MRCOG sept 2009

by **mandible** Wed Feb 24, 2010 3:24 pm

Sept 2009..MCQ

1) The pelvic surface of the sacrum?

a) gives origin to the piriform muscles
b) gives origin to the levator ani muscles
c) is broader in the male than in the female
d) trnasmit dorsal rami of sacral nerves
e) is in contact with the anal canal

2) Prolactin.

a) release is stimulated by TRH
b) plasma levels are raised in the first trim of preg.
c) release is increased by suckling.
d) maybe produced by decidua.
e) release is inhibited by metoclopromide.

3) The foll disorders and org are correctly paired.

a) opthalmia neonatorum: chlamydia trachomatis
b) chancroid: Haemophilus ducreyi.
c) sleeping sickness: Leishmania donovani.
d) ringworm: Trichenella spiralis.
e) non-specific urethritis: Toxoplasma gondii.

4) The heart rate typically increases in response to:

a) pain.
b) hypoxia.
c) ventilatory expiration
d) increase in Intracranial pressure
e) decrease baroreceptor activity

5) Antibodies.

a) are proteins.
b) are formed in the fetus before 12 weeks of Intrauterine life.
c) have an average molecular weight of around 10 000 daltons.
d) of the rhesus type are genetically transmitted.
e) are produced by the ribosome of plasma cells.

6) the foll disorders have an X linked pattern of inheritance.

a) G6PD Deficeincy.
b) Kleinfelter syndrome
c) adrenogenital syndrome
d) haemophilia B
e) familial hypercholestroleamia.

7)The foll are derived from the urogenital sinus:

a) the bladder trigone.
b) the ureters.
c) the female urethra.
d)greater vestibular glands.
e) paraurethral glands.

Cool In the fetal CVS

a) the heart arises from endoderm
b) the heart is formed by fusion of endocardial tubes.
c) Cardiac pulsation is present by the 30th day after fertilization.
d) oxygenated blood is tranferred to the left atrium through the foramen ovale.
e) the ductus arteriosus closes during the last 4 weeks of pregnancy.

9) Arginine vasopressin

a) reduces GFR.
b) controls water loss in the Proximal renal tubule.
c) is synthesised by the post pituitary gland.
d) is released in response to rise in plasma osmolality.
e) is released in response to fall in circulating plasma volume.

10) Renin

a) is secreted by the zona glomerulosa of the adrenal coretx.
b) is a proteolytic enzyme.
c) is secreted at an increased rate if the renal perfusion pressure falls.
d) acts upon circulating angiotensinogen.
e) is released in response to an increase in extracellular fluid volume

11) Actinomyces israelii

a) is a rickettsia.
b) forms yellow granules in pus.
c) is a commensal in the mouth.
d) is a commensal in the vagina.
e) is usually resistant to penicillin.

12) Diseases caused by spirochaetes include.

a) Weil's disease.
b) lymphogranuloma venereum
c) pinta
d) Vincent's angina.
e) bilharzias

13) The foll are inherited as autosomal recessive conditions:

a) tuberous sclerosis.
b) phenylketonuria.
c) achondroplasia
d) sickle cell anaemia.
e) Von gierke's disease.

14) Antibodies play an important part in the development of:

a) phagocytosis.
b) Mantoux responce.
c) erythroblastosis fetalis.
d) hyperemesis gravidarum
e) anaphylaxis

15) chemical mediators concerned in the production of an inflammatory response include:

a) 5-hydroxytryptamine
b) aldosterone.
c) glucocorticoids.
d) bradykinin
e) leukotreines

16) The parathyroid gland.

a) originate from the pharyngeal cleft ectoderm.
b) secrete parathyroid hormone via the chief( principal) cells.
c) secrete calcitonin via the oxyphil cells.
d) may become hyperplastic in the presence of intestinal malabsorption.
e) may develop adenomas in association with islet cell tumour of the pancreas

17) In the abdominal wall:

a) the rectus abdominis muscle is attched to the crest of the pubis.
b) the post border of the external oblique muscle ends in the linea semilunaris.
c) the aponeurosis of the external oblique muscle takes part in the formation of the conjoint tendon.
d) the inferior epigastric artery is a branch of the internal iliac artery.
e) the conjoint tendon blends medially with the anterior layer of the rectus sheath.

1Cool The urogenital sinus in the female gives rise to the following:

a) ureter
b) paraurethral glands
c) Bartholin's gland
d) urachus
e)Gartner's duct.

19) Concerning sex hormone:

a) the ovary secretes androstenedione.
b) The ovary secretes testosterone
c) The ovary secretes dihydrotestosterone.
d) SHBG conc. are higher in women more than men
e) Androgens bound to protein have high biological activity.

20) Features of congenital rubella include:

a) excretion of virus by the neonates.
b) hepatomegaly
c) excessive production of growth hormone.
d) cataract
e) deafness.

