2007 papers

I suggest to review past paper in the last day before the exam.
Below many q from another forum about 2007 M
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From Onexamination:
Copper containing IUDs:
F should be changed every year
F have a high incidence of actinomycoces colonization than plastic devices
T Cause a relative increased in ectopic pregnancy
T have been implicated as a cause of fatal infection in pregnancies
F do not cause menorrhagia

Comments:
Inert devices can be left in place until the menopause, but copper devices need renewal every 3-5 years, depending on the make, because of the gradual absorption of copper. Copper IUCDs produce local concentrations of copper salts which apparently give some protection against bacterial contamination. Pelvic infection with actinomyces organisms is most likely with a plastic device that has been in situ for some years. While the rate of intrauterine pregnancy is reduced, that of ectopics is not. Hence, there is a relative increase in ectopic pregnancy after IUCD insertion. If an IUCD is left in place there is a slight risk of intrauterine infection, preterm labour and antepartum haemorrhage, but most pregnancies are uncomplicated and the device is delivered with the placenta. Increased menstrual loss may be caused by increased fibrinolytic activity which occurs round the IUCD. The progestogen intrauterine system (IUS) reduces menstrual flow and often dysmenorrhoea.

Which of the following is/are true concerning MRI?
A It involves ionizing radiation (False)
B Has no recognised side effects on the foetus (True)
C The pregnant mother should be turned to her left side during scanning
(True)
D Tissue with high hydrogen concentrations are difficult to distinguish False)
E Blood vessels appear white on scanning (False)

Comments:
Water is a molecule composed of hydrogen and oxygen atoms. The nuclei of the hydrogen atoms are able to act as microscopic compass needles. When the body is exposed to a strong magnetic field, the nuclei of the hydrogen atoms are directed into order - stand "to attention". When submitted to pulses of radio waves, the energy content of the nuclei changes. After the pulse, a resonance wave is emitted when the nuclei return to their previous state. The small differences in the oscillations of the nuclei are detected. By advanced computer processing, it is possible to build up a three-dimensional image that reflects the chemical structure of the tissue, including differences in the water content and in movements of the water molecules. This results in a very detailed image of tissues and organs in the investigated area of the body. In this manner, pathological changes can be documented.----------------------------------------------------------------------

Many stats about sensitivity, positive predictive value, accuracy, even the linear regression

Acute UTI in pregnancy
rarely symptomatic ?F


Copper IUD mode of action:
?T sperm motility
?T microthrombi
?T intervent ovary movement

MRI:
ionising radiation F
no adverse effect on fetus T
detect fetal cardiac abn ?F ( I think it will be very small)

USG:
probe: array of magnets? ?F
doppler to detect fetal heart movement T

facial hair increased by:
oestrogen?F
testerone?T
spirolactone F ( I think it is used for treating hirsutism)

Mycobacteria
?T strict ?? *(nor sure which word they use ) aerobic

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48---if a distribution of results is markedly skewed to the left(sep2000)
a-the mean is same as 50th centile— f
b-the same no of values lie on either side of the median- t
c-the mode is equal to the median- f
d-the students test should be used to compare this distribution with another- f
e-logrithmic transformation of the results will produce a distribution close to normal-t


-concerning the ablity of a test to predict disease
a-sensitivity is the ablity to predict those with disease correctly T
b--sensitivity is the same as positive predictive value F
c-the confidence interval must cross 1 to prove significance t (NOT A MUST as CI at 1 is perfect )
d-an odds ratio of 1;3 implies the risk of 33% f
e--an odds ratio of 2 indicates a halving of risk F

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1-SUCCESSFUL LACTATION IS
a-maintained by estrogen --
b-maintained by progesterone --
c-initiated by prolactin surge--
d-maintained by human placental lactogen
e-inhibited by dopamine –


2-THE RELEASE OF CATECHOLAMINES FROM THE ADRENAL MEDULLA INCREASES
a-during sleep—
b-when the nerves to adrenal glands are stimulated—
c-when the blood sugar rises—
d- immediately following a myocardial infarction—
e- in the presence of pheochromocytoma—T
F-DURING ACUTE HAEMORRHAGE—

3- In the pathogenesis of thrombosis
a-prostacyclin induces platelet aggregation—
b-plateletes synthesis thromboxane A2--
c-thromboxane A2 induces vasoconstriction--
d-contact with subendothelial collagen causes platelete aggregation--
e-thrombin inhibits platelete aggregation—


