MARCH 2015 (RECALL)

SBA

1. The probability of sarcomatous change occurring in fibroid is

A. 0.1%
B. 1%
C. 5%
D. 10%
E. 15%
ANSWER : 0.1%

2. Midazolam is an effective anxiolytic drug, used for preoperative sedation. Which

receptor is responsible for its action?
A. 5-HT1a
B. 5-HT3
C. D2
D. GABA
E. N-methyl-D-aspartate (NMDA)
ANSWER : GABA

3. Which one of the following tocolytic drug is a competitive oxytocin receptor

antagonist ?
A. Ritodrine
B. Terbutaline
C. Atosiban
D. Nifedipine
E. Indomethacin
ANSWER : Atosiban

4. What is the mechanism of action of labetalol ?

A. Antimuscranic
B. α blockers
C. β blockers
D. Both α and β blockers
E. Direct-acting smooth-muscle relaxant
ANSWER : Both α1 and β blockers

5. What is the contrast dye used in MRI scans?

A. Iodine
B. Barium
C. Thallium
D. Gadolinium
E. Tecnisian
ANSWER : Gadolinium
6. The most common site of endometriosis is
A. Ovary
B. Uterosacral ligament
C. Vagina
D. Rectum
E. Oviduct
ANSWER : Ovary

7. The posterior fontanelle usually closes by what age?

A. 3 months
B. 6 months
C. 9 months
D. 12 months
E. 18 months
ANSWER : 3 months

8. Frequency of current used in electrosurgery unit is

A. 1KHz to 1.5MHz
B. 100KHz to 1.5MHz
C. 100KHZ to 4MHz
D. 400KHz to 9MHz
E. 800KHz to 9MHz
ANSWER : 100KHZ to 4MHz

9. The most likely karyotype for a patient with complete hydatidiform mole is
A. 46, XX
B. 46, XY
C. 69, XXX
D. 69, XXY
E. 69, XYY
ANSWER : 46, XX

10. Which one of the following congenital infections is most characteristically

associated with fetal hydrops?
A. Toxoplasma gondii
B. Parvovirus B19
C. Rubella
D. Treponema pallidum
E. Cytomegalovirus
ANSWER : Parvovirus B19
11. What is the most common site for tubal ectopic gestation?
A. Ampulla
B. Isthmus
C. Infundibulum
D. Interstitial portion
E. Fimbrial end
ANSWER : Ampulla

12. The standard for conventional cytogenetic analysis of human chromosomes is

A. FISH
B. G banding
C. M banding
D. DNA microarray
E. QF-PCR
ANSWER : G banding

13. Metabolic abnormality seen in congenital hypertrophic pyloric stenosis is

A. Hypochloremic hypokalemic metabolic alkalosis
B. Hyperchloremic hypokalemic metabolic alkalosis
C. Hypochloremic hypokalemic metabolic acidosis
D. Hyperchloremic hyperkalemic metabolic acidosis
E. Hyperchloremic hypokalemic metabolic acidosis
ANSWER : Hypochloremic hypokalemic metabolic alkalosis

14. Which antigen-presenting cells (APCs) are mainly found in the cervix?
A. Plasma cells
B. Hofbauer cells
C. Langerhans cells
D. B cells
E. T cells
ANSWER: Langerhans cells

15. Mifepristone is a drug used in medical termination of pregnancy. What is the

mifepristone mode of action?
A. Estrogen agonist
B. Estrogen antagonist
C. Oxytocin antagonist
D. Progesterone agonist
E. Progesterone antagonist
ANSWER : Progesterone antagonist
16. In the fetal circulation, which structure bypasses the liver, carrying oxygenated
blood directly into the inferior vena cava?
A. Ductus venosus
B. Ductus arteriosus
C. Foramen ovale
D. Right hepatic vein
E. Portal vein
ANSWER : Ductus venosus

17. A 16-year-old girl is diagnosed with transverse vaginal septum. The most likely
embryological mechanism responsible for this anomaly is
A. Absent paramesonepheric ducts
B. Absent fusion of paramesonepheric ducts
C. Incomplete fusion of paramesonephric ducts
D. Incomplete lateral fusion/septum resorption
E. Incomplete fusion of sinovaginal bulb with mullerian system
ANSWER : Incomplete fusion of sinovaginal bulb with mullerian system

18. A structure found within the adult female pelvis formed from the
gubernaculums is the
A. Transverse cervical ligament
B. Suspensory ligament of the ovary
C. Round ligament of the uterus
D. Broad ligament
E. Uterosacral ligament
ANSWER : Round ligament of the uterus

19. What part of the embryo is the origin of primordial germ cells?
A. Gonadal ridge
B. Yolk sac endothelium
C. Coelomic epithelum
D. Extraembryonic mesoderm
E. Primitive sex cord
ANSWER : Yolk sac endothelium

20. Misoprostol is a commonly used drug in the medical treatment of miscarriage.

What type of drug is misoprostol?
A. Cyclooxygenase inhibitor
B. Prostaglandin f2α
C. Progesterone antagonist
D. Prostaglandin E2
E. Prostaglandin E1
ANSWER : prostaglandin E1
21. Which artery supplies the distal portion of round ligament of the uterus?
A. Ovarian artery
B. Uterine artery
C. Vaginal artery
D. Superior vesical artery
E. Inferior epigastric artery
ANSWER : Inferior epigastric artery

22. While performing laparoscopy, the lateral umbilical folds can be seen on the
anterior abdominal wall in the adult. This structure contains :
A. Inferior epigastric vessels
B. Obturator vessels
C. Remnant of urachus
D. Obliterated umbilical arteries
E. Ovarian vessels
ANSWER : Inferior epigastric vessels

23. What is the most abundant carbohydrate in the breast milk?

A. Maltose
B. Galactose
C. Glucose
D. Lactose
E. Sucrose
ANSWER : Lactose

24. Which of the following structure, when dilated, produces caput medusa?
A. Hepatic veins
B. Splenic veins
C. Ductus venosus
D. Umbilical arteries
E. Umbilical veins
ANSWER : Umbilical veins

25. Whenever the intestinal midgut loop fails to return from the umbilical cord into
the abdominal cavity, the defect is known as which of the following?
A. Gastroschisis
B. Exompholos
C. Meckel’s diverticulum
D. Vitelline fistula
E. Left-sided colon
ANSWER : Exompholos
26. Suxamethonium does not readily cross the placenta because of
A. Placental cholinesterase
B. High protein binding
C. Elongated molecular configuration
D. High degree of ionization
E. Insufficient maternal concentration
ANSWER : High degree of ionization

27. Nifedipine belongs to which class of drugs?

A. K+ channel blockers
B. Na+ channel blockers
C. Ca++ channel blockers
D. Angiotensin receptor blockers
E. Angiotensin-converting enzyme inhibitors
ANSWER : Ca++ channel blockers

28. What type of compound is Histones?

A. Carbohydrate
B. Fatty acid
C. Prostaglandin
D. Protein
E. Steroid
ANSWER : Protein

29. Ovarian reserve is a term that is used to determine the capacity of the ovary to
provide egg cells that are capable of fertilization. Determination of ovarian reserve
is important in the treatment of infertility. Test for ovarian reserve
A. LH
B. LH/FSH ratio
C. FSH
D. Estradiol
E. Anti-mullerian hormone
ANSWER : Anti-mullerian hormone

30. 28-year-old Asian woman G2P2 at 26 weeks gestation. Her BMI is 36 kg/m2
Glucose tolerance test report (75 g load) are as follows:
Fasting serum glucose : 4.7 mmol/l
2-hour serum glucose : 7.4 mmol/l
What is the diagnosis?
A. Normal
B. Impaired glucose tolerance
C. Impaired fasting glucose
D. Postprandial hyperglycemia
E. Gestational D.M
ANSWER : Normal
31. Peak maternal serum hCG concentrations occur at
A. 6 weeks gestation
B. 8 weeks gestation
C. 10 weeks gestation
D. 14 weeks gestation
E. 20 weeks gestation
ANSWER : 10 weeks gestation

