despite the infant’s
expiratory efforts
C Leads to poor oxygenation of the blood before birth
D Does not change the overall work of breathing
E Prevents the delivery of fetus in pre-eclampsia at 34 weeks

47. Fetal respiratory movements in utero

A Are normally present for 80% of a 24 hour period
B Occur at a frequency of 2 per minute
C Are increased in diabetic pregnancies
D Are reduced by maternal hyperventilation

-7-
 E Are increased during labour

48. Fetal pulmonary maturity

A Is delayed in diabetic pregnancies
B Normally occurs before the 36th week of gestation
C Is influenced by maternal corticosteroid levels
D Is controlled by α fetoprotein
E Is delayed in anencephaly

49. The following are Gram positive bacteria

A Clostridium welchii
B Mycobacterium tuberculosis
C Neisseria meningitis
D Bacillus anthracis
E Vibrio cholera

50. The following blood coagulation factors are increased during pregnancy
A Factor I
B Factor VII
C Platelets
D Factor XIII
E Factor X

51. The purine bases nucleic acids include

A Adenine
B Cytosine
C Uracil
D Guanine
E Thymine

52. The following vitamins are fat soluble

A Vitamin A
B Vitamin B2
C Vitamin D
D Vitamin K
E Vitamin C

53. In normal thyroid physiology

A The mammary gland can trap iodide
B T4 is released from TBG by proteolysis
C Thyroxine binding protein is a beta globulin
D TBG has 3 times greater affinity for triiodothyronine
E The normal range of protein bound iodine in the blood is 4-8 mcg per 100ml

54. The posterior relation of the ovary include

A Ureter
B Internal iliac artery
C Ovarian artery
D External iliac artery
E Ovarian ligament

-8-
55. Transplacental transfer of blood constituents may cause neonatal disease,
when the mother is suffering from
A Hyperparathyroidism
B Tuberosclerosis
C Idiopathic thrombocytopenic purpura
D SLE
E Rheumatoid arthritis

56. The following are transported across the placenta

A IgA
B IgG
C Calcium
D Insulin
E Pethidine

57. The rate of maternal-to-fetal oxygen flux across the placenta depends on
A Uterine blood flow rate
B Fetal oxygen consumption rate
C The oxygen gradient across the placenta
D Carbon dioxide transfer
E Fetal haemoglobin

58. Normal urodynamic study

A First sensation of micturition at 300ml
B Residual urine 0-10ml
C Maximum urine flow rate 100-150 ml/s
D Voiding volume 200-300 ml
E Bladder capacity >600ml

59. Which of the following have a dominant inheritance

A Marfan’s Syndrome
B Tuberous sclerosis
C Spherocytosis
D Sturge-Weber Syndrome
E Blue/ green colour blindness

60. Human placental lactogen

A Has a molecular weight of 21 600
B Has a half life of 15 minutes
C Has no carbohydrate residues
D Has two chains of amino acids
E Is excreted in the urine

61. the following examples of teratogenic agents and their effects are correct
A Phenytoin – nasal hypoplasia
B Lithium – cleft palate, spina bifida
C Irradiation – leukaemia
D Quinine – optic nerve hypoplasia
E Warfarin – cleft palate

-9-
62. The following description are correct
A Chi- squared test – the standard test for comparing the difference between two
means
B F-test – the standard method for comparing the size of variances
C Correlation – the relation between 2 variables
D Mean – the most frequently occurring value
E Standard deviation – the square of variance

63. the following features of Actinonyces Israeli are true

A Gram positive
B Aerobic
C Mouth commensal
D Causes unilateral salpingitis
E Associated with ‘Dalkon Shield’

64. The cardiovascular changes in pregnancy are

A Increase stroke volume
B Increase heart rate
C All heart sounds are louder
D First heart sound is split
E A diastolic murmur is normal

65. The ECG done during pregnancy may show

A High voltage QRS complexes
B Deep Q waves
C Inversion of T waves
D ST depression
E Ventricular extrasystoles

