2024 01 Recall V2
MRCOG Part 1 Recalls — January 2024 (v2)
Crowd-sourced recall questions from the MRCOG Part 1 exam.
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(Page Page 3) 1. The upper part of the vagina receives its blood supply from which arteries? A. Internal pudendal and obturator arteries B. Uterine and ovarian arteries C. Inferior gluteal and external iliac arteries D. Vaginal and inferior vesical arteries E. Superior rectal and middle rectal arteries Answer: B. Uterine and ovarian arteries Explanation: The upper part of the vagina is mainly supplied by branches of the uterine and ovarian arteries, reflecting its close anatomical relation to the uterus and ovaries. 2. Which nerve is primarily supplied by the perianal area? A. Pudendal nerve B. Inferior rectal nerve C. Ihoinguinal nerve D. Genitofemoral nerve E. Obturator nerve Answer: B. Inferior rectal nerve Explanation: The inferior rectal nerve, a branch of the pudendal nerve, provides sensory innervation to the perianal skin and muscles. 3. Which artery is most commonly injured during an appendectomy? A. Superior mesenteric artery B. Inferior mesenteric artery C. Deep circumflex iliac artery D. Inferior epigastric artery E. Internal iliac artery Answer: C. Deep circumflex iliac artery Explanation: The deep circumflex iliac artery runs along the iliac crest near the site of an appendectomy incision and can be accidentally injured during surgery.
(Page Page 4) 4. The embryological origin of the trigone of the bladder is from which structure? A. Urogenital sinus B. Mesonephric (Wolffian) duct C. Paramesonephric (Millerian) duct D. Allantois E. Cloaca Answer: B. Mesonephric (Wolffian) duct Explanation: The trigone of the bladder develops from the mesonephric ducts, while the rest of the bladder arises from the urogenital sinus. 5. A Gartner’s cyst in the lateral vaginal wall originates from which embryological remnant? A. Paramesonephric duct B. Mesonephric duct C. Urachus D. Cloaca E. Allantois Answer: B. Mesonephric duct Explanation: Gartner’s cysts arise from remnants of the mesonephric (Wolffian) duct in the lateral vaginal wall. 6. The Bartholin gland is located in which anatomical space? A. Deep perineal pouch B. Superficial perineal pouch C. Ischioanal fossa D. Vestibule of vagina E. Pelvic cavity Answer: B. Superficial perineal pouch Explanation: The Bartholin (greater vestibular) glands are located in the superficial perineal pouch, near the vaginal orifice.
(Page Page 5) . The obturator nerve is formed by which spinal nerve roots? Answer: B. L2, L3, L4 Explanation: The obturator nerve arises from the lumbar plexus formed by the anterior divisions of L2-L4 spinal nerves. 8. The protective outer layer of the Graafian follicle is called? A. Theca interna B. Theca externa C. Zona pellucida D. Granulosa cells E. Corona radiata Answer: B. Theca externa Explanation: The theca externa is the outer fibrous layer of the follicle providing structural support. 9. At what vertebral level does the common iliac artery bifurcate? A. LI B. L3 C. L4 D.S1 E. S3 Answer: C. L4 Explanation: The abdominal aorta bifurcates into the common iliac arteries at the level of L4 vertebra.
(Page Page 6) 10. The dermatome of the umbilicus corresponds to which spinal nerve? A. T8 B. T9 C. T10 D. T11 E. T12 Answer: C. T10 Explanation: The umbilical region corresponds to the T10 dermatome. 11. The muscles form the pelvic diaphragm? A. Levator ani and coccyx B. Piriformis and obturator internus C. Iliopsoas and psoas minor D. Gluteus maximus and medius E. Rectus abdominis and transverse abdominis Answer: A. Levator ani and coccyx Explanation: The levator ani and coccyx muscles together form the pelvic diaphragm, supporting pelvic organs. 12. Which episiotomy type is most commonly used in the UK? A. Midline episiotomy B. Mediolateral episiotomy C. Lateral episiotomy D. Posterior episiotomy E. Anterior episiotomy Answer: B. Mediolateral episiotomy Explanation: The mediolateral episiotomy is preferred in the UK to reduce risk of anal sphincter injury.
(Page Page 7) 13. During episiotomy, which muscle is typically incised? A. Bulbospongiosus B. Ischiocavernosus C. Superficial transverse perineal muscle D. Levator ani E. External anal sphincter Answer: A. Bulbospongiosus Explanation: The bulbospongiosus muscle, part of the superficial perineal muscles, is cut during an episiotomy. 14. Antidiuretic hormone (ADH) is secreted from which hypothalamic nuclei? A. Arcuate and suprachiasmatic B. Supraoptic and paraventricular C. Ventromedial and lateral hypothalamic D. Dorsomedial and posterior hypothalamic E. Mammillary and tuberomammillary Answer: B. Supraoptic and paraventricular Explanation: ADH is produced by neurons in the supraoptic and paraventricular nuclei of the hypothalamus. 15. The Alcock canal contains which structure? A. Femoral nerve B. Pudendal nerve C. Obturator artery D. Sciatic nerve E. Inferior gluteal nerve Answer: B. Pudendal nerve Explanation: The pudendal nerve passes through the Alcock (pudendal) canal in the pelvis.
(Page Page 8) 16. The coronal suture of the skull is formed between which bones? A. Frontal and parietal bones B. Parietal and occipital bones C. Temporal and parietal bones D. Frontal and temporal bones E. Occipital and temporal bones Answer: A. Frontal and parietal bones Explanation: The coronal suture connects the frontal bone to the two parietal bones. 17. The spinal level of sympathetic innervation to perform low uterine segment anaesthesia is? A.LI1 B. L2 C. L3 D. L4 E.S1 Answer: B. L2 Explanation: The sympathetic nerves supplying the uterus mainly arise from the spinal segments around L2. 18. Before performing a hysterectomy, which ligament is most important to ligate to control the blood supply? A. Round ligament B. Broad ligament C. Suspensory ligament of the ovary D. Internal iliac ligament E. Cardinal ligament Answer: D. Internal iliac artery ligation (ligament refers to artery ligation) Explanation: Ligation of the internal iliac artery reduces pelvic blood flow and bleeding during hysterectomy.
(Page Page 9) 19. Which nerve runs medial to the anterior superior iliac spine (ASIS)? A. Femoral nerve B. Lateral femoral cutaneous nerve C. Obturator nerve D. Sciatic nerve E. Genitofemoral nerve Answer: B. Lateral femoral cutaneous nerve Explanation: The lateral femoral cutaneous nerve passes medial to the ASIS before supplying the lateral thigh. 20. The middle rectal artery branches from which artery? A. External iliac artery B. Internal iliac artery C. Inferior mesenteric artery D. Superior rectal artery E. Common iliac artery Answer: B. Internal iliac artery Explanation: The middle rectal artery arises from the internal iliac artery and supplies the middle part of the rectum. 21. Which nerve pierces the internal oblique muscle to enter the deep inguinal ring? A. Iliohypogastric nerve B. Iioinguinal nerve C. Genitofemoral nerve D. Femoral nerve E. Obturator nerve Answer: B. Ilioinguinal nerve Explanation: The ilioinguinal nerve passes through the internal oblique muscle near the deep inguinal ring.
