Chapter 1: Structure and Function of the Genome Questions
- 1.
How many pairs of autosome chromosomes does each adult possess?
- A.
11
- B.
22
- C.
23
- D.
44
- E.
46
- A.
- 2.
What is the most common process used for identifying chromosomes in the lab?
- A.
Geisma stain
- B.
PCR
- C.
FISH
- D.
Leishman stain
- E.
Q banding
- A.
- 3.
How many possible combinations of DNA are there?
- A.
22
- B.
46
- C.
64
- D.
82
- E.
108
- A.
- 4.
Which of the following is a base pair in DNA?
- A.
Cytosine and thymine
- B.
Adenine and guanine
- C.
Adenine and cytosine
- D.
Thymine and guanine
- E.
Cytosine and guanine
- A.
- 5.
Which of the following is not a prerequisite for DNA replication?
- A.
DNA template
- B.
Oxygen
- C.
Free DNA nucleotides
- D.
DNA polymerase
- E.
Primer
- A.
- 6.
Which form of cell division results in haploid cells?
- A.
Mitosis
- B.
Meiosis
- C.
Splicing
- D.
Translocation
- E.
Transcription
- A.
- 7.
What is one of the roles of mitochondrial DNA?
- A.
Confirming identity
- B.
Confirming maternal origins
- C.
Confirming paternal origins
- D.
Predicting familial bowel cancer
- E.
Predicting familial pancreatic cancer
- A.
- 8.
Who first proposed the laws of disease inheritance patterns?
- A.
Mendal
- B.
Crick
- C.
Watson
- D.
Franklin
- E.
Sanger
- A.
- 9.
What procedure occurs by amplifying an RNA sequence to generate enough copies to visualise or manipulate?
- A.
FISH
- B.
PCR
- C.
Southern blot
- D.
Western Blot
- E.
RT PCR
- A.
- 10.
What is the basic principle of DNA electrophoresis?
- A.
DNA molecules are slightly negatively charged and hence, under the right conditions, will migrate towards a buffer.
- B.
DNA molecules are slightly negatively charged and hence, under UV conditions, will migrate towards a positive charge.
- C.
DNA molecules are slightly negatively charged and hence, under the right conditions, will migrate towards a positive charge.
- D.
DNA molecules are slightly positively charged and hence, under the right conditions, will migrate towards a negative charge.
- E.
DNA molecules are slightly positively charged and hence, under UV conditions, will migrate towards a negative charge.
- A.
- 11.
Which type of blot is used for protein analysis?
- A.
Western
- B.
Eastern
- C.
Southern
- D.
Northern
- E.
Hybrid
- A.
Chapter 2: Clinical Genetics Questions
- 1.
Patau’s syndrome is a trisomy of which chromosome?
- A.
18
- B.
13
- C.
20
- D.
21
- E.
15
- A.
- 2.
Which trisomy will not survive to birth?
- A.
18
- B.
13
- C.
20
- D.
21
- E.
X
- A.
- 3.
Which of the following syndromes is an example of monosomy?
- A.
Edwards’
- B.
Patau’s
- C.
Down’s
- D.
Turner
- E.
Jenner
- A.
- 4.
Following up a patient after her surgical management of miscarriage, the histopathology describes a partial hydatidiform molar pregnancy. What type of numerical disorder of the chromosomes is this?
- A.
Aneuploidy
- B.
Polyploidy
- C.
Monosomy
- D.
Trisomy
- E.
Mixoploidy
- A.
- 5.
Which of the following is NOT a characteristic of DiGeorge syndrome (microdeletion 22q)?
- A.
Cleft palate
- B.
Autism
- C.
Congenital heart problems
- D.
Moon face
- E.
Hypoparathyroidism
- A.
- 6.
Which of the following characterise ring chromosome disorders?
- A.
Intellectual disability, normal life expectancy
- B.
Seizures, cleft palate
- C.
Intellectual disability, cleft palate
- D.
Seizures, normal life expectancy
- E.
Intellectual disability, seizures
- A.
- 7.
Which of the following is NOT an example of a single gene mutation at DNA level?
- A.
Substitution
- B.
Duplication
- C.
Inversion
- D.
Insertion
- E.
Deletion
- A.
- 8.
What type of mutation is described as mutation ‘occurring when single base pair substitutions cause the generation of a premature stop codon’?
- A.
Nonsense
- B.
Silent
- C.
Mistake
- D.
Missense
- E.
Frameshift
- A.
- 9.
Which of the following is not an autosomal dominant disease?
- A.
Huntington’s
- B.
Cystic fibrosis
- C.
Marfan
- D.
Tuberose sclerosis
- E.
Osteogenesis imperfecta
- A.
- 10.
A couple are both known to be carriers for an autosomal recessive condition. When planning their pregnancy, which of the following statements is correct?
- A.
75% risk of having an affected child
- B.
100% chance the child is a carrier
- C.
