Mrcog Ultimate Study Guide

MRCOG Part 1 — Ultimate Study Guide

A complete exam prep resource: syllabus + format + strategies + 381 practice questions

Sources Consulted

1. EXAM FORMAT

Structure

• Delivery mode: Computer-Based Test (CBT) at Pearson VUE test centres
• Number of papers: 2 papers (Paper 1 and Paper 2)
• Question type: Single Best Answer (SBA) — 5 options per question
• Questions per paper: 100 SBAs each
• Total questions: 200 SBAs
• Duration per paper: 2.5 hours (150 minutes)
• Total exam duration: 5 hours (plus ~1 hour lunch break between papers)
• Marking: No negative marking — answer every question
• Scoring: Each paper contributes equally (50%) to final combined score. No per-paper minimum.

Pass Mark

• Not a fixed percentage. Uses Ebel's Method of standard setting
• Questions classified by difficulty (easy/medium/hard) AND relevance (essential/important/acceptable). Panel decides % of borderline candidates answering correctly per category
• Pass mark fluctuates between sittings based on question difficulty
• Pass rate: Historically 30-40%, but 50-60% from 2021 onwards (per passmrcog.com)
• Standard setting panel = NHS O&G consultants
• Regulated by GMC — annual reports submitted

Attempts Limit

• Max 6 attempts for candidates aiming for UK Specialist Register
• No limit for others
• Must attempt Part 2 at least once within 7 years of passing Part 1

Key Dates & Fees (2026)

• Held twice yearly: January and June/July
• Fees: UK/ROI L577, Band A L696, Band B L601, Band C L479
• Results released ~4 weeks post-exam
• 2-stage application: eligibility assessment -> booking at Pearson VUE

2. COMPLETE SYLLABUS — 15 CORE KNOWLEDGE AREAS

From official MRCOG Syllabus Curriculum v1.0 (April 2024) PDF:

KA 1 — Clinical Skills

• Patterns of symptoms, risk factors
• Pathological basis for physical signs and clinical investigation
• Interpreting clinical investigation results

KA 2 — Teaching and Research

• Screening principles, clinical trial design, statistical methods
• Levels of evidence, quantification of risk, power of study, significance
• Informed consent, ethical and regulatory approvals
• Safe prescribing, quality control, accuracy of tests

KA 3 — Core Surgical Skills

• Informed consent: complication rates, risks, success rates
• Common surgical instruments and sutures
• Basic procedures: laparoscopy, hysteroscopy, laparotomy, vaginal surgery
• Principles of safe surgery, risk management

KA 4 — Postoperative Care (mostly Part 2/3 focus for Part 1)

KA 5 — Antenatal Care

• Maternal anatomical/endocrine/physiological adaptations in pregnancy
• Pathology of major organ systems, haemoglobinopathies, connective tissue disorders
• Screening tests in pregnancy
• Fetal anatomy, embryology, endocrine function, physiology
• Placental development and function, drug handling
• Principles of inheritance, common inherited disorders
• Basic ultrasound in pregnancy
• Maternal/perinatal mortality data
• Impact of maternal health and social deprivation

KA 6 — Maternal Medicine

• Epidemiology and pathology of diabetes, endocrine, respiratory, cardiac, haematological disease
• Infections in pregnancy — pathophysiology, treatments
• Drugs in maternal disease — maternal and fetal complications
• Imaging: ultrasound, X-ray, MRI — interpretation

KA 7 — Management of Labour

• Physiology, biochemistry, endocrinology of parturition
• Fetal endocrine maturation, myometrial signalling, contractility biochemistry
• Tocolysis and stimulation of contractions
• Fetal physiology in late pregnancy
• Fetal assessment in late pregnancy/labour
• Placentation, infection in labour

KA 8 — Management of Delivery

• Mechanism and physiology of childbirth and third stage
• Congenital/bone malformations of genital tract
• Drugs in labour, delivery, third stage
• Operative delivery — indications and risks
• Acid-base balance, fetal physiological changes, cord blood analysis
• Female perineum and perineal repair

KA 9 — Postpartum Problems

• Neonatal physiology and structural changes
• Lactation, uterine involution
• Puerperal sepsis and infection
• Common puerperal complications including mental health
• Postpartum contraception, drugs in lactation

KA 10 — Gynaecological Problems

• Anatomy, physiology, histopathology of pituitary and female reproductive tract
• Puberty, menopause, menstrual cycle, ovulation
• Benign gynaecological conditions including infection
• Interpretation of investigations

KA 11 — Subfertility

• Epidemiology of subfertility
• Anatomy, development, function of male and female reproductive tracts
• Interpretation of subfertility investigations

KA 12 — Sexual and Reproductive Health

• Physiology, endocrinology, epidemiology, pharmacology of contraception
• STIs: serology, microorganisms, drugs, pathology
• Termination of pregnancy: assessment, Fraser competency, surgical/medical management

KA 13 — Early Pregnancy Care

• Basic sciences of early pregnancy and loss
• Endocrine aspects of maternal recognition, luteal maintenance, fetomaternal communication
• Aetiology and histopathology of miscarriage, ectopic, trophoblastic disease
• Diagnostic ultrasound in early pregnancy
• Epidemiology of pregnancy loss
• Medical agents for managing pregnancy loss

KA 14 — Gynaecological Oncology

• Surgical anatomy of abdomen and pelvis
• Cellular biology of cancer, genetic origins, screening principles
• Pain pathways in gynaecological malignancy
• Epidemiology and aetiology of cancers in women
• Pathology and classification of gynaecological cancers
• Principles of radiotherapy and chemotherapy

KA 15 — Urogynaecology and Pelvic Floor

• Structure of bladder and pelvic floor, innervation
• Mechanisms of continence and micturition
• Pelvic floor support principles
• Effects of pregnancy, childbirth, disease, infection, oestrogen deficiency
• Treatment principles, impact of drugs on bladder function

Alternative Framework — 4 Broad Domains

1. Understanding Cell Function: Physiology, Endocrinology, Biochemistry (15-20 Qs each)
2. Understanding Human Structure: Anatomy (15-20), Embryology (5-10), Genetics (5-10)
3. Understanding Measurement and Manipulation: Biophysics (5-10), Epidemiology/Statistics (15-20), Pharmacology (5-10), Data Interpretation
4. Understanding Illness: Immunology (5-10), Microbiology (5-10), Pathology (15-20), Clinical Management (15-20)

3. RECOMMENDED TEXTBOOKS & RESOURCES

Official RCOG Reading List

Books in bold are MRCOG-specific. Cambridge University Press offers 20% discount to RCOG registered trainees.

Question Banks & Online Platforms

• MRCOG Prep (mrcogprep.com) — 5000+ SBAs, AI-driven analytics, past paper recalls
• BMJ OnExamination (onexamination.bmj.com) — Trusted MCQ platform
• RCOG Learning (rcog.org.uk/learning) — Official e-learning platform
• PassMRCOG (passmrcog.com) — Revision info and resources
• DigiNerve "Cracking MRCOG" (diginerve.com) — Comprehensive and crash courses
• RCOG Green-top Guidelines — Essential, directly inform exam questions
• TOG (The Obstetrician & Gynaecologist) — Peer-reviewed articles

4. STUDY TIPS FROM CANDIDATES

Recommended Timelines

• 6 months: Foundation (months 1-3) -> Integration (month 4) -> Mock exams (month 5) -> Intensive revision (month 6)
• 3 months (intensive): Combine theory with daily MCQ; use analytics; mock exams + final revision

Key Tips

1. Start early — 4-6 months minimum. Cramming doesn't work
2. Master the RCOG syllabus PDF first — map topics before diving in
3. Prioritise high-yield subjects: Anatomy, Physiology, Endocrinology, Pathology, Clinical Management, Statistics
4. Practice 3,000-4,000 questions total over your prep period
5. Time yourself: target <1.5 minutes per SBA. Simulate full 2.5-hour exams
6. Review ALL explanations — even correct answers. Know why wrong options are wrong
7. Maintain an error log — revisit top 20 incorrect questions weekly
8. Create flashcards/summary notes for final month rapid revision
9. Use mnemonics for TORCH, fetal circulation, pelvic anatomy
10. Join study communities: Telegram groups, Reddit (r/ObGyn), MRCOG forums

Common Pitfalls

• Starting too late (breadth requires long-term consolidation)
• Skipping SBA practice (familiarity with question logic is critical)
• Over-reliance on passive reading (active recall is far more effective)
• Ignoring statistics and anatomy (heavily tested, often cause failures)
• Not simulating exam conditions (time management is major challenge)
• Spending too long on one question (mark it, move on, return if time)

Subject-Specific Guidance

• Anatomy: Last's Anatomy. Focus on pelvis, reproductive organs, blood supply, innervation
• Physiology: Ganong's. Focus on maternal adaptations, menstrual cycle, fetal physiology
• Endocrinology: Speroff. Hormonal pathways, signalling
• Statistics: Swinscow's Statistics at Square 1. Study designs, p-values, t-tests, sensitivity/specificity
• Pharmacology: BNF + Lecture Notes. Focus on pregnancy drugs, contraception, tocolytics
• Embryology: Larsen's. Focus on reproductive tract development
• Pathology: Robbins Basic Pathology. Cellular changes, inflammation, neoplasia

Exam Administration Summary

• Held twice yearly: January and June/July
• Fees (2026): UK/ROI L577, Band A L696, Band B L601, Band C L479
• Results released ~4 weeks post-exam
• 2-stage application (eligibility -> Pearson VUE booking)
• 6-attempt limit (for UK Specialist Register candidates)
• Must attempt Part 2 within 7 years of passing Part 1
• No Part 1 certificate — only pass letter. Full MRCOG upon Part 3
• Pass mark set by Ebel's Method before each sitting

Practice Questions Bank

381 questions across 2 exam sittings Compiled from Dr. Fath MRCOG Telegram group recall sessions Questions: January 192 | July 189 | 381 total distinct questions

📊 Topic Summary

1. Anatomy

📘 Q1 (January 2024) — The upper part of the vagina receives its blood supply from which arteries? A) Internal pudendal and obturator arteries B) Uterine and ovarian arteries C) Inferior gluteal and external iliac arteries D) Vaginal and inferior vesical arteries E) Superior rectal and middle rectal arteries

Answer: B

The upper part of the vagina is mainly supplied by branches of the uterine and ovarian arteries, reflecting its close anatomical relation to the uterus and ovaries.

📘 Q2 (January 2024) — Which nerve is primarily supplied by the perianal area? A) Pudendal nerve B) Inferior rectal nerve C) Tlioinguinal nerve D) Genitofemoral nerve E) Obturator nerve

Answer: B

The inferior rectal nerve, a branch of the pudendal nerve, provides sensory innervation to the perianal skin and muscles.

📘 Q3 (January 2024) — Which artery is most commonly injured during an appendectomy? A) Superior mesenteric artery B) Inferior mesenteric artery C) Deep circumflex iliac artery D) Inferior epigastric artery E) Internal iliac artery

Answer: C

*The deep circumflex iliac artery runs along the iliac crest near the site of an appendectomy incision and can be accidentally injured during surgery.

📘 Q6 (January 2024) — The Bartholin gland is located in which anatomical space? A) Deep perineal pouch B) Superficial perineal pouch C) Ischioanal fossa D) Vestibule of vagina E) Pelvic cavity

Answer: B

*The Bartholin (greater vestibular) glands are located in the superficial perineal pouch, near the vaginal orifice.

📘 Q7 (January 2024) — The obturator nerve is formed by which spinal nerve roots? A) L1, L2, L3 B) L2, L3, L4 C) L3, L4, L5 D) S1, 82, $3 E) L4, LS, $1

Answer: B

The obturator nerve arises from the lumbar plexus formed by the anterior divisions of L2-L4 spinal nerves.

📘 Q9 (January 2024) — At what vertebral level does the common iliac artery bifurcate?

ALI B) L3 C) L4 D) S1 E) 83

Answer: C

*The abdominal aorta bifurcates into the common iliac arteries at the level of L4 vertebra.

📘 Q10 (January 2024) — The dermatome of the umbilicus corresponds to which spinal nerve?

Cc. T10 A) T8 B) T9 D) TIL E) T12

Answer: C

The umbilical region corresponds to the T10 dermatome.

📘 Q11 (January 2024) — The muscles form the pelvic diaphragm? A) Levator ani and coccyx B) Piriformis and obturator internus C) Iliopsoas and psoas minor D) Gluteus maximus and medius E) Rectus abdominis and transverse abdominis

Answer: A

The levator ani and coccyx muscles together form the pelvic diaphragm, supporting pelvic organs.

📘 Q12 (January 2024) — Which episiotomy type is most commonly used in the UK? A) Midline episiotomy B) Mediolateral episiotomy C) Lateral episiotomy D) Posterior episiotomy E) Anterior episiotomy

Answer: B

*The mediolateral episiotomy is preferred in the UK to reduce risk of anal sphincter injury.

📘 Q13 (January 2024) — During episiotomy, which muscle is typically incised? A) Bulbospongiosus B) Ischiocavernosus C) Superficial transverse perineal muscle D) Levator ani E) External anal sphincter

Answer: A

The bulbospongiosus muscle, part of the superficial perineal muscles, is cut during an episiotomy.

📘 Q15 (January 2024) — The Alcock canal contains which structure? A) Femoral nerve B) Pudendal nerve C) Obturator artery D) Sciatic nerve E) Inferior gluteal nerve

Answer: B

*The pudendal nerve passes through the Alcock (pudendal) canal in the pelvis.

📘 Q16 (January 2024) — The coronal suture of the skull is formed between which bones? A) Frontal and parietal bones B) Parietal and occipital bones C) Temporal and parietal bones D) Frontal and temporal bones E) Occipital and temporal bones

Answer: A

The coronal suture connects the frontal bone to the two parietal bones.

📘 Q17 (January 2024) — The spinal level of sympathetic innervation to perform low uterine segment anaesthesia is?

c.L3 A) LI B) L2 D) L4 E) S1

Answer: B

The sympathetic nerves supplying the uterus mainly arise from the spinal segments around L2.

📘 Q18 (January 2024) — Before performing a hysterectomy, which ligament is most important to ligate to control the blood supply? A) Round ligament B) Broad ligament C) Suspensory ligament of the ovary D) Internal iliac ligament E) Cardinal ligament

Answer: D

*Ligation of the internal iliac artery reduces pelvic blood flow and bleeding during hysterectomy.

📘 Q19 (January 2024) — Which nerve runs medial to the anterior superior iliac spine (ASIS)? A) Femoral nerve B) Lateral femoral cutaneous nerve C) Obturator nerve D) Sciatic nerve E) Genitofemoral nerve

Answer: B

The lateral femoral cutaneous nerve passes medial to the ASIS before supplying the lateral thigh.

📘 Q20 (January 2024) — The middle rectal artery branches from which artery? A) External iliac artery B) Internal iliac artery C) Inferior mesenteric artery D) Superior rectal artery E) Common iliac artery

Answer: B

The middle rectal artery arises from the internal iliac artery and supplies the middle part of the rectum.

📘 Q21 (January 2024) — Which nerve pierces the internal oblique muscle to enter the deep inguinal ring? A) Tliohypogastric nerve B) Tlioinguinal nerve C) Genitofemoral nerve D) Femoral nerve E) Obturator nerve

Answer: B

*The ilioinguinal nerve passes through the internal oblique muscle near the deep inguinal ring.

📘 Q26 (January 2024) — The piriformis muscle originates from where? A) Ventral surface of sacrum B) Ischial spine C) Pubis D) Iliac crest E) Greater trochanter

Answer: A

The piriformis arises from the anterior sacrum and inserts on the greater trochanter.

📘 Q40 (January 2024) — The course of the obturator internus muscle is?

