Mock paper 1 Demo Show session ID Load progressSave Session Welcome to your Mock paper 1 Demo Name Email 1. Bladder contraction during voiding (micturating) is mediated via innervation of which of the following pathways? Sympathetic fibres from S2,S3,S4 nerve roots Parasympathetic fibres from T11,L1,L2 nerve roots Parasympathetic fibres from S2,S3,S4 nerve roots Parasympathetic fibres from L4,L5,S1 nerve roots Sympathetic fibres from T11,L1,L2 nerve roots 2. Lymph drainage from the bladder is via which nodes? Para-aortic Lymph nodes External , Internal and common iliac Mesentric nodes External and common iliac nodes only Internal and common iliac nodes only 3. The ureters receive autonomic supply from which spinal segments? L2-L5 L1-L4 T11-L2 T10-T12 S1-S3 4. Sensory supply to the clitoris is via branches of which nerve? Perineal Inferior rectal Superior rectal Peudendal Genitofemoral 5. A 26 year old patient has phoned the labour ward as she has started having uterine contractions. Which dermatomes are pain from uterine contractions typically referred to in the early stage of labour? L1 , L2 , L3 T12 , L1 T9 , T10 T11 . T12 L1 , L2 6. Which cell type of the testis secrete inhibin? Myoid cells Germ cells Epithelial cells Sertoli cells Leydig cells 7. Regarding the Pituitary gland which of the following statements is true? it rests on ethmoid bone in skull base its an exocrine gland its a part of posterior cranial fossa passes through foramen rotundum Surrounded by sella turcica 8. Regarding Levator Ani which of the following statements is TRUE? Arterial blood supply is from internal iliac artery Arterial blood supply is from superior rectal artery Arterial blood supply is from inferior rectal artery Arterial blood supply is from superior gluteal artery Arterial blood supply is from inferior gluteal artery 9. The blood-testis barrier is formed by junctions between which type of cell? Sertoli Germ Leydig Myoid Morgagni 10. Which of the following muscles is contained within the superficial perineal pouch External sphincter muscle of urethra Deep transverse perineal muscle Ischiocavernosus muscle Compressor urethrae muscle Urethrovaginal sphincter 11. Regarding Levator Ani which of the following statements is TRUE? Innervation is derived from S3/S4 spinal nerves Innervation is derived from L5/S1 spinal nerves Innervation is derived from S1/S2 spinal nerves Is supplied by the superior rectal nerve Is supplied by the inferior gluteal nerve 12. Sertoli cells contain receptors to which hormone? FSH Testosterone Inhibin Oestradiol LH 13. What is the average anteroposterior distance of the female pelvic outlet? 11.5 cm 13 cm 7.5 cm 9 cm 10.5 cm 14. The rectus sheath is formed by which of the following? Rectus abdominus and pyramidalis aponeuroses aponeuroses of transversus abdominis, external and internal oblique External oblique and rectus abdominus aponeuroses Internal oblique and rectus abdominus aponeuroses aponeuroses of internal and external oblique 15. Where are the proximal and distal centriole located in a spermatozoa? Tail Head Middle Piece Neck End Piece 16. ADH increases the permeability of which part of the nephron? Descending loop of Henle Proximal convoluted tubule Distal convoluted tubule Collecting duct Ascending loop of Henle 17. The normal functional bladder capacity of a healthy human urinary bladder is approximately? 250ml 50ml 150ml 500ml 350ml 18. You are called to see a women after a prolonged labour with failed instrumental delivery converted to c-section. She complains of pins and needles to the left thigh. On examination the anterior left thigh including the anterior knee has reduced sensation and there is reduced power on testing knee extension (MRC grade 4 left vs 5 right). What is the likely diagnosis? Common peroneal palsy Obturator palsy Left L2 nerve palsy Femoral nerve palsy Genitofemoral nerve palsy 19. You have been asked to perform a pudendal nerve block on a patient by your consultant. The pudendal nerve is formed from which spinal segments? S3,S4 and S5 S2,S3 and S4 L3,L4,L5 and S1 S1 and S2 L5,S1 and S2 20. What is the average oblique diameter of the pelvic inlet according to the RCOG? 13.5 cm 12 cm 7.5 cm 9 cm 10.5 cm 21. The pudendal nerve travels through the greater sciatic foramen. What are its nerve root origins? L2-L5 