🏠/MRCOG Part 1 — Study Book/Appendices/Recalls/2015 2019 Recalls

2015 2019 Recalls

MRCOG Part 1 Recalls — 2015–2019 Compilation

Crowd-sourced recall questions from the MRCOG Part 1 exam.

By: dr. Mohamed yahia abuelgasem 1. The probability of sarcomatous change occurring in fibroid is a. 0.1% b. 1% c. 5% d. 10% e. 15% 2. Midazolam is an effective anxiolytic drug, used for preoperative sedation. Which receptor is responsible for its action? A. 5-HT 1a B. 5-HT 3 C. D 2 D. GABA E. N-methyl-D-aspartate (NMDA) 3. Which one of the following tocolytic drug is a competitive oxytocin receptor antagonist ? A. Ritodrine B. Terbutaline C. Atosiban D. Nifedipine E. Indomethacin 4. What is the mechanism of action of labetalol ? A. Antimuscranic B. α blockers C. β blockers D. Both α and β blockers E. Direct-acting smooth-muscle relaxant 5. What is the contrast dye used in MRI scans? A. Iodine B. Barium C. Thallium D. Gadolinium E. Tecnisian 6. The most common site of endometriosis is A. Ovary B. Uterosacral ligament C. Vagina D. Rectum E. Oviduct 7. The posterior fontanelle usually closes by what age? A. 3 months B. 6 months C. 9 months D. 12 months E. 18 months 8. Frequency of current used in electrosurgery unit is A. 1KHz to 1.5MHz B. 100KHz to 1.5MHz C. 100KHZ to 4MHz D. 400KHz to 9MHz E. 800KHz to 9MHz 9. The most likely karyotype for a patient with complete hydatidiform mole is A. 46, XX B. 46, XY C. 69, XXX D. 69, XXY E. 69, XYY 10. Which one of the following congenital infections is most characteristically nassociated with fetal hydrops? A. Toxoplasma gondii B. Parvovirus B 19 C. Rubella D. Treponema pallidum E. Cytomegalovirus 11. What is the most common site for tubal ectopic gestation? A. Ampulla B. Isthmus C. Infundibulum D. Interstitial portion E. Fimbrial end

  1. The standard for conventional cytogenetic analysis of human chromosomes is A. FISH B. G banding C. M banding D. DNA microarray E. QF-PCR
  2. Metabolic abnormality seen in congenital hypertrophic pyloric stenosis is A. Hypochloremic hypokalemic metabolic alkalosis B. Hyperchloremic hypokalemic metabolic alkalosis C. Hypochloremic hypokalemic metabolic acidosis D. Hyperchloremic hyperkalemic metabolic acidosis E. Hyperchloremic hypokalemic metabolic acidosis
  3. Which antigen-presenting cells (APCs) are mainly found in the cervix? A. Plasma cells B. Hofbauer cells C. Langerhans cells D. B cells E. T cells
  4. Mifepristone is a drug used in medical termination of pregnancy. What is the mifepristone mode of action? A. Estrogen agonist B. Estrogen antagonist C. Oxytocin antagonist D. Progesterone agonist E. Progesterone antagonist
  5. In the fetal circulation, which structure bypasses the liver, carrying oxygenated blood directly into the inferior vena cava? A. Ductus venosus B. Ductus arteriosus C. Foramen ovale D. Right hepatic vein E. Portal vein
  6. A 16-year-old girl is diagnosed with transverse vaginal septum. The most likely embryological mechanism responsible for this anomaly is A. Absent paramesonepheric ducts B. Absent fusion of paramesonepheric ducts C. Incomplete fusion of paramesonephric ducts D. Incomplete lateral fusion/septum resorption E. Incomplete fusion of sinovaginal bulb with mullerian system
  7. A structure found within the adult female pelvis formed from the gubernaculums is the A. Transverse cervical ligament B. Suspensory ligament of the ovary C. Round ligament of the uterus D. Broad ligament E. Uterosacral ligament
  8. What part of the embryo is the origin of primordial germ cells? A. Gonadal ridge B. Yolk sac endothelium C. Coelomic epithelum D. Extraembryonic mesoderm E. Primitive sex cord
  9. Misoprostol is a commonly used drug in the medical treatment of miscarriage. What type of drug is misoprostol? A. Cyclooxygenase inhibitor B. Prostaglandin f 2α C. Progesterone antagonist D. Prostaglandin E 2 E. Prostaglandin E 1
  10. Which artery supplies the distal portion of round ligament of the uterus? A. Ovarian artery B. Uterine artery C. Vaginal artery D. Superior vesical artery E. Inferior epigastric artery
  11. While performing laparoscopy, the lateral umbilical folds can be seen on

the anterior abdominal wall in the adult. This structure contains : A. Inferior epigastric vessels B. Obturator vessels C. Remnant of urachus D. Obliterated umbilical arteries E. Ovarian vessels 23. What is the most abundant carbohydrate in the breast milk? A. Maltose B. Galactose C. Glucose D. Lactose E. Sucrose 24. Which of the following structure, when dilated, produces caput medusa? A. Hepatic veins B. Splenic veins C. Ductus venosus D. Umbilical arteries E. Umbilical veins 25. Whenever the intestinal midgut loop fails to return from the umbilical cord into the abdominal cavity, the defect is known as which of the following? A. Gastroschisis B. Exompholos C. Meckel’s diverticulum D. Vitelline fistula E. Left-sided colon 26. Suxamethonium does not readily cross the placenta because of A. Placental cholinesterase B. High protein binding C. Elongated molecular configuration D. High degree of ionization E. Insufficient maternal concentration 27. Nifedipine belongs to which class of drugs? A. K + channel blockers B. Na + channel blockers C. Ca ++ channel blockers D. Angiotensin receptor blockers E. Angiotensin-converting enzyme inhibitors 28. What type of compound is Histones? A. Carbohydrate B. Fatty acid C. Prostaglandin D. Protein E. Steroid 29. Ovarian reserve is a term that is used to determine the capacity of the ovary to provide egg cells that are capable of fertilization. Determination of ovarian reserve is important in the treatment of infertility. Test for ovarian reserve A. LH B. LH/FSH ratio C. FSH D. Estradiol E. Anti-mullerian hormone 30. 28-year-old Asian woman G2P2 at 26 weeks gestation. Her BMI is 36 kg/m 2 Glucose tolerance test report (75 g load) are as follows:  Fasting serum glucose : 4.7 mmol/l  2-hour serum glucose : 7.4 mmol/l What is the diagnosis? A. Normal B. Impaired glucose tolerance C. Impaired fasting glucose D. Postprandial hyperglycemia E. Gestational D.M 31. Peak maternal serum hCG concentrations occur at A. 6 weeks gestation B. 8 weeks gestation C. 10 weeks gestation D. 14 weeks gestation E. 20 weeks gestation 32. Forest plot: horizontal lines represent A. Range B. Interquartile range C. 95% CI D. Standard error E. Study's weight

  1. Which one of the following bacteria produces an exotoxin causing 'toxic shock syndrome' associated with tampon usage? A. Escherichia coli B. Streptococcus agalactiae C. Clostridium welchii D. Staphylococcus aureus E. Mycoplasma hominis
  2. Which of the following most accurately describes the mode of action of letrozole? A. Progesterone-receptor antagonist B. Estrogen-receptor antagonist C. Aromatase inhibitor D. Selective estrogen receptor modulator E. Selective serotonin reuptake inhibitor
  3. What is represented by the equation Sensitivity/(1-specificity)? A. Accuracy B. Positive predictive value C. Negative predictive value D. Positive likelihood ratio E. Negative likelihood ratio
  4. 16-year-old has recently become sexually active. She complains of intensely irritating greenish frothy vaginal discharge. The organism is seen under microscope in a drop of saline and PH is 6. What is the most likely causative organism? A. Candida albicans B. Chlamydia trachomatis C. Gardnerella vaginalis D. Trichomonas vaginalis E. Treponema pallidium
  5. A sexually active 18-year-old woman presents with a fever for the past 24 hours and lower abdominal pain and anorexia for the past 5 days. On physical examination, there is generalized tenderness of the abdomen and the cervix appears slightly friable with motion tenderness. A smear of yellow odorless cervical discharge shows gram negative intracellular diplococci and scant neutrophils. What is the most likely causative organism? A. Actinomyces israelii B. Neisseria gonorrhoeae C. Chlamydia trachomatis D. Gardnerella vaginalis E. Treponema pallidium
  6. A 33-year-old woman with an intrauterine contraceptive device develops symptoms of acute salpingitis. On laparoscopy, sulfur granules appear at the fimbria of the tubes. Which of the following is the most likely organism? A. C. trachomatis B. Nocardia species C. N. gonorrhea D. T. pallidium E. Actinomyces species
  7. A 32-year-old woman has increasing white vaginal discharge. She is 7 weeks pregnant. Her Chlamydia swab is positive. All other tests are normal. Which is the single most appropriate treatment? A. Amoxicillin B. Clindamycin C. Doxycycline D. Erythromycin E. Metronidazole
  8. What is the smallest human chromosome? A. Chromosome 20 B. Chromosome 21 C. Chromosome 22 D. Chromosome X E. Chromosome Y
  9. Which antiemetic drug can cause uncontrolled muscle movements? A. Meclizine B. Scopolamine C. Ondansetron D. Granisteron E. Metoclopramide
  10. What is the pathophysiology explain that vitamin A can cause birth defects of the child during pregnancy?

A. Accumulation of free radicals B. Oxidative stress C. Excessive carotenoids D. Hypervitaminosis A E. Deficiency of vitamin A 43. Patient has a heavy menstrual bleeding. She desires an endometrial ablation to stop bleeding after failure of medical treatment. Which part of the uterus is destructed to stop bleeding? A. Basal layer of endometrium B. Functional layer of endometrium C. Both layer of endometrium D. Entire myometrium E. Spiral artery 44. A 26-year-old pregnant woman is found to have an Hb of 11 g/dL on a routine blood test , with an MCV of 70. Serum electrophoresis reveals an Hb F of 0.5 percent, Hb A 1 of 60 percent, Hb A 2 of 2 percent and Hb S of 40 percent. Her ferritin levels are normal. The most likely diagnosis is: A. Iron deficiency anemia B. α - thalassemia C. β-thalassemia D. Sickle cell trait E. Sickle cell disease 45. A 36-year-old woman underwent a total abdominal hysterectomy for uterine fibroids. Postoperatively she complains of loss of flexion of her left hip and numbness over her left anterior and medial thigh. The compression of which nerve is likely to be responsible? A. Common peroneal nerve B. Femoral nerve C. Ilioinguinal nerve D. Obturator nerve E. Pudendal nerve 46. Which nerve or nerve plexus provided sensory innervation to the cervix? A. Pudendal nerve B. Sacral splanchnic nerve C. Pelvic splanchnic nerve D. Superior hypogastric plexus E. Inferior hypogastric plexus 47. The typical effective dose for abdominal CT scan is A. 0.1-0.5 mSv B. 1-2 mSv C. 3-5 mSv D. 10-15 mSv E. 20-25 mSv 48. In which circumstance is rhesus immunisation NOT required in a rhesus- negative mother? A. Amniocentesis B. Chorionic villus sampling C. External cephalic version D. Sweeping membranes E. Caesarean section 49. Which class of immunoglobulin is mainly activate the classical complement system? A. IgM B. IgA C. IgG D. IgE E. IgD 50. Sample size 30, variance 25 and standard error of mean 3 What is the data set's Standard deviation? A. 2 B. 5 C. 8 D. 12 E. 16 51. Physiological variation of the menstrual cycle between 21-35 days due to A. Aberrant LH surge B. Estrogen fails to produce negative feedback on pituitary C. Estrogen fails to produce positive feedback on pituitary D. Luteal phase varies in duration by time taken for corpus luteum to degenerate E. Loss of progesterone secretion 52. 23-year-old woman presents with fishy foul smelling vaginal odour. 'Clue cells' are found in the smear. Which of

the following cell types is belong to 'Clue cells'? A. Neutrophils B. Natural killer cells C. Lymphocytes D. Macrophages E. Epithelial cells 53. A 27-year-old woman after normal vaginal birth develops shortness of birth and seizures. Despite resuscitation she dies within 20 minutes. At autopsy squamous cells and fetal hair are found in lungs. What is the most likely cause of death? A. Amniotic fluid embolism B. Placental abruption C. Eclampsia D. Pulmonary embolism E. Postpartum hemorrhage 54. A 19-year old G2 P1 woman has an amniocentesis performed at 18 weeks gestation. Fibroblasts recovered from amniocentesis are grown in culture to assess the karyotype of fetal cells. These cells are subcultured for additional experimental work, but the culture is lost after 50 doublings of the cells has occurred, and the fibroblasts no longer grow. Which of the following factors affecting these cells is most likely demonstrated by this phenomenon? A. Nutrition B. Mutation C. Apoptosis D. Aging E. Oxidation 55. What percentage triiodothyronin (T 3 ) is free? A. 0.1% B. 1% C. 5 % D. 15% E. 70% 56. Which is non-ergot dopamine agonist drug used to treat hyperprolactinemia? A. Cabergoline B. Quinagolide C. Quinacrine D. Quetiapine E. Terguride 57. Which of the following is commonly used to determine hormone receptor expression 'receptor status' of the breast cancer? A. Mammogram B. Fine needle aspiration cytology C. Pestron emission computed tomography D. Immunohistochemical staining E. fluorescence in situ hybridization 58. The greater omentum is derived from which of the following embryonic structures? A. Dorsal mesoduodenum B. Dorsal mesogastrium C. Pericardioperitoneal canal D. Pleuropericardial membranes E. Ventral mesentery 59. A 19-year-old woman gives birth to her first child. She begins breast feeding the infant. She continues breast feeding for almost a year with no difficulties and no complications. Which of the following cellular processes that occurred in the breast during pregnancy allowed her to nurse the infant for this period of time? A. Stromal hypertrophy B. Epithelial dysplasia C. Steatocyte atrophy D. Ductal dilation E. Lobular hyperplasia 60. Which of the following structures separates the superficial perineal pouch from the deep perineal pouch? A. Superior levator ani B. Inferior levator ani C. Superior fascia of urogenital diaphragm D. Perineal membrane E. Colles fascia 61. Which of the following hormones increases the excretion of calcium in Kidney?

A. Insulin B. Cortisol C. Calcitonin D. parathyroid hormone E. Antidiuretic hormone 62. Choriocarcinoma is a malignant form of gestational trophoblastic disease. When Choriocarcinoma metastasises, it has a propensity for which type of spread? A. Direct invasion B. Hematogenous C. Lymphatic D. Surface implantation E. Transcoelomic 63. The epithelial lining of the cervix exterior to transformation zone is which of the following tissue types? A. Transitional B. Stratified squamous keratinized C. Stratified squamous non￾keratinized D. Stratified columnar E. Simple columnar 64. A patient presents with condyloma lata. At what stage of syphilis does this feature occur? A. Neurosyphilis B. Primary C. Quaternary D. Secondary E. Tertiary 65. What histology constitutes the majority of vulvar cancers? A. Squamous cell carcinoma B. Basal cell carcinoma C. Merkel cell carcinoma D. Adenocarcinoma E. Melanoma 66. What sexually transmitted disease (STD) is caused by Haemophilus ducreyi? A. Chancre B. Chancroid C. Granuloma inguinale D. Condyloma acuminatum E. Molluscum contagiosum 67. Where in the kidney is the majority of bicarbonate reabsorbed? A. Bowman's capsule B. Collecting duct C. Distal convoluted tubule D. loop of Henle E. proximal convoluted tubule 68. What drug can be given to reverse myelosuppression in methotrexate toxicity? A. Folic acid B. Vitamin B 12 C. Pyridoxine D. Thymidine E. Folonic acid 69. Vertical transmission of HIV infection mostly occurs A. In the first trimester B. In the second trimester C. In the third trimester D. During labour and delivery E. In the neonatal period through breastfeeding 70. Which cytokines are secreted by virally infected host cells and Stimulates uninfected neighbouring cells to synthesize antiviral proteins? A. Interleukin 1 (Il-1) B. Interleukin 10 (Il-10) C. Tumor necrosis factor alpha (TNF α) D. Lymphotoxin (LT) E. Interferons alpha and beta (IFN α and IFN β) 71. Insensible loss of water from skin and lungs in 70 year old healthy woman is A. 100 ml/day B. 450 ml/day C. 850 ml/day D. 1350 ml/day E. 2600 ml/day 72. The vaccine for measles, mumps and rubella (MMR) is best characterized as A. Synthetic peptide vaccine B. Killed virus vaccine

C. Inactivated virus vaccine D. Live virus vaccine E. Recombinant viral vaccine 73. Which of the following is a circulatory blood cell that is capable of differentiation into plasma cells? A. Neutrophils B. Basophils C. Monocytes D. B lymphocytes E. T lymphocytes 74. A 40-year-old woman had bilateral silicone breast implants placed two years ago. Since that time, she has noted increased firmness with slight deformity of the breast on the left. The implants are removed, and there is evidence for leakage of the implant contents on the left. Which of the following cell types is most likely to be most characteristic of the inflammatory response in this situation? A. Neutrophils B. Mast cells C. Plasma cells D. Giant cells E. T lymphocytes primary secreted in breast milk and protects the infant's intestinal mucosa from infection? A. IgA B. IgD C. IgE D. IgG E. IgM 76. Which immunoglobulin class has a pentameric structure and is unable to cross the placenta? A. IgA B. IgD C. IgE D. IgG E. IgM 77. Where does fatty acid synthesis occur within the cell? A. Cytosole B. Mitochondria C. Nucleus D. Rough endoplasmic reticulum E. Smooth endoplasmic reticulum 78. What is the most common type of episiotomy performed in the United kingdom (UK)? A. Mediolateral episiotomy B. Median episiotomy C. Paramedian episiotomy D. Lateral episiotomy E. J-shaped episiotomy 79. What is the embryonic origin of the trigone of urinary bladder? A. Mesonephric duct B. Paramesonephric duct C. Ureteric bud D. Urogenital sinus E. Caudal of cloaca 80. What is the most common congenital solid tumour of the newborn? A. Astrocytoma B. Willim's tumour C. Neuroblastoma D. Sacrococcygeal teratoma E. Hepatic hemangioma 81. Which ovarian tumor is associated with Meig's syndrome? A. Cystadenoma B. Teratoma C. Fibroma D. Mucinous E. Granulosa cell tumour 82. Which screening test has high negative predictive value for detection of preterm pre-labour rupture of the membranes? A. Nitrazine test B. Salivary estriol test C. Fetal fibronectin test D. Spinnbarkeit test E. Cervical length measurement 83. Oxybutynin hydrochloride is a non￾selective muscarinic receptor antagonist used to treat bladder overactivity.

Which of the following diseases are aggravated by use of oxybutynin? A. Bronchial asthma B. Closed angel glucoma C. Diabetes mellitus D. Parkinsonism E. Peptic ulcer 84. How many days does it take from the resting follicle stage to ovulation? A. 14 days B. 28 days C. 85 days D. 120 days E. 375 days 85. LH peak precedes ovulation by A. 16 hr B. 24 hr C. 36 hr D. 48 hr E. 72 hr 86. Which one of the following best describes the histological type of endometrium soon after ovulation? A. Decidual reaction B. Atrophic endometrium C. Proliferative endometrium D. Secretory endometrium E. Arias-Stella phenomenon 87. A 49-year-old female asks about the benefits and risks of hormone replacement therapy (HRT) to control the effects of menopause. The use of hormone replacement therapy (HRT) will decreases the risk of which cancer? A. Breast cancer B. Endometrial carcinoma C. Hepatoma D. Ovarian cancer E. Colorectal cancer 88. Which one of the following stages of the cell cycle is cell prepared for DNA synthesis? A. Synthetic phase (S) B. Gap phase 1 (G1) C. Gap phase 0 (G0) D. Gap phase 2 (G2) E. Mitotic phase (M) the cell cycle is preceded by mitosis? A. Synthetic phase (S) B. Gap phase 1 (G1) C. Gap phase 0 (G0) D. Gap phase 2 (G2) E. Gap phase 3 (G3) 90. A neoplasm of the female genital tract occurring in an 18-year-old girl whose mother was treated with diethylstilbestrol during the pregnancy is likely to be a: A. Brenner cell tumor of ovary B. Teratoma of ovary C. Sarcoma botryoides of vagina D. Clear cell carcinoma of vagina E. Squamous cell carcinoma of vulva 91. A 19-year-old extremely anxious parturient requests labor epidural analgesia. During epidural placement, cerebrospinal fluid obtained in the needle catheter. Which along spinal cord dose the needle traverse obtaining CSF leakage from the needle catheter? A. Vertebral canal B. Space between wall of vertebral canal and dura mater C. Space between arachnoid and dura mater D. Space between arachnoid and pia mater E. Spinal canal 92. When should the prophylactic dose of low molecular weight heparin (LMWH) be stopped before regional analgesia? A. 6 hr B. 12 hr C. 24 hr D. 48 hr E. 72 hr 93. Monopolar diathermy cause coagulation effect with sparkling to stop the bleeding vessels by Which of the following procedures?

A. Electrosurgical cutting B. Electrosurgical desiccation C. Electrosection D. Fulguration E. Vaporization 94. Which nerve arises from ventral rami of lumbar plexus and emerges from the medial border of psoas major muscle? A. Femoral nerve B. Genitofemoral nerve C. lateral femoral cutaneous nerve D. Common peroneal nerve E. Obturator nerve 95. Which of the following eicosanoids are mainly increased before menstruation? A. leukotriene LTB4 B. Thromboxane TXA2 C. Prostacyclin PGI2 D. Prostaglandin D2 E. Prostaglandin F2α 96. Which enzyme in the renal tubular cells are responsible for production of ammonia? A. Glutaminase B. Urease C. Arginase D. Glutamate dehydrogenase E. Carbonic anhydrase 97. What type of joint is formed at the sacroiliac joint? A. Primary cartilaginous B. Secondary cartilaginous C. Gomphosis D. Condyloid E. Synovial 98. Which substance removed from proinsulin to release insulin into the circulation? A. Preproinsulin B. Substance P C. A peptide D. B peptide E. C peptide 99. An inherited metabolic disorder called phenylketonuria (PKU) can result in serious problems in infancy. Via which pattern of inheritance is the PKU? A. Autosomal dominant B. Autosomal dominant with incomplete penetrance C. Autosomal recessive D. X-linked recessive E. Polygenic inheritance 100. Which of the following is the most active form of vitamin D? A. Ergosterol B. 7-dehydrocholesterol C. 25 hydroxycholecalciferol D. 24,25 dihydroxycholecalciferol E. 1 alpha 25 hydroxy derivative calcitriol 101. 'Donovan bodies' are associated with? A. Granuloma inguinale B. Lymphogranuloma venereum C. Herpes genitalis D. Congenital syphilis E. Chancroid 102. What is the main mechanism of action of the copper-IUD? A. Blockage of the endometrial cavity B. Blockage of the uterine tubes C. Inhibition of fertilization D. Local inflammatory reaction preventing implantation E. Hostility of the cervical mucus 103. In the developing foetal testis, the cells that produce mullerian-inhibiting substance are the A. Testicular mesenchymal cells B. Interstitial cells of leydig C. Sertoli cells D. Spermatogonia E. Primordial germ cells 104. What kind of cells secrete Calcitonin hormone? A. Chief cells

B. Parafollicular cells C. Oxyphilic cells D. G cells E. Follicular cells 105. Which of the following clotting factors are remain unchanged in normal pregnancy? A. Factor VII B. Factors XI and XIII C. Factors II, V and IX D. Factors VII, VIII, X and XI E. Factors VII, VIII, X, XI and XIII 106. Peptides cross the placenta by: A. Simple diffusion B. Facilitated diffusion C. Solvent drag D. Active transport E. Pinocytosis 107. A 34-year-old woman attends antenatal clinic for a routine ultrasound scan. Abnormalities of placentation are detected and a magnetic resonance imaging (MRI) scan is organized by the fetal medicine consultant. The MRI report shows: ‘The placenta is lower anterior in which invades through the myometrium up to the uterine serosa’. What is the most likely diagnosis? A. Placenta accreta B. Placenta percreta C. Placenta increta D. Placenta praevia E. Vasa previa 108. The progesterone receptor is an example of a : A. Guanylate cyclase receptor B. Nuclear transcription factor C. Tyrosine kinase nuclear receptor D. Ligand-gated ion channel in the cell membrane E. G protein coupled receptor on the Golgi complex 109. The rectum originates from posterior division of which structure? A. Allantois B. Primitive Cloaca C. Ectoderm of proctodeum D. Endoderm of midgut E. Urorectal membrane 110. Sonographically, fluid appear A. Echogenic B. Hypoechoic C. Anechoic D. Isoechoic E. Hyperechoic 111. What is the mode of inheritance of Duchenne muscular dystrophy (DMD)? A. X-linked dominant B. Autosomal recessive C. Autosomal dominant D. Mitochondrial inheritance E. X-linked recessive 112. Which of the following arteries gives rise to the deep dorsal penile artery? A. Internal pudendal B. Testicular C. Inferior vesicle D. Obturator E. Umbilical 113. What is the most common cause of secondary hyperparathyroidism? A. Parathyroid adenoma B. Multiple myeloma C. Sarcoidosis D. Chronic renal failure E. Multiple endocrine neoplasia type 1 114. Besides the skull, the axial skeleton is derived from which structure? A. Neural crest B. Neural tube C. paraxial mesoderm D. Somatic mesoderm E. Splanchnic mesoderm 115. Lithium therapy during pregnancy increases the risk of congenital anomalies in which organ? A. Lung B. Heart C. Brain D. Limb

E. Kidney 116. Which signaling molecule that stimulate the renin-angiotensin system to regulate the sodium concentration? A. Angiotensin B. Aldosterone C. Bradykinine D. Norepinephren E. Oxytocin 117. Antidiuretic hormone (ADH) is released from which part of hypothalamus: A. Arcuate nucleus B. Preoptic nucleus C. Periventricular nucleus D. Suprachiasmatic nucleus E. Supraoptic and Paraventricular nuclei 118. The bifurcation of the abdominal aorta occurs at the level of which of the following structures? A. Lowest point of costal margin B. Highest point of iliac crest C. pubic tubercle D. Anterior superior iliac spine E. Posterior superior iliac spine 119. Combined oral contraceptive pills are safe to use following evacuation of a complete hydatidiform mole at what stage? A. A declining of hCG titers B. A plateau of hCG titers C. hCG titers start to decline D. Return of hCG titer to normal not rising E. Combined oral contraceptive pills cannot be used at all 120. 46-year-old woman who has chronic pelvic discomfort undergo CT scan which shows multiple circumscribed masses in the myometrium. Hysterectomy is performed and histopathological examination shows spindles shaped cells in whorled bundles and the mitotic figures are scarce. The most likely diagnosis is? A. Adenomyosis B. Endometriosis C. Leiomyoma D. Leiomyosarcoma E. Endometrial carcinoma 121. Glucose 6 phosphatase deficiency is a common metabolic disease in Africa. What is the function of the enzyme glucose 6 phosphatase in carbohydrate metabolism? A. Adds glucose to glycogen ends B. Adds phosphate to glucose C. Production of ATP in Aerobic and Anaerobic oxidation D. Production of NADPH in red blood cells E. Converts glucose 6 phosphate to glucose 122. Which neurotransmitter is secreted onto the adrenal medulla? A. Acetylcholine B. Norepinephrine C. Epinephrine D. Dopamine E. Serotonin 123. An 18-year-old woman who had inflammation of the right ovary complains painful spasms in the muscles and some numbness on the skin of the medial part of her right thigh. The following nerves is mostly involved? A. Femoral nerve B. Genitofemoral nerve C. Sciatic nerve D. Obturator nerve E. Nerve to obturator internus 124. Plasma concentration of estrogen increases throughout pregnancy. By 40 weeks, the concentration of estriol increased to estradiol by who much times? A. 100 times B. 50 times C. 20 times D. 10 times E. 5 times 125. If day 0 is the day of fertilization, implantation of the embryo into the

endometrium occurs on what day after fertilization? A. day 3 B. day 5 C. day 7 D. day 14 E. day 28 126. What percentage of Down occur due to Robertsonian Translocation? A. 1% B. 3% C. 5% D. 10% E. 90% 127. A pregnant woman desires screening test for down's syndrome and the following report is obtained :  Age related risk; 1:1000  MoM AFP; 1.05  MoM β-hCG; 0.85  Test risk; 1:10000 What will you counsel this woman? A. The fetus has down's syndrome B. The fetus does not have down's syndrome C. It is high risk for down's D. It is low risk for down's E. Ask the patient to go home 128. Which of the following describes the correct order of musculature of the anal canal from deep to superficial? 1. Deep part of external sphincter 2. Subcutaneous part of external sphincter 3. Internal sphincter 4. Superficial part of external sphincter A. 1,4,2,3 B. 2,1,4,3 C. 3,1,4,2 D. 3,2,1,4 E. 2,4,1,3 129. Which vessels can possibly be injured in the subcutaneous tissue when a transverse suprabic skin incision is made? A. Superficial epigastric B. Superficial circumflex iliac C. Deep circumflex iliac D. Superior epigastric E. Inferior epigastric 130. An Asian woman books in for her third pregnancy at 12 weeks of gestation. She has recently moved to the UK from Thailand to be with her new husband. After pre-test counseling, with the aid of an interpreter, she agrees to hepatitis B virus (HBV) screening. The results return as follows. What is the significance of these results?  HBsAg; POSITIVE  Anti-HBc; POSITIVE  Anti-HBc IgM; NEGATIVE  HBeAg; NEGATIVE  Anti-HBe; POSITIVE  HBV DNA; 203 iu/ml A. Acute HBV infection B. Chronic infection (immune control phase) C. Natural HBV immunity (resolved infection) D. Occult HBV infection E. Post vaccination 131. A 24-year-old woman presents to her GP following sexual contact with her boyfriend. She is concerned about the development of new lesions on her vulva. Upon exam, you note pearly￾white, non-tender several dome-shaped ulcers around 3 mm in diameter. Which of the following is the most likely cause of the patient’s vulvar lesions? A. Chlamydia trachomatis serotype L 1 , L 3 B. Herpes simplex virus (HSV) type 2 C. Molluscum contagiosum D. Donovanosis E. Syphilis 132. Identify which of the following gives the correct pathway of piriformis muscle. Origin Exits pelvis via Insertion

A. Ventral surface of sacrum Greater siactic notch Greater trochanter of femur B. Ventral surface of sacrum Lesser siactic notch Greater trochanter of femur C. Ventral surface of sacrum Greater siactic notch Lesser trochanter of femur D. Dorsal surface of sacrum Greater siactic notch Greater trochanter of femur E. Dorsal surface of sacrum Lesser siactic notch Lesser trochanter of femur 133. Which of the following potential mechanism is more likely to cause tissue damage from ultrasound exposure? A. Cavitation B. Heat C. Scatter D. Fractionation E. Ionization 134. A woman has been diagnosed with carrying the BRCA 1 gene. What is her life time risk of ovarian cancer? A. 5% B. 10% C. 15% D. 20% E. 40% 135. Warfarin blocks postribosomal glutamic acid carboxylation of the precursors of which clotting factors? A. Factor I B. Factor II C. Factor III D. Factor V E. Factor XI 136. Some-town in the UK, has a population of 350,000. During 2010, there were 20,000 live births, 70 stillbirths, and 50 early neonatal deaths. Among the births that year, there were 20 sets of twins and four sets of triplets, and four mothers died at the time of delivery. Which of the following represents the perinatal mortality rate in this town during 2009? A. 50,20,000 B. 70/20,000 C. 120/20,050 D. 120/20,070 E. 120/20,120 137. Which option correctly identifies the embryological origin, Beginning and ending of the round ligament of the uterus? Embryology Beginning Ending A. Gubernaculum ovarii Anteroinferior to uterine cornua labium majus B. Gubernaculum ovarii Posterosuperior to uterine cornua labium majus C. Gubernaculum ovarii Anteroinferior to uterine cornua labium minus D. Paramesonephric duct Posterosuperior to uterine cornua labium minus E. Paramesonephric duct Anteroinferior to uterine cornua labium majus 138. Premenopausal estrogen is mainly produced by which cells? A. Ovarian Stromal cells B. Ovarian Granulosa cells C. Ovarian Theca cells D. Adrenal secretory cells E. Peripheral fat cells 139. A newborn girl is found to have multiple midline malformations. Her physician suspects a chromosomal disorders and orders a karyotype (picture below). Which of the following is the most likely diagnosis?

A. Cri-du-chat syndrome B. Down syndrome C. Turner syndrome D. Edward syndrome E. Patau syndrome 140. Consider the following pedigree: Assuming that the solid square indicate that the person is affected with the condition in the question, What is the likely mode of inheritance? A. Autosomal dominant B. X-linked dominant C. Y-linked dominant D. Autosomal recessive E. X-linked recessive 141. The following is a normal spirometry of a preoperative woman. Which lung volume is indicated by the arrows on the spirometry tracing? A. Residual volume B. Expiratory reserve volume C. Inspiratory reserve volume D. Tidal volume E. Vital capacity 142. The following scatter plot is used to view what type of data? A. Meta analysis data B. Binary data C. Bivariate data D. Digital data E. Ordinal data 143. The following image shows assisted conception technique by intracytoplasmic sperm injection. What will you see in the middle at 12'oclock? A. Mature oocyte B. Sperm C. First polar body D. Second polar body E. Zygote 144. Remifentanil is an ideal controlled analgesia during labour because A. It is a strong µ receptor antagonist B. It has a long duration of action C. It is rapidly metabolized by tissue estrases D. It is more effective than epidural analgesia E. It cannot cross the placenta 145. The following diagram shows the hormonal level in a normal menstrual cycle. Which hormone is indicated in purple in the above diagram? A. Estrogen B. Progesterone C. Inhibin D. luteinizing hormone (LH) E. Follicle stimulating hormone (FSH) 146. Which structure blocks the blood supply to a loop of small intestine at the

femoral ring causing strangulated femoral hernia? A. Inguinal ligament B. Lacunar ligament C. Pectineal ligament D. Pubic tubercle E. Pubis symphysis caushing's syndrome? A. Administration of synthetic ACTH B. Paraneoplastic syndrome C. Pituitary adenoma D. Iatrogenic steroid administration E. Adrenal adenoma 148. The most common cause of delay in puberty in males is: A. Constitutional delay in growth B. Klinefelter's syndrome C. Noonan's syndrome D. Primary hypothyroidism E. Gonadal dysgenesis 149. What electrolyte imbalance can cause paralytic ileus? A. Hypernatremia B. Hyperkalemia C. Hypocalcemia D. Hyponatermia E. Hypokalemia 150. Which one of the following imaging techniques gives maximum radiation exposure to the patient during checking tubal patency? A. Robin tube cannulation B. Hysterosalpingography C. hystero contrast sonography D. Hysteroscopic tube visualization E. Laparoscopy and dye intubation 151. About 2 weeks postnatally, a 36 year old multiparous woman starts to worry that her partner is spying on her as she cares for her baby. She begins to think she can hear someone telling she is doing tasks incorrectly. Her partner calls the health visitor who suspects that the most likely diagnosis is: A. Baby blues B. Bipolar disorder C. Schizophrenia D. Postnatal depression E. Puerperal psychosis 152. What is the correct formula to calculate the specificity? TP = true positive; FP = false positive; TN = true negative; FN = false negative A. TN / (TN + FN) B. TP / (TP + FP) C. TN / (TN + FP) D. TP / (TP + FN ) E. TN/(TP+FP+FN) 153. The Eighth Confidential Enquiry into maternal deaths in the United Kingdom defines maternal mortality as: A. The number of deaths per 1000 pregnancies B. The number of deaths per 100,000 pregnancies C. The number of direct and indirect deaths per 100,000 mortalities D. The number of direct and indirect deaths per 10,000 mortalities E. The number of direct and indirect deaths per 100,000 pregnancies 154. You wish to investigate the time it takes to perform a caesarean section on women with and without pre-eclampsia. At the end of the study you have two groups of women with the duration of caesarean sections recorded for each. It can't be assumed that these are normally distributed. Which non￾parametric statistic test would you use? A. Chi-squared test B. Linear regression analysis C. Mann-Whitney U test D. Pearson’s R test E. Student’s t-test 155. Nitrogenous bases make up cellular nucleic acids including DNA and RNA. Which base pairs with Adenine in the standard DNA helix? A. Thymine B. Guanine C. Inosine

D. Uracil E. Uranine 156. Which of the following human papilloma virus (HPV) subtypes is high￾risk for the development of genital warts? A. HPV serotype 2, 63 B. HPV serotype 5, 8 C. HPV serotype 6, 11 D. HPV serotype 16,18 E. HPV serotype 16, 18, 31 157. Lancefield grouping of streptococci is based on the presence of A. Carbohydrate antigen on cell wall B. Peptidoglycan antigen on cell wall C. M protein D. Color of blood agar E. Sugar fermentation 158. The deep circumflex iliac artery is a branch of which artery? A. Internal iliac artery B. Internal pudendal artery C. External iliac artery D. Common iliac artery E. Femoral artery 159. Which of the following metabolic processes produces the most energy needed for uterine contraction during parturition? A. Aerobic glycolysis B. Anaerobic glycolysis C. krebs cycle D. Oxidative phosphorylation E. Beta oxidation 160. Which hormone is secreted by the placenta and fetal adrenal gland, promotes maturation of the fetal lungs? A. Androstenedione B. Dehydroepiandrosterone C. Corticosterone D. Cortisol E. Cortisone 161. The non pregnant uterus of a 20- year-old female measured 7 x 4 x 3 cm. She became pregnant, and just before delivery of a term infant, the uterus measured 34 x 18 x 12 cm. Which of the following cellular processes was the major reason for the increase in the size of the uterus? A. Endometrial glandular hyperplasia B. Myometrial fibroblast proliferation C. Endometrial stromal hypertrophy D. Myometrial smooth muscle hypertrophy E. Vascular endothelial hyperplasia 162. Which biochemical technique is used to prenatal identification of cystic fibrosis by using specifically amplifying predetermined DNA sequences? A. karyotyping B. Sweat test C. Southern blotting D. Polymerase chain reaction (PCR) E. Fluorescent in situ hybridization (FISH) 163. What is the function of DNA polymerase? A. To unwind DNA helix during replication B. To add nucleotides to the end of a template DNA strand C. To synthesis the nucleotides of DNA strands D. To seal together the broken ends of DNA strands E. To proofread the growing DNA strands and replace mismatched nucleotides 164. Two days after undergoing total abdominal hysterectomy and bilateral salpingo- oophorectomy a 60-year-old woman develops high temperature and confusion. On examination; She has a temperature of 38.2°C, a respiratory rate of 28/min, a pulse of 103 beats/min, a blood pressure of 130/80 and a urine output of 10 ml/hr after catheterization. Which of the following is the most likely diagnosis? A. Sepsis B. Septic shock C. Systemic inflammatory response syndrome

D. Septicemia E. Severe sepsis 165. Six hours after undergoing a laparoscopic tubal ligation, a 32-year￾old woman complains of suprapubic pain and oozing. On examination there is a tender palpable suprapubic mass up to the umbilicus that is dull to percussion. Her Hb level is 11 g/dl. What is the most likely diagnosis? A. Bladder injury B. Intra-abdominal bleeding C. Ureteric trauma D. Urinary retention E. Fluid overload 166. Which enzyme found in red blood cells that buffers blood CO 2 ? A. Cytochrome-b5 reductase B. 5-nucleotidase C. Glucose-6-phosphate dehydrogenase D. Carbonic anhydrase E. Pyruvate kinase 167. Which of the following is the genotype of Edward's syndrome? A. 45, XO B. 46, XX C. 47, XXY D. 47, XX E. 46, XX+18 168. A 30-year-old woman who is 37 weeks pregnant presents with dysuria and urinary frequency. She has been started on cefuroxime that was prescribed for a previous urinary tract infection. Mid stream urine specimen report result shows;  Leukocytes; 50/hpf  100,000 colony of Pure E. coli growth  Co-amoxiclav; sensitive  Nitrofurantoin; sensitive  Trimethoprim; sensitive  Gentamicin; sensitive  Cefuroxime; resistant What is the most suitable antibiotic to use? A. Nitrofurantoin B. Gentamicin C. Trimethoprim D. Co-amoxiclav E. Cefuroxime 169. A 28-year-old primiparous woman is 34 weeks pregnant. Which of the following complains of pregnancy, you will give her a further investigations? A. Backache B. Breast tenderness C. Nausea D. Tiredness E. Dysuria 170. A 43-year-old woman presents to her GP with a 2-month history of galactorrhoea. She is otherwise healthy and is not taking any medications. Nothing abnormal is found in the examination. Her hormonal profile was a follows :  FSH 8.7 iU/l  LH 4.5 iU/l  Oestradiol 100 pmol/l  Prolactin 700 mU/l  TSH 15 mU/l  Free T 4 9 iU/l What is the most likely cause ? A. Prolactinoma B. Non-functioning pituitary tumour C. Addison's disease D. Hypothyroidism E. Hyperthyroidism 171. An 18-year-old woman presented with a history of 15 kg weight loss in the previous four months. She has been amenorrheic for some months. Her examination is completely normal. Her urine pregnancy test is negative. Her laboratory results shows;  Luteinizing hormone; 0.3 mIU/l  Follicle-stimulating hormone; 0.2 iu/l  Prolactin 400 mU/l  Thyroid stimulating hormone; 1.5 mIU/L  Total T 4 ; 200 nmol/L  Total T 3 ; 2 nmol/l

What is the most likely diagnosis? A. Hypothalamic dysfunction B. Pituitary adenoma C. Ovarian dysgenesis D. Polycystic ovary syndrome E. Hyperthyroidism 172. A 70-year-old lady had an ultrasound because she was feeling bloated which showed bilateral ovarian masses with no solid areas associated with abdominal ascites. She is post menopausal and otherwise well. She was sent for a CA 125 which comes back as 50 U/mL. What is her risk of malignancy index score (RMI)? A. 5 B. 10 C. 150 D. 300 E. 450 173. A 28-year-old woman with complete hydatidiform mole is found to have bilateral multiple tiny ovarian cysts along with an enlarged uterus at 12 weeks’ gestational age. The quantitative β-hCG level of 300,000 mIU/mL. What is the most likely type of these ovarian cysts? A. Polycystic ovaries B. Granulosa cell cyst C. Follicular cyst D. Theca lutein cyst E. Corpus luteum cyst 174. A 35-year-old female presents in the emergency department (ED) with severe tachypnea. The following blood gases are obtained on room air:  pH 7.25  pCO 2 7.8 kPa  pO 2 10 kPa  HCO 3 - 18 mEq/L  Saturations 84 per cent What does the blood gas show? A. Metabolic acidosis with respiratory compensation B. Metabolic acidosis C. Respiratory acidosis with metabolic compensation D. Respiratory acidosis E. Mixed metabolic/respiratory acidosis 175. Diagnostic studies frequently use a receiver operating characteristic curve. What do the two axes of the curve represent? A. Accuracy versus 1/sensitivity B. Positive likelihood ratio versus negative likelihood ratio C. Positive predictive value versus negative predictive value D. Sensitivity versus 1 - specificity E. Sensitivity versus positive predictive value 176. Among hundred women during laparoscopic diagnosis of endometriosis. Four women were found with endometriosis. Three out of the four women were found to be true positive. Seven women were found to be healthy i.e. without disease. What is the sensitivity of this test? A. 10% B. 30% C. 43% D. 75% E. 85% 177. A 45-year-old woman with type 2 D.M undergoes an abdominal hysterectomy for fibroids and excess vaginal bleeding. Postoperatively, she develops shortness of breath. A chest X ray reveals bilateral hilar vascular marks with mild pleural effusion. Her blood investigation shows:  Sodium 110 mmol/L  Potassium 4.0 mmol/L  Bicarbonate 24 mmol/L  Urea 3.0 mmol/L  Creatinine 80 µmol/L What is the most likely diagnosis?

A. Adrenal insufficiency B. Syndrome of inappropriate antidiuretic hormone (SIADH) C. Pulmonary edema D. Peumonia E. Renal failure related to endometrial carcinoma? A. Simple hyperplasia B. Complex atypical hyperplasia C. Complex hyperplasia D. Simple atypical hyperplasia E. Polypoid adenoma 179. A 20-year-old, gravida 2, para 1, at 34 weeks of gestation by her last menstrual period presents to the emergency department complaining of mild, painless vaginal bleeding. On examination, her vital signs are: T 37 0 C, HR 100 bpm, BP 120/85 mmHg, RR 18/min and the fundal height 34 cm with a normal CTG tracing. What is the next course of action? A. Perform a sterile vaginal examination B. Perform an amniocentesis to rule out infection C. Perform an ultrasound examination D. Order FBC and cross matching E. Immediate delivery 180. 32 year old 3 rd gravida presents at 32 weeks gestation with a history of ruptured membranes. Which of the following procedures should be avoided in this patient? A. Vital sign assessment B. Electronic fetal monitoring C. Digital examination D. High vaginal swabs E. Ultrasound examination 181. Which process occurs in the mitochondria where uses electrons transport to generate adenosine triphosphate (ATP)? A. Krebs cycle B. Cori's cycle C. Glycolysis D. Substrate level phosphorylation E. Oxidative phosphorylation 182. The level of the umbilicus varies in obese women. What reference point can be used instead? A. Transpyloric plane B. Subcostal plane C. Supracristal plane D. Level of anterior superior iliac spine E. Transtubercular line 183. Which of the following nerves pierces the internal oblique muscle and passes through the inguinal canal? A. Iliohypogastric B. Ilioinguinal C. Genital branch of the genitofemoral D. Obturator E. Lateral femoral cutaneous 184. The chance of malignant transformation occurring in premenopausal benign ovarian cysts is A. 0.1% B. 3% C. 10% D. 15% E. 25% 185. The following ECG trace shows : Regular rhythm, normal rate, multiple P wave before one NN QRS complex (4:1) What is the correct interpretation of this ECG? A. Sinus bradycardia B. Atrial flutter C. 1 st degree heart block D. 2 nd degree heart block E. 3 rd degree heart block 186. Which of the following depression screening questionnaire are frequent normally used during pregnancy?