C. From sacrum to lesser trochanter A) From ilium to greater trochanter B) From pubis and ischium, through lesser sciatic foramen, to greater trochanter C) From sacrum to lesser trochanter D) From ischial tuberosity to lesser trochanter E) From pubis to iliac crest

Answer: B

Obturator internus originates from the obturator membrane and surrounding bones, passes through the lesser sciatic foramen, inserting on the greater trochanter.

📘 Q55 (January 2024) — The obturator internus muscle passes through which foramen? A) Greater sciatic foramen B) Lesser sciatic foramen C) Obturator foramen only D) Foramen ovale E) Foramen rotundum

Answer: B

The Obturator internus originates on the obturator membrane and exits the pelvis via the lesser sciatic foramen.

📘 Q71 (January 2024) — The obturator internus muscle passes through which foramen? A) Greater sciatic foramen, B) Lesser sciatic foramen C) Obturator foramen D) Foramen ovale E) Foramen rotundum

Answer: B

The Obturator internus exits the pelvis via the lesser sciatic foramen.

📘 Q81 (January 2024) — The most common site of ectopic pregnancy is? A) Isthmus of fallopian tube B) Ampulla of fallopian tube C) Cornual region D) Ovary E) Abdomen

Answer: B

*About 70% of ectopic pregnancies implant in the ampulla, the widest part of the tube.

📘 Q103 (January 2024) — Hydralazine acts by? A) Beta-blockade B) Smooth muscle relaxation C) ACE inhibition D) Calcium channel blockade E) Diuresis

Answer: B

Hydralazine directly relaxes arteriolar smooth muscle, reducing blood pressure.

📘 Q129 (January 2024) — Terbutaline is a? A) Beta-1 agonist B) Beta-2 agonist C) Alpha-1 antagonist D) Beta blocker E) Calcium channel blocker

Answer: B

*Terbutaline relaxes uterine smooth muscle via beta-2 stimulation.

📘 Q139 (January 2024) — Botulinum toxin acts by? A) Inhibiting acetylcholine release B) Stimulating dopamine receptors C) Blocking calcium channels D) Enhancing GABA release E) Inhibiting serotonin uptake

Answer: A

Botulinum toxin prevents acetylcholine release causing muscle paralysis.

📘 Q193 (January 2024) — Cocaine overdose can cause myocardial infarction by? A) Vasospasm B) Thrombosis C) Atherosclerosis D) Embolism E) Infection

Answer: A

Cocaine induces coronary artery vasospasm, leading to ischemia.

📙 Q2 (July 2024) — Which structure forms the lateral boundary of the ischio-rectal fossa? A) Gluteus maximus B) Gluteus minimus C) Levator ani muscle D) Obturator internus muscle E) Piriformis muscle

Answer: D

The lateral wall of the ischio-rectal fossa is formed by the obturator internus muscle covered by the obturator fascia.

📙 Q23 (July 2024) — The epidural space lies between: A) Arachnoid and pia mater B) Wall of vertebra and dura mater C) Pia mater and ependyma D) Dura mater and arachnoid mater E) Ligamentum flavum and dura mater

Answer: B

*The epidural space is the potential space between the vertebral canal and dura mater.

24, The internal anal sphincter is continuous with which muscle?

A) Circular muscle of rectum

B) Longitudinal muscle of external anal sphincter

C) Longitudinal muscle of rectum

D) Puborectalis

E) Levator ani

Answer: A) Circular muscle of rectum

Explanation: The internal anal sphincter is a thickening of the circular smooth muscle layer of the rectum.

📙 Q25 (July 2024) — The superficial and deep perineal spaces are separated by the: A) Endopelvic fascia B) Perineal membrane C) Colle's fascia D) Superficial fascia E) Urogenital diaphragm

Answer: B

The perineal membrane separates the superficial perineal pouch from the deep perineal pouch.

📙 Q29 (July 2024) — Which structure allows blood flow from the right atrium to the left atrium in the fetus? A) Ductus venosus B) Foramen ovale C) Ductus arteriosus D) Ligamentum arteriosum E) Umbilical vein

Answer: B

The foramen ovale is an opening in the atrial septum allowing right- to-left atrial blood flow in fetal circulation.

📙 Q36 (July 2024) — The angle that the pelvic brim makes with the horizontal plane is approximately: A) 45 degrees B) 60 degrees C) 90 degrees D) 120 degrees E) 135 degrees

Answer: B

The pelvic brim is inclined at about 60 degrees to the horizontal plane.

📙 Q37 (July 2024) — The structure connecting the umbilical vein to the inferior vena cava (IVC) is: A) Ductus venosus B) Foramen ovale C) Ductus arteriosus D) Ligamentum teres E) Umbilical artery

Answer: A

Ductus venosus shunts oxygenated blood from the umbilical vein to the IVC.

📙 Q39 (July 2024) — The motor supply to the detrusor muscle of the bladder is derived from: A) Pelvic splanchnic nerve B) Pudendal nerve C) Inferior hypogastric plexus D) Superior hypogastric plexus E) Lumbar sympathetic nerves

Answer: A

Parasympathetic fibres from pelvic splanchnic nerves stimulate detrusor contraction.

📙 Q40 (July 2024) — In vacuum (ventouse) delivery, the cup is placed on the: A) Temporal bone B) Frontal bone C) Sagittal suture D) Coronal suture E) Occipital bone

Answer: C

The cup is placed over the flexion point near the sagittal suture to facilitate safe traction.

📙 Q41 (July 2024) — The lateral wall of the ischio-rectal fossa is formed by:

A) Levator ani
B) Anal sphincter
C) Obturator internus
D) Obturator externus
E) Gluteus maximus

Answer: C

*The obturator internus muscle forms the lateral boundary of the ischio-rectal fossa.

42, Which phase of the cell cycle immediately precedes mitosis?

A) GI phase

B) G2 phase

C) S phase

D) M phase

E) GO phase

Answer: B) G2 phase

Explanation: The G2 phase is the gap following DNA synthesis and before mitosis.*

📙 Q43 (July 2024) — The variable type for 'country of birth’ is: A) Category B) Nominal C) Ratio D) Interval E) Ordinal

Answer: B

*Country of birth is a nominal categorical variable with no intrinsic order.

44, Which nerve, other than the pudendal nerve, arises from the sacral plexus?

A) Sciatic nerve

B) Genitofemoral nerve

C) Lateral femoral cutaneous nerve

D) Femoral nerve

E) Obturator nerve

Answer: A) Sciatic nerve

Explanation: The sciatic nerve originates from the sacral plexus along with the pudendal nerve.*

📙 Q46 (July 2024) — The bulbourethral gland is located in which anatomical space? A) Deep perineal pouch B) Superficial perineal pouch C) Ischio-rectal fossa D) Deep inguinal space E) Retropubic space

Answer: B

*The bulbourethral glands lie within the superficial perineal pouch.

📙 Q55 (July 2024) — Which receptor causes bronchodilation, vasodilation, and increased glucagon release? A) Alpha-2 (02) B) Histamine-2 (H2) C) Dopamine-2 (D2) D) Beta-2 (2) E) Muscarinic-2 (M2)

Answer: D

*62 receptors mediate smooth muscle relaxation and increase glucagon secretion.

📙 Q58 (July 2024) — Which structure attaches to the iliac tuberosity? A) Coccygeus B) Inguinal ligament C) Iliolumbar ligament D) Sacroiliac ligament E) Sacrotuberous ligament

Answer: D

*The sacroiliac ligament attaches to the iliac tuberosity stabilizing the sacroiliac joint.

📙 Q72 (July 2024) — What percentage of Brenner cell tumours of the ovary are malignant? A) 5% B) 10% C) 15% D) 20% E) 25%

Answer: A

Brenner tumours are usually benign; around 5% are malignant.

📙 Q79 (July 2024) — A patient has slight vaginal bleeding, irregular periods, and ultrasound shows intrauterine gestational sac with fetal pole CRL 6 mm but no fetal heart rate. The next best step is: A) Admit and start mifepristone B) Arrange the evacuation of retained products C) Arrange a laparoscopy D) Check serum beta-hCG E) Repeat ultrasound in 7-10 days

Answer: D

*Confirm viability with serial beta-hCG before further management.

📙 Q81 (July 2024) — A 65-year-old postmenopausal woman with urinary frequency and dysuria is treated with topical estrogen. The improvement is mainly due to its effect on: A) Bladder mucosa B) Bladder trigone C) Lower vagina D) Upper vagina E) External genitalia

Answer: B

Estrogen improves urogenital atrophy and urinary symptoms via effects on bladder trigone.

📙 Q82 (July 2024) — The most common type of episiotomy performed in the UK is: A) Mediolateral B) Median C) Paramedian D) Lateral E) J-shaped

Answer: A

*Mediolateral episiotomy is favoured in the UK to reduce risk of anal sphincter injury.

📙 Q86 (July 2024) — A normal T-score on bone density testing is: A) Above -1 B) Below -1 C) Above -2.5 D) Below -2.5 E) Between -1 and -2.5

Answer: A

T-score > -1 indicates normal bone density.

📙 Q108 (July 2024) — The anterior superior iliac spine is the attachment site of: A) Inguinal ligament B) Coccygeus ligament C) Obturator internus D) Sacroiliac ligament E) Sacrotuberous ligament

Answer: A

The inguinal ligament extends from the anterior superior iliac spine to the pubic tubercle.

📙 Q111 (July 2024) — A pregnant woman’s LMP is 6 weeks ago, urine pregnancy test positive, and transvaginal scan shows an intrauterine sac with MSD 23 mm but no visible fetal pole. The diagnosis is: A) Pregnancy of unknown viability B) Missed miscarriage C) Anembryonic pregnancy D) Ectopic pregnancy E) Threatened miscarriage

Answer: A

Absence of fetal pole with sac size <25 mm needs repeat scan; viability uncertain.

📙 Q140 (July 2024) — The structure that penetrates the hepatic diverticulum during development is the: A) Septum transversum B) Vitelline duct C) Allantois D) Urachus E) Omphalomesenteric duct

Answer: A

Septum transversum forms the diaphragm and contributes to liver mesenchyme.

📙 Q150 (July 2024) — The sensory innervation of the ovary corresponds to which spinal segment? A) T10 B) T12 C) L2 D) 82 E) L4

Answer: A

Ovarian pain refers to the T10 dermatome.

📙 Q156 (July 2024) — The pelvic structure that forms the lateral boundary of the ischio-rectal fossa is: A) Levator ani B) Obturator internus C) Gluteus maximus D) Coccygeus E) Piriformis

Answer: B

Obturator internus muscle forms the lateral wall of the ischio-rectal fossa.

📙 Q157 (July 2024) — The structure allowing blood flow from the right atrium to the left atrium in fetal circulation is: A) Ductus venosus B) Foramen ovale C) Ductus arteriosus D) Umbilical vein E) Umbilical artery

Answer: B

*The foramen ovale allows blood to bypass fetal lungs.

📙 Q174 (July 2024) — The epidural space is located between: A) Arachnoid mater and pia mater B) Vertebral canal wall and dura mater C) Pia mater and ependyma D) Dura mater and arachnoid mater E) Ligamentum flavum and dura mater

Answer: B

The epidural space lies between the dura mater and vertebral canal wall.

📙 Q175 (July 2024) — The internal anal sphincter is continuous with: A) Circular muscle of the rectum B) Longitudinal muscle of the external anal sphincter C) Longitudinal muscle of the rectum D) Puborectalis muscle E) External sphincter

Answer: A

*The internal sphincter is a thickening of the rectal circular smooth muscle.

📙 Q176 (July 2024) — The superficial and deep perineal spaces are separated by: A) Endopelvic fascia B) Perineal membrane C) Colle’s fascia D) Superficial fascia E) Urogenital diaphragm

Answer: B

The perineal membrane divides the superficial from the deep perineal space.

📙 Q180 (July 2024) — Blood flow from the right atrium to the left atrium in fetal circulation occurs via: A) Ductus venosus B) Foramen ovale C) Ductus arteriosus D) Umbilical vein E) Umbilical artery

Answer: B

The Foramen ovale allows oxygenated blood to bypass the fetal lungs.

📙 Q187 (July 2024) — The pelvic brim angle with the horizontal is approximately: A) 45° B) 60° C) 90° D) 120° E) 135°

Answer: B

*The pelvic inlet is inclined at ~60° to horizontal.

📙 Q188 (July 2024) — The structure connecting the umbilical vein to the inferior vena cava is: A) Ductus venosus B) Foramen ovale C) Ductus arteriosus D) Umbilical artery E) Ligamentum teres

Answer: A

Ductus venosus shunts oxygenated blood to systemic circulation.

📙 Q190 (July 2024) — Motor supply to the detrusor muscle is via: A) Pelvic splanchnic nerve B) Pudendal nerve C) Inferior hypogastric plexus D) Superior hypogastric plexus E) Lumbar sympathetic nerves

Answer: A

*Parasympathetic fibers from pelvic splanchnics contract detrusor.

📙 Q191 (July 2024) — In ventouse (vacuum) delivery, the cup should be placed on: A) Temporal bone B) Frontal bone C) Sagittal suture D) Coronal suture E) Occipital bone

Answer: C

The cup is placed over the flexion point near the sagittal suture to aid safe traction.

📙 Q192 (July 2024) — The lateral wall of the ischio-rectal fossa is formed by: A) Levator ani B) Anal sphincter C) Obturator internus D) Obturator externus E) Gluteus maximus

Answer: C

Obturator internus muscle forms the lateral boundary of the ischio- rectal fossa.

📙 Q195 (July 2024) — Which nerve other than the pudendal nerve arises from the sacral plexus? A) Sciatic nerve B) Genitofemoral nerve C) Lateral femoral cutaneous nerve D) Femoral nerve E) Obturator nerve

Answer: A

The sciatic nerve originates from the sacral plexus along with the pudendal nerve.

📙 Q197 (July 2024) — The bulbourethral gland is located in the: A) Deep perineal pouch B) Superficial perineal pouch C) Ischio-rectal fossa D) Deep inguinal space E) Retroperitoneal space

Answer: B

Bulbourethral glands lie in the superficial perineal space.

10. Gynaecology

📘 Q89 (January 2024) — Most common side effect of fibroids is? A) Heavy menstrual bleeding B) Infertility C) Pelvic pain D) Dysmenorrhea E) Urinary frequency

Answer: A

Fibroids often cause menorrhagia due to increased endometrial surface.

📘 Q185 (January 2024) — Best resolution imaging technique among ultrasound probes? A) 3 MHz probe B) 5 MHz probe C) 7 MHz probe D) 1 MHz probe E) 2 MHz probe

Answer: C

Higher frequency probes give better resolution but less penetration.

📙 Q51 (July 2024) — What is the approximate failure rate of laparoscopic tubal ligation and vasectomy as contraceptive methods? A) 1/2000 for both B) 1/200 for both C) 1/200 for tubal ligation and 1/2000 for vasectomy D) 1/1000 for tubal ligation and 1/2000 for vasectomy E) 1/100 for both

Answer: C

*Vasectomy is more effective, with lower failure rates than tubal ligation.

§2. After ovulation, the endometrium becomes:

A) Luteal phase

B) Secretory phase

C) Proliferative phase

D) Menstrual phase

E) Ischemic phase

Answer: B) Secretory phase

Explanation: Progesterone from corpus luteum induces secretory changes post- ovulation.

📙 Q57 (July 2024) — A woman with 5 children (1 CS, 2 NVD, 2 forceps deliveries) complains of urine leakage on coughing or lifting a heavy weight. The most likely cause is: A) Pelvic organ prolapses B) Weak pelvic floor muscles C) Cystocele D) Stress urinary incontinence E) Urge urinary incontinence

Answer: D

Leakage with increased intra-abdominal pressure indicates stress incontinence.