S2 - S4 S4 & S5 S1 - S3 L5 & S1 22. Regarding lymph drainage of the breast where does the majority of lymph drain to? Interpectoral nodes Supraclavicular nodes Parasternal nodes Axillary nodes Mediastinal nodes 23. The testicular arteries are branches of what? Perineal artery Aorta Internal pudendal artery External Pudendal Internal iliac 24. What is the innervation to the sigmoid colon? T5-T9 T10/11 T12/L1 L1/L2 L2/L3 25. Growth hormone (GH) is structurally similar to which of the following hormones? Oxytocin Oestradiol Follicle Stimulating Hormone (FSH) Human Chorionic Gonadotrophin (HCG) human Placental Lactogen (hPL) 26. The zona glomerulosa produces which of the following hormones? Cortisol Aldosterone Dopamine Somatostatin Calcitonin 27. Which of the following is typical of Conn's Syndrome? hypocalcaemia, hypokalaemia & hypertension hypocalcaemia, hyperkalaemia & hypertension hypercalcaemia, hyperkalaemia & hypotension hypocalcaemia, hyperkalaemia & hypotension hypocalcaemia, hypokalaemia & hypotension 28. Which of the following changes would you expect in pregnancy? Increased TSH, Increased Total T3 and T4 Increased TSH Decreased Total T3 and T4 Decreased TSH Increased Total T3 and T4 Decreased TSH Decreased Total T3 and T4 No change TSH Increased Total T3 and T4 29. What is the definition of puberty in girls? Development of pubic hair Development of secondary sexual characteristics Reaching stage 2 of breast development Start of menses Becoming capable of sexual reproduction 30. A deletion on chromosome 16 is associated with which of the following Alpha Thalassemia Beta Thalassemia Delta Thalassemia Sickle Cell Anaemia Spherocytosis 31. What is the role of DHEA produced by the fetal adrenal glands? Stimulate formation of cholesterol Stimulate placenta to form oestragen Stimulate development of the Thymus Stimulate gonadal development of the fetus None of the above 32. What percentage of testosterone is unbound (free) in men? 25-30% 15-20% 5-10% 1-3% 0.1% 33. Thyroid stimulating hormone (TSH) is inhibited by which hormone? Thyrotropin-releasing hormone (TRH) Growth hormone-releasing hormone (GHRH) Prolactin Follicle-stimulating hormone (FSH) Somatostatin 34. What percentage of pregnancies are affected by hypothyroidism (including subclinical hypothyroidism)? 10% 5% 2.5% 1% <0.5% 35. Aromatase is key to Estradiol production in the ovaries. Which of the following statements is true? FSH induces the theca cells to make aromatase LH induces the theca cells to make aromatase LH induces the granulosa cells to make aromatase FSH induces the granulosa cells to make aromatase Progesterone induces the granulosa cells to make aromatase 36. Where is fetal DHEA produced? Hypothalamus Thymus Pineal Adrenals Anterior pituitary 37. Beta and Delta Thalassemia are associated with abnormalities to which chromosome Chromosome 6 Chromosome 11 Chromosome 16 Chromosome 18 X Chromosome 38. Whilst reviewing a 34 year old patient with amenorrhoea in clinic they tell you they have gained over 10kg in weight in the past 8 weeks and have noticed worsening acne. Routine bloods taken that morning show a random glucose 11.1mmol/l, normal thyroid function tests and negative pregnancy test. BP is 168/96 mmHg. You suspect Cushing's. What would the most appropriate investigation be to conform the diagnosis? Random serum ACTH Plasma Corticotrophin Releasing Hormone Morning urinary cortisol Dexamethasone suppression test 9am serum cortisol 39. You review a 58 year old patient in clinic. She asks what the results of her recent DEXA scan are. You note her hip BMD hip T-score is -1.4. You note she has a history of olecranon fracture 4 years ago. What is her classification according to WHO criteria? Normal bone density Osteopenia Severe Osteopenia Osteoporosis Severe Osteoporosis 40. Which one of the following options best describes glycogen storage and glucose utilisation in pregnancy? There is decreased glycogen storage and decreased utilisation of peripheral glucose There is increased glycogen storage and increased utilisation of peripheral glucose There is increased glycogen storage and decreased utilisation of peripheral glucose There is decreased glycogen storage and increased utilisation of peripheral glucose There is no change in glycogen storage or utilisation of peripheral glucose 