21. The primary function of the descending loop of Henle in the kidney is ?

1. Reabsorption of sodium ions

2. Reabsoption of water by osmosis ✔
3. Secretion of hydrogen ions
4. Secretion of potassium ions
22. Which of the following is not considered a part of the male urethra?
1. Prostatic
2. Membranous
3. Vasapore ✔
4. Penile
23. When glucose if found in urine it is called.
1. Glucosuria ✔
2. Uremia
3. Ureteritis
4. Glucose intolerance
24. Which of the following is not considered a component of kidney stones?
1. Calcium phosphate
2. Uric Acid
3. Calcium oxalate
4. HCO3 ✔
25. The one of the functions occurring at the distal convoluted tubule in the kidney is?
1. Passive secretion of hydrogen ions
2. Passive secretion of potassium ions ✔
3. Limited re-absorption of water
4. No re-absorption of sodium
26. ADH has which of the following effects on the distal convoluted tubule?
1. Decrease water re-absorption
2. Increase water re-absorption ✔
3. Decrease the concentration of urine
4. Increase the urine volume
27. Which of the following is not associated with the role of the kidneys?
1. Release of erythropoietin (hormone)
2. Release of renin (enzyme)
3. Release of Vitamin E ✔
4. Activate Vitamin D
28. Each kidney contains approximately ______ nephrons.
1. 10 million
2. 1 million ✔
3. 100, 000
4. 10, 000
29. The release of Angiotension II causes which of the following to occur?
1. Increased filtration rate ✔
2. Decreased glomerular hydrostatic pressure
3. Increase synthesis of Vitamin E
4. Increased release of erythropoietin
30. Which of the following is an effect of a diuretic?
1. Decreased Cardiac Output ✔
2. Increased fluid volume
3. Increased sodium re-absorption
4. Increased chloride ion re-absorption

31. Which of the following is not considered a loop diuretic ?

1. Bumetadine (BUMEX)
2. Furosemide (LASIX)
3. Chlorthiazide (DIURIL) ✔
4. Ethacrynic Acid (EDECRIN)

 32. Which of the following is not one of the key steps in the grief process?
1. Denial
2. Anger
3. Bargaining
4. Rejection ✔
33. Which of the following matches the definition: Covering up a weakness by stressing a desirable or
stronger trait?
1. Compensation ✔
2. Projection
3. Rationalization
4. Dysphoria
34. Which of the following waveforms is most commonly found with light sleepers?
1. Theta ✔
2. Alpha
3. Beta
4. Zeta
35. Which of the following months matches with an infant first having the ability to sit-up
independently?
1. 4 months
2. 6 months ✔
3. 8 months
4. 10 months
36. Object permanence for toddlers develops in this age range?
1. 5 − 10 months ✔
2. 10 − 14 months
3. 12 − 24 months
4. 15 − 24 months
37. Which of the following matches the definition: Attributing of our own unwanted trait onto another
person?
1. Compensation
2. Projection ✔
3. Rationalization
4. Dysphoria
38. Which of the following matches the definition: The justification of behaviors using reason other
than the real reason?
1. Compensation
2. Projection
3. Rationalization ✔
4. Dysphoria
39. Which of the following matches the definition: Response to severe emotion stress resulting in
involuntary disturbance of physical functions?
1. Conversion disorder ✔
2. Depressive reaction
3. Bipolar disorder
4. Alzheimer’s disease
40. Which of the following waveforms is most commonly found when you are awake?
1. Theta
2. Alpha
3. Beta ✔
4. Zeta
41. The REM sleep cycle occur approximately every ____ minutes?
1. 45
2. 60
3. 75
4. 90 ✔
42. Which of the following reflexes is not found at birth?
1. Babinski
2. Palmar

 3. Moro
4. Flexion ✔
43. Parallel play for toddlers develops in this age range?
1. 5 − 10 months
2. 10 − 14 months
3. 12 − 24 months
4. 24 − 48 months ✔
44. Which of the following is not a sign of anxiety?
1. Dyspnea
2. Hyperventilation
3. Moist mouth ✔
4. GI symptoms
45. Which of the following best describes a person that is completely awake falling asleep
spontaneously?
1. Cataplexy ✔
2. Narcolepsy
3. Transitional sleep
4. REM absence
46. Which of the following best describes a person that is unable to tell you were there hand or foot
is?
1. Autotopagnosia ✔
2. Cataplexy
3. Ergophobia
4. Anosognosia
47. Which of the following is not a characteristic of a panic disorder?
1. Nausea
2. Excessive perspiration
3. Urination ✔
4. Chest pain
48. Which of the following categories would a 70 year old adult be placed in?
1. Intimacy vs. Isolation
2. Generativitiy vs. Stagnation ✔
3. Integrity vs. Despair
4. Longevity vs. Guilt
49. Which of the following categories would a 60 year old adult be placed in?
1. Intimacy vs. Isolation
2. Generativitiy vs. Stagnation ✔
3. Integrity vs. Despair
4. Longevity vs. Guilt
50. Which of the following categories would a 20 year old adult be placed in?
1. Intimacy vs. Isolation ✔
2. Generativitiy vs. Stagnation
3. Integrity vs. Despair
4. Longevity vs. Guilt
51. A 48-year-old woman presents with intermenstrual bleeding for two months and episodes of
bleeding occurring any time in the cycle. There is no associated pain. Differential diagnosis for
intermenstrual bleeding does not include:
1. Endocervical polyp
2. Cervical malignancy
3. Endometrial polyp
4. Ovarian teratoma ✔
5. Atrophic vaginitis.
52. All of the following drugs are associated with hyperprolactinaemia, apart from:
1. Reserpine
2. Progesterone-only contraceptive pill ✔
3. Methyldopa
4. Ranitidine
5. Chlorpromazine.

 53. All of the following are effects of premature menopause, apart from:
1. Decreased cardiovascular risk ✔
2. Infertility
3. Osteoporosis
4. Vasomotor symptoms
5. Vaginal dryness.
54. A 32-year-old woman presents to the gynaecology clinic with infrequent periods. A hormone profi
le is done and all of the following are consistent with polycystic ovarian syndrome, apart from:
1. Increased androgen levels
2. Normal FSH
3. Normal oestradiol
4. Decreased LH ✔
5. Low progesterone levels.
55. A 28-year-old woman attends the colposcopy clinic after an abnormal smear test. The smear is
reported as severe dyskaryosis and she has an intrauterine contraceptive device in situ. All of the
following statements are likely to be true, apart from:
1. The cervix is macroscopically normal
2. Acetic acid is applied and an irregular white area is apparent to the left of the cervical os
3. Lugol’s iodine is applied and the same area stains dark brown while the rest of the cervix
stains pale ✔
4. A biopsy is taken
5. The IUCD can stay, as it will not aggravate the cervical abnormality.
56. 24-year-old woman presents with the absence of periods for nine months. She started her
periods at the age of 13 years and had a regular 28-day cycle until 18 months ago. The periods
then became irregular, occurring every two to three months until they stopped completely. The
following are all included in the differential diagnosis of secondary amenorrhoea, apart from:
1. Excessive exercise
2. Hyperprolactinaemia
3. Hyperthyroidism ✔
4. Premature ovarian failure
5. Signifi cant weight loss
57. The following statements regarding adenomyosis are true, apart from one.
1. It tends to occur in women over 35 years.
2. Risk factors include increased parity, termination and quick labours. ✔
3. The condition commonly occurs in association with endometriosis.
4. With each period, bleeding occurs from the endometrial tissue into the smooth muscle.
5. The diagnosis can be made by ultrasound or magnetic resonance imaging scan.
58. A 20-year-old woman is referred with a problem of post-coital bleeding. Over the past two months
it has occurred on six occasions and there has been a small amount of bright red blood noticed
after intercourse. There is no associated pain. The following investigations should initially be
performed, apart from:
1. Cervical smear
2. Endocervical swab for chlamydia
3. Colposcopy ✔
4. Dndocervical swab for gonorrhoea
5. Speculum examination to observe the cervix.
59. The following are all consistent with the diagnosis of antiphospholipid syndrome except:
1. Hydatidiform mole ✔
2. Severe early-onset pre-eclampsia
3. Arterial or venous thrombosis
4. Mid-trimester fetal loss
5. Placental abruption.
60. The following are all causes of recurrent miscarriage, apart from:
1. Parental chromosomal abnormality
2. Activated protein C-resistance
3. Uncontrolled hypothyroidism
4. Chlamydia infection ✔
5. Submucosal fi broids.

