MOCK 8 Paper 2 Show session ID Load progressSave Session Welcome to your MOCK 8 Paper 2 Name Email 1. Which one of the above drugs is an anti-oestrogen associated with an increased risk of endometrial cancer? Deselect Answer Tranexamic acid Spironolactone Finasteride Flutamide Tamoxifen 2. Cyproterone acetate Deselect Answer Is an anti-oestrogen Is used to induce ovulation in women with polycystic ovary syndrome Has progestogenic activity Is typically administered by intra-muscular injection Can be used on its own as effective contraception 3. Which one of the above statements regarding tamoxifen is true? Deselect Answer Reduces the risk of endometrial hyperplasia Has anti-oestrogenic effects on the post menopausal uterus is an anti-progestogen Can be used to treat hot flushes Can be used to induce ovulation in women with anovulatory infertility 4. Which one of the above drugs does not have anti-androgenic activity? Deselect Answer Spironolactone Norethisterone Flutamide Finasteride Cimetidine 5. Which one of the above statements regarding mefenamic acid is true? Deselect Answer Is associated with reduced fertility with long-term use Is an anti-fibrinolytic agent Is ineffective in copper IUCD associated heavy menstrual bleeding Reduces menstrual blood loss by ~50% in women with heavy menstrual bleeding Is associated with hot flushes 6. Which one of the above statements regarding GnRH analogues is true? Deselect Answer Result in supra-anovulation with long-term us Should not be used on their own for longer than 6 weeks Are associated with loss of bone mineral density Relieve hot flushes Are typically administered orally 7. Which one of the above statements about danazol is true? Deselect Answer Is recommended for use for up to 5 years Is contraindicated in women with a history of thrombo-embolic disease Is effective in treating idiopathic hirsutism Is associated with proliferation of the endometrium If taken in during pregnancy can emasculate a male fetus 8. Which one of the above drugs has anti-oestrogenic activity in the breast? Deselect Answer Finasteride Flutamide Tamoxifen Spironolactone Tranexamic acid 9. Magnesium sulphate Deselect Answer Causes direct inhibition of action potentials in smooth muscle Is excreted by the kidneys at a rate which is inversely proportional to serum concentrations Is recommended for use in women with severe pre-eclampsia at least 24 hours before delivery Inhibits calcium efflux from muscle cells through dihydropyridine-sensitive calcium channels Reduces the risk of eclampsia by 10-15% 10. Which one of the above drug acts on the anterior pituitary gland to reduce menstrual blood loss? Deselect Answer Mefenamic acid Clomiphene citrate Tranexamic acid GnRH analogue Cyproterone acetate 11. Which one of the below statements regarding dimethyl sulfoxide is true? Deselect Answer Is a 5HT re-uptake inhibitor Results in symptomatic improvement in women with stress incontinence Is administered directly into the bladder Is a nor-adrenaline re-uptake inhibitor Has anti-cholinergic effects on the bladder 12. Anti-D immunoglobulin Deselect Answer Should not be administered to Rhesus negative women who have given birth to a Rhesus negative baby Should not be administered before 12 weeks gestation Cannot be administered intravenously Should be administered at weekly intervals if a Rhesus negative woman is bleeding continuously after 12 weeks gestation Should be administered to Rhesus positive women in the event of a massive feto-maternal haemorrhage 13. Which one of the above anti-hypertensive drugs can cause lithium toxicity without an increase in lithium concentrations? Deselect Answer Hydralazine Methyldopa Labetalol Nifedipine Enalapril 14. Desmopressin Deselect Answer Is a recognised cause of hypernatraemia Has vaso-constrictor effects Is effective treatment for urodynamic stress incontinence Is a shorter-acting analogue of anti-diuretic hormone Is contra-indicated in women who are treated with diuretics 15. Which one is not an anti-cholinergic drug? Deselect Answer Tolterodine Trospium chloride Flavoxate Duloxetine Solifenacin 16. In HIV positive women treated with highly active anti-retroviral therapy, which one is not associated with an increased risk of vertical transmission? Deselect Answer