📙 Q93 (July 2024) — Botulinum toxin injection treats an overactive bladder by: A) Stimulating acetylcholine release B) Inhibiting acetylcholine release at neuromuscular junction C) Blocking adrenergic receptors D) Enhancing detrusor muscle contractility E) Acting as a muscarinic agonist

Answer: B

Botulinum toxin blocks presynaptic acetylcholine release, relaxing bladder muscle.

📙 Q110 (July 2024) — The preferred contraceptive for a 28-year-old epileptic woman on carbamazepine is: A) Depot medroxyprogesterone acetate (DMPA) B) High-dose combined oral contraceptive pill (COCP) C) Levonorgestrel-releasing intrauterine system (Mirena) D) Implant E) Progestogen-only pill (POP)

Answer: C

*Mirena is unaffected by enzyme-inducing drugs like carbamazepine.

📙 Q128 (July 2024) — The main side effect of progestogen-only pills (POP) is: A) Deep vein thrombosis B) Hypertension C) Migraine D) Erratic bleeding E) Ectopic pregnancy

Answer: D

Irregular bleeding is common with POP use.

📙 Q129 (July 2024) — The primary mechanism of combined oral contraceptive pills (COCP) is: A) Inhibition of ovulation B) Inhibition of implantation C) Interference with ovum and sperm viability D) Local uterine inflammation E) Thickening of cervical mucus

Answer: A

COCP mainly prevent ovulation via suppression of gonadotropins.

📙 Q149 (July 2024) — A specimen showing heavy menstrual bleeding and dysmenorrhea after hysterectomy is most likely: A) Adenomyosis B) Endometriosis C) Leiomyoma D) Endometrial carcinoma E) Pelvic inflammatory disease

Answer: A

Adenomyosis causes menorrhagia and dysmenorrhea due to ectopic endometrium.

11. Other / General

📘 Q22 (January 2024) — The androgen testosterone is converted to dihydrotestosterone (DHT) by which enzyme? A) Aromatase B) 5-alpha reductase C) 17-beta hydroxysteroid dehydrogenase D) 3-beta hydroxysteroid dehydrogenase E) Sulfatase

Answer: B

5-alpha reductase converts testosterone into the more potent androgen DHT.

📘 Q82 (January 2024) — The narrowest part of the fallopian tube is? A) Infundibulum B) Ampulla C) Isthmus D) Fimbriae E) Cornu

Answer: C

The isthmus is a narrow, muscular part of the tube.

📘 Q86 (January 2024) — The enzyme responsible for ammonia production from glutamine is? A) Glutaminase B) Carbonic anhydrase C) Glutamate dehydrogenase D) Urease E) Ammonia lyase

Answer: A

Glutaminase converts glutamine into glutamate and releases ammonia.

📘 Q107 (January 2024) — Which blood cell differentiates into plasma cells? A) T lymphocytes B) B lymphocytes C) Monocytes D) Neutrophils E) Eosinophils

Answer: B

B cells mature into plasma cells that produce antibodies.

📘 Q110 (January 2024) — Cells that secrete histamine and serotonin are? A) Neutrophils B) Basophils C) Eosinophils D) Monocytes E) Lymphocytes

Answer: B

Basophils release histamine and serotonin during allergic responses.

📘 Q117 (January 2024) — In which cell cycle phase do chromatids separate to opposite poles? A) Prophase B) Metaphase C) Anaphase D) Telophase E) Interphase

Answer: C

*Sister chromatids separate during anaphase.

📘 Q158 (January 2024) — Blood groups are classified as? A) Nominal B) Ordinal C) Interval D) Ratio E) Continuous

Answer: A

Blood groups are categories without intrinsic order.

📘 Q197 (January 2024) — Vitamin deficiency causing homocysteine elevation is? A) Vitamin B6 B) Vitamin B12 C) Vitamin C D) Vitamin D E) Vitamin E

Answer: B

B12 deficiency impairs homocysteine metabolism.

📙 Q48 (July 2024) — The posterior fontanelle typically closes by: A) 3 months B) 6 months C) 9 months D) 12 months E) 18 months

Answer: A

The posterior fontanelle usually closes by 3 months of age.

📙 Q103 (July 2024) — The biologically active metabolite of vitamin D is: A) 1,25-Dihydroxycholecalciferol (calcitriol) B) 25-Hydroxyvitamin D C) Vitamin D2 (ergocalciferol) D) Vitamin D3 (cholecalciferol) E) 24,25-Dihydroxyvitamin D

Answer: A

Calcitriol is the active hormonal form regulating calcium homeostasis.

📙 Q166 (July 2024) — The ratio of T4 to T3 in the blood is approximately: A) 1:7 B) 2:1 C) 3:1 D) 7:1 E) 14:1

Answer: E

*T4 is present in much higher amounts than T3 in circulation.

📙 Q194 (July 2024) — “Country of birth” as a variable is classified as: A) Categorical B) Nominal C) Ratio D) Interval E) Ordinal

Answer: B

Country of birth is a nominal variable with no intrinsic order.

2. Embryology

📘 Q4 (January 2024) — The embryological origin of the trigone of the bladder is from which structure? A) Urogenital sinus B) Mesonephric (Wolffian) duct C) Paramesonephric (Miillerian) duct D) Allantois E) Cloaca

Answer: B

The trigone of the bladder develops from the mesonephric ducts, while the rest of the bladder arises from the urogenital sinus.

📘 Q5 (January 2024) — A Gartner’s cyst in the lateral vaginal wall originates from which embryological remnant? A) Paramesonephric duct B) Mesonephric duct C) Urachus D) Cloaca E) Allantois

Answer: B

Gariner’s cysts arise from remnants of the mesonephric (Wolffian) duct in the lateral vaginal wall.

📘 Q25 (January 2024) — Gonads contain which number of chromosomes? A) Diploid (46) B) Haploid (23) C) Triploid (69) D) Tetraploid (92) E) Aneuploid

Answer: A

Gonadal somatic cells are diploid; gametes are haploid.

📘 Q38 (January 2024) — Klinefelter syndrome features include? A) Normal stature and fertile gonads B) Short stature and hypergonadism C) Normal stature with atrophied gonads and infertility D) Tall stature with normal fertility E) Short stature and infertility

Answer: C

Klinefelter males (47, XXY) typically have tall stature, small testes, and infertility.

📘 Q53 (January 2024) — Klinefelter syndrome is characterized by? A) Short stature and normal fertility B) Normal stature with atrophied gonads and infertility C) Tall stature with normal gonads D) Female phenotype E) Gigantism

Answer: B

*47, XXY males typically have small testes and infertility. 54, Magnesium is excreted primarily by?

A. Liver metabolism

B. Kidney unchanged

C. GI tract

D. Sweat glands

E. Lungs

Answer: B. Kidney unchanged

Explanation: Kidney’s filter and excrete magnesium mostly unchanged.

📘 Q168 (January 2024) — The finding of fetal squamous cells (hair) in the lungs at autopsy indicates? A) Amniotic fluid embolism B) Meconium aspiration C) Pulmonary hypoplasia D) Neonatal pneumonia E) Congenital malformation

Answer: A

*Squamous cells in pulmonary vessels indicate amniotic fluid embolism.

📘 Q172 (January 2024) — An ovarian cyst containing hair, nails, and teeth is? A) Serous cystadenoma B) Mucinous cystadenoma C) Mature teratoma (dermoid cyst) D) Endometrioma E) Follicular cyst

Answer: C

Dermoid cysts are germ cell tumours with ectodermal elements.

📙 Q19 (July 2024) — What level of HbA1c is considered high risk for congenital anomalies, advising women not to get pregnant? A) 46 mmol/mol B) 56 mmol/mol C) 66 mmol/mol D) 76 mmol/mol E) 86 mmol/mol

Answer: E

HbA Ic levels above 86 mmol/mol (about 10%) are associated with increased risk of congenital anomalies.

📙 Q22 (July 2024) — The inner cell mass of the blastocyst is formed from: A) Epiblast and hypoblast B) Gastrulation C) Ectoderm, endoderm, and mesoderm D) Cleavage stages E) Trophoblast cells

Answer: A

The inner cell mass differentiates into the epiblast (which forms embryo proper) and hypoblast (which forms extra-embryonic tissues).

📙 Q28 (July 2024) — When is the second meiotic division completed in oocytes? A) At birth B) At fertilization C) At menarche D) At ovulation E) Before ovulation

Answer: B

The second meiotic division completes only upon fertilization by sperm.

📙 Q45 (July 2024) — The appendix of the testis originates from which embryological structure? A) Paramesonephric (Miillerian) duct B) Mesonephric (Wolffian) duct C) Urogenital sinus D) Genital tubercle E) Gonadal ridge

Answer: A

The appendix testis is a remnant of the paramesonephric duct.

📙 Q47 (July 2024) — The embryonic origin of the trigone of the bladder is: A) Ureteric bud B) Urogenital sinus C) Mesonephric duct D) Paramesonephric duct E) Cloaca

Answer: C

The trigone develops from the mesonephric duct (Wolffian duct) embryologically.

📙 Q69 (July 2024) — HLA antigens often absent in recurrent implantation failure include: A) HLA-A and HLA-B B) HLA-B and HLA-C C) HLA-C and HLA-D D) HLA-DQ and HLA-DR E) HLA-G

Answer: E

HLA-G expression is important for implantation; absence may contribute to failure.

📙 Q101 (July 2024) — The genotype of a partial hydatidiform mole is usually: A) 46, XX B) 69, XXY C) 47, XXX D) 45, X E) 46, XY

Answer: B

*Partial moles are typically triploid with 69 chromosomes.

📙 Q130 (July 2024) — The best fetal abnormality associated with warfarin use is: A) Nasal hypoplasia B) Cardiac defects C) Neural tube defects D) Limb reduction defects E) Cleft palate

Answer: A

*Warfarin embryopathy includes nasal hypoplasia and stippled epiphyses.

📙 Q153 (July 2024) — Identify the cavity surrounding the fetus in early pregnancy: A) Amniotic cavity B) Chorionic cavity C) Yolk sac D) Allantoic cavity E) Amniotic sac

Answer: A

The amniotic cavity contains amniotic fluid and surrounds the embryo/fetus.

📙 Q179 (July 2024) — The second meiotic division in oocytes is completed at: A) Birth B) Fertilization C) Menarche D) Ovulation E) Before ovulation

Answer: B

The second meiotic division completes upon fertilization.

📙 Q193 (July 2024) — The cell cycle phase immediately preceding mitosis is: A) GI phase B) G2 phase C) S phase D) M phase E) GO phase

Answer: B

*G2 is the post-DNA synthesis phase before mitosis.

📙 Q196 (July 2024) — The appendix testis develops from which embryonic structure? A) Paramesonephric (Miillerian) duct B) Mesonephric (Wolffian) duct C) Urogenital sinus D) Genital tubercle E) Gonadal ridge

Answer: A

*Appendix testis is a remnant of the Miillerian duct.

📙 Q198 (July 2024) — The embryonic origin of the trigone of the bladder is: A) Ureteric bud B) Urogenital sinus C) Mesonephric duct D) Paramesonephric duct E) Cloaca

Answer: C

The Trigone arises from mesonephric duct incorporation.

3. Genetics & Molecular Biology

📘 Q8 (January 2024) — The protective outer layer of the Graafian follicle is called? A) Theca interna B) Theca externa C) Zona pellucida D) Granulosa cells E) Corona radiata

Answer: B

The theca externa is the outer fibrous layer of the follicle providing structural support.

📘 Q37 (January 2024) — Turner syndrome karyotype is? A) 46, XX B) 47, XXY C) 45, XO D) 46, XY E) 47, XXX

Answer: C

Turner syndrome is characterized by monosomy X (45, X0).

📘 Q52 (January 2024) — Turner syndrome karyotype is? A) 47, XXY B) 45, XO C) 46, XY D) 47, XXX E) 46, XX

Answer: B

Turner syndrome results from complete or partial absence of one X chromosome.

📘 Q68 (January 2024) — Turner syndrome karyotype is? A) 46, XX B) 47, XXY C) 45, XO D) 47, XXX E) 46, XY

Answer: C

Turmer syndrome is monosomy X.

📘 Q69 (January 2024) — Klinefelter syndrome clinical features include? A) Short stature and infertility B) Normal stature and fertility C) Tall stature, small testes, and infertility D) Female phenotype E) Gigantism

Answer: C

*47, XXY males present with these features.

📘 Q90 (January 2024) — Methotrexate acts by? A) DNA alkylation B) Folate antagonist inhibiting dihydrofolate reductase C) Microtubule stabilization D) Topoisomerase inhibition E) Protein synthesis inhibition

Answer: B

*Methotrexate blocks folate metabolism required for DNA synthesis.

📘 Q101 (January 2024) — DNA nucleotides bind to which proteins to form chromatin? A) Histones B) Actin C) Myosin D) Keratin E) Collagen

Answer: A

DNA wraps around histone proteins forming nucleosomes, the basic unit of chromatin.

📘 Q114 (January 2024) — In DNA, adenine pairs with? A) Guanine B) Cytosine C) Thymine D) Uracil E) Adenine

Answer: C

*Adenine pairs with thymine via two hydrogen bonds.

📘 Q115 (January 2024) — RNA analysis is performed by which technique? A) Southern blot B) Northern blot C) Western blot D) Eastern blot E) Southwestern blot

Answer: B

Northern blot detects RNA sequences.

📘 Q118 (January 2024) — The metabolic process that produces the most energy during uterine contraction is? A) Glycolysis B) Oxidative phosphorylation C) Fermentation D) Beta-oxidation E) Gluconeogenesis

Answer: B

Aerobic metabolism provides energy for sustained contractions.

📘 Q120 (January 2024) — DNA replication occurs during which phase of the cell cycle? A) GI B) S phase C) G2 D) M phase E) Cytokinesis

Answer: B

*DNA synthesis occurs during the synthesis phase (S phase).

📘 Q128 (January 2024) — Lifetime breast cancer risk with a BRCA1 mutation is approximately? A) 25% B) 35% C) 50% D) 75% E) 90%

Answer: D

BRCA1 mutation carriers have ~75% lifetime breast cancer risk.

📘 Q143 (January 2024) — Azathioprine acts by? A) Inhibiting DNA synthesis B) Blocking RNA synthesis C) Inhibiting protein synthesis D) Stimulating RNA polymerase E) Enhancing DNA repair

Answer: B

Azathioprine is a purine analogous that inhibits RNA and DNA synthesis, suppressing immune response.

📘 Q154 (January 2024) — The largest organelle in human cells is? A) Mitochondria B) Golgi apparatus C) Nucleus D) Lysosome E) Endoplasmic reticulum

Answer: C

The nucleus houses genetic material and is the largest organelle.

📘 Q155 (January 2024) — Organelle responsible for ATP production is? A) Nucleus B) Mitochondria C) Ribosome D) Golgi apparatus E) Lysosome

Answer: B

Mitochondria generate ATP via oxidative phosphorylation.

📘 Q159 (January 2024) — Robertsonian translocation is associated with which syndromes? A) Turner and Klinefelter B) Patau and Down syndrome C) Edwards and Turner D) Klinefelter and Patau E) Down and Turner

Answer: B

*Robertsonian translocations involving chromosomes 13, 14, 15, 21, and 22 cause these syndromes.

📘 Q170 (January 2024) — The most common type of fibroid degeneration is? A) Hyaline degeneration B) Red degeneration C) Cystic degeneration D) Calcification E) Fatty degeneration

Answer: A

Hyaline change is the most frequent degenerative process in fibroids.

📘 Q184 (January 2024) — Keilhauer test detects? A) Fetal haemoglobin resistant to acid elution B) Maternal antibodies C) Platelet count D) Leukocyte count E) Reticulocytes

Answer: A

Used to detect fetal-maternal haemorrhage.