32. Forest plot: horizontal lines represent

A. Range
B. Interquartile range
C. 95% CI
D. Standard error
E. Study's weight
ANSWER : 95% CI

33. Which one of the following bacteria produces an exotoxin causing 'toxic shock
syndrome' associated with tampon usage?
A. Escherichia coli
B. Streptococcus agalactiae
C. Clostridium welchii
D. Staphylococcus aureus
E. Mycoplasma hominis
ANSWER : Staphylococcus aureus

34. Which of the following most accurately describes the mode of action of
letrozole?
A. Progesterone-receptor antagonist
B. Estrogen-receptor antagonist
C. Aromatase inhibitor
D. Selective estrogen receptor modulator
E. Selective serotonin reuptake inhibitor
ANSWER : Aromatase inhibitor

35. What is represented by the equation Sensitivity/(1-specificity)?

A. Accuracy
B. Positive predictive value
C. Negative predictive value
D. Positive likelihood ratio
E. Negative likelihood ratio
ANSWER : Positive likelihood ratio
36. 16-year-old has recently become sexually active. She complains of intensely
irritating greenish frothy vaginal discharge. The organism is seen under microscope
in a drop of saline and PH is 6. What is the most likely causative organism?
A. Candida albicans
B. Chlamydia trachomatis
C. Gardnerella vaginalis
D. Trichomonas vaginalis
E. Treponema pallidium
ANSWER : Trichomonas vaginalis

37. A sexually active 18-year-old woman presents with a fever for the past 24
hours and lower abdominal pain and anorexia for the past 5 days. On physical
examination, there is generalized tenderness of the abdomen and the cervix
appears slightly friable with motion tenderness. A smear of yellow odorless
cervical discharge shows gram negative intracellular diplococci and scant
neutrophils. What is the most likely causative organism?
A. Actinomyces israelii
B. Neisseria gonorrhoeae
C. Chlamydia trachomatis
D. Gardnerella vaginalis
E. Treponema pallidium
ANSWER : Neisseria gonorrhoeae

38. A 33-year-old woman with an intrauterine contraceptive device develops

symptoms of acute salpingitis. On laparoscopy, sulfur granules appear at the
fimbria of the tubes. Which of the following is the most likely organism?
A. C. trachomatis
B. Nocardia species
C. N. gonorrhea
D. T. pallidium
E. Actinomyces species
ANSWER : Actinomyces species

39. A 32-year-old woman has increasing white vaginal discharge. She is 7 weeks
pregnant. Her Chlamydia swab is positive. All other tests are normal.
Which is the single most appropriate treatment?
A. Amoxicillin
B. Clindamycin
C. Doxycycline
D. Erythromycin
E. Metronidazole
ANSWER : Erythromycin
40. What is the smallest human chromosome?
A. Chromosome 20
B. Chromosome 21
C. Chromosome 22
D. Chromosome X
E. Chromosome Y
ANSWER : Chromosome Y

41. Which antiemetic drug can cause uncontrolled muscle movements?

A. Meclizine
B. Scopolamine
C. Ondansetron
D. Granisteron
E. Metoclopramide
ANSWER : Metoclopramide

42. What is the pathophysiology explain that vitamin A can cause birth defects
of the child during pregnancy?
A. Accumulation of free radicals
B. Oxidative stress
C. Excessive carotenoids
D. Hypervitaminosis A
E. Deficiency of vitamin A
ANSWER : Hypervitaminosis A

43. Patient has a heavy menstrual bleeding. She desires an endometrial

ablation to stop bleeding after failure of medical treatment.
Which part of the uterus is destructed to stop bleeding?
A. Basal layer of endometrium
B. Functional layer of endometrium
C. Both layer of endometrium
D. Entire myometrium
E. Spiral artery
ANSWER : Both layer of endometrium

44. A 26-year-old pregnant woman is found to have an Hb of 11 g/dL on a routine

blood test , with an MCV of 70. Serum electrophoresis reveals an Hb F of 0.5
percent, Hb A1 of 60 percent, Hb A2 of 2 percent and Hb S of 40 percent. Her ferritin
levels are normal. The most likely diagnosis is:
A. Iron deficiency anemia
B. α-thalassemia
C. β-thalassemia
D. Sickle cell trait
E. Sickle cell disease
ANSWER : Sickle cell trait
45. A 36-year-old woman underwent a total abdominal hysterectomy for uterine
fibroids. Postoperatively she complains of loss of flexion of her left hip and
numbness over her left anterior and medial thigh. The compression of which nerve
is likely to be responsible?
A. Common peroneal nerve
B. Femoral nerve
C. Ilioinguinal nerve
D. Obturator nerve
E. Pudendal nerve
ANSWER : Femoral nerve

46. Which nerve or nerve plexus provided sensory innervation to the cervix?
A. Pudendal nerve
B. Sacral splanchnic nerve
C. Pelvic splanchnic nerve
D. Superior hypogastric plexus
E. Inferior hypogastric plexus
ANSWER : Pelvic splanchnic nerve

47. The typical effective dose for abdominal CT scan is

A. 0.1-0.5 mSv
B. 1-2 mSv
C. 3-5 mSv
D. 10-15 mSv
E. 20-25 mSv
ANSWER : 10-15 mSv

48. In which circumstance is rhesus immunisation NOT required in a rhesus-

negative mother?
A. Amniocentesis
B. Chorionic villus sampling
C. External cephalic version
D. Sweeping membranes
E. Caesarean section
ANSWER : Sweeping membranes

49. Which class of immunoglobulin is mainly activate the classical complement

system?
A. IgM
B. IgA
C. IgG
D. IgE
E. IgD
ANSWER : IgM
50. Sample size 30, variance 25 and standard error of mean 3
What is the data set's Standard deviation?
A. 2
B. 5
C. 8
D. 12
E. 16
ANSWER : 5

51. Physiological variation of the menstrual cycle between 21-35 days due to
A. Aberrant LH surge
B. Estrogen fails to produce negative feedback on pituitary
C. Estrogen fails to produce positive feedback on pituitary
D. Luteal phase varies in duration by time taken for corpus luteum to degenerate
E. Loss of progesterone secretion
ANSWER : Estrogen fails to produce positive feedback on pituitary

52. 23-year-old woman presents with fishy foul smelling vaginal odour. 'Clue cells'
are found in the smear. Which of the following cell types is belong to 'Clue cells'?
A. Neutrophils
B. Natural killer cells
C. Lymphocytes
D. Macrophages
E. Epithelial cells
ANSWER : Epithelial cells

53. A 27-year-old woman after normal vaginal birth develops shortness of birth
and seizures. Despite resuscitation she dies within 20 minutes. At autopsy
squamous cells and fetal hair are found in lungs.
What is the most likely cause of death?
A. Amniotic fluid embolism
B. Placental abruption
C. Eclampsia
D. Pulmonary embolism
E. Postpartum hemorrhage
ANSWER : Amniotic fluid embolism
54. A 19-year old G2 P1 woman has an amniocentesis performed at 18 weeks
gestation. Fibroblasts recovered from amniocentesis are grown in culture to assess
the karyotype of fetal cells. These cells are subcultured for additional experimental
work, but the culture is lost after 50 doublings of the cells has occurred, and the
fibroblasts no longer grow. Which of the following factors affecting these cells is
most likely demonstrated by this phenomenon?
A. Nutrition
B. Mutation
C. Apoptosis
D. Aging
E. Oxidation
ANSWER : Aging

55. What percentage triiodothyronin (T3) is free?

A. 0.1%
B. 1%
C. 5 %
D. 15%
E. 70%
ANSWER : 1%

56. Which is non-ergot dopamine agonist drug used to treat hyperprolactinemia?

A. Cabergoline
B. Quinagolide
C. Quinacrine
D. Quetiapine
E. Terguride
ANSWER : Quinagolide

57. Which of the following is commonly used to determine hormone receptor

expression 'receptor status' of the breast cancer?
A. Mammogram
B. Fine needle aspiration cytology
C. Pestron emission computed tomography
D. Immunohistochemical staining
E. fluorescence in situ hybridization
ANSWER : Immunohistochemical staining