75% chance the child is not a carrier
- D.
66% chance unaffected sibling of an affected child will be a carrier
- E.
100% chance child will be affected
- A.
- 11.
Which of the following is not an autosomal recessive disease?
- A.
Phenylketonuria
- B.
Cystic fibrosis
- C.
Congenital adrenal hyperplasia
- D.
Neurofibromatosis type 1
- E.
Usher syndrome
- A.
Chapter 3: Embryology Questions
- 1.
Which of the following best describes the loss of ovarian follicles that occurs after birth?
- A.
Apoptosis
- B.
Necrosis
- C.
Hypoplasia
- D.
Atresia
- E.
Aplasia
- A.
- 2.
A 37-year-old woman asks what dose of folic acid she should be taking antenatally to prevent neural tube defects. Which of the following is not an indication for 5 mg folic acid?
- A.
BMI >30
- B.
Age >35
- C.
Use of anti-epileptic medication
- D.
Thalassaemia
- E.
Diabetes mellitus
- A.
- 3.
Where does the majority of fertilisation take place?
- A.
Fimbria
- B.
Infundibulum
- C.
Ampulla
- D.
Isthmus
- E.
Fundus of the uterus
- A.
- 4.
Compaction is defined as a change in the embryo shape that leads to the formation of:…
- A.
The morula
- B.
The blastocoele
- C.
The trophoblast
- D.
The cytotrophoblast
- E.
The syncytiotrophoblast
- A.
- 5.
Sertoli cells release
- A.
Progesterone
- B.
Oestrogen
- C.
Testosterone
- D.
Anti-müllerian hormone
- E.
Follicular stimulating hormone
- A.
- 6.
The ligamentum venosum is a remnant of
- A.
Umbilical vein
- B.
Umbilical artery
- C.
Ductus venosus
- D.
Ductus arteriosus
- E.
Ligamentum teres
- A.
- 7.
Which of the pharyngeal arches is associated with the glossopharyngeal nerve?
- A.
1st arch
- B.
2nd arch
- C.
3rd arch
- D.
4th arch
- E.
6th arch
- A.
- 8.
A 41-year-old pregnant woman receives her combined screening result as high risk for trisomy 21. She is offered amniocentesis. Which cells obtained from the amniotic fluid are typically cultured for karyotyping?
- A.
Epithelial cells
- B.
Amniotic cells
- C.
Glial cells
- D.
Fibroblasts
- E.
Red blood cells
- A.
- 9.
Regarding the development of the urogenital system, the bladder and urethra are derived from:
- A.
The primitive streak
- B.
The ureteric bud
- C.
The genital tubercle
- D.
The mesonephric ducts
- E.
The primate urogenital sinus
- A.
- 10.
Regarding the development of the alimentary system, the hindgut is supplied by
- A.
The superior mesenteric artery
- B.
The inferior mesenteric artery
- C.
The coeliac trunk
- D.
The splenic artery
- E.
The carotid artery
- A.
- 11.
The mesoderm gives rise to all of the following except
- A.
Muscles
- B.
Connective tissue
- C.
Reproductive system
- D.
Blood vessels
- E.
Nervous system
- A.
Chapter 4: Fetal and Placental Physiology Questions
- 1.
Following delivery, umbilical arteries constrict under the influence of:
- A.
Serotonin and thromboxane A 2
- B.
Serotonin and prostaglandins
- C.
Dopamine and thromboxane A 2
- D.
Serotonin and nitric oxide
- E.
Progesterone and prostaglandins
- A.
- 2.
Following delivery, the umbilical vein degenerates to become the:
- A.
Ligamentum arteriosum
- B.
Ligamentum flavum
- C.
Ligamentum teres hepatis
- D.
Ligamentum teres
- E.
Ligamentum venosum
- A.
- 3.
In the context of congenital heart disease, patency of the ductus arteriosus can be maintained with:
- A.
Bradykinins
- B.
Endothelin
- C.
Acetylcholine
- D.
Prostaglandin-E
- E.
Oxygen
- A.
- 4.
At what gestation do diaphragmatic breathing movements begin in the fetus?
- A.
From 3 to 4 weeks
- B.
From 5 to 16 weeks
- C.
From 16 to 25 weeks
- D.
From 26 weeks
- E.
From 32 weeks
- A.
- 5.
After birth, the GFR reaches adult levels by:
- A.
Age 1
- B.
Age 2
- C.
Age 5
- D.
Age 12
- E.
Age 16
- A.
- 6.
Fetal heart rate variability is best described as:
- A.
Fluctuations in the fetal heart-rate baseline
- B.
Transient increases in the fetal heart rate
- C.
Transient decreases in the fetal heart rate
- D.
A drop in the fetal heart rate to below 100 beats/min
- E.
A rise in the fetal heart rate to above 160 beats/min
- A.
- 7.