📘 Q188 (January 2024) — BRCA gene inheritance pattern is? A) Autosomal recessive B) X-linked recessive C) Autosomal dominant D) Mitochondrial E) Polygenic

Answer: C

BRCA mutations are inherited in an autosomal dominant manner.

📘 Q189 (January 2024) — In X-linked recessive inheritance, affected males transmit the allele to? A) Sons only B) Daughters only C) Both sons and daughters D) Neither sons nor daughters E) Variable

Answer: B

*Males transmit the X chromosome to daughters; sons inherit Y.

📘 Q196 (January 2024) — What vitamin is essential for DNA synthesis? A) Vitamin B12 B) Vitamin C C) Folic acid D) Vitamin D E) Vitamin K

Answer: C

Folate is necessary for nucleotide biosynthesis.

📙 Q3 (July 2024) — What is the primary mode of action of methotrexate? A) Acts as a fraudulent nucleotide B) DNA chelating agent C) Inhibition of dihydrofolate reductase D) Inhibition of thymidylate synthase E) Inhibition of topoisomerase IT

Answer: C

*Methotrexate is an antimetabolite that inhibits dihydrofolate reductase, preventing tetrahydrofolate formation essential for DNA synthesis.

📙 Q4 (July 2024) — How many genes are encoded by mitochondrial DNA? A) 12 B) 19 C) 23 D) 37 E) 58

Answer: D

Human mitochondrial DNA encodes 37 genes, including 13 proteins, 22 tRNAs, and 2 rRNAs.

📙 Q5 (July 2024) — What is the most common inherited coagulation disorder in humans? A) Haemophilia A B) Haemophilia B C) Immune thrombocytopenic purpura (ITP) D) Protein C deficiency E) Von Willebrand Disease (VWD)

Answer: E

VWD is the most common inherited bleeding disorder caused by a deficiency or dysfunction of von Willebrand factor.

📙 Q7 (July 2024) — In DNA base pairing, which base pairs with adenosine? A) Adenine B) Cytosine C) Guanine D) Thymine E) Uracil

Answer: D

In DNA, adenine pairs with thymine via two hydrogen bonds.

📙 Q9 (July 2024) — How many telomeres are present on chromosomes during metaphase?

C6 A) 2 B) 4 D) 8 E) 10

Answer: B

*Each chromosome has two arms; each arm has one telomere, so a single chromosome has two telomeres. During metaphase, chromosomes are duplicated, resulting in 4 telomeres per chromosome pair.

📙 Q12 (July 2024) — CRISPR/Cas9 gene editing technology consists of: A) Enzyme-enzyme interaction B) DNA-enzyme interaction C) DNA-transcription factor interaction D) Enzyme-DNA interaction E) Protein-protein interaction

Answer: C

*CRISPR/Cas9 uses a guide RNA to direct Cas9 (an enzyme) to target specific DNA sequences, acting somewhat like a transcription factor targeting DNA.

📙 Q21 (July 2024) — Zika virus is classified as: A) Single-stranded RNA (ssRNA) B) Single-stranded DNA (ssDNA) C) Double-stranded RNA (dsRNA) D) Double-stranded DNA (dsDNA) E) Retrovirus

Answer: A

*Zika virus is a single-stranded RNA flavivirus transmitted by mosquitoes.

📙 Q32 (July 2024) — 90% of cases of congenital adrenal hyperplasia (CAH) are caused by a mutation in the CYP21 gene, located on which chromosome? A) 6 B) 10 C) 14 D) 18 E) 22

Answer: A

The CYP21 gene coding 21-hydroxylase is located on chromosome

📙 Q34 (July 2024) — The protective outer layer surrounding the Graafian follicle is the: A) Theca externa B) Theca interna C) Zona pellucida D) Corona radiata E) Cumulus oophorus

Answer: A

The theca externa is a fibrous connective tissue layer protecting the follicle.

📙 Q56 (July 2024) — A 32-year-old pregnant woman has an anomaly scan at 20 weeks showing clenched hands, low-set ears, and rocker-bottom feet. The most likely diagnosis is: A) Gilbert syndrome B) Patau syndrome C) Edward syndrome D) Down syndrome E) Turner syndrome

Answer: C

These features are classic for Trisomy 18.

📙 Q60 (July 2024) — Syndrome with complete or partial absence of one X chromosome is: A) Turner syndrome B) Down syndrome C) Edward syndrome D) Patau syndrome E) Kiinefelter syndrome

Answer: A

Tumer syndrome results from monosomy X (45,X).

📙 Q61 (July 2024) — Robertsonian translocations involve which chromosomes? A) 11, 12, 13, 14, 15 B) 13, 14, 15, 21, 22 C) 21, 22, 23, 24, 25 D) 14, 15, 16, 17, 18 E) 1, 2,3,4,5

Answer: B

*Robertsonian translocations commonly occur between acrocentric chromosomes 13,14,15,21, and 22.

📙 Q68 (July 2024) — Metronidazole acts by: A) Covalent binding to microbial DNA B) Inhibiting cell wall synthesis C) Inhibiting folate synthesis D) Blocking protein synthesis E) Disrupting bacterial membranes

Answer: A

Metronidazole causes DNA strand breaks by covalent binding in anaerobic bacteria.

📙 Q99 (July 2024) — The most common cause of delayed puberty in males is: A) Idiopathic constitutional delay B) Gonadal dysgenesis with normal karyotype C) Kallmann syndrome D) Kiinefelter syndrome E) Orchitis

Answer: A

Most cases of delayed puberty are constitutional and benign.

📙 Q102 (July 2024) — Duchenne muscular dystrophy inheritance is: A) Autosomal dominant B) Autosomal recessive C) X-linked recessive D) X-linked dominant E) Mitochondrial inheritance

Answer: C

Duchenne dystrophy is inherited via an X-linked recessive pattern.

📙 Q104 (July 2024) — The progesterone receptor is: A) Nuclear transcription factor receptor B) Membrane receptor C) G-protein coupled receptor D) Ion channel receptor E) Tyrosine kinase receptor

Answer: A

*Progesterone acts through intracellular nuclear receptors regulating gene transcription.

📙 Q116 (July 2024) — The Kleihauer test identifies:

A) Degree of fetomaternal haemorrhage
B) Fetal Rh status
C) Maternal Rh status
D) Fetal haemolysis
E) Maternal haemoglobin level

Answer: A

It quantifies fetal red cells in maternal blood.

📙 Q117 (July 2024) — Second-generation progesterone used in contraception is: A) Levonorgestrel B) Norethisterone C) Desogestrel D) Drospirenone E) Medroxyprogesterone

Answer: A

Levonorgestrel is a second-generation synthetic progestogen.

📙 Q143 (July 2024) — Northern blot analysis detects: A) RNA B) DNA C) Protein D) Lipids E) Carbohydrates

Answer: A

Northern blotting is used to detect specific RNA sequences.

📙 Q151 (July 2024) — Autosomal dominant inheritance is characteristic of which condition? A) Huntington’s disease B) Cystic fibrosis C) Duchenne muscular dystrophy D) Haemophilia A E) Sickle cell anaemia

Answer: A

*Huntington’s disease is inherited in an autosomal dominant pattern.

📙 Q155 (July 2024) — The most common cause of inherited coagulation disorder is: A) Haemophilia A B) Von Willebrand Disease (VWD) C) Haemophilia B D) Protein C deficiency E) Factor V Leiden

Answer: B

VWD is the most common inherited bleeding disorder.

📙 Q158 (July 2024) — The main mechanism of action of methotrexate is: A) DNA chelation B) Thymidylate synthase inhibition C) Dihydrofolate reductase inhibition D) Topoisomerase II inhibition E) Fraudulent nucleotide incorporation

Answer: C

Methotrexate blocks tetrahydrofolate production, inhibiting DNA synthesis.

📙 Q159 (July 2024) — The DNA base pairing with adenine is: A) Guanine B) Thymine C) Cytosine D) Uracil E) Adenine

Answer: B

Adenine pairs with thymine via two hydrogen bonds in DNA.

📙 Q163 (July 2024) — The gene-editing technology CRISPR/Cas9 involves: A) Enzyme-enzyme interaction B) DNA-enzyme interaction C) DNA-transcription factor interaction D) Enzyme-DNA interaction E) Protein-protein interaction

Answer: B

*The Cas9 enzyme, guided by RNA, cleaves specific DNA sequences.

📙 Q172 (July 2024) — Zika virus belongs to which category of viruses? A) Single-stranded RNA (ssRNA) B) Single-stranded DNA (ssDNA) C) Double-stranded RNA (dsRNA) D) Double-stranded DNA (dsDNA) E) Retrovirus

Answer: A

*Zika virus is an ssRNA flavivirus transmitted by mosquitoes.

📙 Q183 (July 2024) — The CYP21 gene mutation, causing 90% of congenital adrenal hyperplasia, is located on chromosome: A) 6 B) 10 C) 14 D) 18 E) 22

Answer: A

The CYP21 gene is on chromosome 6.

📙 Q185 (July 2024) — The outer protective layer of the Graafian follicle is: A) Theca externa B) Theca interna C) Zona pellucida D) Corona radiata E) Cumulus oophorus

Answer: A

Theca externa is the fibrous connective tissue layer surrounding the follicle.

4. Physiology

📘 Q14 (January 2024) — Antidiuretic hormone (ADH) is secreted from which hypothalamic nuclei? A) Arcuate and suprachiasmatic B) Supraoptic and paraventricular C) Ventromedial and lateral hypothalamic D) Dorsomedial and posterior hypothalamic E) Mammillary and tuberomammillary

Answer: B

ADH is produced by neurons in the supraoptic and paraventricular nuclei of the hypothalamus.

📘 Q24 (January 2024) — Which renal tubule segment absorbs bicarbonate (HCO3-) primarily? A) Proximal convoluted tubule (PCT) B) Loop of Henle C) Distal convoluted tubule D) Collecting duct E) Thick ascending limb

Answer: A

*The majority of bicarbonate reabsorption occurs in the PCT.

📘 Q27 (January 2024) — The major buffer system in urine is? A) Bicarbonate B) Phosphate C) Ammonia D) Protein E) Sulfate

Answer: B

*Phosphate acts as the primary urinary buffer, helping to maintain pH.

📘 Q28 (January 2024) — Which hormone regulates sodium (Na+) levels in the body? A) Antidiuretic hormone B) Aldosterone C) Cortisol D) Parathyroid hormone E) Insulin

Answer: B

Aldosterone increases sodium reabsorption in the distal nephron.

📘 Q29 (January 2024) — Gonadotropin-releasing hormone (GnRH) is a? A) Monopeptide B) Decapeptide C) Polypeptide (>50 amino acids) D) Steroid hormone E) Amino acid derivative

Answer: B

GnRH is a peptide hormone composed of 10 amino acids.

📘 Q30 (January 2024) — Renin is classified as a? A) Enzyme B) Protein hormone C) Steroid hormone D) Lipid E) Amino acid derivative

Answer: A

*Renin is an enzyme that catalyzes the conversion of angiotensinogen to angiotensin I.

📘 Q31 (January 2024) — The most common cause of secondary hyperparathyroidism is? A) Primary hyperplasia of the parathyroid B) Chronic renal failure C) Vitamin D intoxication D) Parathyroid adenoma E) Malignancy

Answer: B

Renal failure leads to hypocalcaemia and compensatory secondary hyperparathyroidism.

📘 Q32 (January 2024) — In pregnancy, the typical acid-base status is? A) Respiratory acidosis B) Metabolic acidosis C) Respiratory alkalosis D) Metabolic alkalosis E) Mixed acidosis

Answer: C

Pregnancy induces a mild respiratory alkalosis due to hyperventilation.

📘 Q42 (January 2024) — The hormone responsible for sodium regulation is? A) Aldosterone B) Antidiuretic hormone C) Cortisol D) Parathyroid hormone E) Renin

Answer: A

*Aldosterone increases sodium reabsorption in renal tubules, regulating body sodium levels.

📘 Q43 (January 2024) — GnRH (Gonadotropin-releasing hormone) is classified as? A) Monopeptide B) Decapeptide C) Polypeptide (>50 amino acids) D) Steroid hormone E) Amino acid derivative

Answer: B

GoRH consists of 10 amino acids and stimulates the release of LH and FSH.

📘 Q44 (January 2024) — Renin is a? A) Protein hormone B) Enzyme C) Steroid hormone D) Neurotransmitter E) Peptide hormone

Answer: B

Renin is an enzyme that initiates the renin-angiotensin-aldosterone system.

📘 Q45 (January 2024) — The most common cause of secondary hyperparathyroidism is? A) Vitamin D intoxication B) Chronic renal failure C) Parathyroid adenoma D) Malnutrition E) Hypercalcemia

Answer: B

*Kidney failure reduces phosphate excretion and vitamin D activation, leading to secondary hyperparathyroidism.

📘 Q46 (January 2024) — The most common cause of Cushing syndrome is? A) Adrenal adenoma B) Pituitary adenoma (Cushing’s disease) C) Iatrogenic glucocorticoid administration D) Ectopic ACTH secretion E) Adrenal carcinoma

Answer: C

Exogenous steroid use is the leading cause of Cushing syndrome.

📘 Q47 (January 2024) — The typical acid-base disturbance in pregnancy is? A) Metabolic acidosis B) Respiratory alkalosis C) Metabolic alkalosis D) Respiratory acidosis E) Mixed acid-base disorder

Answer: B

Pregnancy causes increased ventilation, lowering CO2 and causing mild respiratory alkalosis.

📘 Q57 (January 2024) — The major urinary buffer system is? A) Bicarbonate B) Phosphate C) Ammonia D) Protein E) Sulfate

Answer: B

*Phosphate buffers urine pH to maintain acid-base balance.

📘 Q58 (January 2024) — The hormone responsible for sodium regulation in the kidney is? A) ADH B) Aldosterone C) Cortisol D) Insulin E) Renin

Answer: B

Aldosterone increases sodium reabsorption in the distal tubule and collecting duct.

📘 Q59 (January 2024) — GnRH is a? A) Steroid hormone B) Decapeptide C) Polypeptide (50 AA) D) Amino acid derivative E) Lipid molecule

Answer: B

GnRH consists of 10 amino acids.

📘 Q60 (January 2024) — Renin is an example of a? A) Protein hormone B) Steroid hormone C) Enzyme D) Neurotransmitter E) Vitamin

Answer: C

*Renin catalyzes conversion of angiotensinogen to angiotensin I.

📘 Q61 (January 2024) — The most common cause of secondary hyperparathyroidism is? A) Chronic renal failure B) Parathyroid adenoma C) Vitamin D intoxication D) Hypercalcemia E) Malnutrition

Answer: A

Renal failure causes phosphate retention and low vitamin D, leading to increased parathyroid hormone secretion.

📘 Q62 (January 2024) — The most common cause of Cushing syndrome is? A) Pituitary adenoma B) Ectopic ACTH secretion C) Iatrogenic glucocorticoid administration D) Adrenal carcinoma E) Adrenal adenoma

Answer: C

Exogenous corticosteroid therapy is the leading cause of Cushing syndrome worldwide.

📘 Q63 (January 2024) — Which acid-base disturbance is typical in pregnancy? A) Metabolic acidosis B) Respiratory alkalosis C) Metabolic alkalosis D) Respiratory acidosis E) Mixed disorder

Answer: B

*Increased minute ventilation lowers arterial CO2 causing mild respiratory alkalosis.

📘 Q73 (January 2024) — Major urinary buffer is? A) Bicarbonate B) Phosphate C) Ammonia D) Protein E) Sulfate

Answer: B

Phosphate buffers urinary pH effectively.

📘 Q74 (January 2024) — The hormone regulating sodium in the kidneys is? A) ADH B) Aldosterone C) Cortisol D) Insulin E) Renin

Answer: B

Aldosterone promotes sodium reabsorption.