21) Clomifene citrate:

a) is an anti-androgens.
b) does not stimulate ovulation directly.
c) can produce visual disturbance.
d) is genereally prescribed throughtout the proliferative phase of the menstrual cycle.
e) in the treatment of ovulation increases the risk of multiple pregnancy.

22) The foll are cytotoxic alkylation agents:

a) Cyclophosphamide.
b) mercaptopurine
c) chlorambucil
d) fluorouracil
e) methotrexate.

23) If a distribution of results is markedly skewed to the left:

a) the mean is the same as the 50th centile.
b) the same number of values lie on either side of the median.
c) the mode is equal to the median.
d) the student's t test should be used to compare the distribution with another.
e) logarithmic transformation of the result will produce a distribution closer to the normal.

24) Corcerning the analysis of clinical trials:

a) the 95% confidence interval indicates the range within which 19 out of 20 values will lie.
b) The P value illustrates how often the result would be expected to occur by chance.
c)b The conventional level of statistical significance is set of P<0.005
d) In a randomised trial, there must be equal numbers of results in each arm of the study.
e) A relative risk reduction of 60% is significant irrespective of the value of P.

25) The following substance are normally synthesized in the liver:

a) glucagon
b) vitamin A
c) cholesterol.
d) immunoglobulins
e) prothrombin

26) The pineal gland:

a) is situated at the anterior end of the 3rd ventricles.
b) is innervated by the parasymphathetic nervous system.
c)produces melatonin.
d)maybe calcified in the adults.
e) is most active during daylight.

27)In congenital adrenal cortical hyperplasia.

a) The commonest deficiency is C18 hydroxylase.
b) plasma cortisol concentration is raised.
c) urinary excretion of 17 oxysteroids is elevated.
d) dexamethasone will suppress the urinary excretion of 17 oxysteroids.
e) there is no virilising effects.

28)Foll are RNA containing virus:

a) coxsackie
b) influneza
c) mumps
d) herpes simplex.
e) cytomegalovirus.

29) Listeria monocytogenes:

a) is a gram negative organism.
b) is sensitive to ampicillin.
c) may cause a transplacental infection.
d) is sexually transmitted.
e) can be cultured from a high vagina swab.

30) actinomyces israelii.

a)is a fungus.
b) forms yellow granules in pus.
c)is a mouth commensal
d) occurs in association with IUCD.
e) is resistant to penicillin.

31) The following drugs may cause enlargement of the fetal thyroid gland:

a)methyldopa
b) thyroxine
c) carbimazole
d) propranolol
e) propylthiouracil

32) The foll statements about anticoagulant are correct:

a)Heparin inhibits the action of thrombin
b) The action of heparin is antagonised by vitamin K
c) Heparin increases antithrombin III activity.
d) The effects of anticoagulants are decreased by metronidazole.
e) Warfarin is greater than 80% protein bound in plasma

33) The following drugs and side effects are associated:

a) methydopa: depression
b) paracetamol: thromboembolism
c) indomethacin: peptic ulcer
d) prednisolone: osteoporosis.
e) ritodrine: hypoglycemia

34) Haematopoiesis in the fetus:

a) results in nucleated erythrocytes early in development.
b) occurs in the yolk sac in the first month.
c) does not occur in the bone marrow until term.
d) is predominantly hepatic during the 4th month.
e) does not require folic acid.

35)Early blood borne dissemination is characterised feature of:

a) carcinoma of the endometrium.
b) osteosarcoma
c) basal cell carcinoma
d) carcinoma of the cervix
e) choriocarcinoma.

36) The following cells maybe phagocytic:

a) neutrophils.
b) kupffer cells
c) monocytes
d) Hofbauer cells.
e) plasma cell.

37) The following are premalignant conditions:

a) diverticular disease of the large bowel.
b) ulcerative colitis.
c) pulmonary asbestosis.
d) Paget's disease of the bone.
e) condylomata of the vulva

3Cool In the pituitary gland:

a) the anterior lobe is smaller than the posterior lobe.
b) the posterior lobe is ectodermal in origin.
c) the acidophil cells produces oxytocin.
d) the basophil cells produce growth hormone.
e) the blood supply is derived from the internal carotis artery.

39)The obturator artery:

a)branches from the posterior trunk of the internal iliac artery.
b) passes through the greater sciatic foramen.
c) is crossed by the ureter.
d)supplies the hip joint.
e) may be replaced by a branch of the superior epigastric artery.

40) In congenital adrenal hyperplasia:

a) the commonest cause is a deficiency of 21 hydroxylase.
b) the plasma cortisol conc is increased.
c) there may be excessive secretion of 17 alpha hydroxyprogesterone.
d) sodium retention is characteristic.
e)blood cathecholamine conc are increased.

