- gives origin to the levator ani muscles - is broader in the male than in the female - trnasmit dorsal rami of sacral nerves - is in contact with the anal canal Prolactin. - release is stimulated by TRH - plasma levels are raised in the first trim of preg. - release is increased by suckling. - maybe produced by decidua. - release is inhibited by metoclopromide. The foll disorders and org are correctly paired. - opthalmia neonatorum: chlamydia trachomatis - chancroid: Haemophilus ducreyi. - sleeping sickness: Leishmania donovani. - ringworm: Trichenella spiralis. - non-specific urethritis: Toxoplasma gondii. The heart rate typically increases in response to: - pain. - hypoxia. - ventilatory expiration - increase in Intracranial pressure - decrease baroreceptor activity Antibodies. - are proteins. - are formed in the fetus before 12 weeks of Intrauterine life. - have an average molecular weight of around 10 000 daltons. - of the rhesus type are genetically transmitted. - are produced by the ribosome of plasma cells. The following disorders have an X linked pattern of inheritance. - G6PD Deficeincy. - Kleinfelter syndrome - adrenogenital syndrome - haemophilia B - familial hypercholestroleamia. The following are derived from the urogenital sinus: - the bladder trigone. - the ureters. - the female urethra. - greater vestibular glands. - paraurethral glands. In the fetal CVS - the heart arises from endoderm - the heart is formed by fusion of endocardial tubes. - Cardiac pulsation is present byoxygenated blood is tranferred to the left atrium through the foramen ovale. - the ductus arteriosus closes during the last 4 weeks of pregnancy. Arginine vasopressin - reduces GFR. - controls water loss in the Proximal renal tubule. - is synthesised by the post pituitary gland. - is released in response to rise in plasma osmolality. - is released in response to fall in circulating plasma volume. Renin - is secreted by the zona glomerulosa of the adrenal coretx. - is a proteolytic enzyme. - is secreted at an increased rate if the renal perfusion pressure falls. - acts upon circulating angiotensinogen. - is released in response to an increase in extracellular fluid volume Actinomyces israelii - is a rickettsia. - forms yellow granules in pus. - is a commensal in the mouth. - is a commensal in the vagina. - is usually resistant to penicillin. Diseases caused by spirochaetes include. - Weil's disease. - lymphogranuloma venereum - pinta - Vincent's angina. - bilharzias The following are inherited as autosomal recessive conditions: - tuberous sclerosis. - phenylketonuria. - achondroplasia - sickle cell anaemia. - Von gierke's disease. Antibodies play an important part in the development of: - phagocytosis. - Mantoux responce. - erythroblastosis fetalis. - hyperemesis gravidarum - anaphylaxis chemical mediators concerned in the production of an inflammatory response include: - 5-hydroxytryptamine - aldosterone. - glucocorticoids. - bradykinin - leukotreines The parathyroid gland. - originate from the pharyngeal cleft ectoderm. - secrete parathyroid hormone via the chief( principal) cells. - secrete calcitonin via the oxyphil cells. - may become hyperplastic in the presence of intestinal malabsorption. - may develop adenomas in association with islet cell tumour of the pancreas In the abdominal wall: - the rectus abdominis muscle is attched to the crest of the pubis. - the post border of the external oblique muscle ends in the linea semilunaris. - the aponeurosis of the external oblique muscle takes part in the formation of the conjoint tendon. - the inferior epigastric artery is a branch of the internal iliac artery. - the conjoint tendon blends medially with the anterior layer of the rectus sheath. The urogenital sinus in the female gives rise to the following: - ureter - paraurethral glands - Bartholin's gland - urachus - Gartner's duct. Concerning sex hormone: - the ovary secretes androstenedione. - The ovary secretes testosterone - The ovary secretes dihydrotestosterone. - SHBG conc. are higher in women more than men - Androgens bound to protein have high biological activity. Features of congenital rubella include: - excretion of virus by the neonates. - hepatomegaly - excessive production of growth hormone. - cataract - deafness. Clomifene citrate: - is an anti-androgens. - does not stimulate ovulation directly. - can produce visual disturbance. - is genereally prescribed throughtout the proliferative phase of the menstrual cycle. - in the treatment of ovulation increases the