(Page Page 10) 22. The androgen testosterone is converted to dihydrotestosterone (DHT) by which enzyme? A. Aromatase B. 5-alpha reductase C. 17-beta hydroxysteroid dehydrogenase D. 3-beta hydroxysteroid dehydrogenase E. Sulfatase Answer: B. 5-alpha reductase Explanation: 5-alpha reductase converts testosterone into the more potent androgen DHT. 23. The hormone responsible for glucose metabolism regulation in the fetus is? A. Insulin B. Human placental lactogen (HPL) C. Cortisol D. Thyroxine E. Progesterone Answer: B. Human placental lactogen (HPL) Explanation: HPL alters maternal glucose metabolism to increase glucose availability for the fetus. 24. Which renal tubule segment absorbs bicarbonate (HCO3-) primarily? A. Proximal convoluted tubule (PCT) B. Loop of Henle C. Distal convoluted tubule D. Collecting duct E. Thick ascending limb Answer: A. Proximal convoluted tubule (PCT) Explanation: The majority of bicarbonate reabsorption occurs in the PCT.
(Page Page 11) 25. Gonads contain which number of chromosomes? A. Diploid (46) B. Haploid (23) C. Triploid (69) D. Tetraploid (92) E. Aneuploid Answer: A. Diploid (46) Explanation: Gonadal somatic cells are diploid; gametes are haploid. 26. The piriformis muscle originates from where? A. Ventral surface of sacrum B. Ischial spine C. Pubis D. Iliac crest E. Greater trochanter Answer: A. Ventral surface of sacrum Explanation: The piriformis arises from the anterior sacrum and inserts on the greater trochanter. 27. The major buffer system in urine is? A. Bicarbonate B. Phosphate C. Ammonia D. Protein E. Sulfate Answer: B. Phosphate Explanation: Phosphate acts as the primary urinary buffer, helping to maintain pH.
(Page Page 12) 28. Which hormone regulates sodium (Na+) levels in the body? A. Antidiuretic hormone B. Aldosterone C. Cortisol D. Parathyroid hormone E. Insulin Answer: B. Aldosterone Explanation: Aldosterone increases sodium reabsorption in the distal nephron. 29. Gonadotropin-releasing hormone (GnRH) is a? A. Monopeptide B. Decapeptide C. Polypeptide (+50 amino acids) D. Steroid hormone E. Amino acid derivative Answer: B. Decapeptide Explanation: GnRH is a peptide hormone composed of 10 amino acids. 30. Renin is classified as a? A. Enzyme B. Protein hormone C. Steroid hormone D. Lipid E. Amino acid derivative Answer: A. Enzyme Explanation: Renin is an enzyme that catalyzes the conversion of angiotensinogen to angiotensin I.
(Page Page 13) 31. The most common cause of secondary hyperparathyroidism is? A. Primary hyperplasia of the parathyroid B. Chronic renal failure C. Vitamin D intoxication D. Parathyroid adenoma E. Malignancy Answer: B. Chronic renal failure Explanation: Renal failure leads to hypocalcaemia and compensatory secondary hyperparathyroidism. 32. In pregnancy, the typical acid-base status is? A. Respiratory acidosis B. Metabolic acidosis C. Respiratory alkalosis D. Metabolic alkalosis E. Mixed acidosis Answer: C. Respiratory alkalosis Explanation: Pregnancy induces a mild respiratory alkalosis due to hyperventilation. 33. Breast milk contains which of the following carbohydrates? A. Lactose B. Lactulose C. Maltose D. Sucrose E. Glucose Answer: A. Lactose Explanation: Lactose is the main sugar in breast milk, providing energy for the infant.
(Page Page 14) 34. Which prostaglandin increases during the menstrual cycle? A. PGE1 B. PGE2 C. PGF2a D. PGI2 E. Thromboxane A2 Answer: C. PGF2a Explanation: PGF2a increases during menstruation and induces uterine contractions. 35. The immunoglobulin increased in the term pregnant cervix is? A. IgG B. IgA C. IgM D. IgE E. IgD Answer: B. IgA Explanation: Secretory IgA increases in the cervix during term pregnancy, protecting mucosal surfaces. 36. Which immunoglobulin is involved primarily in allergic reactions? A. IgG B. IgA C. IgM D. IgE E. IgD Answer: D. IgE Explanation: IgE mediates allergic responses by binding to mast cells and basophils.
(Page Page 15) 37. Turner syndrome karyotype is? A. 46, XX B. 47, XXY C. 45, X0 D. 46, XY E. 47, XXX Answer: C. 45, X0 Explanation: Turner syndrome is characterized by monosomy X (45, X0). 38. Klinefelter syndrome features include? A. Normal stature and fertile gonads B. Short stature and hypergonadism C. Normal stature with atrophied gonads and infertility D. Tall stature with normal fertility E. Short stature and infertility Answer: C. Normal stature with atrophied gonads and infertility Explanation: Klinefelter males (47, XXY) typically have tall stature, small testes, and infertility. 39. Magnesium is primarily excreted by? A. Liver B. Kidney unchanged C. Intestine D. Sweat glands E. Lungs Answer: B. Kidney unchanged Explanation: Magnesium is mostly excreted by the kidneys in an unchanged form.
(Page Page 16) 40. The course of the obturator internus muscle is? A. From ilium to greater trochanter B. From pubis and ischium, through lesser sciatic foramen, to greater trochanter C. From sacrum to lesser trochanter D. From ischial tuberosity to lesser trochanter E. From pubis to iliac crest Answer: B. From pubis and ischium, through lesser sciatic foramen, to greater trochanter Explanation: Obturator internus originates from the obturator membrane and surrounding bones, passes through the lesser sciatic foramen, inserting on the greater trochanter. 41. The cause of female urethral caruncle is most commonly? A. Hyperestrogenism B. Hypoestrogenism C. Infection D. Trauma E. Allergic reaction Answer: B. Hypoestrogenism Explanation: Urethral caruncles often occur in postmenopausal women due to estrogen deficiency, causing mucosal atrophy. 42. The hormone responsible for sodium regulation is? A. Aldosterone B. Antidiuretic hormone C. Cortisol D. Parathyroid hormone E. Renin Answer: A. Aldosterone Explanation: Aldosterone increases sodium reabsorption in renal tubules, regulating body sodium levels.
(Page Page 17) 43. GnRH (Gonadotropin-releasing hormone) is classified as? A. Monopeptide B. Decapeptide C. Polypeptide (+50 amino acids) D. Steroid hormone E. Amino acid derivative Answer: B. Decapeptide Explanation: GnRH consists of 10 amino acids and stimulates the release of LH and FSH. 44. Renin is a? A. Protein hormone B. Enzyme C. Steroid hormone D. Neurotransmitter E. Peptide hormone Answer: B. Enzyme Explanation: Renin is an enzyme that initiates the renin-angiotensin-aldosterone system. 45. The most common cause of secondary hyperparathyroidism is? A. Vitamin D intoxication B. Chronic renal failure C. Parathyroid adenoma D. Malnutrition E. Hypercalcemia Answer: B. Chronic renal failure Explanation: Kidney failure reduces phosphate excretion and vitamin D activation, leading to secondary hyperparathyroidism.
