2/19/2020 Biochemistry page 1 | eLearning

(/)

Progress 100% complete

Biochemistry page 1
Assessment Total A empts: 2 Highest Score: 100 %
History
View last results (/quiz/latest/304848/296079) View highest
result (/quiz/highest/304848/296079) Retake quiz
(/quiz/retake/296079)

Your result 26 %

Which of the following amino acid bases is not contained in RNA?

Q

A Your answer:
> Adenine 
View correct answer
Correct answer:
> Thymine
The answer is Thymine. In RNA the thymine is replaced by uracil.
The other bases (adenine, cystosine and guanine) remain the same.

https://elearning.rcog.org.uk/sbas-part-1-mrcog-online-resource/biochemistry-page-1 1/11
2/19/2020 Biochemistry page 1 | eLearning

Which of the following blood clo ng factors ac vates fibrinogen in the

Q common pathway?

A Your answer:
> Factor XIII 
View correct answer
Correct answer:
> Prothrombin
The answer is Prothrombin. Accelerin (V) s mulates ac va on of
prothrombin (II) to thrombin (II), which ac vates fibrinogen (I) to
form fibrin clot. This is stabilised by cross linking with the aid of
fibrin-stabilising factor (XIII). Remember heparin increases the rate
of complex forma on of an thrombin III, which inac vates
thrombin.

Which part of the cell cycle is noted for sister chroma ds separa ng and
Q moving to opposite sides of the cell?

A Your answer:
> Metaphase 
View correct answer

Correct answer:
> Anaphase
The answer is Anaphase. Within the cell cycle DNA replica on
occurs in the synthesis phase before entering the Gap 2 phase.
Mitosis starts with chromosomes condensing (prophase) follow by
chroma ds aligning (metaphase), following by sister chroma ds
separa ng and moving (anaphase). Finally the cell membrane
divides in telophase.

https://elearning.rcog.org.uk/sbas-part-1-mrcog-online-resource/biochemistry-page-1 2/11
2/19/2020 Biochemistry page 1 | eLearning

Which biochemical technique is used to detect the presence and the

Q amount of a protein?

A Your answer:
> Western blo ng 
Correct answer:
> Western blo ng
The answer is Western blo ng. Southern blo ng (named a er
Edwin Southern) is used to detect par cular sequences to DNA.
Northern blo ng is used for the same reason but for RNA.
Polymerase chain reac on is used to amplify very small amounts of
DNA (although it can be used for RNA if converted to DNA). X-ray
crystallography is used to reveal the structure of nucleic acids such
as DNA and RNA.

What molecules generate weak forces that can a ract neutrophils to cell
Q walls?

A Your answer:
> Hemidesmosomes 
View correct answer

Correct answer:
> Selec ns
The answer is selec ns. Selec ns are molecules that are expressed
in endometrial cell walls and also leucocytes. They generate weak
a rac on forces. Inflammatory processes via interleukins increase
the amount of selec ns present and hence, a ract more leucocytes.

Ribosomes are located in which part of the cell?

Q
https://elearning.rcog.org.uk/sbas-part-1-mrcog-online-resource/biochemistry-page-1 3/11
2/19/2020 Biochemistry page 1 | eLearning

A Your answer:
> Smooth endoplasmic re culum 
View correct answer

Correct answer:
> Rough endoplasmic re culum
The answer is Rough endoplasmic re culum. Ribosomes 'read' the
messenger RNA created from the nuclear DNA and translate it to
create proteins via transfer RNA. There are free ribosomes in the
cytoplasm of cells but they are in abundance in the rough
endoplasmic re culum.

Which ketone bodies can be used as an energy supply for the brain in
Q starva on?

A Your answer:
> Choline 
View correct answer
Correct answer:
> Acetoacetate
The answer is acetoacetate. Acetone is also a ketone body but is not
used for energy. It is excreted in urine and is also exhaled in the
breath.

You have been asked to review an asymptoma c pa ent in the early

Q pregnancy unit. Ultrasound scan is nega ve for pregnancy. βhCG levels over
48 hours are 550 and 350, and serum progesterone levels are 17 nmol.
What is the most likely outcome?