risk of multiple pregnancy. The foll are cytotoxic alkylation agents: - Cyclophosphamide. - mercaptopurine - chlorambucil - fluorouracil - methotrexate. If a distribution of results is markedly skewed to the left: - the mean is the same as the 50th centile. - the same number of values lie on either side of the median. - the mode is equal to the median. - the student's t test should be used to compare the distribution with another. - logarithmic transformation of the result will produce a distribution closer to the normal. Corcerning the analysis of clinical trials: - the 95% confidence interval indicates the range within which 19 out of 20 values will lie. - 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 - In a randomised trial, there must be equal numbers of results in each arm of the study. - A relative risk reduction of 60% is significant irrespective of the value of P. The following substance are normally synthesized in the liver: - glucagon - vitamin A - cholesterol. - immunoglobulins - prothrombin The pineal gland: - is situated at the anterior end of the 3rd ventricles. - is innervated by the parasymphathetic nervous system. - produces melatonin. - maybe calcified in the adults. - is most active during daylight. In congenital adrenal cortical hyperplasia. - The commonest deficiency is C18 hydroxylase. - plasma cortisol concentration is raised. - urinary excretion of 17 oxysteroids is elevated. - dexamethasone will suppress the urinary excretion of 17 oxysteroids. - there is no virilising effects. 28)The following are RNA containing virus: - coxsackie - influneza - mumps - herpes simplex. - cytomegalovirus. Listeria monocytogenes: - is a gram negative organism. - is sensitive to ampicillin. - may cause a transplacental infection. - is sexually transmitted. - can be cultured from a high vagina swab. actinomyces israelii. - is a fungus. - forms yellow granules in pus. - is a mouth commensal - occurs in association with IUCD. - is resistant to penicillin. The following drugs may cause enlargement of the fetal thyroid gland: - methyldopa - thyroxine - carbimazole - propranolol - propylthiouracil The following statements about anticoagulant are correct: - Heparin inhibits the action of thrombin - The action of heparin is antagonised by vitamin K - Heparin increases antithrombin III activity. - The effects of anticoagulants are decreased by metronidazole. - Warfarin is greater than 80% protein bound in plasma The following drugs and side effects are associated: - methydopa: depression - paracetamol: thromboembolism - indomethacin: peptic ulcer - prednisolone: osteoporosis. - ritodrine: hypoglycemia Haematopoiesis in the fetus: - results in nucleated erythrocytes early in development. - occurs in the yolk sac in the first month. - does not occur in the bone marrow until term. - is predominantly hepatic during the 4th month. - does not require folic acid. Early blood borne dissemination is characterised feature of: - carcinoma of the endometrium. - osteosarcoma - basal cell carcinoma - carcinoma of the cervix - choriocarcinoma. The following cells maybe phagocytic: - neutrophils. - kupffer cells - monocytes - Hofbauer cells. - plasma cell. The following are premalignant conditions: - diverticular disease of the large bowel. - ulcerative colitis. - pulmonary asbestosis. - Paget's disease of the bone. - condylomata of the vulva In the pituitary gland: - the anterior lobe is smaller than the posterior lobe. - the posterior lobe is ectodermal in origin. - the acidophil cells produces oxytocin. - the basophil cells produce growth hormone. - the blood supply is derived from the internal carotis artery. The obturator artery: - branches from the posterior trunk of the internal iliac artery. - passes through the greater sciatic foramen. - is crossed by the ureter. - supplies the hip joint. - may be replaced by a branch of the superior epigastric artery. In congenital adrenal hyperplasia: - the commonest cause is a deficiency of 21 hydroxylase. - the plasma cortisol conc is increased. - there may be excessive secretion of 17 alpha hydroxyprogesterone. - sodium retention is characteristic. - blood cathecholamine conc are increased. In the fetal lung: - bronchial cartilage formation commences at 18-24 weeks of gestation. - type II alveolar cells first appear at 16-20 weeks gestation. - sphingomyelin is the most common phospholipid present at term - phospholipid release is increased by endogenous adrenaline. - phospholipid production is decreased by exogenous