Advanced maternal HIV disease Short duration of anti-retroviral therapy High viral load Birth after 39 weeks gestation Birth before 32 weeks gestation 17. A pregnant woman is found to have a positive Treponema pallidum enzyme immunoassay (TPHA). Which of the following is the likely cause? Deselect Answer The pregnancy itself Lyme disease Leishmaniasis Systemic lupus erythematosus Past yaws infection 18. A healthy 32 year old woman phones the maternity assessment unit because her 5 year old son has developed chickenpox and the woman is 16 weeks pregnant Deselect Answer She should be treated with acyclovir She should be reassured if she has had chickenpox in the past She should be reassured She should be treated with immune globulin She should be reassured and tested for immunity if she has had chickenpox in the past 19. At which stage of pregnancy are women at greatest risk of severe disease following H1N1 influenza infection? Deselect Answer Second trimester Third trimester First trimester 4-6 weeks post-partum 24-48h post-partum 20. Hepatitis A virus Deselect Answer Is associated with chronic liver disease Infection can be prevented using an inactivated virus vaccine Is a DNA virus Has an incubation period of 3-7 weeks Can be transmitted from mother to fetus during child birth 21. With respect to streptococci Deselect Answer Strep. Pneumonia is isolated from the nose / throat in up to 70% of healthy individuals Group A streptococci are isolated from genital tract cultures in 1 in 4 pregnant women Streptococci are gram negative bacteria Group A streptococci are non-haemolytic Group B streptococci are non-haemolytic 22. Which drug is administered orally to treat H1N1 influenza infection? Deselect Answer Zanamivir Oseltamivir Rimantadine Acyclovir Amantadine 23. Which drug should be used to treat breast-feeding women infected with H1N1 influenza? Deselect Answer Rimantadine Amantadine Zanamivir Oseltamivir Acyclovir 24. The H1N1 virus Deselect Answer Is transmitted from pigs to humans Infection does not result in antibody production Is an influenza virus Does not undergo antigenic drift Undergoes antigenic shift 25. Isolated from the perineum / lower genital tract of 1 in 4 pregnant women Deselect Answer Strep. Fecalis Strep. Pneumonia Strep. Viridans Strep. Algalactiae Strep. Pyogenes 26. The most likely cause of breast abscess in a breast-feeding mother 7 days post-partum Deselect Answer Staph. Epidermidis Strep. Fecalis Staph. Aureus E. Coli Strep. Pneumonia 27. Endotoxins Deselect Answer Are converted to non-toxic toxoid by formalin Are associated with disseminated intra-vascular coagulation Are produced by living bacteria Stimulate the production of natural anti-toxins Are polypeptide molecules 28. Which bacteria typically cause toxic shock syndrome? Deselect Answer Coagulase negative staphylococci Actinomycetes Israelii Group A streptococci Coagulase positive staphylococci Group B streptococci 29. Which organism typically causes IUCD-associated genital tract infections? Deselect Answer Staphylococcus aureus Group A streptococcus Actinomycetes israelii Group B streptococcus Clostridium perfringens 30. Clostridium tetani is sensitive to the following antibiotics Deselect Answer Penicillin and flucloxacillin Cefuroxime and metronidazole Rifampicin and trimrthoprim Penicillin and metronidazole Gentamicin and doxycycline 31. A middle-aged pregnant woman presents to her GP complaining of a sudden onset headache and visual disturbance. She has no known past medical history. On examination you note her blood pressure is 145/90 mm Hg. She has evidence of epigastric tenderness and facial swelling.Urine dipstick Confirms 1+ protein. what Is the most likely diagnosis? Deselect Answer Hypothyroidism Nephrotic syndrome Protein deficiency Pre-eclampsia None of the above 32. A 34-year-old woman presents to her GP. She is currently 21 weeks pregnant. She complains of lower abdominal pain and heavy vaginal bleeding. Speculum examination reveals an open cervical os. There are no associated products of conception. What is the most likely diagnosis? Deselect Answer Septic miscarriage Missed miscarriage Inevitable miscarriage Complete miscarriage Threatened miscarriage 33. A middle-aged woman is in active labour. The head has been