A 32-year-old woman is 24 weeks pregnant and presents with a gush of fluid. On examination, she is found to be 3 cm dilated. Which of the following should be administered within 24 hours of delivery to reduce the risk of cerebral palsy?
- A.
Corticosteroids
- B.
Progesterone
- C.
Nifedipine
- D.
Magnesium sulphate
- E.
Surfactant
- A.
- 8.
A patient experiencing tocophobia from a previous traumatic birth asks you what proportion of cerebral palsy cases are attributed to intrapartum fetal hypoxia:
- A.
10%
- B.
20%
- C.
30%
- D.
50%
- E.
60%
- A.
- 9.
In utero, fetal temperature is regulated by the:
- A.
Fetal liver
- B.
Keratinised fetal skin
- C.
Amniotic fluid
- D.
Fetal gut
- E.
Placenta
- A.
- 10.
Hypoxic-ischaemic encephalopathy is defined as:
- A.
Central nervous system dysfunction secondary to prolonged hypoxia.
- B.
Bleeding inside or around the ventricles of the brain.
- C.
A softening of white brain tissue near the ventricles.
- D.
A group of disorders that involve a motor disability.
- E.
Weakness or paralysis of muscles that can occur with injury to the brachial plexus.
- A.
- 11.
A woman is 34 weeks pregnant and presents with increased leg swelling, headaches and visual symptoms. Her blood pressure is 150/95, and she is diagnosed with pre-eclampsia. By what gestational age is remodelling of the spiral arteries completed?
- A.
6 weeks
- B.
10 weeks
- C.
14 weeks
- D.
24 weeks
- E.
34 weeks
- A.
Chapter 5: Applied Anatomy Questions
- 1.
Which of the following is NOT a characteristic of a somatic nerve?
- A.
The afferent pathways transmit sensor information.
- B.
The efferent pathways innervate skeletal muscles.
- C.
They cross the midline.
- D.
The sensory cells are derived from the neural crest.
- A.
- 2.
Which of the following is NOT a sympathetic effect?
- A.
Increase in heart rate
- B.
Constriction of detrusor muscle
- C.
Dilation of bronchial tree
- D.
Relaxation of the ciliary muscle
- E.
Dilation of coronary arteries
- A.
- 3.
What structures make up the brain stem?
- A.
Cerebral hemispheres, lateral ventricle, midbrain
- B.
Aqueduct of Sylvius, forebrain, pons
- C.
Pons, medulla, forebrain
- D.
Pons, medulla, midbrain
- E.
Cerebral hemispheres, pons, medulla
- A.
- 4.
Pituitary tumours usually grow upwards to cause which symptom?
- A.
Temporal hemianopia
- B.
Dysphagia
- C.
Expressive dysphasia
- D.
Hemiplegia
- E.
Diplopia
- A.
- 5.
Which of the following statements about the lymphatics vessels is incorrect?
- A.
The function of the lymphatics is to remove fluid and debris from the extracellular system.
- B.
This fluid is returned to the venous circulation.
- C.
The lymphatics in the limbs are superficial.
- D.
The thoracic duct drains lymph from the upper half of the body.
- E.
The right thoracic duct drains the right thorax, upper limb, head and neck.
- A.
- 6.
What tissues do the deep inguinal lymph nodes drain?
- A.
Vulva, clitoris
- B.
Superficial inguinal nodes, deep part of leg
- C.
Clitoris, superficial inguinal nodes, vulva
- D.
Superficial inguinal nodes, vulva, deep part of leg
- E.
Deep part of leg, superficial inguinal nodes, clitoris
- A.
- 7.
At which point does the aorta divide into the common iliac arteries?
- A.
L3
- B.
L4
- C.
T12
- D.
L2
- E.
L5
- A.
- 8.
Which of these is NOT a paired arterial branch of the aorta?
- A.
Phrenic arteries
- B.
Splenic arteries
- C.
Lumbar segmental arteries
- D.
Renal arteries
- E.
Gonadal arteries
- A.
- 9.
Which of the following does not drain into the IVC?
- A.
Hepatic veins
- B.
Left renal vein
- C.
Left gonadal vein
- D.
Right renal vein
- E.
Right gonadal vein
- A.
- 10.
The pelvis is made up of the sacrum, ischium, pubis and which other bone?
- A.
Coccyx
- B.
Ilium
- C.
L5 vertebrae
- D.
L4 vertebrae
- E.
Femoral head
- A.
- 11.
What is the name of this diagrammatic representation of a pelvic shape (see Fig. 5.8 )?
- A.
Android
- B.
Gynaecoid
- C.
Anthropoid
- D.
Platypoid
- E.
Rachitic
- A.
- 12.
Which pelvic ligament runs from the lower aspect of the sacrum to the ischial spine?
- A.
Sacrospinous
- B.
Sacroilious
- C.
Iliolumbar
- D.
Sacrotuberous
- E.
Lumbosacral
- A.