58. The greater omentum is derived from which of the following embryonic
structures?
A. Dorsal mesoduodenum
B. Dorsal mesogastrium
C. Pericardioperitoneal canal
D. Pleuropericardial membranes
E. Ventral mesentery
ANSWER : Dorsal mesogastrium
59. A 19-year-old woman gives birth to her first child. She begins breast feeding the
infant. She continues breast feeding for almost a year with no difficulties and no
complications. Which of the following cellular processes that occurred in the breast
during pregnancy allowed her to nurse the infant for this period of time?
A. Stromal hypertrophy
B. Epithelial dysplasia
C. Steatocyte atrophy
D. Ductal dilation
E. Lobular hyperplasia
ANSWER : Lobular hyperplasia

60. Which of the following structures separates the superficial perineal pouch from
the deep perineal pouch?
A. Superior levator ani
B. Inferior levator ani
C. Superior fascia of urogenital diaphragm
D. Perineal membrane
E. Colles fascia
ANSWER : Perineal membrane

61. Which of the following hormones increases the excretion of calcium in Kidney?
A. Insulin
B. Cortisol
C. Calcitonin
D. parathyroid hormone
E. Antidiuretic hormone
ANSWER : Calcitonin

62. Choriocarcinoma is a malignant form of gestational trophoblastic disease.

When Choriocarcinoma metastasises, it has a propensity for which type of spread?
A. Direct invasion
B. Hematogenous
C. Lymphatic
D. Surface implantation
E. Transcoelomic
ANSWER : Hematogenous

63. The epithelial lining of the cervix exterior to transformation zone is which of
the following tissue types?
A. Transitional
B. Stratified squamous keratinized
C. Stratified squamous non-keratinized
D. Stratified columnar
E. Simple columnar
ANSWER : Stratified squamous non-keratinized
64. A patient presents with condyloma lata. At what stage of syphilis does this
feature occur?
A. Neurosyphilis
B. Primary
C. Quaternary
D. Secondary
E. Tertiary
ANSWER : Secondary

65. What histology constitutes the majority of vulvar cancers?

A. Squamous cell carcinoma
B. Basal cell carcinoma
C. Merkel cell carcinoma
D. Adenocarcinoma
E. Melanoma
ANSWER : Squamous cell carcinoma

66. What sexually transmitted disease (STD) is caused by Haemophilus ducreyi?

A. Chancre
B. Chancroid
C. Granuloma inguinale
D. Condyloma acuminatum
E. Molluscum contagiosum
ANSWER : Chancroid

67. Where in the kidney is the majority of bicarbonate reabsorbed?

A. Bowman's capsule
B. Collecting duct
C. Distal convoluted tubule
D. loop of Henle
E. proximal convoluted tubule
ANSWER: proximal convoluted tubule

68. What drug can be given to reverse myelosuppression in methotrexate toxicity?

A. Folic acid
B. Vitamin B12
C. Pyridoxine
D. Thymidine
E. Folonic acid
ANSWER : Folonic acid
69. Vertical transmission of HIV infection mostly occurs
A. In the first trimester
B. In the second trimester
C. In the third trimester
D. During labour and delivery
E. In the neonatal period through breastfeeding
ANSWER : During labour and delivery

70. Which cytokines are secreted by virally infected host cells and Stimulates
uninfected neighbouring cells to synthesize antiviral proteins?
A. Interleukin 1 (Il-1)
B. Interleukin 10 (Il-10)
C. Tumor necrosis factor alpha (TNF α)
D. Lymphotoxin (LT)
E. Interferons alpha and beta (IFN α and IFN β)
ANSWER : Interferons

71. Insensible loss of water from skin and lungs in 70 year old healthy woman is
A. 100 ml/day
B. 450 ml/day
C. 850 ml/day
D. 1350 ml/day
E. 2600 ml/day
ANSWER : 1350 ml/day

72. The vaccine for measles, mumps and rubella (MMR) is best characterized as
A. Synthetic peptide vaccine
B. Killed virus vaccine
C. Inactivated virus vaccine
D. Live virus vaccine
E. Recombinant viral vaccine
ANSWER : Live virus vaccine

73. Which of the following is a circulatory blood cell that is capable of

differentiation into plasma cells?
A. Neutrophils
B. Basophils
C. Monocytes
D. B lymphocytes
E. T lymphocytes
ANSWER : B lymphocytes
74. A 40-year-old woman had bilateral silicone breast implants placed two years
ago. Since that time, she has noted increased firmness with slight deformity of the
breast on the left. The implants are removed, and there is evidence for leakage of
the implant contents on the left. Which of the following cell types is most likely to
be most characteristic of the inflammatory response in this situation?
A. Neutrophils
B. Mast cells
C. Plasma cells
D. Giant cells
E. T lymphocytes
ANSWER: Giant cell

75. Which class of immunoglobulin is primary secreted in breast milk and protects
the infant's intestinal mucosa from infection?
A. IgA
B. IgD
C. IgE
D. IgG
E. IgM
ANSWER : IgA

76. Which immunoglobulin class has a pentameric structure and is unable to cross
the placenta?
A. IgA
B. IgD
C. IgE
D. IgG
E. IgM
ANSWER : IgM

77. Where does fatty acid synthesis occur within the cell?
A. Cytosole
B. Mitochondria
C. Nucleus
D. Rough endoplasmic reticulum
E. Smooth endoplasmic reticulum
ANSWER : Cytosole

78. What is the most common type of episiotomy performed in the United
kingdom (UK)?
A. Mediolateral episiotomy
B. Median episiotomy
C. Paramedian episiotomy
D. Lateral episiotomy
E. J-shaped episiotomy
ANSWER : Mediolateral episiotomy
79. What is the embryonic origin of the trigone of urinary bladder?
A. Mesonephric duct
B. Paramesonephric duct
C. Ureteric bud
D. Urogenital sinus
E. Caudal of cloaca
ANSWER : Mesonephric duct

80. What is the most common congenital solid tumour of the newborn?
A. Astrocytoma
B. Willim's tumour
C. Neuroblastoma
D. Sacrococcygeal teratoma
E. Hepatic hemangioma
ANSWER : Sacrococcygeal teratoma

81. Which ovarian tumor is associated with Meig's syndrome?

A. Cystadenoma
B. Teratoma
C. Fibroma
D. Mucinous
E. Granulosa cell tumour
ANSWER : Fibroma

82. Which screening test has high negative predictive value for detection of
preterm pre-labour rupture of the membranes?
A. Nitrazine test
B. Salivary estriol test
C. Fetal fibronectin test
D. Spinnbarkeit test
E. Cervical length measurement
ANSWER : Fetal fibronectin test

83. Oxybutynin hydrochloride is a non-selective muscarinic receptor antagonist

used to treat bladder overactivity. Which of the following diseases are aggravated
by use of oxybutynin?
A. Bronchial asthma
B. Closed angel glucoma
C. Diabetes mellitus
D. Parkinsonism
E. Peptic ulcer
ANSWER : Closed angel Glucoma
84. How many days does it take from the resting follicle stage to ovulation?
A. 14 days
B. 28 days
C. 85 days
D. 120 days
E. 375 days
ANSWER : 375 days

85. LH peak precedes ovulation by

A. 16 hr
B. 24 hr
C. 36 hr
D. 48 hr
E. 72 hr
ANSWER: 16 hr

86. Which one of the following best describes the histological type of endometrium
soon after ovulation?
A. Decidual reaction
B. Atrophic endometrium
C. Proliferative endometrium
D. Secretory endometrium
E. Arias-Stella phenomenon
ANSWER : Secretory endometrium