66. The vagina

A Has 3 layers of cells
B pH is normally acidic
C Vaginal fluid has a higher potassium level
D Vaginal fluid has a higher sodium level
E Vaginal fluid may act as pheromones

67. The following associations are correct

A Genital folds – labia majora
B Genital swelling – Bartholin’s glands
C Mullerian duct – ovary, fallopian tubes and uterus
D Genital swelling – Bulbouethral glands
E Genital tubercle – clitoris

68. The following nerve originates from the lumbar plexus

A Superior gluteal
B Genitofemoral
C Pedendal
D Obturator
E Femoral

- 10 -
69. Addison’s syndrome
A Hyponatraemia
B Vomiting
C Muscle wasting
D Hypokalaemia
E Metabolic acidosis

70. Pineal gland

A Innervated by parasympathetic neurons
B Secrete melatonin
C Innervated by sympathetic pathways
D Present in the roof of third ventricle
E Vestigial gland in humans

71. Glucagon
A Secreted by alpha cells of islets of langerhans
B Single chain polypeptide
C Secretion increases during exercise and stress
D Glycogenolytic hormone
E Ketogenic hormone

72. Human Chorionic Gonadotrophin

A Has alpha and beta chain
B Has molecular weight of 28000
C UPT detects urine B HCG
D Similar to luteinising hormone
E Secreted by corpus luteum in pregnancy

73. Amniotic fluid

A Is alkalotic
B Contains fetal epithelial cells
C Is the transudate from fetal intracellular cells
D Is acidic
E Volume increases as pregnancy advances

74. Structures passing through the Greater Sciatic Notch below the piriformis
A Internal pudendal neurovascular bundle
B Posterior cutaneous nerve of the thigh
C Tendon of obturator internus
D Superior gluteal nerve
E Inferior gluteal neurovascular bundle

75. Which of the following hormones promotes hypoglycaemia?

A Epinephrine
B Norepinephrine
C Insulin
D Glucagon
E Glucocorticoids

- 11 -
76. Which of the following hormones stimulates gluconeogenesis?
A Progesterone
B Glucagon
C Aldosterone
D Epinephrine
E Thyroxine

77. The citric acid cycle is inhibited by which of the following?

A Fluoroacetate
B Fluorouracil
C Aerobic conditions
D Arsenic
E Malic acid

78. Which one of the following enzymes catalyses high-energy phosphorylation of

substrates during glycolysis?
A Pyruvate kinase
B Phosphoglycerate kinase
C Triose phosphate isomerase
D Aldolase
E Glyceraldehydes-3-phosphate dehydrogenase

79. Which are the ketogenic amino acids?

A Leucine
B Isoleucine
C Phenylalanine
D Tyrosine
E Alanine

80. Tricarboxylic cycle (Krebs Cycle)

A Occurs in aerobic
B Occurs in the mitochondria
C Net production of 2 ATPs
D End product is carbon dioxide and water
E Occurs in both aerobic and anaerobic conditions

81. The following are true

A Human parvovirus B19 is associated with hydrops fetalis
B Intrauterine infection occurs as a result of maternal herpes zoster
C CMV is excreted in breast milk
D Coxsackie A virus causes neonatal myocarditis
E Hepatitis B virus is frequently transmitted to fetus during vaginal delivery

82. Lymphocytes in health

A Form 2% of white cell count
B Play an essential role in cell-medicated immunity
C Can change into plasma cells
D Have proportionately more nuclear material than cytoplasm
E Have a life span of about 30 days

- 12 -
83. Common aetiological agents of salpingitis
A Neisseria gonorrhoea
B Bacteroides fragilis
C E Coli
D Chlamydia trachomatis
E Salmonella sp.

