Mock Exam 06
Final Mock 6
MRCOG Part 1 practice — 106 questions with answers and explanations. Cleaned for readability.
Q1. A 16-year-old has recently become sexually active. She - A) complains of intensely irritating greenish frothy vaginal discharge. The - B) organism is seen under microscope in a drop of saline and PH is 6. - C) What is the most likely causative organism? - D) Candida albicans - E) Chlamydia trachomatis Gardnerella vaginalis Trichomonas vaginalis Treponema palladium
Explanation: Trichomoniasis (trich) is a common STI caused trichomonas vaginalis. While it’s more prevalent in women, men are also susceptible to trich. Genital itching or irritation Irregular discharge color such as green, yellow, white, or orange “Fishy” smell Burning or discomfort while urinating.
Q2. Regarding Influenza vaccine, what type of vaccine can be taken - A) in pregnancy ? - B) Killed vaccine - C) Toxoid vaccine - D) Conjugate vaccine - E) Live attenuated vaccine Organism subunit vaccine
Explanation: Killed vaccine Q3. Which class of immunoglobulin is primarily secreted in breast milk - A) and protects the infant’s intestinal mucosa from infection? - B) IgA - C) IgG - D) IgM - E) IgE IgD
Explanation: IgA Q4. Which immunoglobin is a pentamer? - A) IgA - B) IgM - C) IgG - D) IgE - E) IgD
Explanation: IgM
positive. Which is the single most appropriate treatment? - A) Amoxicillin - B) Clindamycin - C) Doxycycline - D) Erythromycin - E) Azithromycin
Explanation: Doxycycline 100mg bd for 7 days is now recommended as first line treatment for uncomplicated urogenital, pharyngeal and rectal chlamydia infections ( non pregnant state) Pregnancy and breast feeding (bashh guidelines) Doxycycline and ofloxacin are contraindicated in pregnancy Recommended regimens (Level Ia, Grade A) Azithromycin 1g orally as a single dose, followed by 500mg once daily for two days Erythromycin 500mg four times daily for seven days Erythromycin 500mg twice daily for 14 days Amoxicillin 500mg three times a day for seven days. Q5. What sexually transmitted disease (STD) is caused by - A) Haemophilus ducreyi? - B) Chancre - C) Chancroid - D) Granuloma inguinale - E) Condyloma acuminatum Molluscum contagiosum
Explanation: Chancroid
- A) Carbohydrate antigen on cell wall
- B) Peptidoglycan antigen on cell wall
- C) M protein
- D) Color of blood agar
- E) Sugar fermentation
Explanation: Lancefield grouping is a serological method for classifying streptococci into one of 20 groups (designated by a letter) based on the presence of polysaccharide and teichoic acid antigens in the bacterial cell wall.
which organism? - A) Lactobacillus - B) Mobiluncus - C) Gardnella vaginalis - D) Trichomonas vaginalis - E) Trepenoma pallidum
Explanation: Lactobacilli are the most abundant vaginal bacteria in women. They inhibit binding of other bacteria to epithelial cells and produce lactic acid that kills or inhibits the growth of many other bacteria. Bacterial vaginosis (BV), purported to be the most frequent vaginal disturbance in reproductive age women, is characterised by a large decrease in lactobacilli and their replacement by high concentrations of other anaerobic and facultative bacteria.
Q6. 6 hours post laparoscopic tubal ligation, patient c/o pain - A) abdomen, not relieved with analgesics. On examination a tender cystic - B) mass felt under umbilicus with oozing pus from one of the port sites. - C) (LABS) - D) Hb: 11, - E) WCC :17000. What’s your Diagnosis ? Urinary retention Intra-abdominal bleeding Urinary bladder injury Injury to ureter Port Site infection
Explanation: Urinary retention
Q7. The most common in utero infection causing fetal anemia in the - A) UK is? - B) Syphilis - C) Toxoplasmosis - D) Rubella - E) Parvovirus B19 Cytomegalovirus
Explanation: Parvovirus infection can causes severe fetal anemia as a result of fetal erythroid progenitor cells infection with shortened half life of erythrocytes, causing high output cardiac failure and therefore non immune hydrops fetalis. Q8. Women with abnormal smear referred to colposcopy. HSIL. - A) Which HPV is associated with this? - B) HPV 18 - C) HPV 6 - D) HPV 11 - E) HPV 12 HPV 20
Explanation: Low-risk HPVs mostly cause no disease. However, a few low-risk HPV types can cause warts on or around the genitals, anus, mouth, or throat. High-risk HPVs can cause several types of cancer. There are about 14 high-risk HPV types including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68. Two of these, HPV16 and HPV18, are responsible for most HPV-related cancers. Q9. Which HPV causes Genital Warts? - A) HPV 45 - B) HPV 31 - C) HPV 18 - D) HPV 16 - E) HPV 6 and 11
Explanation: HPV 6 and 11
with fever, chills. Blood test falciparum Vivax +VE. Best treatment? - A) Primaquine - B) Mefloquine - C) Choloroquine - D) Procholoquine - E) Artisunate
Explanation: Primaquine is contraindicated in pregnancy due to the risk of severe haemolysis in glucose-6-phosphate dehydrogenase (G6PD) deficient individuals. Pregnant women may require suppressive treatment, usually with chloroquine, until delivery.