 61. Which one of the following statements about pituitary tumours is true?
1. Weight loss is a common feature of pituitary failure (hypopituitarism) due to a pituitary
tumour.
2. Visual fi eld loss in female patients with prolactin-secreting pituitary tumours
(prolactinoma) is usual.
3. Adrenocorticotrophic hormone (ACTH) secreting pituitary tumours cause a syndrome of
cortisol excess that can lead to exaggerated vertical growth in adolescence.
4. Growth hormone defi ciency is a recognised feature in adult patients presenting with
acromegaly due to a pituitary macroadenoma.
5. A low testosterone level is more common than a low thyroxine level in men with non-
functioning gonads. ✔
62. Which of the following statements concerning the anterior pituitary is true?
1. It develops in the embryo from a down-growth of the hypothalamus.
2. It secretes antidiuretic hormone (ADH).
3. It is regulated by hypothalamic-releasing hormones. ✔
4. It secretes its hormones into the pituitary portal system.
5. It is down-regulated by low oestrogen levels.
63. Which one of the following statements about the implantation of the human embryo is true?
1. It will occur at any time over a period of about 14 days.
2. It will occur whether or not the zona pellucida is present.
3. It will occur when the cytotrophoblast contacts the endometrial epithelium and begins to
invade the maternal tissue.
4. It will occur with the inner cell mass closest to the endometrium. ✔
5. It will occur even if there is only cytotrophoblast present.
64. Which one of the following statements about puberty is true?
1. Puberty is preceded by falling plasma levels of adrenal androgens. ✔
2. The fi rst menstrual period is called the adrenarche.
3. The pubertal growth spurt is the fi rst sign of puberty.
4. Pubic hair growth is stimulated in girls by oestrogen.
5. Spermatogenesis starts at puberty.
65. Which is the most appropriate statement concerning pulmonary embolism?
1. It is now rarely fatal, with the introduction of modern diagnostic tests and treatments.
2. It gives an area of lung which is unventilated on a ventilationperfusion scan.
3. It does not usually show up on a CT pulmonary angiogram.
4. It is likely that the patient has symptoms of deep-vein thrombosis.
5. It may give symptoms similar to pneumonia. ✔
66. One of the following is true. It is recognised that the positive predictive value of initial
mammography for breast cancer within the national screening programme in the UK is 16%. This
means that:
1. 16% of people who have breast cancer are detected on initial mammography
2. 84% of people without breast cancer have a normal mammogram
3. 16% of initial mammograms are abnormal
4. A patient with an abnormal initial mammogram has a 16% chance of having breast
cancer ✔
5. Out of every 100 patients with an abnormal mammogram,
67. 17. One of the following is true. Successful fertilisation and subsequent normal embryonic
development:-
1. Require at least two spermatozoa
2. Require the retention of the cortical granules in the oocyte
3. Are most likely when the oocytes have been ovulated in an immature stage
4. Require exclusion of the second polar body ✔
5. Often occur when the oocyte has lost its zona pellucida.
68. One of the following is true. The increase in maternal blood volume in pregnancy occurs as a
result of:
1. Peripheral vasoconstriction
2. A reduction in progesterone
3. Decreased synthesis of vasopressin

 4. Increased aldosterone synthesis ✔

5. Reduced renin activity.
69. One of the following is true. Decreased peripheral resistance in pregnancy has been attributed to
an increase in synthesis of:
1. Angiotensin
2. Endothelin
3. Nitric oxide ✔
4. Renin
5. Thromboxane.
70. A 25-year-old woman on liver enzyme inducers is requesting contraceptive advice. The method
providing her with the most reliable form of contraception would be:
1. Combined oral contraceptive pill
2. Depo-Provera injection ✔
3. Diaphragm
4. Male condom
5. Progesterone-only pill.
71. A 35-year-old woman comes requesting long-term reversible contraception. You advise that the
method that can provide the longest protection is:
1. Contraceptive implant
2. Copper intrauterine device ✔
3. Depo-Provera injection
4. Intrauterine hormonal system (IUS)
5. laparoscopic sterilisation.
72. Regarding cervical cancer, which is the true statement?
1. HPV types 6 and 12 are high risk for developing cervical cancer.
2. The new vaccines can prevent invasive carcinoma but not CIN.
3. As soon as the new vaccination is introduced, cervical screening programmes can cease.
4. HPV types 16 and 18 account for the majority of cervical cancer in the world. ✔
5. HPV is an oncogenic virus for squamous cell but not adenocarcinoma of the cervix.
73. Regarding the menstrual cycle, which is the true statement?
1. Menstruation occurs with vasodilation of the spiral arteries.
2. The LH surge triggers menstruation.
3. The Graafi an follicle develops during the luteal phase.
4. Both the follicle and the corpus luteum secrete oestradiol. ✔
5. Progesterone levels fall after the onset of menstruation.
74. Regarding Müllerian duct abnormalities which is the true statement?
1. Occur about 1 in 500
2. The commonest uterine abnormality is septate uterus ✔
3. Occur not infrequently with gastrointestinal abnormalities
4. Surgical correction of a septate uterus is followed by fetal salvage in <60% of cases
5. Longitudinal vaginal septa are more common than transverseones.
75. Choose the correct statement: Uterine leiomyosarcomas:
1. Are associated with exposure to tamoxifen ✔
2. Originate from leiomyomas
3. Pelvic radiotherapy has a signifi cant impact on survival
4. Commonly metastasise to the brain
5. Anthracycline-based chemotherapy has no place in treatment.
76. Which one of the following statements about the menopause is correct?
1. Progesterone levels rise after the menopause.
2. LH levels rise after the menopause. ✔
3. The pituitary stops secreting LH and FSH at the menopause.
4. Menstrual cycles remain regular until the last menstrual period.
5. The number of oocytes in the ovary remains constant until the menopause.
77. Choose the correct statement: The female reproductive tract plays important roles in sperm
transport by:
1. Trapping most spermatozoa in the cervical crypt for many days
2. Regulating sperm transport so that cells reach the site of fertilisation around the time of
ovulation ✔

 3. Allowing sperm transport at all stages of the ovarian cycle

4. Preventing spermatozoa from swimming out of the peritoneal cavity
5. Providing an acidic environment to keep the spermatozoa active.
78. Which one of the following statements is true: Semen analysis:
1. Identifi es men with high-quality fertile spermatozoa
2. Identifi es men with low sperm ✔ concentrations that might affect fertility
3. Can always be used to predict fertility
4. Cannot identify abnormal spermatozoa
5. Identifi es men with hypopituitarism.
79. One of the following is true. A malignant tumour arising in the mesenchymal tissue is called:
1. Adenoma
2. Carcinoma
3. Lymphoma
4. Melanoma
5. Sarcoma. ✔
80. One of the following is true. Affording moral status to a human embryo/fetus means that it now
has:
1. An inalienable right to life
2. A right to life
3. A right to consideration
4. A right dependent on moral consensus ✔
5. A right not to be harmed.