A Your answer:

https://elearning.rcog.org.uk/sbas-part-1-mrcog-online-resource/biochemistry-page-1 4/11
2/19/2020 Biochemistry page 1 | eLearning

> High risk of ectopic pregnancy needing interven on for

treatment

View correct answer

Correct answer:
> Non-viable pregnancy with the possibility of spontaneous
resolu on
The correct answer is non-viable pregnancy with the possibility of
spontaneous resolu on. Serum progesterone levels are useful
adjuncts in the diagnosis of pregnancy of unknown loca on. Levels
below 15-25 are indica ve of non-viable pregnancy. Results below
20 nmol/l are associated with spontaneous resolu on with
sensi vity of 93% and specificity of 94%. Levels above 60 strongly
indicate development into normal pregnancy in the future. Serum
hCG levels are useful in localising pregnancy while serum
progesterone helps with the prognosis.

Your consultant has asked you to send a urea and electrolytes test (U&E) for
Q a postopera ve woman who has undergone a prolonged and difficult
transcervical resec on of fibroids. What electrolyte disturbance can occur
a er this opera on?

A Your answer:
> Hyponatraemia 
Correct answer:
> Hyponatraemia
The answer is hyponatraemia. Absorp on of large amounts of
glycine is associated with hypervolaemia, hyponatraemia and
reduced osmolality. The term was coined as TURP syndrome. The
pa ent ini ally becomes restless, and complains of headache.
Sodium levels below 120mEq/L cause cardiac depression. Level less
than 115mEq/L is associated with bradycardia, widening of QRS
complex and T inversion. Level below 105mEq/L is associated with
respiratory and cardiac arrest. It is essen al to log input versus
output in transcervical resec on of fibroid cases. A loss of more
than 1.5 L is associated strongly with TURP syndrome.

https://elearning.rcog.org.uk/sbas-part-1-mrcog-online-resource/biochemistry-page-1 5/11
2/19/2020 Biochemistry page 1 | eLearning

In a pregnant woman with diabetes mellitus, target levels of HbA1C should

Q be below what level?

A Your answer:
> 6.5% 
Correct answer:
> 6.5%
The answer is 6.5% (NICE 2015). Diabe c women should be
managed by a specialised mul disciplinary team. There should be
an increased frequency of self monitoring and monthly checks of
HbA1c levels. The aim is to achieve op mum control with the levels
of HbA1c below 6.1%. Maternal and fetal risks are reduced with
decreasing HbA1c levels. However, rapid reduc on is not advisable.
If the levels are above 10%, pregnancy is not recommended.

A 14-year-old child presents to the adolescent gynaecology clinic. She has a

Q history of virilisa on a er undergoing pubertal changes. The karyotype
reveals 46XY. An ultrasound scan does not show the presence of a uterus
and ovaries. Which enzyme deficiency may be associated with these clinical
features?

A Your answer:
> Complete androgen insensi vity syndrome 
View correct answer
Correct answer:
> 5-alpha-reductase deficiency
The answer is 5-alpha-reductase deficiency. Turner syndrome is 45
XO and has been excluded by the karyotype. Polycys c ovarian
syndrome has a normal female karyotype. The child described
above is gene cally male. However, testosterone is not converted to
dihydrotestosterone in target ssues. The child may have been born
with ambiguous genitalia and raised as a girl. At puberty, elevated
levels of androgen lead to masculinisa on including virilisa on.
Complete androgen insensi vity is not the answer because
increased androgens are converted to estrogen and do not show

https://elearning.rcog.org.uk/sbas-part-1-mrcog-online-resource/biochemistry-page-1 6/11
2/19/2020 Biochemistry page 1 | eLearning

any virilisa on. It involves phenotypic females and an

unresponsiveness to androgens. Kallman's syndrome is a form of
hypogonadotropic hypogonadism and anosmia.

Where is a fetus is alpha-fetoprotein synthesised?

Q
A Your answer:
> Kidney 
View correct answer

Correct answer:
> Gut
The answer is the Gut. Alphafetoprotein is synthesised by three fetal
structures: the gut, the liver and the yolk sac. It is a glycol protein. It
may be elevated in the case of an anterior abdominal wall and
neural tube defect. As these defects are not covered by skin, AFP
freely enters the amnio c fluid from the fetal circula on, thus
leading to eleva on of levels.

Which body fat has a major role in gene transcrip on?