management? - A) Antifungal - B) Steroid - C) Tacrolimus - D) Gabapentin - E) Acyclovir
Explanation: Acyclovir
Q10. A 33-year-old woman is admitted with surgical wound infection - A) after emergency caesarean section for suspected fetal compromise. - B) Culture of the wound demonstrates methicillin-resistant Staphylococcus - C) aureus (MRSA). She has no known allergies. - D) Which is the most appropriate treatment? - E) Cephalosporin Clindamycin Clindamycin and vancomycin Piperacillin / tazobactam Carbapenum
Explanation: MRSA may be resistant to clindamycin, hence if the woman is or is highly likely to be MRSA-positive, a glycopeptide such as vancomycin or teicoplanin may be added until sensitivity is known.
Q11. You see a patient in antenatal clinic who is 14 week pregnant and - A) is worried. Her 3 year old son has chicken pox. she does not remember if - B) she had chicken pox in past? Her lab reports are as follows: - C) Varicella IgG negative - D) Varicella IgM negative - E) she had past infection/immunity to chicken pox she is non immune to chicken pox she had general disease in past no need for vaccination immunity to Rubella
Explanation: she is non immune to chicken pox
Q12. Regarding Varicella Zoster , What its infectivity period? - A) When lesion is crusted - B) 24 hour after rash appear - C) 10-14 day after appearance of rash - D) 2 days before rash until the crust appear - E) 2 days before rash and 2 days after crust disappears
Explanation: A person with chickenpox is considered contagious beginning 1 to 2 days before rash onset until all the chickenpox lesions have crusted (scabbed)
Q13. An Asian woman books in for her third pregnancy at 12 weeks of - A) gestation. She has recently moved to the UK from Thailand to be with her - B) new husband. After pre-test counselling, with the aid of an interpreter, she - C) agrees to hepatitis B virus (HBV) screening. - D) The results return as follows. - E) HBsAg POSITIVE Anti-HBc IgG POSITIVE Anti-HBc IgM NEGATIVE AntiHBs NEGATIVE What is the significance of these results? Post vaccination Resolved infection Natural HBV immunity Chronic infection Acute HBV infection
Explanation: Q14. A 34 yr old woman has just returned to the UK following - A) missionary work in the northern part of South America. She is delighted to - B) be pregnant and presents for booking at 12 wks of gestation. After - C) counselling she agrees to have routine blood investigations including - D) screening for syphilis. - E) The results are returned as following: Venereal Disease Research Lab. (VDRL) test : Reactive Treponemal particle agglutination (TP-PA) : non reactive Fluorescent Traponemal Ab absorption (FTA-Abs) : non reactive What is the most likely interpretation for this result? Consistent with traponemal infection at sometime Diagnostic of latent syphilis Indicative of early syphilis Likely biological false positive Suggests a past treated infection
Q15. Explanation: - A) Which of the following immunoglobulin class has a dimeric - B) structure? - C) IgG - D) IgA - E) IgM IgE IgD
Explanation: IgA Q16. What percentage of lymphocytes is present in peripheral blood? - A) 2-8% - B) 15-20% - C) 20-40% - D) 50-70% - E) 70-80%
Explanation: Neutrophils: 40% to 60% Lymphocytes: 20% to 40% Monocytes: 2% to 8% Q17. Which class I major histocompatibility complex human leucocyte - A) antigen (HLA) is expressed only in extravillous trophoblast? - B) HLA-A - C) HLA-B - D) HLA-C - E) HLA-F HLA-G
Explanation: HLA-G
found in the blood. Which of the following is the major site of synthesis of complement proteins? - A) Spleen - B) Liver - C) Thymus - D) Bone marrow - E) Intestine
Explanation: Liver
- A) In the first trimester
- B) In the second trimester
- C) In the third trimester
- D) During labour and delivery
- E) In the neonatal period through breastfeeding
Explanation: During labour and delivery Q18. Which immunoglobulin is a key to passive neonatal immunity? - A) IgG - B) IgA - C) IgM - D) IgE - E) IgD
Explanation: IgG
develops symptoms of acute salpingitis. On laparoscopy, sulfur granules appear at the fimbria of the tubes. Which of the following is the most likely organism? - A) trachomatis - B) Nocardia species - C) N. gonorrhea - D) T. pallidium - E) Actinomyces species
Explanation: Actinomyces species Q19. Which of the following eicosanoids cause arteriolar vasospasm - A) during menstruation? - B) Leukotriene LTB4 - C) Thromboxane TXA2 - D) Prostacyclin PGI2 - E) Prostaglandin E2 Prostaglandin F2α
Explanation: PGF2 alpha vasoconstricts the endometrial vessels during menstruation and contracts the smooth muscle of the myometrium. PGE2 vasodilates the vessels of the endometrium, and PGI2 relaxes smooth muscle, vasodilates the vessels of the myometrium and inhibits thrombocyte aggregation.