41) In the fetal lung:

a)bronchial cartilage formation commences at 18-24 weeks of gestation.
b) type II alveolar cells first appear at 16-20 weeks gestation.
c) sphingomyelin is the most common phospholipid present at term
d) phospholipid release is increased by endogenous adrenaline.
e) phospholipid production is decreased by exogenous corticosteroids.

42) In radiotherapy

a) 1 gray is equivalent to 1 joule/kg.
b) the skin usually receives a greater dose of radiation than the underlying tissues.
c) the major effect of radiation energy is to damage the cytoplasm of the cell.
d)cells in tissues which are hypoxic are more vulnerable to radiation.
e)Radiation induced changes in tissues may take 6 weeks to develop.

43) Concerning the adrenal glands

a) cortex is derived from neural crest cells.
b) Zona fasiculata secretes aldosterone.
c) Cortical adenomas may cause Cushing syndrome.
d) Neuroblastoma arise in the medulla.
e) Addison's disease may result from autoimmune destruction of the cortex.

44)The following are autosomal recessive:

a) neurofibromatosis.
b) cystic fibrosis.
c) phenylketonuria
d) polyposis coli
e) sickle cell anaemia

45) Uterine fibroids:

a) are defines histologically as fibromyxomas.
b) arise from endometrial stroma
c) maybe associated with polycythamia.
d) predispose to endometrial hyperplasia.
e) are liable to sarcomatous change in about 5% of cases.

46) growth of the foll tumors are hormone dependent:

a) squamous cell carcinoma of the cervix.
b) breast adenocarcinoma.
c) uterine leiomyoma.
d) prostatic adenocarcinoma
e) testicular carcinoma

47)Surfactants:

a) is formed mainly in the placenta
b) levels in amniotic fluid diminish after 33 weeks of gestation
c) formation can be inferred from the lecithin-sphingomyelin ratio in amniotic fluid.
d) contains palmitic acid
e) decreases the surface tension in pulmonary alveoli.

4Cool Intracellular fluid differs from Extracellular fluids in that:

a) it forms the major proportion of total body water.
b) its volume can be measured easily.
c) it has a higher concentration of potassium than of sodium.
d) its volume is regulated primarily by the kidneys.
e) it has a higher phosphate concentration.

49) The Anal canal:

a) has an upper part which is innervated by the inferior hypogastric plexus.
b) has a lower part which is supplied by the superior rectal artery
c) drains lymph to the superficial inguinal nodes from its upperpart.
d) has its internal sphincter innervated by the infecrior rectal nerve.
e) has a superficial part of its external sphincter attached to the coccyx.

50) The right ovarian artery:

a) Arises from the abdominal aorta above the renal artery.
b) passes posterior to the 3rd (horizontal) part of the duodenum
c) passes post to the genitofemoral nerve.
d) supplies the right ureter.
e) anastomoses with the right uterine artery.

51) Vulva supplied by:

a) Internal pudendal artery.
b) Inferior rectal artery.
c) Genitofemoral artery
d) obturator artery
e) femoral artery..

This is a question outside past papers..All r false Except internal pudendal artery..

52) The vagina:

a) has an anterior wall longer than the post wall.
b) contains mucus secreting glands in its epithelium.
c) is related in its lower third to the bladder base.
d) during reproductive life has an acid pH.
e) is derived from mesonephric duct.

53) The right ureter:

a) is approx 50cm in length.
b) ia partly covered by duodenum
c) crosses the genitofemoral nerve.
d) enters the bladder anteromedially.
e) receives part of its blood supply from the uterine artery.

54) After birth:

a) allantois froms median umblical ligament
b) umbilical vein forms medial umbilical ligament.
c) umbilical artery forms superior vesical artery.
d) ductus venosus forms the ligamentum teres.
e) ductus arteriosus forms the arch of the aorta.

55)In spermiogenesis:

a) primary spermatocytes undergo reduction division.
b) primary spermatocyte gives rise to 4 spermatids.
c) whole process of spermatogenesis in man takes 6-7 days.
d) grossly abnormal spermatozoa may be found in fertile semen.
e) spermatids are haploid.

56) In the human male, dihydrotestosterone:

a) is a precursor of testosterone.
b) has one-tenth of the ptency of testosterone.
c) is responsible for involution of the Mullerain system.
d) is responsible of the male external genitalia.
e) binds to an intracellular receptor.

57) In Human lactation:

a) estrogens promote development of breast lobules.
b) estrogen promotes milk producing effect of prolactin on the brest,
c) human placental lactogen is essential for milk synthesis.
d) prolactin stimualtes gonadotrophin release.
e) oxytocin causes milk ejection,

58)Concerning testicular hormones:

a) testosterone reduces plasma LH conc.
b) Inhibin stimulates LH production.
c) Estrogen are formed in the testis.
d) Testosterone is converted to dihyrotestosterone by 5 alpha reductase.
e) Testosterone in plasma is predominantly bound to albumin.