- 13.
What is the average diameter of the fetal skull at vertex presentation?
- A.
9.5 cm
- B.
10 cm
- C.
10.5 cm
- D.
11 cm
- E.
11.5 cm
- A.
- 14.
‘Submentobregmatic’ refers to which fetal presentation?
- A.
Occipital
- B.
Face
- C.
Brow
- D.
Vertex
- E.
Shoulder
- A.
- 15.
Which fetal bone is highlighted in Fig. 5.10 ?
- A.
Parietal bone
- B.
Occipital bone
- C.
Frontal bone
- D.
Mandible
- A.
- 16.
Which structure does not lie in the transpyloric plane?
- A.
Duodenojejunal flexure
- B.
Renal hila
- C.
Neck of pancreas
- D.
Fundus of gallbladder
- E.
Liver edge
- A.
- 17.
Which important landmark lies at the plane of the iliac crests?
- A.
Pylorus of stomach
- B.
Bifurcation of the abdominal aorta
- C.
McBurney’s point
- D.
Termination of the spinal cord
- E.
Origin of the inferior mesenteric artery
- A.
Chapter 6: Pathology Questions
- 1.
Which of the following is a feature of apoptosis?
- A.
Cell swelling
- B.
Inflammation
- C.
Release of proinflammatory cytokines
- D.
Absence of tissue destruction
- E.
Disruption of normal tissue architecture
- A.
- 2.
Hyperplasia is defined as
- A.
Cytological changes associated with malignancy
- B.
Reversible increase in cell size
- C.
An increase in the number of cells in a tissue or organ
- D.
A reduction in the cell number within an organ or tissue
- E.
The process of new growth of cells
- A.
- 3.
Which of the following is an example of hypertrophy?
- A.
Postmenopausal changes to the endometrium
- B.
Changes to the uterus during pregnancy
- C.
Changes in the transformation zone of the cervix from columnar to squamous cells
- D.
Changes to breast glands during pregnancy and lactation
- E.
Cellular changes detected during a cervical smear test
- A.
- 4.
Which of the following is not a cytological feature of malignancy?
- A.
Abnormal nuclear shape
- B.
Abnormal mitosis
- C.
Cytological heterogeneity
- D.
Increased nuclear to cytoplasmic ratio
- E.
Abnormal differentiation
- A.
- 5.
Cervical intraepithelial neoplasia precedes cervical carcinoma by approximately how many years?
- A.
1 year
- B.
5 years
- C.
10 years
- D.
20 years
- E.
30 years
- A.
- 6.
A 29-year-old woman is seen in clinic with a 4-week history of postcoital bleeding. Which of the following is not a risk factor for cervical cancer?
- A.
HIV infection
- B.
Smoking
- C.
Number of sexual partners
- D.
Family history
- E.
Prolonged use of oral contraceptives
- A.
- 7.
The most carcinogenic sub-type of human papilloma virus (HPV) is:
- A.
HPV-16
- B.
HPV-18
- C.
HPV-31
- D.
HPV-33
- E.
HPV-35
- A.
- 8.
Which of the following dermatological conditions is most associated with vulval malignancy?
- A.
Lichen sclerosus
- B.
Lichen planus
- C.
Psoriasis
- D.
Candida infection
- E.
Lichen simplex
- A.
- 9.
Miscarriage occurs in what proportion of clinical pregnancies?
- A.
5%
- B.
15%
- C.
30%
- D.
50%
- E.
75%
- A.
- 10.
A woman is 18 weeks pregnant and presents with spotting and abdominal cramping. What is the commonest cause of late second-trimester spontaneous miscarriage?
- A.
Chromosomal abnormalities
- B.
Ascending genital tract infection
- C.
Urinary tract infection
- D.
Alcohol consumption
- E.
Antiphospholipid syndrome
- A.
- 11.
What percentage of partial hydatidiform pregnancies progress into choriocarcinoma?
- A.
0.5%
- B.
5%
- C.
15%
- D.
25%
- E.
50%
- A.
Chapter 7: Microbiology and Virology Questions
- 1.
Regarding gram-positive bacteria, which statement is false?
- A.
Gram-positive bacteria have a thick peptidoglycan layer.
- B.
Gram-positive bacteria stain blue or black.
- C.
Gram-positive bacteria have a complex outer membrane of lipoprotein and lipopolysaccharides.
- D.
Group B streptococcus is gram positive.
- E.
Gram-positive bacteria have teichoic acids present in their cell walls.
- A.
- 2.
Which of the following components within the structure of gram-positive bacteria can contribute to the development of toxic shock?
- A.
Exotoxins
- B.
Teichoic acids
- C.
Peptidoglycans
- D.
Phospholipids
- E.
Flagellin
- A.
- 3.
A woman is 34 weeks pregnant and presents with vomiting, diarrhoea and flu-like symptoms. Listeria monocytogenes is seen as:
- A.