(Page Page 18) 46. The most common cause of Cushing syndrome is? A. Adrenal adenoma B. Pituitary adenoma (Cushing’s disease) C. Iatrogenic glucocorticoid administration D. Ectopic ACTH secretion E. Adrenal carcinoma Answer: C. Iatrogenic glucocorticoid administration Explanation: Exogenous steroid use is the leading cause of Cushing syndrome. 47. The typical acid-base disturbance in pregnancy is? A. Metabolic acidosis B. Respiratory alkalosis C. Metabolic alkalosis D. Respiratory acidosis E. Mixed acid-base disorder Answer: B. Respiratory alkalosis Explanation: Pregnancy causes increased ventilation, lowering CO2 and causing mild respiratory alkalosis. 48. Breast milk contains which of the following sugars? A. Lactulose B. Lactose C. Glucose D. Fructose E. Maltose Answer: B. Lactose Explanation: Lactose is the main carbohydrate in human breast milk.
(Page Page 19) 49. Which prostaglandin increases during the menstrual cycle? A. PGE1 B. PGF2a C. PGI2 D. Thromboxane A2 E. Leukotriene B4 Answer: B. PGF2a Explanation: PGF2a causes uterine contractions and vasoconstriction during menstruation. 50. The immunoglobulin that increases in the term pregnant cervix is? A. IgG B. IgA C. IgM D. IgE E. IgD Answer: B. IgA Explanation: Secretory IgA increases to protect the mucosal surfaces during pregnancy. 51. Which immunoglobulin is involved in allergic reactions? A. IgA B. IgM C. IgG D. IgE E. IgD Answer: D. IgE Explanation: IgE binds to mast cells, causing histamine release in allergies.
(Page Page 20) 52. Turner syndrome karyotype is? A. 47, XXY B. 45, X0 C. 46, XY D. 47, XXX E. 46, XX Answer: B. 45, X0 Explanation: Turner syndrome results from complete or partial absence of one X chromosome. 53. Klinefelter syndrome is characterized by? A. Short stature and normal fertility B. Normal stature with atrophied gonads and infertility C. Tall stature with normal gonads D. Female phenotype E. Gigantism Answer: B. Normal stature with atrophied gonads and infertility Explanation: 47, XXY males typically have small testes and infertility. 54. Magnesium is excreted primarily by? A. Liver metabolism B. Kidney unchanged C. GI tract D. Sweat glands E. Lungs Answer: B. Kidney unchanged Explanation: Kidney’s filter and excrete magnesium mostly unchanged.
(Page Page 21) 55. The obturator internus muscle passes through which foramen? A. Greater sciatic foramen B. Lesser sciatic foramen C. Obturator foramen only D. Foramen ovale E. Foramen rotundum Answer: B. Lesser sciatic foramen Explanation: The Obturator internus originates on the obturator membrane and exits the pelvis via the lesser sciatic foramen. 56. The most common cause of female urethral caruncle is? A. Trauma B. Hypoestrogenism C. Infection D. Allergic reaction E. Malignancy Answer: B. Hypoestrogenism Explanation: Estrogen deficiency leads to mucosal atrophy, causing caruncles. 57. The major urinary buffer system is? A. Bicarbonate B. Phosphate C. Ammonia D. Protein E. Sulfate Answer: B. Phosphate Explanation: Phosphate buffers urine pH to maintain acid-base balance.
(Page Page 22) 58. The hormone responsible for sodium regulation in the kidney is? A. ADH B. Aldosterone C. Cortisol D. Insulin E. Renin Answer: B. Aldosterone Explanation: Aldosterone increases sodium reabsorption in the distal tubule and collecting duct. 59. GnRH is a? A. Steroid hormone B. Decapeptide C. Polypeptide (>50 AA) D. Amino acid derivative E. Lipid molecule Answer: B. Decapeptide Explanation: GnRH consists of 10 amino acids. 60. Renin is an example of a? A. Protein hormone B. Steroid hormone C. Enzyme D. Neurotransmitter E. Vitamin Answer: C. Enzyme Explanation: Renin catalyzes conversion of angiotensinogen to angiotensin I.
(Page Page 23) 61. The most common cause of secondary hyperparathyroidism is? A. Chronic renal failure B. Parathyroid adenoma C. Vitamin D intoxication D. Hypercalcemia E. Malnutrition Answer: A. Chronic renal failure Explanation: Renal failure causes phosphate retention and low vitamin D, leading to increased parathyroid hormone secretion. 62. The most common cause of Cushing syndrome is? A. Pituitary adenoma B. Ectopic ACTH secretion C. Iatrogenic glucocorticoid administration D. Adrenal carcinoma E. Adrenal adenoma Answer: C. Iatrogenic glucocorticoid administration Explanation: Exogenous corticosteroid therapy is the leading cause of Cushing syndrome worldwide. 63. Which acid-base disturbance is typical in pregnancy? A. Metabolic acidosis B. Respiratory alkalosis C. Metabolic alkalosis D. Respiratory acidosis E. Mixed disorder Answer: B. Respiratory alkalosis Explanation: Increased minute ventilation lowers arterial CO2 causing mild respiratory alkalosis.
(Page Page 24) 64. Which sugar is the main carbohydrate in breast milk? A. Glucose B. Fructose C. Lactose D. Maltose E. Sucrose Answer: C. Lactose Explanation: Lactose provides the primary energy source for the infant. 65. Which prostaglandin rises during the menstrual cycle? A. PGE1 B. PGF2a C. PGI2 D. Thromboxane A2 E. Leukotriene B4 Answer: B. PGF2a Explanation: PGF2a promotes uterine contractions and vasoconstriction during menstruation. 66. The immunoglobulin increasing in the term cervix is? A. IgG B. IgA C. IgM D. IgE E. IgD Answer: B. IgA Explanation: IgA protects mucosal surfaces in the cervix.
(Page Page 25) 67. Which immunoglobulin is involved in allergic responses? A. IgA B. IgG C. IgM D. IgE E. IgD Answer: D. IgE Explanation: IgE triggers mast cell degranulation in allergies. 68. Turner syndrome karyotype is? A. 46, XX B. 47, XXY C. 45, X0 D. 47, XXX E. 46, XY Answer: C. 45, X0 Explanation: Turner syndrome is monosomy X. 69. Klinefelter syndrome clinical features include? A. Short stature and infertility B. Normal stature and fertility C. Tall stature, small testes, and infertility D. Female phenotype E. Gigantism Answer: C. Tall stature, small testes, and infertility Explanation: 47, XXY males present with these features.
(Page Page 26) 70. Magnesium is excreted mainly by? A. Liver B. Kidney unchanged C. GI tract D. Sweat glands E. Lungs Answer: B. Kidney unchanged Explanation: Kidney’s filter and excrete magnesium largely unchanged. 71. The obturator internus muscle passes through which foramen? A. Greater sciatic foramen B. Lesser sciatic foramen C. Obturator foramen D. Foramen ovale E. Foramen rotundum Answer: B. Lesser sciatic foramen Explanation: The Obturator internus exits the pelvis via the lesser sciatic foramen. 72. The major cause of female urethral caruncle is? A. Trauma B. Hypoestrogenism C. Infection D. Allergic reaction E. Malignancy Answer: B. Hypoestrogenism Explanation: Estrogen deficiency causes mucosal atrophy, leading to caruncle formation.