delivered slowly, but the neck does not appear with the chin retracting against the perineum. What is the most likely diagnosis? Deselect Answer Placenta praevia Cord prolapse Uterine rupture Shoulder dystocia Uterine inversion 34. The following are all risk factors for placental abruption EXCEPT: Deselect Answer Tobacco use Alcohol Diabetes Pre-eclampsia Hypertension 35. A 53-year-old gentleman presents to his GP. He is keen to have a vasectomy but would like to know about the possible risks and complications. The following are all associated with a vasectomy EXCEPT: Deselect Answer Sperm granuloma Infection Haematoma Failure Malignancy 36. According to the 1967 Abortion Act, the following are all indications for termination of pregnancy if pregnancy were to continue EXCEPT: Deselect Answer The partner’s physical health is likely to be endangered The child is likely to suffer a physical handicap The women’s physical health is likely to be endangered The women’s mental health is likely to be endangered The woman's life is likely to be endangered 37. According to the Pearl index what is the most effective form of contraception from the below list? Deselect Answer Combined oral contraceptive pill Progestogen implants Male sterilization Male condom Female condom 38. A 28-year-old woman presents to A&E. She is currently 23 weeks pregnant. She complains of lower abdominal pain and vaginal bleeding. Speculum examination reveals no evidence of cervical dilatation. What is the most likely diagnosis? Deselect Answer Missed miscarriage Threatened miscarriage Complete miscarriage Septic miscarriage Inevitable miscarriage 39. A middle-aged woman presents to A&E in labour. She is referred to the obstetrician on call. It is noted that the second stage is prolonged after one hour of active maternal pushing. The obstetrician decides to expedite delivery with ventouse suction. The following are all true with regards to ventouse delivery EXCEPT: Deselect Answer Adequate analgesia is required A maximal force should be applied The procedure should be performed with the patient in the lithotomy position Traction should take place during uterine contractions An episiotomy may be required 40. A middle-aged woman is in active labour. The head has been delivered slowly, but the neck does not appear with the chin retracting against the perineum. What is the most likely diagnosis? Deselect Answer Placenta praevia Cord prolapse Uterine rupture Shoulder dystocia Uterine inversion 41. A 26-year-old woman has just given birth. Her newborn baby undergoes assessment. He is pink in appearance and has a heart rate of 125 beats per minute. He demonstrates a strong respiratory effort, good flexion and coughs when stimulated. What is the most likely Apgar score? Deselect Answer 2 4 6 8 10 42. A 53-year-old gentleman presents to his GP. He is keen to have a vasectomy but would like to know about the possible risks and complications. The following are all associated with a vasectomy EXCEPT: Deselect Answer Sperm granuloma Infection Haematoma Failure Malignancy 43. A 32-year-old woman presents to A&E in labour. You note a cervical diameter of 5 cm after seven hours. l-Which management plan would you instigate first? Deselect Answer Prostaglandin pessaries Forceps delivery Ventouse delivery Caesarean section Oxytocin IV 44. A 26-year-old woman who is currently 30 weeks pregnant presents to A&E following an episode of vaginal bleeding. On examination you note fresh red blood. What is the next most appropriate initial investigation? Deselect Answer Abdominal X-ray Abdominal CT scan Pelvic X-ray Abdominal ultrasound scan Vaginal swab 45. The following are all risk factors for the above presentation EXCEPT: Deselect Answer Postmaturity An underweight mother Slow progress in the first stage Macrosomia Slow progress in the second stage 46. The following are all true with regards to primary postpartum haemorrhage EXCEPT: Deselect Answer It is associated with oligohydramnios It can be due to vaginal lacerations It can be due to uterine atony It is associated with greater than 500 mL blood loss within the first 24 hours post delivery It is associated with prolonged labour 47. A 32-year-old woman presents to A&E following an episode of heavy vaginal bleeding. She is