87. A 49-year-old female asks about the benefits and risks of hormone
replacement therapy (HRT) to control the effects of menopause. The use of
hormone replacement therapy (HRT) will decreases the risk of which cancer?
A. Breast cancer
B. Endometrial carcinoma
C. Hepatoma
D. Ovarian cancer
E. Colorectal cancer
ANSWER : Colorectal cancer

88. Which one of the following stages of the cell cycle is cell prepared for DNA
synthesis?
A. Synthetic phase (S)
B. Gap phase 1 (G1)
C. Gap phase 0 (G0)
D. Gap phase 2 (G2)
E. Mitotic phase (M)
ANSWER : Gap phase 1 (G1)
89. Which one of the following stages of the cell cycle is preceded by mitosis?
A. Synthetic phase (S)
B. Gap phase 1 (G1)
C. Gap phase 0 (G0)
D. Gap phase 2 (G2)
E. Gap phase 3 (G3)
ANSWER : Gap phase 2 (G2)

90. A neoplasm of the female genital tract occurring in an 18-year-old girl whose
mother was treated with diethylstilbestrol during the pregnancy is likely to be a:
A. Brenner cell tumor of ovary
B. Teratoma of ovary
C. Sarcoma botryoides of vagina
D. Clear cell carcinoma of vagina
E. Squamous cell carcinoma of vulva
ANSWER : Clear cell carcinoma of vagina

91. A 19-year-old extremely anxious parturient requests labor epidural analgesia.

During epidural placement, cerebrospinal fluid obtained in the needle catheter.
Which along spinal cord dose the needle traverse obtaining CSF leakage from the
needle catheter?
A. Vertebral canal
B. Space between wall of vertebral canal and dura mater
C. Space between arachnoid and dura mater
D. Space between arachnoid and pia mater
E. Spinal canal
ANSWER : Space between arachnoid and pia mater

92. When should the prophylactic dose of low molecular weight heparin (LMWH)
be stopped before regional analgesia?
A. 6 hr
B. 12 hr
C. 24 hr
D. 48 hr
E. 72 hr
ANSWER : 12 hr

93. Monopolar diathermy cause coagulation effect with sparkling to stop the
bleeding vessels by Which of the following procedures?
A. Electrosurgical cutting
B. Electrosurgical desiccation
C. Electrosection
D. Fulguration
E. Vaporization
ANSWER : Fulguration
94. Which nerve arises from ventral rami of lumbar plexus and emerges from the
medial border of psoas major muscle?
A. Femoral nerve
B. Genitofemoral nerve
C. lateral femoral cutaneous nerve
D. Common peroneal nerve
E. Obturator nerve
ANSWER : Obturator nerve

95. Which of the following eicosanoids are mainly increased before menstruation?
A. leukotriene LTB4
B. Thromboxane TXA2
C. Prostacyclin PGI2
D. Prostaglandin D2
E. Prostaglandin F2α
ANSWER : Prostaglandin F2α

96. Which enzyme in the renal tubular cells are responsible for production of
ammonia?
A. Glutaminase
B. Urease
C. Arginase
D. Glutamate dehydrogenase
E. Carbonic anhydrase
ANSWER : Glutaminase

97. What type of joint is formed at the sacroiliac joint?

A. Primary cartilaginous
B. Secondary cartilaginous
C. Gomphosis
D. Condyloid
E. Synovial
ANSWER : Synovial

98. Which substance removed from proinsulin to release insulin into the
circulation?
A. Preproinsulin
B. Substance P
C. A peptide
D. B peptide
E. C peptide
ANSWER : C peptide
99. An inherited metabolic disorder called phenylketonuria (PKU) can result in
serious problems in infancy. Via which pattern of inheritance is the PKU?
A. Autosomal dominant
B. Autosomal dominant with incomplete penetrance
C. Autosomal recessive
D. X-linked recessive
E. Polygenic inheritance
ANSWER : Autosomal recessive

100. Which of the following is the most active form of vitamin D?

A. Ergosterol
B. 7-dehydrocholesterol
C. 25 hydroxycholecalciferol
D. 24,25 dihydroxycholecalciferol
E. 1 alpha 25 hydroxy derivative calcitriol
ANSWER : 1 alpha 25 hydroxy derivative calcitriol

101. 'Donovan bodies' are associated with?

A. Granuloma inguinale
B. Lymphogranuloma venereum
C. Herpes genitalis
D. Congenital syphilis
E. Chancroid
ANSWER : Granuloma inguinale

102. What is the main mechanism of action of the copper-IUD?

A. Blockage of the endometrial cavity
B. Blockage of the uterine tubes
C. Inhibition of fertilization
D. Local inflammatory reaction preventing implantation
E. Hostility of the cervical mucus
ANSWER : Inhibition of fertilization

103. In the developing foetal testis, the cells that produce mullerian-inhibiting
substance are the
A. Testicular mesenchymal cells
B. Interstitial cells of leydig
C. Sertoli cells
D. Spermatogonia
E. Primordial germ cells
ANSWER : Sertoli cells
104. What kind of cells secrete Calcitonin hormone?
A. Chief cells
B. Parafollicular cells
C. Oxyphilic cells
D. G cells
E. Follicular cells
ANSWER: Parafollicular cells

105. Which of the following clotting factors are remain unchanged in normal
pregnancy?
A. Factor VII
B. Factors XI and XIII
C. Factors II, V and IX
D. Factors VII, VIII, X and XI
E. Factors VII, VIII, X, XI and XIII
ANSWER : Factors II, V and IX

106. Peptides cross the placenta by:

A. Simple diffusion
B. Facilitated diffusion
C. Solvent drag
D. Active transport
E. Pinocytosis
ANSWER: Active transport

107. A 34-year-old woman attends antenatal clinic for a routine ultrasound scan.
Abnormalities of placentation are detected and a magnetic resonance imaging
(MRI) scan is organized by the fetal medicine consultant. The MRI report shows:
‘The placenta is lower anterior in which invades through the myometrium up to
the uterine serosa’. What is the most likely diagnosis?
A. Placenta accreta
B. Placenta percreta
C. Placenta increta
D. Placenta praevia
E. Vasa previa
ANSWER : Placenta percreta

108. The progesterone receptor is an example of a :

A. Guanylate cyclase receptor
B. Nuclear transcription factor
C. Tyrosine kinase nuclear receptor
D. Ligand-gated ion channel in the cell membrane
E. G protein coupled receptor on the Golgi complex
ANSWER : Nuclear transcription factor
109. The rectum originates from posterior division of which structure?
A. Allantois
B. Primitive Cloaca
C. Ectoderm of proctodeum
D. Endoderm of midgut
E. Urorectal membrane
ANSWER : Primitive Cloaca

110. Sonographically, fluid appear

A. Echogenic
B. Hypoechoic
C. Anechoic
D. Isoechoic
E. Hyperechoic
ANSWER : Anechoic

111. What is the mode of inheritance of Duchenne muscular dystrophy (DMD)?

A. X-linked dominant
B. Autosomal recessive
C. Autosomal dominant
D. Mitochondrial inheritance
E. X-linked recessive
ANSWER : X-linked recessive

112. Which of the following arteries gives rise to the deep dorsal penile artery?
A. Internal pudendal
B. Testicular
C. Inferior vesicle
D. Obturator
E. Umbilical
ANSWER : Internal pudendal

113. What is the most common cause of secondary hyperparathyroidism?

A. Parathyroid adenoma
B. Multiple myeloma
C. Sarcoidosis
D. Chronic renal failure
E. Multiple endocrine neoplasia type 1
ANSWER : Chronic renal failure

114. Besides the skull, the axial skeleton is derived from which structure?
A. Neural crest
B. Neural tube
C. paraxial mesoderm
D. Somatic mesoderm
E. Splanchnic mesoderm
ANSWER : paraxial mesoderm
115. Lithium therapy during pregnancy increases the risk of congenital anomalies
in which organ?
A. Lung
B. Heart
C. Brain
D. Limb
E. Kidney
ANSWER : Heart