A. Edinburgh Postnatal Depression Scale B. General Health Questionnaire C. Hamilton Depression Rating Scale D. Beck Depression Inventory E. Hospital Anxiety and Depression Scale 187. A-24-year old woman complains of increasing perineal pain after normal vaginal birth. Her labs reveals, Hb of 9 g/dl and white blood cell count of 17,000/cmm. At discharge what should be prescribed for this patient? A. I.V antibiotic, oral ferrous sulfate then discharge B. Oral antibiotic, oral ferrous sulfate then discharge C. Oral antibiotic, oral ferrous sulfate and wait till full blood profile D. Oral ferrous sulfate and wait till full blood profile E. Oral ferrous sulfate then discharge 188. The investigation that should be carried out in every cases with heavy menstrual bleeding is A. Pelvic ultrasound scan B. Full blood count C. Vaginal swaps for microscopy and culture D. Liver function test E. Endometrial biopsy 189. A-19-year-old woman who is 28 weeks pregnant requests treatment for acne and is prescribed antibiotic by her general practitioner (GP). She goes on to deliver a healthy baby girl at term. Two years later her daughter is noted to have unusually gray discoloration of teeth. Which treatment for acne did her GP prescribed for acne? A. Chloramphenicol B. Sulphonamide C. Quinolone D. Aminoglycosides E. Tetracycline 190. Clomiphene citrate is A. Gonadotropin analogue B. Androgenic steroid C. Estrogenic steroid D. Progestogenic steroid E. Selective estrogen receptor modulator 191. Mechanism of action of Neostigmine is A. Choline ester B. Cholinomimetic C. Muscarinic antagonist D. Anticholinesterase E. Nicotinic antagonist 192. Without treatment, asymptomatic bacteriuria at 32 weeks gestation is at risk of what pregnancy complication? A. Eclampsia B. Spontaneous preterm labour C. Renal failure D. Polyhydramnios E. Post term infant 193. At a significant level of P < 0.05, the null hypothesis H 0 states that A. There is a insignificant difference between soya milk feeding and allergy B. There is a difference between soya milk feeding and allergy C. There is no difference between soya milk feeding and allergy 5% of the time D. There is a difference between soya milk feeding and allergy 95% of the time E. There is no difference between soya milk feeding and allergy 95% of the time 194. A 36-year-old woman had intermenstrual and heavy menstrual bleeding for the past 2 months. She had a history of removal of cervical polyp 3 years ago and her cervical smears are normal. On physical examination, there are no remarkable findings. Her Hb level is normal. A pelvic ultrasound scan shows endometrial thickness of 19 mm and a round hyperechoic mass in the endometrial cavity measuring 10X8mm. What is the most likely diagnosis? A. Adenomyosis

B. Endometriosis C. Endometrial hyperplasia D. Endometrial polyp E. Submucous fibroid 195. An 18-year-old woman has had pelvic discomfort for several months. On pelvic examination, there is a right adnexal mass. Ultrasound picture of the right ovary shows cystic lesion measuring 3.3x 2.5 cm with echogenic septea. What is the most likely finding? A. Hemorrhagic cyst B. Benign teratoma C. Ovarian carcinoma D. Serous cystadenoma E. Follicular cyst 196. What is the major estrogen produced by the placenta during pregnancy? A. Dehydroepiandrosterone B. Estradiol C. Estriol D. Estrone E. Ethinylestradiol 197. From what parent compound are most eicosanoids derived? A. Arachidonic acids B. Oleic acids C. Linoleic acids D. Steroids E. Cholesterols 198. What percentage of women with over active bladder have urinary incontinence? A. 1:2 B. 1:3 C. 1:4 D. 1:5 E. 1:6 199. A 32-year-old Asian woman presents at 36 weeks of gestation with abdominal discomfort, 2+ proteinuria and a blood pressure of 140/90 mmHg. She has blood tests in accordance with the NICE guideline for the management of hypertension in pregnancy. The midwife asks you to review the following blood results. What do these results suggest?  Urea 2.8 mmol/l  Creatinine 67 micromol/l  Sodium 138 mmol/l  Potassium 4.2 mmol/l  Urate 0.37 mmol/l  Albumin 32 g/l  Alkaline phosphatase 198 iu/l  Alanine transferase 33 iu/l  Bilirubin 5 mmol/l A. Acute fatty liver of pregnancy B. Cholestasis of pregnancy C. HELLP syndrome D. Normal blood results for 36 weeks of pregnancy E. Cholecystitis 200. A-27-year old woman complains of amenorrhea for 6 months. For the past few months she has been feeling generally tired. Prior to this she had a regular 30 day cycle. Her urine pregnancy test is negative. Pelvic examination is normal and routine bloods are ordered:  Luteinizing hormone; 33 mIU/l  Follicle-stimulating hormone; 51 iu/l  Prolactin; 300 mU/l  Thyroid stimulating hormone; 3.1 mIU/L (0.2-5.5)  Total T 4 ; 100 nmol/L (50-500)  Total T 3 ; 1.5 nmol/l (0.9-2.8)  Oestradiol; 70 pmol/l (100-500) What is the most likely diagnosis? A. Hypothalamic dysfunction B. Gonadotropin-producing pituitary adenoma C. Premature ovarian failure D. Polycystic ovary syndrome E. Primary hypothyroidism

Recall September By: dr. Mohamed yahia abuelgasem 1. At what lumbar vertebrae does the abdominal aorta bifurcate into the two common iliac arteries? A. L 1 B. L 2 C. L 3 D. L 4 E. L 5 2. The level at which the ovarian artery arises from the abdominal aorta is A. T 10 B. T 12 C. L 1 D. L 2 E. L 3 3. A 25-year-old diabetic woman has been morbidly obese for the past five years. In this patient, which one of the following hormones would decrease the appetite as levels increase? A. Leptin B. Thyroxine C. Ghrelin D. Adiponectin E. Insulin 4. From which organ / system does the Krukenberg tumor of the ovaries originate from? A. Lung B. Brain C. Kidney D. Uterus E. GIT supplies the anorectal canal superior to the pectinate line? A. Celiac trunk artery B. Superior mesenteric artery C. Inferior mesenteric artery D. internal iliac artery E. External iliac artery 6. What is the total blood volume in a term newborn? A. 120 ml/kg B. 100 ml/kg C. 85 ml/kg D. 70 ml/kg E. 50 ml/kg 7. Which group of viruses causes molluscum contagiosum? A. Adenovirus B. Herpes virus C. Papovavirus D. Parovirus E. Pox virus nosocomial infection in the UK hospitals? A. Pneumonia B. Urinary tract infection C. Surgical wound infection D. Bacteraemia E. Infectious diarrhea 9. What percent of untreated individuals move on to the third stage of syphilis? A. 5 % B. 10 % C. 15 % D. 25 % E. 35 % trimethoprim? A. Inhibits cross linkage of the peptidoglycan polymer chains B. Inhibits dihydrofolate reductase C. Inhibits dihydropteroate synthetase D. Inhibits DNA gyrase E. Inhibits transpeptidation 11. What is the SI unit for the activity of radioactive decay? A. Gray B. Sievert

C. Rad D. Roentgen E. Becquerel 12. An 18 year-old woman is found to have a largely solid ovarian neoplasm. Tumor markers were obtained and demonstrated a markedly elevated LDH value. The hCG and a-Fetoprotein were negative. Which of the following tumors is the most likely histology for this neoplasm? A. Theca cell tumour B. Dysgerminoma C. Immature teratoma D. Brenner cell tumour E. Endodermal sinus tumour 13. An obstetrician performs a mediolateral episiotomy to expand the birth canal during a child birth. Which of the following muscles is typically incised during this procedure? A. Bulbospongiosus and superficial transverse perineal muscles B. Bulbospongiosus and deep transverse perineal muscles C. Bulbospongiosus and ischiocavernosu muscles D. Ischiocavernosus and levator ani muscles E. Bulbospongiosus and levator ani muscles 14. A premature infant develops progressive difficulty breathing over the first few days of life. Deficient surfactant synthesis by which of the following cell types may have contributed to the baby's respiratory problems? A. Alveolar capillary endothelial cells B. Bronchial mucous cells C. Bronchial respiratory epithelium D. Type I pneumocytes E. Type II pneumocytes 15. Regarding urinary tract infections, which micro-organism is most likely to be associated with bladder catheterisation? A. Bacteroides B. Escherichia coli C. Proteus mirabilis D. Pseudomonas aeruginosa E. Staphylococcus saprophyticus 16. What is the most common microorganism in the vaginal mucosa? A. Mycobacterium B. Candida C. Doderlin lactobacilli D. Gardenrella vaginalis E. Staph. Epidermidis 17. What day of a regular 25-day menstrual cycle is a woman likely to ovulate? A. 4 B. 11 C. 14 D. 22 E. 25 18. Which antibody (immunoglobulin) class is involved in the allergic reactions? A. IgA B. IgD C. IgE D. IgG E. IgM primarily secreted in breast milk and protects the infant’s intestinal mucosa from infection? A. IgA B. IgD C. IgE D. IgG E. IgM 20. In which part of the cell does glycolysis take place? A. Cytosol B. Mitochondrial matrix C. Mitochondrial cristae D. Rough endoplasmic reticulum E. Smooth endoplasmic reticulum

  1. What is the most likely histological subtype of ovarian cancer associated with endometriosis? A. Clear cell carcinoma B. Serous adenocarcinoma C. Borderline serous tumour D. Muscinous cystadenocarcinoma E. Granulosa cell tumour
  2. A 35 year old woman who is 26 wks gestation goes for walking in a hill and when she is on the extreme of the hill she becomes little breathless and has paraesthia in her hands . What is the appropriate acid base imbalance? A. Metabolic acidosis B. Metabolic alkalosis C. Mixed metabolic and respiratory acidosis D. Respiratory alkalosis E. Respiratory acidosis
  3. What type of acid–base disturbance result in a case of Conn's syndrome? A. Metabolic acidosis B. Metabolic alkalosis C. No effect D. Respiratory acidosis E. Respiratory alkalosis
  4. Finasteride exert its action by inhibition of which enzyme? A. 21-hydroxlase B. 5-alpha reductase C. Aromatase D. Phosphodiesterase E. Desmolase
  5. In which subsites does vulvar cancer most commonly arise? A. Mons pubis B. Labia majora C. Labia minora D. Clitoris E. Posterior fourchette
  6. Urea is transferred from fetal circulation to maternal circulation via which transport mechanism? A. Active transport B. Endocytosis C. Exocytosis D. Facilitated diffusion E. Passive diffusion the cell cycle is a mitosis proceeds? A. Synthetic phase (S) B. Gap phase 1 (G1) C. Gap phase 0 (G0) D. Gap phase 2 (G2) E. Gap phase 3 (G3)
  7. What is the name of structure that shunts oxygenated blood from the right to left atrium in the fetus? A. Ductus arteriosus B. Ductus venosus C. Foramen ovale D. Ligamentum venosum E. Pulmonary trunk
  8. Infection with which one of the following human papillomaviruses (HPVs) is associated with an increased risk of cervical cancer A. HPV 6 B. HPV 11 C. HPV 17 D. HPV 30 E. HPV 33
  9. A 34 yr old woman has just returned to the UK following missionary work in the northern part of South America. She is delighted to be pregnant and presents for booking at 12 wks of gestation. After counseling she agrees to have routine blood investigations including screening for syphilis. The results are returned as following:  Venereal Disease Research Lab. (VDRL) test : reactive  Traponema Pallidum particle agglutination (TP-PA) : non reactive  Fluorescent Traponemal Ab absorption (FTA-Abs) : non reactive What is the most likely interpretation for theses result? A. Consistent with traponemal infection at sometime B. Diagnostic of latent syphilis

C. Indicative of early syphilis D. Likely biological false positive E. Suggests a past treated infection fishy foul smelling vaginal odour. 'Clue cells' are found in the smear. What is the most likely causative organism? A. Trichomonas viginalis B. Candida albicans C. Gardnerella vaginalis D. Chlamydia trachomatis E. Treponema pallidum 32. What kind of cells produces parathyroid hormone (PTH)? A. Chief cells B. Parathynotic cells C. Oxyphilic cells D. C cells E. Follicular cells the cell cycle is cell become quiescent? A. Synthetic phase (S) B. Gap phase 1 (G1) C. Gap phase 0 (G0) D. Gap phase 2 (G2) E. Mitotic phase (M) 34. Which of these chromosomes have centromere located at one side? A. Telocentric chromosome B. Metacentric chromosome C. Dicenteric chromosome D. Submetacentric chromosome E. Acrocentric chromosome 35. Twenty-four hours after an abdominal hysterectomy, a 45-year-old woman complains of vomiting and severe gas pain. On examination her abdomen is distended but nontender. Bowel sounds are absent. What is the most likely electrolyte imbalance? A. Hypercalcaemia B. Hyperkalaemia C. Hypernatraemia D. Hypokalaemia E. Hyponatraemia 36. Male infertility in a patient with cystic fibrosis is likely to be due to which condition? A. Congenital absence of testes B. Congenital absence of vas deference C. Hypothalamic failure D. Oligospermia E. Testicular failure 37. Forms the lateral wall of the ischio￾rectal fossa A. Skin B. Anal canal C. Obturator internus fascia D. Vagina E. Rectum 38. A cystic structure is noted lateral to the vagina. This is believed to be a Gartner duct. What is the embryological origin of this structure? A. Cloaca B. Genital tubercle C. Mesonephric duct D. Paramesonephic duct E. Urogenital septum 39. What percentage thyroxine hormone (T 4 ) is free? A. 0.1% B. 1% C. 5% D. 15% E. 70% 40. What is the second common cause of congenital adrenal hyperplasia (CAH)? A. 17-hydroxylase deficiency B. 21-hydroxylase deficiency C. 11-Beta hydroxylase deficiency D. 3 Beta- hydroxysteroid dehydrogenase deficiency E. 17 Beta-hydroxysteroid dehydrogenase deficiency 41. A 30-year-old P1 + 0 woman presents with painful swelling in right posterolateral part of vagina and fever for 3 days. Diagnosis of Bartholin’s abscess is made. Incision and drainage

is planned. What is the anatomical location of Bartholin’s gland? A. Deep perineal pouch B. Ischiorectal fossa C. Pudendal canal D. Superficial perineal pouch E. Urogenital diaphragm 42. Sympathetic supply to the urinary bladder is derived from which lumbar segments? A. L1 and L2 B. L2 and L3 C. L3 and L4 D. L4 and L5 E. S2, S3 and S4 43. A 68-year-old woman developed left￾sided chest pain a day after she has had total abdominal hysterectomy and bilateral-salpingo-oophorectomy. A 12- lead electrocardiogram is performed and is suggestive of an inferior ST elevation myocardial infarction. Which ECG leads represent the inferior myocardial infarction? A. V1, V2 B. V3, V4 C. aVR D. I, aVL E. II, III, aVF 44. A 30-year-old woman with bipolar disorder is 12-week pregnant. She has been taken her lithium every night. Which of the following abnormality may occur if she continues to take lithium? A. Tetralogy of Fallot's B. Dandy walker syndrome C. Ebstein's anomaly D. Limb reduction deformity E. Renal agenesis 45. A 57-year-old postmenopausal woman is referred to clinic with a six￾month history of bloating. Ultrasound reveals a 7 cm multilocular unilateral ovarian cyst with solid areas. There is no ascites. Her CA-125 is 80 IU/ml. What is her risk of malignancy index score (RMI)? A. 240 B. 320 C. 400 D. 480 E. 720 46. Which is the earliest physical sign of puberty in females? A. Growth spurt B. Thelarche C. Adrenarche D. Pubarche E. Menarche postmenopausal bleeding? A. Atrophic vaginitis B. Endometrial cancer C. Endometrial hyperplasia D. Endometrial polyp E. Hormone replacement therapy 48. A woman is admitted with threatened preterm labour and is commenced on atosiban. What is the mechanism of action of atosiban? A. Calcium channel blocker B. GnRH analogue C. GnRH antagonist D. Oxytocin agonist E. Oxytocin antagonist vincristine? A. Inhibits topoisomerase II B. Cross links DNA C. Inhibits function of microtubules D. Inhibits DNA polymerase E. Alkylates nucleophilic groups on DNA bases 50. A 42-year-old woman has frequency, urgency, and urges incontinence. Examination is unremarkable and a midstream specimen of urine is sterile. She is treated for detrusor overactivity with Mirabegron. Which is the single mechanism of action for this drug? A. Selective serotonin re-uptake inhibitor B. Muscarinic receptors agonist C. Selective Beta-1 agonist

D. Selective Beta-3 agonist E. Selective Beta-3 antagonist 51. Which of the following ligaments allows us to stand upright with a minimum of muscular support? A. Sacrospinous ligament B. Sacrotuberous ligament C. Iliolumbar ligament D. Iliofemoral ligament E. Pubofemoral ligament 52. An MRI examination is NOT allowed under any circumstances when the following is present A. A pacemaker B. A hip/knee joint replacement C. An intracranial aneurysm clip D. A metallic heart valve E. A first-trimester pregnancy statements best describes a type I statistical (α error)? A. Rejecting a null hypothesis when there is a difference B. Rejecting a null hypothesis when there is no difference C. Rejecting the alternative hypothesis when there is a difference D. Accepting a null hypothesis when there is a difference E. Accepting the alternative hypothesis when there is a difference 54. Oxytocin cannot be administrated by oral route because A. It is resistant to destruction by gastric juice B. It is destroyed by gastric juice C. It is eliminated very quickly D. It is needed in large doses if taken orally E. It causes nausea and vomiting orally 55. A 65-year-old nulliparous women presents with vaginal spotting. She has been postmenopausal for 15 years and does not take hormones. An ultrasound shows a mass in the uterine fundus. A hysterectomy is performed, and pathologic examination of the removed uterus reveals heterologous components of a malignant tumor of the endometrial glands and metaplastic cartilage. Which of the following is the most likely diagnosis? A. Endolymphatic stromal myosis B. Endometrial stromal sarcoma C. Endometrial carcinosarcoma D. Endometrial adenosarcoma E. Endometrioid carcinoma 56. Which of the following is an objective of a Phase 3 Clinical testing? A. Assess tolerance B. Identify less common adverse reactions C. Demonstrate/confirm efficacy D. Estimate dose for subsequent studies E. Estimate activity 57. Primitive gonads develop from which cell layer? A. Endoderm B. Intermediate mesoderm C. Lateral mesoderm D. Paraxial mesoderm E. Surface ectoderm 58. What cellular organelle is especially abundant in cells that synthesize antibodies? A. Peroxisomes B. Free ribosomes C. Rough endoplasmic reticulum D. Smooth endoplasmic reticulum E. Lysosomes 59. Psammoma bodies are a histologic feature of ovarian papillary serous cystadenoma. ' Psammoma bodies' are composed of A. Collection of calcium B. iron C. Fibrin D. Mucin E. Lipid 60. A 27-year-old woman at 30 weeks of gestation has gross hematuria.

Ultrasound shows a normal pregnancy and a maternal urinary bladder lesion. Cystoscopy reveals a 3 cm multifocal pedunculated papillary lesion. The remainder of the urinary bladder is normal. The most likely diagnosis of this bladder lesion is A. Transitional cell carcinoma B. Squamous cell carcinoma C. Adenocarinoma D. Small cell carcinoma E. Bladder calculi 61. The shelf-life of stored whole blood is approximately A. 3 weeks B. 5 weeks C. 7 weeks D. 9 weeks E. 12 weeks 62. Which type of vaccines is absolutely contraindicated during pregnancy? A. Killed vaccine B. Toxoid vaccine C. Conjugate vaccine D. Live attenuated vaccine E. Recombinant DNA vaccine 63. In what part of the female urogenital system describes the Vestibule? A. Space between labium minus B. Space between labium majus C. Space between labia minora and majora D. Area around hymen E. Area between hymen and labia minora 64. How much percentage of the cardiac output passes through the kidneys at term? A. 5% B. 10% C. 25% D. 50% E. 75% 65. Terbutaline has a preference for stimulation of which of the following receptors? A. Alpha B. Gamma C. Beta 1 D. Beta 2 E. Dopaminergic the female urethral caruncle? A. Trauma B. Tumour C. Infection D. Hypoestrogenism E. Congenital 67. Gonadotropin Releasing Hormone (GnRH) is what type of Biochemical? A. Tripeptide B. Octapeptide C. Nanopeptide D. Decapeptide E. Polypeptide 68. What type of compound is thyroid releasing hormone (TRH)? A. Carbohydrate B. Protein C. Glycoprotein D. Polypepetide E. Steroid 69. The standard chest X-ray is equivalent to what duration of natural background radiation A. 3 days B. 3 weeks C. 3 months D. 18 months E. 5 years 70. The immediate layer around the oocyte of the tertiary follicle is known as the A. Lamina propria B. Cumulus oophorus C. Zona pellucida D. Zona granulosa E. Theca interna

nucleic acids including DNA and RNA. Which of these nitrogen bases is found in RNA but not in DNA? A. Thymine B. Cytosine C. Uracil D. Guanine E. Adenine 72. The number of hours worked per week for a sample of ten students is shown below

Student Hours 1 20 2 0 3 18 4 16 5 22 6 40 7 8 8 6 9 30 10 40 What is the mode of the above data? A. 5 B. 10 C. 20 D. 30 E. 40 73. Which adverse reaction is common and usually dose related in patients taking misoprostol? A. Diarrhea B. Nausea C. Vomiting D. Bloating E. Dyspepsia 74. Following a water birth, a woman elects not to have oxytocics for the management of the third stage of labour. Thirty minutes later, she is brought to the consultant unit with a postpartum haemorrhage owing to an atonic uterus. If she had received standard oxytocic management for the third stage of labour, by what amount would she have reduced her risk of a postpartum haemorrhage? A. 10% B. 20% C. 30% D. 60% E. 90% 75. Which of the following drugs is used to suppress lactation postpartum in mother who suffers from stillbirth? A. Quetiapine B. Metoclopramide C. Loperamide D. Leuprolide E. Cabergoline 76. What is the term used for the anticancer agent methotrexate? A. plant alkaloid B. Antimetabolite C. Alkylating agent D. Chain cutting agent E. Intercalating agent 77. In the kidneys, the largest volume of glucose reabsorption occurs in which of the following? A. Glomerular capillaries B. Proximal tubules C. Loop of henle D. Distal tubules E. Collecting duct 78. Where in the kidney is potassium completely reabsorbed? A. Bowman's capsule B. Distal convoluted tubule and loop of Henle C. Proximal convoluted tubule and loop of Henle D. Distal convoluted tubule and Proximal convoluted tubule

E. Collecting duct 79. A 64-year-old woman undergoes a total abdominal hysterectomy 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 80. The process by which mRNA is made from DNA is A. Synthesis B. Translation C. Transcription D. Reverse transcription E. Replication 81. What is the most important cation in the extracellular fluid? A. Ca 2+ B. Cl - l C. HCO 3 - D. K + E. Na + 82. To perform an elective lower segment caesarean section, the obstetrician makes a transverse suprapubic incision. Which of the following abdominal wall layers will not be encountered transected during this incision? A. Anterior rectus sheath B. Posterior rectus sheath C. Rectus abdominis muscle D. Skin and subcutaneous tissue E. Transversalis fascia and parietal peritoneum 83. Laboratory results of a clinical specimen from a patient with hospital￾acquired pneumonia reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA). MRSA infection best respond to which antibiotics? A. Piperacillin/tazobactam B. Co-amoxiclav C. Ceftazidime D. Clindamycins E. linezolid 84. The ureteric bud is derived from which of the following embryonic structures? A. Allantois B. Pronephros C. Mesonephros D. Mesonephric duct E. Metanephric blastema 85. Twenty percent of estrogen hormone bound to A. Sex hormone-binding globulin (SHBG) B. Corticosteroid-binding globulin (CBG) C. Thyroid-binding globulin (TBG) D. Albumin E. Pre-albumin (transthyretin) 86. The non-invasive, cell-free fetal DNA in maternal blood of prenatal diagnosis would best be used on A. Fetal RBCs B. Fetal WBCs C. Fetal fibroblasts D. Amniotic cells E. Chorionic cells 87. A 35-year-old diabetic woman underwent vaginal surgery. Postoperatively, she has Loss of cutanous sensation over the anterior and lateral surface of the thigh. The compression of which nerve is likely to be responsible? A. Superior gluteal nerve B. Lateral cutanous nerve C. Sciatic nerve D. Femoral nerve E. Obturator nerve 88. Magnesium is secreted in which of the following nephron segments? A. Proximal tubule B. Thin descending loop of Henle C. Thick ascending loop of Henle D. Distal tubule E. Collecting duct

  1. Which artery supplies the structures derived from the midgut of the embryo? A. Coeliac trunk B. Inferior mesenteric C. Middle rectal D. Renal E. Superior mesenteric
  2. The vertebral column is developed from which germ layer? A. Paraxial mesoderm B. Somatic mesoderm C. Splanchnic mesoderm D. Extraembryonic mesoderm E. Lateral plate mesoderm surgeon identified the medial umbilical folds on the deep surface of the anterior abdominal wall. The two medial umbilical folds represent remnants of which of the following structures? A. Urachus B. Inferior epigastric vessels C. Obliterated umbilical veins D. Obliterated umbilical arteries E. Round ligaments of the uterus
  3. The Haldane effect refers to which of the following options? A. The inhibitory effect of oxygen on fermentation B. The chloride shift that maintains electrical neutrality C. The dissociation constant for the bicarbonate buffer system D. The increased capacity for deoxygenated blood to carry CO 2 E. The reduction in affinity of hemoglobin for oxygen in active tissues in response to a drop in pH caused by increased CO 2 production
  4. What percentage of leydig-cell tumours is malignant in females? A. < 1% B. 5-10% C. 25% D. 50% E. 70% hydralazine? A. α2 agonist B. Angiotensin-converting enzyme inhibitor C. Antimuscarinic D. β2 agonist E. Direct-acting smooth-muscle relaxant
  5. Which one of the following class of drugs causes neonatal kernicterus? A. Penicillin B. Aminoglycoside C. Sulphonamide D. Chloramphenicol E. Macrolide caushing's syndrome? A. Administration of synthetic adrenocorticotropic (ACTH) B. Paraneoplastic syndrome C. Pituitary adenoma D. Iatrogenic steroid administration E. Adrenal carcinoma
  6. Motor fibers to detrusor muscle of the urinary bladder are derived from which of the following nerves? A. Pelvic splanchnic B. Greater splanchnic C. T11-L2 D. Superior hypogastric plexus E. Sacral plexus
  7. Which of the following muscles leaves the lesser pelvis through the greater sciatic foramen? A. pubococcygeus B. Iliococcygeus C. Puborectalis D. Piriformis E. Coccygeus
  8. To reduce postoperative pain after caesarean section, an obstetrician performs ilioinginal-iliohypogastric nerve block (IINB) on his 25-year-old patient. What is the nerve root of ilioinguinal and iliohypogastric nerve?

A. T 12 B. T 12 and L 1 C. L 1 D. L 2 E. L 1 and L2 100. A woman experiences a postpartum hemorrhage after delivery and is administrated carboprost to promote uterine contraction. What type of drug is carboprost? A. Oxytocin agonist B. Progestogen C. Synthetic prostaglandin E 1 D. Synthetic prostaglandin E 2 E. Synthetic prostaglandin F 2 α 101. What is the most appropriate treatment for pelvic inflammatory disease (PID)? A. Ofloxacin 400 mg + Doxycycline 100 mg for 14 days B. Metronidazole 400 mg + Doxycycline 100 mg for 14 days C. Augmentin (co-amoxiclav) 1g + Doxycycline 100 mg for 14 days D. Ceftriaxone 500 mg + Doxycycline 100 mg + metronidazole 400 mg for 14 days E. Augmentin (co-amoxiclav) 1g + metronidazole 400 mg for 14 days 102. A 24-year-old woman attends her obstetrics ultrasound appointment. Her medical history noted mechanical prosthetic valves. The scan reveals the presence of depressed nasal bridge, stippling of non-calcified epiphysis and microcephaly. No other abnormalities were noted. A history of taking which drug is likely to explain the aetiology? A. Thalidomide B. Labetalol C. Phenytoin D. Sodium valproate E. Warfarin 103. Which type of epithelium lines the distal urethra near the external urethral orifice? A. Transitional B. Stratified squamous keratinized C. Stratified squamous non￾keratinized D. Stratified columnar E. Simple columnar 104. Which of the following ovarian tumor is most prone to undergo torsion during pregnancy? A. Serous cystadenoma B. Mucinous cystadenoma C. Dermoid cyst D. Theca lutein cyst E. Corpus luteium cyst 105. Red degeneration of uterine fibroid during pregnancy is due to A. Ischemia B. Calcification C. Infection D. Gangrene E. Rupture of capsule 106. A 14-year-old girl is treated with radiotherapy. Which of following tissues is most radioresistant? A. Intestinal epithelium B. Cerebral cortex C. Respiratory epithelium D. Bone marrow E. Skin 107. When does the odds ratio (OR) approximate the risk ratio (RR)? A. When the disease being studied is occur frequently B. When the disease being studied is rare C. When the sample size is large D. When there is a negative association between exposure and disease E. When there is no association between exposure and disease 108. A 42-year-old perimenopausal woman complains of 12 months history of irregular vaginal bleeding. Her husband had vasectomy since 2 years. Her family is complete. Which action is the most appropriate? A. Commence tranexamic acid

B. Insertion of a levonorgestrel￾releasing intrauterine system (IUS) C. Arrange for transvaginal ultrasound D. Perform an endometrial biopsy E. Hysterectomy 109. The bacteria Neisseria gonorrhoeae can be described as what? 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 110. Meckel's diverticulum is an adult remnant of the vitelline duct. Which of the following embryonic structures are joined by the vitelline duct? A. Foregut and yolk sac B. Midgut and yolk sac C. Hindgut and yolk sac D. Foregut and allantois E. Midgut and allantois 111. When should the last therapeutic dose of low molecular weight heparin (LMWH) be stopped before regional anesthesia? A. 6 hrs B. 12 hrs C. 24 hrs D. 48 hrs E. 72 hrs 112. Which organelles do type II pneumocytes utilize for surfactant release? A. Golgi complex B. Lysosomes C. Endosomes D. Lamellar Bodies E. Rough endoplasmic reticulum 113. Human placental lactogen (hPL) is structurally MOST similar to which of the following hormones? A. Anti mullerian hormone B. Cortisol C. Follicle-stimulating hormone D. Growth hormone E. Prolactin 114. A healthy 34-year-old woman had a total abdominal hysterectomy for cervical disease. Routine urea and electrolytes are measured one day after surgery and are as follows :  Sodium 121 (reference range 135-145 mmol/l)  Potassium 4.3 (reference range 3.5-5.0 mmol/l)  Urea 2.8 (reference range 2.5-6.7 mmol/l)  Creatinine 74 (reference range 70-150 micromol/l) What is the most likely cause to explain the blood test results? A. Excessive intravenous dextrose B. Nephrogenic diabetes insipidus C. Primary aldosteronism D. Undiagnosed diabetes mellitus E. Ureteric damage 115. Which of the following fungi is most commonly found in catheter￾related infection? A. Cryptococci B. Candida spp. C. Aspergillus spp. D. Coccidioides spp. E. Pneumocystis jiroveci 116. A 60-year-old woman with stage IIB cervical cancer is currently undergoing radiotherapy by impact of gamma-emitting isotopes on her vagina. This type of therapy is best described by which of the following terms? A. Adjuvant B. Neoadjuvant C. Radical D. Brachytherapy E. Teletherapy 117. A woman who is 14 weeks pregnant presents as she came into 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 118. A 26-year-old second gravid who is work in a nursery school 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 119. A 25-year-old female presents with chronic right lower quadrant pain for 3 months. She is previously received a treatment for Chlamydia. Her ultrasound revealed; a 4-cm diffuse homogeneous hypoechoic focal lesion with low-level internal echoes with little fluid in the douglas pouch, empty uterus with ET 4 mm and normal adnexa are seen bilaterally. What is the most likely diagnosis? A. Para-ovarian cyst B. Hydrosalpinx C. Mucocele appendix D. Cornual ectopic pregnancy E. Endometrioma 120. A 25-year-old woman presented to an early pregnancy unites with mild vaginal bleeding after 5 week's amenorrhea. There is history of irregular menses. Ultrasound shows no evidence of intrauterine pregnancy. Beta hCG is 400 IU/l and beta hCG after 48hrs later is 700 IU/l. What is the most likely diagnosis? A. Pregnancy of uncertain viability B. Early normal pregnancy C. Ectopic pregnancy D. Incomplete miscarriage E. Threatened miscarriage 121. Following Ectopic pregnancy, what percentage of medically treated women with single dose regimen of methotrexate will require surgical intervention? A. 10% B. 15% C. 20% D. 30% E. 40% 122. Two months postoperatively, a 55- year-old woman who is being treated with a diagnosis of small lung cancer presents with excessive polyuria and depression. You should recognize that this patient may be experiencing what electrolyte imbalance? A. Hypernetremia B. Hyponatremia C. Hyperkalemia D. Hypokalemia E. Hypercalcemia 123. During childbirth, anesthesia is administered into the epidural space of the spinal column. Where is the epidural space located? A. Between supraspinous and interspinous ligaments B. Between the wall of vertebral cavity and dura mater C. Between arachnoid and dura mater D. Between arachnoid and pia mater E. Between pia mater and spinal canal 124. During a difficult delivery an obstetrician uses forceps to extract the infant. Upon examining the baby you notice forceps impressions posteroinferior to the ear. Which of the following is very likely to be damaged? A. Trigeminal nerve B. Facial nerve C. Abducens nerve D. Brachial plexus E. C 8 T 1 nerve

  1. What do the bottom and top represent on the box-and-whisker plot? A. Mean and mode B. Mean and median C. Standard deviation and mean D. Least and greatest value E. Lower and upper quartile
  2. A 52-year-old woman presents to her physician for a check-up. She became menopausal at age 50 and did not begin hormone replacement therapy because of a strong family history of breast and endometrial cancer. She now fears future menopausal symptoms and would like to begin a replacement regimen. Which of the following pharmaceutical agents is most appropriate for this patient? A. Oral conjugated estrogen B. Transdermal estrogen C. Tamoxifen D. Raloxifene E. Trastuzumab
  3. An undifferentiated malignant tumour on immunohistochemical stain shows cytoplasmic positivity of most of the tumor cells for cytokeratin. The most probable diagnosis of the tumor is A. Sarcoma B. Lymphoma C. Carcinoma D. Melanoma E. Hamartoma
  4. A 67-year-old woman attends for a preoperative assessment. She has been taking bendroflumethiazide for several years for hypertension. Her ECG shows: What is the most likely electrolyte imbalance? A. Hypercalcaemia B. Hyperkalaemia C. Hypernatraemia D. Hypokalaemia E. Hyponatraemia
  5. In a sample of 100 women the age at the delivery of their first child showed a normal distribution. The mean age at delivery of their first child was 30 years old, with a standard deviation of 5 years. What is the 95% confidence interval? A. 20 – 30 years B. 20 – 40 years C. 25 – 35 years D. 29 – 31 years E. 15 – 45 years
  6. An 18 yr old woman presents to an early pregnancy unit with vaginal bleeding after 5 weeks of amenorrhea. She had taken a urine pregnancy test that had tested positive. A transvaginal ultrasound scan showed CRL of 6 mm with no visible fetal heart. What is the next appropriate step? A. Check the serum progesterone level B. Measure the serum beta hCG 0 - 48 hours C. Repeat U/S after 7-10 days D. Induction with mifepristone E. Intramuscular methotrexate
  7. Which pattern of endometrim do simple endometrial hyperplasia most likely resemble? A. Proliferative endometrim B. Secretory endometrim C. Endometritis D. Endometrial polyp E. Endometrial carcinoma carrying the BRCA1 gene. What is her life time risk of breast cancer and ovarian cancer? Breast cancer Ovarian cancer A. 30% 10%

B. 50% 30% C. 70% 30% D. 80% 40% E. 95% 60% 133. The following diagram describes a structural chromosomal abnormality. What is the name of this structural abnormality? A. Deletion B. Insertion C. Inversion D. Robertsonian translocation E. Reciprocal translocation 134. A 36-year-old woman who had supraspinous ligament fixation 2 days ago complains of pain over right mons pubis, right labia, and the perineum. Which nerve is most likely to be injured? A. Iliohypogastric nerve B. Ilioinguinal nerve C. Genitofemoral nerve D. Pudendal nerve E. Posterior femoral cutaneous nerve 135. What percentage of total body water is intracellular? A. 66% B. 40% C. 33% D. 20% E. 10% 136. A 30-year-old woman underwent lower segment caesarean section. Two weeks into the postpartum period, she has experienced nausea and vomiting for three days. On examination, she has a temperature of 39 0 C, a respiratory rate of 30/min, and a blood pressure of 90/50 mmHg. The patient has warm peripheries with normal capillary refill time. What is the most likely diagnosis? A. Sever gastroenteritis B. Atelectasis C. Pneumonia D. Septic shock E. Hypovolemic shock 137. What type of epithelial tissue undergoes malignant change in the majority of bladder cancers? A. Columnar B. Pseudostratified C. Squamous D. Stratified E. Transitional 138. Which of the following is in direct contact with maternal blood in lacunae of the placenta? A. Chorion B. Amnion C. Fetal capillaries D. Fetal endothelium E. Maternal epithelium 139. A 27-year-old woman complains of amenorrhoea for 12 months with increased facial hair growth and weight gain since she quit smoking. Her urine pregnancy test is negative. Her serum hormonal levels are as follows:  FSH 5 lU/L  LH 15 IU/L  Prolactin 300 mmol/l  Serum oestradiol 350 pmol/L What is the most likely diagnosis? A. Gonadotropin-producing pituitary adenoma B. Congenital adrenal hyperplasia C. Polycystic ovarian disease D. Premature ovarian failure E. Ovarian neoplasm 140. In a city having a population of 1,000,000 there are 300,000 women of childbearing age. The following statistics are reported for the city in the year 2000: Fetal deaths: 200

Live births: 25,000 Maternal deaths: 75 Which of the following is the best estimate of the maternal mortality ratio in the city in the year 2000? A. 150 B. 200 C. 250 D. 300 E. 350 141. Which of the following cell types lyses cells that have been infected with viruses? A. CD4+ T cells B. B cells C. CD8+ T cells D. Killer cells E. Macrophages 142. What is the single best description for the histological appearance of the secretory endometrium? A. Simple columnar B. Simple columnar with subnuclear vacuolation C. Stratified columnar D. Stratified cuboidal E. Simple cuboidal epithelium 143. The tissue in which most lymphocytes are produced is the A. Liver B. Spleen C. Thymus D. Bones marrow E. Lymph nodes 144. What is the most common adverse effect experienced by women taking the progestogen-only pill? A. Acne B. Weight gain C. Erratic bleeding D. Reduced libido E. Mood swings 145. Inhibin is secreted by which cell type of the ovary? A. Theca externa cells B. Theca interna cells C. Ovarian Stromal cells D. Sustentacular cells E. Granulosa cells 146. Iodine accumulation in thyroid cells involves symport with A. Chloride B. Potassium C. Hydrogen D. Sodium E. Calcium 147. Which types of cells are phagocytic for residual bodies left over from the process of spermiogenesis? A. Testicular mesenchymal cells B. Testicular macrophages C. Fibroblast cells D. Interstitial cells of leydig E. Sertoli cells 148. A 63-year-old woman develops cough with bloody sputum and night sweats. Exposure to Mycobacterium tuberculosis was documented 20 years ago, and M. tuberculosis is identified in her sputum. A chest X-ray reveals bilateral apical granulomas. Which prominent cells are found in the tuberculosis granuloma? A. Neutrophils B. Eosinophils C. Plasma cells D. Lymphocytes E. Macrophages 149. Following radical hysterectomy and pelvic lymphadenectomy for Stage I carcinoma of the cervix, 63-year-old woman reports numbness along the medial thigh as well as weakness of hip adduction. Which nerve most likely to have been injured during the operation? A. Obturator nerve B. Femoral nerve C. Inferior gluteal nerve D. Superior gluteal nerve E. Sciatic nerve 150. Pregnant women, in the second or third trimester, may develop diabetes

insipidus due to excessive placental elaboration of A. Antidiuretic hormone B. Arginine-vasopressin C. Vasopressinase D. Renin E. Neurophysin 151. A 30-year-old para 1 woman with previous normal delivery went into spontaneous labour at term and was fully dilated for 3 hours. After pushing for 90 minutes, ventouse delivery was performed for maternal exhaustion. At the ventouse cup application area, the baby's head is left with a "chignon". In which layer of the skull chignon is found? A. Subcutaneous B. Subaponeurotic C. Subperiosteal D. Subdural E. Extradural 152. A woman who had a total abdominal hysterectomy, according to recent protocols, urinary catheter should be removed for at least A. 6 hrs B. 12 hrs C. 24 hrs D. 48 hrs E. 72 hrs 153. When the body is in the upright position, the expected angle between the brim of the pelvis to the horizontal plane of approximately: A. 15 degrees B. 40 degrees C. 60 degrees D. 90 degrees E. 120 degrees 154. Which chromosomes are capable of robertsonian translocations? A. X, Y B. 15, 17, 19 C. 16, 18, 20 D. 9, 10, 11, 12 E. 13, 14, 15, 21, 22 enters the thigh by passing beneath the inguinal ligament, just medial to the anterior superior iliac spine? A. Femoral nerve B. Iliohypogastric nerve C. Ilioinguinal nerve D. Genitofemoral nerve E. Lateral cutaneous nerve of thigh 156. What is the volume for total blood volume that rises in normal pregnancy? A. 5 ml/kg B. 10 ml/kg C. 25 ml/kg D. 50 ml/kg E. 100 ml/kg 157. What is the most common side effect with etonogestrel implant? A. Amenorrhea B. Infrequent bleeding C. Weight gain D. Acne E. Headache 158. Which of the following agents can cause premature closure of the patent ductus arteriosus? A. Prostaglandin E1 B. Nitric oxide C. Cortisone D. Acetaminophen E. Indomethacin 159. Use of which of the following agents during pregnancy is associated with "floppy infant syndrome?" A. Naproxen B. Diazepam C. Nystatin D. Warfarin E. Phenytoin 160. What landmark marks where the external iliac artery becomes the femoral artery? A. Crest of the ilium B. Inguinal ligament C. Pubic tubercle D. Symphysis pubis