41. Which one of the following options best describes fasting glucose concentrations during pregnancy? Fasting glucose concentrations are 80 to 90% higher during pregnancy Fasting glucose concentrations are 10 to 20% higher during pregnancy Fasting glucose concentrations are 80 to 90% lower during pregnancy Fasting glucose concentrations are 10 to 20% lower during pregnancy There is no change in fasting glucose concentrations during pregnancy 42. Which one of the following options best describes the thyroid gland during pregnancy? The size of the thyroid gland is increased and there is a decrease in thyroxine‐binding globulin levels The size of the thyroid gland is increased and there is an increase in thyroxine‐binding globulin levels The size of the thyroid gland is unchanged and there is a decrease in thyroxine‐binding globulin levels The size of the thyroid gland is unchanged and there is an increase in thyroxine‐binding globulin levels The size of the thyroid gland is unchanged and there is no change in thyroxine‐binding globulin levels 43. Which one of the following options best describes insulin in pregnancy? There is increased insulin secretion and an early rise in insulin sensitivity followed by progressive insulin resistance There is increased insulin secretion and an early fall in insulin sensitivity followed by progressive insulin resistance There is decreased insulin secretion and an early rise in insulin sensitivity followed by progressive insulin resistance There is decreased insulin secretion and an early fall in insulin sensitivity followed by progressive insulin resistance There is no change in insulin secretion or insulin sensitivity 44. In the third trimester of pregnancy what is the daily calcium requirement of the fetus? 50 mg 100 mg 200 mg 500 mg 800 mg 45. Which one of the following options best describes testosterone concentrations in pregnancy? Serum total testosterone concentrations are increased as a resultof a six fold increase insex hormone‐binding globulin Serum total testosterone concentrations are increased as a resultof a sixfold decrease in sex hormone‐binding globulin Serum total testosterone concentrations are decreased as a result of a sixfold increase in sex hormone‐binding globulin Serum total testosterone concentrations are decreased as a result of a sixfold decrease in sex hormone‐binding globulin There is no change in serum total testosterone concentrations 46. Which one of the following options best describes triglyceride concentrations in pregnancy? The increase in triglycerides results from decreased hepatic lipase activity and decreased lipoprotein lipase activity The increase in triglycerides results from decreased hepatic lipase activity and increased lipoprotein lipase activity The increase in triglycerides results from increased hepatic lipase activity and decreased lipoprotein lipase activity The increase in triglycerides results from increased hepatic lipase activity and increased lipoprotein lipase activity There is no change in triglyceride concentrations 47. In cellular biology, which one of the following organelles 'reads' the mRNA and builds protein? Endoplasmic reticulum Golgi apparatus Ribosomes Lysosomes Nucleolus 48. In cellular biology, which one of the following organelles contains enzymes capable of digesting cells and cellular material? Endoplasmic reticulum Lysosomes Nucleolus Golgi apparatus Ribosomes 49. Which one of the following options best describes insulin resistance and lipolysis in pregnancy? Insulin resistance and the relative hyperglycaemia in pregnancy leads to decreased lipolysis Insulin resistance and the relative hyperglycaemia in pregnancy leads to increased lipolysis There is no change in lipolysis during pregnancy Insulin resistance and the relative hypoglycaemia in pregnancy leads to increased lipolysis Insulin resistance and the relative hypoglycaemia in pregnancy leads to decreased lipolysis 50. In the muscle fibre, which of the following is the actual length of myosin? A‐band H‐zone M‐line I‐band Sarcomere 51. An 81‐year‐old woman has undergone urethral catheterisation for acute urinary retention. Initially an 800 ml residual of urine was passed. Since catheterisation she has passed in excess of 500 mls of urine per hour. Which one of the following is the most