81. At term amniotic fluid volume is

1. 800 ml ✔
2. 500 ml
3. 400 ml
4. 600 ml
82. what is the principal carbohydrate present in Amniotic fluid ?
1. Glucose ✔
2. Fructose
3. Mannose
4. Galactose
83. Oligohydramnios is related which of the following condition ?
1. Enal Agenesis ✔
2. Esophageal atresia
3. Anencephaly
4. Down’s syndrome
84. Early amniocentesis is done in which period of pregnancy
1. 12-14 wks
2. 14-16 wks ✔
3. 16-18 wks
4. 9-11 wk
85. Immune rejection of fetus prevented by
1. HCG ✔
2. HPL
3. Oestrogen
4. progesterone
86. what happens to GFR in a case of Pre-eclampsia ?
1. GFR Decreases ✔
2. GFR increases
3. Remains same
4. None of the above
87. Shortest diameter of pelvic Cavity
1. Interspinous ✔
2. Transverse
3. Antero-posterior
4. Oblique

 88. Large Chorioangioma associated with

1. Polyhydroamnios ✔
2. Oligohydramnios
3. Both
4. None
89. Commonest presentation of Choriocarcinoma
1. Vaginal bleeding ✔
2. Abdominal pain
3. Breathlessness
4. Perforation of the uterus
90. Frog eye appearance is seen in
1. Anencephaly ✔
2. Acardia
3. Down’s syndrome
4. Patau’s syndrome
91. what of the following is seen in Partial mole
1. Triploidy ✔
2. Haploidy
3. Polyploidy
4. Diploidy
92. Cervical changes in pregnancy are all except ?
1. Increased collagen
2. Increased Hyaluronic acid ✔
3. Increased glands
4. Increased vascularity
93. Symptoms of circulatory systemic overload during excessive IV fluids include all except
1. Oliguria ✔
2. Increased BP
3. Anxiety
4. Pulmonary edema
94. Succinylcholine can produce all except
1. Induce malignant hyperthermia in susceptible patients
2. Prolonged paralysis occurs in case of butyrylcholinesterase abnormalities (as
succinylcholine is not metabolized)
3. Tachycardia, particularly in children ✔
4. Increase intraocular pressure
95. Life threatening risks of anesthesia include all except
1. Hypoxic brain injury
2. Myocardial infarction
3. Postoperative nausea and vomiting ✔
4. Cerebrovascular accident
96. In a lower segment caesarean section, which of the following techniques of anesthesia is
desirable
1. Spinal anesthesia
2. Caudal anesthesi
3. Combined Spinal Epidural ✔
4. General anesthesia
97. Predictors of difficult intubation include.
1. Short muscular neck
2. Prominent upper incisor
3. Protruding mandible
4. All of the above ✔
98. ASA standard monitors include all except
1. Pulse oximeter
2. CVP ✔
3. NIBP cuff
4. ECG
99. Ketamine; all are true except

 1. Induction of anesthesia by IV route

2. Induction of anesthesia
3. Supplementation of sedation…
4. Decrease cerebral blood flow ✔
100. Signs of low perfusion include all except
1. Hypotension
2. Tachycardia
3. High Urine Output ✔
4. Poor Capillary refill
101. Which of the following describes a person using words that have no known meaning?
1. Neologisms ✔
2. Neolithic
3. Verbalism
4. Delusional blocking
102. Which of the following is the mRNA start codon in most cases?
1. UAA
2. AGU
3. AUG ✔
4. UGA
103. Which of the types of RNA is the smallest?
1. mRNA
2. tRNA ✔
3. rRNA
104. Signs of low perfusion include all except.
1. Hypotension
2. Tachycardia
3. High Urine Output ✔
4. Poor Capillary refill
105. Balanced General Anesthesia includes
1. Skeletal muscle relaxant
2. Loss of consciousness
3. Analgesia
4. All of the above ✔
106. Depolarizing block may be done by
1. Atracurium
2. Neostegmin
3. Succinylcholine ✔
4. Rocuronuim
107. Intravenous regional anesthesia is more commonly used for operations of .
1. Neck surgeries
2. Lower abdomen
3. Upper limbs ✔
4. Lower limbs
108. Regarding morphine, all are true Except
1. Respiratory depression … effect
2. Can be IV subcutaneously, rectally and epidurally
3. Can cause nausea and vomiting
4. Less effective against pain of myocardial ischemia ✔
109. ASA III is
1. Normal, healthy patient
2. Patient with mild, well controlled systemic disease
3. Patient with sever systemic disease that limits activity ✔
4. Patient with sever life threatening disease
110. Premedication that can be given
1. Anxiolysis
2. Anti- emetic
3. Antacid
4. All of the above ✔

 111. Mallampati grade suggests difficult intubation

1. Grade I
2. Grade II
3. Grade IV ✔
4. All of the above
112. Factor at increase risk of aspiration includes
1. Drinking clear fluids 8 hours before operation
2. Gastro esophageal reflux ✔
3. Chewing gum
4. Two hours preoperative oral clear fluid administration
113. In 70 kg patient one unit of platelet concentrate should increase platelet count
1. 2000 – 5000 mm3
2. 5000 – 10000 mm3 ✔
3. 10000 – 20000 mm3
4. More than 20000 ;mm3
114. The following are the classical hemolytic transfusion reaction in general anesthesia except
1. Hypotension
2. Wheezing
3. Hemoglobinuria
4. Bradycardia ✔
115. The mean arterial pressure of a blood pressure of 160/80 is
1. 90 mmHg
2. 100 mmHg
3. 110 mmHg ✔
4. 120 mmHg
116. Indication of rapid sequence anesthesia include all except
1. Patient ASA I undergoing elective cholecytectomy. ✔
2. Patient presented with bowel obstruction
3. Morbid Obesity Patients
4. Pregnancy
117. Thiopental (sodium thiopental, Thiopentone, STP) characterized by the following except
1. Prepares as a pale yellow 10.5 (alkaline)
2. After iv bolus, rapidly …
3. Effects include decrease cerebral blood flow and O2 requirements
4. Has good analgesic … ✔
118. An ECG is performed and reveals a progressively increasing PR interval and dropping of QRS
complexes at regular intervals. Which of the following is the most likely diagnosis?
1. First-degree heart block
2. Second-degree heart block (Mobitz type 2)
3. Second-degree heart block (Mobitz type 1) ✔
4. Hyperkalaemia
119. What view of the heart do leads V1 and V2 represent?
1. Inferior
2. Septal ✔
3. Anterior
4. Lateral
120. Which artery is most likely to be affected in the context of ST elevation being present in leads V3
and V4?
1. Left anterior descending coronary artery ✔
2. Right coronary artery
3. All of the above
4. Left circumflex coronary artery
121. What is the most common cause of left axis deviation?
1. Defects of the conduction system ✔
2. Left ventricular hypertrophy
3. Right ventricular hypertrophy
4. Atrial septal defects

 122. Which of the following is a common cause of right axis deviation?

1. Right ventricular hypertrophy ✔
2. Ventricular septal defect
3. Left ventricular hypertrophy
4. Atrial septal defect
123. What does ST-elevation suggest?
1. Myocardial infarction ✔
2. Heart murmur
3. Heart block – Mobitz type II
4. Bundle branch block
124. A patient is noted to have an abnormally shortened PR-interval on their ECG. Which of the
following is the most likely cause?
1. Right bundle branch block
2. Atrioventricular nodal fibrosis
3. Wolff-Parkinson-White (WPW) syndrome ✔
4. Left bundle branch block
125. If ST-elevation was noted in leads II, III and aVF, what would it suggest?
1. A posterior myocardial infarction
2. An inferior myocardial infarction ✔
3. A septal myocardial infarction
4. An anterior myocardial infarction
126. What view of the heart do leads V3 and V4 represent ?
1. Anterior✔
2. Septal
3. Inferior
4. Lateral
127. What is the normal duration of a QRS complex?
1. 0.04 seconds (1 small square)
2. 0.08 seconds (2 small squares)
3. 0.16 seconds (4 small squares)
4. 0.12 seconds (3 small squares) ✔
128. If there were 3 large squares in an R-R interval what would the heart rate be?
1. 70 bpm
2. 80 bpm
3. 90 bpm
4. 100 bpm ✔
129. What view of the heart do leads I, aVL, V5 and V6 represent?
1. Inferior
2. Septal
3. Lateral ✔
4. Anterior
130. An ECG reveals an absence of P-waves and an irregular rhythm. Which of the following is the
most likely diagnosis?
1. 2nd-degree heart block
2. 1st-degree heart block
3. Atrial fibrillation ✔
4. Ventricular tachycardia