E. Obturator foramen 161. Androgen is secreted from which region of the adrenal gland? A. Adrenal capsule B. Zona reticularis C. Zona glomerulosa D. Zona fasciculata E. Adrenal medulla 162. A nineteen year old girl presents to the clinic and reports that she never had a menstrual period. On examination she is short, wide spaced nipples, webbed neck with coarctation of aorta. What is the most likely diagnosis? A. Mullerian agenesis B. 5-alpha reductase deficiency C. Turner syndrome D. Anorexia nervosa E. Primary hypothyroidism 163. Which of the following placental hormones helps ensure adequate fetal nutrition? A. Estriol B. Progesterone C. Human placental lactogen D. Human chorionic gonadotropin E. Human chorionic adrenocorticotropin 164. Chromosomes arrange themselves on equatorial plate in which phase of the cell cycle? A. Anaphase B. Metaphase C. Prophase D. Synthetic phase E. Telophase 165. Which intracellular organelle is concerned with processes, packages and transports proteins out of the cell? A. Smooth endoplasmic reticulum B. Rough endoplasmic reticulum C. Free ribosomes D. Lysosomes E. Golgi apparatus 166. How many telomeres are in the cell in metaphase of mitosis? A. 1 B. 2 C. 4 D. 6 E. 8 167. Chromosomal pattern of turner syndrome is A. 47/XX B. 46/XXY C. 47/XXY D. 46/X0 E. 45/X0 168. One researcher wishes to assess the postoperative recover for a group of postmenopausal women who had hysterectomy. He classified the patients as fell "worse," "same," or "improve". Which level of measurement is this classification? A. Nominal B. Ordinal C. Continuous D. Interval E. Ratio 169. Kolmogorov smirnov (K-S) test is A. Parametric test compare two related, or dependant samples B. Non-parametric test compare two related, or dependant samples C. Parametric test compare two non￾related, or independent samples D. Non-parametric test compare two non-related, or independent samples E. Non-parametric test compare more than two samples with unpaired data 170. Lymphatics of the sigmoid colon drain into A. Superior mesenteric and Pre aortic lymph nodes B. Inferior mesenteric and Pre aortic lymph nodes C. Internal iliac lymph nodes D. External iliac lymph nodes E. Obturator lymph nodes 171. Which neoplasm is characteristically associated with

paraneoplastic syndrome of inappropriate antidiuretic hormone (SIADH)? A. Renal cell carcinoma B. Breast carcinoma C. Small cell lung carcinoma D. Papillary thyroid carcinoma E. Cancer colon 172. What is the basic principle of the Kleihauer-Betke test? A. Detection the presence of immunoglobulin on RBCs in vivo B. Migration of Adult hemoglobins from anode to cathode C. Fetal hemoglobin is resistant to acid elution D. Fetal hemoglobin is resistant to denaturation by alkali E. Fetal hemoglobin is resistant to denaturation by heat 173. Glucagon works by which of the following mechanisms to reverse the hypoglycemia? A. Glycolysis B. Glycogenesis C. Gluconeogenesis D. krebs cycle E. Oxidative phosphorylation 174. A 19-year-old married female complains of vaginal discharge, odor, and itching. Speculum examination reveals a homogeneous grey discharge, vulvar and vaginal erythema, and a "strawberry" cervix. The most likely causative organism is A. Candida albicans B. Gardnerella vaginalis C. Trichomonas vaginalis D. Chlamydia trachomatis E. Herpes simplex type 2 175. Which of the following laboratory techniques is used for RNA analysis? A. Northern blotting B. Southern blotting C. Southwestern blotting D. Western blotting E. Eastern blotting 176. A 37-year-old woman presents to clinic complaining of lower abdominal discomfort. Exam of uterus is enlarged. Biopsy shows normal appearing glands in myometrium. What is the most likely diagnosis? A. Adenocarcinoma B. Basal cell carcinoma C. Leiomyosarcoma D. Adenomyosis E. Endometriosis What is the mode of inheritance? A. Autosomal dominant B. Autosomal recessive C. Mitochondrial inheritance D. X-linked recessive E. X-linked dominant 178. What type of Laser is Neodymium: YAG laser? A. Semiconductor laser B. Excimer Laser C. Dye Laser D. Gas Laser E. Solid Laser 179. Via which pattern of inheritance is a positive father will give the condition to all of his daughters, but not his sons, whereas a positive female will transmit the trait to half of her sons and half of her daughters. A. Autosomal recessive B. X-linked recessive C. X-linked dominant D. Mitochondrial inheritance E. Y-linked dominant 180. A G1P0 patient with a dilated cardiomyopathy and an ejection fraction (EF) of 28% presents for a

caesarean section. What does EF 28% mean? A. 72% of the total amount of blood pumped into the ventricles prior to systole B. 72% of the total amount of blood left over in the ventricles following systole C. 28% of the total amount of blood left over in the ventricles following systole D. 28% the total amount of blood pumped by the heart during a 1- minute period E. 72% of the total amount of blood pumped by the heart during a 1- minute period 181. What are the cells in the region represented by Arrow X in the picture called? A. Decidua B. Blastocele C. Inner cell mass D. Cytotrophoblast cells E. Syncytiotrophoblast cells 182. A 23-year-old woman attends the antenatal clinic in her first pregnancy. Booking bloods reveal her Blood group O and her rhesus status to be cde/cde; her long-standing partner is also tested at her request and his blood group A with rhesus status CDe/CDe. What is the expected blood group of her fetus? A. A positive B. A negative C. O positive D. O negative E. AB positive 183. A 32-year-old female presents with a two month history of breathlessness, tachycardia and menstrual irregularity. Her Investigations revealed:  Serum hCG negative  Serum T4 178 mmol/l  Serum TSH 0.05 mU/L  Prolactin 400 mmol/l What is the most likely diagnosis? A. Primary hypothyroidism B. Graves' disease C. Hashimoto's thyroiditis D. Multi-nodular goitre E. DeQuervain's thyroiditis 184. A 30-year-old second gravida at 10 weeks pregnant wants to know about antenatal Group B streptococcus measures. Which of the following circumstances is an indication for GBS screening? A. Previous baby with invasive GBS infection B. Vaginal swab positive for GBS in current pregnancy C. Woman carriage GBS in previous pregnancy D. Routine antenatal screening for GBS carriage E. No need for routine antenatal screening for GBS carriage 185. A 24-year-old pregnant woman presents with persistent vomiting. She becomes tachypanic. Which is the most likely acid-base disorder in this patient? A. Metabolic acidosis B. Metabolic alkalosis C. Mixed metabolic alkalosis and respiratory acidosis D. Respiratory acidosis E. Respiratory alkalosis 186. A 25-year old primigravida with underlying sickle cell disease presents at 32 weeks of pregnancy with intense itching. A set of liver function tests is requested, with the following results: ALT normal, bilirubin normal, albumin slightly low, bile acid high and ALP slightly high. What is the most likely diagnosis? A. Acute fatty liver B. Obstetric cholestasis C. Haemolytic jaundice D. Obstructive jaundice

E. Sickle cell crisis 187. What type of necrosis is seen in the heart after an acute myocardial infarction? A. Liquefactive necrosis B. Coagulative necrosis C. Caseous necrosis D. Gangrenous necrosis E. Fibrinoid necrosis 188. A normal woman is considering having a child with her partner who is carrier for cystic fibrosis. What is the probability of them having an affected child? A. 0% B. 25% C. 50% D. 75% E. 100% 189. Which of the following antihypertensive drugs induced postnatal depression? A. Alpha methyl dopa B. Hydralazine C. Labetalol D. Amlodipine E. Captopril 190. What level of measurement uses a verbal scale to measure data; slight, moderate and severe? A. Continuous B. Nominal C. Ordinal D. Interval E. Ratio 191. Mean hemoglobin of a sample of 100 pregnant women was found to be 10 mg% with a variance of 1.0 mg%. The standard error of the estimate would be: A. 0.01 B. 0.1 C. 1.0 D. 10.0 E. 100 192. Which statistical test requires a normal population distribution? A. Chi-square test B. Mann-Whitney U test C. Spearman's rank correlation D. Variance estimation test E. Wilcoxon rank sum test 193. Maintenance of the corpus luteum during the first trimester of pregnancy is accomplished principally by the secretion of A. Antidiuretic hormone (ADH) B. Follicle stimulating hormone (FSH) C. Human chorionic gonadotropin (hCG) D. Luteinizing hormone (LH) E. Progesterone 194. What is the blood supply of sigmoid colon? A. Celiac trunk B. Superior mesenteric artery C. Inferior mesenteric artery D. External iliac artery E. Internal iliac artery 195. The following intrauterine growth chart shows the 10th, 50th and 90th weight percentiles by gestational ages. What is the correct interpretation of this chart? A. Appropriate for gestational age (AGA) B. Small for gestational age (SGA) C. Symmetrical intrauterine growth restriction (IUGR) D. Asymmetrical intrauterine growth restriction (IUGR) E. Large for gestational age (LGA)

  1. A primigravida is in labour at 38 weeks of gestation. Midwife has called you as the mother is exhausted and CTG is showing prolonged late decelerations, a baseline of 170 bpm and an adequate variability. On examination, none of the presenting part is palpable per abdomen. The cervix is fully dilated, vertex is at +1 station and position is occipto posterior. What is the most appropriate management? A. Wait for spontaneous vaginal delivery B. Perform fetal blood sample C. Instrumental delivery in the labour ward D. Instrumental delivery in the operating theater E. Emergency caesarean section
  2. Illustrates the bladder diary of 48 year old woman who is a teacher complains of urinary urgency, and leaks urine if she is unable to reach the toilet quickly. Since she was unable to measure her voids, she was asked to put a tick in the column each time she passed urine. One day of three-day charting hows:s » Daytime frequency: 12 times in 24 hours » Nocturia: twice in 24 hours » Leakage with urgency occurred once in 24 hours » Fluid intake: 1,450ml, made up of six cups of coffee and a pint of lager What is the correct interpretation of this urinary diary? A. Excessive fluid intake B. interstitial cystitis C. Urinary stress incontinence D. Bladder overactivity E. Sensory neurogenic bladder
  3. A 29-year-old woman (gravida 2, para 1) is admitted to delivery suite at term. Few minutes after admission the membranes rupture. On examination, thick meconium is noted. Her cervix is 5 cm dilated with vertex at 0 station. The midwife commences a cardiotocograph trace, which shows one variable deceleration, one acceleration, a baseline of 120 bpm and an adequate variability. Contractions are regular, 3 every 10 minutes. What would be your initial management? A. Continuous fetal monitoring B. Perform fetal blood sample C. Assisted vaginal delivery D. Deliver immediately by caesarean section (category 1) E. Deliver by caesarean section (category 2) calculate the positive predictive value? If TP = true positive; FP = false positive; TN = true negative; FN = false negative A. TN / (TN + FN) B. TP / (TP + FP) C. TN / (TN + FP) D. TP / (TP + FN) E. TN / (TP+FP+FN)
  4. A revolutionary tumour marker has been trialed for detecting endometrial carcinoma. 140 women were included in the trial; the result shows that 90 women had a positive tumour marker however only 30 had endometrial cancer. Five women who had endometrial cancer were negative for the tumour marker. The sensitivity of the new tumour marker is A. 40 B. 45 C. 60 D. 75 E. 85

MRCOG RECALLS 2016 – 2017 – 2018 - 2019 WRITTEN BY: Dr. MOHAMED YAHIA ABUELGASEM KHATEM

MRCOG RECALLS 2 صفحة Dr. MOHAMED YAHIA 0900988745 EXAM 1

MRCOG RECALLS 3 صفحة Dr. MOHAMED YAHIA 0900988745 1. What percentage of lymphocytes is present in peripheral blood? A. 2-8% B. 15-20% C. 20-40% D. 50-70% E. 70-80% 2. A 65-year-old woman has a sudden onset loss of speech and hemiparesis. On arrival in hospital her symptoms and neurological examination is suggestive of a cerebrovascular incident. Subsequent imaging supports the diagnosis of an ischaemic stroke, affecting her left cerebral hemisphere. Which of the following forms of tissue necrosis is associated with her loss of function? A. Caseous necrosis B. Coagulative necrosis C. Colliquative necrosis D. Fat necrosis E. Gangrenous necrosis immunoglobulin class has a dimeric structure? A. IgG B. IgA C. IgM D. IgD E. IgE 4. Which of the following is the main cellular origin of clotting factor VIII (antihemophilic factor)? A. Hepatocytes B. Histiocytes C. Megakaryocytes D. Plasma cells E. Vascular Endothelium 5. Which class I major histocompatibility complex human leucocyte antigen (HLA) is expressed only in extravillous trophoblast? A. HLA-A B. HLA-B C. HLA-C D. HLA-F E. HLA-G 6. How many sperm are produced in the testes each day? A. 30,000 B. 300,000 C. 3,000,000 D. 30,000,000 E. 300,000,000 7. Clomifene citrate is a commonly used drug for the induction of ovulation. What type of drug is clomifene citrate? A. Androgenic steroid B. Estrogenic steroid C. Progestogenic steroid D. Gonadotropin analogue E. Selective estrogen receptor modulator 8. The complement system consists of a number of small proteins found in the blood. Which of the following is the major site of synthesis of complement proteins? A. Liver B. Spleen C. Thymus D. Bone marrow E. Intestinal epithelium 9. Botulinum toxin is now used to treat neurogenic bladder because of its ability to A. Block storage of acetylcholine ACH in neuronal vesicles B. Inhibit the release of acetylcholine ACH from the neurons C. Inhibit acetylcholine ACH synthesis D. Block bladder nicotinic receptors E. Block bladder muscarinic receptors passes through the lesser sciatic foramen? A. Iliococcygeus B. Piriformis C. Sciatic nerve D. Posterior femoral cutaneous nerve E. Tendon of obturator internus

MRCOG RECALLS 4 صفحة Dr. MOHAMED YAHIA 0900988745 11. A 50-year-old woman, recently diagnosed with ovarian cancer, started her first cycle of chemotherapy. Several days after a treatment, she notes that she has blood in her urine. Cystoscopy reveals haemorrhagic cystitis. Which of the following antineoplastic drugs is most likely responsible for this side effect? A. Etoposide B. Methotrexate C. Paclitaxel D. Cyclophosphamide E. Vincristine 12. Luteinizing hormone (LH) is structurally related to what other glycoprotein hormones? A. ADH, oxytocin and FSH B. FSH, TSH and growth hormone C. HCG, FSH and TSH D. HCG, ADH and FSH E. TSH, growth hormone and HCG 13. Approximately what percentage of the total human DNA is mitochondrial DNA? A. 1% B. 20% C. 50% D. 80% E. 99% 14. Your consultant asks you to prescribe a 3 month course of ulipristal acetate to a patient with fibroids prior to having a hysterectomy. To which class of drugs does ulipristal acetate belong? A. Aromatase inhibitor B. Gonadotrophin releasing hormone (GnRH) antagonist C. Progestogen antagonist D. Prostaglandin analogue E. Selective estrogen receptor modulator (SERM) supplies foregut derivatives of the digestive system? A. Celiac trunk B. Superior mesenteric artery C. Inferior mesenteric artery D. Right umbilical artery E. Intercostal artery 16. What of the following is the major buffer in urine? A. Bicarbonate B. Phosphate C. Ammonia D. Calcium carbonate E. Potassium chloride 17. Glucocorticoids are secreted from which region of the adrenal gland? A. Adrenal capsule B. Zona reticularis C. Zona glomerulosa D. Zona fasciculata E. Adrenal medulla 18. How many carbon atoms do androgens contain? A. 18 B. 19 C. 20 D. 21 E. 22 19. From which germ cell layer is the allantois derived? A. Endoderm B. Ectoderm C. Paraxial mesoderm D. Intermediate mesoderm E. Lateral plate mesoderm 20. Which process establishes the three definitive germ layers? A. Neurulation B. Gastrulation C. Craniocaudal folding D. Lateral folding E. Angiogenesis 21. Which one of the following is the termination of round ligament? A. Labia minora B. Labia majora C. Deep Inguinal ring D. Superficial Inguinal ring

MRCOG RECALLS 5 صفحة Dr. MOHAMED YAHIA 0900988745 E. Lateral vaginal wall 22. Ductus venosus is completely obliterated after birth to form what adult structure? A. Ligamentum venosum B. Ligamentum arteriosum C. Ligamentum teres D. Medial umbilical ligament E. Median umbilical ligament called phenylketonuria (PKU) can result in serious problems in infancy. Via which pattern of inheritance is the PKU? A. Mitochondrial B. Autosomal dominant C. Autosomal Recessive D. X-Linked Dominant E. X-Linked Recessive which of the following embryonic structures? A. Allantois B. Pronephros C. Mesonephros D. Mesonephric duct E. Metanephric blastema 25. Which part of the endometrium is deep to the fetus and forms the maternal component of the placenta? A. Decidua capsularis B. Decidua rubra C. Decidua vera D. Decidua basalis E. Decidua menstruales form of gestational trophoblastic disease. When choriocarcinoma metastasises, it has a propensity for which type of spread? A. Haematogenous B. Implantation C. Lymphatic D. Transcoelomic E. Transplantation 27. Ondansetron is an effective antiemetic. Which of the following best describes the mechanism of action of Ondansetron? A. Histamine H1-receptor agonist B. Histamine H1-receptor antagonist C. Serotonin 5-HT3 receptor antagonist D. Dopamine D2 receptor agonist E. Dopamine D2 receptor antagonist sacroiliac joint? A. Primary cartilaginous B. Secondary cartilaginous C. Gomphosis D. Condyloid E. Synovial the cell cycle is cell prepared for DNA synthesis? A. Synthetic phase (S) B. Gap phase 1 (G1) C. Gap phase 0 (G0) D. Gap phase 2 (G2) E. Mitotic phase (M) 30. The formation of uric acid from purines is catalyzed by the action of A. Nucleoside phosphorylase B. Xanthine oxidase C. Glutaminase D. Urease E. Uricase her first child. She begins breast feeding the infant. She continues breast feeding for almost a year with no difficulties and no complications. Which of the following cellular processes that occurred in the breast during pregnancy allowed her to nurse the infant for this period of time? A. Stromal hypertrophy B. Epithelial dysplasia C. Steatocyte atrophy D. Ductal dilation E. Lobular hyperplasia

MRCOG RECALLS 6 صفحة Dr. MOHAMED YAHIA 0900988745 trigone of urinary bladder? A. Mesonephric duct B. Paramesonephric duct C. Ureteric bud D. Urogenital sinus E. Caudal of cloaca drug in the medical treatment of miscarriage. What type of drug is misoprostol? A. Cyclooxygenase inhibitor B. Progesterone antagonist C. Synthetic prostaglandin E1 analogue D. Synthetic prostaglandin E2 analogue E. Synthetic prostaglandin f2α analogue 34. What is the most common contrast agent used for MRI examinations? A. Iodine B. Barium C. Thallium D. Gadolinium E. Gallium 35. Defective feedback control of calcium hemostasis may lead to secondary hyperparathyroidism. It is usually associated with A. Parathyroid gland tumour B. Chronic liver disease C. Thyroid carcinoma D. Chronic kidney disease E. Syndrome of inappropriate antidiuretic hormone (SIADH) labetalol? A. Antimuscranic B. Selective alpha 1 receptors antagonist C. Non selective beta receptors antagonist D. Combines selective alpha 1 and non selective beta receptors antagonist E. Direct-acting smooth-muscle relaxant 37. The deep circumflex iliac artery is a branch of which artery? A. Internal iliac artery B. Internal pudendal artery C. External iliac artery D. Common iliac artery E. Femoral artery 38. What is the SI unit for the absorbed dose of ionizing radiation? A. Gray B. Sievert C. Rad D. Roentgen E. becquerels 39. Which organ is the principal site of urea synthesis via the urea cycle? A. Liver B. Kidneys C. GIT D. Lungs E. Bone marrow caushing's syndrome? A. Pituitary adenoma B. Adrenal adenoma C. Adrenal carcinoma D. Adrenal hyperplasia E. Iatrogenic steroid administration 41. Which of the following is a remnant of the mesonephric duct in the female? A. Round ligament B. Ovarian ligament C. Broad ligament D. Gartner duct E. Mullerian tubercle hyperprolactinemia? A. Macroprolactinoma B. Microprolactinoma C. Primary hypothyroidism D. Chronic renal failure

MRCOG RECALLS 7 صفحة Dr. MOHAMED YAHIA 0900988745 E. Pituitary stalk interruption syndrome (PSIS) of bicarbonate reabsorbed? A. Bowman's capsule B. Collecting duct C. Distal convoluted tubule D. loop of Henle E. proximal convoluted tubule 44. What type of inheritance pattern does duchenne muscular dystrophy follow? A. Mitochondrial B. Autosomal dominant C. Autosomal Recessive D. X-Linked Dominant E. X-Linked Recessive 45. What is the Lymphatic drainage of cervix and upper vagina? A. Internal iliac LN B. External iliac LN C. Aortic LN D. External iliac + internal iliac + common iliac + aortic LNs E. External iliac + internal iliac + obturator + sacral LNs infection mostly occurs A. In the first trimester B. In the second trimester C. In the third trimester D. During labour and delivery E. In the neonatal period through breastfeeding most eicosanoids derived? A. Arachidonic acid B. Leukotriene C. Prostacyclin D. Prostaglandins E. Cholesterols 48. What kind of epithelium lines the ectocervix? A. Columnar B. Statified Squamous, non keratinised C. Statified Squamous, keratinised D. Cuboidal E. Transitional 49. A patient asks you how long it will be before her C-section wound is "at maximum strength." What is the typical time taken for wounds closed by primary intention to reach maximum tensile strength? A. 14 days B. 21 days C. 42 days D. 90 days E. 120 days cells that produce mullerian-inhibiting substance are the A. Interstitial cells of leydig B. Interstitial macrophages C. Sertoli cells D. Myoid cells E. Germ cells 51. A 27-year-old woman who is 8 weeks' gestation presents to your clinic with increased sweating on her face. On examination there are no remarkable findings. Which of the following endocrine glands is related to increase activity of sweat glands during pregnancy? A. Adrenal cortex B. Placenta C. Pancreas D. Parathyroid E. Thyroid 52. A 60-year-old woman presents with an erythematous erosive lichen planus on the vulva. What type of cancer is linked to lichen planus? A. Squamous cell carcinoma B. Basal cell carcinoma C. Merkel cell carcinoma D. Malignant melanoma E. Kaposi sarcoma

MRCOG RECALLS 8 صفحة Dr. MOHAMED YAHIA 0900988745 enhances urinary excretion of calcium? A. Insulin B. Cortisol C. Calcitonin D. parathyroid hormone E. Antidiuretic hormone 54. Which immunoglobulin is a key to passive neonatal immunity? A. IgD B. IgE C. IgM D. IgA E. IgG 55. Which of the following tocolytic agents exert their effects by blocking the function of the oxytocin receptor? A. Atosiban B. Magnesium sulphate C. Nifedipine D. Progesterone E. Terbutaline increase after ovulation and decrease the proliferation of endometrium? A. Progesterone B. Follicle-stimulating hormone (FSH) C. Estrogen D. Luteinizing hormone (LH) E. Gonadotropin-releasing hormone (GnRH) 57. You are assessing a patient with an ovarian mass and are using the Risk of Malignancy Index (RMI) score. Which of the following is used to calculate the RMI? A. U (ultrasound score) x M (menopause score) x Ca125 level B. U (ultrasound score) + M (menopause score) + Ca125 level C. U (ultrasound score) / M (menopause score) x Ca125 level D. U (ultrasound score) x M (menopause score) / Ca125 level E. U (ultrasound score) þ M (menopause score) / CA19-9 level effect experienced by women using depot medroxyprogesterone acetate (DMPA)? A. Menstrual abnormalities B. Loss of bone mineral density C. Weight gain D. Injection site reactions E. Headache 59. A 24-year-old female presents with a 2-year history of infertility. An endometrial biopsy is obtained approximately 5 to 6 days after the predicted time of ovulation. This biopsy specimen reveals ''marked glandular growth and mitosis, stromal edema with subnuclear vacuoles and prominent coiled spiral arterioles'' This finding are consistent with what histological type of endometrium? A. Atrophic B. Proliferative C. Secretary D. Simple Hyperplasia E. Arias-Stella phenomenon 60. A 28-day-old baby is brought to the clinic because of projectile vomiting after feeding. Until this time, the baby has had no problems in feeding. On examination, a small knot is palpated at the right costal margin. A diagnosis of hypertrophic pyloric stenosis is suspected. Which metabolic abnormalities are seen in congenital hypertrophic pyloric stenosis? A. Hypochloremic hypokalemic metabolic alkalosis B. Hyperchloremic hypokalemic metabolic alkalosis C. Hypochloremic hypokalemic metabolic acidosis D. Hyperchloremic hyperkalemic metabolic acidosis E. Hyperchloremic hypokalemic metabolic acidosis 61. Following is the narrowest part of fallopian tube? A. Intramural part B. Isthmus

MRCOG RECALLS 9 صفحة Dr. MOHAMED YAHIA 0900988745 C. Ampulla D. Infundibulum E. Fimbriae is based on the presence of A. Carbohydrate antigen on cell wall B. Hemolytic reactions on blood agar C. M protein D. Pigment production E. Sugar fermentation cells which buffers blood CO 2 ? A. Cytochrome-b5 reductase B. 5-nucleotidase C. Glucose-6-phosphate dehydrogenase D. Carbonic anhydrase E. Pyruvate kinase 64. A 35-year-old pregnant woman with multiple drug resistant (MDR) tuberculosis is receiving prolonged treatment with streptomycin. Prolonged administration of streptomycin during pregnancy may result damage to the A. Optic nerve B. Trigeminal nerve C. Facial nerve D. Vestibulocochlear nerve E. Glossopharyngeal nerve 65. Increased glomerular filtration rate during normal pregnancy is a physiological finding results mainly from A. Increased cardiac output B. Increased Plasma volume C. Decreased peripheral vascular resistance D. Constriction of the afferent arteriole E. Compression of the renal capsule 66. Which of the following describes the correct order of musculature of the anal canal from deep to superficial? sphincter A. 1,4,2,3 B. 2,1,4,3 C. 3,1,4,2 D. 3,2,1,4 E. 2,4,1,3 intrauterine contraceptive device develops symptoms of acute salpingitis. On laparoscopy, sulfur granules appear at the fimbria of the tubes. Which of the following is the most likely organism? A. C. trachomatis B. Nocardia species C. N. gonorrhea D. T. pallidium E. Actinomyces species 68. A 30-years-old primigravida presents in a spontinous labour at 41 weeks of gestation. On vaginal examination the cervix is 8 cm dilated and the position of the vertex is left occipto-posterior. What is the presenting diameter? A. Bitemporal B. Occipito Frontal C. Submento Bregmatic D. Sub-occipito Bregmatic E. Vertico Mental tract occurring in an 18-year-old girl whose mother was treated with diethylstilbestrol during the pregnancy is likely to be a A. Brenner cell tumor of ovary B. Teratoma of ovary C. Sarcoma botryoides of vagina D. Clear cell carcinoma of vagina E. Squamous cell carcinoma of vulva laparoscopic tubal ligation, a 32-year￾old woman complains of suprapubic pain and oozing. On examination there is a tender palpable suprapubic mass rising up to the umbilicus that is dull to

MRCOG RECALLS 10 صفحة Dr. MOHAMED YAHIA 0900988745 percussion. Her hemoglobin level is 11 g/dl. What is the most likely diagnosis? A. Bladder injury B. Intra-abdominal bleeding C. Ureteric trauma D. Urinary retention E. Fluid overload 71. A grand multiparous woman has a postpartum haemorrhage soon after delivery. One liter of a colloid solution has already been given intravenously. She has a pulse rate of 140 beats per min, is anxious, confused and hypotensive with a capillary refill time of 3 seconds. What do you think is the estimated blood loss as a percentage of blood volume thus far based on clinical findings? A. 5-10% B. 15-20% C. 25-30% D. 30-40% E. 45-55% 72. A 31-year-old nulliparous woman has heavy bleeding at 8 weeks’ gestation. An early pregnancy scan is suggestive of a molar pregnancy, and no fetus is observed. What is the most likely genotype of a complete molar pregnancy? A. 46 XX B. 46 XY C. 69 XXX D. 69 XXY E. 92 XXXY 73. Mechanism of action of Neostigmine is A. Choline ester B. Cholinomimetic C. Muscarinic antagonist D. Anticholinesterase E. Nicotinic antagonist 74. Which term best describes a homogeneously black area on an ultrasound image? A. Anechoic B. Hypoechoic C. Isoechoic D. Hyperechoic E. Normoechoic 75. Which of the following arteries may occasionally arise as a branch of the external iliac artery or inferior epigastric artery instead of as a branch of the internal iliac artery? A. Internal pudendal artery B. Obturator artery C. Superior gluteal artery D. Umbilical artery E. Uterine artery 76. Blood supply to the medial part of the anterior abdominal wall below the umbilicus A. Superficial epigastric artery B. Superior epigastric artery C. Superior mesenteric artery D. Inferior epigastric artery E. Inferior mesenteric artery population of 350,000. During 2010, data pertaining to deliveries and there outcome is as follows:  Total number of live births: 20000  Total number of in utero deaths delivered bet. 22 +0 and 23 +6 weeks gestation: 200  Total number of stillbirths: 140  Total number of neonatal deaths during first week after birth: 40  Total number of neonatal deaths during second to fourth weeks after birth: 80 Which of the following represents the perinatal mortality rate in this town during 2009? A. 140/20,120 B. 140/20,120 C. 180/20,140 D. 180/20,260 E. 380/20,140 disorder is 12-week pregnant. She has been taken her lithium every night. Which of the following abnormality

MRCOG RECALLS 11 صفحة Dr. MOHAMED YAHIA 0900988745 may occur if she continues to take lithium? A. Tetralogy of Fallot's B. Dandy walker syndrome C. Ebstein's anomaly D. Limb reduction deformity E. Renal agenesis 79. Which part of the cell cycle is noted for sister chromatids separating and moving to opposite sides of the cell? A. Anaphase B. Metaphase C. Prophase D. Synthesis phase E. Telophase analgesia for management of labour pain because A. It is a strong μ receptor antagonist B. It has a long duration of action C. It is rapidly metabolized by tissue estrases D. Multiple smaller doses over time decrease the incidence of side effects E. It cannot cross the placenta 81. In the development of the oocyte, when does the second meiotic division occur? A. At birth B. At fertilisation C. At menarche D. At ovulation E. Before fertilisation 82. A 48-year-old woman visits her GP complaining of pain on the inner surface of her right thigh. A detailed history reveals that she has recently experienced some dull, diffuse pain in the lower right abdominal wall. She is sent for a CT scan which reveals an inflamed right ovary. Which nerve is referring pain from the parietal peritoneum near the ovary to the inner thigh? A. Ilioinguinal B. Saphenous C. Anterior femoral cutaneous D. Obturator E. Femoral 83. The following cell contain haploid number of chromosomes and results after completion of the 1 st meiotic division A. Oogonium B. 2 nd polar body C. 1 ry oocyte D. 2 ry oocyte E. Zygot 84. Which of the following techniques is used to increase the number of copies of a specific DNA sequences? A. Western blotting B. Southern blotting C. DNA chip D. Polymerase chain reaction (PCR) E. Fluorescent in situ hybridization (FISH) 85. A 40-year-old female suffers from a 2 x 2-cm vulval lesion. Biopsy demonstrates a malignant melanoma. The prognosis of this tumour best depends upon A. Grade of tumour B. Darkness of lesion C. Degree of color variation D. Depth of invasion E. Duration of the growth 86. The estrogen receptor is an example of a A. Guanylate cyclase receptor B. Nuclear transcription factor C. Tyrosine kinase nuclear receptor D. Ligand-gated ion channel in the cell membrane E. G protein coupled receptor on the Golgi complex 87. A 28-year-old woman has undergone emergency hysterectomy due to obstetric haemorrhage during her 3rd pregnancy. The previous pregnancies were both term C-section deliveries. Examination of the uterus shows the

MRCOG RECALLS 12 صفحة Dr. MOHAMED YAHIA 0900988745 placenta had invaded the myometrium up to the serosa. What is the most likely diagnosis? A. Placenta praevia B. Placenta accreta C. Placenta increta D. Invasive mole E. Placenta percreta processes produces the most energy needed for uterine contraction during parturition? A. Aerobic glycolysis B. Anaerobic glycolysis C. krebs cycle D. Oxidative phosphorylation E. Beta oxidation 89. A couple with primary subfertility, who have been trying to conceive for over 12 months, attends a reproductive medicine clinic. The male partner has already given a semen sample for analysis with the following results:  Progressive motility: 35%  Total sperm number: 32 million spermatozoa  Normal morphology: 5%  Vitality: 63% live spermatozoa  Liquefaction time: 30 min  pH: 7.3 What is the correct interpretation of this semen analysis? A. Normal semen analysis B. Low sperm count (oligospermia) C. Decreased motility (Asthenospermia) D. High ph indicate an infection E. Teratospermia 90. What is the most common inherited bleeding disorder? A. Von Willebrand’s disease B. Hemophilia A C. Hemophilia B D. Protein C deficiency E. Thrombotic thrombocytopenic purpura consists of two bands of connective tissue and also support the bladder? A. Urachus B. Pubocervical ligament C. Uterosacral ligament D. Coccygeus muscle E. Levator ani muscle 92. A 40-year-old woman complains of heavy menstrual bleeding for five years. Ultrasound scan has revealed no abnormality. Her family is complete. She desires an endometrial ablation. Which part of the uterus must be destructed to stop bleeding? A. The basal layer of endometrium B. The functional layer of endometrium C. Both layer of endometrium D. The entire myometrium E. The spiral artery 93. The rate of growth hormone secretion follows a circardian rhythm. When is the highest peak of growth hormone release? A. Early morning B. After exercise C. Afternoon D. Early sleep E. Deep sleep 94. The optimal ratio between suture and wound length that is associated with a lower rate of incisional hernia is A. 5:1 B. 4:1 C. 1:2 D. 2:1 E. 1:1 95. Which nerve is identified by its position on the anterior surface of the psoas major muscle? A. Ilioinguinal B. Femoral C. Obturator D. Genitofemoral E. lateral femoral cutaneous

MRCOG RECALLS 13 صفحة Dr. MOHAMED YAHIA 0900988745 the resting follicle stage to ovulation? A. 14 days B. 25 days C. 80 days D. 120 days E. 300 days 97. The capsule of the developing Graafian follicle is A. Theca interna B. Theca externa C. Zona pellucida D. Zona granulosa E. Lamina propria change occurring in uterine fibroids is A. 1/5 B. 1/10 C. 1/100 D. 1/1000 E. 1/3000 99. After an elective caesarean section the anesthetic team decided to perform an ultrasound-guided transversus abdominis plane block for analgesia. If the needle is correctly positioned where will be deposit the local anesthetic A. Beneath the peritoneum B. Into the transversus abdominis muscle C. Between the transversus abdominis muscle and the internal oblique muscle D. Between the transversus abdominis muscle and the external oblique muscle E. Between the internal oblique and the external oblique muscle 100. The most common in uetro infection causing fetal anemia in the UK is A. Syphilis B. Toxoplasmosis C. Rubella D. Parvovirus B19 E. Cytomegalovirus 101. A 25-year-old woman has a routine smear test for the first time. She complains of discomfort during the procedure. Which nerve or nerve plexus provided sensory innervations to the cervix? A. Pudendal nerve B. Sacral splanchnic nerve C. Pelvic splanchnic nerve D. Superior hypogastric plexus E. Inferior hypogastric plexus 102. In a female who has BRCA 1 gene, besides hereditary breast and ovarian cancer, what is the next most common cancer she may develop? A. Cancer colon B. Cancer stomach C. Pancreatic cancer D. Cervical cancer E. Endometrial cancer 103. What is the most common clinically significant congenital heart disease? A. Atrial septal defect B. Ventricular septal defect C. Patent ductus arteriosus D. Tetralogy of Fallot E. Coarctation of aorta 104. Warfarin inhibits which clotting factors? A. Factor II B. Factor V C. Factor VI D. Factor VIII E. Factor XI 105. The enzyme which builds an mRNA strand complimentary to the DNA transcription unit is called? A. DNA polymerase B. RNA polymerase C. Reverse transcriptase D. Helicase E. DNA ligase 106. Haemophilus ducreyi is the causative agent of A. Hard chancre B. Chancroid

MRCOG RECALLS 14 صفحة Dr. MOHAMED YAHIA 0900988745 C. Granuloma inguinale D. Lymphogranuloma venereum E. Sarcoid 107. Which of the following divisions of cell growth precedes Mitosis in the cell cycle? A. Synthetic phase (S) B. Gap phase 1 (G1) C. Gap phase 0 (G0) D. Gap phase 2 (G2) E. Gap phase 3 (G3) found to have an Hb of 11 g/dL on a routine blood test, with an MCV of 70. Serum electrophoresis reveals an Hb F of 0.5 per cent, Hb A1 of 60 per cent, Hb A2 of 2 per cent and Hb S of 40 per cent. Her ferritin levels are normal. The most likely diagnosis is A. Iron deficiency anemia B. α-thalassemia C. β-thalassemia D. Sickle cell trait E. Sickle cell disease 109. A 22-year-old primiparous woman books her pregnancy at 11 weeks’ gestation. Her booking blood tests reveal a haemoglobin level of 10.1 g/dL. Haemoglobin electrophoresis reveals homozygous for HbS, she has no HbA A. Sickle cyprositis B. Sickle cell disease C. Sickle cell trait D. Sickle cell anemia E. Sickle beta thalassemia 110. A 28-year-old Asian woman G2P2 is 26 weeks pregnant. Her BMI is 30 kg/m 2 . Her oral glucose tolerance test reports (75 g load) are as follows:  Fasting serum glucose: 4.2 mmol/l  2-hour serum glucose: 7.4 mmol/l What is the diagnosis? A. Normal B. Impaired glucose tolerance C. Impaired fasting glucose D. Postprandial hyperglycemia E. Gestational D.M 111. You see a patient on the ward who is acutely short of breath and perform an arterial blood gases (ABG). The results are as follows:  pH 7.25  pO2 8.6 kPa  pCO2 8.4 kPa  HCO 3 - 28 mmol/l What is the acid-base disturbance? A. Mixed Alkalosis B. Respiratory Acidosis C. Respiratory Alkalosis D. Metabolic Acidosis E. Metabolic Alkolosis 112. Which hemoglobin (Hgb) result represents the lowest acceptable value for a woman in the second trimester of pregnancy? A. 9.5 g/dl B. 10 g/dl C. 10.5 g/dl D. 11 g/dl E. 11.5 g/dl 113. Terbutaline is a β-adrenergic receptor stimulator that is used to arrest preterm labor. Which of the following is a major maternal risk of its use? A. Hypertension B. Decreased plasma glucose C. Decreased serum potassium D. Tachyarrhythmia E. Asthma 114. A 32-year old woman complains of amenorrhea since delivery of a baby 15 months ago. The delivery was complicated by excessive hemorrhage that required transfusion of 2.5 liters of blood. Few days later she complained of failure to produce any breast milk. The most likely cause for this is damage to which of the following endocrine glands? A. Hypothalamus B. Anterior pituitary C. Posterior pituitary D. Thyroid

MRCOG RECALLS 15 صفحة Dr. MOHAMED YAHIA 0900988745 E. Adrenal cortex 115. During which week of pregnancy are normal cardiovascular and hematological changes early begin? A. 4 weeks B. 8 weeks C. 10 weeks D. 12 weeks E. 14 weeks cause arteriolar vasospasm before menstruation? A. Leukotriene LTB4 B. Thromboxane TXA2 C. Prostacyclin PGI2 D. Prostaglandin E2 E. Prostaglandin F2α 117. One month after cesarean section, a 25 year old woman palpates a small nodule beneath the skin at the site of the healed incision. The skin was closed using absorbable sutures. The nodule is excised, and polarizable refractile material is seen in the nodule. Which of the following cell types is most likely to be most characteristic in this inflammatory response? A. Neutrophil B. Macrophage C. Plasma cell D. Lymphocyte E. Langhans giant cell 118. Which two HPV subtypes are responsible for around 90% of genital warts and are targeted in HPV vaccines? A. 6 and 11 B. 16 and 18 C. 31 and 35 D. 31 and 45 E. 73 and 82 119. A 16-year-old girl has recently become sexually active. She complains of intensely irritating greenish frothy vaginal discharge. The organism is seen under microscope in a drop of saline and PH is 6. What is the most likely causative organism? A. Candida albicans B. Chlamydia trachomatis C. Gardnerella vaginalis D. Neisseria gonorrhoeae E. Trichomonas vaginalis 120. Caput medusae are due to engorgement of which of the following vessels? A. Hepatic vein B. Splenic vein C. Umbilical vein D. Umbilical artery E. Superficial epigastric artery 121. Regarding cardiac changes during pregnancy. Which of the following ECG findings during pregnancy should be considered normal? A. Prolonged QT interval B. Absent QRS complex C. T-wave flattening in lead II D. Q-wave in lead III and aVF E. Right axis deviation due to elevated diaphragm 122. A woman is 8 weeks pregnant attends for genetic counseling. She is known to be a carrier of cystic fibrosis and her sister has a child with cystic fibrosis. Her husband is Caucasian and the carrier rate for cystic fibrosis in the Caucasian descent is 1 in 25. What is the risk of the child having cystic fibrosis? A. 1% B. 12.5% C. 25% D. 75% E. 100% 123. A woman and her husband are known carriers of cystic fibrosis. What is the probability of them having an affected child? A. 1% B. 12.5% C. 25% D. 50% E. 75%

MRCOG RECALLS 16 صفحة Dr. MOHAMED YAHIA 0900988745 124. A 30-year-old woman primiparous at 34 weeks' gestation comes to the prenatal facility concerned about reddish purple striae she has increasingly developed on her breast and abdomen. Which of the following hormones is the most likely responsible for her symptoms? A. Melanocyte-stimulating hormone B. Estrogen C. Progesterone D. Aldosterone E. Cortisol 125. The process of programmed gene directed cell death characterized by blebbing, cell shrinkage, nuclear condensation and fragmentation is known as A. Apoptosis B. Autophagy C. Pyknosis D. Chromatolysis E. Necrosis 126. You see a 21-year-old woman in clinic complaining of vaginal 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 127. The most biologically active form of vitamin D is A. Calcidiol B. Ergosterol C. 7-dehydrocholesterol D. 1, 25-Dihydroxycholecalciferol E. 24, 25-Dihydroxycholecalciferol 128. You review a 65-year-old woman with known urinary urgency and prescribe oxybutynin. Which of the following diseases is aggravated by the use of this drug? A. Parkinsonism B. Bronchial asthma C. Closed angle glaucoma D. Diabetes mellitus E. Diarrhea 129. Which of the following drugs is most appropriate for treating uncomplicated Chlamydia? A. Azithromycin B. Clindamycin C. Neomycin D. Penicillin E. Metronidazole 130. A 26-year-old woman has just given birth and her newborn baby undergoes assessment. His body is pink with blue extremities and has a pulse of 105 bpm. He appears to be limp and taking slow, gasping breaths. He also grimaces in response to stimuli. What is his APGAR score? A. 4 B. 5 C. 6 D. 7 E. 8 131. A 23-year-old primigravida is booked with midwife at 21 weeks. She reveals that she had female circumcision done when she was a child. On examination the clitoris is completely absent. You are to document the type of female genital mutilation. What type of female genital mutilation is this best described as? A. Type 1 B. Type 2 C. Type 3 D. Type 4 E. Atypical presentation puberty in males is A. Constitutional delay in growth B. Klinefelter's syndrome C. Low BMI

MRCOG RECALLS 17 صفحة Dr. MOHAMED YAHIA 0900988745 D. Pituitary failure E. Primary hypothyroidism 133. What is the mechanism of antibacterial action of penicillin? A. Alteration of cell membrane permeability B. Inhibition of cell wall synthesis C. Inhibition of arabinogalactan synthesis D. Inhibition of nucleic acid synthesis E. Inhibition of folate metabolism 134. The ratio between indirect to direct maternal cause of death in UK is A. 1:2 B. 2:1 C. 1:3 D. 3:1 E. 1:1 symphysis pubis? A. Fibrous B. Primary cartilaginous C. Secondary cartilaginous D. Synarthrodial E. Synovial 136. Which muscles form the pelvic diaphragm? A. Levator ani and coccygeus B. Levator ani and piriformis C. Obturator internus and coccygeus D. Obturator internus and levator ani E. Obturator internus and piriformis 137. Biological actions of progesterone on estrogen include which of the following? A. Estrogen precursor B. Methylation of estrogen receptors gene C. Decreased estrogen receptors D. Increased sex hormone binding globulins (SHBG) E. Stimulation of the estrogen positive feedback in the luteal phase 138. Which is the commonest type of malignant ovarian neoplasm? A. Endometrioma B. Serous cystadenoma C. Clear cell carcinoma D. Germinal cell carcinoma E. Mucinous cystadenoma 139. At the end of surgery you notice an area of burn near the attached diathermy plate. The diathermy plate seems to be partially detached. Which of the following would be the most likely aetiology? A. Due to the plate not being secured properly, the current density was concentrated in the smaller area where the plate was attached B. High voltage was used C. The injury may have resulted from insulation failure D. The power output was accidentally turned up E. The surgeon may have accidently touched the instrument to the patient’s thigh 140. Which type of pituitary gland tumors increase growth hormone secretion lead to acromegaly? A. Adenoma B. Glioma C. Fibroma D. Sarcoma E. Schwannoma 141. The ovarian artery is a branch of A. Abdominal aorta B. Common iliac artery C. External iliac artery D. Internal iliac artery E. Uterine artery 142. A 62-year-old postmenopausal woman presents for her annual physical exam. On exam of you find a small pink exophytic lesion outgrowth out of the urethra. Otherwise there is no remarkable finding. What is the most likely diagnosis? A. Urethrocele

MRCOG RECALLS 18 صفحة Dr. MOHAMED YAHIA 0900988745 B. Urethral caruncle C. Urethral diverticulum D. Condyloma acuminatum E. Squamous cell carcinoma 143. Which type of cell junctions helps in transmission of small molecules or ions from one cell to another? A. Adherens junctions B. Desmosomes C. Diffusion spheres D. Tight junctions E. Gap junctions 144. A 15-year-old girl attends the genitourinary medicine clinic 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? A. Amoxicillin B. Azithromycin C. Metronidazole D. Entamizole E. Spiramycin investigations is used to determine hormone receptor expression 'receptor status' of the breast cancer? A. Mammogram B. Magnetic resonance imaging C. Fine needle aspiration cytology D. Immunohistochemical staining E. Pestron emission computed tomography 146. A 24-year-old female presents with severe pain during menses. To treat her symptoms, you advise her to take indomethacin in the hopes that it will reduce her pain. What type of drug is indomethacin? A. Mixed opioid agonist antagonist B. Cyclo-oxygenase inhibitor C. Derivative of 17α￾ethinyltestosterone D. Synthetic prostaglandin analogue E. Synthetic steroid hormone onto the adrenal medulla? A. Acetylcholine B. Norepinephrine C. Epinephrine D. Dopamine E. Serotonin 148. Which of the following defines perinatal mortality using the International classification of diseases￾10 (ICD-10)? A. Number of stillbirths from 20 weeks and 7 days neonatal deaths B. Number of stillbirths from 22 weeks and 7 days neonatal deaths C. Number of stillbirths from 24 weeks and 7 days neonatal deaths D. Number of stillbirths from 22 weeks and 28 days neonatal deaths E. Number of stillbirths from 24 weeks and 28 days neonatal deaths 149. A 27-year-old woman has a smear test as part of the UK screening programme. Following an abnormal result she attends a colposcopy clinic. On colposcopy, the whitened appearance of her cervix on application of acetic acid is suggestive of a human papilloma virus (HPV) infection. Which of the following HPV subtypes is high￾risk for the development of cervical intraepithelial neoplasia? A. HPV 1, 2 B. HPV 6, 11 C. HPV 16, 18 D. HPV 32, 34 E. HPV 73, 82 year-old female measured 7 x 4 x 3 cm. She became pregnant, and just before delivery of a term infant, the uterus measured 34 x 18 x 12 cm. Which of the following cellular processes was the

MRCOG RECALLS 19 صفحة Dr. MOHAMED YAHIA 0900988745 major reason for the increase in the size of the uterus? A. Endometrial glandular hyperplasia B. Myometrial fibroblast proliferation C. Endometrial stromal hypertrophy D. Myometrial smooth muscle hypertrophy E. Vascular endothelial hyperplasia 151. A 27-year-old woman is seen because it is exactly 8 weeks since her last menstrual period, which was on March 1, 2016. Her menstrual cycles had previously been regular with a 35- day interval. What is this patient’s estimated date of delivery? A. February 8 of the next year B. February 11 of the next year C. December 8 of the same year D. December 11 of the same year E. December 15 of the same year 152. A 47-year- old woman with choriocarcinoma is treated with very high doses of methotrexate. You anticipate significant host cell toxicity so immediately after giving methotrexate you administer which of the following agents? A. Erythropoietin B. MESNA (2-mercaptoethane sulfonate) C. Acetylcysteine D. Foloinic acid E. Folic acid 153. A 27-year-old woman is 2 weeks' postpartum with her first child. Suddenly she becomes very tearful, irritable and sleepless. She has strange thoughts of hurting herself and feels it difficult to breast-feed her baby. Her physical examination is within normal limits. Which of the following is the best term to describe her symptoms? A. Maternity blues B. Bipolar disorder C. Schizophrenia D. Postpartum depression E. Postpartum psychosis 154. Healthcare workers must have appropriate safe disposal of 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 155. A woman presents at 12 weeks of pregnancy. She has had two previous spontaneous abortions at the first trimester. She has had one live birth at term with the birth of a live baby at 26 weeks who died within a few minutes. Which one of the following correctly expresses her gravidity and parity? A. Gravida 4 Para 1 + 2 B. Gravida 4 Para 2 + 2 C. Gravida 5 Para 1 + 2 D. Gravida 5 Para 2 + 2 E. Gravida 5 Para 1 + 3 156. Glucose-6-phosphatase deficiency is a common metabolic disease in Africa. What is the function of the enzyme glucose-6-phosphatase in carbohydrate metabolism? A. Adds glucose to glycogen ends B. Adds phosphate to glucose C. Production of ATP in aerobic and anaerobic oxidation D. Production of NADPH in red blood cells E. Converts glucose-6-phosphate to glucose multiple midline malformations. Her physician suspects a chromosomal disorder and orders a karyotype (picture below). Which of the following is the most likely diagnosis?