(Page Page 27) 73. Major urinary buffer is? A. Bicarbonate B. Phosphate C. Ammonia D. Protein E. Sulfate Answer: B. Phosphate Explanation: Phosphate buffers urinary pH effectively. 74. The hormone regulating sodium in the kidneys is? A. ADH B. Aldosterone C. Cortisol D. Insulin E. Renin Answer: B. Aldosterone Explanation: Aldosterone promotes sodium reabsorption. 75. GnRH is a? A. Steroid hormone B. Decapeptide C. Polypeptide (+50 amino acids) D. Amino acid derivative E. Lipid molecule Answer: B. Decapeptide Explanation: GnRH is a 10-amino-acid peptide.
(Page Page 28) 76. Renin is? A. Protein hormone B. Steroid hormone C. Enzyme D. Neurotransmitter E. Vitamin Answer: C. Enzyme Explanation: Renin catalyzes angiotensinogen to angiotensin I. 77. Most common cause of secondary hyperparathyroidism? A. Vitamin D intoxication B. Chronic renal failure C. Parathyroid adenoma D. Malnutrition E. Hypercalcemia Answer: B. Chronic renal failure Explanation: Kidney disease leads to increased PTH secretion. 78. Most common cause of Cushing syndrome? A. Pituitary adenoma B. Ectopic ACTH secretion C. Iatrogenic glucocorticoid use D. Adrenal carcinoma E. Adrenal adenoma Answer: C. Iatrogenic glucocorticoid use Explanation: Steroid therapy is the main cause.
(Page Page 29) 79. Typical acid-base change in pregnancy? A. Metabolic acidosis B. Respiratory alkalosis C. Metabolic alkalosis D. Respiratory acidosis E. Mixed disorder Answer: B. Respiratory alkalosis Explanation: Hyperventilation causes low CO2. 80. Main sugar in breast milk? A. Glucose B. Fructose C. Lactose D. Maltose E. Sucrose Answer: C. Lactose Explanation: Lactose is the primary carbohydrate. 81. The most common site of ectopic pregnancy is? A. Isthmus of fallopian tube B. Ampulla of fallopian tube C. Cornual region D. Ovary E. Abdomen Answer: B. Ampulla of fallopian tube Explanation: About 70% of ectopic pregnancies implant in the ampulla, the widest part of the tube.
(Page Page 30) 82. The narrowest part of the fallopian tube is? A. Infundibulum B. Ampulla C. Isthmus D. Fimbriae E. Cornu Answer: C. Isthmus Explanation: The isthmus is a narrow, muscular part of the tube. 83. The functional unit of the kidney responsible for filtration is? A. Nephron B. Glomerulus C. Collecting duct D. Proximal tubule E. Loop of Henle Answer: A. Nephron Explanation: The nephron includes the glomerulus and tubules, where filtration and reabsorption occur. 84. The hormone responsible for ovulation inhibition in DMPA contraceptive is? A. Estrogen B. Progesterone C. Gonadotropin-releasing hormone D. Progestogen E. Testosterone Answer: D. Progestogen Explanation: DMPA contains medroxyprogesterone acetate (a progestogen) that inhibits ovulation.
(Page Page 31) 85. The mechanism of action of Atosiban is? A. Oxytocin antagonist B. Prostaglandin inhibitor C. Beta-2 agonist D. Calcium channel blocker E. NSAID Answer: A. Oxytocin antagonist Explanation: Atosiban inhibits oxytocin receptors to delay labour. 86. The enzyme responsible for ammonia production from glutamine is? A. Glutaminase B. Carbonic anhydrase C. Glutamate dehydrogenase D. Urease E. Ammonia lyase Answer: A. Glutaminase Explanation: Glutaminase converts glutamine into glutamate and releases ammonia. 87. The buffer enzyme that helps in blood CO2 transport is? A. Carbonic anhydrase B. Glutaminase C. Lactate dehydrogenase D. Cytochrome oxidase E. Catalase Answer: A. Carbonic anhydrase Explanation: It catalyzes conversion of CO2 and water to carbonic acid, facilitating CO2 transport.
(Page Page 32) 88. Severe itching in pregnancy with increased bile acids indicates? A. Intrahepatic cholestasis of pregnancy B. Viral hepatitis C. Acute fatty liver of pregnancy D. Preeclampsia E. HELLP syndrome Answer: A. Intrahepatic cholestasis of pregnancy Explanation: Itching and raised bile acids characterize obstetric cholestasis. 89. Most common side effect of fibroids is? A. Heavy menstrual bleeding B. Infertility C. Pelvic pain D. Dysmenorrhea E. Urinary frequency Answer: A. Heavy menstrual bleeding Explanation: Fibroids often cause menorrhagia due to increased endometrial surface. 90. Methotrexate acts by? A. DNA alkylation B. Folate antagonist inhibiting dihydrofolate reductase C. Microtubule stabilization D. Topoisomerase inhibition E. Protein synthesis inhibition Answer: B. Folate antagonist inhibiting dihydrofolate reductase Explanation: Methotrexate blocks folate metabolism required for DNA synthesis.
(Page Page 33) 91. Which antiemetic is contraindicated in pregnancy? A. Metoclopramide B. Ondansetron C. Doxylamine D. Prochlorperazine E. Promethazine Answer: B. Ondansetron (Note: This is debated; historically considered safe but some concerns remain.) Explanation: Some studies suggest potential risks with ondansetron; clinical decisions vary. 92. Suxamethonium does not cross the placenta because of? A. High ionization B. Large molecular weight C. Lipid insolubility D. Protein binding E. Rapid metabolism Answer: A. High ionization Explanation: Ionized drugs poorly cross lipid membranes like the placenta. 93. The Haldane effect refers to? A. Increased oxygen affinity with increased CO2 B. Increased capacity of deoxygenated blood to carry CO2 C. Decreased affinity of haemoglobin for oxygen at high CO2 D. Increased CO2 solubility in plasma E. Increased oxygen delivery in hypoxia Answer: B. Increased capacity of deoxygenated blood to carry CO2 Explanation: Deoxygenated haemoglobin binds CO2 better, facilitating CO2 transport.
(Page Page 34) 94. Which type of cell junction allows transmission of small molecules between cells? A. Tight junction B. Gap junction C. Desmosomes D. Hemidesmosomes E. Adherents junctions Answer: B. Gap junction Explanation: Gap junctions permit small-molecule passage between adjacent cells. 95. Diagnostic test for haemolysis in newborn is? A. Direct Coombs test B. Indirect Coombs test C. Haemoglobin electrophoresis D. Reticulocyte count E. Peripheral smear Answer: A. Direct Coombs test Explanation: Detects antibodies bound to red blood cells, indicating haemolysis. 96. Syndrome with bilateral hilar vascular markings, mild pleural effusion, and hyponatremia (Na+ 110 mmol/L) is? A. SIADH B. Heart failure C. Nephrotic syndrome D. Cirrhosis E. Hypothyroidism Answer: A. SIADH Explanation: The Syndrome of inappropriate ADH causes water retention leading to hyponatremia.
(Page Page 35) 97. Jarisch-Herxheimer reaction occurs with treatment of? A. Syphilis B. Tuberculosis C. Malaria D. HIV E. Hepatitis B Answer: A. Syphilis Explanation: Endotoxin release after antibiotic treatment causes this reaction. 98. A patient with pH 7.1, low bicarbonate, and decreased PCO2 likely has? A. Metabolic acidosis with respiratory compensation B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis E. Normal acid-base Answer: A. Metabolic acidosis with respiratory compensation Explanation: Low pH and bicarbonate with decreased PCO2 indicate compensation. 99. What hormone decreases appetite? A. Ghrelin B. Leptin C. Insulin D. Cortisol E. Thyroxine Answer: B. Leptin Explanation: Leptin signals satiety and suppresses hunger.