📘 Q75 (January 2024) — GnRH is a? A) Steroid hormone B) Decapeptide C) Polypeptide (>50 amino acids) D) Amino acid derivative E) Lipid molecule

Answer: B

*GnRH is a 10-amino-acid peptide.

📘 Q76 (January 2024) — Renin is? A) Protein hormone B) Steroid hormone C) Enzyme D) Neurotransmitter E) Vitamin

Answer: C

Renin catalyzes angiotensinogen to angiotensin I.

📘 Q77 (January 2024) — Most common cause of secondary hyperparathyroidism? A) Vitamin D intoxication B) Chronic renal failure C) Parathyroid adenoma D) Malnutrition E) Hypercalcemia

Answer: B

Kidney disease leads to increased PTH secretion.

📘 Q78 (January 2024) — Most common cause of Cushing syndrome? A) Pituitary adenoma B) Ectopic ACTH secretion C) Iatrogenic glucocorticoid use D) Adrenal carcinoma E) Adrenal adenoma

Answer: C

*Steroid therapy is the main cause.

📘 Q79 (January 2024) — Typical acid-base change in pregnancy? A) Metabolic acidosis B) Respiratory alkalosis C) Metabolic alkalosis D) Respiratory acidosis E) Mixed disorder

Answer: B

Hyperventilation causes low CO2.

📘 Q87 (January 2024) — The buffer enzyme that helps in blood COZ transport is? A) Carbonic anhydrase B) Glutaminase C) Lactate dehydrogenase D) Cytochrome oxidase E) Catalase

Answer: A

*It catalyzes conversion of CO2 and water to carbonic acid, facilitating CO2 transport.

📘 Q94 (January 2024) — Which type of cell junction allows transmission of small molecules between cells? A) Tight junction B) Gap junction C) Desmosomes D) Hemidesmosomes E) Adherents junctions

Answer: B

Gap junctions permit small-molecule passage between adjacent cells.

📘 Q96 (January 2024) — Syndrome with bilateral hilar vascular markings, mild pleural effusion, and hyponatremia (Na+ 110 mmol/L) is? A) SIADH B) Heart failure C) Nephrotic syndrome D) Cirrhosis E) Hypothyroidism

Answer: A

*The Syndrome of inappropriate ADH causes water retention leading to hyponatremia.

📘 Q98 (January 2024) — A patient with pH 7.1, low bicarbonate, and decreased PCO2 likely has? A) Metabolic acidosis with respiratory compensation B) Metabolic alkalosis C) Respiratory acidosis D) Respiratory alkalosis E) Normal acid-base

Answer: A

Low pH and bicarbonate with decreased PCO2 indicate compensation.

📘 Q106 (January 2024) — Advice for a hepatitis B-positive mother regarding breastfeeding? A) Breastfeed and avoid nipple cracks B) Avoid breastfeeding C) Use the formula only D) Breastfeed without restrictions E) Stop breastfeeding if the infant is infected

Answer: A

Breastfeeding is safe unless the nipple is cracked to reduce transmission risk.

📘 Q112 (January 2024) — A simple follicular cyst seen on ultrasound measures 4.3 x 3.3 x 4.6 cm. What is the diagnosis? A) Complex ovarian cyst B) Simple follicular cyst C) Dermoid cyst D) Endometrioma E) Hydrosalpinx

Answer: B

Simple cysts are thin-walled and anechoic on ultrasound.

📘 Q130 (January 2024) — ACE inhibitors affect which organ primarily? A) Liver B) Kidney C) Lung D) Heart E) Brain

Answer: B

ACE inhibitors reduce angiotensin II, affecting renal vasculature and function.

📘 Q135 (January 2024) — Lithium use in pregnancy is associated with? A) Ebstein anomaly B) Neural tube defects C) Cleft palate D) Cardiac septal defects E) Renal agenesis

Answer: A

*Lithium increases the risk of Ebstein anomaly (tricuspid valve malformation).

📘 Q138 (January 2024) — Paroxetine is teratogenic to which organ system? A) CNS B) Cardiovascular system C) Renal system D) Musculoskeletal system E) Gastrointestinal system

Answer: B

*Paroxetine exposure in pregnancy has been linked to cardiac defects.

📘 Q141 (January 2024) — Tranexamic acid’s mechanism of action is? A) Anticoagulant B) Antifibrinolytic C) Platelet inhibitor D) Vitamin K antagonist E) Thrombolytic

Answer: B

*Tranexamic acid inhibits plasminogen activation, preventing fibrin degradation.

📘 Q142 (January 2024) — The normal percentage of free T4 hormone in blood is approximately? A) 0.01% B) 0.1% C) 1% D) 10% E) 50%

Answer: B

About 0.1% of circulating T4 is free and biologically active.

📘 Q161 (January 2024) — The epithelial lining of the urinary bladder is? A) Stratified squamous epithelium B) Transitional epithelium C) Simple cuboidal epithelium D) Columnar epithelium E) Pseudostratified epithelium

Answer: B

The urinary bladder is lined by transitional epithelium, allowing distension.

📘 Q162 (January 2024) — The epithelium lining the endometrium is? A) Stratified squamous epithelium B) Transitional epithelium C) Simple columnar epithelium D) Simple cuboidal epithelium E) Pseudostratified epithelium

Answer: C

*The endometrial lining is composed of simple columnar epithelial cells.

📘 Q169 (January 2024) — Choriocarcinoma spreads primarily by? A) Lymphatic spread B) Hematogenous spread C) Direct extension D) Transcoelomic spread E) Perineural invasion

Answer: B

Choriocarcinoma is highly vascular and metastasizes through the bloodstream.

📘 Q171 (January 2024) — Is the type of endometrium present before ovulation? A) Secretory B) Proliferative C) Menstrual D) Atrophic E) Decidual

Answer: B

*The endometrium thickens under estrogen influence before ovulation,

📘 Q186 (January 2024) — Colposcopy uses which physical principle? A) Low-density current B) High-density current C) UV light D) Infrared radiation E) X-rays

Answer: B

*Electrosurgical colposcopy uses high-frequency electrical current.

📘 Q190 (January 2024) — A 50-year-old patient underwent hysterectomy with vaginal repair, has uterine output 300 ml, increased urea and creatinine. The likely cause is? A) Dehydration B) Infection C) Renal failure D) Haemorrhage E) Cardiac failure

Answer: A

Low output and raised renal markers suggest a pre-renal cause, often dehydration.

📘 Q191 (January 2024) — Parathyroid hormone is secreted by which cells? A) Chief cells B) Oxyphil cells C) Follicular cells D) Parafollicular cells E) Beta cells

Answer: A

Chief cells produce parathyroid hormone, regulating calcium.

📘 Q192 (January 2024) — Prolactin secretion is inhibited by? A) Dopamine B) Serotonin C) Acetylcholine D) GABA E) Norepinephrine

Answer: A

*Dopamine inhibits prolactin release from anterior pituitary.

📘 Q194 (January 2024) — The commonest cause of hypothyroidism worldwide is? A) Iodine deficiency B) Hashimoto thyroiditis C) Thyroidectomy D) Radiation E) Congenital

Answer: A

Globally, iodine deficiency is the leading cause of hypothyroidism.

📙 Q1 (July 2024) — By how much does the glomerular filtration rate (GFR) increase during pregnancy? A) 0-10% B) 15-20% C) 30-40% D) 50-60% E) 80-90%

Answer: C

GFR increases by approximately 30-40% during pregnancy due to increased renal plasma flow and changes in hormonal regulation, facilitating enhanced clearance of waste products.

📙 Q8 (July 2024) — How are amino acids transported across the placenta between mother and fetus? A) Active transport B) Direct hematogenous transfer C) Facilitated diffusion D) Passive diffusion E) Receptor-mediated endocytosis

Answer: A

Amino acids are transported actively against a concentration gradient through specific transporters in the placenta.

📙 Q14 (July 2024) — Which lung volume decreases during pregnancy? A) Functional residual capacity FRC) B) Minute ventilation (MV) C) Peak flow rate (PFR) D) Tidal volume (TV) E) Vital capacity (VC)

Answer: A

FRC decreases due to the upward displacement of the diaphragm by the enlarging uterus.

📙 Q15 (July 2024) — What is the ratio of T4 to T3 in blood? A) 1:7 B) 2:1 C) 3:1 D) 7:1 E) 14:1

Answer: E

*The blood contains about 14 times more T4 than T3, but T3 is the more biologically active thyroid hormone.

📙 Q16 (July 2024) — What causes hyperprolactinemia in PCOS? A) Unopposed estrogen B) Opposed estrogen C) Pituitary adenoma D) Hypothyroidism E) Dopamine antagonist drugs

Answer: A

Chronic anovulation in PCOS leads to unopposed estrogen, stimulation, increasing prolactin secretion.

📙 Q17 (July 2024) — What percentage of pituitary cells are lactotrophs? A) 10-15% B) 20-25% C) 30-35% D) 40-45% E) 50-55%

Answer: A

Lactotrophs comprise about 10-15% of anterior pituitary cells and secrete prolactin.

📙 Q18 (July 2024) — What stimulates aldosterone release from the adrenal cortex? A) Angiotensin II B) Renin C) Angiotensin I D) ACTH E) Potassium

Answer: A

*Aldosterone secretion is primarily stimulated by angiotensin II as part of the renin-angiotensin-aldosterone system.

📙 Q26 (July 2024) — Androgens are secreted primarily from which adrenal cortex zone? A) Zona reticularis B) Zona glomerulosa C) Zona fasciculata D) Adrenal medulla E) Zona intermedia

Answer: A

*The zona reticularis is the innermost layer of the adrenal cortex and secretes androgens.

27, How does progesterone act as an anti-estrogen at the cellular level? A) Reduces synthesis of estrogen receptor

B) Reduces estrone activity

C) Inactivates estrogen receptor

D) Methylates estrogen

E) Inhibits aromatase

Answer: A) Reduces synthesis of estrogen receptor

Explanation: Progesterone downregulates estrogen receptor expression, reducing estrogen's effects.

📙 Q31 (July 2024) — Thyrotropin-releasing hormone (TRH) is a: A) Decapeptide B) Tripeptide C) Polypeptide D) Octapeptide E) Pentapeptide

Answer: B

TRH is a tripeptide hormone that stimulates the release of TSH and prolactin.

📙 Q35 (July 2024) — Growth hormone secretion shows a circadian rhythm with the highest peak during: A) Early morning B) After exercise C) Afternoon D) Early sleep E) Deep sleep

Answer: D

*Growth hormone secretion peaks shortly after sleep onset, during early slow-wave sleep.

📙 Q38 (July 2024) — The difference between jejunum and ileum includes: with short arcades shorter with long arcades with short arcades

A) Jejunum is thin-walled, longer, with long arcades; ileum is thick-walled, shorter
B) Jejunum is thin-walled, longer, with short arcades; ileum is thick-walled,
C) Jejunum is thick-walled, shorter with long arcades; ileum is thin-walled, longer
D) Jejunum and ileum have similar walls and arcades
E) Jejunum is more vascular than ileum

Answer: C

Jejunum has thicker walls and longer arterial arcades, while ileum has thinner walls and shorter arcades.

📙 Q59 (July 2024) — The SI unit for measuring radioactivity is: A) Gray B) Sievert C) Rad D) Roentgen E) Becquerel

Answer: E

Becquerel measures radioactive decay (disintegrations per second).

📙 Q62 (July 2024) — According to RCOG, grade B recommendation corresponds to: A) Randomized controlled trials (RCT) without meta-analysis B) Expert opinion C) Well-controlled study without randomization D) Well-designed controlled study with or without randomization E) Meta-analysis of RCTs

Answer: C

Grade B evidence is from well-controlled non-randomized studies.

📙 Q64 (July 2024) — Hyperventilation during panic attack causes: A) Respiratory alkalosis B) Respiratory acidosis C) Metabolic acidosis D) Metabolic alkalosis E) Normal blood gases

Answer: A

*Hyperventilation lowers CO2, leading to respiratory alkalosis.

📙 Q65 (July 2024) — Major histocompatibility complex (MHC) class I antigens NOT expressed by extravillous cytotrophoblasts include: A) HLA-A and HLA-B B) HLA-B and HLA-C C) HLA-C and HLA-D D) HLA-G E) HLA-DQ and HLA-DR

Answer: A

Extravillous trophoblasts lack HLA-A and HLA-B but express HLA-C and HLA-G.

📙 Q71 (July 2024) — The typical endometrial pattern seen in granulosa cell tumors is: A) Luteal phase B) Secretory phase C) Proliferative phase D) Atrophic E) Hyperplastic

Answer: C

Granulosa cell tumours secrete estrogen, causing proliferative endometrium.

📙 Q73 (July 2024) — What percentage of Leydig cell tumours of the ovary are malignant? A) 5-10% B) 15-20% C) 25-30% D) 35-40% E) 45-50%

Answer: A

*Leydig cell tumours have low malignant potential (~5-10%).

74, The primary pathology causing renal damage in pre-eclampsia is: A) Glomerulonephritis

B) Vascular endothelial injury

C) Pyelonephritis

D) Tubular necrosis

E) Interstitial nephritis

Answer: B) Vascular endothelial injury

Explanation: Endothelial dysfunction leads to glomerular damage and proteinuria.*

📙 Q100 (July 2024) — The most common cause of hyperthyroidism is: A) Graves' disease B) Hashimoto thyroiditis C) Toxic multinodular goiter D) Thyroid adenoma E) Thyroiditis

Answer: A

Graves’ disease is the leading cause of hyperthyroidism.

📙 Q105 (July 2024) — A woman with secondary amenorrhea and high FSH, LH, and TSH on repeated tests most likely has: A) Polycystic ovarian syndrome (PCOS) B) Premature ovarian insufficiency (POD C) Kallmann syndrome D) Sheehan syndrome E) Hypothyroidism

Answer: B

High gonadotropins indicate ovarian failure in POI.

📙 Q113 (July 2024) — Ultrasound causes tissue lysis primarily by:

A) Cavitation
B) Reflection
C) Scatter
D) Heating
E) Absorption

Answer: A

Cavitation causes microbubble formation and collapse leading to cell damage.

📙 Q124 (July 2024) — A woman has Hb 11 g/dL, MCV 65 fl, ferritin 97 ug/L, and CRP 78 mg/L. The likely deficiency is: A) Vitamin B12 deficiency B) Folate deficiency C) Iron deficiency D) Lead poisoning E) Hypothyroidism

Answer: C

*Low MCV with normal/high ferritin but raised CRP suggests functional iron deficiency.

📙 Q131 (July 2024) — Iodine uptake into thyroid cells is co-transported with: A) Sodium B) Magnesium C) Chloride D) Potassium E) Calcium

Answer: A

Iodide is transported into thyroid follicular cells by a sodium-iodide symporter.

📙 Q139 (July 2024) — Which analgesic should NOT be given to breastfeeding mothers? A) Tramadol B) Naproxen C) Morphine D) Paracetamol E) Ibuprofen

Answer: A

*Tramadol is contraindicated due to risk of neonatal respiratory depression.

📙 Q142 (July 2024) — The steroidogenesis pathway includes: A) DHEA — androstenedione — testosterone B) Cholesterol -- DHEA — cortisol C) Progesterone — aldosterone — cortisol D) Testosterone — estradiol — cortisol E) DHEA — progesterone — aldosterone

Answer: A

*DHEA is converted to androstenedione, which is converted to testosterone.

📙 Q147 (July 2024) — The major urinary buffer is: A) Phosphate B) Chloride C) Sodium D) Potassium E) Bicarbonate

Answer: A

Phosphate acts as a major urinary buffer to maintain acid-base balance.