Gram-positive rods
- B.
Gram-negative rods
- C.
Gram-positive cocci
- D.
Gram-negative cocci
- E.
Gram-positive spirillum
- A.
- 4.
A 22-year-old woman reports a change in her vaginal discharge and superficial dyspareunia following unprotected sex with a new partner 3 weeks ago. Which of the following is correct regarding Neisseria gonorrhoea?
- A.
N. gonorrhoea is gram positive.
- B.
N. gonorrhoea is a commensal of the genital tract.
- C.
Infection is asymptomatic in 10% of women.
- D.
N. gonorrhoea is an anaerobic organism.
- E.
It is a gram-negative diplococci bacteria.
- A.
- 5.
Which of the following viruses does not have oncogenic ability?
- A.
Human immunodeficiency virus
- B.
Human T-cell lymphotrophic virus type 1
- C.
Varicella zoster virus
- D.
Human papilloma viruses
- E.
Epstein–Barr virus
- A.
- 6.
Infection with which virus can lead to T-cell leukaemia?
- A.
Human immunodeficiency virus
- B.
Human T-cell lymphotrophic virus type 1
- C.
Varicella zoster virus
- D.
Human papilloma virus
- E.
Epstein-Barr virus
- A.
- 7.
Which of the following is a DNA virus?
- A.
Hepatitis A
- B.
Human immunodeficiency virus
- C.
Japanese B virus
- D.
Cytomegalovirus
- E.
Rubella
- A.
- 8.
The SARS-CoV-2 genome is:
- A.
Double-stranded DNA
- B.
Single-stranded DNA
- C.
Double-stranded RNA
- D.
Single-stranded RNA
- E.
Approximately 200,000 base pairs long
- A.
- 9.
A 27-year-old woman presents with an increase in thin grey-coloured vaginal discharge with an offensive fishy odour. Microscopy demonstrates clue cells. What is the most likely causative organism?
- A.
Staphylococcus aureus
- B.
Trichomonas vaginalis
- C.
Neisseria gonorrhoea
- D.
Candida albicans
- E.
Gardnerella vaginalis
- A.
- 10.
Which of the following is not routinely screened for as part-antenatal booking bloods?
- A.
Syphilis
- B.
Hepatitis B
- C.
Varicella zoster virus
- D.
Human immunodeficiency virus
- E.
Sickle cell disease
- A.
- 11.
Which of the following HPV subtypes can cause genital warts?
- A.
6 and 11
- B.
16 and 18
- C.
6 and 16
- D.
11 and 18
- E.
18 and 31
- A.
Chapter 8: Immunology Questions
- 1.
A 32-year-old woman presents with an acute asthma attack. Which immunoglobulin type binds to mast cells and basophils leading to release of histamine?
- A.
IgA
- B.
IgG
- C.
IgM
- D.
IgD
- E.
IgE
- A.
- 2.
A 37-week pregnant woman asks about the benefits of breastfeeding. Which immunoglobulin is found in mucosal secretions, such as breast milk?
- A.
IgA
- B.
IgG
- C.
IgM
- D.
IgD
- E.
IgE
- A.
- 3.
Which of the following immune cells stimulate naïve T cells?
- A.
Natural killer cells
- B.
Macrophages
- C.
Mast cells
- D.
Dendritic cells
- E.
Cytotoxic T cells
- A.
- 4.
In which part of the immunoglobulin structure is the antigen binding region found?
- A.
Variable light chain
- B.
Variable heavy chain
- C.
Variable light chain and heavy chain
- D.
Hinge region
- E.
Constant domain
- A.
- 5.
Which of the following immune cells destroy virally infected cells?
- A.
B cells
- B.
T cells
- C.
T-helper cells
- D.
Cytotoxic T cells
- E.
Mast cells
- A.
- 6.
Which of the following statement about the adaptive immune system is false? The adaptive immune system:
- A.
Is slow
- B.
Relies on memory
- C.
Is activated with re-exposure
- D.
Consists of B- and T-cell lymphocytes
- E.
Produces antibodies
- A.
- 7.
Haemolytic disease of the newborn occurs when…
- A.
Maternal Rhesus positive, fetus Rhesus positive
- B.
Maternal Rhesus positive, fetus Rhesus negative
- C.
Maternal Rhesus negative, fetus Rhesus positive
- D.
Maternal Rhesus negative, fetus Rhesus negative
- E.
All of the above
- A.
- 8.
Which of the following immunoglobulin subtypes can cross the placenta?
- A.
IgA
- B.
IgG
- C.
IgM
- D.
IgD
- E.
IgE
- A.
- 9.
Which of the following steps is in common in all of the complement pathways?
- A.
Binding of lectin to mannose on pathogens
- B.
Activation of C1 by antigen-antibody complexes
- C.
Cleavage of C3 into C3a and C3b
- D.
Binding of C3b directly with a microbe
- E.