discharge for the last 3 days. She has recently become sexually active with a new boyfriend. Analysis of the discharge reveals gram-negative intracellular diplococci with scant neutrophils. Which organism is most likely to be responsible? - A) Chlamydia trachomatis - B) Neisseria gonorrhoeae - C) Gardnerella vaginalis - D) Treponema pallidum - E) Mycoplasma hominis
Explanation: Neisseria gonorrhoeae
complaining of frothy yellow vaginal discharge. She is sexually active with her 17-year-old boyfriend and uses the oral contraceptive pill. Speculum examination reveals haemorrhages on her cervix. A urine pregnancy test is negative. Considering the most likely diagnosis, what is the most appropriate first line antibiotic? Amoxicillin Azithromycin Metronidazole Entamizole
(Page 2) 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. - A) 50. - B) 51. - C) 52. - D) Entamizole - E) Spiramycin
Explanation: DIAGNOSIS is trichomonas vaginalis UPDATE Q20. Which of the following investigations is used to determine - A) hormone receptor expression 'receptor status' of the breast cancer? - B) Mammogram - C) Magnetic resonance imaging - D) Fine needle aspiration cytology - E) Immunohistochemical staining Pestron emission computed tomography
Explanation: Immunohistochemistry (IHC) uses antibodies to detect the location of proteins and other antigens in tissue sections. Although less quantitative than assays such as western blotting or ELISA, IHC gives invaluable information about protein localization in the context of intact tissue.
sharps waste. Sharps containers must be located in a safe position to avoid spillage. According to NICE guidance where we have to put the sharps containers in the hospital? - A) Out of reach of kids and visitors - B) Near to medication cupboard - C) Near to garbage - D) Under patient's beds - E) Outside the hospital wards
Explanation: Sharps containers: must be located in a safe position that avoids spillage, is at a height that allows the safe disposal of sharps, is away from public access areas and is out of the reach of children must not be used for any other purpose than the disposal of sharps must not be filled above the fill line must be disposed of when the fill line is reached should be temporarily closed when not in use should be disposed of every 3 months even if not full, by the licensed route in accordance.
Q21. A 25-year-old woman who is 20 weeks pregnant was admitted via - A) A&E with severe loin pain, shivering and vomiting. Her temperature is - B) 38.8°C, pulse is 110 bpm and blood pressure is 88/56 mmHg. Urine dip - C) shows leucocytes ++ and protein ++. Her midstream urine sample result - D) shows: Culture: E.coli +++ - E) Sensitivities: Trimethoprim: Resistance Amoxicillin: Resistance Nitrofurantoin: Sensitive Cephalexin: Sensitive Gentamicin: Sensitive What is the drug of choice for the treatment? Trimethoprim oral Nitrofurantoin oral Cephalexin oral Cephalexin injection Gentamicin injection
Explanation: Cephalexin injection Q22. Whooping cough vaccine leads to providing long immunity from? - A) Cytotoxic T cells - B) Memory B cells - C) Naive B cells and TH cells - D) Innate immune cells - E) Inoculation of microorganism
Explanation: Memory B cells
genital blisters. A swab results reveals a diagnosis of genital herpes. Which of the following is the best drug to be used to treat this patient? - A) Topical acyclovir - B) Topical gabapentin - C) Topical tacrolimus - D) Topical ultrapotent steroid - E) Steroid with antifungal
Explanation: Topical acyclovir
Q23. A 37-year-old lady had a hysterectomy for multiple fibroids at - A) 15:00 am. She felt unwell and developed a spiking fever of over 38.2oC - B) on the first postoperative day at 22:00 am. - C) Which of the following is the most likely? - D) Deep venous thrombosis - E) Pulmonary embolism Post operative inflammation Surgical site infection Reactive temperature spike response to surgery
Explanation: Reactive temperature spike response to surgery caused by stress hormones and cytokines.
Q24. IgG passing through the placenta? - A) Active transport - B) Passive transport - C) Phagocytosis - D) Pinocytosis - E) Diffusion
Explanation: Pinocytosis Q25. What type of agglutination test used to detect fetal blood - A) hemolysis? - B) Indirect coombs test - C) Direct coombs test - D) Indirect & direct coombs test - E) None of above
Explanation: The direct Coombs test is used clinically when immune-mediated hemolytic anemia suspected. A positive Coombs test indicates that an immune mechanism is attacking the patient's RBCs. This mechanism could be autoimmunity, alloimmunity or a drug-induced immunemediated mechanism. Drug-induced immune-mediated hemolysis Methyldopa (IgG mediated type II hypersensitivity) Penicillin (high dose) Quinidine (IgM mediated activation of classical complement pathway and Membrane attackcomplex, MAC)
- A) Cefalexin
- B) Amoxicillin
- C) Erythromycin
- D) Azithromycin
- E) Metronidazole
Explanation: Penicillin, ampicillin, and amoxicillin have been used most extensively in the treatment of listeriosis. Most experts recommend 6 g or more per day of ampicillin for treatment during pregnancy. This dosage provides adequate intracellular penetration and crosses the placenta in adequate amounts.