--4- CONVERSION OF GLUCOSE TO LACTIC ACID
a-occurs in single enzymatic reaction—
b-is the only pathway for synthesis of ATP in red blood cells—
C-is a reversible process in skeletal muscle
d- is inhibited by high cellular conc of ATP-
e-occurs in skeletal muscle when availability of oxygen is limited-

5-GLUCOCORTICOIDS
a- promotes hepatic gluconeogenesis-
b- suppress uptake of glucose by muscle-
c—promotes protein breakdown-
d—promotes fat breakdown-
e-increase glycolysis in adipose tissue-

6-Actinomycete israelii

1-Is a fungus—
2- forms yellow granules in pus –
3-is a commensal in mouth--
4- is a commensal in vagina--
5- is usually resistant to penicillin—

7-Following substances increase the serum uric acid concentration(
a-colchicine--
b-chlorothiazide--
c-allopurinol--
d-probenecid--
e-phenylbutazone—


7--THE FOLLOWING ARE INHERITED AS AUTOSOMAL RECESSIVE CONDITIONS

A. tuberous sclerosis.
b-phenylketonuria--
C. ahondroplasia.--
D. sickle cell anaemia-
E. Von Giek l disease.—

8-. Genes on sex chromosomes are responsible for the inheritance of (
A. glucose-&pbosphate dehydrogenase defiency.
B. defective colour vision.—
C. hairy ear rims. –
D. homocystinuria.
E. Hurler syndrome.

9-in human a haploid no of chromosomes is found in)

a-red blood cells-
b-blastocysts-
c-primary oocytes-.
d-the first polar body-
e-spermatozoa-


10-osteoprosis is associated with
a-an increase in uncalcified bone matrix(osteoid tissue
b-prolonged oestrogen therapy—
c-a normal histological bone structure-
d-bone fracture—
e-irregularity of epiphyseal plates—


11-THE FOLLOWING HAVE an anti-emetic effect
a-hyoscine bromide—
b-morphine sulphate—
c-chlorpropamide--
d-promethazine hydrochloride—
e-perphenazine—

12CLOMIFENE CITRATE
a- is an antiandrogen—
b-does not stimulate ovulation directly—
c-can produce visual disturbances--
d-is generally prescribed throughout the proliferative phase of the menstrual cycle—
e-in the treatment of anovulation increases the risk of multiple pregnancy—

13--if a distribution of results is markedly skewed to the left
a-the mean is same as 50th centile
b-the same no of values lie on either siDe of the median
c-the mode is equal to the median-
d-the students test should be used to compare this distribution with another-
e-logrithmic transformation of the results will produce a distribution close to normal-

15. when a man has hemophilia
a. 50% of his daughters would not expected to be carriers –
b. 25% of his sons expected to be carriers
c. Good medical control of blood definition reduce the risk of this condition in his children
d. His new born child is likely to require an urgent blood transfusion -
e. His sister has 50% probability of being a carrier


16- THE INTERSTITIAL CELL (LEYDIG) OF THE TESTIS
a--secrete seminal fluid—
b-are stimulated by LH –
c-secrete androgen binding protein—
d-secrete fructose –
e-produce testosterone T in response to LH --

17--CONCERNING VIRUSES
a-the core of every virus contain RNA—
b-they usually produce intracellelur toxin causing cell death

c-antibodies are directed against capsular protein—
d- they can be grown in intact cells--
e-interferone are synthetic antiviral substances—

18-THE FOLLOWING ARE CYTOTOXIC ALKYLATING AGENTS(
a-cyclophosphamide—
b-mercaptopurine--
c-chlorambucil--
d-fluorouracil--
e-methotrexate-

19-2,3 DIPHOSPHOGLYCERATE
a-is present in higher conc in maternal erythrocytes than fetal erythrocytes--
b-binds more avidly to haemoglobin A than to haemoglobin E—

c-increases the affinity of haemoglobin for oxygen—
d-is a phospholipid
e- is synthesised by the pentose phosphate pathway


18-HYPERKALEMIA IS A CHARACTERSTIC FINDING IN TINDALL
a-primary aldosteronism
b-treatment with Spironolactone-
c-hyperparathyroidism-
d-ACTH secreting tumours of bronchus-
e-renal failure-