MRCOG RECALLS 20 صفحة Dr. MOHAMED YAHIA 0900988745 A. Cri-du-chat syndrome B. Down syndrome C. Turner syndrome D. Edward syndrome E. Patau syndrome 158. The null hypothesis states that a given variable is without effect. What type of error is present when the null hypothesis is incorrectly not rejected? A. Type I error B. Type II error C. Type III error D. Type IV error E. Type V error when does the second meiotic is completed? A. At birth B. At fertilization C. At menarche D. At ovulation E. Before fertilization 160. A 45-year-old female patient with a history of ischaemic heart disease is being reviewed in the pre-operative clinic prior to undergo endometrial ablation. You review her Electrocardiogram (ECG) below: Which of the following is the most likely diagnosis? A. Atrial flutter B. 1st degree heart block C. 2nd degree heart block D. 3rd degree heart block E. Wolff-parkinson-white syndrome A. Skin B. Anal canal C. Obturator internus fascia D. Vagina E. Rectum 162. You are fast-bleeped to attend a major post-partum hemorrhage on labour ward. The midwife estimates that the patient has lost approximately 1000 ml of blood. The patient requires many units of blood transfusion, after how many units of packed red cells transfusion fresh frozen Plasma should be given? A. Two units B. Three units C. Four units D. Five units E. Six units 163. The following diagram is concerning about a 12-day-old blastocyst. Which of the following regions is represented by the arrow? A. Allantois B. Yolk sac C. Amniotic cavity D. Chorionic cavity E. Extraembryonic coelom 164. A 25-year-old woman who is 20 weeks pregnant was admitted via A&E with severe loin pain, shivering and vomiting. Her temperature is 38.8°C, pulse is 110 bpm and blood pressure is 88/56 mmHg. Urine dip shows leucocytes ++ and protein ++. Her midstream urine sample result shows:

MRCOG RECALLS 21 صفحة Dr. MOHAMED YAHIA 0900988745  Culture: E.coli +++  Sensitivities:  Trimethoprim: Resistance  Amoxicillin: Resistance  Nitrofurantoin: Sensitive  Cephalexin: Sensitive  Gentamicin: Sensitive What is the drug of choice for the treatment? A. Trimethoprim oral B. Nitrofurantoin oral C. Cephalexin oral D. Cephalexin injection E. Gentamicin injection 165. Which system organs have the highest risk of teratogenicity in the embryonic period? A. Cardiovascular system B. Genitourinary system C. Respiratory system D. Digestive system E. Central nervous system 166. A 25-year-old woman presents with right-sided pelvic pain for more than one year. An ultrasound scan is arranged which shows a 5 cm well￾defined cystic lesion in the right adnexa with mixed echoes. There is no fluid in the cul-de-sac with the following sonographic image: What is the most likely diagnosis for the image of the adnexa? A. Benign cystic teratoma B. Endodermal sinus tumour C. Endometrioma D. Mucinous cystadenoma E. Serous cystadenoma 167. You are carrying out analysis of a new test for DVTs and decide to plot a receiver operating characteristic curve. What are the axes of the curve? A. Sensitivity versus Specificity B. Specificity versus Sensitivity C. Positive Predictive Value versus Negative Predictive Value D. Sensitivity versus (1-Specificty) E. (1-Sensitivity) versus Specificity 168. Which antibiotic is effective against staph. aurus exotoxin? A. Vancomycin B. Co-amoxiclave C. Metronidazole D. Methicillin E. Clindamycin 169. Consider the figure. Muscle lactate is transported in liver and converted to glucose by the process of A. Rapport luebering cycle B. Glucose alanine cycle C. Cori's cycle D. Citric acid cycle E. Glycolysis 170. A 42-year-old woman presents in her first pregnancy with monochorionic twins at ten weeks gestation. Antenatal screening for anemia in multiple pregnancies should be undertaken A. As per routine antenatal care B. Once in every month C. At booking and at 16 weeks D. At booking, 28 and 36 weeks E. At booking, 24 and 28 weeks 171. Which cell type, in the islets of Langerhans, secretes glucagon? A. Alpha cells B. Beta cells C. Delta cells D. Epsilon cells

MRCOG RECALLS 22 صفحة Dr. MOHAMED YAHIA 0900988745 E. PP cells 172. Which of the following growth factors is the most important for formation of granulation tissues during wound healing? A. Epidermal growth factor (EGF) B. Transforming growth factor α (TGF-α) C. Platelet-derived growth factor (PDGF) D. Vascular endothelial growth factor (VEGF) E. Transforming growth factor β (TGF-β) structural chromosomal abnormality. What does this structural chromosomal abnormality represent? A. Insertion B. Inversion C. Deletion D. Duplication E. Translocation 174. A study is conducted to investigate whether there is a relationship between soy milk and improve menopause symptoms. The Null hypothesis represents which of the following statements? A. A relationship between soy milk and improve menopause symptoms B. A positive relationship between soy milk and improve menopause symptoms C. A negative relationship between soy milk and improve menopause symptoms D. A difference between soy milk and improve menopause symptoms E. No relationship between soy milk and improve menopause symptoms 175. A 21-year-old woman presents with heavy menstrual bleeding for 8 months. She has a regular 28 day cycle and her LMP was 3 weeks ago. For the past few months she has been feeling generally tired and noticed some weight gain. Pelvic examination demonstrates an enlarged uterus. What are the recommended investigations you would offer? A. FBC, pelvic ultrasound scan B. FBC, thyroid profile, pelvic ultrasound scan C. FBC, pelvic ultrasound scan, Endometrial sampling D. FBC, coagulation profile, thyroid profile, pelvic ultrasound scan E. FBC, coagulation profile, thyroid profile, pelvic ultrasound scan, Endometrial sampling 176. What pattern of inheritance does this picture most likely illustrate? A. X-Linked Recessive B. X-Linked Dominant C. Autosomal dominant D. Mitochondrial E. Autosomal Recessive 177. During childbirth a bilateral pudendal nerve block may be performed to provide anesthesia to the majority of the perineum and the lower one fourth of the vagina. To do this an anesthetic agent is injected near the pudendal nerve. During the procedure blood comes in on withdrawl the plunger of the anesthetic syringe. Which of the following vessels has been entered? A. Obturator

MRCOG RECALLS 23 صفحة Dr. MOHAMED YAHIA 0900988745 B. Femoral C. Vaginal D. External pudendal E. Internal pudendal 178. Whooping cough vaccine leads to provide long immunity from A. Memory B cells B. Cytotoxic T cells C. Naïve B cells and TH cells D. Innate immune cells E. Inoculation of microorganism 179. Carbon dioxide gas laser is better preferred for the removal of endometriotic implants as A. It does not capable to vaporize tissue B. It penetrates deeply into tissue C. It has a minimal lateral thermal tissue damage D. It is less transmitted in soft tissue that contains water E. It produces an invisible beam and does not affect the one who use it 180. The diagram below illustrates some of the steps (reactions) of steroidogenesis in their proper sequence. Which substance is indicated by letter 'X' in the above diagram? A. Estrone B. Testosterone C. Dihydrotestosterone D. Androstenedione E. Dehydroepiandrosterone sulphate 181. When using gestational age, when does crown rump length (CRL) get to 40 mm? A. 6 weeks B. 7 weeks C. 8 weeks D. 9 weeks E. 11 weeks congenital solid tumour of the newborn? A. Astrocytoma B. Willim's tumour C. Neuroblastoma D. Sacrococcygeal teratoma E. Hepatic hemangioma 183. A 25-year-old woman patient presents with number of small 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 184. A 24-year-old G2P0 woman is seen in clinic at 12 weeks gestation. She is known to have epilepsy with grand mal seizures, for which she is currently on lamotrigine. Her last fit was one year ago. Her full blood count result shows:  Haemoglobin 9.9 g/dl  Hematocrit 35%  Mean corpuscular volume (MCV) 110 fl  Mean corpuscular hemoglobin (MCH) 34 pg  Platelets 198 x 10 9 /l  Total white cell count 8.0 x 10 9 /l What is the most likely interpretation of this blood count? A. Physiological hyderemia of pregnancy B. Iron deficiency anaemia C. Folate deficiency D. β-thalassemia trait E. Hemolytic anemia 185. A 23-year-old woman who is six weeks by dates is referred to EPU with vaginal spotting, which continuous today. Ultrasound shows a fetal pole

MRCOG RECALLS 24 صفحة Dr. MOHAMED YAHIA 0900988745 with a CRL of 4 mm. There is no fetal heart action noted. The ovaries and adnexa appear normal. What is the most likely diagnosis? A. Heterotopic pregnancy B. Viable intrauterine pregnancy C. Could be a viable pregnancy D. Non viable pregnancy E. Threatened miscarriage 186. The blood test of a 36-year-old fertility patient shows elevated luteinizing hormone (LH) levels and high estradiol levels. What is the most likely cause of this? A. Hypogonadotrophic hypogonadism B. Ovarian failure C. Midcycle LH surge D. Polycystic ovary syndrome E. Weight-related amenorrhoea 187. A 30-year-old woman presents with a three month history of amenorrhea. In addition, her periods are irregular of two years' duration. She is overweight and complains of increasing lethargy. Nothing abnormal is found on examination. Her hormone profile was a follows:  βhCG < 5 IU/L  LH = 4 IU/L  FSH = 3.5 IU/L  Prolactin = 400 mIU/L  TSH = 7 mIU/L  Free T4 = 9 IU/L What is the most likely diagnosis? A. Hyperthyroidism B. Hypothyroidism C. Normal pregnancy D. kallmann syndrome E. Polycystic ovary syndrome 188. While you are attending to the hospital you found a pregnant woman unresponsive and collapsed in the car parking lot. During your initial evaluation you open her airway but she is not breathing. Which of the following is the appropriate initial management? A. Make safe environment B. Shake and shout C. Call for help D. Left lateral tilt E. Commence cardiac compressions 189. A woman presents in spontaneous labour at term with her first baby; then she delivered at term and the baby was fine. Six hours post delivery she finds to have group B streptococcus on a high vaginal swap done three days previously when she was seen in another maternity unit. What is the most appropriate management plane to prevent early￾onset neonatal group B streptococcal disease? A. Reassure that no action is necessary B. Immediately refer to the neonatologist C. Start antibiotics to the baby D. Start antibiotics to the mother E. Inform the mother to be given antibiotics in the next pregnancy 190. A 55 year-old woman has recurrent urinary retention after a radical hysterectomy done for stage I carcinoma of the cervix. Which of the following nerves should be preserved in radical hysterectomy? A. Obturator B. Pudendal C. Genitofemoral D. Superior hypogastric plexus E. Inferior hypogastric plexus 191. The following table shows the following results: Lab test +ve Lab test ‐ve New test +ve 20 5 New test‐ve 15 60 What is the negative predictive value of the new test? A. 25% B. 57% C. 75% D. 80%

MRCOG RECALLS 25 صفحة Dr. MOHAMED YAHIA 0900988745 E. 92% 192. In a given sample for a group of size 16, the standard deviation of the data is 12 and the mean is 2. What is the standard error of mean (SEM)? A. 2 B. 3 C. 4 D. 5 E. 6 193. A publication reports the outcome of a new therapy in a placebo controlled primary prevention of venous thromboembolism (VTE). 200 patients were randomised to receive the new therapy and 200 allocated to placebo. The study was completed over a 2 year period. In the placebo group there were 50 have venous thromboembolism and in the group treated with the new therapy there were 100 have venous thromboembolism. What is the number needed to treat to prevent one VTE over the course of this study? A. 2 B. 4 C. 10 D. 20 E. 40 194. In an investigation to study the effect of smoking in cancer cervix, it is observed that 30 of the 60 patients were smokers as compared to 20 out of 60 control subjects. The odds ratio of cancer cervix associated with smoking will be? A. 0.33 B. 0.5 C. 1.5 D. 2 E. 3 a sharply circumscribed nodule on the interlabial fold. The nodule has a tendency to ulcerate and bleed. This nodule can be completely cured by surgical excision. Which of the following is most likely? A. Merkel cell carcinoma B. Papillary hidradenoma C. Squamous cell carcinoma D. Basal cell carcinoma E. Adenocarcinoma 196. A 33-year-old woman is admitted with surgical wound infection after emergency caesarean section for suspected fetal compromise. Culture of the wound demonstrates methicillin￾resistant Staphylococcus aureus (MRSA). She has no known allergies. Which is the most appropriate treatment? A. Cephalosporins B. Clindamycine C. Vancomycin D. Clindamycine and vancomycin E. Piperacillin/tazobactam 197. A primiparous woman at 39 weeks of gestation is in labour at 8 cm dilation. The cardiotocography (CTG) has been classified as pathological due to a base rate of 105 bpm and persistent, long standing typical decelerations. Fetal blood sampling (FBS) has been performed, showing a pH of 7.29. What is the most appropriate management option? A. Needs caesarean section immediately with general anaesthetic due to fetal hypoxia B. Needs delivery within 30 minutes due to fetal hypoxia C. Repeat FBS in no more than 1 hour if CTG remains the same D. Repeat FBS in no more than 20 minutes independent of CTG findings E. Repeat FBS in no more than 30 minutes is CTG remains the same 198. A 37-year-old lady had a hysterectomy for multiple fibroids at 15:00 am. She felt unwell and developed a spiking fever of over 38.2ºC on the first postoperative day at 22:00 am.

MRCOG RECALLS 26 صفحة Dr. MOHAMED YAHIA 0900988745 Which of the following is the most likely? A. Deep venous thrombosis B. Pulmonary embolism C. Post operative inflammation D. Surgical site infection E. Reactive temperature spike response to surgery caused by stress hormones and cytokines 199. A 25-year-old woman intending to commence the combined contraceptive pills wishes to discuss the risk of venous thromboembolism (VTE). She has no other risk factors for VTE. Which type of COCP is associated with the highest risk of VTE? A. Loestrin 30 (ethinylestradiol / norethisterone) B. Microgynon 30 (ethinylestradiol / levonorgestrel) C. Microgynon 50 (ethinylestradiol / levonorgestrel) D. Yasmin (ethinylestradiol / drosperinone) E. Cilest (ethinylestradiol / norgestimate) 200. 19. A 37-year-old multiparous woman with gestational diabetes is in labour. On examination her cervix is 3 cm dilated with intact membranes. The labour is being continuously monitored using a cardiotocograph (CTG). She is reviewed by the obstetric team and the parameters of the CTG are noted.  Baseline < 100 beats per minute  Accelerations: Absent  Variability: < 5 beats per minute for 50 minutes  Decelerations: late decelerations for 20 minutes  Contractions: three to four contractions in 10 minutes What is the most appropriate course of action? A. Continuous fetal monitoring and reassess in 1 hour B. Turn to left lateral position with oxygen therapy C. Perform a Fetal blood sampling D. Proceed to Category 1 C.S E. Proceed to Category 2 C.S

MRCOG RECALLS 27 صفحة Dr. MOHAMED YAHIA 0900988745 EXAM 2

MRCOG RECALLS 28 صفحة Dr. MOHAMED YAHIA 0900988745 1.During Laparoscopy an injury to vessel during right lateral port insertion this vessel is a branch of which artery? A. External iliac artery B. Internal iliac artery C. Uterine artery D. Aorta E. Inferior epigastric artery 2.which structure Forms the lateral wall of the ischio-rectal fossa A. Skin B. Anal canal C. Obturator internus fascia D. Vagina E. Rectum 3. To perform an elective lower segment caesarean section, the obstetrician makes a transverse suprapubic incision. Which of the following abdominal wall layers will not be encountered transected during this incision? A. Anterior rectus sheath B. Posterior rectus sheath C. Rectus abdominis muscle D. Skin and subcutaneous tissue E. Transversalis fascia and parietal peritoneum 4. At what level ovarian artery arise A. L2 B. L1 C. L4 5. Which of the following muscles leaves the lesser pelvis through the greater sciatic foramen? A. pubococcygeus B. Iliococcygeus C. Puborectalis D. Piriformis E. Coccygeus caesarean section, an obstetrician performs ilioinginal-iliohypogastric nerve block (IINB) on his 25-year-old patient. What is the nerve root of ilioinguinal and iliohypogastric nerve? A. T12 B. T12 and L1 C. L1 D. L2 E. L1 and L2 7. Following radical hysterectomy and pelvic lymphadenectomy for Stage I carcinoma of the cervix, 63-year-old woman reports weakness of hip adduction. Which nerve most likely to have been injured during the operation? A. Obturator nerve B. Femoral nerve C. Inferior gluteal nerve D. Superior gluteal nerve E. Sciatic nerve 8. Surgeon wants to take blood from femoral artery. What is the relation of nerve with femoral artery and vein from lateral to medial? A. VAN B. NAV C. AVN 9. Dorsal artery of clitoris and deep artery of clitoris are a branch of? A. External iliac artery B. Internal pudendal artery 10. What is the dermatome level at suprapubic incision A. T10 B. L1 C. T12 D. L2 11. What is the level of dermatome for epidural at umblical region ? A. L1 B. T12 C. T10 D. L3 E. L4 12. What is the nerve supply of external anal sphincter ? A. Pelvic splanchnic nerve B. Pudendal Nerve C. Inferior hypogastric plexus

MRCOG RECALLS 29 صفحة Dr. MOHAMED YAHIA 0900988745 13.Which structure in female is homologous to male prostate? A. Skene gland B. Gartner duct C. Bartholin’s gland 14. Pudendal cleft is defined as A. Area btw labia majora and thigh B. Area btw labia majora and hymen C. Area between labia majora 15. What is the anatomical location of Bartholin’s gland? A. Deep perineal pouch B. Ischiorectal fossa C. Pudendal canal D. Superficial perineal pouch E. Urogenital diaphragm 16. Pyramidalis is supplied by which nerve? A. Obturator n. B. Genitofemoral nerve. C. Subcostal nerve D. Ilioinguinal E. Iliohypogastric 17. Pain due to ovarion irritation can be felt through which nerve segment A. T10 B. T12 C. L1 D. L2 18. During Laparoscopy structure is seen which is a remnant of Mesonephric duct A. Epoophoron B. Gartner duct cyst C. Ovarian ligament 19.During Sacrospinous ligament fixation which artery can be damaged A. Internal pudendal artery B. Internal iliac C. External iliac D. Femoral artery E. Inferior vesical artery 20. Superior vesicles artery is direct branch from A. Anterior division of Internal iliac B. External iliac C. Umbilical artery 21 In Renal transplant kidney is anastomosed to A. Vesical artery B. Aorta C. External iliac artery D. Internal iliac artery E. Uterine artery 22. Symphysis diathesis in a patient ..what is the type of joint which is involves A. Primary cartilaginous B. Secondary cartilaginous C. Synovial 23. Correct relation of round ligament with its embryological origin and anatomy is: A. Gubernaculum ovarii. In front of the uterine cornu to the labia majora B. Gubernaculum ovaria. In front of the uterine cornu to the ovarian ligament C. Paramesonephric duct. In front of the uterine cornu to the labia majora D. Paramesonephric duct. Behind the uterine cornu to the labia majora 24. Partial mole genotype A. 46XX B. 69 XXY C. 47XX D. 46XY 25. Layer surrounding the zona pellucida? A. Mural granulosa cell B. Cumulus oophorus C. Basal lamina D. Theca externa E. Theca interna 26.. What happened to decidua basalis is in third trimester? A. Remain decidua basalis

MRCOG RECALLS 30 صفحة Dr. MOHAMED YAHIA 0900988745 B. Become nutabach C. Disappear D. Merge with placenta which of the following embryonic structures? A. Urogenital sinus B. Pronephros C. Mesonephros D. Mesonephric duct 28. Lower part of vagina is derived from A. Ectoderm B. Endoderm C. Urogenital sinus D. Mesonephric duct 29. Which hernia will be the result of small defect in lateral umblical region due to regression of umblical vein A. Congenital umbilical hernia B. Omphalocele C. Gastroschisis 30. The medial umbilical ligament is a remnant of what structure? A. Fetal paraumbilical veins B. Fetal umbilical arteries C. Lateralumbilical fold D. Urachus 31. In the new non invasive prenatal diagnostic test of cell-free fetal DNA what is the source of the cells in maternal blood ? A. Fetal WBCs B. Fetal fibroblasts C. Amniotic cells D. Placental trophoblast 32. Embryological origin of GnRH neurons A. neural crest B. Neural tube C. Olfactory bulb D. Hypothalamus 33. Gastrulation is the process of a. Triple germ cell layer formation 34. Indifferent gonads arise from A. Intermediate mesoderm B. Paraxial mesoderm C. Endoderm D. Ectoderm shunts oxygenated blood from the right to left atrium in the fetus? A. Ductus arteriosus B. Ductus venosus C. Foramen ovale D. Ligamentum venosum E. Pulmonary trunk cause premature closure of the patent ductus arteriosus? A. Prostaglandin E1 B. Nitric oxide C. Cortisone D. Acetaminophen E. Indomethacin represent on the box-and-whisker plot? A. Mean and mode B. Mean and median C. Standard deviation and mean D. Least and greatest value E. Lower and upper quartile takes to perform a caesarean section on women with and without pre-eclampsia. At the end of the study you have two groups of women with the duration of caesarean sections recorded for each. It can't be assumed that these are normally distributed. Which non￾parametric statistic test would you use? A. Chi-squared test B. Linear regression analysis C. Mann-Whitney U test D. Pearson’s R test E. Student’s t-test 39. .Data was collected from maternal records of the women having shoulder dystocia at delivery and reviewed and compared with normal deliveries along

MRCOG RECALLS 31 صفحة Dr. MOHAMED YAHIA 0900988745 with birth weight of babies.what is the type of study A. Retrospective cohort B. Case Control C. Cross sectional D. Randomised control 40.. The number of hours worked per week for a sample of students is shown below Hours. students 1 12 2 9 3 29 4 28 5 15 6 10 7 18 8 15 What is the mode of the above data? A. 10 B. 4 C. 3 D. 12 E. 2 41. Calculate the odds ratio of asymmetrical IUGR and symmetrical IUGR ....etc etc Asymmetrical. Symmetrical Apgar <7 2 10 2 40 A. 4 B. 2.5 C. 16 D. 1.5 42. .What type of variable is BMI ? A. Ordinal B. Nominal C. Continuous D. Categorical E. Discrete 43. How to calculate standard error of the mean ? Answer : SEM = SD/√n 44. A range of one SD above and one SD below the mean includes CI of A. 68.2% B. 95.4% C. 99.7% statements best describes a type I statistical (α error)? A. Rejecting a null hypothesis when there is a difference B. Rejecting a null hypothesis when there is no difference C. Rejecting the alternative hypothesis when there is a difference D. Accepting a null hypothesis when there is a difference E. Accepting the alternative hypothesis when there is a difference 46. 700 women were enrolled for the assesment of PPV for test preterm labour?320 women were test positive out of them 80 had preterm labor .380 were test negative and out of them 20 had preterm labor. what is the positive predictive value of the test? A. 25% B. 50% C. 70% D. 10% E. 100% 47.. In which phase of the cell cycle do chromosome are align to the equatorial plate A. Metaphase B. Anaphase C. Telophase D. Interphase robertsonian translocation

MRCOG RECALLS 32 صفحة Dr. MOHAMED YAHIA 0900988745 A. 16, 17,18, 20 B. 9, 10, 11, 12 C. 13, 14, 15, 21, 22 49. .In which stage DNA replicates. A. G1 B. G0 C. G2 D. S phase 50. What is the primary function of DNA polymerase? A. Addition of nucleotide B. DNA repair the cell cycle is cell become quiescent? A. Synthetic phase (S) B. Gap phase 1 (G1) C. Gap phase 0 (G0) D. Gap phase 2 (G2) E. Mitotic phase (M) 52.. Mother has sickle cell disease married to sickle cell trait husband chance of baby to having disease A. 25% B. 50% C. 75% D. 100% 53. Father with cystic fibrosis mother normal Chance of baby to have cystic fibrosis ? A. 0% B. 25% C. 50% 54.. What role does messenger RNA play in the synthesis of proteins? a. Translation 55. Detection of protein? A. Southern plot B. Northen plot C. Western plot D. PCR 56. Which nucleotide only present in DNA a. Thymine 57. Which protein coiled in DNA ? a. Histones 58. What is the diagnosis 60. Which hormone prevent regression of corpus luteum? A. Hcg B. Progesterone C. Estrogen D. HPL E. FSH 61. Estradiol 20% bound to? A. shbg B. albumin 62..Patient with primary hyperparathyroidism what will be the correct value of calcium and phosphate A. Inc Ca. Dec phosphate B. Dec Ca. Inc phosphate C. Inc Ca. Inc phosphate D. Dec Ca. Dec phosphate 63. ADH synthesized in A. Para ventricular nucleus of hypothalamus B. Acidophillic cells of anterior pituitary C. Neuroendocrine cells of posterior pituitary 64. HPL similar to? A. FSH B. GH congenital adrenal hyperplasia (CAH)? A. 17-hydroxylase deficiency B. 21-hydroxylase deficiency

MRCOG RECALLS 33 صفحة Dr. MOHAMED YAHIA 0900988745 C. 11-Beta hydroxylase deficiency D. 3 Beta- hydroxysteroid dehydrogenase deficiency E. 17 Beta-hydroxysteroid dehydrogenase deficiency parathyroid hormone (PTH)? A. Chief cells B. Parathynotic cells C. Oxyphilic cells D. C cells E. Follicular cells 67. most common cause of hyperthyroidism in young woman A. Graves disease B. Hashimoto’s thyroiditis C. Iodine deficiency 68. Commonest cause of Cushing disease A) pituitary adenoma B) adrenal adenoma 69. What percentage (T4) is free? A. 0.1% B. 1% C. 5 % D. 15% E. 70% 70. Which test you is used to check ovarian reserves in pre menopausal women A. Antimullerian hormone B. FSH C. LH 71. which inhibit prolactin Dopamine 72. Question about obesity amenorhea which hormone decrease apetite? Leptin 73. After how many hours of LH surge ovulation occur A. 16 hr B. 24 hr C. 36 hr D. 48 hr E. 72 hr 74. Which hormone causes rupture of graffian follicle and release of esrtogen and progesterone? A) LH B) FSH C) TSH D) GnRH E) Hcg 75. which of the following order of hormones according to that increase the potency of male from maximum to minimum A) DHT ...Testosterone. ...Androstanedione A2 ...DHEA B) DHT...A2...DHEA ...testosterone C) Testosterone. .DHT...A2...DHEA 76. Androgen secreted through which layer of adrenal ? A) Zona fasciculata B) Zona reticularis C) Zona glomerulosa 77. The graph showing normal spirometry of a preoperative woman. Which lung volume is indicated by the number 6 on the spirometry tracing? A. Residual volume B. Expiratory reserve volume C. Inspiratory reserve volume D. Tidal volume E. Vital capacity 78. In ECG lead V1 and aVR represent which portion of heart A. Inferior wall B. Right atrium and right ventricle C. Right atrium and left ventricle D. Left atrium right ventricle. 79. women 7 week not feeling well came in ER with shortness of breath  PH 7.36  PCO2 normal  PO2 12  Base excess 9.8

MRCOG RECALLS 34 صفحة Dr. MOHAMED YAHIA 0900988745  HCO3 18  Normal pregnancy values What is the diagnosis? A. Respiratory acidosis B. Metabolic acidosis C. Compensatory metabolic acidosis 80. Renin is secreted from Juxtaglomerular cells 81 . What is the most abundant carbohydrate in the breast milk? A. Caesin B. Galactose C. Glucose D. Lactose E. Sucrose 82. Acid base disturbance in Conns syndrome metabolic alkalosis 83.. GFR is maximum at which gestation A. 32 wk B. 36 wk C. 18 wk D. 16wk 84. A 20 year old girl goes for walking in a hill with friends and when she is on the extreme of the hill she becomes little breathless and has paraesthesia in her hands . What is the appropriate acid base imbalance? A. Metabolic acidosis B. Metabolic alkalosis C. Mixed metabolic and respiratory acidosis D. Respiratory alkalosis E. Respiratory acidosis 85. Vaginal arousal secretion are released from A) Ectocervix. B) Endocervix C) Skene gland D) Bartholin’s gland E) Transudate from vagina 86. Iodine accumulation in thyroid cells involves symport with A. Chloride B. Potassium C. Hydrogen D. Sodium E. Calcium 87. Mg excreted : A. Excreted Unchanged in urine B. Metabolized in liver and excreted thru kidney C. Conjugated in liver and excreted through kidney. 88. Vitamin C action Synthesize collagen 89. Which enzyme is present in granulosa cells but not in theca cells? A. Aromatase B. 17 B hydroxylase 90. Cloasma in pregnancy is due to A. Cortisol B. MSH 91. A women had two children who had received phototherapy after delivery she has O - blood group got married 2nd time and currently pregnant. Husband has A + CDe CDe what can be the blood group of the fetus A- O+ A. A+ B. O￾C. A+ O￾D. A+ O + menstrual cycle between 21-35 days due to A. Aberrant LH surge B. Estrogen fails to produce negative feedback on pituitary C. Estrogen fails to produce positive feedback on pituitary D. Luteal phase varies in duration by time taken for corpus luteum to degenerate

MRCOG RECALLS 35 صفحة Dr. MOHAMED YAHIA 0900988745 E. Loss of progesterone secretion 93. What is the change in plasma volume during pregnancy? B- Increase 20 to 30% C- Increase 30 to 50% D- Increase 60 to 70% E- Increase 50 to 70% 94. Transfer of free fatty acid thru placenta A- Active B- Passive C- Facilitated D- Endocytosis E- Pinocytosis 95. Glucose transported across the placenta thru A- Facilitated diffusion B- Active transport C- Passive diffusion D- Endocytosis 96.. Which types of cells are phagocytic for residual bodies left over from the process of spermiogenesis? A. Testicular mesenchymal cells B. Testicular macrophages C. Fibroblast cells D. Interstitial cells of leydig E. Sertoli cells 97. NO from which amino acid A- L arginine B- L aspartate C- L lysine D- L guanine (GnRH) is what type of Biochemical structure A. Tripeptide B. Octapeptide C. Nanopeptide D. Decapeptide E. Polypeptide 99. Cristae are present in A. Mitochondria B. Rough endoplasmic reticulum C. Smooth ER glycolysis take place? A. Cytosol B. Mitochondrial matrix C. Mitochondrial cristae D. Rough endoplasmic reticulum E. Smooth endoplasmic reticulum 1. Arrow was on columnar epithelium 2. 1) columner A. 2)squamous 2) transformation zone 2. a graph showing x y z levels (almost same in past papers) ..what is y that was asked LH 3.Picture showing cut section of umblical cord and asked about labelled thing umbilical vein 4. Indian Origin Lives In London Have History Of Low Grade Fever Weight Loss Cough For 5 Months. She is pregnant. CXR image given. What is your diagnosis? A. Tuberculosis B. Bronchitis

MRCOG RECALLS 36 صفحة Dr. MOHAMED YAHIA 0900988745 C. Pneumonia 5. Fetal skull picture and question was asking about bone marked Parietal bone 6. Brow presentation in labor what is the head diameter mentovertical 7. Growth chart showing growth above 10 th centile Normal for gestational age 8. Ct scan of a post hysterectomy patient who came in emergency as not feeling well shows a. Ureteric obstruction b. Pelvic hematoma 9. Labetalol A. Non selective alpha and beta blocker B. Selective alpha and beta blocker C. Non selective beta blocker D. Selective beta blocker 10. What is the objective of phase 3 clinical trial? Check effectiveness of the drug to suppress lactation postpartum in mother who suffers from stillbirth? A. Quetiapine B. Metoclopramide C. Loperamide D. Leuprolide E. Cabergoline 12. Drosperinone is A. Antiandrogenic B. Androgenic C. Estrogenic D. Progestogenic E. Antiminrelocorticoid of low molecular weight heparin (LMWH) be stopped before regional analgesia? A. 6 hr B. 12 hr C. 24 hr D. 48 hr E. 72 hr 14. Mirena secret in 24 hours A. 20 micro gram B. 35 micro gram C. 75 micro gram 15. Women on anti emetics came in ER with complain of involuntary muscle movements Which drug she is using Answer : Metoclopramide 16. Main action of cocps A. Inhibit ovulation B. Inhibit fertilization C. Thick cervical mucus 17. Drugs readily cross the placenta because of which quality A. High lipid solubility B. High protein binding C. ionization of molecules anticancer agent methotrexate? A. plant alkaloid B. Antimetabolite C. Alkylating agent D. Chain cutting agent E. Intercalating agent 19.. What is the mechanism of action of hydralazine? A. α2 agonist B. Angiotensin-converting enzyme inhibitor C. α blocker D. β2 agonist E. Direct-action on smooth-muscle trimethoprim? A. Inhibit Nucleic acid synthesis B. Antimetabolite

MRCOG RECALLS 37 صفحة Dr. MOHAMED YAHIA 0900988745 21. Patient on lithium me which organ anomaly occur A. Heart B. Kidney C. Brain 22. Which organ anomaly occur with the use of ACE inhibitor A. Heart B. Cranio facial C. Kidney 23. 28 year old Women on carbamazepine for epilepsy what is the suitable contraception A. COCP B. High dose COCP C. Mirena D. POP E. Implant 24. Patient on ulipristal acetate for the treatment of fibroid which contraceptive method you advice to her A. Barrier method B. POP C. COC D. Mirena 25.A woman experiences a postpartum hemorrhage after delivery and is administrated carboprost to promote uterine contraction. What type of drug is carboprost? A. Oxytocin agonist B. Progestogen C. prostaglandin E1 D. prostaglandin E2 E. prostaglandin F2 26. Aspirin and indomethacin what is the difference in action? A. Aspirin Irreversibly inhibit COX 1 than ibuprofen B. Aspirin reversibly inhibits COX 1 than ibuprofen 27. Patient allergic to penicillin which drug is adviced in labor as GBS Prophylaxis? A. Clindamycin B. Ceftriaxone C. Erythromycin D. Ciprofloxacin 28. Most common side effect of misoprostol A. A-vomiting B. B-diarrhea C. C-nausea D. D-constipation 29. Mifipristone action?? Anti progesterone ultrasound because she was feeling bloated which showed bilateral ovarian masses with no solid areas associated with abdominal ascites. She is post menopausal and otherwise well. She was sent for a CA 125 which comes back as 50 U/mL. What is her risk of malignancy index score (RMI)? A. 5 B. 10 C. 150 D. 300 E. 450 31. Commonest cause of postmenopausal bleeding? A- Endometrial hyperplasia B- Endometrial cancer C- Atrophic vaginitis D- Endometrial polyp 32. On performing hysteroscopy on a postmenopausal women surgeon find resistence at internal Os what is the ratio of uterine corpus till this point A- 1:3 B- 3:1 C- 1:1 D- 1:2 E- 2:1 33. Women presented in emergency with acute abdomen which waked her up at night..she has a history of surgical management of missed miscarriage one week ago.hitopathology report showed

MRCOG RECALLS 38 صفحة Dr. MOHAMED YAHIA 0900988745 normal decidua no chorionic villi.what is your further action A. Admit for observation and ultrasound in morning B. Urgent CT scan C. Call surgical team to check for bowel perforation D. Call a consultant as you think she may have ruptured ectopic and might need intervention 34. CTG image of 45 minutes A. Baseline normal B. Acceleration present C. Variability normal D. Some variable decelerations which are v shaped and going down upto 20 seconds. E. Good uterine contractions G2P1+0 with previous normal delivery with labor pains and membrane ruptured showed thick meconium she is 5cm dilated. what will be your plan A. Continue CTG and reassess in 30min B. Do fetal blood sampling C. Cesarian section category 1 D. Cesarean section category 2 35. Which radiotherapy need vaginal devise insertion Brachytherapy 36. Postpartum haemorrage after vaginal delivery. pharmaceutically failed to stop the bleeding. what is the first surgical step to stop the bleeding? A. Intrauterine balloon tamponade B. Bilateral uterine artery ligation C. Bilateral int. iliac ligation D. Uterine b-lynch brace suture A. E Uterine artery embolization 37. mother with twins diagnosed hyperthyroidism comes with vomiting TSH 0.1, T4 29 . A) start propiothiouracil B) start radioactive iodine C) bring preganncy to singleton. Like seriously. D) treat hyerpemesis repeat tests in a week. 38. Which vitamin is deficient in wernick s encephalopathy Vitamin B1 39. Most common site of vulval cancer? A) Labia majora, B) Labia minora C) Vestibule D) vagina 40. Women died after cesarian she had shortness of breath postpartum haemorrhage. .was in DIC Postmortem showed fetal hair and epithelial cells Amniotic fliud embolism 41. 42 year old with frequency urgency urge incontinence. No stress incontinence bladder diary showed low compliance bladder us normal ..no improvement in symptoms with bladder drill. What is the next plan A) Antimuscarinic B) Pelvic floor exercise C) Post tibial nerve stimulation D) Urodynamic studies E) Beta blocker 42. Women with PPROM..Which test is using in practice to diagnose preterm labor A) Fern test B) Fibronectin test C) Nitrazine test 43. A male came for infertility check up who was taking Finasteride .Finasteride exert its action by inhibition of which enzyme? A. 21-hydroxlase B. 5-alpha reductase C. Aromatase D. Phosphodiesterase E. Desmolase 44. 15 yrs old British Teenager Ask about having contraception . What will the Doctor do in line with best practice?