Q26. High grade neoplasia caused by HPV ,that can affect the patient - A) even after vaccination by which HPV type? - A) 6 - B) 11 - C) 16 - D) 18 - E) 31
Explanation: The national NHS HPV vaccination programme uses a vaccine called Gardasil. Gardasil protects against 4 types of HPV: 6, 11, 16 and 18. Between them, types 16 and 18 are the cause of most cervical cancers in the UK (more than 70%) Cervarix prevents infection with types 16 and 18 ONLY HPV types 6 and 11 cause around 90% of genital warts, so using Gardasil helps protect girls against both cervical cancer and genital warts. But because the HPV vaccine does not protect against all types of HPV that can cause cervical cancer, it's important that all women who receive the HPV vaccine also have regular cervical screening once they reach the age of 25.
Q27. IgM pentamer by - A) Mu chain - B) Lambda chain - C) L chain - D) Gamma chain - E) J chain
Explanation: Q28. Pregnant women at 22 weeks with group b streptococcus in urine - A) growth of greater than 10^5 cfu/ml? - B) Give intrapartum gbs treatment - C) Perform c section Treat uti - D) Treat uti and repeat culture during term and if no gbs no treatment - E) Treat uti and give intrapartum antibiotic prophylaxis None of above
Explanation: According to GTG, Women with GBS urinary tract infection (growth of greater than 10^5 cfu/ml) during pregnancy should receive appropriate treatment at the time of diagnosis as well as IAP.
Q29. Smear taken from a patient with vaginal discharge. Gram stain - A) shows gram negative diplococci. - B) Identify the organism - C) C trachomatis - D) Bacterial vaginosis - E) Neisseria gonorrhoea T pallidum Actinomycetes
Explanation: Neisseria gonorrhea is a Gram negative, coffee-bean shaped intracellular diplococcus It survives phagocytosis and grows inside neutrophils Diagnosis is through culture, Gram stain, or nucleic acid tests, such as polymerase chain reaction, of a urine sample, urethral swab, or cervical swab. Chlamydia co-testing and testing for other STIs is recommended due to high rates of co-infection. Q30. Which is major cell for adaptive immunity? - A) Lymphocyte - B) Neutrophil - C) Eosinophils - D) Dendritic cell - E) Macrophage
Explanation: The cells that carry out the adaptive immune response are white blood cells known as lymphocytes. B cells and T cells are 20–40% of white blood cells The peripheral bloodstream contains only 2% other 98% move within tissues and the lymphatic system B cells play a large role in the humoral immune response, whereas T cells are intimately involved in cell-mediated immune responses B cells and T cells are produced by stem cells in the bone marrow T cell progenitors then migrate from the bone marrow to the thymus, where they develop further.
- A) Neutrophil
- B) Eosinophil
- C) Monocyte
- D) Lymphocyte
- E) Macrophage
Explanation: Most of the macrophages that accumulate at diseased sites typically derive from circulating monocytes.
Q31. Nature of clue cells? - A) Epithelial cell - B) Columnar cell - C) Cuboidal cell
Explanation: Clue cells are epithelial cells of the vagina that get their distinctive stippled appearance by being covered with bacteria.
Q32. 40-year-old woman had bilateral silicone breast implants placed - A) two years ago. Since that time, she has noted increased firmness with - B) slight deformity of the breast on the left. The implants are removed, and - C) there is evidence for leakage of the implant contents on the left. - D) Which of the following cell types is most likely to be most characteristic of - E) the inflammatory response in this situation? Neutrophils Mast cells Plasma cells Giant cells T lymphocytes
Explanation: Non-osteoclast MGCs (multinucleated giant cell) can arise in response to an infection, such as from tuberculosis, herpes, or HIV, or foreign body are also responsible for the clearance of cell debris which is necessary for tissue remodeling after injuries. Foreign-body giant cells form when a subject is exposed to a foreign substance. Q33. Most common protozoan causes zoonotic infection (associated - A) with cerebral calcification, retinitis)? - B) Chlamydia - C) Plasmodium - D) Toxoplasma - E) Giardia lamblia Trichomonas
Explanation: The classic triad of signs suggestive of congenital toxoplasmosis includes chorioretinitis, hydrocephalus, and intracranial calcification.
birth. Organism - A) Chlamydia trachomatis - B) Neisseria gonorrhoea - C) Trichomonas vaginalis - D) Bacterial vaginosis - E) None of above
Explanation: 1st 5 days mostly N gonorrhoea, after 5 days C trachomatis.
Q34. Alternate complement pathway initiation? - A) Microorganism - B) C3b - C) Protein - D) Cell death
Explanation: Q35. Herpes simplex is what type of virus? - A) DsDNA - B) DsRNA - C) Susana - D) Sedona - E) Retrovirus
Explanation: DsDNA virus
Q36. Lifelong Immunity - A) Innate - B) Adaptive - C) Active - D) Natural - E) None of above
Explanation: Active immunity results when exposure to a disease organism triggers the immune system to produce antibodies to that disease. Exposure to the disease organism can occur through infection with the actual disease (resulting in natural immunity), or introduction of a killed or weakened form of the disease organism through vaccination (vaccine-induced immunity). Either way, if an immune person comes into contact with that disease in the future, their immune system will recognize it and immediately produce the antibodies needed to fight it. Active immunity is long-lasting, and sometimes life-long.