likely electrolyte disturbance in this scenario? High potassium, high sodium, high bicarbonate High chloride, low bicarbonate Low chloride, low sodium Low potassium, low chloride, high bicarbonate Low potassium, low sodium, low chloride, low bicarbonate 52. In the muscle fibre, which of the following is the distance between two Z‐lines? A‐band H‐zone M‐line I‐band Sarcomere 53. In cellular biology, which one of the following organelles is involved in modification of lipids and proteins with storage of material prior to export out of the cell? Endoplasmic reticulum Lysosomes Nucleolus Golgi apparatus Ribosomes 54. Which one of the following statements concerning breast cancer is correct? Alpha‐fetoprotein is typically raised above normal A GP with 2,500 patients will see on average 2 new cases per year The five year survival of all patients with breast cancer is less than 50% The incidence has been shown to be higher in women who have had previous bilateral oophorectomy for non‐malignant disease Surgery has been shown to improve survival rates more than radiotherapy 55. Which of the following statistical terms best describes the sum of all the values divided by the number of values? Median Standard deviation Mean Standard error Mode 56. Which of the following statistical terms best describes the spread of estimates of sample means around the true population mean? Mode Standard error Standard deviation Median Mean 57. Which of the following statistical terms best describes the most frequent value? Mode Mean Standard deviation Standard error Median 58. With regard to statistics which one of the following is true? The standard deviation (SD) is less than the standard error of the mean (SEM) The SD equals the SEM in non‐parametric tests The SEM determines the accuracy of measurement of the observations SD = SEM/√n The SD is a measure of observation variability 59. Which of the following statistical terms best describes the mid value when all values are listed in ascending order? Standard error Standard deviation Mode Median Mean 60. Which of the following is correct in statistics? A normally distributed population, 95 per cent of the values fall in the range of the mean plus or minus one standard deviation Variance is equal to the square‐root of the standard deviation Standard error and standard deviation (SD) are synonymous The statement "p is less than 0.01" means that there is less than 1% likelihood of an event having occurred by chance The chi‐squared test applies only to parametric data 61. Which of the following is correct concerning the standard deviation of a group? Is numerically lesser than the standard error of the mean Is a valid statistical parameter for observations that have a skewed distribution Is the square of the variance Is a measure of the scatter of observations about the mean Can be used for the calculation of chi square 62. Which of the following statistical terms best describes the measure of spread of values around the mean? Standard error Standard deviation Mean Median Mode 63. Which of the following is correct in comparing confidence intervals with P values? Confidence intervals refer to the target population 95% confidence intervals are equivalent to a P value of 0.95 The confidence interval is approximately equal to the standard deviation The P value measures how clinically significant a statistical result is As the sample size decreases, the confidence interval will decrease 64. A diagnostic test has a sensitivity of 90% and a specificity of 95%. Based on this, which of the following is correct? 10% of positive tests are false positive The test is likely to be useful for general screening 5% of negative tests are false negative Sensitivity is equal to true positives/(true positives + false negatives) Sensitivity indicates the test will be negative in disease 65. In a case‐control study, 10/127 patients in the exposed group, and 4/253 in the unexposed group developed the condition. Which one of the following would be the standard methods of reporting the results? Median, range, and interquartile ranges Rate and 95% confidence interval Mean, standard deviation, and 95% confidence intervals Risk difference and 95% confidence interval Odds ratio and standard error 66. Which of the following is correct if a characteristic is normally