MRCOG RECALLS 39 صفحة Dr. MOHAMED YAHIA 0900988745 A. Follow Fraser's Law B. Follow British guidelines C. Follow non British guidelines 45. A 34 week prenatal lady came in emergency with the complain of heavy painless vaginal bleeding. She is vitally stable.what you will advice A. CBC B. Perform vaginal examination C. Cesarian section 46. Treatment of hypovolemia after surgery? Patient vitally stable A. 500 ml crystaloid over 15 min B. 500ml haemaccel over 15 min C. Group specific blood D. Gelofusin infusion in 30 min techniques gives maximum radiation exposure to the patient during checking tubal patency? A. Robin tube cannulation B. Hysterosalpingography C. hystero contrast salpingography D. Hysteroscopic tube visualization E. Laparoscopy and dye intubation 48. Which modality you will use to check growing thyroid nodule in pregnancy A. Technetium scan B. Radio isotope C. Ultrasound D. CT E. MRI 49. What is the SI Unit of magnetic field A. Tesla B. Weber C. Gray 50. What is the threshold for ultrasound frequency 20 KHz 51. The difference between the peak and the base line of ultrasound wave is called? A. Amplitude B. Acoustic impedence C. Frequency D. Resolution E. Wave length radiotherapy. Which of following tissues is most radioresistant? A. Intestinal epithelium B. Cerebral nuerons C. Respiratory epithelium D. Bone marrow E. Skin third pregnancy at 12 weeks of gestation. She has recently moved to the UK from Thailand to be with her new husband. After pre-test counselling, with the aid of an interpreter, she agrees to hepatitis B virus (HBV) screening. The results return as follows. What is the significance of these results? HBsAg POSITIVE Anti-HBc POSITIVE Anti-HBc IgM NEGATIVE AntiHBs NEGATIVE A. Post vaccination B. Resolved infection C. Natural HBV immunity D. Chronic infection E. Acute HBV infection 54. Women has PPROM at 29 weeks clear liquor managed conservatively as an outpatient coticosteroids given. she came in labor at 32 weeks and delivered normally...she also had pph after delivery...she was asses (on next day or after 2 days ) in ward round  Pulse 120  RR 22  Temp 38.2  BP 110/50  Urine output 100ml in last 4 hours  Labs  normal Hb  Tlc 18000  Plt normal

MRCOG RECALLS 40 صفحة Dr. MOHAMED YAHIA 0900988745  Lactate 3  CRP >250  Rest I forgot What is your diagnosis A. Hypovolemic shock B. Sepsis C. Internal bleeding 55. A pregnant woman got screening test for down's syndrome and the following report is obtained  Age related risk; 1:1000MoM  AFP; 1.05MoM  β-hCG; 1.7 mom  NT : 0.85MoM  Test risk; 1:100000 What will you counsel this woman? A. The fetus has down's syndrome B. The fetus does not have down's syndrome C. It is high risk for down's D. It is low risk for down's E. Ask the patient to go home 56. Young girl secondary amenorrhea for 5 months  Fsh 4  .Lh 3  Prolactin normal  Tsh normal What is your Diagnosis? A. Hypothalamic amenorrhea B. Premature ovarian failure C. Hyperthyroidism 57. According to who definition of perinatal mortality No. Of stillbirth after 22 week and early neonatal deaths 58. A 28 year old tall man normal normally virilaized and do regular daily exercise came for infertility check up  Fsh <0.1iu/L  Testosterone 42  Prolactin 300 What is the diagnosis A. A kallman B. B steroid use C. C retrograde ejaculatio D. D pituitary adenoma E. E adrogen tumor 59. Peripartum cardiomyopathy resembles to which type A. Dilated cardiomyopathy B. Hypertrophic cardiomyopathy 60. SIADH is associated with which cancer Small cell lung cancer fishy foul smelling vaginal odour. 'Clue cells' are found in the smear. Which of the following cell types is belong to 'Clue cells'? A. Neutrophils B. Natural killer cells C. Lymphocytes D. Macrophages E. Vaginal Epithelial cells 62. Most common site of endometriosis? A. Fallopian tube B. Ovaries C. Uterosacral D. Pouch of douglas E. Peritoneum have a largely solid ovarian neoplasm. Tumor markers were obtained and demonstrated a markedly elevated LDH value. Which of the following tumors is the most likely histology for this neoplasm? A. Theca cell tumour B. Dysgerminoma C. Immature teratoma D. Brenner cell tumour E. Endodermal sinus tumour feature of ovarian papillary serous cystadenoma. ' Psammoma bodies' are composed of

MRCOG RECALLS 41 صفحة Dr. MOHAMED YAHIA 0900988745 A. calcium B. iron C. Fibrin D. Mucin E. Lipid year-old woman who is being treated with a diagnosis of small lung cancer presents with excessive polyuria and depression and urine showed red cells +++ what is the electrolyte imbalance? A. Hypernetremia B. Hyponatremia C. Hyperkalemia D. Hypokalemia E. Hypercalcemia 66. Which cancer is most commonly diagnosed in pregnancy and postpartum A. Breast cancer B. Cervical cancer C. Melanoma 67. Kleihauer test is a test to quantify the amount of fetal blood in maternal circulation, following fetomaternal hemorrhage. What is the basis behind Kleihauer test? HbF is resistant to denaturation by acids Commonest type of vulval Cancer A. Melanoma B. Squamous cell carcinoma C. Adenocarcinoma 69. In pre eclampsia what changes occur in kidney A. Vascular enditheliosis B. Acute renal failure C. Glomerulonephritis 70. Most common type of degeneration in fibroid a. red degeneration b. Hyaline degeneration c. sarcomatous changes woman complains of 12 months history of Heavy vaginal bleeding. Pelvic examination normal.Her husband had vasectomy since 2 years. Her family is complete. Which investigation will you do before starting treatment a. Complete blood count b. Arrange for ultrasound c. Perform an endometrial biopsy for the histological appearance of the secretory endometrium? A. Simple columnar B. Simple columnar with sub nuclear vacuolation C. Stratified columnar D. Stratified cuboidal E. Simple cuboidal epithelium simple endometrial hyperplasia most likely resemble? A. Proliferative endometrim B. Secretory endometrim C. Endometritis D. Endometrial polyp E. Endometrial carcinoma Krukenberg tumor of the ovaries originate from? A. Lung B. Brain C. Kidney D. Uterus E. GIT 75. Twin pregnancy itching on hands and on abdomen especially at linea nigra ...rash was not on any other place  ALT normal  Bile salt 5 mmol  Alk phosphatase mildly raised What is your diagnosis? A. A Obs cholestasis B. B Polymorphic eruption of pregnancy 76. Most common cancer type in fallopian tube

MRCOG RECALLS 42 صفحة Dr. MOHAMED YAHIA 0900988745 A. Adenocarcinoma B. Sq cell carcinoma C. Sarcoma 77. Patient presented in emergency with complain of shortness of breath and hemoptysis she has history of miscarriage and histopathology showed molar pregnancy .Chest x ray showed above picture. which tumor marker is raised in this condition Bhcg 78. Patient with complete molar pregnancy with ultrasound showing bilateral cyst with thin septa A. Theca leuten cysts B. PCOS C. Corpus luteal cysts D. Follicular cysts 79. Ovarian solid mass on ultrasound Benin histopathology with spindle shaped cells chest X ray showing pleural effusion diagnosis? A. Fibroma B. Leiomyoma C. Endomerioma D. Dermoid (This is meig syndrome) 80. Most commonly seen female urethral cancer? A. Transitional cell B. Squamous cell solid tumor of the newborn? A. astrocyte B. wilms tumor C. Sacrococcygeal teratoma D. hepatic Hemangioma 82. Question about cystoscopy which showed papillary bladder cancer which is the commonest type of cancer in bladder Transitional 83. A women got infection in first trimester rash and joint pain later on ultrasound showed only fetal ascites with no other structural defect Parvovirus b19 84 .A patient is diagnosed as having vaginal infection Trichomonas vaginalis. .what will be the treatment A. 1gm metronidazole stat B. Metronidazole 400 mg BD for 5 days C. 1 gm Azithromycin molluscum contagiosum? A. Adenovirus B. Herpes virus C. Papovavirus D. Parovirus E. Pox virus 86. Bacteria causing sepsis in pregnancy A. Group A streptococcus B. Group Bstreptococcus 87. Bacteria causing toxic shock syndrome? A. Staph aureus B. Group B streptococcus 88. Condylomata lata seen in which stage of syphilis A. Second stage syphilis B. Third stage syphilis 89. Which HPV virus is high risk for cervical cancer A. 33 B. 11 C. 6 90. Patient with IUCD came for a routine check up and high vaginal sab

MRCOG RECALLS 43 صفحة Dr. MOHAMED YAHIA 0900988745 showed gonorrhoea .What will be your management? A. Only remove iucd B. Treat the patient with antibiotics and remove iucd C. Treat with antibiotics and keep iucd in situ 91 . Patient presented with thin yellow fishy smelling discharge. Vaginal ph 5 What is the most likely causative organism? A. Trichomonas B. Gardenela vaginalis C. Chlamydia D. Gonorrhoea 92. Patient came out to be chlamydia positive .She is 12 weeks pregnant.what is the management plan? A. Treat the partner B. Do not treat the patient till delivery C. Treat the patient and screen the partner D. treat the patient and screen the partner E. Ask to use barrier method in pregnancy 93. Origin of macrophage A- lymphocyte B- neutrophil A. C Monocytes 94. Characteristics of igG A) crosses placenta B) activates complement pathway C) makes up 7p percent of pool D) binds to fc from antibody complexes 95. Most important complement in opsonisation A) C3a B) C3b 96.. Which of the following is the main immunoglobulin in mucosa A. IgA B. IgD C. IgE D. IgG E. IgM (APCs) are mainly found in the cervix? A. Plasma cells B. Hofbauer cells C. Langerhans cells D. B cells E. T cells 98 Rubella vaccine is which type of vaccine Live attenuated vaccine 99. Thrombosis in protein C and S deficiency is due to A) Decrease antithrombin III B) Factor 5 and 8a

MRCOG RECALLS 44 صفحة Dr. MOHAMED YAHIA 0900988745 EXAM 3

MRCOG RECALLS 45 صفحة Dr. MOHAMED YAHIA 0900988745 1. A 16-year-old has recently become sexually active. She complains of intensely irritating greenish frothy vaginal discharge. The organism is seen under microscope in a drop of saline and PH is 6. What is the most likely causative organism? A. Candida albicans B. Chlamydia trachomatis C. Gardnerella vaginalis D. Trichomonas vaginalis E. Treponema palladium derived from the midgut of the embryo? A. Coeliac trunk B. Inferior mesenteric artery C. Middle rectal artery D. Renal arteries E. Superior mesenteric artery 3. Regarding Influenza vaccine , what type of vaccine? A. Killed vaccine B. Toxoid vaccine C. Conjugate vaccine D. Live attenuated vaccine E. Organism Subunit vaccine Answer : Organism Subunit vaccine presents with vaginal spotting. A hysterectomy is performed, and pathologic examination of the removed uterus reveals heterologous components of a malignant tumor of the endometrial glands and metaplastic cartilage. Which of the following is the most likely diagnosis? A. Stromal sarcoma B. Carcinosarcoma C. Adenosarcoma D. Endometrioma E. Adenocarcinoma 5. For overactive bladder a new drug called Mirabegron is used. Which is the single mechanism of action for this drug? A. Selective serotonin re-uptake inhibitor B. Muscarinic receptors agonist C. Selective Beta-1 agonist D. Selective Beta-3 agonist E. Selective Beta-3 antagonist 6. Which drug antagonises the action of oxytocin? A. A: Atosiban B. Nifedipine C. Methyl-Dopa D. Terbutuline E. Sulbutamol 7.Misoprostol is analogue of which of the following : A. PGE1 B. PGE2 C. PGF2 D. PGI2 E. Thromboxane A2 8. Which of the following is a Side effect of Terbutaline : A. A . Maternal tachycardia B. B . Maternal bradycardia C. C . Fetal tachycardia D. D . Fetal bradycardia E. E . IUGR 9. A 50 years old women with absent periods for 2years, has bilateral ovarian mass with solid areas on scan and CA 125 of 100. What is her RMI score? A. A.900 B. B.600 C. c.700 D. d.450 E. e.250 disorder is 12-week pregnant. She has been taken her lithium every night. Which of the following abnormality may occur if she continues to take lithium? A. Tetralogy of Fallot's B. Dandy walker syndrome C. Ebstein's anomaly D. Limb reduction deformity E. Transposition of great arteries

MRCOG RECALLS 46 صفحة Dr. MOHAMED YAHIA 0900988745 11. In ECG which lead reflects the inferior wall of heart? A. V1, V2 B. V3, V4 C. aVR D. I, aVL E. II, III, aVF 12. What is the embryological origin of Gartners duct cyst? A. Cloaca B. Genital tubercle C. Mesonephric duct D. Paramesonephic duct E. Urogenital septum 13. Which of these chromosomes in humans have centromere located at one end? A. Telocentric chromosome B. Metacentric chromosome C. Dicenteric chromosome D. Submetacentric chromosome E. Acrocentric chromosome the cell cycle immediately preceeds Mitosis ? A. Synthetic phase (S) B. Gap phase 1 (G1) C. Gap phase 0 (G0) D. Gap phase 2 (G2) E. Gap phase 3 (G3) 15. Urea transfer from fetal circulation to maternal circulation? A. Active transport B. Endocytosis C. Exocytosis D. Facilitated diffusion E. Passive diffusion subtype of ovarian cancer associated with endometriosis? A. Clear cell carcinoma B. Serous adenocarcinoma C. Borderline serous tumour D. Muscinous cystadenocarcinoma E. Granulosa cell tumour primarily secreted in breast milk and protects the infant’s intestinal mucosa from infection? A. IgA B. IgD C. IgE D. IgG E. IgM 18. which Immunoglobin is a pentamer? A. IgG B. IgM C. IgE D. IgA E. IgD 19.What day of a regular 25-day menstrual cycle is a woman likely to ovulate? A. 4 B. 11 C. 14 D. 22 E. 25 20.what is the SI unit for the activity of radioactive decay? A. Gray B. Sievert C. Rad D. Roentgen E. Becquerel 21.What is the % of fibroid undergo sarcomatous change? A. 0.1% B. 1% C. 5% D. 10% E. 15% 22. What is the contrast dye used in MRI scans? A. Iodine B. Barium C. Thallium D. Gadolinium E. Tecnisia

MRCOG RECALLS 47 صفحة Dr. MOHAMED YAHIA 0900988745 23. A 7 week pregnant women with history of previous two miscarriage. Ultrasound show : what is the most likely karyotype? A. 46, XX B. 46, XY C. 69, XXX D. 69, XXY E. 69, XYY 24. which of the following is narrowest segment of fallopian tube? A. Ampulla B. Isthmus C. Infundibulum D. Interstitial portion E. Fimbrial end 25. A 32-year-old woman 7 weeks pregnant. Her Chlamydia swab is positive. Which is the single most appropriate treatment? A. Amoxicillin B. Clindamycin C. Doxycycline 100 BD D. Erythromycin 500 QDS E. Azithromycin 26. Which anti-emetic drug has extrapyramidal side effect? A. Meclizine B. Scopolamine C. Ondansetron D. Granisteron E. Metoclopramide 27. Pregnant women with Nausea and vomiting. Which fluid should not be given? a. 0.9%NS b. 0.9% NS with KCL c. 5% Dextrose d. Ringer lactate e. Hartmans solution ondansetrone? a. H2 Antagonist b. Seretonin HT3 c. H1 receptor d. D2 Agonist e. D2 Antagonist 29. A Doctor is making a discharge summary for a women who underwent a laparoscopic saplingo-oophorectomy for Ectopic pregnancy after 4days. You realise that her blood group is O-. What is the best course of action? a. Anti D b. check partner blood group & Rh. c. there is no need for anti D as it passed 72 hour. d. High dose Anti-D e. Anti-D in next pregnancy her first child. She begins breast feeding the infant. She continues breast feeding for almost a year with no difficulties and no complications. Which of the following cellular processes that occurred in the breast during pregnancy allowed her to nurse the infant for this period of time? A. Stromal hypertrophy B. Epithelial dysplasia C. Steatocyte atrophy D. Ductal dilation E. Lobular hyperplasia 31.Which of the following hormones increases the excretion of calcium in Kidney? A. Insulin B. Cortisol C. Calcitonin D. parathyroid hormone E. Antidiuretic hormone 32. When Choriocarcinoma metastasizes, it has a predominantly spread by which route?

MRCOG RECALLS 48 صفحة Dr. MOHAMED YAHIA 0900988745 A. Direct invasion B. Hematogenous C. Lymphatic D. Surface implantation E. Transcoelomic (STD) is caused by Haemophilus ducreyi? A. Chancre B. Chancroid C. Granuloma inguinale D. Condyloma acuminatum E. Molluscum contagiosum 34.What drug can be given in methotrexate toxicity? A. Folic acid B. Vitamin B12 C. Pyridoxine D. Thymidine E. Folonic acid 35.A 40-year-old woman had bilateral silicone breast implants placed two years ago. Since that time, she has noted increased firmness with slight deformity of the breast on the left. The implants are removed, and there is evidence for leakage of the implant contents on the left. Which of the following cell types is most likely to be most characteristic of the inflammatory response in this situation? A. Neutrophils B. Mast cells C. Plasma cells D. Giant cells E. T lymphocytes 36. Which is common malignant tumour in newborn? A. Retinoblastoma B. Teratoma C. Fibroma D. Neuroblastoma E. Granulosa cell tumour 37. Which of the following is contraindication of the use of oxybutynin? A. Bronchial asthma B. Narrow angle glaucoma C. Diabetes mellitus D. Parkinsonism E. Peptic ulcer 38.A neoplasm of the female genital tract occurring in an 18-year-old girl whose mother was treated with diethylstilbestrol during the pregnancy is likely to be a: A. Brenner cell tumor of ovary B. Teratoma of ovary C. Sarcoma botryoides of vagina D. Clear cell carcinoma of vagina E. Squamous cell carcinoma of vulva 39.When should the prophylactic dose of low molecular weight heparin (LMWH) be given post-c-section? A. 6 hr B. 12 hr C. 24 hr D. 48 hr E. there is no limit 40. Active form of Vit-D is produced in which organ? A. Skin B. Liver C. Lungs D. Kidney E. Adrenal glands 41.What is the mode of inheritance of Duchenne muscular dystrophy (DMD)? A. X-linked dominant B. Autosomal recessive C. Autosomal dominant D. Mitochondrial inheritance E. X-linked recessive 42.What is the most common cause of secondary hyperparathyroidism? A. Parathyroid adenoma B. Multiple myeloma C. Sarcoidosis D. Chronic renal failure E. Multiple endocrine neoplasia type 1 43. Regarding the following Karyotyping

MRCOG RECALLS 49 صفحة Dr. MOHAMED YAHIA 0900988745 Which of the following is the most likely diagnosis? A. Cri-du-chat syndrome B. Down syndrome C. Turner syndrome D. Edward syndrome E. Patau syndrome 50.Considering the following pedigree , What is the mode of inheritance ? A. Autosomal dominant B. X-linked dominant C. Y-linked dominant D. Autosomal recessive E. X-linked recessive 51.Remifentanil is an ideal controlled analgesia during labour because A. It is a strong μ receptor antagonist B. It has a long duration of action C. It is rapidly metabolized by tissue estrases D. It is more effective than epidural analgesia E. It cannot cross the placenta 52.The most common cause of delay in puberty in males is: A. Constitutional delay in growth B. Klinefelter's syndrome C. Noonan's syndrome D. Primary hypothyroidism E. Gonadal dysgenesis 53.Which base pairs with Adenine in the standard DNA helix? A. Thymine B. Guanine C. Inosine D. Uracil E. Uranine is based on the presence of ? A. Carbohydrate antigen on cell wall B. Peptidoglycan antigen on cell wall C. M protein D. Color of blood agar E. Sugar fermentation 55. Antihypertensive which causes postnatal depression, when used in permpartum period? A. Methyl dopa A. b. Labetalol B. c. Nifedipine C. d. Lisinopril D. Hydralazine is A. Choline ester B. Cholinomimetic C. Muscarinic antagonist D. Anticholinesterase E. Nicotinic antagonist 57. Coumarin drug antagonise which vitamin? A. A.Vitamin A B. Vitamin D C. Vitamin K D. Vitamin C E. Vitamin E 58. Clomifene citrate mechanism of action ? A. Androgenic steroid B. Estrogenic steroid C. Progestogenic steroid D. Gonadotropin analogue E. Selective estrogen receptor modulator 59. Which of the following the only structures passes through the lesser sciatic foramen?

MRCOG RECALLS 50 صفحة Dr. MOHAMED YAHIA 0900988745 A. Iliococcygeus B. Piriformis C. Sciatic nerve D. Posterior femoral cutaneous nerve E. Tendon of obturator internus muscle Antineoplastic drugs causing hemorrhagic cystitis? A. Cisplatin B. Methotrexate C. Paclitaxel D. Cyclophosphamide E. Vincristine structurally related to what other glycoprotein hormones? A. ADH, oxytocin and FSH B. FSH, TSH and growth hormone C. HCG, FSH and TSH D. HCG, ADH and FSH E. TSH, growth hormone and HCG 62. Mechanism of action of ulipristal acetate ? A. Partial progesterone receptor blockage B. Selective Estrogen receptor modulator C. Prostaglandin analogue. D. Selective progesterone receptor modulator E. Oxytocin Antagonist 63. A girl presented to your clinic requesting emergency contraception. LMP 20 days ago. h/o unprotected intercourse 7days ago for which she took levonorgestrel. The couple had regular intercourse since then and last night the condom had breached. What is the best course for action? A. Urlipristal acetate. B. Copper T IUD C. No need for additional contraception as levonorgestrel already inhibited ovulation this cycle D. Levonorgestrel 1500 mu E. Levonorgestrel 3000 mu definitive germ layers? A. Neurulation B. Gastrulation C. Craniocaudal folding D. Lateral folding E. Angiogenesis termination of round ligament? A. Labia minora B. Labia majora C. Deep Inguinal ring D. Superficial Inguinal ring E. Lateral vaginal wall obliterated after birth to form what adult structure? A. Ligamentum venosum B. Ligamentum arteriosum C. Ligamentum teres D. Medial umbilical ligament E. Median umbilical ligament 67. What is the frequency used in trans￾abdominal Ultrasonography ? A. 7-10 MHZ B. 10-15 MHZ C. 15-20 MHZ D. 2-6 MHZ E. >20 MHZ 68. A 60-year-old with erythematous erosive lichen planus on the vulva. What type of cancer is linked to lichen planus? A. Squamous cell carcinoma B. Basal cell carcinoma C. Merkel cell carcinoma D. Malignant melanoma E. Adenocarcinoma 69. which of the following organisms Colonize copper IUD? A. Lactobacillus. B. Actinomyces species. C. Mobilincus D. Ureaplasma E. Staphyllococcus aurues

MRCOG RECALLS 51 صفحة Dr. MOHAMED YAHIA 0900988745 70. Bacterial vaginosis is diagnosed with depletion in numbers of which organism? A. Lactobacillus B. Mobiluncus C. Gardnella vaginalis D. Trichomonas vaginalis E. Trepenoma pallidum. 71. The following image from ICSI procedure . What is the structure represented by the arrows ? A. Oocyte. B. First polar body. C. Second polar body. D. Cumulus oophorus E. Zona pellucida 72. Side effect of Aminoglycosides is mainly by affection of which of the following nerves? A. Optic nerve B. Trigeminal nerve C. Facial nerve D. Vestibulocochlear nerve E. Glossopharyngeal nerve 73. Regarding Breech presentation, What is the Bi-trochanteric diameter? A. 9 cm B. 10 cm C. 11 cm D. 8 cm E. 13 cm 74. 6 hours post laparoscopic tubal ligation, patient c/o pain abdomen, not reliefed with analgesics. On examination a tender cystic mass felt under umbilicus with oozing pus from one of the port sites. (LABS) Hb: 11, WCC :17000. What is your Diagnosis ? A. Urinary retention B. b. Intra-abdominal bleeding C. c. Urinary bladder injury D. d. Injury to ureter E. Port Site infection 75.What is the most common inherited bleeding disorder? A. Von Willebrand’s disease B. Hemophilia A C. Hemophilia B D. Protein C deficiency E. Thrombotic thrombocytopenic purpura 76. The most common in Utero infection causing fetal anemia in the UK is A. Syphilis B. Toxoplasmosis C. Rubella D. Parvovirus B19 E. Cytomegalovirus 77. Women with abnormal smear referred to colposcopy. HSIL. Which HPV is associated with this? A. HPV 18 B. HPV 11 C. HPV 6 D. HPV 12 E. HPV 20 78. Which HPV causes Genital Warts? A. HPV 6 B. HPv 16 C. HPV 18 D. HPV 31 E. HPV 45 79. A 20 week GA women with h/o recent travel to India, presents with fever, chills. Blood test falciparum Vivax +VE. Best treatment? A. Primaquine B. Mefloquine C. Choloroquine D. Procholoquine E. Artisunate

MRCOG RECALLS 52 صفحة Dr. MOHAMED YAHIA 0900988745 80. A Women with 150cm height and 90 kgs weight, What is her category of BMI? A. Normal B. Obesity Class I C. Obesity Class II D. Obesity Class III E. Morbid obesity 81. The Lowest acceptable Hb in second trimester? A. 9.5 g/dl B. 10 g/dl C. 10.5 g/dl D. 11 g/dl E. 11.5 g/dl 82. Sheehan syndrome Mainly affects? A. Hypothalamus B. Anterior pituitary C. Posterior pituitary D. Thyroid E. Adrenal cortex become sexually active. She complains of intensely irritating greenish frothy vaginal discharge. PH is 6. What is the most likely causative organism? A. Candida albicans B. Chlamydia trachomatis C. Gardnerella vaginalis D. Neisseria gonorrhoeae E. Trichomonas vaginalis attends for genetic counseling as she worried about CF, her sister has a child with cystic fibrosis. She is a carrier and her partner is Caucasian with a rate of 1/25 What is the risk of the child having cystic fibrosis? A. 1% B. 12.5% C. 25% D. 75% E. 100% 85. Pregnant women when exposed to sun, get pigmentation on cheeks & face? A. Melasma B. Linea alba C. Linea Nigra D. Stria gravidarum E. Polymorphic eruption of pregnancy Indomethacin? A. cyclo-oxygenase inhibitor B. Lipo-oxygenase inhibitor C. Prostaglandin E1 agonist D. Cyclo-oxygenase agonist E. Prostaglandin E2 agonist 87. The following diagram is concerning about a 12-day-old blastocyst. Which of the following regions is represented by the arrows ? A. Allantois B. Yolk sac C. Amniotic cavity D. Chorionic cavity E. Extraembryonic coelom right-sided pelvic pain for more than one year. An ultrasound scan is arranged which shows a 5 cm well￾defined cystic lesion in the right adnexa with mixed echoes. There is no fluid in the cul-de-sac with the following sonographic image:

MRCOG RECALLS 53 صفحة Dr. MOHAMED YAHIA 0900988745 What is the most likely diagnosis for the image of the adnexa? A. Benign cystic teratoma B. Endodermal sinus tumour C. Endometrioma D. Mucinous cystadenoma E. Serous cystadenoma 89. Regarding the following image what it is called ? A. Rapport luebering cycle B. Cori's cycle C. Citric acid cycle D. Glycolysis E. kreb's cycle 90. Which substance is indicated by letter 'X' in the Below diagram? A. C holesterol B. Testosterone C. Dihydrotestosterone D. Androstenedione E. Aldosterone 91. Regarding Genital herpes infection , what is the best management? A. Acyclovir B. Gabapentin C. Tacrolimus D. Steroid E. Antifungal in clinic at 12 weeks gestation. She is known to have epilepsy with grand mal seizures, for which she is currently on lamotrigine. Her last fit was one year ago. Her full blood count result shows:  Haemoglobin 9.9 g/dl  Hematocrit 35%  Mean corpuscular volume (MCV) 110 fl  Mean corpuscular hemoglobin (MCH) 34 pg  Platelets 198 x 109/l  Total white cell count 8.0 x 109/l What is the most likely interpretation of this blood count? A. Physiological hyderemia of pregnancy B. Iron deficiency anaemia C. Folate deficiency D. β-thalassemia trait E. Hemolytic anemia weeks by dates is referred to EPU with vaginal spotting, which continuous today. Ultrasound shows irregular sac, with yolk sac and no Fetal pole. There is no fetal heart action noted. The ovaries and adnexa appear normal. What is the most likely diagnosis? A. Heterotopic pregnancy B. Viable intrauterine pregnancy C. inevitable miscarriage D. Missed miscarriage E. Threatened miscarriage with surgical wound infection after emergency caesarean section for suspected fetal compromise. Culture of the wound demonstrates methicillin￾resistant Staphylococcus aureus

MRCOG RECALLS 54 صفحة Dr. MOHAMED YAHIA 0900988745 (MRSA). She has no known allergies. Which is the most appropriate treatment? A. Cephalosporins B. Clindamycin C. Vancomycin D. Clindamycin and vancomycin E. Piperacillin/tazobactam 95. What is Evidence based medicine? a. Using current guidelines for treating individual patients. b. Using current clinical evidence to treat individual patients. c. Using most experience consultant advise to treat patients d. Using current experimental evidence for treating patients e. Studying the most recent clinical evidence in treating patients 96. During laparoscopy you visualize medial umbilical folds. what structure it contains? A. Umbilical vein B. Medial umbilical ligament C. Median umbilical ligament D. Inferior epigastric artery E. Deep Circumflex artery 97. Blood supply for ascending part of colon ? A. Superior mesenteric B. Inferior mesenteric C. Right anterior mesenteric D. Celiac trunk E. Right colic artery 98. A study compares 2 types of suture materials for skin closure for caesarean section, subcuticular monofilament and subcuticular polyfilament, who should close the skin to obtain best external validity? A. One consltant in each unit. B. Anyone who normally closes skin. C. Anyone with 3 OSAT for competence in abdominal closure any specialist. A. D. B. E. 99. A 22 years old patient presents to your clinic with on and off pain RIF. During Workup of the pain an ultrasound Scan shows 4cm simple ovarian cyst. What is your Management? A. Reassure & discharge B. US guided aspiration C. lap cystectomy. D. CA 125. E. Yearly MRI scan follow-up 100. What is the source for premenopausal Oestrogen secretion? A. Theca cells B. Oocyte C. Granulosa cells D. Polar body E. Adipose tissue 101. 41 years old women presents to clinic Complaining of galactorrhea. Labs show: FSH, LH and TSH raised. A. Hypothyroidism B. Hyperthyroidism C. Premature ovarian insufficiency D. PCOS E. Hypothalamic Dysfunction 102. Diazepam can cross placenta, due to? a. Lipid solubility b. Protein binding c. Large molecular weight d. Facilities diffusion e. Active transport 103. 80 years old women presents to clinic with dysuria, on Examination you notice a growth at urethral orifice exophytic with well circumscribed edges? a. Urethral caruncle b. Squamous cell carcinoma c. Basal cell carcinoma d. Uretheral diverticulum e. Uretheritis

MRCOG RECALLS 55 صفحة Dr. MOHAMED YAHIA 0900988745 104. which clotting factor does not rise in pregnancy? A. VIII & VIII B. VIII & IX C. XI & XIII D. XII & IX E. II & VII 105. You see a patient in antenatal clinic who is 14 week pregnant and is worried. Her 3 year old son has chicken pox. she does not remember if she had chicken pox in past? her lab reports are as follows: Varicella IgG negative Varicella IgM negative A. she had past infection/immunity to chicken pox B. she is not immune to chicken pox C. she had general disease in past D. No need for vaccination E. Immunity to Rubella . 106. Which cells secrete histamine and serotonin? A. Basophils B. Neutrophils C. Dendritic cells D. Platelets E. Macrophage 107. Post-delivery the registrar notes that baby's HR 150bpm, pink body and blue extremities, Grimace, some flexion & friable cry. What is the apgar score? A. 3 B. 4 C. 6 D. 8 E. 10 108. Which Type of Ovarian cancer occurs which BRCA 1 mutation ? A. Clear cell carcinoma B. Endrometroid carcinoma C. Stromal Ovarian tumours D. Krukenberg tumour E. Papillary serous cystadenocarinoma. 109. A 25 years old patient presents to your clinic with history of Heavy menstrual bleeding for 1year. She has a history of asthma. She plans to start family in a year's time. This bleeding is limiting her routine activity. What is the First line in Management of this patient? A. COCP B. Norethisterone C. Mirena D. Tranexmic acid E. Mefanimic acid 110. What is affected in Horner syndrome? A. Loss of Motor supply B. Excessive Sympathetic stimulation C. Excessive Parasympathetic stimulation D. Loss of Parasympathetic supply E. Loss of Sympathetic supply 111. Regarding the following brachial plexus Diagram What is the “ D “ structure represents ? A. Axillary nerve B. Median nerve C. Musculo-cutaneous nerve D. Ulnar nerve E. Radial nerve 112. Regarding Varicella Zoster , What its infectivity period? A. 2 days before rash and 2 days after crust disappears B. 2 days before rash until the crust appear.

MRCOG RECALLS 56 صفحة Dr. MOHAMED YAHIA 0900988745 C. 10-14 day after appearance of rash. D. 24 hour after rash appear E. When lesion is Crusted. 113. Gestation age is which type of data? a. Nominal b. Ordinal c. Interval d. Regression e. Ratio 114. Which type of electrosurgical circuits is safest in theatres? A. Grounded B. Patient is Attached to pad C. Isolation D. On parallel E. On series 115. A 30 years old women who regularly takes insulin for diabetes. Presents with lethargy and loss of weight , TSH is low & Total T3 high ? A. Graves disease B. Hashimotos thoiditis C. Toxic nodule D. Ketoacidosis E. Hypothyroidism cushing's syndrome? A. Pituitary adenoma B. Adrenal adenoma C. Adrenal carcinoma D. Adrenal hyperplasia E. Iatrogenic steroid administration which region of the adrenal gland? A. Adrenal capsule B. Zona reticularis C. Zona glomerulosa D. Zona fasciculata E. Adrenal medulla a branch of which artery? A. Internal iliac artery B. Internal pudendal artery C. External iliac artery D. Common iliac artery E. Femoral artery 119. Which cells produce mullerian￾inhibiting substance in fetal testis? A. Interstitial cells of leydig B. Interstitial macrophages C. Sertoli cells D. Theca cells E. Granulosa cells 120.Which enzyme found in red blood cells which buffers blood CO2? A. Cytochrome-b5 reductase B. 5-nucleotidase C. Glucose-6-phosphate dehydrogenase D. Carbonic anhydrase E. Pyruvate kinase 121 . Which of the following essential amino acids not found in OMEGA 3 and should be taken from dietry intake ? A. α-Linoliec acid B. Ecosapentoenoic acid C. Arginine D. Arachidonic acid. E. Histidine 122 . Correct interpretation of the following Urogram : A. Stress incontinence. B. Urge incontinence C. Detrusor muscle instability D. Detrusor muscle overactivity E. Urinary tract infection . 123. A town with a total number of live birth is 250,000, and maternal death is 750, number of stillbirth is 250, what is the Maternal mortality ratio?

MRCOG RECALLS 57 صفحة Dr. MOHAMED YAHIA 0900988745 a. 300 b. 600 c. 900 d. 200 e. 750 124 . A women 40 week induced by dinoprostone pessary 20 minutes later and the pessary is removed . Regarding the following CTG , what is the most appropriate management ? A. Give terbutuline 20 mg tocolytic. B. Category 1 CS. C. Category 2 CS. D. Reassure and observe. E. Perform fetal blood sampling. 125. Cervical cancer incidence in UK ? A. 1/250 B. 1/300 C. 1/1000 D. 1/3000 E. 1/5000 126. In a town with 20,000 live birth, calculate perinatal mortality ? Weeks prenatally Postnatally 20w 20 21w 10 22w 40 23w 10 24w 20 25w 20 26-30w 10 31-35w 20 35-42w 10 1 st week after birth 50 A. 1/9000. B. 180/24000. C. 160/20000. D. 210/20000. E. 240/20000. 127. What is the anatomical space of External uretheral sphincter? A. Superficial perineal pouch. B. Deep perineal pouch. C. Ischiorectal fossa. D. Superficial inguinal space. E. Deep inguinal space 128. Pain due to ovarian irritation is felt through which spinal segment ? A. T10 B. T11 C. T12 D. L1 E. L2 Trimethoprim ? A. Inhibit bacterial cell wall synthesis. B. Inhibit 30S Ribosomal protein synthesis C. Inhibit Dihydrofolate reductase enzyme D. Inhibit Nucleic acid synthesis. E. Act on bacterial Cell membrane 130. Post-operatively , the nurse noticed an area of burn near attached diathermy plate , what is the mechanism of injury ? A. Inadequate current used . B. Low frequency current focused on small area C. High frequency current focused on small area A. D. B. E. 131. What is the measurement of Anteroposterior diameter of pelvic inlet in Engagement ?

MRCOG RECALLS 58 صفحة Dr. MOHAMED YAHIA 0900988745 A. 10cm B. 11cm C. 12cm. D. 13cm E. 9cm. third pregnancy at 12 weeks of gestation. She has recently moved to the UK from Thailand to be with her new husband. After pre-test counselling, with the aid of an interpreter, she agrees tohepatitis B virus (HBV) screening. The results return as follows. What is the significance of these results? HBsAg POSITIVE Anti-HBc POSITIVE Anti-HBc IgM NEGATIVE AntiHBs NEGATIVE A. A.Post vaccination B. B Resolved infection C. C.Natural HBV immunity D. D.Chronic infection E. E.Acute HBV infection 133. A 34 yr old woman has just returned to the UK following missionary work in the northern part of South America. She is delighted to be pregnant and presents for booking at 12 wks of gestation. After counseling she agrees to have routine blood investigations including screening for syphilis. The results are returned as following: Venereal Disease Research Lab. (VDRL) test : Reactive particle agglutination (TP-PA) : non reactive Fluorescent Traponemal Ab absorption (FTA-Abs) : non reactive What is the most likely interpretation for theses result? A. Consistent with traponemal infection at sometime B. Diagnostic of latent syphilis C. Indicative of early syphilis D. Likely biological false positive E. Suggests a past treated infection 134. What is the site of production of Thromboxane A2 ? A. Platelets B. Liver. C. Macrophages. D. Kidney. E. Mast cells 135. What is the site where Urea cycle occurs ? A. Liver B. Kidney C. Adrenal gland. D. Brain. E. Red blood cells 136. What makes the lateral border of ischiorectal fossa? A. Levator ani. B. Anal canal. C. Coccygeus muscle. D. Obtrator internus fascia. E. Obtrator Externus fascia. 137. What is the Nerve that most commonly injured during Gynecological laparotomy ? A. Obtrator nerve. B. ilioinguinal nerve. C. iliohypogastric nerve. D. Femoral nerve. E. Lateral cutaneous nerve. 138. The Umbilical artery is branch of ? A. Anterior division of Internal iliac artery. B. Posterior division of Internal iliac artery. C. Abdominal aorta. D. Internal pudendal artery. E. External iliac artery 139. How Diagonal conjugate diameter is measured ? A. From upper border of symphysis pubis to sacral promontory. B. From Lower border of Symphsis pubis to sacral promontory.

MRCOG RECALLS 59 صفحة Dr. MOHAMED YAHIA 0900988745 C. From the back of symphsis pubis to tip of coccyx. D. From Sacroiliac joint to opposite iliopectineal line. E. It is the distance between ischial tuboristies. 140. Preterm labour Normal labour +ve Fibronectin 5 20 -ve Fibronectin 15 60 What is the Negative predictive value ? A. 70% B. 80% C. 85% D. 90% E. 92% 141. A women with inflammation in ovary develop pain along medial side of thigh , what nerve most likely to be the cause ? A. Obturator nerve. B. Femoral nerve. C. Lateral cutaneous nerve of thigh. D. Sciatic nerve. E. Common peroneal nerve. 142. What is the best investigation to detect receptor status in breast cancer? A. MRI scan. B. Ultrasound C. Fine needle aspiration cytology D. Immuno-histochemistry E. CA 15-3 143. A Women after delivery found to be in lithotomy position for 2 hours , now she develop drop foot , what nerve most likely to be the cause ? A. Tibial nerve. B. Femoral nerve. C. Sciatic nerve. D. Common peroneal nerve. E. Lateral cutaneous nerve 144. The Progesterone receptor is example of which type of receptor ? A. Guanylate cyclase receptor B. Nuclear transcription factor C. Tyrosine kinase nuclear receptor D. Ligand-gated ion channel in the cell membrane E. G protein coupled receptor on the Golgi complex 145. Regarding OOCYTE , when the second meiotic division is completed ? A. At fertilization. B. At Ovulation. C. At birth. D. At puberty. E. first 2 days of menstrual cycle. 146. Regarding Wound healing process , what is the first stage ? A. Hemostasis. B. Inflammation. C. Proliferation. D. Remodeling. E. Wound contraction. 147. Regarding inferior vesical artery , where does it come from ? A. Anterior division of Internal iliac artery. B. Posterior division of Internal iliac artery. C. Abdominal aorta. D. Internal pudendal artery. E. External iliac artery preoperative assessment. She has been taking bendroflumethiazide for several years for hypertension. Her ECG shows: What is the most likely electrolyte imbalance? A. Hypercalcaemia B. Hyperkalaemia C. Hypernatraemia D. Hypokalaemia E. Hyponatraemia books her pregnancy at 11 weeks’

MRCOG RECALLS 60 صفحة Dr. MOHAMED YAHIA 0900988745 gestation. Her booking blood tests reveal a haemoglobin level of 10.1 g/dL. Electrophoresis reveals haemoglobin karyotype HbAS. What is the diagnosis? A. Beta-thalassaemia major B. Beta-thalassaemia trait C. Hereditary spherocytosis D. Sickle cell anaemia E. Sickle cell trait used to detect the presence and the amount of a protein? A. Northern blotting B. Polymerase chain reaction C. Southern blotting D. Western blotting E. X-ray crystalography 151. A study design is made with a Power sensitivity 90% and P = 0.05 . What is the chance of type 2 error ? A. 5% B. 10% C. 15% D. 50% E. 90% 152. Which of the following drugs cause Kernictrus ? A. Penicillin B. Gentamycin. C. Sulphonamides D. Methotrexate. E. Erythromycin 154. Which of the following statements best describe Tidal volume ? A. The normal volume of air displaced between normal inhalation and exhalation(in and out ) when extra effort is not applied B. The volume in the lungs at maximal inflation C. The volume of air remaining in the lungs after a maximal exhalation D. The maximal volume that can be inhaled from the end-inspiratory level E. The maximum volume of air inhaled from the point of maximum expiration 155. Regarding cell cycle , when does chromatids seperates to opposite poles ? A. Prophase. B. Metaphase. C. Anaphase. D. Telophase. E. Interphase. 156. Which of the following methods used for DNA Amplification ? A. Western blotting. B. Northern blotting. C. Polymerase chain reaction. D. Eastern blotting. E. G-banding Letrozole drug ? A. Aromatase inhibitor. B. 5 alpha reductase inhibitor. C. 5HT3 Antagonist. D. Selective estrogen reuptake inhibitor. E. Selective progesterone reuptake inhibitor , who have been trying to conceive for over 12 months , attends a reproductive medicine clinic , the male partner has already give a semen sample for analysis which return back showing : 32 million spermatozoa , morphology >5 , vitality >5% , live spermatozoa 63% , PH 7.2 , What is the correct interpretation of this result ? A. Normal semen analysis B. Azoospermia C. Oligospermia D. Asthenospermia E. PH indicate infection. 159. A 28 years old women undergoing a D&C for a missed abortion , develop

MRCOG RECALLS 61 صفحة Dr. MOHAMED YAHIA 0900988745 pain on cervical dilatation , what is the nerve supply of cervix ? A. Inferior rectal nerve. B. Perineal nerve. C. Pelvic splanchnic nerve. D. Superior rectal nerve. E. Obtruator nerve. 160. Regarding Insulin, it gets activated by removing ? A. A-peptide B. B-peptide C. C-peptide D. D-peptide E. E-peptide 161. What represent the 2 axis of ROC curve ? A. Senstivity Vs 1/specifity B. Specifity Vs 1/ Senstivity C. Senstivity Vs specifity D. 1-Senstivity Vs 1-Specifity E. 1/Senstivity Vs 1/Specifity 162. A condition where the uterus is bulky and endometrial glands are in myometrium is called ? A. Leiomyoma. B. Endometriosis. C. Adenomyosis. D. Choriocarcinoma E. Endometriod carcinoma 163. From what structure does ligamentum Arteriosus come from? A. Ductus arteriosus B. 4 th pharyngeal arch C. 6 th Pharyngeal arch D. Sinus venousus E. Dorsal arch 164. Conversion of Fe3+ to Fe2+ in gut require which of the following vitamins? A. Vit A B. Vit B6 C. Vit B12 D. Vit C E. Vit K 165. 88 years old women with vaginal vault prolapse come for repair , she is asymptomatic for UTI , but her urine analysis show heavy growth (100000X/cm3) E-Coli , WBC 17000 , She is allergic to penicillin whats your management ? A. Reassure . B. Give her Amoxicillin. C. Give her Gentamycin. D. Give her Nitrofurantoin. E. No need for treatment as she is asymptomatic. 166. What is the incidence of pregnancies complicating by cancer ? A. 1/300 B. 1/500 C. 1/1000 D. 1/3000 E. 1/5000 Cysts most prone to undergo Torsion ? A. Mucinous cyst B. Serous cyst. C. Dermoid cyst. D. Endodermal sinus tumour. E. Hemorrhagic cyst 168. A 28 years old women present with 8 weeks pregnancy , she develop heavy bleeding ( abortion ) and the condition is uncomplicated , what the next step ? A. Expectant management. B. Dilatation and curettage. C. Vacuum extraction. D. Misoprostol + mifepristone E. Surgical Evacuation 169. Which of the following enzymes used in Transcription ? A. DNA Polymerase. B. RNA Polymerase. C. Reverse transcriptase D. Restriction endonuclease. E. DNA Ligase 170. What is the Direct arterial blood supply of decidua ? A. Uterine artery. B. Basal arteries C. Spiral arteries

MRCOG RECALLS 62 صفحة Dr. MOHAMED YAHIA 0900988745 D. Straight arteries. E. Arcuate arteries 171. What is the component of Placental barrier at term pregnancy? A. Endothelium and cytotrophoblast. B. Syncitiotrophoblast & Cytotrophoblast. C. Endothelium and connective tissue. D. Syncitiotrophoblast and Endothelium E. Syncitiotrophoblast and connective tissue 172. Regarding sex differentiation , at what gestational age does the External genitalia of male and female is Identical ? A. 6 weeks. B. 12 weeks. C. 20 weeks. D. 25 weeks. E. 30 weeks. 173. Which of the following testicular cells is responsible for androgen production? A. Sertoli cells. B. Lydig cells C. Seminal vesicles. D. Theca cells. E. Granulosa cells 174. Which of the following is male homologous of bartholin gland ? A. Bulbouretheral gland ( Cowper’s gland ) B. Seminal vesicles. C. Prostatic utricle D. Prostatic gland. E. Skene gland neurotransmitters secreted onto adrenal medulla? A. Adrenaline B. Nor epinephrine C. Serotonin D. Acetylcholine E. Dopamine 176. A Mother delivered her baby 2 weeks ago , now she comes with delusions and hallucinations , she feed her baby normally with no other complains. Whats your diagnosis ? A. Postpartum Blues. B. Postpartum psychosis C. Panic attacks. D. Postpartum depression E. Manic attacks 177. During a procedure of Pudendal nerve block , a blood come back in the syringe , which artery most likely to be injured ? A. Internal iliac artery. B. Internal pudendal artery. C. Inferior rectal artery. D. Perineal artery E. Inferior gluteal artery. 178. What hormone secreted by placenta leading to fetal diuresis ? A. Relaxin. B. Estriol C. Oxytocin D. Vasopressinase. E. Inhibin describe Type 2 error ? A. The erroneous acceptance of the null hypothesis B. The erroneous rejection of the null hypothesis C. The inclusion of extreme outliers in a data set D. The occurrence of a γ error E. None of the above 180. Regarding the following data : The Mean BMI is 25 , and the Standard deviation is 5 , what is the percentage of obese people ? A. 5 B. 10 C. 16 D. 34 E. 36 Foregut ?

MRCOG RECALLS 63 صفحة Dr. MOHAMED YAHIA 0900988745 A. Celiac trunk. B. Superior mesenteric artery C. Inferior mesenteric artery D. Abdominal aorta E. Internal iliac artery 182. A Multiparous women with prolapse , which muscle is most likely to be injured ? A. Pubococcygeus. B. Puborectalis. C. Coccygeus muscle D. Ischocavernosus. E. Bulbospongiosus. Ammonia ? A. Liver B. Kidney C. Lungs. D. Adrenals. E. Red blood cell 184. Regarding Standard error of mean [ SEM ] how it is calculated ? A. Square root SD / n B. SD / n C. SD / Square root n D. SD x square root n E. SD – Square root n 185. A 55 year old presents to clinic due to vulval itch and discolouration. examination reveals pale white discoloured areas to the vulva. A biopsy shows epidermal atrophy with subepidermal hyalinization and deeper inflammatory infiltrate. What is this characteristic of? A. Lichen Simplex Chronicus B. Vulval intraepithelial neoplasia C. Vitiligo D. Extramammary Pagets E. Lichen Sclerosus 186. A Pregnant lady 11 week , presented by UTI , what the best course of action ? A. Penicillin. B. Gentamycin C. Doxycyline D. Nitrofurnatoin. E. Trimethoprim 187. Regarding the following table, calculate value of specifity ? Diseased Not diseased +ve test 85 15 -ve test 40 60 A. 20% B. 40% C. 60% D. 80% E. 90% 188. What is the most common solid benign tumour of ovary ? A. Serous tumours. B. Mucinous tumours. C. Endodermal sinus tumours D. Benign teratoma. E. Yolk sac tumour 189. A Patient come complaining of a groin pain , a ureteric stone is suspected and Xray is requested , at what level you would expect to see the stone ? A. iliac crest B. Paravertebral C. Pelvic prim D. Mid-clavicular line. E. Mid-axillary line and usually dose related in patients taking misoprostol? A. Diarrhea B. Nausea C. Vomiting D. Bloating E. Dyspepsia 191. The ureteric buds is derived from which of the following structures ? A. Metanephros B. Mesonephros. C. Mesonephric duct D. Paramesonephric duct E. Allantois.