116. Which signaling molecule that stimulate the renin-angiotensin system to

regulate the sodium concentration?
A. Angiotensin
B. Aldosterone
C. Bradykinine
D. Norepinephren
E. Oxytocin
ANSWER : Norepinephren

117. Antidiuretic hormone (ADH) is released from which part of hypothalamus:

A. Arcuate nucleus
B. Preoptic nucleus
C. Periventricular nucleus
D. Suprachiasmatic nucleus
E. Supraoptic and Paraventricular nuclei
ANSWER : Supraoptic and Paraventricular nuclei

118. The bifurcation of the abdominal aorta occurs at the level of which of the
following structures?
A. Lowest point of costal margin
B. Highest point of iliac crest
C. pubic tubercle
D. Anterior superior iliac spine
E. Posterior superior iliac spine
ANSWER : Highest point of iliac crest

119. Combined oral contraceptive pills are safe to use following evacuation of a
complete hydatidiform mole at what stage?
A. A declining of hCG titers
B. A plateau of hCG titers
C. hCG titers start to decline
D. Return of hCG titer to normal not rising
E. Combined oral contraceptive pills cannot be used at all
ANSWER : Return of hCG titer to normal not rising at all
120. 46-year-old woman who has chronic pelvic discomfort undergo CT scan which
shows multiple circumscribed masses in the myometrium. Hysterectomy is
performed and histopathological examination shows spindles shaped cells in
whorled bundles and the mitotic figures are scarce. The most likely diagnosis is?
A. Adenomyosis
B. Endometriosis
C. Leiomyoma
D. Leiomyosarcoma
E. Endometrial carcinoma
ANSWER : Leiomyoma

121. Glucose 6 phosphatase deficiency is a common metabolic disease in Africa.

What is the function of the enzyme glucose 6 phosphatase in carbohydrate
metabolism?
A. Adds glucose to glycogen ends
B. Adds phosphate to glucose
C. Production of ATP in Aerobic and Anaerobic oxidation
D. Production of NADPH in red blood cells
E. Converts glucose 6 phosphate to glucose
ANSWER : Converts glucose 6 phosphate to glucose

122. Which neurotransmitter is secreted onto the adrenal medulla?

A. Acetylcholine
B. Norepinephrine
C. Epinephrine
D. Dopamine
E. Serotonin
ANSWER : Acetylcholine

123. An 18-year-old woman who had inflammation of the right ovary complains
painful spasms in the muscles and some numbness on the skin of the medial part
of her right thigh. The following nerves is mostly involved?
A. Femoral nerve
B. Genitofemoral nerve
C. Sciatic nerve
D. Obturator nerve
E. Nerve to obturator internus
ANSWER : Obturator nerve

124. Plasma concentration of estrogen increases throughout pregnancy. By 40

weeks, the concentration of estriol increased to estradiol by who much times?
A. 100 times
B. 50 times
C. 20 times
D. 10 times
E. 5 times
ANSWER : 20 times
125. If day 0 is the day of fertilization, implantation of the embryo into the
endometrium occurs on what day after fertilization?
A. day 3
B. day 5
C. day 7
D. day 14
E. day 28
ANSWER : day 7

126. What percentage of Down occur due to Robertsonian Translocation?

A. 1%
B. 3%
C. 5%
D. 10%
E. 90%
ANSWER : 3%

127. A pregnant woman desires screening test for down's syndrome and the
following report is obtained :
Age related risk; 1:1000
MoM AFP; 1.05
MoM β-hCG; 0.85
Test risk; 1:10000
What will you counsel this woman?
A. The fetus has down's syndrome
B. The fetus does not have down's syndrome
C. It is high risk for down's
D. It is low risk for down's
E. Ask the patient to go home
ANSWER : It is low risk for down's

128. Which of the following describes the correct order of musculature of the anal
canal from deep to superficial?
1. Deep part of external sphincter
2. Subcutaneous part of external sphincter
3. Internal sphincter
4. Superficial part of external sphincter
A. 1,4,2,3
B. 2,1,4,3
C. 3,1,4,2
D. 3,2,1,4
E. 2,4,1,3
ANSWER : 3,1,4,2
129. Which vessels can possibly be injured in the subcutaneous tissue when a
transverse suprabic skin incision is made?
A. Superficial epigastric
B. Superficial circumflex iliac
C. Deep circumflex iliac
D. Superior epigastric
E. Inferior epigastric
ANSWER : superficial epigastric

130. An Asian woman books in for her third pregnancy at 12 weeks of gestation.
She has recently moved to the UK from Thailand to be with her new husband. After
pre-test counseling, with the aid of an interpreter, she agrees to hepatitis B virus
(HBV) screening. The results return as follows.
What is the significance of these results?
HBsAg; POSITIVE
Anti-HBc; POSITIVE
Anti-HBc IgM; NEGATIVE
HBeAg; NEGATIVE
Anti-HBe; POSITIVE
HBV DNA; 203 iu/ml
A. Acute HBV infection
B. Chronic infection (immune control phase)
C. Natural HBV immunity (resolved infection)
D. Occult HBV infection
E. Post vaccination
ANSWER : Chronic infection

131. A 24-year-old woman presents to her GP following sexual contact with her
boyfriend. She is concerned about the development of new lesions on her vulva.
Upon exam, you note pearly-white, non-tender several dome-shaped ulcers
around 3 mm in diameter. Which of the following is the most likely cause of the
patient’s vulvar lesions?
A. Chlamydia trachomatis serotype L1, L3
B. Herpes simplex virus (HSV) type 2
C. Molluscum contagiosum
D. Donovanosis
E. Syphilis
ANSWER : Molluscum contagiosum

132. Identify which of the following gives the correct pathway of piriformis muscle.
Origin Exits pelvis via Insertion
A. Ventral surface of sacrum Greater siactic notch Greater trochanter of femur
B. Ventral surface of sacrum Lesser siactic notch Greater trochanter of femur
C. Ventral surface of sacrum Greater siactic notch Lesser trochanter of femur
D. Dorsal surface of sacrum Greater siactic notch Greater trochanter of femur
E. Dorsal surface of sacrum Lesser siactic notch Lesser trochanter of femur
ANSWER : Ventral surface of sacrum, Greater siactic notch, Greater trochanter of femur
133. Which of the following potential mechanism is more likely to cause tissue
damage from ultrasound exposure?
A. Cavitation
B. Heat
C. Scatter
D. Fractionation
E. Ionization
ANSWER : Cavitation

134. A woman has been diagnosed with carrying the BRCA 1 gene. What is her life
time risk of ovarian cancer?
A. 5%
B. 10%
C. 15%
D. 20%
E. 40%
ANSWER : 40%

135. Warfarin blocks postribosomal glutamic acid carboxylation of the precursors

of which clotting factors?
A. Factor I
B. Factor II
C. Factor III
D. Factor V
E. Factor XI
ANSWER : Factor II

136. Some-town in the UK, has a population of 350,000. During 2010, there were
20,000 live births, 70 stillbirths, and 50 early neonatal deaths. Among the births
that year, there were 20 sets of twins and four sets of triplets, and four mothers
died at the time of delivery. Which of the following represents the perinatal
mortality rate in this town during 2009?
A. 50,20,000
B. 70/20,000
C. 120/20,050
D. 120/20,070
E. 120/20,120
ANSWER : 120/20,070
perinatal mortality rate (UK) = Stillbirths (≥24W) + Early neonatal
deaths (1st W) / Total live births + Stillbirths
137. Which option correctly identifies the embryological origin, Beginning and
ending of the round ligament of the uterus?
Embryology Beginning Ending
A. Gubernaculum ovarii Anteroinferior to uterine cornua labium majus
B. Gubernaculum ovarii Posterosuperior to uterine cornua labium majus
C. Gubernaculum ovarii Anteroinferior to uterine cornua labium minus
D. Paramesonephric duct Posterosuperior to uterine cornua labium minus
E. Paramesonephric duct Anteroinferior to uterine cornua labium majus
ANSWER : Gubernaculum ovarii, Anteroinferior to uterine cornua, labium majus

138. Premenopausal estrogen is mainly produced by which cells?

A. Ovarian Stromal cells
B. Ovarian Granulosa cells
C. Ovarian Theca cells
D. Adrenal secretory cells
E. Peripheral fat cells
ANSWER : Ovarian Granulosa cells

139. A newborn girl is found to have multiple midline malformations. Her physician
suspects a chromosomal disorders and orders a karyotype (picture below).