Activation of C2
- A.
- 10.
Which of the following immune cells destroy neoplastically transformed cells?
- A.
B cells
- B.
T cells
- C.
T-helper cells
- D.
Cytotoxic T cells
- E.
Mast cells
- A.
- 11.
Which of the following is not a main function of antibodies?
- A.
To act as the B-cell receptor for antigens
- B.
To bind directly to toxins, viruses and other molecules, blocking their ability to bind to target cells
- C.
To recruit effector mechanisms to the target cell
- D.
To activate the complement system
- E.
To destroy viral infected cells
- A.
Chapter 9: Biochemistry Questions
- 1.
Which of the following statements about the cell nucleus is false?
- A.
The cells nucleus contains cytoplasm.
- B.
The cells nucleus contains the chromosomes.
- C.
The nucleus walls are made up of a lipid bilayer.
- D.
The nucleus may contain more than one nucleolus.
- E.
RNA is transported out of the nucleus.
- A.
- 2.
What is the function of ribosomes?
- A.
Oxidative phosphorylation
- B.
mRNA generation
- C.
Splicing of genomes
- D.
Catalysis and synthesis of proteins
- E.
Release of energy
- A.
- 3.
What type of collagen is predominantly found in the fetus?
- A.
Type 0
- B.
Type I
- C.
Type II
- D.
Type III
- E.
Type IV
- A.
- 4.
Where in the adult is albumin synthesised?
- A.
Liver
- B.
Kidneys
- C.
Adrenal glands
- D.
Lungs
- E.
Duodenum
- A.
- 5.
Which of the following amino acids cannot be synthesised in vivo?
- A.
Alanine
- B.
Aspartic acid
- C.
Asparagine
- D.
Cysteine
- E.
Arginine
- A.
- 6.
Glycolytic enzymes are found in which part of a cell?
- A.
Nucleus
- B.
Cell membrane
- C.
Cytoplasm
- D.
Mitochondria
- E.
Golgi apparatus
- A.
- 7.
Where does the citric acid cycle take place?
- A.
Golgi apparatus
- B.
Mitochondrian
- C.
Filament
- D.
Centriole
- E.
Endoplasmic reticulum
- A.
- 8.
Where are erythrocytes degraded?
- A.
Liver
- B.
Spleen
- C.
Adrenal glands
- D.
Bone marrow
- E.
Pancreas
- A.
- 9.
At which temperature are most enzymes destroyed?
- A.
100°C
- B.
80°C
- C.
60°C
- D.
40°C
- E.
20°C
- A.
- 10.
What is missing from the above equation describing a single substrate reaction?
<SPAN role=presentation tabIndex=0 id=MathJax-Element-1-Frame class=MathJax style="POSITION: relative" data-mathml='Enzyme+Substrate→Enzyme−Substratecomplex→Enzyme+’>𝐸𝑛𝑧𝑦𝑚𝑒+𝑆𝑢𝑏𝑠𝑡𝑟𝑎𝑡𝑒→𝐸𝑛𝑧𝑦𝑚𝑒−𝑆𝑢𝑏𝑠𝑡𝑟𝑎𝑡𝑒𝑐𝑜𝑚𝑝𝑙𝑒𝑥→𝐸𝑛𝑧𝑦𝑚𝑒+Enzyme+Substrate→Enzyme−Substratecomplex→Enzyme+
E n z y m e + S u b s t r a t e → E n z y m e − S u b s t r a t e c o m p l e x → E n z y m e +
- A.
Complex
- B.
Amino acid
- C.
Gas
- D.
Product
- E.
ATP
- A.
- 11.
In competitive enzyme inhibition, what happens to the V max when the Michaelis constant is increased?
- A.
It increases.
- B.
It remains constant.
- C.
It is doubled.
- D.
It is halved.
- E.
It is reduced.
- A.
Chapter 10: Physiology Questions
- 1.
Which of the following situations does not cause an increase in the anion gap?
- A.
Myeloma
- B.
Ketoacidosis
- C.
Lactic acidosis
- D.
Salicylate poisoning
- E.
Hypoalbuminaemia
- A.
- 2.
Which of the following shortens the QT interval?
- A.
Hypocalcaemia
- B.
Hypokalaemia
- C.
Rheumatic carditis
- D.
Digoxin
- E.
Citalopram
- A.
- 3.
What is the normal resting cardiac output in females?
- A.
3.5 L/min
- B.
4 L/min
- C.
4.5 L/min
- D.
5 L/min
- E.
5.5 L/min
- A.
- 4.
Which of the following regarding cardiac function in pregnancy is false?
- A.
Plasma volume increases.
- B.
Red cell mass increases.
- C.
Haematocrit increases.
- D.
Cardiac output increases.
- E.
Stroke volume increases.
- A.
- 5.
What is the maximum healthy blood pressure at term?
- A.
110/70 mmHg
- B.
120/80 mmHg
- C.