Q37. During the inflammatory phase of wound healing what is the - A) predominant cell type found in the wound during the first 48 hours?
- B) (Page 3)*
- C) 53.
- D) 54.
- E) 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79. 80. 81. Macrophage PMN Fibroblast Lymphocyte B-Cells
Explanation: PMN (neutrophils)
Q38. Tetanus toxoid vaccine - A) Toxoid protein - B) Live attenuated - C) Subunit - D) Conjugated - E) None of above
Explanation: Toxoid protein
Q39. Transmission of chlamydia trichomonas from mother to fetus? - A) Direct face to face - B) Materno placental transfer - C) Breast feeding - D) While vaginal delivery - E) None of above
Explanation: Chlamydia during pregnancy has been linked to preterm labor, premature rupture of the membranes and low birth weight. Chlamydia can be passed from women to their babies during a vaginal delivery.
Q40. Neisseria gonorrhea treatment - A) Doxycycline - B) Erythromycin - C) Ceftriaxone + erythromycin - D) Tetracycline - E) Ceftriaxone with Azithromycin
Explanation: Single intramuscular (IM) dose of 1g ceftriaxone is recommended as the first-line treatment. Q41. Mother has chicken pox. Pneumonia chance? - A) 5% - B) 10% - C) 10-15% - D) 20% - E) 25%
Explanation: The incidence of pneumonia complicating varicella in pregnancy has been quoted at 10– 14%, 28 but these rates are based on small case series. In a series of 347 cases of varicella infection in pregnancy, prospectively documented, 5% of women developed pneumonia. Q42. Mother has flu like symptoms... myalgia... her baby having - A) bradycardia hepatosplenomegaly. - B) Organism - C) Herpes simplex - D) T pallidum - E) Toxoplasma Plasmodium Listeria
Explanation: It can be found in refrigerated, ready-to-eat foods (meat, poultry, seafood, and dairy unpasteurised milk and milk products or foods made with unpasteurized milk), and produce harvested from soil contaminated with L. monocytogenes The symptoms can take a few days or even weeks to appear and may include fever, chills, muscle aches, diarrhea or upset stomach, headache, stiff neck, confusion, and loss of balance. In more serious cases, listeriosis could also lead to the mother's death. First trimester infection commonly results in spontaneous abortion or stillbirth Neonatal listeriosis occurs in approximately 8.6/100,000 of live births, and is one of the most common causes of neonatal meningitis. Listeria monocytogenes can cause sepsis and meningitis during the neonatal period Early onset neonatal septicemia caused by Listeria monocytogenes Clinical findings includes prematurity, meconium stained amniotic fluid , hepatomegaly, splenomegaly, maculopapular exanthema, anal prolapse and meningitis.
- A) Artesunate
- B) Quinine & Clindamycin
- C) Doxycycline
- D) Chloroquine
- E) Mefloquine
Explanation: Mefloquine (5mg/kg once a week) is the recommended drug of choice for prophylaxis in the second and third trimesters for chloroquineresistant areas. With very few areas in the world free from chloroquine resistance, mefloquine is essentially the only drug considered safe for prophylaxis in pregnant travelers.
- A) Pink
- B) Green
- C) Brick red
- D) Pale yellow/colorless
- E) None of above
Explanation: MacConkey Agar (MAC) is a selective and differential medium designed to isolate and differentiate enterics based on their ability to ferment lactose Pseudomonas is lactose non fermenter
Q43. CMV symptomatic at birth - A) 5% - B) 10-15% - C) 20% - D) 40% - E) 50%
Explanation: Around 10–15% of neonates with congenital CMV will be symptomatic at birth, with a similar percentage developing problems later in childhood.
Q44. Rubella type of vaccination - A) Live vaccine - B) Killed vaccine - C) Subunit - D) Polysaccharide - E) None of above
Explanation: Pregnant women should NOT get MMR vaccine Because MMR vaccine is an attenuated (weakened) live virus vaccine However, vaccination in pregnancy is not an automatic reason for termination of the pregnancy.