Which of the following is the most likely diagnosis?

A. Cri-du-chat syndrome
B. Down syndrome
C. Turner syndrome
D. Edward syndrome
E. Patau syndrome
ANSWER : Patau syndrome
140. Consider the following pedigree:

Assuming that the solid square indicate that the person is affected with the
condition in the question, What is the likely mode of inheritance?
A. Autosomal dominant
B. X-linked dominant
C. Y-linked dominant
D. Autosomal recessive
E. X-linked recessive
ANSWER : X-linked recessive

141. The following is a normal spirometry of a preoperative woman.

Which lung volume is indicated by the arrows on the spirometry tracing?

A. Residual volume
B. Expiratory reserve volume
C. Inspiratory reserve volume
D. Tidal volume
E. Vital capacity
ANSWER : Residual volume
142. The following scatter plot is used to view what type of data?

A. Meta analysis data

B. Binary data
C. Bivariate data
D. Digital data
E. Ordinal data
ANSWER : Bivariate data

143. The following image shows assisted conception technique by intracytoplasmic

sperm injection.

What will you see in the middle at 12'oclock?

A. Mature oocyte
B. Sperm
C. First polar body
D. Second polar body
E. Zygote
ANSWER: First polar body

144. Remifentanil is an ideal controlled analgesia during labour because

A. It is a strong µ receptor antagonist
B. It has a long duration of action
C. It is rapidly metabolized by tissue estrases
D. It is more effective than epidural analgesia
E. It cannot cross the placenta
ANSWER : It is rapidly metabolized by estrases
145. The following diagram shows the hormonal level in a normal menstrual cycle.

Which hormone is indicated in purple in the above diagram?

A. Estrogen
B. Progesterone
C. Inhibin
D. luteinizing hormone (LH)
E. Follicle stimulating hormone (FSH)
ANSWER : Progesterone

146. Which structure blocks the blood supply to a loop of small intestine at the
femoral ring causing strangulated femoral hernia?
A. Inguinal ligament
B. Lacunar ligament
C. Pectineal ligament
D. Pubic tubercle
E. Pubis symphysis
ANSWER : Lacunar ligament

147. What is the most common cause of caushing's syndrome?

A. Administration of synthetic ACTH
B. Paraneoplastic syndrome
C. Pituitary adenoma
D. Iatrogenic steroid administration
E. Adrenal adenoma
ANSWER : Iatrogenic steroid administration

148. The most common cause of delay in puberty in males is:

A. Constitutional delay in growth
B. Klinefelter's syndrome
C. Noonan's syndrome
D. Primary hypothyroidism
E. Gonadal dysgenesis
ANSWER : Constitutional delay in growth
149. What electrolyte imbalance can cause paralytic ileus?
A. Hypernatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hyponatermia
E. Hypokalemia
ANSWER : Hypokalemia

150. Which one of the following imaging techniques gives maximum radiation
exposure to the patient during checking tubal patency?
A. Robin tube cannulation
B. Hysterosalpingography
C. hystero contrast sonography
D. Hysteroscopic tube visualization
E. Laparoscopy and dye intubation
ANSWER : Hysterosalphingoraphy

151. About 2 weeks postnatally, a 36 year old multiparous woman starts to worry
that her partner is spying on her as she cares for her baby. She begins to think she
can hear someone telling she is doing tasks incorrectly. Her partner calls the health
visitor who suspects that the most likely diagnosis is:
A. Baby blues
B. Bipolar disorder
C. Schizophrenia
D. Postnatal depression
E. Puerperal psychosis
ANSWER : Puerperal psychosis

152. What is the correct formula to calculate the specificity?

TP = true positive; FP = false positive; TN = true negative; FN = false negative
A. TN / (TN + FN)
B. TP / (TP + FP)
C. TN / (TN + FP)
D. TP / (TP + FN )
E. TN/(TP+FP+FN)
ANSWER : TN / (TN + FP)

153. The Eighth Confidential Enquiry into maternal deaths in the United Kingdom
defines maternal mortality as:
A. The number of deaths per 1000 pregnancies
B. The number of deaths per 100,000 pregnancies
C. The number of direct and indirect deaths per 100,000 mortalities
D. The number of direct and indirect deaths per 10,000 mortalities
E. The number of direct and indirect deaths per 100,000 pregnancies
ANSWER : The number of direct and indirect deaths per 100,000 mortalities
154. You wish to investigate the time it takes to perform a caesarean section on
women with and without pre-eclampsia. At the end of the study you have two
groups of women with the duration of caesarean sections recorded for each. It
can't be assumed that these are normally distributed.
Which non-parametric statistic test would you use?
A. Chi-squared test
B. Linear regression analysis
C. Mann-Whitney U test
D. Pearson’s R test
E. Student’s t-test
ANSWER : Mann-Whitney U test

155. Nitrogenous bases make up cellular nucleic acids including DNA and RNA.
Which base pairs with Adenine in the standard DNA helix?
A. Thymine
B. Guanine
C. Inosine
D. Uracil
E. Uranine
ANSWER : Thymine

156. Which of the following human papilloma virus (HPV) subtypes is high-risk for
the development of genital warts?
A. HPV serotype 2, 63
B. HPV serotype 5, 8
C. HPV serotype 6, 11
D. HPV serotype 16,18
E. HPV serotype 16, 18, 31
ANSWER : HPV serotype 6, 11

157. Lancefield grouping of streptococci is based on the presence of

A. Carbohydrate antigen on cell wall
B. Peptidoglycan antigen on cell wall
C. M protein
D. Color of blood agar
E. Sugar fermentation
ANSWER : Carbohydrate antigen on cell wall

158. The deep circumflex iliac artery is a branch of which artery?

A. Internal iliac artery
B. Internal pudendal artery
C. External iliac artery
D. Common iliac artery
E. Femoral artery
ANSWER : External iliac artery
159. Which of the following metabolic processes produces the most energy needed
for uterine contraction during parturition?
A. Aerobic glycolysis
B. Anaerobic glycolysis
C. krebs cycle
D. Oxidative phosphorylation
E. Beta oxidation
ANSWER : Oxidative phosphorylation

160. Which hormone is secreted by the placenta and fetal adrenal gland, promotes
maturation of the fetal lungs?
A. Androstenedione
B. Dehydroepiandrosterone
C. Corticosterone
D. Cortisol
E. Cortisone
ANSWER : Cortisol

161. The non pregnant uterus of a 20-year-old female measured 7 x 4 x 3 cm.

She became pregnant, and just before delivery of a term infant, the uterus
measured 34 x 18 x 12 cm. Which of the following cellular processes was the major
reason for the increase in the size of the uterus?
A. Endometrial glandular hyperplasia
B. Myometrial fibroblast proliferation
C. Endometrial stromal hypertrophy
D. Myometrial smooth muscle hypertrophy
E. Vascular endothelial hyperplasia
ANSWER : Myometrial smooth muscle hypertrophy

162. Which biochemical technique is used to prenatal identification of cystic

fibrosis by using specifically amplifying predetermined DNA sequences?
A. karyotyping
B. Sweat test
C. Southern blotting
D. Polymerase chain reaction (PCR)
E. Fluorescent in situ hybridization (FISH)
ANSWER : Polymerase chain reaction (PCR)