131. What is the duration of a normal PR-interval?

1. 0.04 – 0.08 seconds (1-2 small squares)
2. 0.08 – 0.12 seconds (2-3 small squares)
3. 0.12 – 0.2 seconds (3-5 small squares) ✔
4. 0.04 – 0.12 seconds (1-3 small squares)
132. What view of the heart do leads II, III and aVF represent?
1. Inferior ✔
2. Septal
3. Lateral
4. Anterior

 133. Which of the following are functions of progesterone?

1. Inhibition of oestrogen production
2. Inhibition of LH and FSH production ✔
3. Initiation of the secretory phase of the endometrium ✔
4. Increase in basal body temperature ✔
134. Where are luteinizing hormone (LH) and follicle stimulating hormone (FSH) produced?
1. Hypothalamus
2. Anterior pituitary ✔
3. Posterior pituitary
4. Adrenal glands
135. At which stage in the uterine cycle does the proliferative phase occur?
1. Days 1-5
2. Days 5-14 ✔
3. Days 15-28
136. Which of the following symptoms indicate that a woman is about to ovulate?
1. Decrease in basal body temperature
2. Increase in basal body temperature ✔
3. Thickening of cervical mucous
4. Thinning of cervical mucous
137. Where is gonadotrophin-releasing hormone produced?
1. Anterior pituitary
2. Posterior pituitary
3. Hypothalamus ✔
4. Adrenal glands
138. At which point in the menstrual cycle is a woman most fertile?
1. Days 1-5
2. Days 9-16 ✔
3. Days 17-21
4. Days 22-28
139. Which of the following statements are true about menstruation?
1. In a normal 28 day menstrual cycle you would expect menstruation to last approximately
3-5 days. ✔
2. During menstruation the entire endometrium is shed.
3. During menstruation only the functional layer of the endometrium is shed, with the basal
layer remaining intact. ✔
4. Absence of menstruation always indicates an active pregnancy.
140. At which stage of the uterine cycle does the menstrual phase occur?
1. Days 1-5 ✔
2. Days 5-14
3. Days 14-28
141. At which stage in the uterine cycle does the secretory phase occur?
1. Days 1-5
2. Days 5-14
3. Days 14-28 ✔
142. Which of the following are functions of luteinizing hormone (LH)?
1. Formation and maintenance of the corpus luteum ✔
2. Thinning of the Graafian follicles membrane ✔
3. Stimulation of follicle development
4. Stimulation of GnRH production
143. In a normal 28 day menstrual cycle, when would you expect the LH surge to occur?
1. Days 8-10
2. Days 11-13 ✔
3. Days 14-16
4. Days 17-19
144. Which one of the following is the primary source of progesterone in the later stages of
pregnancy?
1. Fetus
2. Endometrium

 3. Corpus luteum
4. Placenta ✔
145. Which hormone is the corpus luteum responsible for producing?
1. Oestrogen
2. Progesterone ✔
3. Follicle-stimulating hormone
4. Luteinizing hormone
146. Which of the following are effects of increased levels of oestrogen in the follicular phase of the
menstrual cycle?
1. Hair thinning
2. Thickening of cervical mucous
3. Thinning of cervical mucous ✔
4. Thickening of the endometrium ✔
147. At 22 weeks gestation where would you expect to find the uterine fundus?
1. Halfway between umbilicus and xiphisternum
2. Umbilicus ✔
3. Xiphisternum
4. Symphysis pubis
148. Which of the following are causes of postpartum haemorrhage?
1. Vaginal or vulval lacerations
2. Uterine atony
3. Retained placenta
4. Coagulapathy
5. All of Above ✔
149. Which of the following are recognised causes of intrauterine growth restriction (IUGR)?
1. Diabetes
2. Pre-eclampsia
3. Smoking
4. Hypertension
5. Alcohol
6. All of above ✔
150. Which period of gestation does the 3rd trimester represent?
1. 30-41 weeks
2. 27-39 weeks
3. 28-40 weeks
4. 29-40 weeks ✔
151. At 28 weeks gestation where would you expect to feel the uterine fundus?
1. Symphysis pubis
2. Umbilicus
3. Xiphisternum
4. Halfway between xiphisternum and umbilicus ✔
152. Which of the following is thought to be a cause of hyperemesis gravidarum?
1. High levels of circulating HCG ✔
2. Underlying infection
3. Over eating
4. Psychological issues
153. Which of the following methods is the correct way to calculate the estimated date of delivery
(EDD)?
1. First day of LMP + 9 months and 1 week ✔
2. Last day of LMP + 8 months and 1 week
3. First day of LMP + 9 months
4. First day of last menstrual period (LMP) + 8 months and 1 week
154. Which period of gestation does the 2nd trimester represent?
1. 13-28 weeks ✔
2. 15-30 weeks
3. 14-29 weeks
4. 10-20 weeks
155. At 36 weeks gestation where would you expect to find the uterine fundus?

 1. Halfway between umbilicus and xiphisternum

2. Symphysis pubis
3. Umbilicus
4. Xiphisternum ✔
156. At what stage of gestation would you expect a nulliparous women to begin to feel fetal
movements?
1. 14-16 weeks
2. 18-20 weeks ✔
3. 10-12 weeks
4. 22-24 weeks
157. What is the most common cause of postpartum haemorrhage?
1. Vulval or vaginal lacerations
2. Retained placenta
3. Uterine atony ✔
4. Uterine rupture
158. Which period of gestation does the 1st trimester represent?
1. 1-12 weeks ✔
2. 1-13 weeks
3. 1-11 weeks
4. 1-10 weeks
159. Which of the following are risk factors for pre-eclampsia?
1. First pregnancy
2. Family history of pre-eclampsia in mother or sisters
3. Obesity (BMI >35)
4. Maternal age > 40
5. Change of partner
6. All of Above ✔
160. Which of the following is a prostaglandin commonly used in induction of labour?
1. Labetalol
2. Atenolol
3. Misoprostol ✔

161. At 12 weeks gestation where would you expect to feel the uterine fundus?
1. Xiphisternum
2. Halfway between umbilicus and xiphisternum
3. Symphysis pubis ✔
4. Umbilicus
162. Which of the following are causes of Addison’s disease?
1. Tuberculosis ✔
2. Autoimmune destruction of the adrenal cortex ✔
3. Adrenoleukodystrophy ✔
4. Pyelonephritis
163. What is the most common cause for the overproduction of growth hormone in acromegaly?
1. Hyperplasia of the pituitary stalk
2. Pituitary adenoma ✔
3. Hypothalamic lesion
4. Pituitary lesion
164. Which one of the following hormones binds to the pituitary and stimulates the release of
luteinizing hormone (LH) and follicle stimulating hormone (FSH)?
1. Gonadotrophin releasing hormone (GnRH) ✔
2. Adrenocorticotropic hormone (ACTH)
3. Corticotropic releasing hormone (CRH)
165. Which one of the following statements describes the underlying pathology of Grave’s disease?
1. Inflammation of the thyroid gland due to lymphocytic infiltration causes the stored thyroid
hormones to be released into the circulation leading to hyperthyroidism.