distributed in a population? The median will be less than the mean The mean will be less than the mode The numbers of individuals above and below the mean will be equal 20% of individuals will be more than two standard deviations from the mean This implies that most of the population are normal individuals 67. In a set of values which of the following is correct? Having a skewed distribution, the arithmetic mean, the mode and the median are equal The median is the value that occurs the most frequently Of a normally distributed variable, the probability of attaining a value higher than two standard deviations above the mean is approximately 1 in 4 (p = approx. 0.25) Having a normal distribution, approximately 95% of the values will lie within the range between mean +2 standard deviations and mean −2 standard deviations The mode is that point on the scale of measurement above which lie exactly half the values and below which lie the other half 68. A cohort study suggests a statistical link between drinking a specific local herbal tea and the development of oesophageal cancer. Which one of the following would suggest that the link is causative? The finding of similar odds ratios for osteoarthritis in thesame environment The finding of similar results in a number of studies The finding that increasing consumption is associated with adecreased rate of disease The finding of a number of different histological types ofoesophageal carcinoma in the cluster An odds ratio of 2:1 69. What is the likely cause of an alpha fetoprotein (AFP) concentration of 300 mU/L (reference range <25 mU/L)? Colonic carcinoma with hepatic metastases Cirrhosis of the liver Carcinoid syndrome Orchitis Hepatoma 70. Hormones synthesised by the kidney include which of the following? Aldosterone Angiotensin II 1,25 dihydroxycholecalciferol Cortisol Angiotensin I 71. Which one of the following substances does not increase the capillary permeability in acute inflammation? Histamine Bradykinin Prostacycline Angiotensin Serotonin 72. Exudative ascites occurs in which of the following? Hepatic failure Congestive cardiac failure Peritoneal malignancy Constrictive pericarditis Nephrotic syndrome 73. Hyperkalaemia occurs in association with which of the following? Hormone‐secreting tumours of the bronchus Chronic diarrhoea Type IV renal tubular acidosis Hypoparathyroidism Primary hyperaldosteronism 74. The metabolic response to trauma causes a decrease in which of the following? Growth hormone Anti‐diuretic hormone Insulin secretion Glucagon secretion Urine osmolality 75. Which one of the following has a lower concentration in the cerebrospinal fluid (CSF) than plasma? Magnesium Chloride Bicarbonate Sodium Glucose 76. Which of the following statements regarding blood groups and blood products is true? Normal oxygen affinity is restored within 6‐12 hours of transfusion Group A, rhesus negative is the universal donor blood The ABO system is inherited in an autosomal recessive pattern The volume of a unit of packed cells is 350 +/− 20 ml Stored whole blood contains the normal concentration of clotting factors 77. Which of the following substances is correctly paired with the disease that ensues as a result of deficiency? Ascorbic acid ‐ night blindness Niacin ‐ beriberi Folates ‐ sprue Cyanocobalamin ‐ microcytic anaemia Thiamine ‐ pellagra 78. Which of the following is true regarding C‐reactive protein (CRP)? Is produced primarily in the affected tissue Is functionally analogous to immunoglobulin G (IgG) Is increased when a patient is taking non‐steroidal anti‐inflammatory drugs (NSAIDs) Synthesis is initiated by the release of adrenocorticotropic hormone (ACTH) Shows a less intense increase than the erythrocyte sedimentation rate (ESR) in acute inflammation 79. Concentrations of this hormone peak in the first trimester and rise again at term Progesterone Human chorionic gonadotrophin Human placental lactogen E Progest Inhibin A Activin 80. Which one of the above is not readily transferred across the placenta? Amino acids Thyroxine Ca2+ Glucose IgG 81. Venous drainage of the right ovary Superior mesenteric vein Inferior vena cava Left renal vein Inferior mesenteric vein Right renal vein 82. Placental hormone which is produced by the syncytiotrophoblast but not by the cytotrophoblast in vivo Human