Q45. Identity the organism - A) Trichomonas - B) Plasmodium - C) Toxoplasma - D) Actinomycetes - E) Mycoplasma
Explanation: Mycoplasma genitalium (MG) is a sexually transmitted infection (STI) with many of the hallmarks of its better-known counterpart, chlamydia. Common cause of nongonococcal urethritis in men and cervicitis in women. (Flask shaped and do not have a cell wall) Q46. Group a streptococcus on Lancefield shows? - A) A-hemolytic - B) B-hemolytic - C) $-hemolytic - D) No-hemolysis - E) None of above
Explanation: B-hemolytic
- A) Leukotrienes
- B) Cytokines
- C) TNF
- D) Dendritic cells
- E) Neutrophils
Explanation: An essential link between innate and adaptive immunity is provided by dendritic cells (DCs), the unique inducers of primary immune responses. As a component of the innate immune system, DCs collect and transfer information from the outside world to the cells of the adaptive immune system. Q47. Which organism produce exotoxin that causes toxic shock - A) syndrome? - B) Bacillus - C) Clostridium - D) Listeria - E) Staphylococcus Actinomycetes
Explanation: Toxic shock syndrome (TSS) is a condition caused by bacterial toxins. Symptoms may include fever, rash, skin peeling, and low blood pressure. There may also be symptoms related to the specific underlying infection such as mastitis, osteomyelitis, necrotising fasciitis, or pneumonia. TSS is typically caused by bacteria of the Streptococcus pyogenes or Staphylococcus aureus type, though others may also be involved.
- A) Herpes virus
- B) Pox virus
- C) Toga virus
- D) Retro virus
- E) None of above
Explanation: Herpes virus
Q48. Treatment of GBS in labor? - A) Benzathine penicillin - B) Benzyl penicillin - C) Vancomycin - D) Ceftriaxone - E) Erythromycin
Explanation: Benzyl penicillin
Q49. Treatment for syphilis in pregnancy? - A) Benzyl penicillin - B) Benzathine penicillin - C) Penicillin G
Explanation: Benzathine penicillin G 2.4 MU IM single dose
Q50. Painless vulval lesion and painless lymph node enlargement - A) H ducreyi - B) Herpes - C) T pallidum - D) Trachomatis - E) Molluscum
Explanation: Q51. T lymphocytes percentage of all lymphocytes - A) 50% - B) 60% - C) 70% - D) 80% - E) None of above
Explanation: Lymphocytes in human circulating blood are approximately 80 to 90 percent T cells and 10 to 20 percent B cells.
Q52. Antigen antibody complex activates which pathway of - A) complement? - B) Classical - C) Alternative - D) MBL pathway
Explanation: In the classical pathway, C1 binds with its C1q subunits to Fc fragments (made of CH2 region) of IgG or IgM, which has formed a complex with antigens. C4b and C3b are also able to bind to antigenassociated IgG or IgM, to its Fc portion Alternative pathway is activated by viruses, fungi, bacteria, parasites, cobra venom, immunoglobulin A, and polysaccharides and forms an important part of the defense mechanism independent of the immune response.
Q53. Complement central for both pathways - A) C1 - B) C2 - C) C3 - D) C4 - E) C5
Explanation: Q54. Risk of transmission to baby in vaginal delivery in case of primary - A) herpes infection? - B) 1% - C) 21% - D) 31% - E) 41%
Explanation: The transmission rate is approximately 40% with a primary or initial infection with genital herpes at time of delivery, but is less than 1% with recurrent attacks of infection.
Q55. Reduced response to cell mediated immunity in pregnancy - A) occurs due to reduction of which of these? - B) Th 1 cells - C) Th 2 cells - D) Neutrophil - E) Dendritic cell
Explanation: Th 1 cells Q56. Which one of the following congenital infections is most - A) characteristically nassociated with fetal hydrops? - B) Toxoplasma gondii - C) Parvovirus B19 - D) Rubella - E) Treponema pallidum Cytomegalovirus
Explanation: Parvovirus B19 Q57. Which one of the following bacteria produces an exotoxin causing - A) 'toxic shock syndrome' associated with tampon usage? - B) Escherichia coli - C) Streptococcus agalactiae - D) Clostridium welchii - E) Staphylococcus aureus Mycoplasma hominis
Explanation: Staphylococcus aureus
past 24 hours and lower abdominal pain and anorexia for the past 5 days. On physical examination, there is generalized tenderness of the abdomen and the cervix appears slightly friable with motion tenderness. A smear of yellow odorless cervical discharge shows gram negative intracellular diplococciand scant neutrophils. What is the most likely causative organism? - A) Actinomyces israelii - B) Neisseria gonorrhoeae - C) Chlamydia trachomatis - D) Gardnerella vaginalis - E) Treponema pallidium
Explanation: Type explanation here...
She is 7 weeks pregnant. Her Chlamydia swab is positive. All other tests are normal. Which is the single most appropriate treatment? - A) Amoxicillin - B) Clindamycin - C) Doxycycline - D) Erythromycin - E) Metronidazole
Explanation: Pregnancy and breast feeding (bashh) Doxycycline and ofloxacin are contraindicated in pregnancy Recommended regimens (Level Ia, Grade A) Azithromycin 1g orally as a single dose, followed by 500mg once daily for two days or Erythromycin 500mg four times daily for seven days or Erythromycin 500mg twice daily for 14 days or Amoxicillin 500mg three times a day for seven days Q58. Which class of immunoglobulin is mainly activate the classical - A) complement system? - B) IgG - C) IgA - D) IgM - E) IgE IgD
Explanation: IgM is the strongest inducer of classical complement activation; a single bound IgM results in a conformational change from a planar to a stable molecule, exposing a C1q-binding site within the constant (Fc) region of the Ab. Q59. Which cytokines are secreted by virally infected host cells and - A) Stimulates uninfected neighbouring cells to synthesize antiviral proteins? - B) Interleukin 1 (IL-1) - C) Interleukin 10 (IL-10) - D) Tumor necrosis factor alpha (TNFα) - E) Lymphotoxin (LT) Interferons alpha and beta (IFN α and IFN β)
Explanation: Interferon is secreted by cells in response to stimulation by a virus or other foreign substance, but it does not directly inhibit the virus's multiplication. Rather, it stimulates the infected cells and those nearby to produce proteins that prevent the virus from replicating within them.