163. What is the function of DNA polymerase?

A. To unwind DNA helix during replication
B. To add nucleotides to the end of a template DNA strand
C. To synthesis the nucleotides of DNA strands
D. To seal together the broken ends of DNA strands
E. To proofread the growing DNA strands and replace mismatched nucleotides
ANSWER : To proofread the growing DNA strands
164. Two days after undergoing total abdominal hysterectomy and bilateral
salpingo- oophorectomy a 60-year-old woman develops high temperature and
confusion. On examination; She has a temperature of 38.2°C, a respiratory rate of
28/min, a pulse of 103 beats/min, a blood pressure of 130/80 and a urine output of
10 ml/hr after catheterization. Which of the following is the most likely diagnosis?
A. Sepsis
B. Septic shock
C. Systemic inflammatory response syndrome
D. Septicemia
E. Severe sepsis
ANSWER : Severe sepsis

165. Six hours after undergoing a laparoscopic tubal ligation, a 32-year-old woman
complains of suprapubic pain and oozing. On examination there is a tender
palpable suprapubic mass up to the umbilicus that is dull to percussion. Her Hb
level is 11 g/dl. What is the most likely diagnosis?
A. Bladder injury
B. Intra-abdominal bleeding
C. Ureteric trauma
D. Urinary retention
E. Fluid overload
ANSWER : Urinary retention

166. Which enzyme found in red blood cells that buffers blood CO2?
A. Cytochrome-b5 reductase
B. 5-nucleotidase
C. Glucose-6-phosphate dehydrogenase
D. Carbonic anhydrase
E. Pyruvate kinase
ANSWER : Carbonic anhydrase

167. Which of the following is the genotype of Edward's syndrome?

A. 45, XO
B. 46, XX
C. 47, XXY
D. 47, XX
E. 46, XX+18
ANSWER : 47, XX
168. A 30-year-old woman who is 37 weeks pregnant presents with dysuria and
urinary frequency. She has been started on cefuroxime that was prescribed for a
previous urinary tract infection. Mid stream urine specimen report result shows;
Leukocytes; 50/hpf
100,000 colony of Pure E. coli growth
Co-amoxiclav; sensitive
Nitrofurantoin; sensitive
Trimethoprim; sensitive
Gentamicin; sensitive
Cefuroxime; resistant
What is the most suitable antibiotic to use?
A. Nitrofurantoin
B. Gentamicin
C. Trimethoprim
D. Co-amoxiclav
E. Cefuroxime
ANSWER : Trimethoprim

169. A 28-year-old primiparous woman is 34 weeks pregnant. Which of the

following complains of pregnancy, you will give her a further investigations?
A. Backache
B. Breast tenderness
C. Nausea
D. Tiredness
E. Dysuria
ANSWER : Dysuria

170. A 43-year-old woman presents to her GP with a 2-month history of

galactorrhoea. She is otherwise healthy and is not taking any medications. Nothing
abnormal is found in the examination. Her hormonal profile was a follows :
FSH 8.7 iU/l
LH 4.5 iU/l
Oestradiol 100 pmol/l
Prolactin 700 mU/l
TSH 15 mU/l
Free T4 9 iU/l
What is the most likely cause ?
A. Prolactinoma
B. Non-functioning pituitary tumour
C. Addison's disease
D. Hypothyroidism
E. Hyperthyroidism
ANSWER : Hypothyroidism
171. An 18-year-old woman presented with a history of 15 kg weight loss in the
previous four months. She has been amenorrheic for some months. Her
examination is completely normal. Her urine pregnancy test is negative. Her
laboratory results shows;
Luteinizing hormone; 0.3 mIU/l
Follicle-stimulating hormone; 0.2 iu/l
Prolactin 400 mU/l
Thyroid stimulating hormone; 1.5 mIU/L
Total T4; 200 nmol/L
Total T3; 2 nmol/l
What is the most likely diagnosis?
A. Hypothalamic dysfunction
B. Pituitary adenoma
C. Ovarian dysgenesis
D. Polycystic ovary syndrome
E. Hyperthyroidism
ANSWER : Hypothalamic dysfunction

172. A 70-year-old lady had an ultrasound because she was feeling bloated which
showed bilateral ovarian masses with no solid areas associated with abdominal
ascites. She is post menopausal and otherwise well. She was sent for a CA 125
which comes back as 50 U/mL. What is her risk of malignancy index score (RMI)?
A. 5
B. 10
C. 150
D. 300
E. 450
ANSWER : 450

173. A 28-year-old woman with complete hydatidiform mole is found to have

bilateral multiple tiny ovarian cysts along with an enlarged uterus at 12 weeks’
gestational age. The quantitative β-hCG level of 300,000 mIU/mL.
What is the most likely type of these ovarian cysts?
A. Polycystic ovaries
B. Granulosa cell cyst
C. Follicular cyst
D. Theca lutein cyst
E. Corpus luteum cyst
ANSWER : Theca lutein cyst
174. A 35-year-old female presents in the emergency department (ED) with severe
tachypnea. The following blood gases are obtained on room air:
pH 7.25
pCO2 7.8 kPa
pO2 10 kPa
HCO3- 18 mEq/L
Saturations 84 per cent
What does the blood gas show?
A. Metabolic acidosis with respiratory compensation
B. Metabolic acidosis
C. Respiratory acidosis with metabolic compensation
D. Respiratory acidosis
E. Mixed metabolic/respiratory acidosis
ANSWER : Mixed Metabolic/respiratory acidosis

175. Diagnostic studies frequently use a receiver operating characteristic curve.

What do the two axes of the curve represent?

A. Accuracy versus 1/sensitivity
B. Positive likelihood ratio versus negative likelihood ratio
C. Positive predictive value versus negative predictive value
D. Sensitivity versus 1 - specificity
E. Sensitivity versus positive predictive value
ANSWER : Sensitivity versus 1 – specificity
176. Among hundred women during laparoscopic diagnosis of endometriosis. Four
women were found with endometriosis. Three out of the four women were found
to be true positive. Seven women were found to be healthy i.e. without disease.
What is the sensitivity of this test?
A. 10%
B. 30%
C. 43%
D. 75%
E. 85%
ANSWER : 75%

177. A 45-year-old woman with type 2 D.M undergoes an abdominal hysterectomy

for fibroids and excess vaginal bleeding. Postoperatively, she develops shortness of
breath. A chest X ray reveals bilateral hilar vascular marks with mild pleural
effusion. Her blood investigation shows:
Sodium 110 mmol/L
Potassium 4.0 mmol/L
Bicarbonate 24 mmol/L
Urea 3.0 mmol/L
Creatinine 80 µmol/L
What is the most likely diagnosis?
A. Adrenal insufficiency
B. Syndrome of inappropriate antidiuretic hormone (SIADH)
C. Pulmonary edema
D. Peumonia
E. Renal failure
ANSWER : Syndrome of inappropriate antidiuretic hormone (SIADH)

178. Which of the following is the most related to endometrial carcinoma?

A. Simple hyperplasia
B. Complex atypical hyperplasia
C. Complex hyperplasia
D. Simple atypical hyperplasia
E. Polypoid adenoma
ANSWER : Complex atypical hyperplasia
179. A 20-year-old, gravida 2, para 1, at 34 weeks of gestation by her last
menstrual period presents to the emergency department complaining of mild,
painless vaginal bleeding. On examination, her vital signs are: T 37 0C, HR 100 bpm,
BP 120/85 mmHg, RR 18/min and the fundal height 34 cm with a normal CTG
tracing. What is the next course of action?
A. Perform a sterile vaginal examination
B. Perform an amniocentesis to rule out infection
C. Perform an ultrasound examination
D. Order FBC and cross matching
E. Immediate delivery
ANSWER : Order FBC and cross matching

180. 32 year old 3rd gravida presents at 32 weeks gestation with a history of
ruptured membranes. Which of the following procedures should be avoided in this
patient?
A. Vital sign assessment
B. Electronic fetal monitoring
C. Digital examination
D. High vaginal swabs
E. Ultrasound examination
ANSWER : Digital examination