 2. An autoimmune disease directed against thyroid stimulating hormone (TSH) receptors.

The autoantibodies stimulate the TSH receptors causing increased T3 and T4
production. ✔
3. A benign tumour of the thyroid gland which produces excessive amounts of thyroid
hormones.
4. Consumption of ground beef which has been contaminated with thyroid tissue. The
thyroid tissue contains metabolically active thyroid hormones which causes
hyperthyroidism.
166. Which one of the following statements is true regarding the prevalence of acromegaly?
1. Acromegaly affects twice as many men than it does women
2. Acromegaly effects a similar number of men and women ✔
3. Acromegaly affects twice as many women than men
167. Which of the following statements best describes Cushing’s syndrome?
1. Cushing’s syndrome refers to a disease process caused by abnormally low levels of
aldosterone
2. Cushing’s syndrome refers to a disease process caused by abnormally low levels of
cortisol
3. Cushing’s syndrome refers to a disease process caused by abnormally high levels of
aldosterone
4. Cushing’s syndrome refers to a disease process caused by abnormally high levels of
cortisol ✔
168. Which of the following statements regarding Cushing’s syndrome is correct?
1. Men are more likely to develop Cushing’s syndrome
2. Women are more likely to develop Cushing’s syndrome ✔
3. The incidence of Cushing’s syndrome is distributed equally between sexes
169. Which one of the following statements best describes an Addisonian crisis?
1. Dangerously high levels of testosterone
2. Severe adrenal insufficiency resulting in dangerously low serum testosterone levels
3. Severe adrenal insufficiency resulting in dangerously low serum cortisol levels ✔
4. Dangerously high serum cortisol levels
170. Which of the following hormones are produced in the anterior pituitary gland?
1. Follicle-stimulating hormone (FSH) ✔
2. Growth hormone (GH)✔
3. Oxytocin
4. Thyroid-stimulating hormone (TSH) ✔
5. Vasopressin (antidiuretic hormone)
6. Adrenocorticotrophic hormone (ACTH) ✔
7. Prolactin ✔
8. Luteinizing hormone (LH) ✔
171. In males which hormone stimulates Leydig cells to produce testosterone?
1. Luteinizing hormone (LH) ✔
2. Follicle stimulating hormone (FSH)
172. Which of the following statements correctly describes the pathophysiology of Cushing’s disease?
1. Cushing’s disease results from a benign adrenal adenoma secreting excess ACTH. High
levels of ACTH in turn cause increased production of cortisol from the adrenal cortex.
2. Cushing’s disease results from a benign adrenal adenoma secreting excess levels of
cortisol.
3. Cushing’s disease results from a benign pituitary adenoma secreting excess levels of
cortisol.
4. Cushing’s disease results from a benign pituitary adenoma secreting excess ACTH. High
levels of ACTH in turn causes increased production of cortisol from the adrenal cortex. ✔
173. Which of the following are Sertoli cells responsible for producing?
1. Testosterone
2. Gonadotrophin releasing hormone (GnRH)
3. Androgen binding globulin (ABG) ✔
4. Oestrogen
174. Which one of the following is acromegaly caused by?
1. Overproduction of gonadotrophin releasing hormone (GnRH)

 2. Overproduction of vasopressin (antidiuretic hormone)

3. Overproduction of adrenocorticotropic hormone (ACTH)
4. Overproduction of growth hormone (GH) ✔
175. Which of the following are symptoms of Addison’s disease?
1. Weight gain
2. Diplopia
3. Hyperpigmentation✔
4. Weight loss✔
5. Striae
6. Postural hypotension✔
7. Moon face
8. Fatigue✔
176. Which of the following are causes of nephrogenic diabetes insipidus?
1. Post obstructive uropathy ✔
2. Amyloidosis ✔
3. Atenolol
4. Mutations in the vasopressin (ADH) receptor gene ✔
5. Mutations in vasopressin gene
6. Sheehan’s syndrome
7. Lithium ✔
177. Which one of the following is the main function of aldosterone?
1. Increase in blood volume ✔
2. Decrease in blood volume
178. Which of the following investigations is the gold standard for diagnosing acromegaly?
1. Growth hormone measurement
2. Growth hormone releasing hormone measurement
3. Oral glucose tolerance test + Growth hormone measurement ✔
4. Serum IGF1 measurement
179. Which of the following statements best describes diabetes insipidus?
1. Diabetes insipidus is a disease characterised by the passage of large volumes of dilute
urine ✔
2. Diabetes insipidus is a disease characterised by the passage of small volumes of
concentrated urine
3. Diabetes insipidus is a disease characterised by the passage of small volumes of dilute
urine
4. Diabetes insipidus is a disease characterised by the passage of large volumes of
concentrated urine
180. What is the most common cause of Cushing’s syndrome?
1. Glucocorticoid treatment (iatrogenic) ✔
2. Pituitary adenoma
3. Adrenal adenoma
4. Ectopic ACTH production
181. Which of the following are not causes of neurogenic diabetes insipidus?
1. Trauma
2. Sheehan’s syndrome
3. Meningitis
4. Mutatations in the vasopressin gene
5. Polycystic kidney disease ✔
6. Pituitary adenoma
7. Mutatations in the vasopressin (ADH) receptor gene ✔
182. Which of the following does the adrenal cortex produce?
1. Cortisol ✔
2. Adrenaline
3. Noradrenaline
4. Aldosterone ✔
183. Which of the following statements best describes Hashimoto’s thyroiditis?
1. Inflammation of the thyroid gland as the result of a virus. The disease is often preceded
by an upper respiratory tract infection.

 2. A destructive autoimmune disease caused by auto-reactive antibodies against

thyroglobulin. ✔
3. Iodine deficiency
184. In regard to the investigation of hyperthyroidism, which one of the following antibodies is specific
to Grave’s disease?
1. TSH receptor antibodies ✔
2. Thyroid peroxidase antibody
3. Thyroglobulin antibody
185. Which of the following causes of Cushing’s syndrome does the phrase “Cushing’s disease”
specifically refer to ?
1. Pituitary adenoma ✔
2. Ectopic ACTH production
3. Adrenal adenoma
4. Iatrogenic
186. Which of the following is not a symptom of Cushing’s syndrome?
1. Easy bruising
2. Stretch marks
3. Increased pigmentation of skin ✔
4. Acne
5. Weight gain
187. What of the following statements best describes a toxic thyroid adenoma?
1. Inflammation of the thyroid gland due to lymphocytic infiltration causing stored thyroid
hormones to be released into the circulation leading to hyperthyroidism.
2. A malignant tumour of the thyroid gland which produces excessive amounts of thyroid
hormones. These arise from the follicular cells of the thyroid gland.
3. An autoimmune disease directed against thyroid stimulating hormone (TSH) receptors.
The autoantibodies stimulate the TSH receptors causing increased T3 and T4 production
4. A benign tumour of the thyroid gland which produces excessive amounts of thyroid
hormones. These arise from the follicular cells of the thyroid. ✔
188. Which of the following are common symptoms of hyperthyroidism?
1. Urinary frequency
2. Diarrhoea ✔
3. Weight gain
4. Weight loss✔
5. Heat intolerance ✔
6. Tremor ✔
189. Which age group does acromegaly most commonly affect?
1. 55-70 years
2. 10-25 years
3. 30-50 years ✔
4. 25-40 years
190. What is Addison’s disease?
1. Addison’s disease involves the overproduction of cortisol and aldosterone by the adrenal
cortex.
2. Addison’s disease involves the overproduction of androgens by the adrenal medulla.
3. Addison’s disease is a long-term endocrine disorder in which the adrenal glands do not
produce enough steroid hormones. ✔
4. Addison’s disease involves the underproduction of androgens by the adrenal medulla.
191. Which of the following is the underlying problem in neurogenic diabetes insipidus?
1. Overproduction of oxytocin
2. Overproduction of prolactin
3. Lack of prolactin
4. Lack of oxytocin
5. Overproduction of vasopressin (antidiuretic hormone)
6. Lack of vasopressin (antidiuretic hormone) ✔
192. Which is a more sensitive measure of thyroid function?
1. Thyroid stimulating hormone (TSH) ✔
2. Free T4