currently 29 weeks pregnant. She complains of severe abdominal pain. Routine observations reveal a blood pressure of 90/50 mm Hg and pulse rate of 140 beats per minute. She is pale in appearance and clammy to touch. VV hat is the next most appropriate step in management? Deselect Answer Abdominal ultrasound scan Abdominal X-ray Vaginal swab IV access and urgent fluid resuscitation Cardiotocography 48. A 24-year-old woman presents to A&E following an episode of heavy vaginal bleeding. She is currently two weeks post-delivery. Routine observations reveal a blood pressure of 90/50 mm Hg and pulse rate of 140 beats per minute. Speculum examination reveals an open cervical os. Bimanual examination reveals a soft bulky uterus. What is the most likely diagnosis? Deselect Answer Placenta praevia Endometritis Retained products of conception Menorrhagia Placental abruption 49. The following are all true with regards to fetal heart rate EXCEPT: Deselect Answer A tachycardia may be due to hypoxia Early decelerations occur with the onset of a contraction A tachycardia is greater than 160 beats per minute A bradycardia is less than 80 beats per minute A bradycardia may be due to hypoxia 50. A 25 -year-old woman presents to A&E. She is currently 41 weeks pregnant. She is referred to the obstetric registrar on call who feels she is a candidate for immediate surgical induction of labour. What is the most appropriate Bishop’s score required prior to such induction? Deselect Answer 2 4 5 6 7 and above 51. For IM injection adrenaline should be diluted in Deselect Answer 1in 10 1 in 100 1 in 100000 1 in 1000 1 in 200 52. Woman bleed 4 litre of blood after vaginal delivery. The anatomises between uterine artery and which of the following should be ligated to stop bleeding ? Deselect Answer Vaginal artery Ovarian artery Hypogastric artery External iliac artery Sampson artery 53. What is the most common cause for transfer from mid-wifery to consultant unit ? Deselect Answer Request for regional anasthesia Abnormal fetal heart rate Retained placenta Repair of perineal trauma Delay during first or second stage of labour 54. What is the recurrence rate of shoulder dystocia ? Deselect Answer 2 Fold 4 Folds 6 Folds 8 Folds 10 Folds 55. Postpartum haemorrage after vaginal delivery. pharmaceutically failed to stop the bleeding. what is the 1st surgical step to stop the bleeding? Deselect Answer Uterine b-lynch brace suture Bilateral int. iliac ligation Bilateral uterine artery ligation Intrauterine balloon tamponade Uterine artery embolization 56. What is the best way to perform intermittent auscultation during 1st stage of labour : Deselect Answer During contraction, for at least 1 minute, every 15 mins During contraction, for at least 1 minute, every 30 mins Immediately after contraction, for at least 1 minute, every 15 mins Immediately after contraction, for at least 1 minute, every 30 mins Immediately before contraction, for at least 1 minute, every 15 mins 57. Unwanted effect of pregnancy not related to physiological changes : Deselect Answer Backache Dysuria Constipation Tiredness Lower limb edema 58. which type of tumor increase Growth hormone secretion lead to acromegaly? Deselect Answer Adenoma Glioma Fibroma Sarcoma Meningioma 59. Patient with pleurtic chest pain shortness of breath. 1st investigation to be done Deselect Answer ABG Chest x ray ECG V/Q scan D-dimer 60. A 27 year old patient who is 8 weeks pregnant has been referred in due to vomiting. Bloods show a a TSH of <0.01mU/l and free T4 of 34pmol/l. What is the first line treatment for this patient? Deselect Answer Carbimazole Labetalol Iodine 131 Propylthiouracil Propranolol 61. At what stage of gestation does physiological anaemia of pregnancy become most apparent? Deselect Answer 4 to 8 weeks 20 to 24 weeks 30 to 34 weeks 36 to 40 weeks 12 to 16 weeks 62. In shoulder dystocia chances of Brachial Plexus injury is which of the following ? Deselect Answer <1% 20 % 2.3-16% 17.3-30% >50 % 63. Which of the following is not a recognized sign of impending eclampsia Deselect Answer Headache Epigastric pain Blurred vision Decreased fetal movement Hypertension 64. A new study aims to look for risk factors associated with cervical cancer. Using a sample of 35 women who have a diagnosis