(Page Page 36) 100. A hepatitis B patient who is HBsAg +ve, HBeAg -ve, anti-HBc +ve likely has? A. Chronic inactive carrier B. Acute hepatitis C. Vaccinated D. Immune due to past infection E. No infection Answer: A. Chronic inactive carrier Explanation: HBsAg positive with HBeAg negative and anti-HBc positive indicates inactive carrier status. 101. DNA nucleotides bind to which proteins to form chromatin? A. Histones B. Actin C. Myosin D. Keratin E. Collagen Answer: A. Histones Explanation: DNA wraps around histone proteins forming nucleosomes, the basic unit of chromatin. 102. Nifedipine’s mechanism of action is? A. Beta-2 agonist B. Calcium channel blocker C. ACE inhibitor D. Alpha blocker E. Diuretic Answer: B. Calcium channel blocker Explanation: Nifedipine inhibits L-type calcium channels, causing vasodilation.
(Page Page 37) 103. Hydralazine acts by? A. Beta-blockade B. Smooth muscle relaxation C. ACE inhibition D. Calcium channel blockade E. Diuresis Answer: B. Smooth muscle relaxation Explanation: Hydralazine directly relaxes arteriolar smooth muscle, reducing blood pressure. 104. Streptococcus species on agar produces? A. No haemolysis B. Alpha (green) haemolysis C. Beta (clear) haemolysis D. Gamma haemolysis E. Partial haemolysis Answer: B. Alpha (green) haemolysis Explanation: Some Streptococcus species produce greenish alpha haemolysis on blood agar. 105. Which drug is contraindicated in pregnancy? A. Paracetamol B. Sulphonamides C. Insulin D. Metformin E. Penicillin Answer: B. Sulphonamides Explanation: Sulphonamides can cause kernicterus and are avoided, especially near term.
(Page Page 38) 106. Advice for a hepatitis B-positive mother regarding breastfeeding? A. Breastfeed and avoid nipple cracks B. Avoid breastfeeding C. Use the formula only D. Breastfeed without restrictions E. Stop breastfeeding if the infant is infected Answer: A. Breastfeed and avoid nipple cracks Explanation: Breastfeeding is safe unless the nipple is cracked to reduce transmission risk. 107. Which blood cell differentiates into plasma cells? A. T lymphocytes B. B lymphocytes C. Monocytes D. Neutrophils E. Eosinophils Answer: B. B lymphocytes Explanation: B cells mature into plasma cells that produce antibodies. 108. Which neurotransmitter is inhibited by atropine? A. Dopamine B. Acetylcholine C. Serotonin D. Norepinephrine E. GABA Answer: B. Acetylcholine Explanation: Atropine blocks muscarinic acetylcholine receptors.
(Page Page 39) 109. Iodine uptake in thyroid cells occurs via symport with? A. Potassium B. Sodium C. Chloride D. Calcium E. Magnesium Answer: B. Sodium Explanation: The sodium-iodide symporter transports iodine into thyroid cells. 110. Cells that secrete histamine and serotonin are? A. Neutrophils B. Basophils C. Eosinophils D. Monocytes E. Lymphocytes Answer: B. Basophils Explanation: Basophils release histamine and serotonin during allergic responses. 111. Brunner’s glands are located in? A. Stomach B. Duodenum C. Jeyunum D. Tleum E. Colon Answer: B. Duodenum Explanation: Brunner’s glands secrete alkaline mucus to protect duodenal mucosa.
(Page Page 40) 112. A simple follicular cyst seen on ultrasound measures 4.3 x 3.3 < 4.6 cm. What is the diagnosis? A. Complex ovarian cyst B. Simple follicular cyst C. Dermoid cyst D. Endometrioma E. Hydrosalpinx Answer: B. Simple follicular cyst Explanation: Simple cysts are thin-walled and anechoic on ultrasound. 113. The main intracellular cation is? A. Sodium B. Potassium C. Calcium D. Magnesium E. Chloride Answer: B. Potassium Explanation: Potassium is the major intracellular positive ion. 114. In DNA, adenine pairs with? A. Guanine B. Cytosine C. Thymine D. Uracil E. Adenine Answer: C. Thymine Explanation: Adenine pairs with thymine via two hydrogen bonds.
(Page Page 41) 115. RNA analysis is performed by which technique? A. Southern blot B. Northern blot C. Western blot D. Eastern blot E. Southwestern blot Answer: B. Northern blot Explanation: Northern blot detects RNA sequences. 116. Conversion of Fe* to Fe” in the gut requires which vitamin? A. Vitamin A B. Vitamin B12 C. Vitamin C D. Vitamin D E. Vitamin E Answer: C. Vitamin C Explanation: Vitamin C reduces ferric to ferrous iron for absorption. 117. In which cell cycle phase do chromatids separate to opposite poles? A. Prophase B. Metaphase C. Anaphase D. Telophase E. Interphase Answer: C. Anaphase Explanation: Sister chromatids separate during anaphase.
(Page Page 42) 118. The metabolic process that produces the most energy during uterine contraction is? A. Glycolysis B. Oxidative phosphorylation C. Fermentation D. Beta-oxidation E. Gluconeogenesis Answer: B. Oxidative phosphorylation Explanation: Aerobic metabolism provides energy for sustained contractions. 119. Most eicosanoids are derived from which parent compound? A. Linoleic acid B. Arachidonic acid C. Palmitic acid D. Oleic acid E. Stearic acid Answer: B. Arachidonic acid Explanation: Arachidonic acid is metabolized into prostaglandins, leukotrienes. 120. DNA replication occurs during which phase of the cell cycle? A. G1 B. S phase C. G2 D. M phase E. Cytokinesis Answer: B. S phase Explanation: DNA synthesis occurs during the synthesis phase (S phase).
(Page Page 43) 121. How many carbon atoms are present in estrogen? A. 16 B. 17 C. 18 D. 19 E. 20 Answer: C. 18 Explanation: Estrogens are C18 steroids derived from androgens by aromatization. 122. The organism most commonly causing IUCD-associated genital tract infections is? A. Actinomyces B. Staphylococcus aureus C. Escherichia coli D. Neisseria gonorrhoeae E. Chlamydia trachomatis Answer: A. Actinomyces Explanation: Actinomyces israelii can colonize [UCDs, causing pelvic infections. 123. Vaginal infection often shows depletion of? A. Candida species B. Gardnerella vaginalis C. Lactobacilli D. Trichomonas vaginalis E. Streptococcus Answer: C. Lactobacilli Explanation: Lactobacilli maintain acidic vaginal pH; their depletion predisposes to infections.