130/90 mmHg
- D.
145/95 mmHg
- E.
150/95 mmHg
- A.
- 6.
Which of the following acts as a vasodilator?
- A.
Endothelin
- B.
Angiotensin
- C.
Thromboxane
- D.
Nitric oxide
- E.
Oxytocin
- A.
- 7.
Levels of which clotting factors fall in pregnancy?
- A.
Fibrinogen and protein S
- B.
Fibrinogen and factor V
- C.
Factor V and factor VIII
- D.
Factor VIII and endogenous anticoagulant
- E.
Endogenous anticoagulant and protein S
- A.
- 8.
A 25-year-old woman who uses the combined oral contraceptive pill presents with shortness of breath and pleuritic chest pain. Which of the following would be consistent with a pulmonary embolism?
- A.
Respiratory acidosis
- B.
Respiratory alkalosis
- C.
Metabolic acidosis
- D.
Metabolic alkalosis
- E.
Normal acid-base balance
- A.
- 9.
How is cardiac output calculated?
- A.
Cardiac output = stroke volume × heart rate
- B.
Cardiac output = stroke volume × systolic blood pressure
- C.
Cardiac output = heart rate × systolic blood pressure
- D.
Cardiac output = systolic blood pressure − diastolic blood pressure
- E.
Cardiac output = stroke volume × diastolic blood pressure
- A.
- 10.
During pregnancy,
- A.
Ventilation decreases.
- B.
Tidal volume increases.
- C.
FEV 1 increases.
- D.
Peak flow rate increases.
- E.
Peak flow rate decreases.
- A.
- 11.
During pregnancy, bronchoconstriction is caused by:
- A.
Nitric oxide
- B.
Progesterone
- C.
Oxytocin
- D.
Prostaglandin E 2
- E.
Prostaglandin F 2
- A.
Chapter 11: Endocrinology Questions
- 1.
Steroid hormones are synthesised from:
- A.
Prostaglandins
- B.
Arachidonic acid
- C.
Cholesterol
- D.
Leukotrienes
- E.
Catecholamines
- A.
- 2.
Aldosterone secretion occurs in the:
- A.
Outer zona glomerulosa of the adrenal cortex
- B.
Middle zona fasciculata of the adrenal cortex
- C.
Inner zona reticularis of the adrenal cortex
- D.
Anterior pituitary
- E.
Posterior pituitary
- A.
- 3.
Arachidonic acid is a precursor molecule for:
- A.
Guanylyl cyclase
- B.
Prostaglandins
- C.
Nitric oxide
- D.
Cholesterol
- E.
Testosterone
- A.
- 4.
The pineal gland plays a role in producing the following hormone, which is involved in the regulation of the ‘body clock’ and puberty:
- A.
GnRH-associated peptide
- B.
Melatonin
- C.
Kisspeptin
- D.
Leptin
- E.
Dihydroepiandrostenedione
- A.
- 5.
The adenohypophysis secretes all of those below except for:
- A.
Luteinising hormone
- B.
Follicle-stimulating hormone
- C.
Thyroid-stimulating hormone
- D.
Oxytocin
- E.
Prolactin
- A.
- 6.
In females, what proportion of circulating testosterone is produced in the ovary?
- A.
<1%
- B.
5%
- C.
25%
- D.
50%
- E.
75%
- A.
- 7.
Leptin expression is increased by all the below except for:
- A.
Insulin
- B.
Food
- C.
Noradrenaline
- D.
Glucocorticoids
- E.
Oestrogen
- A.
- 8.
What is the average age of menarche in the United Kingdom?
- A.
11
- B.
12
- C.
13
- D.
14
- E.
15
- A.
- 9.
What is the average age of menopause in the United Kingdom?
- A.
48
- B.
49
- C.
50
- D.
51
- E.
52
- A.
- 10.
A 37-year-old woman presents with amenorrhoea for 1 year, accompanied with hot flushes and reduced libido. Which of the following blood tests, if taken on two occasions 4 to 6 weeks apart, can assist in the diagnosis?
- A.
Anti-müllerian hormone
- B.
FSH
- C.
Progesterone
- D.
Inhibin A
- E.
Inhibin B
- A.
- 11.
Which of the following statements about growth hormone is false?
- A.
Growth hormone is a 191 amino acid peptide.
- B.
Growth hormone is released from the anterior pituitary gland.
- C.
Growth hormone promotes fat lipolysis.
- D.
Growth hormone levels are increased by somatostatin.
- E.
Exercise stimulates growth hormone release.
- A.
Chapter 12: Drugs and Drug Therapy Questions
- 1.
What is the Henderson-Hasselbalch equation used to calculate?
- A.
The volume of plasma cleared of the drug in unit time
- B.
The rate at which a drug leaves its site of administration
- C.
The pH at which half the drug is in its ionised form
- D.
The ratio of ionised to non-ionised drug at each pH
- E.