 3. Free T3
193. Which of the following are symptoms of acromegaly?
1. Headache ✔
2. Visual changes (double vision, reduced vision, tunnel vision) ✔
3. Abdominal distention
4. Vomiting
5. Excessive sweating (hyperhidrosis) ✔
6. Widespread rash
7. Increased finger ring size ✔
8. Deepening voice ✔
9. Diarrhoea
10. Paresthesia and weakness in the hands ✔
194. What is the most common cause of hyperthyroidism?
1. Grave’s disease ✔
2. Toxic thyroid adenoma
3. Toxic multinodular goitre
4. Thyroiditis
195. Which of the following hormones are stored in the posterior pituitary gland?
1. Luteinizing hormone (LH)
2. Growth hormone (GH)
3. Thyroid stimulating hormone (TSH)
4. Follicle stimulating hormone (FSH)
5. Adrenocorticotropic hormone (ACTH)
6. Oxytocin ✔
7. Prolactin
8. Vasopressin (antidiuretic hormone) ✔
196. Which of the following are correct regarding the effects of increased levels of growth hormone in
acromegaly?
1. Increased levels of growth hormone stimulate increased production of insulin like growth
factor one (IGF1) from the adrenal glands
2. Increased levels of growth hormone stimulate increased production of vasopressin from
the adrenal glands
3. Increased levels of growth hormone stimulate increased production of vasopressin from
the liver
4. Increased levels of growth hormone stimulate increased production of insulin like growth
factor one (IGF1) from the liver ✔
197. What do Leydig cells produce?
1. Testosterone ✔
2. Semen
3. Androgen binding globulin
4. Oestrogen
198. Which of the following are common symptoms of hypothyroidism?
1. Weight gain ✔
2. Hyporeflexia ✔
3. Hair loss ✔
4. Oily skin
5. Excessive hair growth
6. Weight loss
7. Dry skin ✔
199. Which one of the following statements best defines dipsogenic diabetes insipidus?
1. Dipsogenic diabetes insipidus is caused by a defect or damage to the pituitary gland
causing malfunction of the thirst mechanism.
2. Dipsogenic diabetes insipidus is caused by a defect or damage to the pituitary stalk
causing malfunction of the thirst mechanism.
3. Dipsogenic diabetes insipidus is caused by a defect or damage to the hypothalamus
causing malfunction of the thirst mechanism. ✔
4. Dipsogenic diabetes insipidus is caused by a defect or damage to the pituitary stalk
causing malfunction of the hunger mechanism.

 200. Which of the following hormones are produced by the adrenal cortex?
1. Epinephrine (adrenaline)
2. Aldosterone ✔
3. 5-DHEA ✔
4. Cortisol ✔
5. Norepinephrine (noradrenaline)
201. In males which hormone stimulates Sertoli cells to produce androgen binding globulin (ABG)?
1. Luteinizing hormone (LH)
2. Follicle stimulating hormone (FSH) ✔
3. Oxytocin
4. Gonadotrophin releasing hormone (GnRH)
202. At what age should a child be referred to a paediatrician if they have not begun to walk?
1. 18 months ✔
2. 12 months
3. 15 months
4. 9 months
203. A resurgence of which hormone precipitates puberty?
1. Oestrogen
2. GnRH ✔
3. Testosterone
4. LH
5. FSH
204. How is the seasonal flu vaccination usually administered in children aged 2 and 3?
1. SC injection
2. Orally
3. Rectally
4. Nasally ✔
5. EIM injection
205. Which of the following sentences best describes meconium?
1. The first stool when a child has been fully weaned.
2. green stool.
3. The first stool passed by a child. ✔
4. The first stool after introduction of wheat.
5. The first stool after introduction of feeds.
206. Around what age should a child be able to build a tower of three building blocks?
1. 21 months
2. 18 months ✔
3. 15 months
4. 9 months
5. 12 months
207. At what age should a child develop a mature pincer grip?
1. 3-6 months
2. 2 years
3. 9-12 months ✔
4. 6-9 months
5. 12-18 months
208. In normal fine motor development, which of the following should occur first?
1. Copying a triangle
2. Copying a circle ✔
3. Drawing a square
4. Tripod pencil grip
5. Copying a cross
209. What is the cut-off for an acceptable weight loss in the first 7 days of life?
1. 7%
2. 10% ✔
3. 5%
4. 20%
5. 15%

 210. Which of the following should be avoided when weaning a child of 7 months?
1. Wheat
2. Formula milk
3. Honey ✔
4. Meat-containing products
5. Breastmilk

211. Which of the following is an example of “Double-syllable babble” displayed by an infant around
9-12 months?
1. Ma-da
2. Ba-ma
3. Ma-ba
4. Ba-da
5. Ba-ba ✔
212. What type of cardiomyopathy is most commonly associated with the sudden death of young
athletes?
1. Hypertrophic cardiomyopathy ✔
2. Restrictive cardiomyopathy
3. Dilated cardiomyopathy
213. What are the classic signs of a cardiac tamponade?
1. Hypotension, muffled heart sounds, increased jugular venous distension (JVD) ✔
2. Tachycardia, dyspnoea, fever
3. Bradycardia, weakness in arms, diaphoresis
4. Hypertension, palpitations, chest pain
214. Ventricular septal defect (VSD) is the most common congenital heart defect, what condition is it
most likely to be associated with?
1. Congenital rubella
2. Down’s syndrome
3. Fetal alcohol syndrome ✔
4. Maternal diabetes
215. What are the characteristics of stable angina?
1. Chest pain that occurs with exertion and/or emotional stress ✔
2. Severe and crushing chest pain (>20 mins)
3. Chest pain that occurs at rest
4. Bradycardia
216. What is the most frequent etiologic agent of acute infective endocarditis in IV drug abusers?
1. Streptococcus viridans
2. Staphylococcus aureus ✔
3. Staphylococcus epidermidis
4. Streptococcus bovis
217. What is the key complication in the first 24 hours of an MI?
1. Fibrinous pericarditis
2. Coronary artery aneurysm
3. Arrhythmia ✔
4. Mitral insufficiency
218. What is the most commonly involved coronary artery in myocardial infarction (MI) ?
1. Right coronary artery (RCA)
2. Left anterior descending artery (LAD) ✔
3. Left circumflex artery (LCA)
4. Posterior descending artery (PDA)
219. What is the best description of Eisenmenger’s syndrome?
1. It occurs when a right to left shunt becomes left to right due to a build-up of pressure on
the left side of the heart.
2. It is due to failure of the aorticopulmonary septum to spiral.
3. It is due to lack or aorticopulmonary septum formation.
4. An initial left to right shunt becomes right to left due to increased pulmonary blood flow
and eventual right ventricular hypertrophy (RVH). ✔
220. What is the most common cause of right-sided heart failure?

 1. Left-sided heart failure ✔

2. Chronic lung disease (Cor Pulmonale)
3. Hypothyroidism
221. What gross histological change correlates with white blood cells’ (WBCs) invasion into cardiac
tissue during the first week after an MI?
1. Yellow pallor ✔
2. Dark discolouration
3. White scar
4. Red border around yellow pallor
222. What is the most common cause of sudden cardiac death (SCD)?
1. Cocaine abuse
2. Mitral valve prolapse
3. Cardiomyopathy
4. Ventricular arrhythmia ✔
223. What heart condition is Turner’s syndrome associated with?
1. Tricuspid atresia
2. Truncus arteriosus
3. Coarctation of the aorta ✔
4. Patent ductus arteriosus
224. What is the main complication of the macrophage phase (4 to 7 days) after an MI?
1. Fibrinous pericarditis
2. Arrhythmia
3. Aneurysm / Mural thrombus / Dressler’s syndrome
4. Cardiac tamponade / Shunt through the ventricular wall / Mitral insufficiency ✔
225. Choose the complete and accurate grouping of right to left shunts
1. Atrial septal defect (ASD), Patent ductus arteriosus (PDA), Ventricular septal defect
(VSD)
2. Truncus arteriosus, Transposition of great vessels, Tricuspid atresia, Tetralogy of Fallot,
Total anomalous pulmonary venous return (TAPVR) ✔
3. ASD, TAPVR, VSD
4. PDA, Truncus arteriosus, tetralogy of fallot
226. What is the most common cause of mitral stenosis?
1. Chronic rheumatic valve disease ✔
2. Acute rheumatic fever
3. Congestive heart failure
4. Infective endocarditis
227. What does the ECG show in prinzmetal angina?
1. ST segment elevation ✔
2. ST segment depression
3. Absent P waves
4. Prolonged PR interval
228. Which of the following conditions is Marfan’s syndrome most commonly associated with?
1. Endocarditis
2. Restrictive cardiomyopathy
3. Arrhythmia
4. Aortic dissection ✔
229. What bone disorder is caused by an autosomal dominant defect in the synthesis of collagen type
1?
1. Osteogenesis imperfecta ✔
2. Achondroplasia
3. Osteopetrosis
4. Osteomyelitis
230. A patient presents with a heliotrope rash, a malar rash and Gottron’s papules on the elbows and
knees. She cannot comb her hair or climb the stairs due to muscle weakness. Lab results show
an increased creatine kinase, positive antinuclear antibody (ANA) and anti-Jo-1 antibody. Biopsy
reveals perimysial inflammation with perifascicular atrophy. She is treated with corticosteroids.
What disease does the patient have?
1. Polymyositis