(Page Page 44) 124. Zidovudine (AZT) is classified as? A. Protease inhibitor B. NRTI (nucleoside reverse transcriptase inhibitor) C. NNRTI (non-nucleoside reverse transcriptase inhibitor) D. Integrase inhibitor E. Entry inhibitor Answer: B. NRTI Explanation: Zidovudine inhibits HIV reverse transcriptase by nucleotide analog incorporation. 125. To reverse methotrexate-induced myelosuppression, administer? A. Folinic acid (leucovorin) B. Vitamin B12 C. Vitamin C D. Iron supplements E. Calcium gluconate Answer: A. Folinic acid (leucovorin) Explanation: Folinic acid rescues normal cells by bypassing DHFR inhibition. 126. Which drug causes kernicterus in neonates? A. Sulphonamides B. Penicillin C. Erythromycin D. Metronidazole E. Ciprofloxacin Answer: A. Sulphonamides Explanation: Sulphonamides displace bilirubin causing neurotoxicity in newborns.
(Page Page 45) 127. Entonox is a mixture of? A. Nitric oxide and oxygen (50:50) B. Nitrous oxide and oxygen (50:50) C. Oxygen and carbon dioxide D. Helium and oxygen E. Nitric oxide and carbon dioxide Answer: B. Nitrous oxide and oxygen (50:50) Explanation: Entonox is commonly used for analgesia during labour. 128. Lifetime breast cancer risk with a BRCA1 mutation is approximately? A. 25% B. 35% C. 50% D. 75% E. 90% Answer: D. 75% Explanation: BRCA1 mutation carriers have ~75% lifetime breast cancer risk. 129. Terbutaline is a? A. Beta-1 agonist B. Beta-2 agonist C. Alpha-1 antagonist D. Beta blocker E. Calcium channel blocker Answer: B. Beta-2 agonist Explanation: Terbutaline relaxes uterine smooth muscle via beta-2 stimulation.
(Page Page 46) 130. ACE inhibitors affect which organ primarily? A. Liver B. Kidney C. Lung D. Heart E. Brain Answer: B. Kidney Explanation: ACE inhibitors reduce angiotensin II, affecting renal vasculature and function. 131. Drospirenone’s unique feature is? A. Estrogenic activity B. Anti-androgenic activity C. Androgenic activity D. Glucocorticoid activity E. Mineralocorticoid activity Answer: B. Anti-androgenic activity Explanation: Drospirenone antagonizes androgen receptors, reducing acne/hirsutism. 132. Offensive greenish vaginal discharge at pH 6 is most commonly caused by? A. Bacterial vaginosis B. Trichomoniasis C. Candida infection D. Gonorrhea E. Chlamydia Answer: B. Trichomoniasis Explanation: Trichomonas causes foul, greenish, malodorous discharge.
(Page Page 47) 133. Fishy odour and vaginal discharge with pH >4.5 suggests? A. Candidiasis B. Bacterial vaginosis C. Trichomoniasis D. Chlamydia E. Gonorrhoea Answer: B. Bacterial vaginosis Explanation: Bacterial vaginosis causes a fishy odour and clue cells on microscopy. 134. Oxybutynin is contraindicated in? A. Urinary retention B. Open-angle glaucoma C. Narrow-angle glaucoma D. Diabetes E. Asthma Answer: C. Narrow-angle glaucoma Explanation: Oxybutynin’s anticholinergic effect can precipitate angle closure glaucoma. 135. Lithium use in pregnancy is associated with? A. Ebstein anomaly B. Neural tube defects C. Cleft palate D. Cardiac septal defects E. Renal agenesis Answer: A. Ebstein anomaly Explanation: Lithium increases the risk of Ebstein anomaly (tricuspid valve malformation).
(Page Page 48) 136. Which agent cannot be used as a tocolytic? A. Beta-2 agonists B. Calcium channel blockers C. NSAIDs (Prostaglandin inhibitors) D. Prostacyclin E. Magnesium sulfate Answer: D. Prostacyclin Explanation: Prostacyclin is a vasodilator but not used to inhibit labor contractions. 137. Hyperprolactinemia as a side effect occurs with? A. Antipsychotics (antiemetic drugs) B. Beta blockers C. ACE inhibitors D. Calcium channel blockers E. SSRIs Answer: A. Antipsychotics (antiemetics like metoclopramide) Explanation: Dopamine antagonists disinhibit prolactin secretion causing hyperprolactinemia. 138. Paroxetine is teratogenic to which organ system? A. CNS B. Cardiovascular system C. Renal system D. Musculoskeletal system E. Gastrointestinal system Answer: B. Cardiovascular system Explanation: Paroxetine exposure in pregnancy has been linked to cardiac defects.
(Page Page 49) 139. Botulinum toxin acts by? A. Inhibiting acetylcholine release B. Stimulating dopamine receptors C. Blocking calcium channels D. Enhancing GABA release E. Inhibiting serotonin uptake Answer: A. Inhibiting acetylcholine release Explanation: Botulinum toxin prevents acetylcholine release causing muscle paralysis. 140. Letrozole acts as a? A. Aromatase inhibitor B. 5-alpha reductase inhibitor C. Progesterone antagonist D. Estrogen receptor antagonist E. Gonadotropin analogous Answer: A. Aromatase inhibitor Explanation: Letrozole blocks estrogen synthesis by inhibiting the aromatase enzyme. 141. Tranexamic acid’s mechanism of action is? A. Anticoagulant B. Antifibrinolytic C. Platelet inhibitor D. Vitamin K antagonist E. Thrombolytic Answer: B. Antifibrinolytic Explanation: Tranexamic acid inhibits plasminogen activation, preventing fibrin degradation.
(Page Page 50) 142. The normal percentage of free T4 hormone in blood is approximately? A. 0.01% B. 0.1% C.1% D. 10% E. 50% Answer: B. 0.1% Explanation: About 0.1% of circulating T4 is free and biologically active. 143. Azathioprine acts by? A. Inhibiting DNA synthesis B. Blocking RNA synthesis C. Inhibiting protein synthesis D. Stimulating RNA polymerase E. Enhancing DNA repair Answer: B. Blocking RNA synthesis Explanation: Azathioprine is a purine analogous that inhibits RNA and DNA synthesis, suppressing immune response. 144. The percentage of infants with congenital CMV infection who are asymptomatic at birth is? A. 5% B. 10-15% C. 25% D. 50% E. 75% Answer: B. 10-15% Explanation: Most congenital CMV infections are asymptomatic at birth.
(Page Page 51) 145. Neisseria species are? A. Gram-positive cocci B. Gram-negative aerobic diplococci C. Anaerobic rods D. Gram-positive rods E. Acid-fast bacilli Answer: B. Gram-negative aerobic diplococci Explanation: Neisseria gonorrhoeae and meningitidis are Gram-negative diplococci. 146. A VDRL positive, TPPA negative, VTA negative test indicates? A. Active syphilis infection B. False positive VDRL C. Late syphilis D. Congenital syphilis E. Secondary syphilis Answer: B. False positive VDRL Explanation: TPPA confirms treponemal infection; negative TPPA suggests falsepositive VDRL. 147. The incidence of pneumonia with congenital CMV infection is approximately? A. 1-5% B. 10-15% C. 25% D. 50% E. 75% Answer: B. 10-15% Explanation: Pneumonia is an uncommon but recognized CMV complication.
(Page Page 52) 148. The incidence of uterine rupture with VBAC is approximately? A. 1/50 B. 1/250 C. 1/500 D. 1/1000 E. 1/2000 Answer: B. 1/250 Explanation: Uterine rupture risk in VBAC is about 0.4%. 149. HIV primarily infects which cell type? A. CD4+ T-helper cells B. CD8+ cytotoxic cells C. B lymphocytes D. Neutrophils E. Macrophages Answer: A. CD4+ T-helper cells Explanation: HIV targets and depletes CD4+ T cells. 150. Viral infections mainly activate which immune cells? A. B cells B. CD8+ cytotoxic T cells C. Macrophages D. Neutrophils E. Eosinophils Answer: B. CD8+ cytotoxic T cells Explanation: CD8+ T cells kill virus-infected cells.