corticosteroids. In radiotherapy - 1 gray is equivalent to 1 joule/kg. - the skin usually receives a greater dose of radiation than the underlying tissues. - the major effect of radiation energy is to damage the cytoplasm of the cell. - cells in tissues which are hypoxic are more vulnerable to radiation. - Radiation induced changes in tissues may take 6 weeks to develop. Concerning the adrenal glands - cortex is derived from neural crest cells. - Zona fasiculata secretes aldosterone. - Cortical adenomas may cause Cushing syndrome. - Neuroblastoma arise in the medulla. - Addison's disease may result from autoimmune destruction of the cortex. The following are autosomal recessive: - neurofibromatosis. - cystic fibrosis. - phenylketonuria - polyposis coli - sickle cell anaemia Uterine fibroids: - are defines histologically as fibromyxomas. - arise from endometrial stroma - maybe associated with polycythamia. - predispose to endometrial hyperplasia. - are liable to sarcomatous change in about 5% of cases. growth of the foll tumors are hormone dependent: - squamous cell carcinoma of the cervix. - breast adenocarcinoma. - uterine leiomyoma. - prostatic adenocarcinoma - testicular carcinoma Surfactants: - is formed mainly in the placenta - levels in amniotic fluid diminish after 33 weeks of gestation - formation can be inferred from the lecithin-sphingomyelin ratio in amniotic fluid. - contains palmitic acid - decreases the surface tension in pulmonary alveoli. Intracellular fluid differs from Extracellular fluids in that: - it forms the major proportion of total body water. - its volume can be measured easily. - it has a higher concentration of potassium than of sodium. - its volume is regulated primarily by the kidneys. - it has a higher phosphate concentration. The Anal canal: - has an upper part which is innervated by the inferior hypogastric plexus. - has a lower part which is supplied by the superior rectal artery - drains lymph to the superficial inguinal nodes from its upperpart. - has its internal sphincter innervated by the infecrior rectal nerve. - has a superficial part of its external sphincter attached to the coccyx. The right ovarian artery: - Arises from the abdominal aorta above the renal artery. - passes posterior to the 3rd (horizontal) part of the duodenum - passes post to the genitofemoral nerve. - supplies the right ureter. - anastomoses with the right uteriVulva supplied by: - Internal pudendal artery. - Inferior rectal artery. - Genitofemoral artery - obturator artery - femoral artery.. This is a question outside past papers..All r false Except internal pudendal artery.. The vagina: - has an anterior wall longer than the post wall. - contains mucus secreting glands in its epithelium. - is related in its lower third to the bladder base. - during reproductive life has an acid pH. - is derived from mesonephric duct. The right ureter: - is approx 50cm in length. - ia partly covered by duodenum - crosses the genitofemoral nerve. - enters the bladder anteromedially. - receives part of its blood supply from the uterine artery. After birth: - allantois froms median umblical ligament - umbilical vein forms medial umbilical ligament. - umbilical artery forms superior vesical artery. - ductus venosus forms the ligamentum teres. - ductus arteriosus forms the arch of the aorta. In spermiogenesis: - primary spermatocytes undergo reduction division. - primary spermatocyte gives rise to 4 spermatids. - whole process of spermatogenesis in man takes 6-7 days. - grossly abnormal spermatozoa may be found in fertile semen. - spermatids are haploid. In the human male, dihydrotestosterone: - is a precursor of testosterone. - has one-tenth of the ptency of testosterone. - is responsible for involution of the Mullerain system. - is responsible of the male external genitalia. - binds to an intracellular receptor. In Human lactation: - estrogens promote development of breast lobules. - estrogen promotes milk producing effect of prolactin on the brest, - human placental lactogen is essential for milk synthesis. - prolactin stimualtes gonadotrophin release. - oxytocin causes milk ejection, Concerning testicular hormones: - testosterone reduces plasma LH conc. - Inhibin stimulates LH production. - Estrogen are formed in the testis. - Testosterone is converted to dihyrotestosterone by 5 alpha reductase. - Testosterone in plasma is predominantly bound to albumin. Epidermal growth factor: - is mitogenic. - synthesis is stimulated by estradiol. - is a steroid molecule. - is found