📙 Q152 (July 2024) — Identify the structure: a yellowish hormone-secreting ovarian structure present after ovulation. A) Corpus luteum B) Corpus albicans C) Graafian follicle D) Primordial follicle E) Theca interna

Answer: A

Corpus luteum forms from the ruptured follicle and secretes progesterone.

📙 Q154 (July 2024) — Which lung volume decreases during pregnancy? A) Functional residual capacity (FRC) B) Tidal volume (TV) C) Minute ventilation (MV) D) Peak expiratory flow rate (PEFR) E) Vital capacity (VC)

Answer: A

*Diaphragmatic elevation reduces FRC in pregnancy.

📙 Q165 (July 2024) — Which lung volume decreases during pregnancy? A) Functional residual capacity (FRC) B) Minute ventilation (MV) C) Peak flow rate (PFR) D) Tidal volume (TV) E) Vital capacity (VC)

Answer: A

The upward displacement of the diaphragm reduces FRC.

📙 Q167 (July 2024) — Causes of hyperprolactinemia in PCOS include: A) Unopposed estrogen B) Opposed estrogen C) Pituitary adenoma D) Dopamine agonists E) Hypothyroidism

Answer: A

Chronic anovulation in PCOS results in unopposed estrogen, raising prolactin.

📙 Q168 (July 2024) — Lactotroph cells comprise what percentage of anterior pituitary? A) 10-15% B) 20-25% C) 30-35% D) 40-45% E) 50-55%

Answer: A

Lactotrophs represent about 10-15% of anterior pituitary cells.

📙 Q169 (July 2024) — Aldosterone release from adrenal cortex is primarily stimulated by: A) Angiotensin II B) Renin C) Angiotensin I D) ACTH E) Potassium

Answer: A

*Angiotensin II directly stimulates zona glomerulosa aldosterone secretion.

📙 Q170 (July 2024) — An HbAIc level considered too high for pregnancy, advising against conception, is approximately: A) 46 mmol/mol B) 56 mmol/mol C) 66 mmol/mol D) 76 mmol/mol E) 86 mmol/mol

Answer: E

HbA lc >86 mmol/mol (~10%) is associated with increased fetal anomaly risk.

📙 Q173 (July 2024) — The inner cell mass of the blastocyst consists of: A) Epiblast and hypoblast B) Gastrulation layer C) Ectoderm, mesoderm, and endoderm D) Trophoblast cells E) Syncytiotrophoblast

Answer: A

The inner cell mass differentiates into the epiblast and hypoblast layers.

📙 Q177 (July 2024) — Androgens are secreted by which adrenal cortex layer? A) Zona reticularis B) Zona glomerulosa C) Zona fasciculata D) Medulla E) Zona intermedia

Answer: A

The zona reticularis secretes androgens.

📙 Q182 (July 2024) — Thyrotropin-releasing hormone (TRH) is a: A) Decapeptide B) Tripeptide C) Polypeptide D) Octapeptide E) Pentapeptide

Answer: B

TRH is a tripeptide hormone stimulates TSH release.

📙 Q186 (July 2024) — Peak growth hormone secretion occurs during: A) Early morning B) Post-exercise C) Afternoon D) Early sleep E) Deep sleep

Answer: D

GH peaks shortly after sleep onset during slow-wave sleep.

📙 Q189 (July 2024) — The difference between the jejunum and the ileum includes: A) Jejunum has long arterial arcades, ileum has short arcades B) Jejunum is thick-walled, ileum is thin-walled C) Jejunum has more lymphoid tissue D) Jejunum is shorter than ileum E) Both have the same wall thickness

Answer: A

Jejunum has longer vasa recta and fewer arcades.

5. Pharmacology

📘 Q23 (January 2024) — The hormone responsible for glucose metabolism regulation in the fetus is? A) Insulin B) Human placental lactogen (HPL) C) Cortisol D) Thyroxine E) Progesterone

Answer: B

HPL alters maternal glucose metabolism to increase glucose availability for the fetus.

📘 Q33 (January 2024) — Breast milk contains which of the following carbohydrates? A) Lactose B) Lactulose C) Maltose D) Sucrose E) Glucose

Answer: A

*Lactose is the main sugar in breast milk, providing energy for the infant.

34, Which prostaglandin increases during the menstrual cycle?

A. PGE1

B. PGE2

C. PGF2a

D. PGI2

E. Thromboxane A2

Answer: C. PGF2a,

Explanation: PGF 2c increases during menstruation and induces uterine contractions.*

📘 Q39 (January 2024) — Magnesium is primarily excreted by? A) Liver B) Kidney unchanged C) Intestine D) Sweat glands E) Lungs

Answer: B

*Magnesium is mostly excreted by the kidneys in an unchanged form.

📘 Q41 (January 2024) — The cause of female urethral caruncle is most commonly? A) Hyperestrogenism B) Hypoestrogenism C) Infection D) Trauma E) Allergic reaction

Answer: B

Urethral caruncles often occur in postmenopausal women due to estrogen deficiency, causing mucosal atrophy.

📘 Q49 (January 2024) — Which prostaglandin increases during the menstrual cycle? A) PGE1 B) PGF2a, C) PGI2 D) Thromboxane A2 E) Leukotriene B4

Answer: B

PGF2c. causes uterine contractions and vasoconstriction during menstruation.

📘 Q56 (January 2024) — The most common cause of female urethral caruncle is? A) Trauma B) Hypoestrogenism C) Infection D) Allergic reaction E) Malignancy

Answer: B

Estrogen deficiency leads to mucosal atrophy, causing caruncles.

📘 Q70 (January 2024) — Magnesium is excreted mainly by? A) Liver B) Kidney unchanged C) GI tract D) Sweat glands E) Lungs

Answer: B

Kidney’s filter and excrete magnesium largely unchanged.

📘 Q72 (January 2024) — The major cause of female urethral caruncle is? A) Trauma B) Hypoestrogenism C) Infection D) Allergic reaction E) Malignancy

Answer: B

*Estrogen deficiency causes mucosal atrophy, leading to caruncle formation.

📘 Q84 (January 2024) — The hormone responsible for ovulation inhibition in DMPA contraceptive is? A) Estrogen B) Progesterone C) Gonadotropin-releasing hormone D) Progestogen E) Testosterone

Answer: D

*DMPA contains medroxyprogesterone acetate (a progestogen) that inhibits ovulation.

📘 Q85 (January 2024) — The mechanism of action of Atosiban is? A) Oxytocin antagonist B) Prostaglandin inhibitor C) Beta-2 agonist D) Calcium channel blocker E) NSAID

Answer: A

Atosiban inhibits oxytocin receptors to delay labour.

📘 Q92 (January 2024) — Suxamethonium does not cross the placenta because of? A) High ionization B) Large molecular weight C) Lipid insolubility D) Protein binding E) Rapid metabolism

Answer: A

Ionized drugs poorly cross lipid membranes like the placenta.

📘 Q99 (January 2024) — What hormone decreases appetite? A) Ghrelin B) Leptin C) Insulin D) Cortisol E) Thyroxine

Answer: B

*Leptin signals satiety and suppresses hunger.

📘 Q102 (January 2024) — Nifedipine’s mechanism of action is? A) Beta-2 agonist B) Calcium channel blocker C) ACE inhibitor D) Alpha blocker E) Diuretic

Answer: B

*Nifedipine inhibits L-type calcium channels, causing vasodilation.

📘 Q105 (January 2024) — Which drag is contraindicated in pregnancy? A) Paracetamol B) Sulphonamides C) Insulin D) Metformin E) Penicillin

Answer: B

*Sulphonamides can cause kernicterus and are avoided, especially near term.

📘 Q109 (January 2024) — Iodine uptake in thyroid cells occurs via symport with? A) Potassium B) Sodium C) Chloride D) Calcium E) Magnesium

Answer: B

The sodium-iodide symporter transports iodine into thyroid cells.

📘 Q113 (January 2024) — The main intracellular cation is? A) Sodium B) Potassium C) Calcium D) Magnesium E) Chloride

Answer: B

Potassium is the major intracellular positive ion.

📘 Q119 (January 2024) — Most eicosanoids are derived from which parent compound? A) Linoleic acid B) Arachidonic acid C) Palmitic acid D) Oleic acid E) Stearic acid

Answer: B

Arachidonic acid is metabolized into prostaglandins, leukotrienes.

📘 Q121 (January 2024) — How many carbon atoms are present in estrogen? A) 16 B) 17 C) 18 D) 19 E) 20

Answer: C

Estrogens are C18 steroids derived from androgens by aromatization.

📘 Q125 (January 2024) — To reverse methotrexate-induced myelosuppression, administer? A) Folinic acid (leucovorin) B) Vitamin B12 C) Vitamin C D) Iron supplements E) Calcium gluconate

Answer: A

Folinic acid rescues normal cells by bypassing DHFR inhibition.

📘 Q126 (January 2024) — Which drug causes kernicterus in neonates? A) Sulphonamides B) Penicillin C) Erythromycin D) Metronidazole E) Ciprofloxacin

Answer: A

*Sulphonamides displace bilirubin causing neurotoxicity in newborns.

📘 Q131 (January 2024) — Drospirenone’s unique feature is? A) Estrogenic activity B) Anti-androgenic activity C) Androgenic activity D) Glucocorticoid activity E) Mineralocorticoid activity

Answer: B

Drospirenone antagonizes androgen receptors, reducing acne/hirsutism.

📘 Q136 (January 2024) — Which agent cannot be used as a tocolytic? A) Beta-2 agonists B) Calcium channel blockers C) NSAIDs (Prostaglandin inhibitors) D) Prostacyclin E) Magnesium sulfate

Answer: D

Prostacyclin is a vasodilator but not used to inhibit labor contractions.

📘 Q137 (January 2024) — Hyperprolactinemia as a side effect occurs with? A) Antipsychotics (antiemetic drugs) B) Beta blockers C) ACE inhibitors D) Calcium channel blockers E) SSRIs

Answer: A

Dopamine antagonists disinhibit prolactin secretion causing hyperprolactinemia.

📘 Q140 (January 2024) — Letrozole acts as a? A) Aromatase inhibitor B) 5-alpha reductase inhibitor C) Progesterone antagonist D) Estrogen receptor antagonist E) Gonadotropin analogous

Answer: A

Letrozole blocks estrogen synthesis by inhibiting the aromatase enzyme.

📘 Q187 (January 2024) — About what percentage of estrogen binds to SHBG (sex hormone-binding globulin)? A) 10% B) 20% C) 50% D) 80% E) 100%

Answer: B

Approximately 20% of estrogen is bound to SHBG.

📘 Q195 (January 2024) — Prostaglandins act as? A) Hormones B) Paracrine agents C) Autocrine agents D) Neurotransmitters E) Enzymes

Answer: B

*Prostaglandins act locally near their site of synthesis.

📙 Q67 (July 2024) — Apixaban’s mechanism of action is: A) Factor V inhibitor B) Factor Xa inhibitor C) Thrombin inhibitor D) Vitamin K antagonist E) Platelet aggregation inhibitor

Answer: B

*Apixaban selectively inhibits Factor Xa.

📙 Q88 (July 2024) — Carboprost is a synthetic analogous of: A) PGEI B) PGE2 C) PGF2a D) PGI2 E) Thromboxane A2

Answer: C

*Carboprost mimics PGF2« and is used for uterine contraction.

📙 Q95 (July 2024) — Finasteride inhibits which enzyme? A) 3B-Hydroxysteroid dehydrogenase B) 5a-Reductase C) 17B-Hydroxysteroid dehydrogenase D) 21-Hydroxylase E) Aromatase

Answer: B

*Finasteride inhibits 5a-reductase converting testosterone to dihydrotestosterone.

📙 Q96 (July 2024) — The mode of action of atosiban is: A) Progesterone agonist B) Progesterone antagonist C) Oxytocin antagonist D) Oxytocin agonist E) Prostaglandin inhibitor

Answer: C

Atosiban blocks oxytocin receptors, inhibiting uterine contractions.

📙 Q114 (July 2024) — Which drug is known to cause ototoxicity (deafness)? A) Carbimazole B) Phenobarbital C) Phenytoin D) Methyldopa E) Streptomycin

Answer: E

Aminoglycosides like streptomycin are ototoxic antibiotics.

📙 Q118 (July 2024) — A female patient with inferior myocardial infarction and multiple drug abuse; which drug is commonly implicated? A) Heroin B) Cocaine C) Benzodiazepines D) Amphetamine E) Methadone

Answer: B

Cocaine induces vasospasm and thrombosis causing MI.

📙 Q120 (July 2024) — For suppression of lactation after stillbirth, the drug of choice is: A) Cabergoline B) Metoclopramide C) Methyldopa D) Cyclizine E) Bromocriptine

Answer: A

Cabergoline inhibits prolactin, suppressing milk production.

📙 Q122 (July 2024) — Magnesium is primarily excreted by:

A) Kidney unchanged
B) Liver metabolism
C) Fecal elimination
D) Sweat glands
E) Pulmonary excretion

Answer: A

Magnesium is filtered and excreted primarily by the kidneys.

📙 Q123 (July 2024) — Non-ergot dopamine agonist used for lactation suppression is: A) Quinagolide B) Cabergoline C) Bromocriptine D) Metoclopramide E) Domperidone

Answer: A

Quinagolide is a non-ergot dopamine agonist used for prolactin suppression.

📙 Q141 (July 2024) — Prophylactic low molecular weight heparin (LMWH) should be stopped how long before regional anaesthesia? A) 12 hours B) 24 hours C) 36 hours D) 48 hours E) 72 hours

Answer: A

Guidelines recommend stopping prophylactic LMWH 12 hours before neuraxial blocks.

📙 Q145 (July 2024) — Bendroflumethiazide causes which ECG change? A) Hypokalaemia B) Hyperkalaemia C) Hypocalcaemia D) Hypercalcemia E) Prolonged QT

Answer: A

*Thiazides increase potassium excretion, leading to hypokalaemia.

📙 Q178 (July 2024) — Progesterone acts as an anti-estrogen by: A) Reducing estrogen receptor synthesis B) Reducing estrone activity C) Inactivating estrogen receptor D) Methylating estrogen E) Inhibiting aromatase

Answer: A

*Progesterone downregulates estrogen receptor expression.

6. Pathology & Oncology

📘 Q151 (January 2024) — The most common cause of post-menopausal bleeding is? A) Endometrial cancer B) Atrophic vaginitis and endometritis C) Cervical cancer D) Uterine fibroids E) Polyps

Answer: B

Atrophy leads to fragile mucosa, causing bleeding.

📘 Q152 (January 2024) — The most common vulvar cancer is? A) Melanoma B) Basal cell carcinoma C) Squamous cell carcinoma D) Adenocarcinoma E) Sarcoma

Answer: C

SCC accounts for a majority of vulvar cancers.

📘 Q153 (January 2024) — Postmenopausal woman with 5 cm bilateral cystic masses, ascites, and CA-125 50-450 suggests? A) Benign cysts B) Ovarian malignancy C) Endometriosis D) Pelvic inflammatory disease E) Polycystic ovaries

Answer: B

*Ascites, bilateral cystic masses, and elevated CA-125 suggest ovarian cancer.

📘 Q156 (January 2024) — Keratin pearls are a histologic feature of? A) Adenocarcinoma B) Squamous cell carcinoma C) Melanoma D) Basal cell carcinoma E) Lymphoma

Answer: B

*Keratin pearls indicate squamous differentiation.

📘 Q157 (January 2024) — Fleshy endometrium with papillary growth under a microscope is characteristic of? A) Endometrioid carcinoma B) Papillary serous carcinoma C) Clear cell carcinoma D) Carcinosarcoma E) Leiomyoma

Answer: B

Papillary serous carcinoma has papillary structures and is aggressive.