84. The following are frequently associated with postpartum infection

A Group B streptococcus
B Staphylococcus aureus
C Pseudomonas aeruginosa
D Bacteroides fragilis
E Eischerichia coli

85. Chlamydia trachomatis is associated with

A Low sperm counts in men
B Chronic pelvic pain in women
C Asymptomatic endometritis
D Recurrent salphingitis
E Prostatic hypertrophy

86. Morphine
A Is detoxified by oxidation to gentisic acid
B Increases biliary tract pressure
C Is eliminated mainly in conjugated state via glomerular filtrate
D Is secreted in bile
E Alters the threshold or responsivity of nerve endingd to noxious stimuli

87. In 28 days old embryo

A Ureteric bud present
B Otic vesicle and lens placode
C Neural fold begins to fuse
D Myocardium forms and hearts begins to pump
E Spinal nerve begins to sprout

88. Which of these derived from derived from hypoblast

A Extraembryonic endoderm
B Amniotic membrane
C Exocoelomic membrane
D Heuser’s membrane
E Extraembryonic endoderm

89. Wilm’s tumour

A Is a nephroblastoma that contain mixed layer of cells and tissues
B Is one of the most frequent neoplasm in children
C Arised from abnormal gonadal agenesis
D Is a type of benign tumour found in teenagers
E Is associated with VAGR syndrome

- 13 -
90. Collagen
A Has double helical structure
B Shows regular banding pattern on electronic microscopy
C Not found normally in absence of ascorbic acid
D Is not found within basement membrane
E Synthesis imhibited by glucocorticoids

91. High alpha fetoprotein is associated with

A Seminoma
B Hepatoblastoma
C Embryonal carcinoma
D Choriocarcinoma
E Breast carcinoma

92. Extrabasal cells are commonly seen in smears of

A Normal reproductive women
B Postnatal period
C Postmenopausal period
D Pregnancy
E Impending abortion

93. Features of secretory phase endometrium include

A Supranuclear vacuolation of epithelium
B Decidual change in stroma
C Pseudostratification of columnar epithelium
D Stromal oedema
E Saw-tooth appearance of glands

94. Features of hydropic swelling in a cell are due to

A Accumulation of fluid in cytoplasm
B Dilatation of endoplasmic reticulum
C Mitochondrial swelling
D Swelling of nuclei
E Disruption of Golgi apparatus

95. Examples of metaplasia include

A Leukoplakia of vulva
B Development of cystitis glandularis of urinary bladder
C Intestinalisation of gastric epithelium
D Development of carcinoma in situ in cervical epithelium
E Ossification of scar tissue

96. In acute disseminated intravascular coagulation

A PT and PTT are prolonged
B There is presence of fragmented RBCs in peripheral blood film
C Important part of management is treatment of the cause
D Heparin may be useful
E Thrombin time is not prolonged

- 14 -
97. Bromocriptine
A Suppresses LH production
B Causes headache
C Is teratogenic
D Causes postural hypotension
E Is antiestrogenic

98. The effects of clomiphene include

A Hot flushes
B Transient blurring of vision
C Abortion
D Ovarian enlargement
E Hirsutism

99. Combined oral contraceptives

A Prevent menstruation if given continuously
B Are contraindicated in pregnancy
C Act mainly by preventing implantation of fertilised ovum
D Depress secretion of anterior pituitary hormones
E Increase body weight

100. Bacteriosis
A Is due to Gram negative organisms
B May be effectively treated with penicillin
C May occur as transplacental infection
D May be sexually transmitted
E Presents in adults as a flu-like illness

101. The following structures are likely to be injured in submandibulectomy

A Cervical branch of the facial nerve
B Otic ganglion
C Hypoglossal nerve
D Lingual nerve
E Retromandibular vein

102. The following statements are true of perianal suppuration

A It arises from anal glands
B It travels to ischiorectal fossa via the external sphincter
C It passes intersphincterically to the perianal skin
D Is found in ulcerative colitis
E The surgical drainage leads to perianal fistula

103. The following are true of hypercalcaemia

A It can present as an acute pancreatitits
B Is commonly caused by metastatic lesion in the bones
C Is lowered by calcitonin
D There is a U wave in ECG
E It can cause cardiac arrest