Q

A Your answer:
> Fa y acids 
Correct answer:
> Fa y acids
The answer is Fa y acids. The eicosanoids have a role in hormone
synthesis. The phospholipids are involved in membrane forma on.
Membrane phospholipids are broken down to second messengers
when the hormone binds to its receptor.

https://elearning.rcog.org.uk/sbas-part-1-mrcog-online-resource/biochemistry-page-1 7/11
2/19/2020 Biochemistry page 1 | eLearning

What electrolyte has a role in maintaining intracellular fluids, helping the

Q regula on of pH and establishing res ng membrane poten al of the cells?

A Your answer:
> Chloride 
View correct answer
Correct answer:
> Potassium
The answer is Potassium. Hypokalaemia may be caused by
inadequate replacement by intravenous therapy, insulin therapy,
vomi ng and diarrhoea. It is commonly associated with paraly c
ileus. Sodium has a key role in fluid balance. It contributes half the
osmolarity of the extracellular fluid. Calcium has a main role in
excitable cells, neurotransmi er release and blood clo ng.

Which biochemical process creates pyruvate as an energy supply?

Q

A Your answer:
> Gluconeogenesis 
View correct answer
Correct answer:
> Glycolysis
The answer is Glycolysis. Glycolysis converts monosaccharides into
pyruvate before conversion to acetyl coenzyme A anf this then acts
as a fuel in the citric acid cycle. It is par cularly helpful because it
does not require oxygen. Gluconeogenesis is metabolic pathway
resul ng in genera on of glucose from non-carbohydrate substrates
such as lactates,glycerol and aminoacids. Beta oxida on involves
fa y acid breakdown in mitochondria to generate acetyl CoA .

https://elearning.rcog.org.uk/sbas-part-1-mrcog-online-resource/biochemistry-page-1 8/11
2/19/2020 Biochemistry page 1 | eLearning

Chronic renal failure can produce what effect on the parathyroid system?
Q

A Your answer:
> Pseuohypoparathyroidism 
View correct answer
Correct answer:
> Secondary hyperparathyroidism
The answer is Secondary hyperparathyroidism. Chronic renal failure
is the most common cause of secondary hyperparathyroidism.
Other causes include chronic pancrea s and small bowel disease.

An ac ve 70-year-old woman is admi ed to the gynaecology clinic for a

Q sling procedure with a known history of Paget’s disease of the bone. Which
biochemical findings are most likely?

A Your answer:
> Normal calcium, normal phosphate and elevated alkaline 
phosphatase

Correct answer:
> Normal calcium, normal phosphate and elevated alkaline
phosphatase
The answer is Normal calcium, normal phosphate and elevated
alkaline phosphatase. Calcium and phosphate are usually normal
but alkaline phosphatase is o en highly elevated.

Glycated haemoglobin (HbA1C) is a marker of diabe c control over what

Q me period?

https://elearning.rcog.org.uk/sbas-part-1-mrcog-online-resource/biochemistry-page-1 9/11
2/19/2020 Biochemistry page 1 | eLearning

A Your answer:
> 4–8 weeks 
View correct answer
Correct answer:
> 8–12 weeks
The answer is 8–12 weeks. Measurement of HbA1c is an indicator of
glycaemic control over the previous 8–12 weeks, and is used to
monitor pa ents with type I diabetes. It should not be used as a
diagnos c test for type I diabetes.

With regard to the oxygen dissocia on curve, which factor increases the
Q percentage of oxygen satura on for the same par al pressure of oxygen
available, shi ing the curve to the le ?

A Your answer:
> Heat 
View correct answer
Correct answer:
> Alkalosis
The answer is Alkalosis. All the other op ons shi the curve to the
right, in promo ng the release of oxygen to the ssues that need it.

Royal College of Obstetricians and Gynaecologists

© 2020

Registered charity no. 213280

https://elearning.rcog.org.uk/sbas-part-1-mrcog-online-resource/biochemistry-page-1 10/11
2/19/2020 Biochemistry page 1 | eLearning

10-18 Union Street

London SE1 1SZ
UK

Tel +44 20 7772 6200

Fax +44 20 7723 0575

https://elearning.rcog.org.uk/sbas-part-1-mrcog-online-resource/biochemistry-page-1 11/11