MRCOG RECALLS 64 صفحة Dr. MOHAMED YAHIA 0900988745 192. A Patient come with an ischemic stroke , regarding brain ischemia and necrosis , what type of necrosis occur in brain ? A. Colliquative necrosis. B. Coagulative necrosis. C. Fat necrosis. D. Fibrinoid necrosis. E. Dry gangrene 193. What is the Action of mRNA ? A. Translation B. Transcription C. Transfer D. DNA synthesis E. Reverse transcription 194. From Which structure inhibin is produced ? A. Theca cells. B. Granulosa cells. C. Cumulus oophorus D. Corpus leutem E. Lydig cells 195. Which of the following cells is considered the basis for the adaptive immune system? A. Neutrophils B. Monocytes C. Lymphocytes D. Basophils E. Eosinophils 196. Main hydrogen ion buffer found in urine ? A. Bicarbonate. B. Magnisium C. Phosphate. D. Chloride E. Sodium 197. Which Immunoglobulin is a Dimer ? A. IgA B. IgD C. IgE D. IgG E. IgM 198. Which nerve emerges on anterior border of psoas major muscle ? A. Obturator nerve. B. Femoral nerve. C. Lateral cutaneous nerve. D. Genitofemoral nerve. E. iliohypogastric nerve. 199. LMP : 1 st of march in a regular 35-day cycle, What is [ EDD] ? A. 8 DEC. B. 15 DEC. C. 8 NOV D. 15 NOV. E. 22 DEC responsible for the striae during pregnancy ? A. Melatonin. B. Cortisol. C. Estrogen D. Melanocyte stimulating hormone. E. Aldosterone

MRCOG RECALLS 65 صفحة Dr. MOHAMED YAHIA 0900988745 EXAM 4

MRCOG RECALLS 66 صفحة Dr. MOHAMED YAHIA 0900988745 1.Which of the following depression screening questionnaire are frequently used during pregnancy? A. Edinburgh Postnatal Depression Scale B. General Health Questionnaire C. Hamilton Depression Rating Scale D. Beck Depression Inventory E. Hospital Anxiety and Depression Scale 2.Pain due to ovarian irritation is felt through which spinal segment ? A. T10 B. T11 C. T12 D. L1 E. L2 3.What makes the lateral border of ischiorectal fossa? A. Levator ani. B. Anal canal. C. Coccygeus muscle. D. Obtrator internus fascia. E. Obtrator Externus fascia. 4.Which artery supplies the structures derived from the midgut of the embryo? A. Coeliac trunk B. Inferior mesenteric artery C. Middle rectal artery D. Renal arteries E. Superior mesenteric artery 5.In which phase of oocyte development does zona pellucida apear around ovum ? A) primordial follicle B) primary oocyte C) secondary oocyte D) Dominant follicle E) Tertiary follicle/graffian follicle 6.The HPV vaccine is what type of vaccine? a. Live attenuated viruses b. Inactivated viruses c. Toxoid based vaccine d. Polysaccaride based vaccine e. Recombinant/ Subunit Vaccine 7.Atosiban is ... a) Progesterone agonist b) Progesterone antagonist c) Use as tocolytic d) Oxitocin agonist e) Oxytocin antagonist 8.Which adverse reaction is common and usually dose related in patients taking misoprostol? a. Diarrhea b. Nausea c. Vomiting d. Bloating e. Dyspepsia 9.Terbutaline has the following mechanism of action A. Alpha agonist B. Alpha receptor blocker C. Beta 1 agonist D. Beta 2 agonist E. Dopaminergic 10.71 y/o with unilocular cyst measuring 30 mm and a Ca 125 of 25 iu/ml. What is her RMI? a. 0 b. 25 c. 75 d. 225 e. 250 11.30-year-old woman with bipolar disorder is 12-week pregnant. She has been taken her lithium every night. Which of the following abnormality may occur if she continues to take lithium? A. Tetralogy of Fallot's B. Dandy walker syndrome C. Ebstein Anomaly D. Limb reduction deformity E. Transposition of great arteries 12.The ureteric buds is derived from which of the following structures ? A. Metanephros B. Mesonephros. C. Mesonephric duct D. Paramesonephric duct

MRCOG RECALLS 67 صفحة Dr. MOHAMED YAHIA 0900988745 E. Allantois. 13.Allantois embryonic origin a. Endoderm b. Paraxial mesoderm c. Internediate mesoderm d. Lateral plate mesoderm e. Ectoderm 14.Which one the following stage of the cell cycle immediately preceeds mitosis a. S phase b. G1 phase c. G2 phase d. G0phase 15.Amino acids transfer through placenta is by which mechanism.?? a. A.simple diffusion b. B.facilitated diffusion. c. C.active transport d. D.passive transport e. E.endocytosis 16.Which of the following antibodies is found as a dimer? A. IgA B. IgM C. IgG D. IgD E. IgE 17.With regard to MRI scanning what is the SI unit measure of strength of magnetic field? a. Weber b. Tesla c. Coulomb d. Ampere e. Gauss 18.The most likely karyotype for a patient with complete hydatidiform mole is A. 46, XX B. 46, XY C. 69, XXX D. 69, XXY E. 69, XYY 19.Magnesium excretion a. metabolized in the liver b. Excreted through the kidneys c. Excreted Unchanged in urine d. b. Metabolized in liver and excreted through kidney e. Conjugated in liver and excreted through kidney 20.Which is common malignant tumour in newborn? A. Retinoblastoma B. Teratoma C. Fibroma D. Nephroblastoma E. Sacrococcygeal Teratoma 21.Vitamin A has 2 diet sources. Plant source is carotene and the animal source is... a. cryptoxantene b. gamma carotene c. isotretinoin d. retinal e. retinyl palmitate 22.Young female 25 years old patient 7 weeks pregnant with complaint of tiredness TSH 8.5 T4 14 T3 5.4 a. Euthyroid b. Primary Hypothyroidism c. Secondary Hypothyroidism d. Subclinical Hypothyroidism e. Hyperthyroidism 23.Identify the karyotype a. Down's syndrome b. Edwards c. Patau d. Klinefelter's Syndrome e. Turner's

MRCOG RECALLS 68 صفحة Dr. MOHAMED YAHIA 0900988745 24.Case of a male with azoospermia and loss of smell(anosmia) diagnosis? a. Kallman's Syndrome b. Klinefelter Syndrome a. c Kartagener Syndrome c. Prader Willi Syndrome d. Turner Syndrome 25.Edwards syndrome manifestation in a male patient a) 46 XX b) 46 XXY c) 47 XX d) 47 XY e) 45 XO 26.Nitrogenous bases make up cellular nucleic acids including DNA and RNA. Which of these nitrogen bases is found only in DNA but not in RNA? A. Uracil B. Cytosine C. Thymine D. Guanine E. Adenine 27.A 30 year old women comes to see you and advises she has felt a little unwell with diarrhoea and flu like symptoms. She is 28 weeks pregnant. A blood culture confirms listeria infection. What is the appropriate treatment (she has no known dug allergies)? a. Amoxicillin b. Cefalexin c. Gentamicin d. Erythromycin e. Clindamycin 28.The antibacterial action of Penicillin is due to its effect on? a. Cell membrane permeabilty b. Cell wall synthesis c. Protein synthesis d. DNA synthesis e. RNA synthesis 29.Which organ anomaly occur with the use of ACE inhibitor? a. Heart b. Cranio facial c. Kidney d. Limbs e. Teeth 30.Which organ anomaly occur with the use of Tetracycline a. Heart b. Cranio facial c. Kidney d. Limbs e. Teeth 31.CNS is the most affected during teratogenesis. What is the first sensation developed in the fetus? a. hearing b. touch c. smell d. taste e. eyesight 32.What is the mechanism of action of Clindamycin? a. It inhibits bacterial protein synthesis by binding to the 50s subunit of the ribosome. b. inhibits cell wall formation c. inhibits DNA gyrase d. interfere with DNA synthesis e. dihydrofolate reductase 33.What is the mechanism of action of Dibagatran? a. Thrombin inhibitor b. Thrombin activator c. Antithrombin inhibitor d. Antithrombin activator e. Vitamin K inhibitor 34.Warfarin acts where in the clotting cascade a. factor V precursor b. factor VII precursor c. fibrinogen precursor d. prothrombin precursor 35.Pyramidalis is supplied by which nerve? a. Obturator n. b. Genitofemoral nerve.

MRCOG RECALLS 69 صفحة Dr. MOHAMED YAHIA 0900988745 c. Subcostal nerve d. Ilioinguinal e. Iliohypogastric 36.The pathway of piriformis muscle?? A. Lumbar surface of sacrum,greater sciatic notch,greater trochanter B. Pelvic surface of sacrum,greater sciatic notch,greater trochanter C. Lumbar surface of sacrum,lesser sciatic notch,greater trochanter D. Pelvic surface of sacrum,lesser sciatic notch,greater trochanter 37.What is the term used for the anticancer agent methotrexate? A. plant alkaloid B. Antimetabolite C. Alkylating agent D. Chain cutting agent E. Intercalating agent 38.Which hormone has a structure similar to Prolactin? a) Anti-müllerian hormone b) Cortisol c) Follicle-stimulating hormone d) Insulin e) Growth Hormone 39.Gastrulation is process of : a) Development of three germ layer b) Fusion of sperm and ovum c) Type of mitotic division d) Formation of GIT e) Formation of neural tubes 40.Which drug trial phase primarily assesses the safety of a drug? A. Phase IV B. Phase III C. Phase II D. Phase I E. Phase 0 41.In fetal circulation which structure caryy oxygenated blood from right atrium to left atrium? a) A.Ductus venosus b) B.foramen ovale c) C.ductus arteriosus d) D.descending aorta 42.Which of the following is predominant type of bacteria in the vagina during pregnancy? A. A-lactobacillus. B. B-peptostreptococcus. C. C-listeria monocytogenous. D. D-streptococcus agalactia. What is the structure pointed by the arrow A. A.Trophoblast B. B.Amniocytes C. C.Polar body from zygote D. D.Inner cell mass E. E.Blastocyst cells 43.The following diagram describes a structural chromosomal abnormality. What is the name of this structural abnormality?(picture similar to this) A. Deletion B. Insertion C. Inversion D. Robertsonian translocation E. Reciprocal translocation 44.Identify the bone of the fetal skull b. frontal bone c. parietal bone

MRCOG RECALLS 70 صفحة Dr. MOHAMED YAHIA 0900988745 d. occipital bone e. temporal bone 45.Coronal suture is located in? A. between frontal and parietal B. between posterior part of parietal and occipital C. between parietal and temporal D. between two parietal bones E. between temporal and occipital 46.Identify the structure pointed by the arrow a. allantoic duct b. umbilical artery c. umbilical vein d. warthon's jelly e. amniotic epithelium 47.What is the area pointed by the thin arrows a. squamous keratinizing epithelium b. squamous non keratinizing c. columnar epithelium d. transformation zone e. cuboidal epithelium 48.A 33 year old women with known stage III cervical cancer post hysterectomy patient presents to A&E with lower abdominal and unilateral flank pain. CT scan contrast urogram was done. From the following list what is the likely diagnosis?(similar picture was given in exam where there is interrupted flow of the dye) a. Renal stones b. Ischemia secondary to Uterine artery obstruction c. UTI d. Urethral obstruction e. Ureteric Obstruction 49.Indian Origin Lives In London Have History Of Low Grade Fever Weight Loss and Cough For 5 Months.She is pregnant. CXR image below. What is your diagnosis? a. Tuberculosis b. Bronchitis c. Pneumonia d. Sarcoidosis e. Silicosis 50.Patient post abortion came in with difficulty of breathing, and hemoptysis. Chest xray done (like the one below). With the following findings what is the tumor marker that is possibly elevated? a. AFP b. CEA c. HCG d. Ca 125 e. LDH

MRCOG RECALLS 71 صفحة Dr. MOHAMED YAHIA 0900988745 51..A pregnant woman desires screening test for down's syndrome and the following report is obtained :  Age related risk; 1:1000MoM  AFP; 1.05MoM  β-hCG; 0.85  Test risk; 1:10000 What will you counsel this woman? A. The fetus has down's syndrome B. The fetus does not have down's syndrome C. It is high risk for down's down's syndrome D. It is low risk for down's syndrome E. Ask the patient to go home 52.LDH elevates in which type of ovarian ca ? a. Dysgerminoma b. Endodermal sinus tumor c. Choriocarcinoma d. Yolk Sac Tumor e. Endometriod Tumor 53.Infection with which one of the following human papillomaviruses (HPVs) is associated with an increased risk of cervical cancer? A. HPV 6 B. HPV 11 C. HPV 17 D. HPV 30 E. HPV 33 54.Which group of viruses cause molluscum contagiosum? A. Adenovirus B. Herpes virus C. Papovavirus D. Parovirus E. Pox virus 55.HPV high risk for cervical cancer include a) 6 b) 11 c) 16 d) 30 e) 31 56.Which enzyme is present in granulosa cells but not in theca cells? A. 11 b hydroxylase B. Glucoronidase C. 17 b hydroxylase D. Acid Phosphatase E. Aromatase 57.Where in body is androgen produced? A. Distal tubules B. Lung C. Zona fasciculata D. Zona reticularis E. Zona glomerulosa 58.A woman is 8 weeks pregnant attends for genetic counseling as she worried about CF, her sister has a child with cystic fibrosis. She is a carrier and her partner is normal What is the risk of the child having cystic fibrosis? A. 0% B. 25% C. 50% D. 75% E. 100% 59..Mother has sickle cell disease married to sickle cell trait husband chance of baby to having disease? a. 0% b. 25% c. 50% d. 75% e. 100% 60..Aspirin and ibuprofen what is the difference in action? a. Aspirin Irreversibly inhibit COX 1 than ibuprofen b. Aspirin Irreversibly inhibit COX 2 than ibuprofen c. Aspirin reversibly inhibits COX 1 than ibuprofen d. Aspirin reversibly inhibits COX 2 than ibuprofen 61..Patient menopause came in with profuse vaginal bleeding 1 week ago. U/S done with the following findings

MRCOG RECALLS 72 صفحة Dr. MOHAMED YAHIA 0900988745 point A to point B = 1.2mm. What is your management? a. ask her to come back if bleeding recurs b. give her COCP c. give her POPs d. for diagnostic curettage e. hysterectomy 62..26yr woman on COCP with ethyl estradiol 30mcg came in with frequent light bleeding episodes after 3 weeks of use with negative chlamydia test and negative cx smear. What is your management? a. No need to do anything follow up after 3 months if bleeding persist b. Change to ocp with higher eostrogen content 35ug EE c. Change to ocp with lower eostrogen content 20 ug EE d. Repeat cervical smear e. Endometrial biopsy 63.A 25-year-old woman presented to an early pregnancy unit with mild vaginal bleeding after 5 week's amenorrhea. There is history of irregular menses. Ultrasound shows no evidence of intrauterine pregnancy. Beta hCG is 400 IU/l and beta hCG after 48hrs later is 700 IU/l. What is the most likely diagnosis? A. Pregnancy of uncertain viability B. Early normal pregnancy C. Ectopic pregnancy D. Incomplete miscarriage E. Pregnancy of unknown location 64.Grade A recommendation of RCOG means a. at least one randomized controlled trial b. meta analysis from several randomized controlled trials c. at least one well designed study not randomized d. well controlled studies but non randomized e. expert opinion 65..Sigmoid Colon Mesentery| Blood Supply | Lymphatic ----——————————————— a. No Superior Mesenteric a. pre aortic LN b. No Inferior mesenteric a. pre aortic LN c. Yes Inf Mesenteric a. pre aortic LN d. Yes Superior Mesenteric a. pre aortic LN e. Yes Inferior Mesenteric a. inguinal LN 66..Appendiceal artery is a branch of a. Ileocolic artery b. inferior mesenteric a. c. left colic a. d. middle colic a. e. right colic a. 67.What is the major estrogen found in menopause? a. a...Estradiol b. b...Estriol c. c...Estrone 68.Drugs readily cross the placenta because of which quality? A. High lipid solubility B. High protein binding C. ionization of molecules 69..HIV positive patient came with ruptured membranes 38 weeks. Already on HAART. Viral copies 1450. Management? a. Category 1 CS b. Category 2 CS with IV Zidovudine c. Immediate Cesarean Delivery 70..A 34-year-old woman has just returned to the UK following missionary work in the northern parts of South America. She is delighted to be pregnant and presents for booking at 12 weeks of gestation. After counselling she agrees to have routine blood investigations including screening for

MRCOG RECALLS 73 صفحة Dr. MOHAMED YAHIA 0900988745 syphilis. The results are returned as follows:  Venereal Disease Research Laboratory (VDRL) test REACTIVE  Treponema pallidum particle agglutination (TP-PA) test NON￾REACTIVE  Fluorescent treponemal antibody absorption (FTA-Abs) test NON￾REACTIVE What is the most likely appropriate interpretation of these results? A. Consistent with treponemal infection at sometime B. Diagnostic of latent syphilis C. Indicative of early primary syphilis D. Likely biological false positive E. Suggests a past treated infection 72..What is the most common cause of the female urethral caruncle? A. Trauma B. Tumour C. Infection D. Hypoestrogenism E. Congenital 73..Macrophages are derived from what type of cell? a. Natural Killer Cells b. Lymphocytes c. Basophils d. Monocytes e. Neutrophils 74..From which organ / system does the Krukenberg tumor of the ovaries originate from? a. Lung b. Brain c. Kidney d. Uterus e. GIT 75.A 57-year-old woman presents with hematuria and dysuria based on the clinical finding what is your possible diagnosis? a. Adenocarcinoma b. Transitional cell carcinoma c. Paraganglioma d. Squamous cell carcinoma e. Adenocarcinoma 76..Most common cancer type in fallopian tube? a. Adenocarcinoma b. Squamous cell carcinoma c. Sarcoma d. Carcinosarcoma e. Clear Cell Carcinoma 77..What type of variable is BMI ? a. Ordinal b. Nominal c. Continuous d. Categorical e. Discrete 78..Half life of Mifepristone? a. 5-10 hrs b. 25-30 hrs c. 45-50 hrs d. 75-80 hrs e. 85-90 hrs 79.In pregnancy, what is the total percentage increase in plasma volume by term compared to a non-pregnant woman? a. 10 to 30% b. 30 to 50% c. 50 to 70% d. 70 to 90% e. No increase 80.Motor fibers to detrusor muscle of the urinary bladder are derived from which of the following nerves? A. Pelvic splanchnic B. Greater splanchnic C. T11-L2 D. Superior hypogastric plexus E. Sacral plexus 81.Deep perineal and dorsal clitoral nerve is a branch of ? a. external pudendal b. internal pudendal

MRCOG RECALLS 74 صفحة Dr. MOHAMED YAHIA 0900988745 c. ilioinguinal d. iliohypogastric 82.During laparoscopy, the remnant of theumbilical artery could be identified sometimes the it is patent. In the adult the patent segment supplies which vessel? a. internal iliac b. inferior vesical c. superior vesical d. external iliac e. internal pudendal 83.Which test you is used to check ovarian reserves in pre menopausal women a. Estradiol b. Anti mullerian hormone c. FSH d. LH e. Progesterone 84..Which is the most common cause of the premature ovarian failure? A. A)idiopathic B. B)autoimmune C. C)chromosomal D. D)infection E. E)iatrogenic 85..A male came for infertility check up who was taking Finasteride for treatment of his male pattern baldness. Finasteride exert its action by inhibition of which enzyme? A. 21-hydroxlase B. 5-alpha reductase C. Aromatase D. Phosphodiesterase E. Desmolase 86..The enzyme involve in the final oxidation of uric acid? a. decarboxylase b. carbonic anhydrase c. dihydropurine d. xanthine oxidase 87..Most enzymes that take part in Kreb’s cycle are located in? a. cytoplasm b. mitochondria c. plasma membrane d. rough ER e. smooth ER 88..Which of the following is precursor of Serotonin? . A) Histidine. B) Glycine. C) Arginine. D) Tyrosine. E) Tryptophan. 89..What is the percentage of uterine rupture during IUCD insertion? A. a.1/25 B. b.1/50 C. c.1/100 D. d.1/500 E. e.1/5000 90..Which cancer most commonly diagnosed in pregnancy and postpartum? a. Breast CA b. Cervical CA c. Melanoma d. Colon CA 91..What is the most common cause of postmenopausal bleeding? A. Atrophic vaginitis and endometritis B. Endometrial cancer C. Endometrial hyperplasia D. Endometrial polyp E. Hormone replacement therapy 92..An Asian woman books in for her third pregnancy at 12 weeks of gestation. She has recently moved to the UK from Thailand to be with her new husband. After pre –test counselling, with the aid of an interpreter, she agrees to hepatitis B virus (HBV) screening. The results return as follows. What is the significance of these results?  HBsAg POSITIVE  Anti-HBc POSITIVE  Anti-HBcIgM NEGATIVE  AntiHBs NEGATIVE

MRCOG RECALLS 75 صفحة Dr. MOHAMED YAHIA 0900988745 A) A.Post vaccination B) B Resolved infection C) C.Natural HBV immunity D) D.Chronic infection E) E.Acute HBV infection 93.What is the function of DNA polymerase? A. To unwind DNA helix B. To add nucleotides to the end of a template DNA strand C. To synthesis the nucleotides of DNA strands D. To seal together the broken ends of DNA strands E. DNA repair 94..What is represented by the equation Sensitivity/(1-specificity)? A. Accuracy B. Positive predictive value C. Negative predictive value D. Positive likelihood ratio E. Negative likelihood ratio 95..What is the correct formula to calculate specificity? a. TP/(TP+FP) b. TN/(TN+FN) c. TN/(TN+FP) d. TP/(TP+FN) 96..700 women were enrolled for the assesment of PPV for test preterm labour?320 women were test positive out of them 80 had preterm labor .380 were test negative and out of them 20 had preterm labor.what is the positive predictive value of the test? A. 25% B. 50% C. 70% D. 10% E. 100% 97..Out of the women enrolled in a study 50 had PTL and 40 of those who had preterm labor were tested positive for fetal fibronectin and 10 who had preterm labor were tested negative what is the sensitivity of the test? a. 10/50=20% b. 40/50=80% 98.Which of the following ovarian Cysts most prone to undergo Torsion during pregnancy? A. Mucinous cyst B. Serous cyst. C. Dermoid cyst. D. Endodermal sinus tumour. E. Hemorrhagic cyst 99..Patient came in with abdominal pain with history of heavy and painful periods. Exlap was done which revealed the following: What is the likely diagnosis? A. Functional cyst B. Physiologic cyst C. Ovarian Endometrioma D. Ovarian Teratoma E. Germ cell tumor 100.Which one of the following best describes the histological type of endometrium that is with enlarged and tortous glands? A. Decidual reaction B. Atrophic endometrium C. Proliferative endometrium D. Secretory endometrium E. Arias-Stella phenomenon 101..Telogen Effluvium (hair loss) is more pronounced in what stage of pregnancy? a. first trimester b. second trimester c. third trimester d. during delivery e. after delivery 102..Natural Killer Cells(NK) is increased significantly at which stage of menstrual cycle? a. early proliferative b. late proliferative c. early secretory d. late secretory e. at ovulation 103..Sympathetic supply of bladder largely comes from which nerve?

MRCOG RECALLS 76 صفحة Dr. MOHAMED YAHIA 0900988745 a. Pudendal b. Pelvic splanchnic c. Hypogastric d. Sacral 104.Which structure in female is homologus to male prostate? a. Skenes gland b. Gartner duct c. Bartholin gland d. Bulbourethral gland 105..Rate limiting step in the synthesis of catecholamines? a. acetylcholine esterase b. DOPA decarboxylase c. tyrosine hydroxylase d. dopamine B hydroxylase e. phenyl N methyl transferase 106..The anesthesiologist wanted to anesthesize the anterior andomen using TAP block. In this procedure where are the nerves mostly located? a. between external and internal oblique b. between internal oblique and transversus abdominis c. between transversus abdominis and transversalis fascia d. between transversalis fascia and parietal peritoneum 107..Antidiuretic hormone (ADH) is released from which part of hypothalamus: A. Arcuate nucleus B. Preoptic nucleus C. Periventricular nucleus D. Suprachiasmatic nucleus E. Supraoptic and Paraventricular nuclei 108.What is the chemical structure of GnRH ? a. glycoprotein b. Tripeptide c. Nonapeptide d. Octapepide e. Decapeptide 109.What is the chemical structure of Renin? a. Polypeptide b. Oligopeptide c. Carbohydrate d. Steroid e. Protein 110.The difference between the peak and the throughs of ultrasound wave is called? A. Amplitude B. Acoustic impedence C. Frequency D. Resolution E. Wave length 111..There are 3 components of interaction of ultrasound with the tissue medium: absorption, scattering, and the third one is... a. cavitation b. reflection c. refraction d. attenuation e. amplitude 112.A study between soya milk and improvement of menopause symptom. the null hypothesis H0 should state that A. There is a insignificant relation/ difference between soya milk intake and menopause symptoms B. There is a relation/ difference between soya milk intake and menopause C. There is no relation/difference between soya milk intake and menopause symptoms 113.Blood supply to the medial part of the anterior abdominal wall below the umbilicus? A- Superior epigastric artery B- Superior mesenteric artery C- Intercostal arteries D- Inferior epigastric artery E- Inferior mesenteric artery 114..A primigravida at 22 weeks is scared to have vaginal delivery. On examination she had absent clitoris and

MRCOG RECALLS 77 صفحة Dr. MOHAMED YAHIA 0900988745 normal labia majora. What type of genital mutilation is it? a. Type 1 b. Type 2 c. Type 3 d. Type 4 e. Type 5 115..Regarding the following data: mean bmi is 25% and standard deviation is 5, what is the percentage of obese class 2 and 3? A. 2.5% B. 5% C. 16% D. 32% E. 34% 116..Ovarian CA associated with mutation of mismatch repair genes a. clear cell Ca b. endometriod CA c. papillary Ca d. Serous CA e. Mucinous CA 117..What type of necrosis is seen in the heart after an acute myocardial infarction? A. Liquefactive necrosis B. Coagulative necrosis C. Caseous necrosis D. Gangrenous necrosis E. Fibrinoid necrosis 118..Increase in cell size is called? a. hyperplasia b. hypertrophy c. atrophy d. metaplasia e. dysplasia 119..Physiological variation in menstrual cycle between 21 to 35 days due to a. a-aberrant LH surge b. b-estrogen fails to produce negative feedback on pituitary c. c-estrogen fails to produce positive feedback on pituitary d. d-luteal phase varies in duration by time taken for corpus luteum to degenerate e. e-loss of progesterone secretion 120.A 60-year-old woman with stage IIB cervical cancer is currently undergoing radiotherapy by impact of gamma￾emitting isotopes containing Casieum 137 on her vagina. This type of therapy is best described by which of the following terms? a. A Adjuvant B. Neoadjuvant C. Radical D. Brachytherapy E. Teletherapy 121.Choroid Plexus can be found impinging on ? a. arachnoid and dura matter b. dura matter and pia matter c. arachnoid and pia matter d. dura matter and endocranium 122.Adult hemoglobin is synthesized when? a. 28 wks b. 34 wks c. 36 wks d. at birth e. 7 days post natal 123..Where is prolactin produced that is not under dopaminergic control? a. maternal decidua b. anterior pituitary c. hypothalamus d. posterior pituitary e. warthon's jelly 124.Patient with ovarian mass plus pleural effusion histopath revealed white, firm, spindle shape cells. Diagnosis? a. glioma b. fibroma c. sarcoma d. leiomyoma e. adenoma

MRCOG RECALLS 78 صفحة Dr. MOHAMED YAHIA 0900988745 125..You see a patient who is 35 weeks pregnant in your day assessment unit. She presents with itching... more on the area of the abdominal striae. Lab results given which showed normal ALP, normal bilirubin levels. Diagnosis? A. Intrahepatic Obstetric Cholestasis B. Polymorphic Eruption of Pregnancy C. Fatty Liver D. Acute Hepatitis E. Cholecystitis 126..A 27-year-old woman after normal vaginal birth develops shortness of birth and seizures. Despite resuscitation she died. At autopsy squamous cells and fetal hair are found in lungs. What is the most likely cause of death? A. Amniotic fluid embolism B. Placental abruption C. Eclampsia D. Pulmonary embolism E. Postpartum hemorrhage 127..Primary amenorrhea with absent uterus, vagina ends in a blind pouch, normal breasts and scant pubic hair is seen in: a. Klinefelter syndrome b. Mayer Rokitanski Kuster Hauser syndrome c. Turner’s syndrome d. Androgen Insensitivity Syndrome e. Noonan syndrome 128..Which one of the following bacteria produces an exotoxin causing 'toxic shock syndrome'? A. Escherichia coli B. Streptococcus agalactiae C. Clostridium welchii D. Staphylococcus aureus E. Mycoplasma hominis 129..Which organism is the most common cause of sepsis in pregnancy? A) Group A Streptococcus B) Group B Streptococcus C) Gardnerella vaginalis D) Staphylococcus aureus E) Enterococcus 130..A lady was injured while walking in the garden barefoot. After that she developed cellulitis.. What's the possible cause? A. Stap aureus B. Strep Viridens C. Staph Epidermidis D. Pseudomonas E. Clostridium 131.Nerve passing below inguinal ligament medial to anterior superior iliac spine? A. Femoral n. B. Anterior iliac n. C. Ilioinguinal n. D. Genitofemoral n. E. Lateral cutaneous n. Of thigh 132..There is difficulty in extracting blood in the upper arm, the intern decided to extract from the femoral vein. What is the relation of the femoral vein to the artery and nerve from lateral to medial? a. VAN b. NAV c. AVN d. NVA e. ANV 133.Which organelles do type II pneumocytes utilize for surfactant release? A. Golgi complex B. Lysosomes C. Endosomes D. Lamellar Bodies E. Rough endoplasmic reticulum 134.Most important complement in opsonization a) C3a b) C3b 135..Psammoma bodies are a histologic feature of ovarian papillary serous cystadenoma. ' Psammoma bodies' are composed of ?

MRCOG RECALLS 79 صفحة Dr. MOHAMED YAHIA 0900988745 A. calcium B. iron C. Fibrin D. Mucin E. Lipid 136..23-year-old woman presents with fishy foul smelling vaginal odour. 'Clue cells' are found in the smear. Which of the following cell types is belong to 'Clue cells'? A. Neutrophils B. Natural killer cells C. Lymphocytes D. Macrophages E. Epithelial cells 137..Vestibule is a. area between two labia majora b. area between two labia minora c. area between hymen and labia minora d. area between hymen and labia majora 138..WHO defines perinatal mortality as a. A.number of neonatal deaths per 1000 births b. B.number of still births after 22 wks & early neonatal deaths per 1000 births c. C.number of still births after 24 weeks & early neonatal births per 1000 births d. D.number of still births per 1000 births e. E.number of still births per year 139..A 28-year-old woman with complete hydatidiform mole is found to have bilateral multiple tiny ovarian cysts along with an enlarged uterus at 12 weeks’ gestational age. The quantitative β-hCG level of 300,000 mIU/mL.What is the most likely type of these ovarian cysts? A. Polycystic ovaries B. Granulosa cell cyst C. Follicular cyst D. Theca lutein cyst✅ E. Corpus luteum cyst 140..What is the most common cause of acromegaly? a. MEN I b. MEN II c. Pituitary infarct d. Pituitary adenocarcinoma e. Pituitary adenoma 141..What is the most common adverse effect experienced by women taking the progestogen- only pill? A. Acne B. Weight gain C. Erratic bleeding D. Reduced libido E. Mood swings 142.Labetalol is: a) Selective alpha and beta blocker b) Non Selective alpha and beta blocker c) Non selective beta blocker d) Selective Alpha blocker e) Direct vasodilation 143..What is the mechanism of action of hydralazine? a. Alpha 2 agonist b. Angiotensin converting enzyme inhibitor B. C.Antimuscarinic a. Beta 2 Agonist b. Direct acting smooth muscle relaxant 144..A woman experiences a postpartum hemorrhage after delivery and is administrated carboprost to promote uterine contraction. What type of drug is carboprost? A. Progestogen B. prostaglandin E1 C. prostaglandin E2 D. prostaglandin F2 145..Patient has heavy menstrual bleeding. She desires an endometrial ablation to stop bleeding after failure of medical treatment. Which part of the uterus is destructed to stop bleeding?

MRCOG RECALLS 80 صفحة Dr. MOHAMED YAHIA 0900988745 A. Basal layer of endometrium B. Functional layer of endometrium C. Entire myometrium D. Spiral artery 146..A 28-year￾old woman has undergone emergency hysterectomy due to obstetric haemorrhage during her 3rd pregnan cy. The previous pregnancies were bo th term C￾section deliveries. Examination of the uterus shows the placenta had invad ed through the full thickness of the myometrium. What is the most likely diagnosis? A. Placenta praevia B. Placenta accreta C. Placenta increta D. Invasive mole 146.What is the new non invasive prenatal diagnostic test of cell-free fetal DNA of maternal blood derived from? A. Fetal RBCs B. Fetal WBCs C. Fetal fibroblasts D. Amniotic cells E. Placental Trophoblast 147..Which of the option correctly identified the embryological origin beginning and ending of the round ligament of the uterus? A. Gubernaculum ovarii , ant surface of uterine cornua, labia majus B. Gubernaculum ovarii, post inf to uterine cornua, labium majus C. Gubernaculum ovarii post inf to the uterine cornua,labium minus D. Paramesonephric duct, post sup to uterine cornua, labium minus E. Paramesonephric duct, ant inf to uterine cornua, labium majus 148.Which of the following is predominant type of bacteria in the vagina during pregnancy: A. A-lactobacillus B. B-peptostreptococcus. C. C-listeria monocytogenous. D. D-streptococcus agalactia. 149..The most common site of endometriosis is? A. ovary B. Uterosacral ligament C. Vagina D. Rectum E. Oviduct 150.In which subsites does vulvar cancer most commonly arise? A. Mons pubis B. Labia majora C. Labia minora D. Clitoris E. Posterior fourchette 151..What type of Laser is Neodymium: YAG laser? A. Semiconductor laser B. Excimer Laser C. Dye Laser D. Gas Laser E. Solid Laser 152..Which type of epithelium lines the distal urethra near the external urethral orifice? A. Transitional B. Squamous✅ C. Cuboidal D. Stratified columnar E. Simple columnar 153..A 35 year old woman has a pelvic ultrasound scan showing multiple fibroids. What is the most common form of fibroid degeneration? a. Red degeneration b. Hyaline degeneration c. Carneous degeneration d. Myxoid degeneration e. Cystic degeneration 154..From where in the nephron is the enzyme renin secreted ? a) Collecting ducts b) Distal convoluted tubules c) Juxtaglomerular apparatus d) Loop of Henle e) Proximal convoluted tubules

MRCOG RECALLS 81 صفحة Dr. MOHAMED YAHIA 0900988745 155.Which neoplasm is characteristically associated with paraneoplastic syndrome of inappropriate antidiuretic hormone (SIADH)? A. Renal cell carcinoma B. Breast carcinoma C. Small cell lung carcinoma D. Papillary thyroid carcinoma E. Cancer colon 156.Which of the following drugs is used to suppress lactation postpartum in mother who suffers from stillbirth? A. Quetiapine B. Metoclopramide C. Loperamide D. Leuprolide E. Cabergoline✅ 157.Wernicke-Korsakoff syndrome Deficiency disease of vitamin? A. Vitamin B1 ✅ B. Vitamin B2 C. Vitamin B3 D. Vitamin B6 E. Vitamin B12 158.Which types of cells are phagocytic for residual bodies left over from the process of spermiogenesis? A. Testicular mesenchymal cells B. Testicular macrophages C. Fibroblast cells D. Interstitial cells of leydig E. Sertoli cells 159.Insensible loss of water from sweat and lungs in 70 yr old healthy woman is A. 100ml/kg B. 450ml/kg C. 850ml/kg D. 1350ml/kg E. 2600 ml/kg 160.The sacroiliac joint is what type of joint? A) Condyloid B) Synovial C) Primary Cartilaginous D) Secondary Cartilaginous E) Fibrous 161.Which kind of cell produce parathyroid hormone? A. chief cells B. oxyphilic cells C. parathynotic cells D. follicular cells E. basophil cells 162.Which chromosomes are capable of robertsonian translocations? A. X, Y B. 15, 17, 19 C. 16, 18, 20 D. 9, 10, 11, 12 E. 13, 14, 15, 21, 22 163.Which signaling molecule that stimulate the renin-angiotensin system to regulate the sodium concentration? A. Angiotensin B. Aldosterone C. Bradykinin D. Oxytocin 164..Which class I major histocompatibility complex human leucocyte antigen (HLA) is not expressed in extravillous trophoblast? A. HLA-A, HLA-B B. HLA-B, HLA-C C. HLA-C, HLA-F D. HLA-F, HLA-DR E. HLA-DR, HLA-G 165.31 yr old c/o subfertility for 2yrs , no medical problem , BMI 38kg/m2 , hormone result :  FSH 8  LH 18  progesterone 4 nm m/l  E2 198  HSG patent bil tubes  U/s poly cystic ovaries , Male ( husband ) normal , What is most appropriate management : a. Clomiphene

MRCOG RECALLS 82 صفحة Dr. MOHAMED YAHIA 0900988745 b. Metformin c. Metformin + Clomiphene d. Letrozole e. Weight loss✅ 166.Woman climbed up the hill with her friends suddenly felt breathless plus parasthesia in her hands. What is the acid-base imbalance ? A. Metabolic alkalosis B. Metabolic acidosis C. Respiratory alkalosis D. Respiratory acidosis E. Mixed acidosis 167.What type of acid–base disturbance result in a case of Conn's syndrome? A. Metabolic acidosis B. Metabolic alkalosis C. No effect D. Respiratory acidosis E. Respiratory alkalosis 168..The Haldane effect refers to which of the following options? A. The inhibitory effect of oxygen on fermentation B. The chloride shift that maintains electrical neutrality C. The dissociation constant for the bicarbonate buffer system D. The increased capacity for deoxygenated blood to carry CO2 E. The reduction in affinity of hemoglobin for oxygen in active tissues in response to a drop in pH caused by increased CO2 production 169..Areas appear dark or black in ultrasound? ???? a. hyperechoic b. anechoic c. isoechoic d. hypoechoic 170.The following intrauterine growth chart shows the 10th, 50th and 90th weight percentiles by gestational ages.What is the correct interpretation of this chart? a. Normal Growth b. Below the 10th percentile c. Above the 10th percentile d. Small for gestational age (SGA) e. Large for gestational age (LGA) 172..Trichomonas Vaginalis ???? a. facultative anaerobe b. flagelated protozoan✅ c. obligate aerobe d. obligate anaerobe e. fungi 173..A midwife asks the obstetric registrar to review a primigravida in labour who has progressed to 6 cm dilatation with an abnormal CTG. The CTG has been normal up to 30 minutes previously. The registrar reviews the patient and confirms that the CTG has a baseline heart rate of 150 bpm with a baseline variability of 4 for the last 30 minutes. There were no accelerations but variable decelerations were present. What would be appropriate management with these CTG findings? A. This is a normal CTG and no intervention required B. This is a suspicious CTG and requires continued obstetric review C. This is a pathological CTG and fetal blood sampling is required D. This is a pathological CTG and urgent delivery is required (Category 1 CS) E. This is a suspicious CTG and fetal blood sampling is required 174.25 y/o had lscs at term for breech presentation with spinal anesthesia After what timen you start low dose molecular heparin(LMWH)

MRCOG RECALLS 83 صفحة Dr. MOHAMED YAHIA 0900988745 a. 4 hrs b. 6 hrs c. 12 hrs d. 24 hrs e. No need for treatment only hydration and mobilization✅ 175..VIN3 is caused by which organism ? a. HPV 11 b. HPV 16 c. HIV d. HLT 176..Zika virus is a. Ss DNA b. DsDNA c. Ss RNA d. Ds RNA e. DNA replicating RNA 177.Thrombosis in protein C deficiency is due to a. A.decrease antithrombin 3 b. B.Factor 5 and 8a 178..Transport of iodide in the cells is associated with a. calcuim b. sodium c. chlorine d. magnesium e. potassium 179..Patient presented with heavy vaginal discharge but no itching,PH 6. What is the cause? a. Candida b. Bacterial vaginosis c. Trichomonas vaginalis d. Physiological discharge e. Chlamydia trachomatis 180..During a hysterectomy, vaginal bleeding may be a significant complication even after removal of the uterus and ligation of the uterine arteries. Such bleeding would most likely originate from which of the following arteries which anastomoses with uterine artery? a. internal pudendal b. superior hemorrhoidal c. inferior mesenteric d. superior vesical e. ovarian 181..Renal Calculus referred pain ?????? a. groin b. lumbar region c. anterior abdominal wall d. umbilicus e. hypochondriac area 182..CAH is caused by 21 hydroxylase the remaining is due to? a. 17a- hydroxylase b. 11b- hydroxylase c. 3b HSD d. 20,22 desmolase 183..Incidence of "RARE" disease when translated into mathematics is? a. 1:100 b. 1:1000 c. 1:10,000 d. 1:10,000 -1:100,000 e. 1:100,000 184..You are assessing a patient with an ovarian mass and are using the Risk of Malignancy Index 1 (RMI) score. Which of the following is used to calculate the RMI? A. Menopause status, Serum Ca 125 iu/ml, US score B. Menopause status , Serum Ca 125 mg/dl, US score C. Age, Serum Ca 125 iu/ml, US score D. Age, Serum Ca 125 mg/dl, US score 185.Embryonic origin of oocytes a. extra embryonic coelom b. yolk sac c. primordial germ cell 186..Definition of Tidal Volume a. amount of air left inside the lungs after forceful expiration.