(Page Page 53) 151. The most common cause of post-menopausal bleeding is? A. Endometrial cancer B. Atrophic vaginitis and endometritis C. Cervical cancer D. Uterine fibroids E. Polyps Answer: B. Atrophic vaginitis and endometritis Explanation: Atrophy leads to fragile mucosa, causing bleeding. 152. The most common vulvar cancer is? A. Melanoma B. Basal cell carcinoma C. Squamous cell carcinoma D. Adenocarcinoma E. Sarcoma Answer: C. Squamous cell carcinoma Explanation: SCC accounts for a majority of vulvar cancers. 153. Postmenopausal woman with 5 cm bilateral cystic masses, ascites, and CA-125 50-450 suggests? A. Benign cysts B. Ovarian malignancy C. Endometriosis D. Pelvic inflammatory disease E. Polycystic ovaries Answer: B. Ovarian malignancy Explanation: Ascites, bilateral cystic masses, and elevated CA-125 suggest ovarian cancer.
(Page Page 54) 154. The largest organelle in human cells is? A. Mitochondria B. Golgi apparatus C. Nucleus D. Lysosome E. Endoplasmic reticulum Answer: C. Nucleus Explanation: The nucleus houses genetic material and is the largest organelle. 155. Organelle responsible for ATP production is? A. Nucleus B. Mitochondria C. Ribosome D. Golgi apparatus E. Lysosome Answer: B. Mitochondria Explanation: Mitochondria generate ATP via oxidative phosphorylation. 156. Keratin pearls are a histologic feature of? A. Adenocarcinoma B. Squamous cell carcinoma C. Melanoma D. Basal cell carcinoma E. Lymphoma Answer: B. Squamous cell carcinoma Explanation: Keratin pearls indicate squamous differentiation.
(Page Page 55) 157. Fleshy endometrium with papillary growth under a microscope is characteristic of? A. Endometrioid carcinoma B. Papillary serous carcinoma C. Clear cell carcinoma D. Carcinosarcoma E. Leiomyoma Answer: B. Papillary serous carcinoma Explanation: Papillary serous carcinoma has papillary structures and is ageressive. 158. Blood groups are classified as? A. Nominal B. Ordinal C. Interval D. Ratio E. Continuous Answer: A. Nominal Explanation: Blood groups are categories without intrinsic order. 159. Robertsonian translocation is associated with which syndromes? A. Turner and Klinefelter B. Patau and Down syndrome C. Edwards and Turner D. Klinefelter and Patau E. Down and Turner Answer: B. Patau and Down syndrome Explanation: Robertsonian translocations involving chromosomes 13, 14, 15, 21, and 22 cause these syndromes.
(Page Page 56) 160. Staphylococcus aureus produces? A. Cytotoxins B. Endotoxins C. Exotoxins only D. Neurotoxins only E. No toxins Answer: A. Cytotoxins Explanation: Staphylococcus aureus produces various cytotoxins that damage host cells. 161. The epithelial lining of the urinary bladder is? A. Stratified squamous epithelium B. Transitional epithelium C. Simple cuboidal epithelium D. Columnar epithelium E. Pseudostratified epithelium Answer: B. Transitional epithelium Explanation: The urinary bladder is lined by transitional epithelium, allowing distension. 162. The epithelium lining the endometrium is? A. Stratified squamous epithelium B. Transitional epitheltum C. Simple columnar epithelium D. Simple cuboidal epithelium E. Pseudostratified epithelium Answer: C. Simple columnar epithelium Explanation: The endometrial lining is composed of simple columnar epithelial cells.
(Page Page 57) 163. Endometrial tissue found within the myometrium is called? A. Endometriosis B. Adenomyosis C. Leilomyoma D. Endometrial hyperplasia E. Polyp Answer: B. Adenomyosis Explanation: Adenomyosis is the presence of endometrial glands within the uterine muscle. 164. A patient with long-standing endometriosis is at increased risk of developing? A. Clear cell carcinoma B. Squamous cell carcinoma C. Adenocarcinoma D. Sarcoma E. Melanoma Answer: A. Clear cell carcinoma Explanation: Endometriosis predisposes to certain ovarian cancers, including clear cell carcinoma. 165. The type of necrosis typically seen in the heart after infarction is? A. Liquefactive necrosis B. Caseous necrosis C. Coagulative necrosis D. Fat necrosis E. Gangrenous necrosis Answer: C. Coagulative necrosis Explanation: Coagulative necrosis is characteristic of ischemic injury in solid organs.
(Page Page 58) 166. The epithelium lining the labia majora is? A. Stratified squamous keratinized epithelium B. Stratified squamous non-keratinized epitheltum C. Simple cuboidal epithelium D. Transitional epithelium E. Pseudostratified columnar epithelium Answer: A. Stratified squamous keratinized epitheltum Explanation: The labia majora skin is keratinized for protection. 167. The approximate percentage of leiomyomas that undergo sarcomatous transformation is? A. 1in10 B. 1 in 100 C. 1 in 1000 D. 1 in 10,000 E. None Answer: C. | in 1000 Explanation: Sarcomatous change in leiomyomas is very rare (~0.1%). 168. The finding of fetal squamous cells (hair) in the lungs at autopsy indicates? A. Amniotic fluid embolism B. Meconium aspiration C. Pulmonary hypoplasia D. Neonatal pneumonia E. Congenital malformation Answer: A. Amniotic fluid embolism Explanation: Squamous cells in pulmonary vessels indicate amniotic fluid embolism.
(Page Page 59) 169. Choriocarcinoma spreads primarily by? A. Lymphatic spread B. Hematogenous spread C. Direct extension D. Transcoelomic spread E. Perineural invasion Answer: B. Hematogenous spread Explanation: Choriocarcinoma is highly vascular and metastasizes through the bloodstream. 170. The most common type of fibroid degeneration is? A. Hyaline degeneration B. Red degeneration C. Cystic degeneration D. Calcification E. Fatty degeneration Answer: A. Hyaline degeneration Explanation: Hyaline change is the most frequent degenerative process in fibroids. 171. Is the type of endometrium present before ovulation? A. Secretory B. Proliferative C. Menstrual D. Atrophic E. Decidual Answer: B. Proliferative Explanation: The endometrium thickens under estrogen influence before ovulation.
(Page Page 60) 172. An ovarian cyst containing hair, nails, and teeth is? A. Serous cystadenoma B. Mucinous cystadenoma C. Mature teratoma (dermoid cyst) D. Endometrioma E. Follicular cyst Answer: C. Mature teratoma (dermoid cyst) Explanation: Dermoid cysts are germ cell tumours with ectodermal elements. 173. The ovarian tumour most predisposed to torsion is? A. Serous cystadenoma B. Dermoid cyst C. Endometrioma D. Fibroma E. Granulosa cell tumour Answer: B. Dermoid cyst Explanation: Dermoid are often large and mobile, increasing torsion risk. 174. SEM (standard error of the mean) is calculated as? A. SD x Vn B. SD / Vn C. Variance < n D. Mean / SD E. SD?/n Answer: B. SD / Vn Explanation: SEM decreases with increasing sample size.