At what stage of syphilis does this feature occur?
(Page 4) 82. 83. 84. 85. 86. 87. 88. 89. 90. 91. 92. 93. 94. 95. 96. 97. 98. 99. 100. 101. 102. 103. 104. 105. 106. Logout - A) Neurosyphilis - B) Primary - C) Quaternary - D) Secondary - E) Tertiary
Explanation: Secondary Q60. What sexually transmitted disease(STD) is caused by - A) Haemophilus ducreyi? - B) Chancre - C) Chancroid - D) Granuloma inguinale - E) Condyloma acuminatum Molluscum contagiosum
Explanation: Chancroid
characterized as - A) Synthetic peptide vaccine - B) Killed virus vaccine - C) Inactivated virus vaccine - D) Live virus vaccine - E) Recombinant viral vaccine
Explanation: MMR is an attenuated (weakened) live virus vaccine Q61. Which of the following is a circulatory blood cell that is capable of - A) differentiation into plasma cells? - B) Neutrophils - C) Basophils - D) Monocytes - E) B lymphocytes T lymphocytes
Explanation: B lymphocytes
- A) Granuloma inguinale
- B) Lymphogranuloma venereum
- C) Herpes genitalis
- D) Congenital syphilis
- E) Chancroid
Explanation: Donovan bodies are rod-shaped, oval organisms that can be seen in the cytoplasm of mononuclear phagocytes or histiocytes in tissue samples from patients with granuloma inguinale.
with her boyfriend. She is concerned about the development of new lesions on her vulva. Upon exam, you note pearly white non-tender several dome-shaped ulcers around 3 mm in diameter. Which of the following is the most likely cause of the patient’s vulvar lesions? - A) Chlamydia trachomatis serotype L1 , L3 - B) Herpes simplex virus (HSV) type 2 - C) Molluscum contagiosum - D) Donovanosis - E) Syphilis
Explanation: Molluscum contagiosum Q62. Which of the following human papilloma virus (HPV) subtypes is - A) highrisk for the development of genital warts? - B) HPV serotype 2, 6 - C) HPV serotype 5, 8 - D) HPV serotype 6, 11 - E) HPV serotype 16,18 HPV serotype 16, 18, 31
Explanation: HPV serotype 6, 11
bilateral salpingo- oophorectomy a 60-year-old woman develops high temperature and confusion. On examination; She has a temperature of 38.2°C, a respiratory rate of 28/min, a pulse of 103 beats/min, a blood pressure of 130/80 and a urine output of 10 ml/hr after catheterization. Which of the following is the most likely diagnosis? - A) Sepsis - B) Septic shock - C) Systemic inflammatory response syndrome - D) Septicemia - E) Severe sepsis
Explanation: Severe sepsis
Q63. Six hours after undergoing a laparoscopic tubal ligation, a 32- - A) yearold woman complains of suprapubic pain and oozing. On examination - B) there is a tender palpable suprapubic mass up to the umbilicus that is dull - C) to percussion. Her Hb level is 11 g/dl. - D) What is the most likely diagnosis? - E) Bladder injury Intra-abdominal bleeding Ureteric trauma Urinary retention Fluid overload
Explanation: Urinary retention Q64. Which group of viruses causes molluscum contagiosum? - A) Adenovirus - B) Herpes virus - C) Papovavirus - D) Parovirus - E) Pox virus
Explanation: Pox virus Q65. What is the most common type of nosocomial infection in the UK - A) hospitals? - B) Pneumonia - C) Urinary tract infection - D) Surgical wound infection - E) Bacteraemia Infectious diarrhoea
Explanation: Post pandemic, Pneumonia is the most common type of nosocomial infection in UK Q66. What percent of untreated individuals move on to the third stage - A) of syphilis? - B) 5% - C) 10% - D) 15% - E) 25% 30%
Explanation: Late disease occurs in approximately one-third of untreated patients around 20–40 years after initial infection. Q67. What is the most common microorganism in the vaginal mucosa? - A) Mycobacterium - B) Candida - C) Doderlin lactobacilli - D) Gardenrella vaginalis - E) Staph. Epidermidis
Explanation: Doderlin lactobacilli
likely to be associated with bladder catheterisation? - A) Bacteroides - B) Escherichia coli - C) Proteus mirabilis - D) Pseudomonas aeruginosa - E) Staphylococcus saprophyticus
Explanation: The most common infecting organism is Escherichia coli. Other Enterobacteriaceae as well as Enterococci spp, coagulase negative Staphylococcus, Pseudomonas aeruginosa, other non-fermenters, and Candida spp are also frequently isolated. Q68. Which type of vaccines is absolutely contraindicated during - A) pregnancy? - B) Killed vaccine - C) Toxoid vaccine - D) Conjugate vaccine - E) Live attenuated vaccine Recombinant DNA vaccine
Explanation: Live attenuated vaccine
and bilateral salpingo-oophorectomy for endometrial carcinoma. This procedure will be placed in which of the following wound classifications? - A) Clean - B) Clean/contaminated - C) Contaminated - D) Infected - E) Dirty
Explanation: Clean-contaminated wounds have no signs of infection at the time of surgery but do involve repairing or removing an internal organ. Examples of this type of wound include surgery on your lungs and appendix and vaginal procedures. The risk for an infection is usually less than 10%
- A) Gram-negative anaerobic bacilli
- B) Gram-positive aerobic bacilli
- C) Gram-positive anaerobic cocci
- D) Gram-negative aerobic bacilli
- E) Gram-negative aerobic cocci
Explanation: Type explanation here... Q69. Which of the following fungi is most commonly found in catheter - A) related infection? - B) Cryptococci - C) Candida spp. - D) Aspergillus spp. - E) Coccidioides spp. Pneumocystis jiroveci
Explanation: Candida spp.