📘 Q163 (January 2024) — Endometrial tissue found within the myometrium is called? A) Endometriosis B) Adenomyosis C) Leiomyoma D) Endometrial hyperplasia E) Polyp

Answer: B

Adenomyosis is the presence of endometrial glands within the uterine muscle.

📘 Q164 (January 2024) — A patient with long-standing endometriosis is at increased risk of developing? A) Clear cell carcinoma B) Squamous cell carcinoma C) Adenocarcinoma D) Sarcoma E) Melanoma

Answer: A

Endometriosis predisposes to certain ovarian cancers, including clear cell carcinoma.

📘 Q167 (January 2024) — The approximate percentage of leiomyomas that undergo sarcomatous transformation is? A) 1in 10 B) 1 in 100 C) 1 in 1000 D) 1 in 10,000 E) None

Answer: C

Sarcomatous change in leiomyomas is very rare (~0.1%).

📙 Q63 (July 2024) — Which HPV types are most commonly associated with cervical cancer? A) HPV 6 and 11 B) HPV 16 and 18 C) HPV 31 and 33 D) HPV 45 and 52 E) HPV 58 and 59

Answer: B

HPV 16 and 18 cause approximately 70% of cervical cancers.

📙 Q70 (July 2024) — Ovarian cancer associated with endometriosis is commonly: A) Serous adenocarcinoma B) Endometrioid carcinoma C) Mucinous carcinoma D) Clear cell carcinoma E) Germ cell Tumor

Answer: D

*Clear cell carcinoma is strongly linked with endometriosis.

📙 Q75 (July 2024) — 90% of genital and anal warts are caused by which HPV types? A) HPV 6 and 11 B) HPV 16 and 18 C) HPV 31 and 33 D) HPV 45 and 52 E) HPV 58 and 59

Answer: A

*Low-risk types of HPV 6 and 11 cause most genital warts. 76, Ovarian cancer associated with a BRCA mutation is usually:

A) Clear cell carcinoma

B) Serous cystadenocarcinoma

C) Endometrioid carcinoma

D) Mucinous carcinoma

E) Germ cell Tumor

Answer: B) Serous cystadenocarcinoma

Explanation: BRCA mutations predispose to high-grade serous ovarian carcinoma,

77, A 71-year-old woman has a unilateral simple ovarian cyst 3 mm in size and CA-125 of 25. What is the Risk of Malignancy Index (RMI)?

A)O

B) 25

C)75

D) 150

E) 225

Answer: A) 0

Explanation: Simple cyst and normal CA-125 indicate low risk; RMI is essentially zero.*

📙 Q78 (July 2024) — Schiller-Duval bodies are characteristic of which tumour? A) Choriocarcinoma B) Yolk sac tumour C) Dysgerminoma D) Teratoma E) Endometrial sinus tumour

Answer: B

Schiller-Duval bodies are pathognomonic for yolk sac tumours.

📙 Q83 (July 2024) — The most common type of fallopian tube malignancy is: A) Serous carcinoma B) Transitional carcinoma C) Clear cell carcinoma D) Endometrioid carcinoma E) Mucinous carcinoma

Answer: A

High-grade serous carcinoma is the most common malignancy in fallopian tubes.

📙 Q85 (July 2024) — Elevated serum LDH levels are commonly seen in: A) Dysgerminoma B) Brenner cell tumour C) Immature teratoma D) Endodermal sinus tumour E) Granulosa cell tumour

Answer: A

*Dysgerminomas secrete LDH, making it a useful tumour marker.

📙 Q148 (July 2024) — A history of heavy bleeding after hysterectomy specimen shows: A) Endometrial polyp B) Adenomyosis C) Fibroids D) Endometrial hyperplasia E) Malignancy

Answer: A

*Polyps are common benign causes of abnormal uterine bleeding.

7. Microbiology & Virology

📘 Q35 (January 2024) — The immunoglobulin increased in the term pregnant cervix is? A) IgG B) IgA C) IgM D) IgE E) IgD

Answer: B

Secretory IgA increases in the cervix during term pregnancy, protecting mucosal surfaces.

📘 Q36 (January 2024) — Which immunoglobulin is involved primarily in allergic reactions? A) IgG B) IgA C) IgM D) IgE E) IgD

Answer: D

*IgE mediates allergic responses by binding to mast cells and basophils.

📘 Q50 (January 2024) — The immunoglobulin that increases in the term pregnant cervix is? A) IgG B) IgA C) IgM D) IgE E) IgD

Answer: B

Secretory IgA increases to protect the mucosal surfaces during pregnancy.

📘 Q51 (January 2024) — Which immunoglobulin is involved in allergic reactions? A) IgA B) IgM C) IgG D) IgE E) IgD

Answer: D

*IgE binds to mast cells, causing histamine release in allergies.

📘 Q66 (January 2024) — The immunoglobulin increasing in the term cervix is? A) IgG B) IgA C) IgM D) IgE E) IgD

Answer: B

*IgA protects mucosal surfaces in the cervix.

📘 Q67 (January 2024) — Which immunoglobulin is involved in allergic responses? A) IgA B) IgG C) IgM D) IgE E) IgD

Answer: D

IgE triggers mast cell degranulation in allergies.

📘 Q97 (January 2024) — Jarisch-Herxheimer reaction occurs with treatment of? A) Syphilis B) Tuberculosis C) Malaria D) HIV E) Hepatitis B

Answer: A

Endotoxin release after antibiotic treatment causes this reaction.

📘 Q100 (January 2024) — A hepatitis B patient who is HBsAg +ve, HBeAg -ve, anti-HBc +ve likely has? A) Chronic inactive carrier B) Acute hepatitis C) Vaccinated D) Immune due to past infection E) No infection

Answer: A

HBsAg positive with HBeAg negative and anti-HBc positive indicates inactive carrier status.

📘 Q104 (January 2024) — Streptococcus species on agar produces? A) No haemolysis B) Alpha (green) haemolysis C) Beta (clear) haemolysis D) Gamma haemolysis E) Partial haemolysis

Answer: B

Some Streptococcus species produce greenish alpha haemolysis on blood agar.

📘 Q122 (January 2024) — The organism most commonly causing [UCD-associated genital tract infections is? A) Actinomyces B) Staphylococcus aureus C) Escherichia coli D) Neisseria gonorrhoeae E) Chlamydia trachomatis

Answer: A

Actinomyces israelii can colonize IUCDs, causing pelvic infections.

📘 Q123 (January 2024) — Vaginal infection often shows depletion of? A) Candida species B) Gardnerella vaginalis C) Lactobacilli D) Trichomonas vaginalis E) Streptococcus

Answer: C

*Lactobacilli maintain acidic vaginal pH; their depletion predisposes to infections.

124, Zidovudine (AZT) is classified as?

A. Protease inhibitor

B. NRTI (nucleoside reverse transcriptase inhibitor)

C. NNRTI (non-nucleoside reverse transcriptase inhibitor)

D. Integrase inhibitor

E. Entry inhibitor

Answer: B. NRTI

Explanation: Zidovudine inhibits HIV reverse transcriptase by nucleotide analog incorporation.*

📘 Q132 (January 2024) — Offensive greenish vaginal discharge at pH 6 is most commonly caused by? A) Bacterial vaginosis B) Trichomoniasis C) Candida infection D) Gonorrhea E) Chlamydia

Answer: B

*Trichomonas causes foul, greenish, malodorous discharge.

📘 Q133 (January 2024) — Fishy odour and vaginal discharge with pH >4.5 suggests? A) Candidiasis B) Bacterial vaginosis C) Trichomoniasis D) Chlamydia E) Gonorrhoea

Answer: B

Bacterial vaginosis causes a fishy odour and clue cells on microscopy.

📘 Q144 (January 2024) — The percentage of infants with congenital CMV infection who are asymptomatic at birth is? A) 5% B) 10-15% C) 25% D) 50% E) 75%

Answer: B

*Most congenital CMV infections are asymptomatic at birth.

📘 Q145 (January 2024) — Neisseria species are? A) Gram-positive cocci B) Gram-negative aerobic diplococci C) Anaerobic rods D) Gram-positive rods E) Acid-fast bacilli

Answer: B

Neisseria gonorrhoeae and meningitidis are Gram-negative diplococci.

📘 Q146 (January 2024) — A VDRL positive, TPPA negative, VTA negative test indicates? A) Active syphilis infection B) False positive VDRL C) Late syphilis D) Congenital syphilis E) Secondary syphilis

Answer: B

TPPA confirms treponemal infection; negative TPPA suggests false- positive VDRL.

📘 Q147 (January 2024) — The incidence of pneumonia with congenital CMV infection is approximately? A) 1-5% B) 10-15% C) 25% D) 50% E) 75%

Answer: B

*Pneumonia is an uncommon but recognized CMV complication.

📘 Q149 (January 2024) — HIV primarily infects which cell type? A) CD4+ T-helper cells B) CD8+ cytotoxic cells C) B lymphocytes D) Neutrophils E) Macrophages

Answer: A

HIV targets and depletes CD4+ T cells.

📘 Q160 (January 2024) — Staphylococcus aureus produces? A) Cytotoxins B) Endotoxins C) Exotoxins only D) Neurotoxins only E) No toxins

Answer: A

Staphylococcus aureus produces various cytotoxins that damage host cells.

📘 Q165 (January 2024) — The type of necrosis typically seen in the heart after infarction is? A) Liquefactive necrosis B) Caseous necrosis C) Coagulative necrosis D) Fat necrosis E) Gangrenous necrosis

Answer: C

*Coagulative necrosis is characteristic of ischemic injury in solid organs.

📙 Q20 (July 2024) — SARS in COVID-19 virus is: A) Single-stranded RNA (ssRNA) B) Single-stranded DNA (ssDNA) C) Double-stranded RNA (dsRNA) D) Double-stranded DNA (dsDNA) E) Retrovirus

Answer: A

SARS-CoV-2, the virus causing COVID-19, is a single-stranded RNA virus.

📙 Q66 (July 2024) — Chickenpox virus belongs to which family? A) Adenovirus B) Herpesvirus C) Poxvirus D) Polyomavirus E) Papillomavirus

Answer: B

Varicella-zoster virus is a member of the herpesvirus family.

📙 Q90 (July 2024) — Lactational mastitis is most commonly caused by: A) Staphylococcus aureus B) Group B Streptococcus C) Lactobacilli D) Escherichia coli E) Candida albicans

Answer: A

S. aureus is the primary pathogen in lactational mastitis.

📙 Q91 (July 2024) — The infectious period of chickenpox is: A) 2 days before rash and 2 days after crust disappears B) 2 days before rash until crust appears C) 10-14 days after rash appears D) 24 hours after rash appears E) When lesions are crusted

Answer: B

*Varicella is contagious from about 2 days before rash onset until lesions crust over.

📙 Q94 (July 2024) — A pregnant woman with a rash and joint pain in the first trimester has an ultrasound showing isolated fetal ascites. The most likely infection is: A) Parvovirus B19 B) Varicella-zoster virus C) Toxoplasmosis D) Cytomegalovirus E) Rubella

Answer: D

CMV can cause fetal hydrops, including ascites and non-structural defects.

📙 Q109 (July 2024) — A non-pregnant woman with generalized fatigue has elevated ALP (230), with normal ALT, GGT, albumin, and bilirubin. The most likely cause is: A) Epstein-Barr virus infection B) Non-alcoholic fatty liver disease C) Hepatitis D) Gallstones E) Vitamin D deficiency

Answer: E

Vitamin D deficiency can cause elevated ALP due to bone turnover.

📙 Q112 (July 2024) — A woman returning from northern South America has reactive VDRL but non-reactive TP-PA and FTA-Abs tests. The most likely interpretation is: A) Past treated syphilis B) Latent syphilis C) Early syphilis D) Biological false positive E) Active syphilis

Answer: D

Reactive non-treponemal but non-reactive treponemal tests suggest a false positive.

📙 Q115 (July 2024) — Red degeneration of fibroid is caused by: A) Ischemia of fibroid B) Infection C) Haemorrhage D) Malignant transformation E) Cystic degeneration

Answer: A

Rapid growth causes infarction and red degeneration.

📙 Q119 (July 2024) — In HIV infection, which cell type undergoes lysis?

A) CD4+ T cells
B) CD8+ T cells
C) B cells
D) Macrophages
E) Natural killer cells

Answer: A

HIV primarily infects and depletes CD4+ T helper cells.

📙 Q125 (July 2024) — A pregnant woman has positive HCV antibody but negative HCV PCR. This indicates: A) Chronic infection B) Past infection or cleared virus C) Acute infection D) False positive antibody test E) Vaccinated.

Answer: B

PCR negativity indicates no active viremia.

📙 Q126 (July 2024) — A pregnant woman exposed to chickenpox has VZV IgG positive and IgM negative. This indicates: A) Immunity to varicella infection B) Acute infection C) Susceptible to infection D) False positive IgG E) Active infection

Answer: A

IgG positivity with negative IgM indicates past immunity.

📙 Q127 (July 2024) — A pregnant woman has HBsAg positive, anti-HBs negative, anti-HBe IgG positive, and anti-HBc IgM negative. The most likely diagnosis is: A) Vaccinated B) Susceptible C) Chronic carrier D) Acute HBV infection E) Resolved infection

Answer: C

*Positive HBsAg with anti-HBc IgG positive and IgM negative indicates chronic carrier state.

📙 Q132 (July 2024) — A 32-week pregnant woman has a positive Group B Streptococcus (GBS) urine culture >1000 CFU/mL with dysuria. The management is: A) Treat UTI and give intrapartum antibiotic prophylaxis (IAP) during labour B) Treat UTI, do urine culture, no need for IAP if culture negative C) Give IAP only during labour D) Treat UTI and consider IAP during labour E) No treatment needed

Answer: D

Treat infection and administer IAP to reduce neonatal GBS infection risk.

📙 Q135 (July 2024) — Neisseria gonorrhoeae is a: A) Gram-negative aerobic cocci B) Gram-negative aerobic bacilli C) Gram-positive anaerobic cocci D) Gram-positive aerobic bacilli E) Gram-negative anaerobic bacilli

Answer: A

Gonococcus is a gram-negative diplococcus requiring aerobic conditions.

📙 Q136 (July 2024) — The treatment of herpes simplex virus (HSV) infection is: A) Acyclovir B) Penicillin C) Ciprofloxacin D) Metronidazole E) Fluconazole

Answer: A

*Acyclovir inhibits viral DNA polymerase and treats HSV infections.

📙 Q137 (July 2024) — Ultrasound finding of fetal ascites in pregnancy is most commonly associated with: A) Cytomegalovirus (CMV) infection B) Rubella infection C) Parvovirus B19 infection D) Toxoplasmosis E) Syphilis

Answer: C

Parvovirus causes fetal anaemia and hydrops, including ascites.

📙 Q138 (July 2024) — A pregnant woman has flu-like symptoms and delivers a baby with jaundice, hepatosplenomegaly, and bradycardia. The most likely infection is: A) Listeria monocytogenes B) Varicella-zoster virus C) Herpes simplex virus D) Cytomegalovirus E) Rubella

Answer: A

Listeriosis can cause neonatal sepsis with jaundice and hepatosplenomegaly.

📙 Q144 (July 2024) — Maternal antibodies protecting the fetal gut are predominantly: A) IgA B) IgG C) IgM D) IgE E) IgD

Answer: A

Secretory IgA is present in colostrum and protects the neonatal gut.

📙 Q146 (July 2024) — Chancroid is caused by: A) Haemophilus ducreyi B) Treponema pallidum C) Neisseria gonorrhoeae D) Herpes simplex virus E) Gardnerella vaginalis

Answer: A

Haemophilus ducreyi causes painful genital ulcers characteristic of chancroid.