- 15 -
104. Regarding ambiguous genitalia
A Palpable gonads with chromatin – True haemophradite (XX/XY)
B Gonad not palpable with positive chromatin – CAH
C Commonest cause of ambiguous genitalia – CAH
D Incomplete 46XY gonadal dysgenesis – normal gonad
E Klinefelter’s – 46XY/ 45XO

105. Regarding prescribing in pregnancy

A Tetracycline is not contraindicated
B Cotrimoxazole causes Grey Syndrome
C Heparin crosses the placenta
D Nitrofurantoin is harmful to the fetus
E Warfarin causes chondrodysplasia

106. Regarding the gene

A Unit of genetic information which is a Mendel’s factor
B The protein polypeptide chains of gene is synthesized in the nucleus
C Only riboxine and mRNA necessary for polypeptide synthesis
D TATA box aids in mRNA polymerase II to the correct initiation site for
transcription
E Hybridization is not part of DNA diagnosis

107. These combinations are true

A Autosomal dominant – Huntington’s disease
B Autosomal recessive – Tuberous sclerosis
C Autosomal recessive – monozygote carriers
D Autosomal recessive – Albinism
E Sex linked – father to son transmission

108. Regarding bacteria

A Transition of losing the capsule is a R
S transition
B As the refractive index is less than H2O it is difficult to be visualized
C The basis of typing in GMN is the Thecoic acid
D The B lactamase is found in plasmic spaces
E The hydrophobic nature of mycobacterium confers the acid fastness
characteristics

109. Regarding fat

A The density of fat is proportionate to protein content
B Complexes composed of triglycerides and phospholipids
C HDL transports the main bulk of plasma cholesterol
D The synthesis of LDL is in the liver
E HDL contains 50% protein mainly A1, A2

110. In the adult human

A Plasma albumin is synthesized in the liver
B Elevated serum lactate dehydrogenase (LDH) activity is a good indicator of liver
damage
C There are about 76g of protein per litre of plasma
D Plasma fibrinogen is synthesized in the liver

- 16 -
 E An alpha 2 globulin synthesized in the liver is a substrate for renin

111. Coagulation of blood may me impaired

A When factor VIII is deficient
B When factor IX is deficient
C When vitamin A is deficient
D Immediately on administration of coumarin anticoagulants
E By heparin which promotes inhibition of thrombin synthesis

112. Coagulation of blood

A Is inhibited by plasmin
B Is promoted by urokinase
C Is inhibited by ancrod, a thrombin-like enzyme
D Is inhibited by aminocaproic acid
E May be promoted by aprotinin

113. In the skeletal muscle

A Tetrodotoxin blocks membrane calcium channel
B Thiocyanate ions lower the threshold for mechanical activation
C Caffeine potentiates contraction by inhibition of phosphodiesterase
D Beta 2 selective adrenoceptor agonists increase twitch tension in fast contracting
fibres
E Excessive circulating thyroid hormones cause tremors

114. D tubocurarine (Curare)

A Is a competitive neuromuscular blocker
B Causes a blockade which is intensified by neostigmine
C Does not affect transmission in autonomic ganglia
D Causes paralysis preceded by fasciculations of skeletal muscles
E Produces a block at the motor end plate that is antagonized by potassium chloride

115. Cardiac sympathetic nerves

A Have preganglionic axons arising from the lumbar segments of the spinal cord
B Have postganglionic axons in three bilateral nerve trunks
C Innervate cardiac pacemaker and contractile tissue only
D Contain both afferent and efferent axons
E Have postganglionic cell bodies entirely within the stellate ganglion

116. In an normal resting man, a bradycardia would be expected to occur following

A Increased carotid sinus pressure
B Increased right atrial pressure
C Application of pressure to the eyeball
D Intravenous administration of a large dose of atropine
E inspiration

117. Angina pectoris may be ameliorated by

A An effect of glyceryl trinitrate on coronary arterial perfusion of ischaemic
myocardium
B B adrenoceptor antagonist, such as propranolol
C Administration of hyperbaric oxygen