19- CONCERNING INHERITABLE DISEASES
A-huntigdon ,s chorea is transmitted by a dominant gene—
b-phenylketonuria is transmitted by a recessive gene—
c-haemophillia ia an autosomal dominant condition--
d- Von Willebrand disease is a sex linked condition—
e-cystic fibrosis is transmitted by an x linked recessive gene--


20-Early blood borne dissemination is a characteristic feature of:
a) carcinoma of the endometrium –
b) osteosarcoma –
c) basal cell carcinoma –
d) carcinoma of the cervix-
e) choriocarcinoma-

21- in tissue pigmentation the following are associated
a-kernicterus and conjugated billirubin
b-addison disease and increased cutaneous melanin
c-melanosis coli and bile pigments-
d—wilson disease and copper deposition in the cornea-
e-corpus leuteum and carotenoids-

22-acquired diverticular disease of the colon
a-is present in at least 15% of Caucasian over the age of 50 years-
b-is due to congenital abnormality of the bowel wall
c-is associated with increased intraluminal pressure—
d-is associated with muscular thickening—
e-may result in intestinal obstruction—

23 stored blood which is to be used for transfusion—
a-kept at -4 degree
b-must be used in 1 week –
c-is tested for compliment content before transfusion --
d-may be used for platelet replacement –
e-contains an acid anticoagulant –


24- in uncomplicated homozygous beta thalasemia there is
a-hypochromasia--
b-a reduction in haemoglobin A—
c-an increase in haemoglobin F—
d- RED CELL SICKLING
e-presence of megaloblasts in bone marrow-


32-The following are capable of cellular regeneration
a)spinal cord
b)liver parenchyma –
c)gut epithelium –
d)kidney ???
e)bone marrow—


33-during the development of female reproductive system
a-primordial germ cells arise in yolk sac--
b-ovarian development is dependent upon oestrogen activity--
c-the paramesonephric duct give rise to the cervix--
d-the greater vestibular glands arise from the urogenital sinus--
e-differentiation of external genitalia is dependent upon ovarian activity--


36- IN CONGENITAL ADRENAL CORTICAL HYPERPLASIA
a-commonest deficiency is C21
b- plasma cortisol conc is raised –
c-there may be excessive secretion of 17 hydroxy progesterone--
d- sodium retension is characterstic –
e-blood catecholamine conc are increased –


37-- SCHISTOSOMA HAEMATOBIUM
a- is a snail –
b- is prevalent in china—
c- infestation may affect the uterine cervix
d- give rise to chronic granulomatous lesions--
e- infestation predisposes to carcinoma—

38- KETONE BODIES
.
a-can be utilised by theadult brain—.
B-Include acetone -
c-are water soluble --
d- are synthesised in skeletal muscles—
e-can be utilised during starvation—


39-IRON IONS
a-diffuse passively into erythropoitic cells-
b-bind to transferin-
c-are taken up by hepatocytes-
d- are necessary for cytochrome synthesis-
e-are absorbed predominantly by the ileum-

40-- --the conjugation of billirubin
a-takes place in hepatocytes-
b-is catalysed by UDP glucuronyl transferase-
c-is inhibited by phenobarbitone-
d-renders it water soluble-
e-is impaired in acute billiary obstruction-

41- in radiotherapy(

a-1Gray is eq to 1joule per kg
b- the skin usually recieve a greater dose of radiation than underlying tissue-
c-the major effect of radiation energy is to damage the cytoplasm of the cell-
d-cells in tissue which are hypoxic are more vulnerable to radiation-
e-radiation induced changes in tissues may take 6 weeks to develop-


-42--osteomalacia is characterised by
a-mineralization of the periostium –
b-deposition of uncalcifiedbone matrix --
c-normal osteobastic activity --
d-increase capillary fragility -
e-normal calcification of bone—


43-progesterone
a-is a C21 compound
b-synthesised by the ovary before ovulation-
c-increases ventilation-
d- raises BMR-
e-binds to corticotrophin –binding globulin-

44-EPIDERMAL GROWTH FACTOR
A- is mitogenic-.
b- synthesis is stimulated by oestradiol-
c-is a steroid molecule-F ...
d- is found in endometrium--
e- binds to receptor on the nuclear membrane-


45-the following are structural aberrations of chromosomes:
a. deletions --
b. inversions—
c. aneuploidy –
d. . polyploidy-
e translocations—