181. Which process occurs in the mitochondria where uses electrons transport to
generate adenosine triphosphate (ATP)?
A. Krebs cycle
B. Cori's cycle
C. Glycolysis
D. Substrate level phosphorylation
E. Oxidative phosphorylation
ANSWER : Oxidative phosphorylation

182. The level of the umbilicus varies in obese women. What reference point can
be used instead?
A. Transpyloric plane
B. Subcostal plane
C. Supracristal plane
D. Level of anterior superior iliac spine
E. Transtubercular line
ANSWER : Transtubercular line
183. Which of the following nerves pierces the internal oblique muscle and passes
through the inguinal canal?
A. Iliohypogastric
B. Ilioinguinal
C. Genital branch of the genitofemoral
D. Obturator
E. Lateral femoral cutaneous
ANSWER : Ilioinguinal

184. The chance of malignant transformation occurring in premenopausal benign

ovarian cysts is
A. 0.1%
B. 3%
C. 10%
D. 15%
E. 25%
ANSWER : 10%

185. The following ECG trace shows :

Regular rhythm, normal rate, multiple P wave before one NN QRS complex (4:1)

What is the correct interpretation of this ECG?

A. Sinus bradycardia
B. Atrial flutter
C. 1st degree heart block
D. 2nd degree heart block
E. 3rd degree heart block
ANSWER : Atrial flutter

186. Which of the following depression screening questionnaire are frequent

normally used during pregnancy?
A. Edinburgh Postnatal Depression Scale
B. General Health Questionnaire
C. Hamilton Depression Rating Scale
D. Beck Depression Inventory
E. Hospital Anxiety and Depression Scale
ANSWER : Edinburgh Postnatal Depression Scale
187. A-24-year old woman complains of increasing perineal pain after normal
vaginal birth. Her labs reveals, Hb of 9 g/dl and white blood cell count of
17,000/cmm. At discharge what should be prescribed for this patient?
A. I.V antibiotic, oral ferrous sulfate then discharge
B. Oral antibiotic, oral ferrous sulfate then discharge
C. Oral antibiotic, oral ferrous sulfate and wait till full blood profile
D. Oral ferrous sulfate and wait till full blood profile
E. Oral ferrous sulfate then discharge
ANSWER : Oral ferrous sulfate then discharge

188. The investigation that should be carried out in every cases with heavy
menstrual bleeding is
A. Pelvic ultrasound scan
B. Full blood count
C. Vaginal swaps for microscopy and culture
D. Liver function test
E. Endometrial biopsy
ANSWER : Full blood count

189. A-19-year-old woman who is 28 weeks pregnant requests treatment for acne
and is prescribed antibiotic by her general practitioner (GP). She goes on to deliver
a healthy baby girl at term. Two years later her daughter is noted to have
unusually gray discoloration of teeth.
Which treatment for acne did her GP prescribed for acne?
A. Chloramphenicol
B. Sulphonamide
C. Quinolone
D. Aminoglycosides
E. Tetracycline
ANSWER : Tetracycline

190. Clomiphene citrate is

A. Gonadotropin analogue
B. Androgenic steroid
C. Estrogenic steroid
D. Progestogenic steroid
E. Selective estrogen receptor modulator
ANSWER : Selective estrogen receptor modulator
191. Mechanism of action of Neostigmine is
A. Choline ester
B. Cholinomimetic
C. Muscarinic antagonist
D. Anticholinesterase
E. Nicotinic antagonist
ANSWER : Anticholinesterase

192. Without treatment, asymptomatic bacteriuria at 32 weeks gestation is at risk

of what pregnancy complication?
A. Eclampsia
B. Spontaneous preterm labour
C. Renal failure
D. Polyhydramnios
E. Post term infant
ANSWER : Spontaneous preterm labour

193. At a significant level of P < 0.05, the null hypothesis H0 states that
A. There is a insignificant difference between soya milk feeding and allergy
B. There is a difference between soya milk feeding and allergy
C. There is no difference between soya milk feeding and allergy 5% of the time
D. There is a difference between soya milk feeding and allergy 95% of the time
E. There is no difference between soya milk feeding and allergy 95% of the time
ANSWER : There is no difference between soya milk feeding and allergy 95% of the
time

194. A 36-year-old woman had intermenstrual and heavy menstrual bleeding for
the past 2 months. She had a history of removal of cervical polyp 3 years ago and
her cervical smears are normal. On physical examination, there are no remarkable
findings. Her Hb level is normal. A pelvic ultrasound scan shows endometrial
thickness of 19 mm and a round hyperechoic mass in the endometrial cavity
measuring 10X8mm. What is the most likely diagnosis?
A. Adenomyosis
B. Endometriosis
C. Endometrial hyperplasia
D. Endometrial polyp
E. Submucous fibroid
ANSWER : Endometrial polyp
195. An 18-year-old woman has had pelvic discomfort for several months. On
pelvic examination, there is a right adnexal mass. Ultrasound picture of the right
ovary shows cystic lesion measuring 3.3x 2.5 cm with echogenic septea.
What is the most likely finding?
A. Hemorrhagic cyst
B. Benign teratoma
C. Ovarian carcinoma
D. Serous cystadenoma
E. Follicular cyst
ANSWER : Benign teratoma

196. What is the major estrogen produced by the placenta during pregnancy?
A. Dehydroepiandrosterone
B. Estradiol
C. Estriol
D. Estrone
E. Ethinylestradiol
ANSWER : Estriol

197. From what parent compound are most eicosanoids derived?

A. Arachidonic acids
B. Oleic acids
C. Linoleic acids
D. Steroids
E. Cholesterols
ANSWER : Arachidonic acids

198. What percentage of women with over active bladder have urinary
incontinence?
A. 1:2
B. 1:3
C. 1:4
D. 1:5
E. 1:6
ANSWER : 1:3
199. A 32-year-old Asian woman presents at 36 weeks of gestation with abdominal
discomfort, 2+ proteinuria and a blood pressure of 140/90 mmHg. She has blood
tests in accordance with the NICE guideline for the management of hypertension in
pregnancy. The midwife asks you to review the following blood results.
What do these results suggest?
Urea 2.8 mmol/l
Creatinine 67 micromol/l
Sodium 138 mmol/l
Potassium 4.2 mmol/l
Urate 0.37 mmol/l
Albumin 32 g/l
Alkaline phosphatase 198 iu/l
Alanine transferase 33 iu/l
Bilirubin 5 mmol/l
A. Acute fatty liver of pregnancy
B. Cholestasis of pregnancy
C. HELLP syndrome
D. Normal blood results for 36 weeks of pregnancy
E. Cholecystitis
ANSWER : Normal blood results for 36 weeks of pregnancy

200. A-27-year old woman complains of amenorrhea for 6 months. For the past
few months she has been feeling generally tired. Prior to this she had a regular 30
day cycle. Her urine pregnancy test is negative. Pelvic examination is normal and
routine bloods are ordered:
Luteinizing hormone; 33 mIU/l
Follicle-stimulating hormone; 51 iu/l
Prolactin; 300 mU/l
Thyroid stimulating hormone; 3.1 mIU/L (0.2-5.5)
Total T4; 100 nmol/L (50-500)
Total T3; 1.5 nmol/l (0.9-2.8)
Oestradiol; 70 pmol/l (100-500)
What is the most likely diagnosis?
A. Hypothalamic dysfunction
B. Gonadotropin-producing pituitary adenoma
C. Premature ovarian failure
D. Polycystic ovary syndrome
E. Primary hypothyroidism
ANSWER : Premature ovarian failure

Note: RECALLS are collected from the students who appeared in previous exams,
Answers of these questions are not verified (Use RECALL only for the purpose of
Exam pattern/trend understanding)

MADE by DR A. KH
Pray for me and good luck