MRCOG RECALLS 84 صفحة Dr. MOHAMED YAHIA 0900988745 b. amount of air that goes in and out of the lungs during normal respiration c. additional amount of air that can be expired from the lungs by determined effort after normal expiration d. additional amount of air that can be inspired from the lungs by determined effort after normal inspiration e. the volume of air contained in the lungs at the end of a maximal inspiration 187..What type of compound is Histones? A. Carbohydrate B. Fatty acid C. Prostaglandin D. Protein E. Steroid 188..Most important function of Vitamin C a. antioxidant b. boost immune system c. collagen formation d. helps in wound healing 189..Cells in the body produce hormones among them how many are lactotrophs? a. 1-5% b. 10-15% c. 15-25% d. 25-30% e. 40-50% 190..Inflammatory mediators involved in wound healing a. tumor necrosis factor b. vascular endothetial growth factor c. transforming growth factor beta d. interferon e. interleukin 192..Indirect Inguinal Hernia a. lateral to inferior epigastric arteries b. medial to inferior epigastric arteries c. weakening of conjoint tendon 193..What is the most common cause of endogenous Cushing's syndrome? a. Small cell carcinoma of the lung b. Adrenal adenoma c. Phaeochromocytoma d. Multiple Endocrine Neoplasia type 1 e. Pituitary adenoma 194..What is the most common cause of hyperthyroidism in pregnant woman? a. Adenoma b. Graves disease c. Iodine excess d. Subacute thyroiditis e. Toxic multinodular goitre 195..Trophoblast cells that invade the lumen of spiral arteries a. extravillous trophoblast b. endovascular trophoblast c. interstitial trophoblast d. villous trophoblast e. extravascular trophoblast 196..Patient pregnant with right adnexal mass on ultrasound not separable from ovary with no intrauterine gestational sac sac, patient is stable a. rescan after 7 days b. serum b hcg 48 hrs apart c. explore lap 197..Sudden disorientation of a women following delivery now on 35% Oxygen Abgs showed  Ph 7.2  Spo2 13.4  Spco2 8.4  Base excess -2.4  Hco3 25 Whats the metabolic disorder? a. Respiratory Acidosis b. Respiratory Alkalosis c. Metabolic Acidosis d. Metabolic Alkalosis

MRCOG RECALLS 85 صفحة Dr. MOHAMED YAHIA 0900988745 e. Respiratory Acidosis with Metabolic compensation 198..Heavy menstrual bleeding, tired, lethargy, examination reveals larger uterus, what investigation will u do? a. Coagulation Screen, FBC, US, TFT b. FBC, US, TFT c. CBC, Endometrial biopsy d. Coagulation Screen, FBC, US e. US, TFT, Endometrial biopsy 199..HPV proliferate in? a. Basal Cell of endometrium b. Liver sinusoids c. Spleen d. Bone marrow e. Trigeminal neuron

MRCOG RECALLS 86 صفحة Dr. MOHAMED YAHIA 0900988745 EXAM 5

MRCOG RECALLS 87 صفحة Dr. MOHAMED YAHIA 0900988745 1. Atosiban is A. Progesterone agonist B. Progesterone antagonist C. Use as tocolytic D. Oxitocin agonist E. Oxytocin antagonist 2. 30-year-old woman with bipolar disorder is 12-week pregnant. She has been taken her lithium every night. Which of the following abnormality may occur if she continues to take lithium? A. Tetralogy of Fallot's B. Dandy walker syndrome C. Ebstein Anomaly D. Limb reduction deformity A. E. Transposition of great arteries history of previous two miscarriage. Ultrasound showed... What is the most likely karyotype ? A. 46, XX B. 46, XY C. 69, XXX D. 69, XXY E. 69, XYY 4. The antibacterial action of BenzylPenicillin is due to its effect on? a. Cell membrane permeabilty b. Cell wall synthesis c. Protein synthesis d. DNA synthesis e RNA synthesis 5. Warfarin acts where in the clotting cascade?(SEPT 2017) a. factor V b. factor VII c. fibrinogen d. prothrombin e. Vitamin K antagonist 6. Grade B recommendation of RCOG means a. at least one randomized controlled trial b. meta analysis from several randomized controlled trials c. at least one well designed study not randomized a. d. well controlled studies but non randomized b. e. expert opinion 7. Appendiceal artery is a branch of ? a. Ileocolic artery b. inferior mesenteric a. c. left colic a. d. middle colic a. e. right colic a. the female urethral caruncle? A. Trauma B. Tumour C. Infection D. Hypoestrogenism E. Congenital 9. What type of variable is ABO Blood Group ? A. Ordinal B. Nominal C. Continuous D. Categorical E. Discrete 10. Which of the following is precursor of Serotonin? A) Histidine. B) Glycine. C) Arginine. D) Tyrosine. E) Tryptophan 11.Identify the area represented by B in the diagram

MRCOG RECALLS 88 صفحة Dr. MOHAMED YAHIA 0900988745 a. Pudendal cleft b. Vestibule c. c. Fourchette d. Fossa Navicularis 12. Wernicke-Korsakoff syndrome Deficiency disease of vitamin? A. Vitamin B1 B. Vitamin B2 C. Vitamin B3 D. Vitamin B6 E. Vitamin B12 13. Incidence of "RARE" disease when translated into mathematics is? a. 1:100 b. 1:1000 c. 1:1000- 1:10,000 d. 1:10,000 -1:100,000 e. >1:100,000 14. Which protein is coiled in DNA? a. Polymerase b. B. Cytosine c. C. Helicase d. Histones e. Steroid sexually active. She complains of intensely irritating greenish frothy vaginal discharge. The organism is seen under microscope with peri nuclear halo. What is the most likely causative organism? a. Candida albicans b. B. Chlamydia trachomatis c. Gardnerella vaginalis d. Trichomonas vaginalis e. Treponema palladium presents with vaginal spotting. A hysterectomy is performed, and pathologic examination of the removed uterus reveals heterologous components of a malignant tumor of the endometrial glands and metaplastic cartilage. Which of the following is the most likely diagnosis? A. Stromal sarcoma B. Carcinosarcoma C. Adenosarcoma D. Endometrioma E. Adenocarcinoma called Mirabegron is used. Which is the single mechanism of action for this drug? A. Selective serotonin re-uptake inhibitor B. Muscarinic receptors agonist C. Selective Beta-1 agonist D. Selective Beta-3 agonist E. Selective Beta-3 antagonist 18. Which of the following is a Side effect of Terbutaline A. A . Maternal tachycardia B. B . Maternal bradycardia C. C . Fetal tachycardia D. D . Fetal bradycardia E. E. IUGR periods for 2years, has bilateral ovarian mass with solid areas on scan and CA 125 of 100. What is her RMI score? A. A.900 B. B.600 C. c.700 D. d.450 E. e.25 inferior wall of heart? A. V1, V2 B. B. V3, V4 C. C. aVR D. I, aVL

MRCOG RECALLS 89 صفحة Dr. MOHAMED YAHIA 0900988745 E. E. II, III, aVF Gartners duct cyst? A. Cloaca B. B. Genital tubercle C. C. Mesonephric duct D. D. Paramesonephic duct E. Urogenital septum radioactive decay? A. Gray B. Sievert C. Rad D. Roentgen E. Becquerel MRI scans? A. Iodine a. B. Barium b. C. Thallium E. Gadolinium F. Tecnisium increases the excretion of calcium in Kidney? A. A. Insulin B. Cortisol C. Calcitonin D. D. parathyroid hormone E. Antidiuretic hormone metastasizes, it has a predominantly spread by which route ? A. Direct invasion B. Hematogenous A. C. Lymphatic C. Surface implantation D. Transcoelomic (STD) is caused by Haemophilus ducreyi? A. Chancre B. Chancroid C. Granuloma inguinale D. Condyloma acuminatum E. Molluscum contagiosum 27. What drug can be given in methotrexate toxicity? A. Folic acid B. Vitamin B12 A. C. Pyridoxine C. Thymidine D. Folinic acid 28. 40-year-old woman had bilateral silicone breast implants placed two years ago. Since that time, she has noted increased firmness with slight deformity of the breast on the left. The implants are removed, and there is evidence for leakage of the implant contents on the left. Which of the following cell types is most likely to be most characteristic of the inflammatory response in this situation? A. Neutrophils B. Mast cells C. Plasma cells D. Giant cells E. T lymphocytes in newborn? A. Retinoblastoma B. Teratoma C. Neurofibroma D. Sarcococcygeal teratoma E. E. Granulosa cell tumour contraindication of the use of oxybutynin? A. Bronchial asthma B. Narrow angle glaucoma C. Diabetes mellitus D. Parkinsonism E. Peptic ulcer tract occurring in an 18-year-old girl whose mother was treated with

MRCOG RECALLS 90 صفحة Dr. MOHAMED YAHIA 0900988745 diethylstilbestrol during the pregnancy is likely to be a: A. Brenner cell tumor of ovary B. Teratoma of ovary C. Sarcoma botryoides of vagina D. Clear cell carcinoma of vagina A. E. Squamous cell carcinoma of vulva which organ? a. Skin b. Liver c. Lungs d. Kidney e. Adrenal glands Karyotyping Which of the following is the most likely diagnosis? A. Cri-du-chat syndrome a. B. Down syndrome B. Turner syndrome C. Edward syndrome D. Patau syndrome 34. Considering the following pedigree. What is the mode of inheritance? A. Autosomal dominant B. X-linked dominant A. C. Y-linked dominant B. D. Autosomal recessive E. X-linked recessive puberty in males is: A. Constitutional delay in growth F. Klinefelter's syndrome G. C. Noonan's syndrome C. Primary hypothyroidism D. Gonadal dysgenesis is based on the presence of ? A. Carbohydrate antigen on cell wall A. B. Peptidoglycan antigen on cell wall B. C. M protein C. Color of blood agar D. Sugar fermentation postnatal depression, when used in permpartum period? A. Methyl dopa b. Labetalol c. Nifedipine d. Lisinopril E. Hydralazine action ? A. Androgenic steroid B. Estrogenic steroid C. Progestogenic steroid F. D. Gonadotropin analogue G. E. Selective estrogen receptor modulator Antineoplastic drugs causing hemorrhagic cystitis? A. Cisplatin A. B. Methotrexate B. C. Paclitaxel C. Cyclophosphamide D. Vincristine

MRCOG RECALLS 91 صفحة Dr. MOHAMED YAHIA 0900988745 structurally related to what other glycoprotein hormones? A. A. ADH, oxytocin and FSH B. B. FSH, TSH and growth hormone C. HCG, FSH and TSH D. D. HCG, ADH and FSH E. TSH, growth hormone and HCG acetate ? A. Partial progesterone receptor blockage B. Selective Estrogen receptor modulator C. Prostaglandin analogue. D. Selective progesterone receptor modulator E. Oxytocin Antagonist termination of round ligament? A. Labia minora B. Labia majora a. C. Deep Inguinal ring C. Superficial Inguinal ring D. Lateral vaginal wall 43.Ductus venosus is completely obliterated after birth to form what adult structure?  A. Ligamentum venosum  B. Ligamentum arteriosum  Ligamentum teres  Medial umbilical ligament  Median umbilical ligament erosive lichen planus on the vulva. What type of cancer is linked to lichen planus? o Squamous cell carcinoma  B. Basal cell carcinoma o Merkel cell carcinoma o Malignant melanoma o Adenocarcinoma Colonize copper IUD? o Lactobacillus. o Actinomyces species. o Mobilincus  D. Ureaplasma  E. Staphyllococcus aurues depletion in numbers of which organism?  A. Lactobacillus  Mobiluncus  Gardnella vaginalis  D. Trichomonas vaginalis  Trepenoma pallidum. causing fetal anemia in the UK is  Syphilis  B. Toxoplasmosis o Rubella o Parvovirus B19 o Cytomegalovirus o HPV 6 and 11✔  B. HPV 16 and 18  C. HPV 16 and 45  HPV 18 and 45  HPV 31 and 33 kgs weight, What is her category of BMI?  A. Normal  Overweight  Obesity Class I  Obesity Class II  Obesity Class III 50. Sheehan syndrome affects?

MRCOG RECALLS 92 صفحة Dr. MOHAMED YAHIA 0900988745 o Hypothalamus B. Anterior pituitary o Posterior pituitary o Thyroid o Adrenal cortex attends for genetic counseling as she worried about CF, her sister has a child with cystic fibrosis. She is a carrier and her partner is Caucasian with a rate of 1/25 What is the risk of the child having cystic fibrosis? (MARCH 2017) o 1%  B. 12.5% o 25% o 75% o 100% right-sided pelvic pain for more than one year. An ultrasound scan is arranged which shows a 5 cm well￾defined cystic lesion in the right adnexa with mixed echoes. There is no fluid in the cul-de-sac with the following sonographic image: What is the most likely diagnosis for the image of the adnexa? o Benign cystic teratoma  B. Endodermal sinus tumour o Endometrioma  D. Mucinous cystadenoma  Serous cystadenoma it is called ? o Rapport luebering cycle o Cori's cycle  C. Citric acid cycle  D. Glycolysis  kreb's cycle letter 'X' in the diagram below? o Cholesterol  B. Testosterone  C. Dihydrotestosterone  Androstenedione  E. Aldosterone with surgical wound infection after emergency caesarean section for suspected fetal compromise. Culture of the wound demonstrates methicillin￾resistant Staphylococcus aureus (MRSA). She has no known allergies. Which is the most appropriate treatment? o Cephalosporins  B. Clindamycin + flucloxacillin o Vancomycin o Clindamycin and vancomycin o Piperacillin/tazobactam 56. Post-delivery the registrar notes that baby's HR 150bpm, pink body and blue extremities, Grimace, some flexion & friable cry. What is the apgar score? 3 o 4 o 6 o 8  e. 10 syndrome

MRCOG RECALLS 93 صفحة Dr. MOHAMED YAHIA 0900988745 o Loss of Motor supply o Excessive Sympathetic stimulation o Excessive Parasympathetic stimulation o Loss of Parasympathetic supply o Loss of Sympathetic supply 58 Hashimotos thoiditis  C. Toxic nodule o Ketoacidosis  E. Hypothyroidism ✔ cushing's syndrome? o Pituitary adenoma B. Adrenal adenoma C. Adrenal carcinoma  Adrenal hyperplasia E. Iatrogenic Steroid Administration which region of the adrenal gland?( Adrenal capsule o Zona reticularis o Zona glomerulosa o Zona fasciculata E. Adrenal medulla Interstitial cells of leydig  B. Interstitial macrophages o Sertoli cells o Theca cells  E. Granulosa cells cells which buffers blood CO2? o Cytochrome-b5 reductase  B. 5-nucleotidase  C. Glucose-6-phosphate dehydrogenase  Carbonic anhydrase  Pyruvate kinase 63. Correct interpretation of the following Urogram : Stress incontinence. o Urge incontinence  C. Detrusor muscle instability  D. Detrusor muscle overactivity  E. Urinary tract infection . birth is 250,000, and maternal death is 750, number of stillbirth is 250, what is the Maternal mortality ratio? o 300 o 600 o 900 o 200  750 65. A women 40 week induced by dinoprostone pessary 20 minutes later and the pessary is removed . Regarding the following CTG , what is the most appropriate management ? o Give terbutuline 20 mg tocolytic. o Category 1 CS.  C. Category 2 CS.  D. Reassure and observe  Perform fetal blood sampling. calculate perinatal mortality ? (MARCH 2017)

MRCOG RECALLS 94 صفحة Dr. MOHAMED YAHIA 0900988745 Weeks Prenatally Postnatally 20w 20 21w 10 22w 40 23w 10 24w 20 25w 20 26-30w 10 31-35w 20 35-42w 10 1st week after birth 50 o 9/1000  B. 180/24000 o 160/20000 o 210/20000 o 240/20000 External uretheral sphincter? o Superficial perineal pouch.  B. Deep perineal pouch.  C. Ischiorectal fossa.  Superficial inguinal space.  Deep inguinal space 68. A Women after delivery found to be in lithotomy position for 2 hours , now she develop drop foot , what nerve most likely to be the cause ?  A. Tibial nerve.  B. Femoral nerve.  Sciatic nerve.  D. Common peroneal nerve.  Lateral cutaneous nerve example of which type of receptor ? o Guanylate cyclase receptor o Nuclear transcription factor o Tyrosine kinase nuclear receptor o Ligand-gated ion channel in the cell membrane o G protein coupled receptor on the Golgi complex preoperative assessment. She has been taking bendroflumethiazide for several years for hypertension. Her ECG shows: What is the most likely electrolyte imbalance? Hypercalcaemia o Hyperkalaemia o Hypernatraemia o Hypokalaemia o Hyponatraemia Kernictrus ? o Penicillin  B. Gentamycin o Sulphonamides o Methotrexate. o Erythromycin chromatids divides and seperates to opposite poles ? o Prophase.  B. Metaphase.  C. Anaphase. Telophase.  Interphase. 73. A Couple with primary subfertility , who have been trying to conceive for over 12 months , attends a reproductive medicine clinic , the male partner has already give a semen sample for

MRCOG RECALLS 95 صفحة Dr. MOHAMED YAHIA 0900988745 analysis which return back showing : 32 million spermatozoa , morphology >5 , vitality >5% , live spermatozoa 63% , PH 7.2 , What is the correct interpretation of this result ? o Normal semen analysis o Azoospermia  C. Oligospermia  D. Asthenospermia  PH indicate infection. by removing ? o A-peptide  B. B-peptide  C. C-peptide  D-peptide  E-peptide curve ? o Senstivity Vs 1/specificity o Sensitivity Vs 1- Specificity o Senstivity Vs specifity o 1-Senstivity Vs 1- Specificity o 1/Senstivity Vs 1/Specificity 76. What hormone secreted by placenta leading to fetal diuresis ? o Relaxin.  B. Estriol o Oxytocin o Vasopressinase. o Inhibin 77. What is the blood supply of Foregut ? o Celiac trunk. o Superior mesenteric artery o Inferior mesenteric artery o Abdominal aorta o Internal iliac artery 78. Regarding Standard error of mean [ SEM ] how it is calculated ? o Square root SD / n o SD / n o SD / Square root n o SD x square root n o SD – Square root n to vulval itch and discolouration. examination reveals pale white discoloured areas to the vulva. A biopsy shows epidermal atrophy with subepidermal hyalinization and deeper inflammatory infiltrate. What is this characteristic of? o Lichen Simplex Chronicus  B. Vulval intraepithelial neoplasia o Vitiligo  D. Extramammary Pagets  E. Lichen Sclerosus 80. A Pregnant lady 11 week , presented by UTI , what the best course of action ? o Penicillin.  B. Gentamycin o Doxycyline  D. Nitrofurnatoin.  Trimethoprim o Translation o Transcription  C. Transfer o DNA synthesis  E. Reverse transcription produced ? o Theca cells  B. Granulosa cells.  C. Cumulus oophorus  Corpus leutem  Lydig cells 83. At what level ovarian artery arise ? o L1 o L2

MRCOG RECALLS 96 صفحة Dr. MOHAMED YAHIA 0900988745 o L3 o L4 o L5 leaves the lesser pelvis through the greater sciatic foramen?  A. pubococcygeus  B. Iliococcygeus  Puborectalis  D. Piriformis  Coccygeus caesarean section, an obstetrician performs ilioinginaliliohypogastric nerve block (IINB) on his 25-year-old patient. What is the nerve root of ilioinguinal and iliohypogastric nerve?  A. T12  T12 and L1  L1  D. L2  L1 and L2 pelvic lymphadenectomy for Stage I carcinoma of the cervix, 63-year-old woman reports weakness of hip adduction. Which nerve most likely to have been injured during the operation? o Obturator nerve o Femoral nerve  C. Inferior gluteal nerve o Superior gluteal nerve o Sciatic nerve epidural at umblical region ? o L1  B. T12  C. T10  L3  L4 Bartholin’s gland? o Deep perineal pouch  B. Ischiorectal fossa  C. Pudendal canal  Superficial perineal pouch  E. Urogenital diaphragm represent on the box-and-whisker plot? o Mean and mode  B. Mean and median  C. Standard deviation and mean  Least and greatest value  Lower and upper quartile 90. Calculate the odds of asymmetrical IUGR and symmetrical IUGR for Apgar < 7 Assymetrical. Symmetrical Apgar < 7. 1 1 Apgar > 7 1 4 o 4 o 2.5 o 16 o 1.5 o 1 of corpus luteum? o HCG  B. Progesterone  C. Estrogen  HPL  FSH 92. Hormone that regulates apetite and is important in obesity? o Leptin o Relaxin o Estrogen o Progesterone glycolysis take place? o Cytosol

MRCOG RECALLS 97 صفحة Dr. MOHAMED YAHIA 0900988745  B. Mitochondrial matrix o Mitochondrial cristae o Rough endoplasmic reticulum o Smooth endoplasmic reticulum radiotherapy. Which of following tissues is most radioresistant?  A. Intestinal epithelium  Cerebral nuerons  Respiratory epithelium  Bone marrow  Skin year-old woman who is being treated with a diagnosis of small lung cancer presents with excessive polyuria and depression and urine showed red cells +++ what is the electrolyte imbalance? o Hypernetremia  B. Hyponatremia  C. Hyperkalemia  Hypokalemia  E. Hypercalcemia 96. Which pattern of endometrium do simple endometrial hyperplasia most likely resemble? o Proliferative endometrium  B. Secretory endometrium o Endometritis o Endometrial polyp  E. Endometrial carcinoma histocompatibility complex human leucocyte antigen (HLA) is expressed only in extravillous trophoblast?  A. HLA-A  HLA-B  HLA-C  D. HLA-F  E. HLA-G neurogenic bladder because of its ability to o Inhibit the release of acetylcholine o Block storage of acetylcholine  C. Inhibit acetylcholine ACH synthesis o Block bladder nicotinic receptors  E. Block bladder muscarinic receptors trigone of urinary bladder? o Mesonephric duct  B. Paramesonephric duct o Ureteric bud  D. Urogenital sinus  E. Caudal of cloaca when does the second meiotic division occur?  A. At birth  B. When sperm penetrates the zone pellucida  At Ovulation  D. When sperm enters the tube  E. Before the sperm enters the zone pellucida 101. A 28-year-old woman has undergone emergency hysterectomy due to obstetric haemorrhage during her 3rd pregnancy. The previous pregnancies were both term C-section deliveries. Examination of the uterus shows the placenta has not invaded the myometrium. What is the most likely diagnosis? o Placenta praevia o Placenta accreta o Placenta increta o Invasive mole o Placenta percreta

MRCOG RECALLS 98 صفحة Dr. MOHAMED YAHIA 0900988745 secretion follows a circardian rhythm. When is the highest peak of growth hormone release? o Early morning o After exercise o Afternoon  D. Early sleep o Deep sleep of vitamin D is o Calcidiol  B. Ergosterol  C.7-dehydrocholesterol  D. 1, 25- Dihydroxycholecalciferol  E. 24, 25- Dihydroxycholecalciferol diaphragm? o Levator ani and coccygeus  B. Levator ani and piriformis o Obturator internus and coccygeus o Obturator internus and levator ani o Obturator internus and piriformis You are carrying out analysis of a new test for DVTs and decide to plot a receiver operating characteristic curve. What are the axes of the curve?(MARCH 2016)  A. Sensitivity versus Specificity  Specificity versus Sensitivity  Positive Predictive Value versus Negative Predictive Value  Sensitivity versus (1-Specificty)  E. (1-Sensitivity) versus Specificity weeks by dates is referred to EPU with vaginal spotting, which continuous today. Ultrasound shows a fetal pole with a CRL of 4 mm. There is no fetal heart action noted. The ovaries and adnexa appear normal. What is the most likely diagnosis? o Heterotopic pregnancy  B. Viable intrauterine pregnancy o Could be a viable pregnancy  D. Non viable pregnancy  E. Threatened miscarriage of a new therapy in a placebo controlled primary prevention of venous thromboembolism (VTE). 200 patients were randomised to receive the new therapy and 200 allocated to placebo. The study was completed over a 2 year period. In the placebo group there were 20 have venous thromboembolism and in the group treated with the new therapy there were 10 have venous thromboembolism. What is the number needed to treat to prevent one VTE over the course of this study? b. 2 c. B. 4 d. C. 10 e. D. 20 f. E. 40 antenatal clinic in her first pregnancy. Booking bloods reveal her Blood group O and her rhesus status to be cde/cde; her long-standing partner is also tested at her request and his blood group A with rhesus status CDe/CDe. What is the expected blood group of her fetus?  A. A positive  B. A negative  O positive  O negative  AB positive a two month history of breathlessness,

MRCOG RECALLS 99 صفحة Dr. MOHAMED YAHIA 0900988745 tachycardia and menstrual irregularity. Her Investigations revealed: Serum hCG negative Serum T4 178 mmol/l Serum TSH0.05 mU/L 
 Prolactin400 mmol/l 
 What is the most likely diagnosis? o Primary hypothyroidism o Graves' disease  C. Hashimoto's thyroiditis o Multi-nodular goitre o DeQuervain's thyroiditis change occurring in fibroid is o 0.1% o 1%  C. 5%  D. 10%  E. 15% origin of primordial germ cells? o Gonadal ridge  B. Yolk sac endothelium  C. Coelomic epithelum  D. Extraembryonic mesoderm  E. Primitive sex cord from which of the following embryonic structures? o Dorsal mesoduodenum o Dorsal mesogastrium o Pericardioperitoneal canal o Pleuropericardial membranes o Ventral mesentery spirometry of a preoperative woman. Which lung volume is indicated by the arrows on the spirometry tracing? o Residual volume  B. Expiratory reserve volume o Inspiratory reserve volume o Tidal volume o Vital capacity cause paralytic ileus? Hypernatremia  B. Hyperkalemia  C. Hypocalcemia  D. Hyponatermia  E. Hypokalemia 114. Vasopressin act on increasing water re-absorption at o Proximal tubule o Loop of henle  C. Distal convoluted tubules  collecting duct 115. Placement of cup during ventose delivery when the neck is flexed o Sagittal o Coronal o Temporal o Frontal o Lamdoid 116. Schiller Duval Bodies is found in o choriocarcinoma o endodermal sinus tumor o dysgerminoma o teratoma  Gonadoblastoma 117. No of carbons in Estrogen? o 18 o 19

MRCOG RECALLS 100 صفحة Dr. MOHAMED YAHIA 0900988745 o 20 o 21 o 22 118. Pregnancy related nausea and vomiting uses PUQE index. What is the Maximum score? o 5  B.11  C.15  D.20 120. Most common endocrine disorder in reproductive age group o Diabetes Mellitus o Polycystic Ovarian Syndrome o Premature Ovarian Failure o Hypothyroidism o Hyperprolactenimia 121. Perineal Nerve Supply with diagram What is the nerve root? o S2,S3,S4 o L3,L4 o S3,S4 o L1,L2 o L4,L5 122. Structural diagram to which carbon number base will attach o 1 o 2 o 3  4  5 123. How much in the UK population has RH negative blood group? o 5% o 10% o 15% o 20% o 25 % 124. In Horseshoe Kidney what is the structure preventing the kidney to ascend from pelvis to abdomen? o superior mesenteric a. o inferior mesenteric a. o bifurcation of aorta o coeliac trunk  median sacral artery 125. Muscles found in the scrotum o Tunica Albuginea o Dartos Ms. o Tunica Vaginalis 126. Angle of the vagina with the horizontal while standing o 45 o 60 o 70 o 80 o 90 127. Joint which resist horizontal rotation of the pelvis o Sacroiliac o Sacrospinous o Ileolumbar o Sacrotuberous 128. Two Most common dermatitis in pregnancy

MRCOG RECALLS 101 صفحة Dr. MOHAMED YAHIA 0900988745 o Atopic Dermatitis + Polymorphic (PUPP) o Pustulae + Cholestasis o Pemphigoid + Choletatis o Polymorphic (PUPP) + Pemphigoid o Polymorphic (PUPP) + Obstetric Cholestasis 129. Most common protozoan causes zoonotic infection(cerebral calcification, retinitis) o Chlamydia o Plasmodium o Toxoplasma o Trichomonas o Gardia lambia 130. Paroxetine is teratogenic to which organ  A.CVS  CNS  Craniofacial  Limb  Kidneys 131. Which electrolyte is involved in central pontine mylenosis due to fluid overload? o Potassium o Sodium  C Calcium o Magnesium o Chloride 132. Vitamin E toxicity a. dementia, b. hemorrhage.. c. renal failure, d. cardiomyopathy, e. lung fibrosis 133. Homologue of round ligament in males o Vas deferens o Gubernaculum o Rete testis 134. Origin of obturator artery o Internal Iliac a. o External Iliac a. o Common Iliac a o Deep circumflex iliac a. o Femoral a. 135. At Term G2 wearing seat belt has car accident she has abdominal pain and consults you for anti D  she doesn’t need  anti D 250iu  anti D 500iu  anti D 1500 iu  perform kleihauer test 136. Dalteparin a Low molecular wt heparin is measured using? o APTT o PT-INR o AntiFactor Xa activity 137. Congenital conjunctivitis organism. Purulent discharge 36 hours after birth o Chlamydia trachomatis o Neisseria gonorrgea 138. Piezoelectric used in o MRI o PET o U/S o XRAY o CT Scan o Glandular to squamous metaplasia o Glandular to squamous dysplasia o Squamous to glandular dysplasia o Squamous to glandular metaplasia 140. Alternate complement pathway initiation o Microorganism o C3b o Protein o Cell death 141. Prostaglandin is o Autocrine

MRCOG RECALLS 102 صفحة Dr. MOHAMED YAHIA 0900988745 o Paracrine o Endocrine o Eccrine o Exocrine 142. Infertility case, Male 190 cm wt 60 kg, testicular volume 5 ml. What is the possible karyotype o 46xy o 46xxy o 46xx o 46xyy 143. Target Hgb with oral and IV iron o 0.8g/dl/ml o 1.2 g/dl/ml o 1.5g/dl/ml 144. 18 y/o non penetrative intercourse, + painful ulcers in the vagina o Primary HSV genitalia o Behchet's disease o Aphthous ulcer 145. Incomplete early miscarriage, bleeding PV, refuse surgical intervention. o Misoprostol o Carboprost o Mifepristone o Ergometrine 146. HSG is done on what day of cycle o 1-5 o 6-12 o 13-21 o 22-28 o 28-32 147. In ECG, T wave represents o Atrial depolarization o Ventricular depolarization o Ventricular repolarization o Atrial repolarization 148. Herpes simplex is what type of virus o DsDNA o SsDNA o DsRNA o SsRNA o Retrovirus 149. First trimester pregnancy with simple ovarian cyst measuring 5x5cm o Wait no follow up o Follow up at anomaly scan for size o First trimester surgery o CS + cystectomy o Remove immediately 150. Abnormal LFTs, HbsAg -ve, HbeAg -ve, HbeAb +ve, HbsAb 3miu/hr,HbcAb +ve o Chronic infection ( high infectivity) o Chronic infection ( low infectivity) o Post vaccination o Immune to Viral Infection o Acute infection 151. 25 y/o first papsmear , low grade dyskaryosis, next step? o Colposcopy o Repeat after 6 months o HPV testing 152. Cauterization of large area with appearance of smoke o Carbonization o Fulguration o Vaporization o Coagulation o Desiccation 154. Pregnancy rate with COCP if perfectly compliant and non perfectly compliant o 0.05 2-4 o 0.1 5-6 o 0.3 10-15 155. VTE with COCP o 2 to 6/10,000  B.  C. 156. INH Metabolism is by o Acetylation

MRCOG RECALLS 103 صفحة Dr. MOHAMED YAHIA 0900988745 o Oxidation o Reduction o Conjugation o Sulfonization 157. Muscles of internal sphincter derived from? o Longitudinal Muscle o Circular Muscle o Lavatory Ani o External anal sphincter 158. Cardiac output after delivery o <20% o 20-40% o 40-60% o 60-80% o > 80% 159. Where does the inferior rectal vein drain? o superior mesentric vein o superior rectal vein o External pudendal vein o middle rectal vein o Internal pudendal vein 160. IUD+ Pregnancy. What is the risk of Ectopic Pregnancy o 1/10 o 1/50 o 1/20 o 1/5 o 1/100 163. Primary Mechanism of shunting blood away from the pulmonary circulation o Foramen Ovale o Ductus Arteriosus o Ductus Venosos 164. Rate of miscarriage in couples with balanced translocation? ANSWER: 2-5% secondary hyperparathyroidism? o Parathyroid adenoma o Multiple myeloma o Sarcoidosis o Chronic renal failure o Multiple endocrine neoplasia type 1 166. L-arginine - Arachidonic acid 167. Gonadal artery level? 171. Sensitivity of test ( PTL) ANSWER: 4/6= 67% 172. Lifelong Immunity o Adaptive o Innate o Active o Natural 173. During the inflammatory phase of wound healing what is the predominant cell type found in the wound during the first 48 hours?

MRCOG RECALLS 104 صفحة Dr. MOHAMED YAHIA 0900988745 o Macrophages o PMNs o Fibroblast o Lymphocytes o B-Cells 174. Mechanism of amino acid transfer across the placenta:- o active transport o simple diffusion o facilitated diffusion o secondary active transport  bulk transfer placenta thru? o Facilitated Diffusion o Active Transport o Passive Diffusion D. Endocytosis 176. Gonads are derived from which embryonic layer? o Endoderm o Ectoderm o Intermediate Mesoderm o Splanchnic Mesoderm 177. Which of the following is true for a patient whose pre-transfusion blood type is group O?(Please select 1 option) o + AB antigen -ve antibodies o + A antigen +ve B antibodies o + B antigen -ve A antibodies o - AB antigen +ve Anti A and Anti B antibodies o + AB antigen and +ve AB antibodies passive neonatal immunity? A. IgD B. IgE C. IgM D. IgA E. IgG 179. 50 yrs old female had hysterectomy 2 hrs ago. The nurse noticed that urine output was 35 ml/hr in the past 2 hours. What is the normal rate of urine output per hour? o 0.25ml/kg/hr o 0.5ml/kg/hr o 1ml/kg/hr o 1.5ml/kg/hr o 2ml/kg/hr 180. Precursor of testosterone in theca cell o Androstenedione o DHT o Estriol o Estradiol o Cholesterol 181. Tetanus toxoid vaccine o Toxoided protein o Live attenuated o Subunit o Conjugated 185. 80 y/o no subjective complaints came in for pessary change then with profuse vaginal discharge. Culture result moderate beta hemolytic streptococcus with coliform and anaerobic bacteria . o No treatment o Clindamycin suppository

MRCOG RECALLS 105 صفحة Dr. MOHAMED YAHIA 0900988745 o Metronidazole + Clindamycin p.o. X 7 days 186. Thromboprophylaxis on patient with hyperemesis o Until discharge o All throughout antenatal period o Up to first trimester only o 3 days after commencement change occurring in fibroid is o 0.1% o 1% o 5% o 10% o 15% infection mostly occurs o In the first trimester o In the second trimester o In the third trimester o During labor and delivery o In the neonatal period through breastfeeding 189. Primary amenorrhea with absent uterus, vagina ends in a blind pouch, normal breasts and scant pubic hair is seen in: o Klinefelter Syndrome o Mayer Rokitanski Kusher Hauser Syndrome o Turner's Syndrome o Androgen Insensitivity Syndrome o Noonan Syndrome 190. Why ramifentanyl used in patient controlled analgesia? ANSWER: Short acting easily metabolized by serum esterase 191. Patient Hypertensive, Gravida 2 in labor 4cm dilated, membranes ruptured spontaneously clear liquor, CTG showed Baseline FHR 120-130 bpm, good beat to beat variability, no acceleration, no deceleration. She was on Oxytocin. After 2 hours, Baseline FHR 120 bpm, Variability < 5bpm, No acceleration, No deceleration. Next management? o Category 1 CS o Category 2 CS o FBS o Wait for 1/2 hours 192. 24 y/o suffer from right pelvic pain with nausea but no vomiting for 1 year. She stopped OCP 2 years ago. Ca 125= 60iu/ml? What is your diagnosis? ANSWER: 193. Diagonal conjugate is the only diameter that can be measured clinically. How is it measured ? o From upper border of symphysis pubis to sacral promontory. o From Lower border of Symphsis pubis to sacral promontory. o From the back of symphsis pubis to tip of coccyx. o From Sacroiliac joint to opposite iliopectineal line. o It is the distance between ischial tuboristies. 194. Identify the muscle in the diagram ANSWER: Levator Ani Muscle 195. Question about probability 196. During which phase DNA synthesis and chromosome duplication take place o S phase o G1 o G2 o G0 o Mitosis 197. BRCA 1 associated ovarian cancer 198. Endometrial tissue found within the myometrium is o Endometriosis o Fibroid

MRCOG RECALLS 106 صفحة Dr. MOHAMED YAHIA 0900988745 o Myoma o Adenomyosis o Leiomyoma 199. Question about trophoblast invasion techniques is used for RNA analysis? A. Northern blotting  Southern blotting  Southwestern blotting  Western blotting  Eastern blottin EXAM 6

MRCOG RECALLS 107 صفحة Dr. MOHAMED YAHIA 0900988745 1. IgG passing through the placenta a. Active transport, b. passive transport, c. phagocytosis, d. diffusion, e. Pinocytosis 2. Usual questions of atosiban, labetalol, hydralazine, 3. which of the following Receptors Ondansetron act: a. Seretonin, b. histamine, c. muscarinic, 4, Nature of heparin a. Glycoproteins, b. polypeptide, c. polysaccharide, d. protein 5. Why oxytocin can't be used orally a. Will be restricted by gastric juice

MRCOG RECALLS 108 صفحة Dr. MOHAMED YAHIA 0900988745 b. B) will be metabolized by liver enzymes c. C) will cause very powerful contractions d. D) will be delay Ed in action e. Rapidly des by gastric juice 6. A new diagram for possible fertilization through which a complete mole can occur and asked to identify which can form complete mole.. empty egg with one sperm or 2 sperms 7. Another new picture about adenomyosis - It also had a leiomyoma - Adenomyosis 8. There was another MRI picture of intramural fibroid 9. Picture of a Testis..Arrow on something looking like Ductus deferenns and asking of the embryonic origin a. Mullerian duct b. Mesonephric duct c. Gartners duct 10. MRI Of submucous fibroid - Intramural 11. Case scenarios of ovarian cyst 4mm.usual options a. Send her back b. Reassure and discharge 12. Question about about hirshsprung disease..Aetiology a. Abnormality in circular muscles b. Abnormality in longitudnal muscle c. Abnormality in parasympathetic ganglia d. Abnormality in sympathetic ganglia 13. What group of drug is heparin a. Peptide b. Glycoprotein c. Polypeptide 14. Patient 8 weeks GA with threatened miscarriage..which ia an indication for AntiD Ig a. Surgical intervention b. Complete miscarriage c. vaginal bleeding 15. Picture of direct coombs test 16. Most common cancer pregnancy and post partum a. Ca Breast b. Ca cervix c. Ca ovary 17. Non ergot dopa agoinst for hyperprolactinemia - Guinagolide 18. Post lap ligarion as daycare surgery pt was admitted for pain management. Given morphine. After 6 hrs pt cmpls of pain. A cystic swelling present upto umbilicus. Tender with oozing from port sites.... diagnosis a. Urine retention b. Hemorrhage c. Infection 19. which of the following is a Pentamer immunoglobulin? a. IgM b. IgG c. IgE d. IgD e. IgA 20. Level of common iliac arteries a. L4 b. L5

MRCOG RECALLS 109 صفحة Dr. MOHAMED YAHIA 0900988745 c. S1 d. S2 e. S3 21. Bifurcation of aorta occurs at a. L4 b. L5 c. S1 d. S2 e. S3 22. Cut section of hysterectomy specimen of a Uniformly enlarged uterus.. history of painful menses.. Diagnosis a. Adenomyosis b. Polyp. c. leiomyoma d. Adenocarcinoma 23. Most common type of malignancy in tube - Adenocarcinoma 24. Pic of fetal circulation to identify DV Ductus venosus 25. One question for rmi calculation. Postmenopausal bilateral solid ovarian T CA 125 100.... - 900 26. Root value of ilioinguinal and iliohypogastric..Repeat question - L1 27. Rfeered pain of ovary felt near umbilicus... level - T 1o 28. Most common intracellular cation - Potassium 29. Absorption of glucose occurs in which part - Proximal CT 30. Insensible waterloss - 850ml 31. What type is zika virus - SsRna 32 Picture of testes...what is the structure is labelled? - Paramesonephric duct the embryonic origin 33. The vitamin causing pellagra.... a. niacin, b. cobalamin, c. pyridoxine, d. thiamine 34. What type of epithelium is in the fallopian tubes: a. simple columnar, b. pseudostratified columnar, c. cuboidal d. squamois stratified 35. Picture of placenta and cord... what type is it? Velamentous, vasa previa, differentiate etc - Velamentous or vasaprevia? - Velamentous insertion of cord? 36. Picture of twin gestation: what type of chorionicity? a. Diamniostic dichorionic, b. Monoamniotic monochorionic Twin gestation at eight weeks... 37. Picture of cut section of ovary...what is the structure with arrow? a. Corpus luteum, b. endometrioma, c. albicans

MRCOG RECALLS 110 صفحة Dr. MOHAMED YAHIA 0900988745 38. Woman ?60 years with urgency, urge incontinence, no symptoms of stress incontinence....etc...what is the next step? a. Beta sympathometic agonist, b. beta sympathometic antagonist, c. antimuscarinic etc d. Urogram investigation 39. Photo of cervix – type of epithelium - Columonar epithelium 40. Immunoglobin g transport mechanism - Pinocytosis Piriformis nerve supply - Subcostal Adenomyosis? Circumscribed fibroid Wernicke caused by which vitamin- - Thiamine Gnrh is? - Decapeptide The only content of lesser sciatic foramen? a. Tendon of obturator, b. piriformis c. Internal pudental vessle X ray radiation is equivalent to - 2.5 dsys to 3 days Gonadal artery is branch of - Aorta Umbilical artery branch of a. deep circumflex iliac b. Aorta c. Internal iliac artery Calculation of odds ratio Sensitivity/ 1-specificity is .... a. negative likelihood ratio, b. positive likelihood ratio c. Positive predictive value Derive the null hypothesis from relationship of soymilk and menopause - No relation between menopause and soymilk Iodine transport in thyroid cell symport a. Na b. Ca Most important role of vit c... collagen.. immunity.. - Answer?? Collagen? - Coenzyme for collagen Caumarin acts again which vit - Vit k Umbilical artery is branch of.... - Anterior branch of internal iliac Derp circumflec artery is branch of.... - Ext iliac Structure differentiating ext iliac from femoral artery - Ingiinal ligament Which structure differentiates superficial perineal pouch from deep - Perineal membrane Bartholins occupy which space. Usual option Superficial perineal pouch

MRCOG RECALLS 111 صفحة Dr. MOHAMED YAHIA 0900988745 Vestibule is between 2 - Minora Ondansteron inhibits what - 5ht3 Question on ecg heart block 3 degree heart block? Question on CtG picture no h/o read paper on ctg -FBS -repeat after 30 min -type 1 cs -Cont ctg reasses after 30 min - It was reassuring cTg bt bc of meconium v hv to continue. HPLC with peaks at A, A2 and S HbF normal Interpretation?? a. Alfa thalassemia b. Beta thalassemia c. Sickle cell disease d. Sickle cell trait e. Normal interpretation Finesterde act on enzyme - 5 alpha reductase Primary amenorrhea, absent uterus, FSH 6.0, ovaries normal, karyotype 46XX Diagnosis?? - MRKH… Odd ratio answer -4? Pedigree chart -X recessive? -X linked dominant? Fetal skull showing parietal bone Fetal head is said to be engaged when the BPD passes through which AP Diameter measuring? a. 11 cm b. 12 cm… Chromosome 2 diagrams ? Is it inversion - Inversion Hydrogen containing buffer in urine? Ammonia Phosphate Chloride - Phosphate ?? Ammonia is synthesised by the action of which enzyme? - Glutaminase Urea cycle takes place in ? Liver Glycolysis.... in cytosol Cytosol Microscopic pictuof diplococci Gonorrhea Chlamydia Angiotensin 1 to angiotensin 2 convertion at ? - Lung Teratogenicity of lithium, aminoglycozide, tetracycline

MRCOG RECALLS 112 صفحة Dr. MOHAMED YAHIA 0900988745 - Heart -Vestibulocochlear nerve -Teeth Clue cells of bacterial vaginosis are ?? -Vaginal epithelial Treatment of listeria Amoxicillin Cefalexin Erythromycin Azithromycin -A HPV types causing warts, another one for types causing high grade intraepithelial dysplesea High grade neoplasia after vaccination... -33 Velamintous insertion Epithelium of Fallopian tube ?? Epithelium of distal urethra stratified squamous ciliated columnar epithelium simple columnar Chromosome with centeromere towards one side - Telocentric? - Acrocentric? Carcinoma with endometriosis -Clear cell There was a question asking to calculate mode ... I think 3. The one opposite 29 Carcinoma of the vulva - Scc Most common degeneration in fibroid ?? - Hyaline Most common type of bacteria in endometritis - strept A CTG of a low risk PG , 39 week had AROM with meconium stained liquor

CTG for 55 minutes showed decreased variability and variable decelerations a) 30 monitor B) CS I C) CS II D) FBS E)? 30 min? Supra umbilical versus suprapubic incision ... which layer is not encountered in supra pubic incision? Posterior rectus sheath -First polar body Maximum radiation exposure in Hystero contrast salpingography Hysterosalpingogram Lap and dye test Cristae present in... mitochondria

MRCOG RECALLS 113 صفحة Dr. MOHAMED YAHIA 0900988745 Liver and biliary system are differentiated by invagination of what structure? Dorsal mesogastrium Ventral mesogastrium… - Septum transversum Corpus luteum? Corpus albicans? - luteum The girls on a hill trek...respiratory alkalosis The acid base balance q: ph 7.2 PCO2 8.2 HCO3 25 - Respiratory alkalosis whch chains joins IgM together to make pentamer: J chain L chain Mu chain Lambda chain Prev 3 sections, placenta now invading upto serosa... ans- pl percreta Male infertile, small soft testis in scrotum, Fsh high, testosterone normal. Anabolic steroids Congenital absence of Vas Testicular failure Seminoma Vasectomy abserbce of vas defernce ? ? Why elevated FSH and normal testosterone? Testicular failure MRI Tesla Site of vassopressin production - Supra and paraventricula Diathermy burn High density small return plate Low density earthed Low density small return plate Similarity growth hormone And HPL or prolactin can't remember In a Dexa bone mineral density scan the results are reported which two ways? T score (compares the individual to another individual of the same age and gender) and Z score (compares the individual to a young adult where normal is greater than –2.5) T score (compares the individual to another individual of the same age and gender) and Z score (compares the individual to a young adult where normal is greater than -1) Z score (compares the individual to another individual of the same age and gender) and T score (compares the individual to a young adult where normal is greater than 0) Z score (compares the individual to another individual of the same age and gender) and T score (compares the individual to a young adult where normal is greater than –1) 2nd common cause of CAH - 11 beta hydroxylase

MRCOG RECALLS 114 صفحة Dr. MOHAMED YAHIA 0900988745 Common type of valvular cancer Placenta invading myometrium on to serosa Primary function of DNA polymerase -added nuclotide -dna repair Skeletal muscle embryology from where except skull Endoderm Exoderm Neural tube Neural cret - Paraxial mesoderm -It was skeletal development except skull....paraxial mesoderm Which HLA not i extra villous trophoblast?? - A nd b CT scan post hysterectomy?? Renal stone pelvic hematoma or ureteric obst - Uretric obst Hershsprung disease Absence of Neurons Which sympathetic or parasympathetic Pregnant women at 22 weeks with group b streptococcus in urine more than 1 lakh ? Give intrapartum gbs treatment Perform c section Treat uti Treat uti and repeat culture during term and if no gbs no treatment - Treat uti and give intrapartum antibiotic prophylaxis - Treat UTI and test again prior to labour Nerve from medial border of psoas muscle? Obturator nerve Adduction of thigh? -Obturator nerve Bifurcation of aorta ? L1 L2 L3 L4 - L4 Lateral border of ischiorectal fossa - Lateral obturator faschia - obturator internus Letrazol - Aromatase inhibitor Antiemetic with involuntary movements ? Cyclizine Promethazine Metclopromide - Metoclopramide Enzym in granulosa cells not in theca cells - Aromatase which nerve passes medially by poas major muscle? - Obturator medial - Genitofemoral anterior -The rest of lumbar plexus nerve lateral

MRCOG RECALLS 115 صفحة Dr. MOHAMED YAHIA 0900988745 - from lumber plexus androgen secreted from which cell under LH? - Leydig cell Sertoli cells phagocytosis in testis mild dykaryosis?which HPV reaponsilbe Histology of endometrium in follicular phase with graph of hormones -Proliferative Biopsy if taken at the arrow point what is the histology.. options proliferative secretory luteal follicular AMH as ovarian reserve marker Nerve supply of bladder Greater splanchinic Lesser splanchinic Pelvic splanchinic Hypogastric - Hypo gastric? - its sympathetic-inf,hypogastric Cycle length 21 to 35 days variability due to ? Variable follicular phase positive feedback of esrogen Fail toPositive feedback Free T4 -0.1 percent Structure passing through lesser sciatic foramen -Pudendal nerve -Obturator tendon Thromboxane A2 produced in platelets - Platelets anticonvulsant therapy,hb low,which aneamia? - Folic acid deficiency Intense vasospasm before menstruation due to... - Pgf2 alpha Coronal suture between which Bones -Frontal and parietal Parietal bones shown in picture Anteroposterior diameter of pelvic inlet - 11? A primi is informed that engagement has occurred. which is the anteroposterior diameter of the inlet through which the biparietal diameter has to cross 1.11 2.12 3.13 4.10 Thromboxane released from platelets High level b hcg what cyst ? Theca leuutin cyst 32 year old with 4 cm simple cyst ? Reassure her which nerve passes by medialy by poas major mucle - Obturator nerve -,illioinguinal MCH-1 extravilluos ?