46-- Messenger RNA
a-Synthesis is dependent on RNA polymerase –
b-is an exact copy of sense DNA—
c-Contains exons –
d-Is measured by Western blotting –
e-translation occurs in the nucleus


47-- BETA SYMPATHOMIMETIC DRUGS MAY—
A- caue bronchospasm—
b-reduce frequency of uterine contraction—
c-cause heart block—
d-reduce diastolic blood pressure—

e- increase blood glucose conc

48- The following statistical statements are correct-
a-in the normal distribution,the value of mode is 1.73 times the median –b-in a distribution skew to the right,the mean lies to the left of median-
c-in the series- 2;7;5;2;3;2;5;8, the mode is 2 -
d-student’s ‘t’ test is designed to correct for skew distribution –
e-the chi squared testmay be used when data are not normally distributed--

50-Contraindicated in breast feeding—

A-POPs
B-Bromocriptine-
C-chloroqunine-
d-??
e-warfarine—F

51-Contraindicated with kidney impairment
A-Dopamine -
B-Gentamycine –
C-Cephahexin
D-Cis platin

52- the following are characters of hypoxic cell death:

A-Apoptosis… --
B-Phagocytosis—…
C-Pyknosis… --
D-Poikilocytosis…
E-Release of phospholipids—

52- the following are characters of hypoxic cell death:

A-Apoptosis… --
B-endocytosis
C-Pyknosis… --
D-Poikilocytosis…
E-koliosytosis

prostagladins-
a-lipooxygenase pathway
b-thromboxane causes vasoconstriction
c-increased in the myometruim
d-?
e-?

linear regression:
a-starts from the origin
b-passes thru the mean-
c-values vary
d-ranking is done???

following test r used to compare 2 drugs a and b
a-student t test
b-meta analysis
c-wiloxone paired test
withney u paired test
e?

toxic shock syndrome
associated with the use of tampoons
b-due to toxigenic starinsof strep
c-infrequently reported outside n america
d-a consequence of previous antibioitic therapy
e-confined to seualy active women

the following can regenerate
a-kidneyepitheluim?
b-pheriheral axons-
c-liver parenchyme
d-bone marrow
e-bone

radiation sensitive
a-bone
b-bone marrow
c-epith of gut
d-skin
e-?

Mycobacteruim
a- are alchochol acid fast
b-does not form spores
c-d-a facultative anaerobes
d-responsible for leprosy
e-pathogenic inhumans all strains

the germination of tetanus spores in a wound is inhibited by

a-tissue trauma
b-oxygen
c-inject of toxoid
d-injection of antitoxin
e-removal of devitalised tissue

Aldosterone
a-reduces Na resorption in PCT
b-reduces Na absorption in descen loop of henle
c-Increase Na absortion in DCT
Increase K loss from the tubule
e increases Na absortion in collecting tubules

the following r conclusive evidence of pregnancy in uterine cureetings???? can, t remmber
a-decidua compacta-
b-Arias -stella changes in endometrail glad-
c-spiral arterioles
d-plasma cell infiltration
e chorionic villi

White cell migration from the bld vessels in areas of inflammation involves--- march 1997/2 21
a-call migration between the endothelial cells
b-a pssive loss of fluid bld elements
c-cell migration independeant of endothelial cell motion
d-initail emigration of polymorhs neutrophils
e-more polymorphs than monocytes after 2 day=

the vulva is supplied by
a-ant cutaneu erve of the thigh
b-femoral br/o genito femoral nerve
c-?
d?
e?

glucocorticoids
a-promote hepatic gluconeogenesis
b-suppress uptake of glucose by muscles
c-promote protein break down
d-promote fat reakdown
e-increase glycolysis

halothane(refer sept 1997)42
a-cardic arrythmias
b-explosive mixtures with air
c-liver damage


53- U/S:

A-Pulstile
B-Increase body temp 1 degree after 15 min scanning..
C-High frequency penetrates deeper TISSUE,-
D-Can distinguish between 2 points closer than 0.5 mm
E-Best echoes are produded by beam at right angle to the structures.

54-Disinfectant solutions may become contaminated with:
1-Enterobacter species –
2-Streptococcus species -
3-Escherichia coli -
4-Pseudomonas aeruginosa -
5-Staphyloccus pyogenes-


55-Nitric oxide
a) is synthesised in the endothelium –
b) has a short half life --
c) causes smooth muscle contraction
d) increases during pregnancy -
e) combines with oxygen to produce L-arginine—