 2. X- linked muscular dystrophy

3. Dermatomyositis ✔
4. Rheumatoid arthritis

231. What bone tumour is associated with lifting of periosteum off bone producing the Codman triangle
and a sunburst appearance on X-ray?
1. Osteosarcoma ✔
2. Osteoma
3. Ewing sarcoma
4. Chondroma
232. On biopsy, a mosaic pattern of lamellar bone is revealed. What disease is associated with these
results?
1. Osteoporosis
2. Sickle cell disease
3. Paget’s disease of bone ✔
4. Osteopetrosis
233. Select the cause/s of vitamin D deficiency.
1. Minimal sun exposure ✔
2. Poor diet ✔
3. Liver failure and renal failure ✔
4. Malabsorption ✔
234. Acute gout presents as painful inflammation of the big toe which is referred to as podagra. What
is an acute treatment for gout?
1. Allopurinol
2. Probenecid
3. Febuxostat
4. Colchicine ✔
235. What are the key lab features in osteomalacia?
1. Normal serum calcium, normal serum phosphate, normal PTH, normal alkaline
phosphatase
2. ↑ serum calcium, ↓serum phosphate, ↑PTH, ↑alkaline phosphatase
3. ↓ serum calcium, ↓ serum phosphate, ↑ PTH, ↑ alkaline phosphatase ✔
4. ↓ serum calcium , ↑ serum phosphate , ↑PTH, ↑alkaline phosphatase
236. Synovial fluid was sampled for a joint condition and rhomboid shaped crystals with weak positive
birefringence under polarised light were found. What joint disease is this an indicator of?
1. Pseudogout ✔
2. Gout
3. Rheumatoid arthritis
4. Osteoarthritis
237. Achondroplasia is a disorder of bone whereby there is a mutation in the fibroblast growth factor
receptor 3 (FGFR3) gene leading to impaired cartilage proliferation in the growth plate. Why is it
that affected children have a normal sized head and vertebral column whilst arms and legs are
shortened?
1. Growth hormone and insulin like growth factor 1 levels only affect long bones
2. Intramembranous bone formation (flat bones) vs endochondral bone formation (long
bones) ✔
3. Flat bones are less susceptible to fracture
4. Difference in bone density
238. What is the pathogenesis of osteopetrosis (marble bone disease)?
1. Poor osteoclast function due to a carbonic anhydrase II mutation ✔
2. Defective mineralization of osteoid
3. Reduction in trabecular bone mass
4. Imbalance between osteoclast and osteoblast activity with an osteoclastic phase, a mixed
osteoclastic- osteoblastic phase followed by an osteoblastic phase
239. Which joint disease is associated with morning stiffness that improves with activity?
1. Osteoarthritis
2. Gout
3. Rheumatoid arthritis (RA)D ✔

 4. Ankylosing spondylitis
240. What is the pathogenesis of pemphigus vulgaris?
1. IgG antibody against desmoglein ✔
2. IgG antibody against hemidesmosome components
3. Autoimmune deposition of IgA at tips of dermal papillae
4. DEnzyme defect in tyrosinase
241. What condition is associated with this presentation? A pink pearly nodule with telangiectasias,
ulceration and rolled borders on the upper lip.
1. Squamous cell carcinoma
2. Basal cell carcinoma ✔
3. Melanoma
4. Eczema
242. How does impetigo present?
1. Golden honey coloured crust over an erythematous base✔
2. Salmon coloured plaque with silvery scale
3. Comedones, pustules and nodules
4. Flesh coloured papule with a rough surface
243. What is the pathogenesis of vitiligo?
1. Congenital lack of pigmentation
2. Increase in the number of melanosomes
3. Autoimmune destruction of melanocytes✔
4. Benign proliferation of melanocytes
244. What disease is associated with dermatitis herpetiformis?
1. Herpes
2. Coeliac disease ✔
3. Atopic dermatitis
4. Melanoma
245. What childhood infection is associated with Koplik spots?
1. Measles✔
2. Rubella
3. Varicella
4. Fifth disease
246. What type of melanoma is often seen in dark skinned individuals?
1. Superficial spreading
2. Lentigo maligna melanoma
3. Nodular
4. Acral lentiginous✔
247. What is the best indicator of prognosis for a melanoma?
1. Asymmetry
2. Colour
3. Diameter
4. Invasion of the dermis ✔
248. How does lichen planus present clinically?
1. Salmon coloured plaques with silvery scale
2. Pruritic, red, oozing rash with edema
3. Golden coloured crusts
4. Pruritic, purple, polygonal, planar papules and plaques ✔
249. What are the histological findings of psoriasis?
1. Inflammation of the dermal-epidermal junction
2. Peripheral palisading of basal cells
3. Acanthosis, Parakeratosis and Munro microabscesses ✔
4. Keratin pseudocysts
250. What is the most common causative agent of erythema multiforme (EM)?
1. Penicillin and sulphonamides
2. Systemic lupus erythematosus
3. HSV infection ✔
4. Malignancy
251. What is the most common mole found in adults?

 1. Junctional nevus
2. Compound nevus
3. Intradermal nevus ✔
4. Congenital nevus
252. What condition is associated with acanthosis nigricans?
1. Type 2 diabetes and gastric adenocarcinoma ✔
2. Rubella
3. Varicella zoster
4. Basal cell carcinoma
253. What disorder is characterised by an initial ‘herald patch’ which is then followed by scaly
erythematous plaques usually in a ‘Christmas tree’ distribution?
1. Pityriasis rosea ✔
2. Herpes
3. Varicella zoster virus
4. Erysipelas
254. What is the infective agent implicated in acne?
1. Staphylococcus aureus
2. Streptococcus pyogenes
3. Staphylococcus epidermidis
4. Propionibacterium acnes ✔
255. What is a precursor to squamous cell carcinoma (SCC)?
1. Keratoacanthoma
2. Actinic keratosis ✔
3. Leser-Trélat sign
4. Measles
256. What is Leser-Trélat sign?
1. Sudden appearance of multiple seborrhoeic keratoses and is an indicator of a
gastrointestinal tract carcinoma. ✔
2. A left supraclavicular node associated with gastric carcinoma
3. Metastasis of gastric carcinoma to the periumbilical region
4. Metastasis of gastric carcinoma to the bilateral ovaries
257. What skin condition is caused by poxvirus?
1. Verruca
2. Molluscum contagiosum ✔
3. Impetigo
4. Cellulitis
258. An elderly lady presents to her doctor with a raised, round discoloured plaque, ‘stuck on
appearance’ on her face. What skin condition is this?
1. Rubella
2. Seborrheic keratosis ✔
3. Basal cell carcinoma
4. Melasma
259. What is the grading system for prostatic cancer?
1. Breslow thickness
2. Bloom Richardson
3. Gleason ✔
4. Fuhrman
260. What is priapism?
1. Inability to void the bladder
2. Abnormal curvature of the penis
3. Painful erection lasting > 4 hours ✔
4. Cyst due to a dilated testicular duct