(Page Page 61) 175. The number needed to treat (NNT) is calculated as? A. 1 / ARR (absolute risk reduction) B. 1 / RR (relative risk) C. 1 / OR (odds ratio) D. ARR/1 E.RR/1 Answer: A. 1 / ARR Explanation: NNT tells how many patients need treatment to prevent one event. 176. Specificity is calculated as? A. TP / (TP + FP) B. TN/(TN + FP) C. TP / (TP + FN) D. TN / (TN + FN) E. FP / (FP + TN) Answer: B. TN / (TN + FP) Explanation: Specificity measures the ability to correctly identify negatives. 177. Negative predictive value (NPV) is calculated as? A. TP / (TP + FN) B. TN / (TN + FN) C. TN / (TN + FP) D. FP / (FP + TN) E. TP / (TP + FP) Answer: B. TN / (TN + FN) Explanation: NPV is the probability that a negative test is truly negative.
(Page Page 62) 178. For comparing two normally distributed groups (e.g., preeclampsia and diabetes), which non-parametric test is used? A. Student’s t-test B. Mann—Whitney U test C. Chi-square test D. ANOVA E. Fisher’s exact test Answer: B. Mann—Whitney U test Explanation: Mann—Whitney is used for non-normally distributed or ordinal data. 179. Intrauterine growth chart shows weight below the 5th percentile, with reversed end-diastolic flow on Doppler, indicates? A. Normal growth B. IUGR (intrauterine growth restriction) C. Macrosomia D. Polyhydramnios E. Hydrops fetalis Answer: B. IUGR Explanation: Reversed flow indicates severe placental insufficiency, causing IUGR. 180. The lateral angle of the diamond-shaped forest plot represents? A. Median value B. 95% confidence limits C. Range D. Interquartile range E. Mean difference Answer: B. 95% confidence limits Explanation: Forest plots depict 95% CIs as whiskers around the point estimate.
(Page Page 63) 181. The bottom and top of a box in a box-and-whisker plot represent? A. Mean and median B. Minimum and maximum C. Lower and upper quartiles D. Standard deviation limits E. Confidence intervals Answer: C. Lower and upper quartiles Explanation: The box edges mark the 25th (Q1) and 75th (Q3) percentiles. 182. Perinatal mortality includes? A. Only stillbirths after 28 weeks B. Stillbirths from 22 weeks plus neonatal deaths within 7 days C. Neonatal deaths after 28 days D. Only neonatal deaths E. Infant deaths within | year Answer: B. Stillbirths from 22 weeks plus neonatal deaths within 7 days Explanation: Perinatal mortality combines fetal and early neonatal deaths. 183. In a normally distributed curve with a mean of 245 and an SD of 50, the median is? A. 195 B. 245 C. 295 D. Variable E. Cannot be determined Answer: B. 245 Explanation: For normal distribution, mean = median = mode.
(Page Page 64) 184. Keilhauer test detects? A. Fetal haemoglobin resistant to acid elution B. Maternal antibodies C. Platelet count D. Leukocyte count E. Reticulocytes Answer: A. Fetal haemoglobin resistant to acid elution Explanation: Used to detect fetal-maternal haemorrhage. 185. Best resolution imaging technique among ultrasound probes? A. 3 MHz probe B. 5 MHz probe C. 7 MHz probe D. 1 MHz probe E. 2 MHz probe Answer: C. 7 MHz probe Explanation: Higher frequency probes give better resolution but less penetration. 186. Colposcopy uses which physical principle? A. Low-density current B. High-density current C. UV light D. Infrared radiation E. X-rays Answer: B. High-density current Explanation: Electrosurgical colposcopy uses high-frequency electrical current.
(Page Page 65) 187. About what percentage of estrogen binds to SHBG (sex hormone-binding globulin)? A. 10% B. 20% C. 50% D. 80% E. 100% Answer: B. 20% Explanation: Approximately 20% of estrogen is bound to SHBG. 188. BRCA gene inheritance pattern is? A. Autosomal recessive B. X-linked recessive C. Autosomal dominant D. Mitochondrial E. Polygenic Answer: C. Autosomal dominant Explanation: BRCA mutations are inherited in an autosomal dominant manner. 189. In X-linked recessive inheritance, affected males transmit the allele to? A. Sons only B. Daughters only C. Both sons and daughters D. Neither sons nor daughters E. Variable Answer: B. Daughters only Explanation: Males transmit the X chromosome to daughters; sons inherit Y.
(Page Page 66) 190. A 50-year-old patient underwent hysterectomy with vaginal repair, has uterine output 300 ml, increased urea and creatinine. The likely cause is? A. Dehydration B. Infection C. Renal failure D. Haemorrhage E. Cardiac failure Answer: A. Dehydration Explanation: Low output and raised renal markers suggest a pre-renal cause, often dehydration. 191. Parathyroid hormone is secreted by which cells? A. Chief cells B. Oxyphil cells C. Follicular cells D. Parafollicular cells E. Beta cells Answer: A. Chief cells Explanation: Chief cells produce parathyroid hormone, regulating calcium. 192. Prolactin secretion is inhibited by? A. Dopamine B. Serotonin C. Acetylcholine D. GABA E. Norepinephrine Answer: A. Dopamine Explanation: Dopamine inhibits prolactin release from anterior pituitary.
(Page Page 67) 193. Cocaine overdose can cause myocardial infarction by? A. Vasospasm B. Thrombosis C. Atherosclerosis D. Embolism E. Infection Answer: A. Vasospasm Explanation: Cocaine induces coronary artery vasospasm, leading to ischemia. 194. The commonest cause of hypothyroidism worldwide is? A. Iodine deficiency B. Hashimoto thyroiditis C. Thyroidectomy D. Radiation E. Congenital Answer: A. Iodine deficiency Explanation: Globally, iodine deficiency is the leading cause of hypothyroidism. 195. Prostaglandins act as? A. Hormones B. Paracrine agents C. Autocrine agents D. Neurotransmitters E. Enzymes Answer: B. Paracrine agents Explanation: Prostaglandins act locally near their site of synthesis.
(Page Page 68) 196. What vitamin is essential for DNA synthesis? A. Vitamin B12 B. Vitamin C C. Folic acid D. Vitamin D E. Vitamin K Answer: C. Folic acid Explanation: Folate is necessary for nucleotide biosynthesis. 197. Vitamin deficiency causing homocysteine elevation is? A. Vitamin B6 B. Vitamin B12 C. Vitamin C D. Vitamin D E. Vitamin E Answer: B. Vitamin B12 Explanation: B12 deficiency impairs homocysteine metabolism. 198. In vitamin B12 deficiency, the defect is? A. Intrinsic factor deficiency B. Folate deficiency C. Vitamin D deficiency D. Iodine deficiency E. Calcium deficiency Answer: A. Intrinsic factor deficiency Explanation: Pernicious anaemia results from a lack of intrinsic factor, causing B12 malabsorption.
(Page Page 69) DR. FATH MRCOG ONLINE COURSES This is a part of the preparation course for MRCOG / MRCPI, follow us on https://www.drfathmrcog.com 8 R: FAT HAARCOG \ All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers. Alb sine asball (5 sis ayes