- 17 -
 D Oral administration of Verapamil
E Intravenous administration of Dobutamine

118. Essential aminoacids for adults include

A Leucine
B Phenylalanine
C Histidine
D Valine
E Lysine

119. The following hormones are increased during pregnancy

A Insulin
B Parathyroid hormones
C Calcitonin
D Cortisol
E Growth hormones

120. The following associations are correct

A Chloramphenicol – Grey syndrome
B Tetracycline – hypoplasia of primary teeth
C Novobiocin – neonatal jaundice
D Rifampicin – spina bifida
E Chlorothiazide - thrombocytopenia

121. Spinbarkeit activity

A Pertains to the arborisation phenomenon
B Peaks following ovulation
C Increases in activity in the proliferative phase
D Is caused by the progesterone effect
E Is taken in consideration in the Billing’s method

122. The early menstrual cycles in a woman reproductive life are usually
A Anovulatory
B Painful
C Irregular
D Has longer luteal phase
E Before breast enlargement occurs

123. These are examples of primary chronic inflammation

A Unresolving lobar pneumonia
B Sarcoidosis
C Appendiceal abscess mass
D Tuberculosis
E Leprosy

124. The following substances are recognized chemical mediators of inflammation

A Histamine
B Prostaglandin
C Dopamine
D Amiodarone

- 18 -
 E Kallidin

125. Benign, rather than malignant neoplasms are characterized by the following
features
A Increased numbers of mitotic figures
B Microinvasion
C Nuclear pleomorphism
D Orderly maturation
E Ability to metastasize

126. The following tumours are correctly matched

A Burkitt’s lymphoma – a t-cell lymphoma common in Europe
B Kaposi’s sarcoma – a vascular neoplasm associated with AIDS
C Wilm’s tumour – an embryonal tumour of the kidney
D Grawitz tumour – adrenocortical carcinoma
E Ewing’s tumour – a malignant tumour of bone of uncertain histogenesis

127. Which of the following is NOT associated with thrombosis

A Bleeding
B Activation of the coagulation mechanism
C Endothelial damage
D Formation of platelet aggregates
E Thrombocytopenia

128. In a patient with the following results:

pH = 7.34, PCO2 = 29 mmHg, bicarbonate = 15 mmol/L
Na = 134 mmol/L, Cl- = 90mmol/L, K+ = 4 mmol/L

A The patient is hyperventilating

B The patient has respiratory alkalosis
C It could be at a compensated stage
D The anion gap is reduced
E In this patient, formation of ammonia in the kidneys will be increased

129. Concerning acid-base balance

A The proteins are quantitatively most important buffers in the body
B The renal H+ secretion mechanism depends on tubular acidity
C The urine may be acidic during chronic vomiting
D The chloride concentration will increase in chronic vomiting
E The body K+ concentration will increase in chronic diabetic ketosis

130. The plasma concentration of HCO3- is low in

A Compensated metabolic acidosis
B Uncompensated respiratory acidosis
C Compensated respiratory acidosis
D Uncompensated respiratory alkalosis
E Compensated respiratory alkalosis

- 19 -
131. Normal micturition
A Depends on the integrity of a sacral spinal reflex arc
B Is prevented by sectioning of the ensory nerves supplying the bladder
C May occur with spinal transaction in the thoracic region
D Relaxation of sphincters followed by detrusor contraction
E Is under voluntary control in healthy young adults

132. The following are correct embryological associations

A Germ cells – wall of the yolk sac
B Mullerian duct – female genital tract
C Mullerian duct – Garner’s cyst
D Genital tubercle – clitoris
E Metanephros - kidneys

133. Regarding puberty

A Pubarche – onset of pubic hair
B Adrenarche – elevation of DHA and DHAS
C Menarche – before breast growth
D Ovulation – after menarche
E Pubertal growth – 45% of final adult height

134. Regarding the menstrual cycle

A Corpus luteum regulates the constant postovulatory interval
B LH stimulates follicular development
C The mean duration of LH surge is 24 hours
D The preceded increase of progesterone initiates LH surge
E The raised level of progesterone 36 hours after LH surge indicates ovulation