📙 Q171 (July 2024) — SARS-CoV-2, the virus causing COVID-19, is classified as: A) Single-stranded RNA (ssRNA) B) Single-stranded DNA (ssDNA) C) Double-stranded RNA (dsRNA) D) Double-stranded DNA (dsDNA) E) Retrovirus

Answer: A

SARS-CoV-2 is a positive-sense ssRNA virus.

8. Statistics & Epidemiology

📘 Q48 (January 2024) — Breast milk contains which of the following sugars? A) Lactulose B) Lactose C) Glucose D) Fructose E) Maltose

Answer: B

*Lactose is the main carbohydrate in human breast milk.

📘 Q64 (January 2024) — Which sugar is the main carbohydrate in breast milk? A) Glucose B) Fructose C) Lactose D) Maltose E) Sucrose

Answer: C

Lactose provides the primary energy source for the infant.

📘 Q80 (January 2024) — Main sugar in breast milk? A) Glucose B) Fructose C) Lactose D) Maltose E) Sucrose

Answer: C

Lactose is the primary carbohydrate.

📘 Q83 (January 2024) — The functional unit of the kidney responsible for filtration is? A) Nephron. B) Glomerulus C) Collecting duct D) Proximal tubule E) Loop of Henle

Answer: A

The nephron includes the glomerulus and tubules, where filtration and reabsorption occur.

📘 Q91 (January 2024) — Which antiemetic is contraindicated in pregnancy? A) Metoclopramide B) Ondansetron C) Doxylamine D) Prochlorperazine E) Promethazine

Answer: B

Some studies suggest potential risks with ondansetron; clinical decisions vary.

📘 Q108 (January 2024) — Which neurotransmitter is inhibited by atropine? A) Dopamine B) Acetylcholine C) Serotonin D) Norepinephrine E) GABA

Answer: B

*Atropine blocks muscarinic acetylcholine receptors.

📘 Q111 (January 2024) — Branner’s glands are located in? A) Stomach B) Duodenum C) Jejunum D) Tleum E) Colon

Answer: B

*Brunner’s glands secrete alkaline mucus to protect duodenal mucosa.

📘 Q134 (January 2024) — Oxybutynin is contraindicated in? A) Urinary retention B) Open-angle glaucoma C) Narrow-angle glaucoma D) Diabetes E) Asthma

Answer: C

Oxybutynin’s anticholinergic effect can precipitate angle closure glaucoma.

📘 Q148 (January 2024) — The incidence of uterine rupture with VBAC is approximately? A) 1/50 B) 1/250 C) 1/500 D) 1/1000 E) 1/2000

Answer: B

Uterine rupture risk in VBAC is about 0.4%.

📘 Q166 (January 2024) — The epithelium lining the labia majora is? A) Stratified squamous keratinized epithelium B) Stratified squamous non-keratinized epithelium C) Simple cuboidal epithelium D) Transitional epithelium E) Pseudostratified columnar epithelium

Answer: A

The labia majora skin is keratinized for protection.

📘 Q173 (January 2024) — The ovarian tumour most predisposed to torsion is? A) Serous cystadenoma B) Dermoid cyst C) Endometrioma D) Fibroma E) Granulosa cell tumour

Answer: B

*Dermoid are often large and mobile, increasing torsion risk. 174, SEM (standard error of the mean) is calculated as? A. SD x vn

B.SD/ Vn

C. Variance x n

D. Mean / SD

E. SD?/n

Answer: B. SD / Vn

Explanation: SEM decreases with increasing sample size.

📘 Q175 (January 2024) — The number needed to treat (NNT) is calculated as? A) 1/ ARR (absolute risk reduction) B) 1 / RR (relative risk) C) 1/ OR (odds ratio) D) ARR/1 E) RR/1

Answer: A

NNT tells how many patients need treatment to prevent one event.

📘 Q176 (January 2024) — Specificity is calculated as? A) TP/ (TP + FP) B) TN/ (IN + FP) C) TP / (TP + FN) D) TN/ (IN +FN) E) FP / (FP + TN)

Answer: B

Specificity measures the ability to correctly identify negatives.

📘 Q180 (January 2024) — The lateral angle of the diamond-shaped forest plot represents? A) Median value B) 95% confidence limits C) Range D) Interquartile range E) Mean difference

Answer: B

*Forest plots depict 95% CIs as whiskers around the point estimate.

📘 Q181 (January 2024) — The bottom and top of a box in a box-and-whisker plot represent? A) Mean and median B) Minimum and maximum C) Lower and upper quartiles D) Standard deviation limits E) Confidence intervals

Answer: C

The box edges mark the 25th (Q1) and 75th (Q3) percentiles.

📘 Q182 (January 2024) — Perinatal mortality includes? A) Only stillbirths after 28 weeks B) Stillbirths from 22 weeks plus neonatal deaths within 7 days C) Neonatal deaths after 28 days D) Only neonatal deaths E) Infant deaths within | year

Answer: B

Perinatal mortality combines fetal and early neonatal deaths.

📘 Q183 (January 2024) — In a normally distributed curve with a mean of 245 and an SD of 50, the median is? A) 195 B) 245 C) 295 D) Variable E) Cannot be determined

Answer: B

*For normal distribution, mean = median = mode.

📘 Q198 (January 2024) — In vitamin B12 deficiency, the defect is? A) Intrinsic factor deficiency B) Folate deficiency C) Vitamin D deficiency D) Iodine deficiency E) Calcium deficiency

Answer: A

*Pernicious anaemia results from a lack of intrinsic factor, causing B12 malabsorption.

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📙 Q10 (July 2024) — Which human cell lacks mitochondria? A) Hepatocyte B) Mature red blood cells C) Myocyte D) Nephron cells E) Neurons

Answer: B

Mature erythrocytes lack mitochondria to maximize space for haemoglobin and rely on anaerobic metabolism.

📙 Q11 (July 2024) — What are the primary bile acids synthesized in the liver? A) Cholic acid and cholic acid B) Cholic acid and chenodeoxycholic acid C) Chenodeoxycholic acid and lithocholic acid D) Deoxycholic acid and lithocholic acid E) Glycocholic acid and taurocholic acid

Answer: B

These two primary bile acids are synthesized from cholesterol in the liver.

📙 Q13 (July 2024) — At what gestational age does fetal kidneys begin producing urine? A) 6 weeks B) 12 weeks C) 18 weeks D) 24 weeks E) 30 weeks

Answer: B

Fetal kidneys begin urine production around 12 weeks of gestation, contributing to amniotic fluid.

📙 Q30 (July 2024) — In a study of 700 women assessed for preterm labour test, 320 tested positive; of these, 80 had preterm labour. Among 380 test-negative women, 20 had preterm labour. What is the positive predictive value (PPV) of the test?

A) 25%
B) 33%
C) 60%
D) 80%
E) 95%

Answer: A

PPV = True Positives / (True Positives + False Positives) = 80 / 320 = 25%,

📙 Q49 (July 2024) — The positive likelihood ratio is calculated as: A) Sensitivity / (1 - Specificity) B) Sensitivity - Specificity C) Sensitivity + (1 - Specificity) D) C1 - Sensitivity) / Specificity E) Specificity / Sensitivity

Answer: A

*A Positive likelihood ratio indicates how much the odds of disease increase when a test is positive.

📙 Q50 (July 2024) — Standard error of the mean (SEM) is calculated as: A) SD x YN B) SD/N C) SD/1N D) Mean / SD E) Variance /N

Answer: C

SEM is the standard deviation divided by the square root of the sample size.

📙 Q53 (July 2024) — The highest incidence of cervical cancer occurs in women aged: A) 20-24 B) 30-34 C) 40-44 D) 50-54 E) 60-64

Answer: E

Peak incidence of invasive cervical cancer is seen in women aged 60-64.

📙 Q54 (July 2024) — The most abundant protein in colostrum is: A) Casein B) Galactose C) Lactalbumin D) Lactoglobulin E) Lactoferrin

Answer: A

Casein is the major milk protein, especially abundant in colostrum.

📙 Q80 (July 2024) — A woman 150 cm tall, weighing 90 kg, has a BMI of 40. What category does she belong to? A) Normal weight B) Overweight C) Obesity Class I D) Obesity Class II E) Obesity Class III

Answer: E

BMI > 40 defines Class III obesity (morbid obesity).

📙 Q84 (July 2024) — The risk of miscarriage following amniocentesis is approximately: A) 1% B) 5% C) 10% D) 15% E) 20%

Answer: A

Procedure-related miscarriage risk after amniocentesis is about 1%.

📙 Q87 (July 2024) — The 'sparkling' effect seen in coagulation over a large area is termed: A) Fulguration B) Coagulation C) Vaporization D) Desiccation E) Electrosection

Answer: A

Fulguration is superficial coagulation with electric spark effects.

📙 Q89 (July 2024) — Natural killer (NIX) cells develop from which type of cell? A) Lymphocyte B) Monocyte C) Basophil D) Neutrophil E) Eosinophil

Answer: A

NK cells are lymphoid lineage innate immune cells.

📙 Q106 (July 2024) — In a diagnostic test scenario with 44 positive TVUS cases: 36 true positive (TP), 9 false positive (FP), 2 false negative (FN), and 26 true negative (TN), the positive predictive value (PPV) is: A) 0.75 B) 0.80 C) 0.85 D) 0.90 E) 0.95

Answer: B

PPV = TP / (TP + FP) = 36 / (36 + 9) = 0.80.

📙 Q107 (July 2024) — An odds ratio calculation gives which of the following values?

Cc)4 A) 0.5 B) 2 D) 10 E) 20

Answer: C

*This is an example; odds ratios >1 indicate increased odds.

📙 Q133 (July 2024) — Paralytic ileus is commonly associated with which electrolyte disturbance? A) Hypokalaemia B) Hyperkalaemia C) Hypocalcaemia D) Hypercalcemia E) Hyponatremia

Answer: A

*Low potassium impairs gut motility, causing ileus.

📙 Q161 (July 2024) — Which cell lacks mitochondria? A) Hepatocyte B) Mature red blood cell C) Neuron D) Myocyte E) Kidney tubule cell

Answer: B

Mature erythrocytes lack mitochondria to maximize haemoglobin content.

📙 Q162 (July 2024) — The main component of bile acids synthesized by the liver is: A) Cholic acid and chenodeoxycholic acid B) Cholic acid and deoxycholic acid C) Chenodeoxycholic acid and lithocholic acid D) Deoxycholic acid and lithocholic acid E) Glycocholic acid and taurocholic acid

Answer: A

These are the two primary bile acids synthesized from cholesterol.

📙 Q164 (July 2024) — At what gestational age does the fetal kidney begin producing urine? A) 6 weeks B) 12 weeks C) 18 weeks D) 24 weeks E) 30 weeks

Answer: B

Fetal urine production starts at about 12 weeks of gestation.

📙 Q181 (July 2024) — The positive predictive value (PPV) of a test with 80 true positives out of 320 positives is: A) 25% B) 33% C) 60% D) 80% E) 95%

Answer: A

*PPV = TP/((TP+FP) = 80/320 = 25%.

📙 Q199 (July 2024) — The posterior fontanelle typically closes by: A) 3 months B) 6 months C) 9 months D) 12 months E) 18 months

Answer: A

*The posterior fontanelle usually closes by 3 months of age.

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9. Obstetrics

📘 Q65 (January 2024) — Which prostaglandin rises during the menstrual cycle?

C, PGI2 A) PGEI B) PGF2a D) Thromboxane A2 E) Leukotriene B4

Answer: B

PGF2a promotes uterine contractions and vasoconstriction during menstruation.

📘 Q88 (January 2024) — Severe itching in pregnancy with increased bile acids indicates? A) Intrahepatic cholestasis of pregnancy B) Viral hepatitis C) Acute fatty liver of pregnancy D) Preeclampsia E) HELLP syndrome

Answer: A

Itching and raised bile acids characterize obstetric cholestasis.

📘 Q93 (January 2024) — The Haldane effect refers to? A) Increased oxygen affinity with increased CO2 B) Increased capacity of deoxygenated blood to carry CO2 C) Decreased affinity of haemoglobin for oxygen at high CO2 D) Increased CO2 solubility in plasma E) Increased oxygen delivery in hypoxia

Answer: B

*Deoxygenated haemoglobin binds CO2 better, facilitating CO2 transport.

📘 Q95 (January 2024) — Diagnostic test for haemolysis in newborn is? A) Direct Coombs test B) Indirect Coombs test C) Haemoglobin electrophoresis D) Reticulocyte count E) Peripheral smear

Answer: A

Detects antibodies bound to red blood cells, indicating haemolysis.

📘 Q116 (January 2024) — Conversion of Fe* to Fe” in the gut requires which vitamin? A) Vitamin A B) Vitamin B12 C) Vitamin C D) Vitamin D E) Vitamin E

Answer: C

Vitamin C reduces ferric to ferrous iron for absorption.

📘 Q127 (January 2024) — Entonox is a mixture of? A) Nitric oxide and oxygen (50:50) B) Nitrous oxide and oxygen (50:50) C) Oxygen and carbon dioxide D) Helium and oxygen E) Nitric oxide and carbon dioxide

Answer: B

Entonox is commonly used for analgesia during labour.

📘 Q178 (January 2024) — For comparing two normally distributed groups (e.g., preeclampsia and diabetes), which non-parametric test is used? A) Student’s t-test B) Mann-Whitney U test C) Chi-square test D) ANOVA E) Fisher’s exact test

Answer: B

Mann-Whitney is used for non-normally distributed or ordinal data.

📘 Q179 (January 2024) — Intrauterine growth chart shows weight below the 5th percentile, with reversed end-diastolic flow on Doppler, indicates? A) Normal growth B) IUGR (intrauterine growth restriction) C) Macrosomia D) Polyhydramnios E) Hydrops fetalis

Answer: B

Reversed flow indicates severe placental insufficiency, causing IUGR.

📙 Q33 (July 2024) — The postpartum reduction in uterine size due to shortening of myometrial fibres is called: A) Contraction B) Inversion C) Retraction D) Reduction E) Remodelling

Answer: D

Uterine involution primarily occurs by reduction in length of muscle fibres (reduction).

📙 Q97 (July 2024) — A woman dies at 38 weeks gestation due to a road traffic accident. The maternal death classification is: A) Coincident maternal death B) Direct maternal death C) Indirect maternal death D) Perinatal death E) Late maternal death

Answer: B

Death from trauma during pregnancy is classified as a direct maternal death.

📙 Q98 (July 2024) — A pregnant woman dies 2 weeks postpartum from asthma complications. The maternal death classification is: A) Coincidental maternal death B) Direct maternal death C) Indirect maternal death D) Perinatal death E) Late maternal death

Answer: C

*Death from a pre-existing medical condition aggravated by pregnancy is indirect.

📙 Q121 (July 2024) — On Doppler ultrasound, the direction of blood flow towards the transducer is usually shown as: A) Blue B) Green C) Orange D) Red E) Yellow

Answer: D

By convention, red indicates flow towards the transducer.

📙 Q134 (July 2024) — In pelvic floor operative delivery, when the fetal head is on the pelvic floor, the type of forceps used is: A) Inlet forceps B) Outlet forceps C) Low forceps D) High forceps E) Caesarean section

Answer: B

Outlet forceps are used when the head is visible at the introitus.

📙 Q160 (July 2024) — The transport of amino acids across the placenta occurs mainly by: A) Passive diffusion B) Active transport C) Facilitated diffusion D) Receptor-mediated endocytosis E) Direct hematogenous transfer

Answer: B

*Placental amino acid transport is an energy-dependent active process.

📙 Q184 (July 2024) — Postpartum uterine size reduction by myometrial fiber shortening is called: A) Contraction B) Involution C) Retraction D) Reduction E) Remodeling

Answer: D

*Uterine involution occurs via reduction in muscle fiber length.