in endometrium. - binds to a receptor on the nuclear membrane. folic acid: - deficiency causes megaloblastic bone marrow.. - is hydroxycobalamin. - is present in green vegetables. - is predominantly absorbed from the large intestine. - is destroyed by boiling water. Doppler Ultrasound: - is used to monitor fetal breathing. - is used in fetal HR monitors. - can be used to measure blood velocity in the fetus. - measure proton relaxation times. - requires injection of contrast agents. The following are structural aberration of chromosomes: - deletions. - inversions. - aneuploidy. - polyploidy. - translocation. Messenger RNA - synthesis is dependant on RNA polymerase. - is an exact copy of sense DNA. - contains exons. - is measured by western analysis. - translationoccurs in the nucleus. In tumors of the bones: - primary malignancy is more common than 2ndry malignancy. - osteoma rarely present in skull bones. - osteosarcoma is associated with Paget's disease of bone. - lymph node metastases are unusual. - simple bone cysts have a strong tendency to recur. Concerning the rectus sheath. - Above the costal margin rectus abdominis lies on the costal cartilages. - Below the arcuate line the internal oblique splits to enclose rectus abdominis. - It contains the musculophrenic artery. - It is innervated by the ilioinguinal nerve - Pyramidalis is innervated by the subcostal nerve. The external iliac artery. - Enters the thigh anterior to the inguinal ligament. - at its origin is crossed by the ureter. - at its origin is crossed by the ovarian vessels. - Lies medial to the external iliac vein at its distal end. - gives rise to the deep external pudendal artery. Action of Insulin include stimulation of: - glycogenolysis by the liver. - cellular uptake of amino acids. - entry of glucose into neurons. - d)entry of glucose into adipose tissue. - cellular uptake of potassium. Metronidazole: - is effective against Giardia lamblia. - is effective when administered per rectum - should not be administered intravenously. - is usually effective against Entamoeba histolytica. - interferes with ethanol metabolism. Amniotic fluid: - at term is hyperosmolar compared to fetal plasma. - normally contains maternal and fetal cells. - contains a higher concentration of alpha feto protein at 16 weeks than at term. - contains bilirubin. - contains phospholipids. Chromosomes: - are found in the same numb in all mammalian cells. - can be analysed more quickly from a blood sample than from an amniotic fluid sample. - can be reliably identified by their length. - the Y chromosome is larger than the X chromosome. - DNA content is doubled during the S phase of the cell cycle. In cystic fibrosis, abnormalities are seen in the - pancreas - salivary glands. - brain - kidneys - ileum Neutrophil polymorphs at the site of inflammation are capable of the following: - Phagocytosis. - production of oxygen free radicals. - replication - fusion to form giant cells. - antibody production In the statistical analysis of any group of numericals - the mean is always less than the mode - standard deviation is always greater than the standard error - the median value lies at the midpoint of the range - the standard error of the mean is independent of the total number of observations - there are the same number of observations greater than and less than the median value In a randomised double blind trial comparing a new drug with a placebo - the patient will be taking either of two drugs - patients can choose their mode of treatment - doctors prescribing treatment decide which patients take the new drug - a large trial is more likely to give a statistically significant result than a small trial - half of the patients will take the new drug 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) - these results reach an accepted level of statistical significants - Non- parametric statistical analysis bshould be used if datd are not normally distributed - In biological terms drugs A and B have been shown to be eqully effective - 6% more patients responded to drug A than drug B - Unequal numbers in the two groups invalidate the trial The following statistical statements are correct - In the normal distribution the value of the mode is 1.73 * that of the median - In a distribution skewed to the right, the mean lies to the left to the median - In the series 2;7;5;2;3;2;5;8, the mode is 2 - Student's test is designed to correct for skewed distributions - the Chi-squared test may be used when data are not normally distributed