135. Regarding the menopause

A Climacteric is the first year of menopause
B Average age of menopause in Asian women is 50.7 years
C High levels of FSH result in the loss of follicular reserve
D Sole primary phenomenon is decrease in ovulatory follicle production of
oestrogen
E There is a primary increase of FSH

136. Regarding mycology

A The fungus is dimorphic
B The yeast is a non-facultative organism
C Biopsies are not useful for laboratory investigations
D Tricophytons causes subcutaneous infection
E Phyconicosis is a systemic infection related with immune suppressed patient

137. The following condition causes a rise in prolactin level

A Exercise
B Pain
C Puerperium
D Naloxone
E Renal failure

- 20 -
138. In left ventricular heart failure
A There is often peripheral vasodilatation
B Salt and water retention is common
C There is a tendency towards oedema in the feet and legs when standing
D Cardiac glycosides may produce a diuresis
E Left ventricular end diastolic pressure is reduced

139. In the process of blood coagulation

A Prothrombin II is converted to thrombin IIa by platelet factor 3
B The role of thrombin is confined to the conversion of fibrinogen I to fibrin Ia
C The initiating stimulus activates factor XII
D The initiating stimulus may elevate plasma factor III levels
E Defects in the final stages may be assessed by addition of thrombin to plasma

140. The following tissues are likely to regenerate following damage:

A Cereberal cortex
B Myocardium
C Bone
D Liver
E Spinal cord

141. Granulation tissue

A Contains fibroblasts
B Always contain granulomas
C Often occurs after acute short-lived injury to the liver
D Contains thin-walled capillaries
E Actively contracts

142. The following factors will delay healing of a bony fracture

A Stabilisation
B Infection
C Malalignment
D Interposed soft tissue
E Paget’s disease of bone

143. In cell death by apoptosis

A Cell membrane integrity is lost
B Death of contiguous cell groups occurs
C An inflammatory response is usual
D There is energy-dependant fragmentation of DNA by endogenous endonucleases
E Lysosome leak lytic enzymes

144. Phenylketonuria
A May be detected using the Guthrie test
B Is due to a deficiency of phenylalanine hydroxylase
C Is characterized by hyperpigmentation of the skin
D Occurs in 1:1000 infants in Britain
E Is characterized by mental retardation

- 21 -
145. Dystrophic calcification
A May occur in the absence of any derangement of calcium metabolism
B May result in the formation of psammoma bodies
C Is associated with hyperparathyroidism
D Is associated with the ingestion of large amounts of milk
E May lead to heterotopic bone formation

146. The following organisms characterictically induce a granulomatous

inflammatory response
A Mycobacterium tuberculosis
B Staphylococcus Aureus
C Treponema pallidum
D Mycobacterium leprae
E Streptococcus pneumoniae

147. Examples of aneuploidy are seen in patients suffering from:

A Klinefelter’s syndrome
B Cystic fibrosis
C Edward’s syndrome
D Huntington’s chorea
E G6PD deficiency

148. The following statements is/ are true of carbohydrate metabolism

A There is an increased rate of absorption of glucose in pregnancy
B During mid and late pregnancy there is progressive rise in plasma insulin
C The production of lactate from glucose or glycogen is dependent upon the
presence of oxygen
D Muscle glycogen is the main source of blood glucose
E The fasting blood glucose concentration in pregnancy is greater than in the non-
pregnant state

149. Chylomicrons
A Are the lightest of the lipoproteins
B Are not present in fasting plasma in a normal individual
C Are rich in triacylglycerol
D Are metabolized in the liver
E Impart milkiness to the plasma if present in large numbers

150. Regarding glucose

A Main organ of glucogenolysis in the muscles
B Is not found in plants
C The hexokinase is important for gluconeogenesis
D Fructose-1,6-PIP is only found in the liver
E Insulin inhibits lipolysis of adipose tissue

- 22 -