chorionic thyrotropin Human placental lactogen Oestriol Human chorionic gonadotrophin Inhibin 83. Monozygotic twins cannot have this type of placentation Dichorionic monoamniotic Monochorionic monoamniotic Dichorionic diamniotic Monochorionic diamniotic None of the above 84. Is used by the placenta to produce oestrogens DHEA-sulphate Cholesterol Cortisol Testosterone Progesterone 85. Dizygotic twins Are less common than monozygotic twins Can share the same placenta Can be monochorionic Can share the same chorionic sac Have no more resemblance than siblings of different ages 86. Which one of the above is readily transferred across the placenta? Calcitonin Testosterone Parathyroid hormone IgM Vitamin D 87. The fetal component of the placental bed Endovascular trophoblasts Extra-villous trophoblasts Villous and endovascular trophoblasts Endovascular and extra-villous trophoblasts Villous and extra-villous trophoblasts 88. The volume of amniotic fluid at term 100-150 ml 300-400 ml 2000-3000 ml 200-250 ml 800-1000 ml 89. With respect to the structure of DNA Nucleotides do not contain sugar molecules Phosphate groups are found in RNA but not DNA DNA contains the base uracil Nucleotides contain a nitrogenous base Bases are held together by 3-5-phosphodiester bonds 90. A 23 year old woman and her 24 year old partner have been referred for genetic counseling. One of them carries a 13q 21q balanced translocation. There is no increase in risk because the translocation is balanced The risk of Down’s syndrome in their offspring is identical regardless of the sex of the carrier If the female is the carrier of the translocation, all her offspring will have Down’s syndrome All pregnancies will have an abnormality because of an autosomal monosomy If the male is the carrier of the translocation, his offspring have a 1-3% risk of having Down’s syndrome 91. Autosomal dominant traits / conditions Have a vertical pedigree pattern Affect males more often than females Are expressed in homozygous but not heterozygous individuals Tend to have the same disease severity in different individuals Typically have a maternal age effect with respect to the incidence of new mutations 92. DNA replication Occurs during translation Occurs during transcription Requires separation of the double helix by DNA polymerase Is semi-conservative Occurs with the new DNA chain synthesized in the 3 prime to 5 prime direction 93. With respect to the structure of chromosomes The centromere is formed from chromatin fibres coiled around the DNA double helix The DNA double helix coils around non-histone proteins to form chromatin fibres One in three chromosomes do not have a centromere Chromatine fibres are coiled around histone beades to form the chromosome The DNA double helix is coiled around spherical histone beads to form nucleosomes 94. Reciprocal translocations Carry a 1-10% risk of phenotypic abnormality in the individual Are also called Robertsonian translocations Are always balanced Most commonly involve chromosome 21 Usually involve acrocentric chromosomes 95. Which disease is not an autosomal dominant condition? Von Willebrand’s disease Alpha thalassaemia Tuberous sclerosis Hereditary spherocytosis Myotonic dystrophy 96. Autosomal dominant conditions The offspring of an affected individual will either inherit the condition or be normal Are transmitted from male to female and from female to male Have a horizontal pedigree pattern The offspring of an affected individual will either have the condition or be a carrier The offspring of an affected individual have a 1 in 4 chance of having the condition 97. A 24 year old woman attends the antenatal clinic at 10 weeks gestation. She is known to have Von Willebrand’s disease. There is a 1 in 2 chance that her offspring would be a carrier of the disease Her partner should be tested for the disease If she is carrying a male fetus, there is a 100% chance that he would inherit the disease If she is carrying a female fetus, there is a 1 in 2 chance that she would be a carrier of the disease There is a 1 in 2 chance that her offspring would inherit the disease 98. Which one is not an autosomal recessive condition? Phenylketonuria Sickle cell disease Adrenogenital syndrome Cystic fibrosis Huntington’s disease 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