261. What area does prostate cancer spread to most frequently?

1. Brain
2. Lung
3. Pancreas
4. Lumbar spine ✔

 262. What tumour is characterised by findings of ‘Schiller Duval bodies’ on histology and raised levels
of AFP on blood tests?
1. Yolk sac tumour ✔
2. Embryonal carcinoma
3. Teratoma
4. Sertoli cell tumour
263. What is the most common congenital male reproductive disorder?
1. Hydrocoele
2. Testicular torsion
3. Peyronie’s disease
4. Cryptorchidism ✔
264. What are the risk factors for developing germ cell tumours?
1. Orchitis
2. Hydrocoele and varicocele
3. Klinefelter syndrome and cryptorchidism ✔
4. Hypospadias and epispadias
265. How does testicular torsion typically present?
1. Sudden pain in the scrotum and an absent cremasteric reflex ✔
2. Swelling of the scrotum and fever
3. A painless testicular mass that cannot be transilluminated
4. ‘Bag of worms’ appearance of the scrotum
266. Are testicular tumours usually biopsied?
1. Yes
2. No ✔
267. What type of testicular tumour fits this description? A homogenous and painless mass with the
absence of haemorrhage. On histology, findings include large cells in lobules with clear cytoplasm
‘fried egg appearance’.
1. Teratoma
2. Choriocarcinoma
3. Leydig cell tumour
4. Seminoma ✔
268. What is the causative agent of condyloma acuminatum?
1. Chlamydia trachomatis
2. HPV 6 or 11 ✔
3. HSV
4. E-coli
269. Do varicoceles typically appear on the right side or the left side?
1. Right
2. Left ✔
270. What is hypospadias?
1. Opening of urethra on the ventral surface of the penis ✔
2. Opening of urethra on dorsal surface of the penis
3. Inflammation of the testicles
4. Benign warty growth on genital skin
271. What is the best description for the area of the prostate that the carcinoma usually affects?
1. Posterior and peripheral region ✔
2. Anterior and peripheral region
3. Periurethral region
4. Entire anterior region
272. The vocal cords are attached anteriorly by the arytenoid cartilage.
1. True
2. False ✔
273. The bridge of the nose is made out of cartilage.
1. True
2. False ✔
274. Waldeyer’s ring is the ring that surrounds the tympanic membrane.
1. True
2. False ✔

 275. The superior part of the tympanic membrane is known as the pars flaccida.
1. True ✔
2. False
276. The bones of the ear from the outside to inside are:
1. Incus
2. Stapes
3. Malleus
1. True
2. False ✔
277. The ‘cone of light’ is a reflection of light on the tympanic membrane that points superiorly.
1. True
2. False ✔
278. The Eustachian tube connects the eye to the nose.
1. True
2. False ✔
279. The tensor tympani is the only muscle present in the inner ear.
1. True
2. False ✔
280. The tongue is partially innervated by the facial nerve
1. True ✔
2. False

281. The cochlea is responsible for balance.

1. True
2. False ✔
282. A 28-year-old man presents to his GP with a 4cm mobile anterior neck mass. A fine needle
aspirate is performed which reveals cells with ‘orphan Annie eye’ nuclei and psammoma bodies.
What is the most likely diagnosis?
1. Thyroglossal duct cyst
2. Follicular carcinoma
3. Medullary carcinoma
4. Papillary carcinoma ✔
5. Lingual thyroid
283. What is the most common type of thyroid carcinoma?
1. Follicular carcinoma
2. Papillary carcinoma ✔
3. Medullary carcinoma
4. Anaplastic carcinoma
284. Which of the following features is NOT typical for Graves disease?
1. Hyperplasia of the follicles
2. Scalloping of the colloid
3. Irregular shaped follicles
4. Infiltration of mononuclear cells into retro-orbital connective tissues
5. Extensive infiltration of the mononuclear cells into the thyroid parenchyma ✔
285. A 37-year-old woman presents to the clinic with 2 days of sudden onset pain in the anterior neck
radiating to the jaw. She is otherwise well having reported a full recovery from a ‘cold’ a week
ago.
What findings are NOT consistent with her diagnosis?
1. Plasma cells aggregating around damaged thyroid follicles
2. Dense fibrosis of the thyroid gland ✔
3. Neutrophilic infiltration of the thyroid
4. Formation of microabscesses
5. Multinucleated giant cells encapsulating colloid fragments
286. A 62-year-old gentleman presents to the clinic with a 5cm painless neck mass as well as
diarrhoea for the past 3 months. A biopsy is taken and he is subsequently diagnosed with
medullary carcinoma.
Which of the following features is consistent with a medullary carcinoma?
1. Grossly soft and tender mass





 2. Diagnosis of MEN-1 syndrome
3. Haematologic metastatic spread
4. High levels of calcitonin ✔
5. Localised amyloid deposits
287. Which of the following features is NOT consistent with follicular carcinoma?
1. Malignant proliferation of follicular cells
2. Follicular carcinomas are diagnosed via fine needle aspiration ✔
3. More common in women than men
4. Commonly have PI-3K/AKT signalling pathway mutations
5. Uniform cells forming small colloid containing follicles
288. A 46-year-old female presents to the preadmission clinic and is found to have a 3cm anterolateral
firm painless neck mass along with a minor decrease in calcium serum levels.
What is the most likely diagnosis?
1. Anaplastic carcinoma
2. Medullary carcinoma ✔
3. Follicular carcinoma
4. Papillary carcinoma
5. Parathyroid carcinoma
289. Which of the following features are NOT consistent with anaplastic carcinoma?
1. Large, pleomorphic giant cells
2. Occasional osteoclast-like multinucleated giant cells
3. Spindle cells
4. Poor prognosis
5. Positive thyroglobulin markers ✔
290. What thyroid cancer has the worst prognosis? (choose the answer that shows the correct
descending order, the first being the cancer with the worst prognosis and the last being the one
with the best prognosis)
1. anaplastic > medullary > follicular > papillary ✔
2. anaplastic > medullary > papillary > follicular
3. anaplastic > papillary > medullary > follicular
4. medullary > anaplastic > papillary > follicular
5. medullary > anaplastic > follicular > papillary
291. An 18-year-old female presents with a painless 1cm mass in the anterior neck region. A biopsy is
taken revealing fluid contained within pseudostratified columnar epithelium.
What is the most likely diagnosis?
1. Follicular adenoma
2. Branchial cyst
3. Thyroglossal duct cyst ✔
4. Thyroid cystitis
5. Parotid tumour
292. Conjoint tendon is formed by ?
1. External and internal oblique
2. External oblique and transversus abdominis
3. Internal oblique and transversus abdominis ✔
4. Internal oblique
293. Multiple bilateral dentigerous cysts are seen in ?
1. Down’s syndrome
2. Maroteaux lamy syndrome ✔
3. Teacher collin syndrome
4. Gorlin Goltz syndrome
294. COC is now called as?
1. Odontogenic ghost cell tumor
2. Dentinogenic ghost cell tumor ✔
3. Keratcysticodontogenic tumour
4. A&C
295. Facial nerve paralysis is common with?
1. Pleomorphic adenoma
2. Epidermoid carcinoma

 3. Warthin’s stumour
4. Lymphoepithelial carcinoma ✔
296. The most aggressive and destructive cyst is ?
1. Periapical cyst
2. Dentigerous cyst✔
3. Globulomaxillary cyst
4. Nasopalatine cyst
297. Standard treatment of ameloblastoma ?
1. Segmental resection with 1 cm of normal bone ✔
2. Enbloc resection
3. Enucleation
4. Enucleation with cauterization
298. The most common odontogenic cyst is ?
1. Primordial cyst
2. Dentigerous cyst
3. Radicular cyst ✔
4. Mucocele
299. Cyst arising from dental lamina ?
1. Radicular cyst
2. Paradental cyst
3. Eruption cyst
4. Glandular odontogenic cyst ✔
300. Adenomatoid odontogenic tumour is characterized histologically by ? (1)
1. Polyhedral epithelial cells
2. Tubular / duct like cells ✔
3. Stellate shaped cells
4. Stratified squamous epithelial cells