of cervical cancer, and a sample of 42 healthy volunteers, researchers asked, "How old were you when you first had sexual intercourse?" Those who stated an age that was under 18 were classed as "young first age of sexual intercourse", whilst those who stated an age over and including 18 were classified as "older first age of sexual intercourse". The number of people classified as "young" in each group were then compared. Which of the following study designs is being described? Deselect Answer Case series Case‐control study Cohort study Correlation study Randomised control trial 65. A 22 year old patient who is 18 weeks pregnant presents with vaginal discharge. Swabs are taken which show heavy growth of neisseria gonorrhoea. Which of the following is the most appropriate treatment regime? Deselect Answer Ciprofloxacin 750mg BD for 7 days Ceftriaxone 500 mg intramuscularly immediately followed by oral doxycycline 100mg twice daily plus metronidazole 400 mg twice daily for 14 days Oral doxycycline 100mg twice daily plus metronidazole 400 mg twice daily for 14 days Ceftriaxone 500 mg intramuscularly as a single dose with azithromycin 1 g oral as a single dose None of the above 66. At what week in pregnancy is testing for gestational diabetes (GD) advised Deselect Answer 24-28 weeks of pregnancy if past history of GD As soon as possible after booking if past history of GD 16-18 weeks of pregnancy if no history of GD At booking appointment regardless of past history 20-22 weeks of pregnancy if no history of GD 67. A patient has returned to your clinic. She presented with painful periods 18 months earlier and laparoscopy confirmed endometriosis. She now gets pain on opening her bowels as well as low back pain. What structure is likely to be involved? Deselect Answer Psoas muscle Mesovarium Uterosacral ligament Suspensory ligament Iliacus muscle 68. A 26 year old patient attends the A&E department. She reports becoming acutely short of breath with chest pain 1 hour prior to attending. She is not on any regular medication. Of note she had an uncomplicated birth by normal vaginal delivery at term 3 weeks ago. Her observations are as follows: Blood pressure: 100/60 Heart Rate: 100 Respiratory Rate: 20 Oxygen sats: 94% on air What is the likely diagnosis? Deselect Answer Amniotic fluid embolism Muscular chest pain Myocardial Infarction Pulmonary embolism Pneumothorax 69. Which statistical test is most appropriate in a study in which the means of three groups are being compared? Deselect Answer One way ANOVA Mann‐Whitney U test Kruskal‐Wallis test Student's t test Regression co‐efficient 70. Which of the following statements regarding management of obstetric anal sphincter injuries (OASIS) is true? Deselect Answer Women should be advised they have a 95% chance they will be asymptomatic in 12 months Women with OASIS should be advised to have episiotomy in subsequent pregnancies Figure of eight sutures should be used during repair to improve haemostasis Broadspectrum antibiotics should be given routinely following OASIS Bulking agents should be given routinely 71. The most common site for carcinoid tumor Deselect Answer Stomach Appendix Doudenum Liver Pancrease 72. Which of the following proteins is correctly matched to it's malignancy Deselect Answer Cytokeratin , Sarcoma Vimentin , Sarcoma Desmin , Melanoma Cytokeratin , Melanoma Amyloid , Lymphoma 73. Most common site for squamous cell carcinoma in vagina Deselect Answer Anterior lower third Posterior lower third Upper anterior part Upper posterior part All vaginal fornicies 74. Which of the following proteins is correctly matched to it's malignancy Deselect Answer Cytokeratin , Sarcoma Vimentin , Carcinoma Desmin , Melanoma Cytokeratin , Carcinoma Amyloid , Lymphoma 75. What does Bowen's disease refer to Deselect Answer Transitional carcinoma in-situ Adenocarcinoma in-situ Squamous cell carcinoma in-situ invasive adenocarcinoma Invasive transitional carcinoma 76. Which of the following proteins is correctly matched to it's malignancy Deselect Answer Cytokeratin , Sarcoma Vimentin , Carcinoma Desmin , Muscle tumors Cytokeratin , Melanoma Amyloid , Lymphoma 77. Which one of the following pathogens is uncommonly isolated from intra‐abdominal pus? Deselect Answer Clostridia Klebsiella