59) Epidermal growth factor:

a) is mitogenic.
b) synthesis is stimulated by estradiol.
c) is a steroid molecule.
d) is found in endometrium.
e) binds to a receptor on the nuclear membrane.

60) folic acid:

a) deficiency causes megaloblastic bone marrow..
b) is hydroxycobalamin.
c) is present in green vegetables.
d) is predominantly absorbed from the large intestine.
e) is destroyed by boiling water.

61) Doppler Ultrasound:

a) is used to monitor fetal breathing.
b) is used in fetal HR monitors.
c) can be used to measure blood velocity in the fetus.
d) measure proton relaxation times.
e) requires injection of contrast agents.

62) The following are structural aberration of chromosomes:

a) deletions.
b) inversions.
c) aneuploidy.
d) polyploidy.
e) translocation.

63) Messenger RNA

a) synthesis is dependant on RNA polymerase.
b) is an exact copy of sense DNA.
c) contains exons.
d) is measured by western analysis.
e) translationoccurs in the nucleus.

64) In tumors of the bones:

a) primary malignancy is more common than 2ndry malignancy.
b) osteoma rarely present in skull bones.
c) osteosarcoma is associated with Paget's disease of bone.
d) lymph node metastases are unusual.
e) simple bone cysts have a strong tendency to recur.

65) Concerning the rectus sheath.

a) Above the costal margin rectus abdominis lies on the costal cartilages.
b) Below the arcuate line the internal oblique splits to enclose rectus abdominis.
c) It contains the musculophrenic artery.
d) It is innervated by the ilioinguinal nerve
e) Pyramidalis is innervated by the subcostal nerve.

66) The external iliac artery.

a) Enters the thigh anterior to the inguinal ligament.
b) at its origin is crossed by the ureter.
c) at its origin is crossed by the ovarian vessels.
d) Lies medial to the external iliac vein at its distal end.
e) gives rise to the deep external pudendal artery.

67) Action of Insulin include stimulation of:

a) glycogenolysis by the liver.
b) cellular uptake of amino acids.
c) entry of glucose into neurons.
d)entry of glucose into adipose tissue.
e) cellular uptake of potassium.

6Cool Metronidazole:

a) is effective against Giardia lamblia.
b) is effective when administered per rectum
c) should not be administered intravenously.
d) is usually effective against Entamoeba histolytica.
e) interferes with ethanol metabolism.

69) Amniotic fluid:

a) at term is hyperosmolar compared to fetal plasma.
b) normally contains maternal and fetal cells.
c) contains a higher concentration of alpha feto protein at 16 weeks than at term.
d) contains bilirubin.
e) contains phospholipids.

70) Chromosomes:

a) are found in the same numb in all mammalian cells.
b) can be analysed more quickly from a blood sample than from an amniotic fluid sample.
c) can be reliably identified by their length.
d) the Y chromosome is larger than the X chromosome.
e) DNA content is doubled during the S phase of the cell cycle.

71) In cystic fibrosis, abnormalities are seen in the

a) pancreas
b) salivary glands.
c) brain
d) kidneys
e) ileum

72) Neutrophil polymorphs at the site of inflammation are capable of the following:

a) Phagocytosis.
b) production of oxygen free radicals.
c) replication
d) fusion to form giant cells.
e) antibody production

73) In the statistical analysis of any group of numericals
a. the mean is always less than the mode
b. standard deviation is always greater than the standard error
c. the median value lies at the midpoint of the range
d. the standard error of the mean is independent of the total number of observations
e. there are the same number of observations greater than and less than the median value

74) In a randomised double blind trial comparing a new drug with a placebo
a. the patient will be taking either of two drugs
b. patients can choose their mode of treatment
c. doctors prescribing treatment decide which patients take the new drug
d. a large trial is more likely to give a statistically significant result than a small trial
e. half of the patients will take the new drug

75) In a trial of oral hypoglycaemic agents 42 patients were given drug A and 38 drug B . blood glucose conc. were measured befor and after a single dose of the drug. Drug B apparently caused greater fall in the blood glucose conc. (P=0.06)
a. these results reach an accepted level of statistical significants
b. Non- parametric statistical analysis bshould be used if datd are not normally distributed
c. In biological terms drugs A and B have been shown to be eqully effective
d. 6% more patients responded to drug A than drug B
e. Unequal numbers in the two groups invalidate the trial

76) The following statistical statements are correct

a. In the normal distribution the value of the mode is 1.73 * that of the
median
b. In a distribution skewed to the right, the mean lies to the left to the median
c. In the series 2;7;5;2;3;2;5;8, the mode is 2
d. Student's test is designed to correct for skewed distributions
e. the Chi-squared test may be used when data are not normally distributed

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