MRCOG RECALLS 116 صفحة Dr. MOHAMED YAHIA 0900988745 Absent is HLA-A HLA-B Radiation exposure.. background risk equal to one CXR , repeat XRay in PE 3mths, 4mths?? - 3 days? 2-3 days Drug of choice to treat HMB with history of asthma and wish to start family within one year ...? -Tranexamic acid -Mirena wish to start family within one year Mirnea it says at year of time Psammoma bodies contain calcium LDH tumour marker in dysgerminoma Bartholins gland is situated in superficial perineal pouch Lane tall mechanism of action ? Listeria what is treatment ?? - Amoxacillin Anal sphincter layers -Internal deep external superficial subcutaneous Which hormone maintains corpus letueum in early pregnancy ? Hcg Progesterone - a Test to compare unpaired non parametric data?..chi squared or Mann Whitney ? - Mann whitney Pregnant lady with rash and fetal ascitis .. parvovirus -Parvovirus Standard deviation of mean in normally distuributed population ? 95 or 99.7 ? one SD-68 Normal distribution curve ..Wat percentage of data is encompassed by 1 std deviation 1.34 2.68 3.95 4.99 Placental transfer of molecules...high lipid soluble Structure formed in inner cell mass which divides it symmetrically and gastrulation occurs in future ? Primitive streak Notocord … - Primitive streak - Amniotic cavity? Haldane effect - Deoxygenated Hb carries more CO2 Ureteric bud from mesonephric or wolfian duct - mesonephric Graph showing fetal weight between 10 th and 50 th centile ? -Normal yes-10%above means normal

MRCOG RECALLS 117 صفحة Dr. MOHAMED YAHIA 0900988745 chickn pox immunization - Not exposed to chicken pox vdrl test - Biological false positive grb B (+) neonate delivery after konw sawb 4days +,-info m neonatologist - Give antibiotics ? -no reffer to neonatologist Twins diagram... Biopsy on day 7 to 14 of menstrual cycle...proliferative or follicular -Histologically proliferative - Arrow one was secretory Phase 3 clinical setting shows efficacy of rct or new drugs only - Randomised trial with other gold standard drug POP only pill most common side effect - erratic bleed Cell free Fetal DNA source - placntal trophoblast DMPA mechanism of action - inhibition of ovulation medalzzolam act on-gaba receptor labetalol - Nonselective alpha and beta antagonisy -selective alpha ,non selective beta bloker Hyperemesis which fluid to avoid 5% dextrose -Hyperemesis which fluid to avoid 5% dextrose ICF which ion is reamin more-k+ - K which layer ablated for mennorrhegia￾functional layer of endometrium - Basal -but basal is not upto stop bleeding dear,its on functional i mean upto serosa Perinatal mortality by WHO..22 wks plus 7 days early neonatal mortality -it was 7days or 4wks upto?i forgot,not sure -It's 7 days HPV type for high grade cervical lesions...16 and 18 6 and 11 warts. Questions was 90% genital warts formed by 1.6 and 11… Molluscum contagiosum..poxvirus Smear taken from a patient with vaginal discharge..Gram stain shows following picture..Identify the organism Umbilical cord section showing umbilical vein caput medusa Repeat question..Which embryological remnant results in this 1.umbilical artery 2.umbilcal vein Caput medusae formed by opening of embryological remnants of umbilical vein

MRCOG RECALLS 118 صفحة Dr. MOHAMED YAHIA 0900988745 Fetal circulation diagram showing ductus venosus What abt anti d is given in ? I wrote surgical abortion i wrote threatened. its threatedn in threatened you should not give anti D till it is established bleeding Upto 9 wks but it was writtn in oxfrd revision ?? threatened means she bled bt os is closed. Ans what is the true answer And me surgical abottion but dont know true or false Less than 12weeks of gestation no need of anti d in painless single episode of bleeding But when surgical intervention plannd then 250 anti d given Source pass mrcog It uterine vein drains into int iliac vein Left renal vein RCOG trick The question was left uterine vein drains into..So ans is left int iliac vein Maintainance of lactation through ductal dilatation, lobar hyperplasia, stromal hyperplasia, fat atrophy - Lobule one - Ithink stromal because he said when she was pregnancy not after delivery She is lactating since last one year - I think lobular hyperplasia Pain scale as varianc -Analysis of variance ?? no ordinary -Mann whitney??? There was one q on discrete/nominal ? - Ordinal H ducrey causes chanchroid Condyloma lata secondary syphillis Placenta formation..lacunae develop in... inyermediate trplophoblast -Syncitiotrophoblast .sure Nerve root for ilionguinal and iliohypogastric nerve s - L1 Nerve injury following hysterectomy with failure of adduction of the thigh - Obturator Nerve from the medical border of psoas Sensory nerve of ovary - t10 There was q 20% transport ? Albumin ?shbg ? - Oestrogen transport -Oestrogen in menopause.. estrone -albumin binds to 20%,estrone-in postmenopouse -also qet about -pre menoposal estrogen soucer -granulosa cell What is the term used for the anticancer agent methotrexate?

MRCOG RECALLS 119 صفحة Dr. MOHAMED YAHIA 0900988745 plant alkaloid Antimetabolite Alkylating agent Chain cutting agent Intercalating agent -Antimetabolite or cytotoxic...Not sure which one is correct -antimetabolite Commonest type of fibriod degeneration. Hyaline ,red - hyaline Q64 ) mechanism of drug crossing the placental barrier. -high lipid Q65) mechanism of action of methotraxate - Antimetabolite 67) regarding magnesium metabolism - Doesn't chng -Its was abt excretion ? -Yes magnesium excretion... Unchanged nature of vincristine - Tubule - Attatches Q 68 landfall is alpha and beta agonist q 69 ) letrazole is aromatase inhibitor q70) nature of heparin paper 2 Vdrl+ bt others test negative management? - It was repeat question..vdrl +ve and tpha neg..So false positive was the answer Most common type of ca in fallopian tube? - Adenocarcinoma Benign tumor histology shows Spindle shaped cells? -Fibroma -History suggestive of meighs syndrome..Mild pleural effusion Present..So ans fibroma..( repeat) Type of radiotherapy inside vagina - Brachytherapy - Repeat question this was.. Image of twins on ultrasound A pregnant patient is more than happy to see twin viable gestation..Wat is the chorionicity 1.dcda 2.mcda 3.chorionicity can't be assessed 4.mcma DCDA? Mcda Mcda, there is no delta/lambda sign characteristic for dcda Inner cell mass? - Amniotic cavity Skeletal system? - Paraaxial mesoderm Which is major cell for adaptive immunity - Lymphocyte Krukenberg tumour from GIT Macrophage from monocyte

MRCOG RECALLS 120 صفحة Dr. MOHAMED YAHIA 0900988745 Which phase of Cell cycle immediately precedes Mitosis? - G1 - G2 Steroid secreted by fetal adrenal and placenta which hastens lung maturity - Cortisol Post sterilization has received mprphine fr pain relief inpatient fr 24hrs. Nw has pain on exam cystic mass upto umbilicus tender to touch, some oozing frm portsite - Urinary retention -Potr site infection recall -Another option was post bleeding I think Null hypothesis Q ? Type 2 error? The hypothesis was falsely accepted.. Options Type 1 Type 2 Formula of positive likelihood ratio Which enzyme is in granulosa and lacking in thecal cells -Aromatase Sertoli cells (cleaning)cells Nature psammona -Calcium - Nature of clue cells Épithélial cells Labetolol is? Ans: alpha & beta antagonist Antimetabolite? Ans: Methotrexate Finestrate? Ans: 5 alpha reductase Letrozole? Ans: Aromatse inhibitor Treatment for hyperprolactinaemia? Ans: Quinagolide (all options started with ‘Q’...bastards) Lithium toxicity affects which system? Options: CNS, CVS, GI... Oxytocin can’t be given orally because? Ans: destroyed by gastric juice Main defect of tetracycline administration? Options: included teeth and limbs Cranial nerve risk with aminoglycosides? CN 8 Type of genital mutilation after clitorectomy - Repeat question.. clitoris excised..Labia normal..No cauterisation..So answer type 1 A women aged --35--45yrs with right adnexal cyst with torsion like symptoms diagnosis? A.cystadenocarcinoma B.dermoid cyst C.peritoneal pseudocyst

MRCOG RECALLS 121 صفحة Dr. MOHAMED YAHIA 0900988745 D.fimbrial cyst E.......... Plasma volume increases in pregnancy by? A.60-90% B.30-50% C.10-20% D.15_30% A case of difficult hysterectomy followed by abd pain , MRI showed unilateral distended kd and mass in the pelvis , this one I was confused between ureteric ligation and harmatoma. Please help me guys can't remember the whole details of the question - Lateral umbilical folds contain which structure -Inferior epigastric vessels Q was medial ligament not lateral What is the mechanism during breastfeeding which increases the flow and keeps it going for exclusive breastfeeding???? Something like that A.hyperplasia of ducts B.I don't remember rest options.......can someone recall???? - Lobular hyperplasia EXAM 7

MRCOG RECALLS 122 صفحة Dr. MOHAMED YAHIA 0900988745 1. Percentage of Brenner tumor of ovary are malignant--- 5%. 2. Diagram of arcuate line 3. Diagram of rectus muscles below umbilicus asking for during suprapubic incision after cutting rectus sheath u will encounter ……… answer was fascia transversalis. 4. Diagram of epidural space 5. 6. Complication with retroverted uterus……… 7. Pic of trichomonas viginalis 8. Semen analysis report ….. it was normal semen report. 9. Woman with 28days menstrual cycle when to perform hysterosalpingography………on day 6-12. 10. Decrease in amplitude of ultrasound due to absorption, scattering, reflection is called as…..attenuation Artifact

MRCOG RECALLS 123 صفحة Dr. MOHAMED YAHIA 0900988745 a. Ileocolic artery b. inferior mesenteric a. c. left colic a. d. middle colic a. e. right colic a. 12. What is the most common cause of the female urethral caruncle? A. Trauma B. Tumour C. Infection D. Hypoestrogenism E. Congenital 13. 10. Which of the following is precursor of Serotonin? A) Histidine. B) Glycine. C) Arginine. D) Tyrosine. E. Tryptophan 14. For overactive bladder a new drug called Mirabegron is used. Which is the singlemechanism of action for this drug? A. Selective serotonin re-uptake inhibitor B. Muscarinic receptors agonist C. Selective Beta-1 agonist D. Selective Beta-3 agonist E. Selective Beta-3 antagonist 15. A 47 years old women with absent periods for 8 months, has bilateral ovarian mass with solid areas and ascites on scan and CA 125 of 250. What is her RMI score? A.750 B.2250 16. woman having chancroid causative organism Hemophilus ducyri. 17.Which is common malignant tumour in newborn? A. Retinoblastoma B. Teratoma C. Nephroblastoma D. Sarcococcygeal teratoma 18.A neoplasm of the female genital tract occurring in an 18-year-old girl whose mother wastreated with diethylstilbestrol during the pregnancy is likely to be A. Brenner cell tumor of ovary B. Teratoma of ovary C. Sarcoma botryoides of vagina D. Clear cell carcinoma of vagina E. Squamous cell carcinoma of vulva 19. 20.Which of the following Antineoplastic drugs causing hemorrhagic cystitis? A. Cisplatin B. Methotrexate C. Paclitaxel D. Cyclophosphamide E. Vincristine 21. Mechanism of action of ulipristal acetate ? A. Partial progesterone receptor blockage B. Selective Estrogen receptor modulator C. Prostaglandin analogue. D. Selective progesterone receptor modulator E. Oxytocin Antagonist 22.Clomiphene citrate mechanism of action ? A. Androgenic steroid B. Estrogenic steroid

MRCOG RECALLS 124 صفحة Dr. MOHAMED YAHIA 0900988745 C. Progestogenic steroid D. Gonadotropin analogue E. Selective estrogen receptor modulator 23.Ductus venosus is completely obliterated after birth to form what adult structure? A. Ligamentum venosum B. Ligamentum arteriosum C. Ligamentum teres D. Medial umbilical ligament E. Median umbilical ligament 24. ligamentum arteriosus is completely obliterated after birth to form what adult structure? A. truncus arteriosus B.4th aortic arch C. 6th aortic arch D. dorsal aorta 25. A 60-year-old with erythematous erosive lichen planus on the vulva. What type of canceris linked to lichen planus? A. Squamous cell carcinoma B. Basal cell carcinoma C. Merkel cell carcinoma D. Malignant melanoma E. Adenocarcinoma Colonize copper IUD? A. Lactobacillus. B. Actinomyces C. Mobil incus D. Ureaplasma E. Staphylococcus aureus causing fetal anemia in the UK is A. Syphilis B. Toxoplasmosis C. Rubella D. Parvovirus B19 E. Cytomegalovirus 28. Which HPV causes Genital Warts? It was scenario on anogenital warts. A. HPV 6 and 11 B. HPV 16 and 18 C. HPV 16 and 45 D. HPV 18 and 45 E. HPV 31 and 33 29.A Women with 150cm height and 90 kgs weight, What is her category of BMI? A. Normal B. Overweight C. Obesity Class I D. Obesity Class II E. Obesity Class III 30.A woman is 8 weeks pregnant attends for genetic counseling as she worried about CF, hersister has a child with cystic fibrosis. She is a carrier and her partner is Caucasian with a rateof 1/25 What is the risk of the child having cystic fibrosis? A. 1%B. 12.5%C. 25%D. 75%E. 100% 31. Scenario on Location of Bartholin glands A. superficial perineal pouch 32.Anatomical location of external anal sphincter A. deep perineal pouch 33. mechanism of action of apixaban A. factor Xa B. thrombin inhibitor 34. 35.What is affected in Horner syndrome?

MRCOG RECALLS 125 صفحة Dr. MOHAMED YAHIA 0900988745 A. Loss of Motor supply B. Excessive Sympathetic stimulation C. Excessive Parasympathetic stimulation D. absence of Parasympathetic supply E. absence of Sympathetic supply 36.Post-delivery the registrar notes that baby's HR 150bpm, pink body and blue extremities, Grimace, some flexion & friable cry. What is the apgar score? a. 3 b. 4 c. 6 d. 8 e. 10 37.What is the most common cause of active prolactin secreting tumor? A. Adenoma B. Sarcoma C. carcinoma D. hyperplasia E. Iatrogenic Steroid Administration 38.A town with a total number of live birth is 250,000, and maternal death is 750, number ofstillbirth is 250, what is the Maternal mortality ratio? a. 300 b. 600c. 900d. 200e. 750 39.A Women after delivery found to be in lithotomy position for 2 hours , now she develop drop foot and loss of sensation. what nerve most likely to be the cause ? A. Tibial nerve. B. Femoral nerve. C. Sciatic nerve. D. Common peroneal nerve 40.The Progesterone receptor is example of which type of receptor ? A. Guanylate cyclase receptor B. Nuclear transcription factor C. Tyrosine kinase nuclear receptor D. Ligand-gated ion channel in the cell membrane E. G protein coupled receptor on the Golgi complex 41.Which of the following drugs cause Kernicterus ? A. Penicillin B. Gentamycin C. Sulphonamide D. Methotrexate. E. Erythromycin 42. 43.A Pregnant lady 11 week , presented by UTI , what the best course of action ?with urine cs report showing enterococcus sensitive to nitrofurantoin and trimethoprim and resistant to cephalosporin. Repeated urine c/s report is same. A. give no treatment. B. repeat urine c/s C. cephalosporins D. Nitrofurantoin. E. Trimethoprim 44.What do the bottom and top represent on the box-and-whisker plot? A. Mean and mode B. Mean and median C. Standard deviation and mean D. Least and greatest value E. Lower and upper quartile 45.Radiation could be transmitted or decay SI unit of radiation is A. becquerel B. gray C. rad D. sievert E. Hertz 46.A scenario on Botulinum toxin is now used to treat neurogenic bladder because of its ability to A. Inhibit the release of acetylcholine B. Block storage of acetylcholine C. Inhibit acetylcholine ACH synthesis D. Block bladder nicotinic receptors E. Block bladder muscarinic receptors 47.What electrolyte imbalance can cause paralytic ileus? A. bicarbonate B. hydrogen C. chloride D. sodium E. potassium 48.Schiller Duval Bodies is found in A. choriocarcinoma B. endodermal sinus tumor C. dysgerminoma D. teratoma E. Gonadoblastoma

MRCOG RECALLS 126 صفحة Dr. MOHAMED YAHIA 0900988745 49. bHCG tumor marker for Choriocarcinoma 50.Rubella type of vaccination live vaccination 51. 20 years old lady menarche since age of 12 years, complaining of heavy menstrual bleeding since menarche. CBC done. Physical examination not remarkable. What to do next? A. no any test to do B. thyroid profile C. serum ferritin D.Clottingtest E. FSH 52. Mycoplasma genitalium….flask shaped and do not have a cell wall 53. Chlamydia trachomatous …. Gram negative cocco-bacillus 54. Ovarian surface epithelium….. cuboidal 55. Fallopian tube most common tumor….Papillary serous adenocarcinomas ovary 57. Arias Stella phenomenon effect on…. Endometrium 58. Transverse colon blood supply….. Middle colic artery 59. postmenopausal bleeding with granulosa cell tumor of ovary effect on endometrium A. Proliferative B. Secretory C. Atrophic D. Inflammatory 60. Group A streptococcus on Lancefield shows A. B-hemolytic B. a-hemolytic C. $-hemolytic d. no-hemolysis 61. Most common cause of secondary hyperparathyroidism A. chronic renal failure B. Vitamin D deficiency C. Increased calcium D. liver cirrhosis 62. Innate and adaptive system are linked together via A. Leukotrienes B. Cytokines C. TNF 63. TRH A. tripeptide B. Glycoprotein C. Polysaccharide 64. delta cells of pancreas secrets A. Somatostatin B. glucagon C. Insulin D. Pancreatic polypeptide E. Cholecystokinin 65. Electrolyte disturbance caused by Conns syndrome A. Metabolic alkalosis B. Respiratory alkalosis 66. Oestrogen type secreted by placenta A. estriol 67. HPL increased in which trimester A. 3rd trimester B. 2nd trimester C. Labor D. 1st trimester E. after delivery

MRCOG RECALLS 127 صفحة Dr. MOHAMED YAHIA 0900988745 68. alpha subunit of LH…. Similar to alpha subunit of FSH, TSH, Bhcg 69. prolactin with PCOs… due to increased unopposed estrogen 70. iodine with sodium 71. OGTT: FBS- 5.8 2hr 7.9 gestational diabetes 72. aldosterone… angiotensin II 73. carboprost … f2a 74. delayed puberty… constituational 75. adrenal medulla… acetylcholine 76.duchenne muscular dystrophy… X linked recessive 77. pedigree of X linked dominant 78.mitrochondial DNA genes… 37genes 79. DNA GCAT…. CGTA 80. transcription requires …. RNA polymerase 81. median 1 82. Calculate standard error of mean answer 0.05 83. allantosis endoderm 84.carbohydrate I breast milk …. Lactose 85. dimer igA 86. mucosal immunity igA 87.Internal anal sphincter… continuation of circular rectal muscles. 88. Nevirapine…. Noncompetitively inhibit reverse transcriptase 89. only hRT breast cancer…. Low risk or no risk 90. Female , early pregnancy , doesn’t know about her vaccination status for VZV , she may have immunity against it ? a.<10 b.40 c 60-80 d.>80 91. perinatal mortality 100/1000 92. burner cells found in duodenum. 93. It was thalassemia major 94.Chronsdisease , history of gut resection , investigations show MCV increase , cause vitamin b12 defeciency 95. misopristol diarrhea 96.lithium ebstein 97.cystic fibrosis congenital absence of vas deifference 98. VIN III by HPV 16 99. complete mole 46 XX 100. vitamin d unchanged 101. DMPA 12 weeks 102. ACE… kidneys 103.cardiac output in first stage of labour A. 20% B. 30% C. 10% 104. fetal cardiac output to fetal kidney A. 10-15% B 20- 25% C.35% 105. antenatal anti d at 28 – 34 weeks

MRCOG RECALLS 128 صفحة Dr. MOHAMED YAHIA 0900988745 106. Remnant of patent umbilical artery .. superior vesical artery 107.A scenarios of 15years girls wants contraception Follow Fraser law 108.This cyst is derivative of Mesonephric duct 109. type 1 mutilation 110.type of necrosis in brain .. liquefactive 111.Ventose applied on… sagittal suture 112.postnatal depression methyldopa 113.PUPQmaximum score 15 114. pt with severe nausea and vomiting thromboprophylaxis given till LMWH until discharge 115.Hrt … increases thyroid binding globulin 116.heat stable enzyme in PCR taq polymerase 117.ND YAG laser…. Solid 118.MRI …. Hydrogen ion 119.grastulation formation of three germ layer 120.Which organism produce exotoxin that causes toxic shock syndrome Staphylococcus aureus 121.ratio of t4 to t3 in blood 7:1 122.After pelvic surgery of sacrospinous fixation patient complains of perineal and valval pain that exaggerate on sitting which nerve is most likely to be damaged …… Pudendal nerve Ilioinguinal nerve 123.fetal kidneys mature to form urine at 10 weeks 12weeks 124.test done on pregnant patients serum x is positive in a patient.How likely she may develop preeclampsia 80% 60% 125.placenta previa early confirmed at what gestational age 24 weeks 28 weeks 32 weeks 126.calculate the sensitivity 80% 127.odds ratio having apgar score less than 7…. 4 128.which cell cycle precedes mitosis G2 G1 129.CRISPR/Cas9 indicate what in molecular biology A transcription factor and an enzyme A DNA and an enzyme 130. Identify the muscle …obturator internus muscle

MRCOG RECALLS 129 صفحة Dr. MOHAMED YAHIA 0900988745 131.monochorionic and diamniotic occurs at which stage…. Morula 132.appendix testis derivative of Paramesonephric duct 133.A scenario about patient developed caput medusae that is connected to embryological remnant of…….Umbilical veins 134.ovaries contain enzyme for androgen production 5alpha reductase 11 b hydroxylase 3β-hydroxysteroid dehydrogenase 135. Identify the artery arrow was on internal pudendal artery 136.in PKU there is deficiency of enzyme known as hydroxylase. This enzyme catalyze the reaction and converting phenylalanine to Tyrosine Tryptophan 137. Identify the specimen Mature teratoma 138.one spontaneous mutation in human over years One in one million years One in one crore years One in 10million years 139.during the cell cycle second meiotic division occurs at which stage Primary oocyte Secondary oocyte 140.senerio of 47XXY 141.senerio of 45XO 142.oocyte originate from Yolk sac 143.warfarin causes embryopathy at what gestational age 6-9 weeks 144.Ebola virus is Single standard RNA virus 145.chiken pox virus is Herpes virus 146.pregnant woman undergoes routine antennal test reports shows Treponema palladium IgG Positive EIA Biologically false positive Latent syphilis Secondary syphilis 147.Herpes simplex virus 1 Double stranded DNA virus 148.Vitamin K source Leafy vegetables 149. Pelvic diaphragm is formed by A. Levator ani and coccygeus and its fascia B. Levator ani and its fascia

MRCOG RECALLS 130 صفحة Dr. MOHAMED YAHIA 0900988745 150.Tidal volume defines as A. The amount of air inspired or expired at each respiration 151.Non pregnant with weakness general Malaise Labs high alkaline phosphatase A. Vit d deficiency B. Gall bladder disease 152.increase in caloric requirements after first trimester A.200 k calories B. 300k calories C.400 k calories 153.diagram of urodynamic studies Detrusor overactivity 154. A patient came to general practitioner complaining of numbness and muscle spasm. ECG done. There was ECG pic. That indicates Hypocalcemia Hypokalemia 155. conn disease … metabolic alkalosis 156. cushing disease Increase ACTH, increase Cortisol, Increase GH 157. Identify the muscle involved in episiotomy. Arrow was on bulbospongiosus 158.senerio of woman presented with galactorrhea. Labs were advised which shows high TSH Hypothyroidism 159.muscle not innervated on perineal body Ishiocavernosus 160.patient blood group O positive. Antibodies present would be Anti A, Anti B, Anti O Anti A, Anti B 161. 24 years woma had LMP 12days back. Presented 96 hours after unprotected sexual intercourse. Which contraceptive advise u will offer Levonorgestrel, copper IUD Levonorgestrel, copper iud, ullipristril acetate Ullipristril acetate, copper iud 162.senerio of pregnancy of uncertain viability 163. scenario of normal rise of hcg in singleton pregnancy 164.mechanism of action of POP implants… inhibition of ovulation 165.drug that cannot be given in third trimester to cause hemolytic anemia Nitrofurantoin 166.sheehan syndrome Anterior pituitary 167.mechanisum of action of methotrexate Dihydrofolate reductase inhibitor 168.oxybutynin common side effect Dry mouth Blurring of vision 169.BMI 40kg/m2 loss 30kg for IVF 170.forest plot … confidence interval 171.abdominal mass ca125 172.bicarbonate PCT 173.round ligament blood supply inferior epigastric artery 174.secondary cartilageous joint 175.free fatty acid are transported via Albumin 176.patient on estrogen only HRT since 5years risk of breast cancer Low risk or no risk

MRCOG RECALLS 131 صفحة Dr. MOHAMED YAHIA 0900988745 177.pic of complete mole 46XX 178.hepatocytic hematopoiesis commence at which week 6 week 8week 179.Azoospermia … steroid overuse 180.TVS frequency 7-9 hz 181.shoulder dystocia first maneuremcroberts 182.menstrual cycle of 25days .. ovulate at 11 days 183.5 weeks bhcg…2400, 4800 184.inhibin synthesis in granulosa cells 185.antiemetic causes extrapyramidal effects … metoclopramide 186.vitamin c promotes hydroxylation in protein synthesis 187.Northern blotting for rna 188.level of evidence 2a, 2b 189.Lichen planus symptomatic? Erosive Hyperpigmented 190.no of patients with BMI 19-25 --- 34% 191.itching and rashes… pup 192.B1 193.Question was 80 women died in which bmi was checked as a risk factor so how many died coz of obesity…80 194.senerio of vitamin b12 deficiencybicytopenia 195.most common cause of hyperthyroidism in pregnancy…..graves 196. number needed to treat…… 4 197. albumin synthesized in hepatocytes. EXAM 8

MRCOG RECALLS 132 صفحة Dr. MOHAMED YAHIA 0900988745 1-woman with Bhcg 155 and after 48 hours Bhcg is 270, no C/O lower abdominal pain, no gestational sac seen, no adnexal mass, no fluid in pouch of douglas: a. Normal singleton pregnancy b. Molar pregnancy c. C-Ectopic pregnancy d. D-Non-viable pregnancy 2-A woman have got stillbirth at 34 weeks, her thrombophilia screening shows: Hb:10.1 Platelates:135 Protein C:normal protein S :decreased Anticardiolipin antibodies: -ve A- normal pregnancy changes B- congenital thrombophilia C- acquired thrombophilia 3-Convex outline of uterus, lap and dye shows two uterine cavities: A- A-septate B- bicornuate C- C-didelphus 4-Identify the type of placenta;

MRCOG RECALLS 133 صفحة Dr. MOHAMED YAHIA 0900988745 A- succenturiate B- circumvallate C- velamentous 5-patient have normal menstrual cycles but now she have amenorrhea for 8 months,she is taking metoclopramide and valproate for epilepsy, she have no visual symptoms,no hirsutism, her serum prolactin is 1000,your further management? A- A-stop metoclopramide and repeat test B- B-stop metoclopramide and review from neurosurgeon C- C -MRI brain D- stop valproate and review from neurophysician 6-patient have IUCD in place since 8 months and now she have C/O vaginal discharge ,your management a. Don’t remove iucd and take vaginal swabs and treat accordingly 7-Patient with heavy menstrual bleeding: identify the picture b. A-Polyp c. B-Adenomyosis d. C-Leiomyoma 8-Pt have mild lower abdominal pain,have H/O irregular menstrual cycles,not taking ocps,these ultrasound findings indicate: a. A-Corneal ectopic pregnancy b. B-Endometrioma 9-Minor PPh is called: a. A-500 blood loss b. B-500-1000 with no signs of shock c. C - >1000 with no signs of shock d. D-1500 with no signs 0f shock 10-A 25 years old with chronic left lower abdominal pain for 3 months,she have previously received treatment for chlamydia,her ultrasound revealed a 4cm diffuse homogenous hypoechoic focal lesion with little fluid in pouch of douglas:

MRCOG RECALLS 134 صفحة Dr. MOHAMED YAHIA 0900988745 a. A-mucocele appendix b. B-hydrosalpinx c. C-Endometrioma 11-Direc most common cause of maternal death according to 2017 guideline: A-PPH B-Thromoembolism 12-Patient having severe pre- eclampsia symptoms, BP 160/110,blurring of vision, severe headache, pulse 85,she is known case of asthma, drug you will give to decrease her BP: A- I/v hydralazine B- I/v labetalol C- methyldopa 13-placentation at site A is called: a. A-accreta b. B-Normal placentation c. C-Abruption D-Praevia 14-patient is low risk and she came for antenatal visit,her symphysiofundal height shown by this graph, what you will advise after looking this graph ? a. A-Reasure b. B-Ultrasound 2 weekly D- FKC charting at home 15-Patient pregnant , PID due to gonorrhea, appropriate treatment: a. A-Ceftriazone,doxycycline b. B-Ceftriazone, azithromycin 16- MRI picture of intramural fibroid (Same picture as came in July 2018) 17-Patient postpartum and is breast feeding, have CT scan due to some reason ,regarding breast feeding you will advise a. A-Encourage breast feeding normally b. B-Encourage breast feeding but send baby’s UCE after 24 hours 18-A woman have multiple fibroids ,is planned for hysterectomy, she is on ulipristal acetate prior to have surgery which additional contraception you will advise: Barrier contraception 19- identify picture of complete mole:

MRCOG RECALLS 135 صفحة Dr. MOHAMED YAHIA 0900988745 - 20-Combined oral contraception can be used in woman had GTD: After Bhcg titer return to normal, not rising at all. 21- Senario of ovarian cyst of 4 cm; Reassure no follow up 22-Drug not given in 3 rd trimester to treat UTI: Nitrofurantoin 23-patient came with pv bleeding at home,now pv bleeding is controlled and all signs clued about complete miscarriage,what will be your further management: A- PT after 2 weeks B- D and E C- Ultrasound after 2 weeks 24- 30 years old woman having HMB that is disturbing her daily life routine,she is not going to plain family soon,your choice of treatment: Mirena 25-Woman is 22 weeks pregnant,asked about alchohol intake during pregnancy: a. A-Should not be taken at all b. B-she can take 14 units/ day c. D-Can take 18 units/ day 26-when does the prophylactic dose of LMWH is stopped? a. A-12 hours b. B-24 hours 27-Identify the muscle; a. A ischiocavernous b. B bulbospongiosus c. C sphincter urethrae d. D-Deep transverse perineal muscle 28-Which structure devide the paravesical and para rectal pouches a. A-ureter b. B-uterine artery c. C-external iliac artery d. D internal iliac artery 29-Which structure does not contain paracrine glands: a. A-Mons pubis b. B-Labia majora c. C-Labia minora 30-Difference between jejunum and ileum: JEJUNUM ILEUM a. A Thin walled, longer, long arcades Thicker, shorter, short arcades

MRCOG RECALLS 136 صفحة Dr. MOHAMED YAHIA 0900988745 b. B Thin walled, longer, short arcades Thick walled, shorter, long arcades c. C Thick walled, shorter, long arcades Thin walled, longer, short arcades 31-Which line indicates the junction between hindgut and lower anal canal: It was asked about dentate line. 32-sacral plexus situated behind which muscle : a. A-Obturator internus b. B-Pyriformis 33- During laparoscpy surgeons have limitization of lymphectomy on lateral abdominal wall due this structure: a. A-Inferior Myenteric b. B-Obliterated umblical artery c. C-Inferior epigastric artery 34-The expected angle between brim of pelvis and horizontal line that is also the angle of vagina: 60 degrees 35-Which of the following structure passes immediately anterior to that marked in x ray: ( Arrow was marked over sacro iliac joint) a. A-Ureter b. B-Uterine artery 36-Sacrotuberous and sacrospinous ligaments prevent from: a. A-Anterior rotation at horizontal line of sacrum b. B-Posterior rotation at horizontal line of sacrum c. C-downward displacement of ilium and ischium 37- Which artery of internal iliac is mostely absent: Obturator 38-Uterine artery supplies what percentage of blood supply to ovary: a. A-10 % b. B-20 % c. C-30% d. D-40 % 39- hepatic artery is a branch of: Celiac trunck

MRCOG RECALLS 137 صفحة Dr. MOHAMED YAHIA 0900988745 40-Rectus sheath is formed by: internal oblique, external oblique, transversus abdominus apponeurosis. 41- Sacrospinous fixation, which artery is close to it and is prone to be ligated? Internal pudendal Artery 42-Difference between inguinal and femoral hernia: INGUINAL FEMORAL A- Superior and medial to pubic tubercle inferior and lateral to pubic tubercle B- Inferior and lateral to pubic tubercle Superior and medial to pubic tubercle C- Superior and lateral to pubic tubercle Inferior and Medial to pubic tubercle 43- Left uterine vein drain into : Internal iliac vein 44- Rate limiting step in urea synthesis: N acetylglutamate dehydrogenase 45-Important function of glucagon : Gluconeogenesis (glycogenolysis not in options) 46- RNA analysis: Northern blotting 47- Prostaglandins are synthesized from: a. A-Saturated fatty acids b. B-Unsaturated fatty acids 48-Which organel can attach to tRNA and can synthesise protein:Ribosomes 49 -Source of cholesterol in term fetus: a. A-fetal kidney b. B-Fetal liver c. C-placenta 50- NO derived from : L-Arginine 51-Which vitamin given to prevent from wernickes encephalopathy: B1 52:Essential Fatty acid OMEGA 3: Linolenic acid 53-Bending used for Cytogenic analysis: a. A-G Banding B-M banding b. C-D banding D-A banding 54-DNA replicates: S phase 55-CRISP/Cas : DNA+Enzyme 56-Biological active form of vit d: 1,25 Dihydrocholechalciferol 57-Bile salts produced by liver: Cholic and deoxycholic 58-Which of the following metabolic processes produce the most energy needed for uterine contraction: Oxidative phosphorylation 59 -Diagnostic test for megaloblatic anaemia : serum B12 60-At 4 weeks primordial germ cells are within what structure: Yolk sac Genital ridge 61-Major contribution to amniotic fluid by fetal urine: A -16 weeks B -18 weeks 62-Monozygotic dichorionic twins is formed at: A-morula B-Blastocyst

MRCOG RECALLS 138 صفحة Dr. MOHAMED YAHIA 0900988745 C-zygote( 2 cell stage) D-Bilaminar disc 63-In lateral wall of vagina remnant of mesonephric ducts: Garteners duct 64-Anterior pituitary start to develop from: A-6-7 weeks B-8-9 weeks C-11-12 weeks 65-Fetus start to produce urine: A- 10 weeks B-12 weeks 66-Ductus arteriosus is between which structures: Aorta and pulmonary artery 67-Lower 2/3 of vagina develop from: urogenital sinus 68-Posterior fontanelle closes by: 3 months 69-New drug 0.8, placebo drug 0.65, calculate absolute risk reduction: 0.15 70-Laparoscopy sensitivity 90 %,specificity 90 %,what will be false positive rate? A-90 % B 10% C 5 % 71-when does the Odds ratio approximate risk ratio: When the disease being studied is rare 72-A tumor marker is revolutionized for detection of endometrial cancer,60 women included in study, however confirmatory test shows only 40 have ca endometrium,what is the sensitivity of test? (false negative not given in scenario) A-20% B-60% C-80% 73-Histogram shows which variable: A-Time variable B- Continuous variable C-Ordinal 74-Type 1 error: Rejecting null hypothesis when there is difference 75-SEM definition 76-Statistical heterogeneity indicate: Difference between studies outcome 77-Gestational age is: A-Interval B-Ratio 78-Odds ratio calculation answer was :3 79--A couple visited fertility clinic, woman have normal investigations and examination, the picture showing kelinfelters features, asked about what will be results in man: TESTOSTERONE FSH LH SHBG A- Dec inc inc inc B- Inc dec dec inc C- Dec inc inc dec 80-Throid profile in pregnancy is checked by: A triiodothyronine B TSH C Thyroid binding globulin

MRCOG RECALLS 139 صفحة Dr. MOHAMED YAHIA 0900988745 81-which hormone decrease osteoclast activity and inc cartilage deposition at the end of long bones in term fetus: A -calcitonin B -Growth hormone 82-In girls puberty indicated by: Growth spurt, Thelarchae, adrenarchae, menarchae 83-Progesterone is increased maximum up to: A-At term B-6 weeks C-12 weeks 84-Half life of LH: A-30 minutes B-6 hours C-12 hours 85-GnRH other than brain is synthesized in which abdominal structure? a. A-Kidney b. B-liver c. C-pancreas d. D-Duedenum e. E-Gall bladder 86-Which hormone leads to nutrient transfer from mother to fetus: HPL 87-primary aldosteronism features: Hypernatraemia,hypertension,hypokala emia 88-Calcitonin produced by:thyroid 89-Percentage of T3 free: 1% 90-FNN act through : Integrin 91-Hormone raised in post menopausal woman : FSH 92-In pregnancy normal physiological changes; A-Inc plasma volume,dec haematocrit,inc blood volume B-Inc plasma volume,inc haematocrit,inc blood volume 93-How many days it takes resting follicle stage to ovulation: 300 days 94-Which type of cell junctions help in transmission of small molecules from cell to cell in placenta: A-Gap junctions B-Tight junctions C-Hemidesmosomes D-Desmosomes 95-Free fatty acids transferred from maternal to fetal circulation: passive diffusion 96-Correct sequence of sperm peneterates the oocyte: Corrona radiata, zona pallucida, perivitelline space, plasma membrane 97-What is the primary haemoglobin at 32 weeks of gestation: HbF 98-What is the component of placental barrier at term: synchtrophoblast+endothelium 99-Amino Acids tranfer through placenta by: Active transport 100-left side deviation of Oxygen dissociation curve due to ; dec 2,3 DPG 101-volume dec in pregnancy: ERV 102-identify the picture:

MRCOG RECALLS 140 صفحة Dr. MOHAMED YAHIA 0900988745 A-Endocrine B-Paracrine C-Autocrine 103- O blood group: Anti A and B positive 104-Miscarriage occur due to withdraw of this hormone: Progesterone 105-PTH function : dec calcium excretion 106-Inc milk production during pregnancy: HPL+Prolactin. 107-Sex differentiation occur due to: Short arm of Y chromosome 108 -BRCA 1 associated with: A-Ca breast 75% and ca ovary 35% 109 -POF may have karyotype or mutant gene: a. A-46xx b. B-46xxi c. C-47xxy d. D-45x0 110-Edwards male karyotype: 47XY 111-Oligohydroamnios,low set ears,limb hypoplasia,renal,agenesis; A-Potter syndrome B-pataue syndrome 112 -X linked recessive pedigree 113-Autosomal recessive pedigree 114-woman with flu like symptoms and bachachae, delivered baby after 1 week, baby got jaundiced, have hepatosplenomegaly, rashes over body cause? A-listeriosis B-GBS 115-Bacterial vaginosis diagnosis criteria according to amsel criteria: A-Clue cells, fishy smell,Ph > 4.5 116-woman having parvo virus infection ,what is her risk 0f fetal loss if she got infection in 1 st trimester: a. A-5% b. B-10% c. C-20% d. D-50 % 117-Patient have history of ca colon,ureter is fixed in colon,sigmoid audit is performed,shunts are left inside,don’t

MRCOG RECALLS 141 صفحة Dr. MOHAMED YAHIA 0900988745 remember complete thread,was asked about gram negative bacilli in ureter: a. A-psuedomonas aurginosa b. B-s.aureus c. C-E.coli d. D-Faecalis 118-woman with hepatis C test,her PCR is negative and HCV antibody positive:indicate Previous infection 119-neonates with CMV symptomatic at birth: 10-15 % 120- Woman with VDRL positive : (repeated )Likely biological false positive 121-MMR: Live attenuated vaccine 122-Lancified grouping of streptococci is based on: a. A-Antigen present in their cell wall b. B-colour on AGAR c. C-Sugar fragmentation 123-Malaria common: p.Falciparum 124-Which vulval disease is associated mostely with autoimmune diseases: a. A-Lichen sclerosis b. B-Eczema c. C-lichen planus 125-Which of the following is non epithelial carcinoma of vagina: a. A-Rhabdomysarcoma b. B-Leimyosarcoma c. C-Lymphoma 126-Postmenopausal women having typical complex hyperplasia: progress to ca endometrium < 5 % 127--Benign ovarian tumor: dermoid (teratoma) 128-Red degeneration of fibroid occur due to: Ischemia 129-Most common fibroid degeneration :hyaline 130-Ovarian ca associated with mutation of mismatch repair genes: a. A-Clear cell carcinoma b. B-serous ca c. C-Mucinous d. D-papillary 131-Pt Operated for ca cervix and TAH+BSO is performed, Ovarian histopath shows which type of carcinoma: A-Metastatic carcinoma B-Leimyoma C￾Lymphoma 132-24 years old sexual contact with her new boyfriend,she is concerned about development of new lesions on vulva.On examination you note pearly white ,non tender,dome shaped ulcers: Molloscum Contagiosum 133-BRCA is: tumor suppressor 134-Brenner tumor malignant :5% 135-unmarried, history of non peneterative intercourse, C/O painfull ulcers over vulva :

MRCOG RECALLS 142 صفحة Dr. MOHAMED YAHIA 0900988745 A-Behchets disease B-herpes 136-Lynch syndrome occur due to: mutation of genes involved in DNA mismatch repair. 137-Symptomatic lichen planus with dysuria and some vulval lesions ( A very big scenario): 138-which of the following cell types lyses cells that have been infected with virus: A-CD4+T cells B-CD8+T cells 139-The tissue in which most lymphocytes are produced: Bone Marrow 140-What percentage of lymphocytes is present in blood: 20-40% 141-Patient have recurrent miscarriage due to inadequate placentation,what Type of HLA is deficient in each pregnancy: HLA-G 142-What in body secretions such as cervical secretions attack bacteria lipoprotein: A-Lysozymes 143-cell lysis by: A-C3 B-C5 144-Complemt system synthesized in: Liver 145-Radiation exposure with ventilation perfusion scan: A-3 days b-3 months C-6 months D-12 months 146-ultrasound resolution maximum at; A focal region B interface C gray D axial 147-Type of TVS probe used in obese woman; a. A low frequency curvilinear probe b. B high frequency curvilinear c. C low frequency linear probe d. D high frequency linear probe 148-radiation dosing in: msv (mili sievert) 149-In electro surgery long loop is used for: a. A-To earth the patient b. B To complete circuit High density current c. C-To complete circuit Low density current 150-CTG shows baseline heart rate of 155, no acceleration, baseline variability 8, Variable D cells for 2 hours, pretend CTG: a. A:Suspicious b. B:Pathological c. C: Non-reassuring 151-CTG paper frequency

MRCOG RECALLS 143 صفحة Dr. MOHAMED YAHIA 0900988745 A- 1cm B-2cm C-3cm 152- A small square of ECG: a-0.02 sec B- 0.04 sec 153-Inferior myocardial infarction ,leads show it: A-II aVF B-III aVF C-aVF 154-Normal ECG changes in pregnancy :Q waves in lead III 155- Partograph, what this arrowed line indicate? (Left arrow) a. A action line b. B alert line c. C active stage d. D second stage 156- 6weeks gestasional amenorrhea ,gestational sac of 20 mm, fetal pole of 4mm,no fetal heart beat seen ,what does it indicate? a. A-fetal pole 4mm with no fetal heart beat is appropriate for gestational age b. B-Fetal pole of 4mm with no fetal heart beat shows non viable pregnancy c. C-Fetal pole of 4mm with no heart beat shows viable pregnancy d. D-gastational sac of 20 mm is appropriate for gestational age 157- In a study comparison of singleton and twin pregnancy is made: A-If cervical length less than 20mm then double chances of preterm before 34 weeks in twins than singletons B-If cervical lenth Less than 30 mm then double chances of preterm before 34 weeks in twins than singletons 158-Identify the Diagram,,a scenario was given and was asked about the cause: A-Normal voiding urogram B-Bladder overactivity 159-Haemolytic disease in newborn is detected by: direct coombs test 160-FBS 7.23 your action : repeat after 30 minutes 161-In Emergency department with tachypenia,ABGs show following results:

MRCOG RECALLS 144 صفحة Dr. MOHAMED YAHIA 0900988745 PH:7.25 pC02 normal range,p02 normal range,HCO3: dec A-Mixed respiratory/metabolic acidosis B-Metabolic acidosis 162-Pt with headache on day of hysterectomy,ABGs shows following results: Ph:7.5 Pc02 low HCO3 normal Interpret: Hyperventilation 163- Normal level of fibrinogen in blood:( 1-2 gm That is what I did ,don’t remember other options) 164-woman have history of eclampsia in previous pregnancy,now she is 12 weeks pregnant,what is her risk of pre eclampsia in current pregnancy: a. A-10 % b. B-15-20 % c. c-30 % d. D-55% 165-woman have history of salpingectomy due to ectopic pregnancy,recurrent risk in next pregnancy of ectopic is : a. A-1-3 % b. B-5-10% c. C-15-20% 166-patient having GDM,what is her life time risk of diabetes type II: a. A-5-10% b. B-15-20% c. C-25-35% d. D-45-55% 167-Risk of miscarriage with amniocentesis: a. A-1% b. B-2% c. C-5% 168-Mechanism of action of clindamycin :Inhibit protein synthesis by binding to 50s subunit 169-Mechanism of action of metronidazole: covalentely bind DNA 170-Mechanism of action of fluconazole: Inhibit cell wall synthesis by binding to 14 a demethylase 171-Mechanism of action of neostigmine: Anti cholinesterase 172-Trimethoprim is: antimetabolite (affects DNA synthsis) 173-Diazepam can cross placenta because of : Lipid Solublity 174-Mechanism of action of vincristine: Inhibit fuction of microtubules 175-Mechanism of action of Indomethacin: cyclo oxygenase inhibitor 176-Midazolam acts over:GABA receptors 177-Ulipristal type of drug: Selective progesterone receptor modulator 178-Depoprovera :Inhibition of ovulation 179-Oxytocin cant be administered through oral route because:Is destroyed by gastric juice enzymes 180-Calcium channel blocker: Nifidepine 181-Drosperinone is: a. A-Mineralocorticoid b. B-Progestogenic c. C-Androgenic 182-Second generation progestogen is: Levonorgestril

MRCOG RECALLS 145 صفحة Dr. MOHAMED YAHIA 0900988745 183-Non ergot dopamine agonist used after stillbirth :quinagolide 184-Drug excretion dec in pregnancy due to: A-Dec plasma volume B-Dec albumin and binding proteins 185-Indirect action of warfarin : prothrombin II BEST OF LUCK د. محمد يحيى أبوالقاسم ختم

Next →
2020 02 Recall
2015 2019 Recalls