spp. Actinomyces Enterococci Escherichia coli 78. Nephropathy and Neuropathy can result from exposure to Deselect Answer Silver Lead Mercury Cobalt Paraffin oil 79. If left untreated , Vulvar Intra-epithelial neoplasia will progress to squamous cell carcinoma in Deselect Answer 40% of cases 50% of cases 60% of cases 70% of cases 80% of cases 80. Prevalence of Endometriosis Deselect Answer 5% of females 10% of females 15 % of females 20% of females 25% of females 81. Which immunoglobulin (or antibody) has the largest molecular weight and has a pentamer structure? Deselect Answer IgA IgE IgG IgM IgD 82. You are reviewing a patient in the antenatal clinic who has moved to the UK from Bangladesh 1 month ago. She asks about BCG vaccination for her baby. What type of vaccine is the BCG? Deselect Answer Inactivated Polysaccaride Attenuated Toxoid Subunit 83. At what stage of gestation does maternal immunoglobulin G transfer to the fetus start? Deselect Answer From conception 2 weeks 6 weeks 12 weeks 18 weeks 84. Which of the following increases in pregnancy? Deselect Answer Th1 Th2 IFN-y IL-2 TNF-alpha 85. A patient with significant weight loss has a set of tumour markers tested. The results show a significantly raised alpha fetoprotein(AFP). Which of the following malignancies is this associated with? Deselect Answer Peritoneal carcinoma Seminoma Hepatocellular carcinoma Breast carcinoma Pancreatic carcinoma 86. Which of the following is a tumour marker for trophoblastic disease? Deselect Answer MCA CEA HCG AFP Ca 15-3 87. Which of the following diseases has a lower incidence/incidence of flare ups in pregnancy? Deselect Answer Hyperthyroidism Rheumatoid arthritis Graves disease Inflammatory bowel disease Systemic Lupus Erythematous 88. Haemolytic Disease of the Newborn falls into what type of hypersensitivity reaction? Deselect Answer Type I Type II Type III Type IV Type V 89. Which immunoglobulin exists as a dimer and is found in secretions such as saliva? Deselect Answer IgG IgM IgD IgA IgE 90. Which complement protein is the product of all 3 activation pathways Deselect Answer C20 C2a C7 C1a C3b 91. You have taken a history from a patient with symptoms of urinary incontinence. There is no history of cancer, no suggestion of neurological disease and no pelvic masses. According to NICE guidelines which of the tests below is indicated in the initial assessment of patients with urinary incontinence? Deselect Answer Videourodynamics Ambulatory urodynamics Multi-channel cystometry Post void residual volume by bladder scan Cystoscopy 92. What percentage of patients undergoing radiotherapy develop fatigue as an acute side effect? Deselect Answer 5% 10% 25% 50% 80% 93. A patient undergoes LASER treatment for CIN. Which of the following is the most appropriate choice of LASER? Deselect Answer Nd YAG Argon CO2 Neodynium Diode 94. What frequency would typically be used for monopolar diathermy? Deselect Answer 5 Hz 50 KHz 100 KHz 500 KHz 10,000 KHz 95. With regard to XRAYs what is the SI unit of absorbed dose? Deselect Answer Becquerel Hertz Tesla Gray Sievert 96. At what gestation does the fetal heart first become detectable on ultrasound? Deselect Answer 4 weeks 6 weeks 7 weeks 8 weeks 9 weeks 97. Oligohydramnios is defined as an amniotic fluid index of? Deselect Answer < 2 cm < 5 mm < 5 cm < 8 mm < 8 cm 98. Polyhydramnios is defined as an amniotic fluid index of? Deselect Answer > 2cm > 8cm > 15cm > 5cm > 25cm 99. Which of the following best describes magnetic resonance imaging? Deselect Answer Involves a gain medium that stimulates emission of electromagnetic radiation Utilise a piezoelectric transducer to generate a field Typically uses Klystron tubes to generate EM waves with a frequency of 0.3 to 300 GHz Utilises ionising radiation Utilises a radiofrequency pulse to alter the spin of protons 100. You are discussing radiation doses for an abdominal CT. The radiation dose of an abdominal CT is equivalent to which of the following? Deselect Answer 10 years natural background radiation 1 year natural background radiation 40 Chest X-rays 400 Chest X-rays 40 Days natural background radiation You’ve already answered some of the questions! Would you like to continue with quiz or restart it from beginning? Time is Up! Time's up