contact with a child who has chickenpox around 4 days ago. She is unsure if she had the condition herself as a child. Blood tests show the following: VZV IgG : Negative VZV IgM : Negative What is the most likely diagnosis? - A) Non-immunity to measles - B) Non-immunity to chickenpox - C) She is immune to chickenpox - D) Recent infection to measles - E) Recent infection to chickenpox
Explanation: Non-immunity to chickenpox
attends the GP’s surgery as she noticed vesicular rash on her back and abdomen. She is 25 weeks pregnant. Her GP confirms the diagnosis of chickenpox. What is the most appropriate action? - A) Reassurance - B) Give a single dose of varicella zoster immunoglobulin - C) Advise serial ultrasound scans - D) Commence oral acyclovir - E) Commence intravenous acyclovir
Explanation: Commence oral acyclovir
night sweats. Exposure to Mycobacterium tuberculosis was documented 20 years ago, and M. tuberculosis is identified in her sputum. A chest Xray reveals bilateral apical granulomas. Which prominent cells are found in the tuberculosis granuloma? - A) Neutrophils - B) Eosinophils - C) Plasma cells - D) Lymphocytes - E) Macrophages
Explanation: Macrophages
Q70. The tissue in which most lymphocytes are produced is the - A) Liver - B) Spleen - C) Thymus - D) Bone marrow - E) Lymph nodes
Explanation: Bone marrow
Q71. A 19-year-old married female complains of vaginal discharge, - A) odor, and itching. Speculum examination reveals a homogeneous grey - B) discharge, vulvar and vaginal erythema, and a"strawberry" cervix. - C) The most likely causative organism is - D) Candida albicans - E) Gardnerella vaginalis Trichomonas vaginalis Chlamydia trachomatis Herpes simplex type 2
Explanation: Trichomonas vaginalis
Q72. A 30-year-old second gravida at 10 weeks pregnant wants to - A) know about antenatal Group B streptococcus measures. - B) Which of the following circumstances is an indication for GBS screening? - C) Previous baby with invasive GBS infection - D) Vaginal swab positive for GBS in current pregnancy - E) Woman carriage GBS in previous pregnancy Routine antenatal screening for GBS carriage No need for routine antenatal screening for GBS carriage
Explanation: Universal bacteriological screening is not recommended.
Q73. A 27-year-old woman has a smear test as part of the UK - A) screening programme. Following an abnormal result she attends a - B) colposcopy clinic. On colposcopy, the whitened appearance of her cervix - C) on application of acetic acid is suggestive of a human papilloma virus - D) (HPV) infection. - E) Which of the following HPV subtypes is highrisk for the development of cervical intraepithelial neoplasia? HPV 1, 2 HPV 6, 11 HPV 16, 18 HPV 32, 34 HPV 73, 82
Explanation: Type explanation here...
Q74. A woman presents in spontaneous labour at term with her first - A) baby; then she delivered at term and the baby was fine. Six hours post - B) delivery she finds to have group B streptococcus on a high vaginal swap - C) done three days previously when she was seen in another maternity unit. - D) What is the most appropriate management plane to prevent early onset - E) neonatal group B streptococcal disease? Reassure that no action is necessary Immediately refer to the neonatologist Start antibiotics to the baby Start antibiotics to the mother Inform the mother to be given antibiotics in the next pregnancy
Explanation: When testing for GBS carrier status, a swab should be taken from the lower vagina and the anorectum. A single swab (vagina then anorectum) or two different swabs can be used. Postnatal antibiotic prophylaxis is not recommended for asymptomatic term infants without known antenatal risk factors. How should well babies at risk of EOGBS disease whose mothers have not received adequate IAP be monitored? Well babies should be evaluated at birth for clinical indicators of neonatal infection and have their vital signs checked at 0, 1 and 2 hours, and then 2 hourly until 12 hours.