The fractional extent to which a dose of drug reaches its site of action
- A.
- 2.
At what gestation is the risk of teratogenicity highest?
- A.
7–10 weeks
- B.
0–11 weeks
- C.
3–7 weeks
- D.
4–16 weeks
- E.
9–12 weeks
- A.
- 3.
What type of drug transport is described as the diffusion of the drug through the cell membrane along a concentration gradient by virtue of its lipid solubility?
- A.
Active
- B.
Passive
- C.
Transcellular
- D.
Transcapillary
- E.
Facilitated diffusion
- A.
- 4.
A patient is on MgSO 4 following an eclamptic seizure. She is noted to have respiratory depression, and MgSO 4 levels are high. What is the key contributory factor to this?
- A.
Oliguria
- B.
Pulmonary oedema
- C.
Tachycardia
- D.
Sedation
- E.
Anaemia
- A.
- 5.
Which of the following physiological changes of pregnancy does NOT affect drug metabolism?
- A.
Hyperemesis
- B.
Delayed gastric emptying
- C.
Increased α 1 -acid glycoprotein levels
- D.
Increased GFR
- E.
Decreased albumin concentrations
- A.
- 6.
A patient is taking 30 mg prednisolone. She wishes to breastfeed. What is the best advice to give her?
- A.
Do not breastfeed.
- B.
Breastfeed, but wait 2 hours until after the dose to feed the infant.
- C.
Breastfeed, but wait 4 hours until after the dose to feed the infant.
- D.
Breastfeed, but wait 6 hours until after the dose to feed the infant (use expressed milk in meantime).
- E.
Breastfeed, but wait 12 hours until after the dose to feed the infant (use expressed milk in meantime).
- A.
- 7.
A patient presents in threatened preterm labour. She is offered steroids. What % of the maternal dose of β-methasone will cross the placenta?
- A.
20
- B.
40
- C.
60
- D.
80
- E.
100
- A.
- 8.
Which of the following antiepileptic drugs is NOT teratogenic?
- A.
Sodium valproate
- B.
Carbamazepine
- C.
Phenobarbital
- D.
Lamotrigine
- E.
Phenytoin
- A.
- 9.
You are seeing a 25-year-old epileptic patient in clinic. She is 18 weeks pregnant and taking 100 mg lamotrigine/day. She has been fit free for 1 year and is feeling well. What advice will you give her regarding her medicine?
- A.
It will need stepwise increments as her pregnancy increases.
- B.
Levels do not need to be checked.
- C.
Her levels will need checking regularly during the pregnancy.
- D.
Stop taking the medicine as she has been fit-free for 1 year.
- E.
She will need dose reduced due to impaired clearance during pregnancy.
- A.
- 10.
You are in the early pregnancy unit scanning a patient who presented following referral from her GP with PV bleeding at 11 weeks. The scan shows a viable intrauterine pregnancy. In the consultation, she brings up that she has been struggling with hyperemesis, and taking a variety of antiemetics. She is suffering from a dry mouth, blurred vision and constipation. Which antiemetic is likely to be the cause of this?
- A.
Ondansetron
- B.
Domperidone
- C.
Cyclizine
- D.
Promethazine
- E.
None of the above
- A.
- 11.
Which antibiotic causes ‘grey baby syndrome’ and thus should be avoided in labour and the third trimester?
- A.
Streptomycin
- B.
Chloramphenicol
- C.
Tazocin
- D.
Nitrofurantoin
- E.
Gentamicin
- A.
Chapter 13: Physics in Obstetrics and Gynaecology Questions
For each of the questions below, please select the single most appropriate answer from the five options listed.
- 1.
What are the four defined modes of electrosurgery?
- A.
Cutting, diathermy, coagulation, cauterisation
- B.
Desiccation, cutting, coagulation, cauterisation
- C.
Coagulation, desiccation, cutting, fulguration
- D.
Faridation, coagulation, desiccation, cutting
- E.
Diathermy, cutting, coagulation, desiccation
- A.
- 2.
A surgeon applies diathermy forceps to an artery clip holding a 6 mm bleeding vessel. What is this an example of?
- A.
Direct coupling
- B.
Indirect coupling
- C.
Capacitive coupling
- D.
Direct application
- E.
Poor insulation
- A.
- 3.
What does LASER stand for?
- A.
Long Amplification by Stimulated Emission of Radiation
- B.
Low Amplification by Simulated Emission of Radiation
- C.
Light Amplification by Simulated Emission of Radiation
- D.
Light Amplification by Stimulated Emission of Radiation
- E.
Low Amplification by Stimulated Emission of Radiation
- A.
- 4.
Which of the below would show up as white on a T2-weighted MRI scan?
- A.
Fat- and water-containing tissues
- B.
Fluid-containing tissues
- C.
Fat-containing tissues
- D.
Water-containing tissues
- E.
Fluid- and water-containing tissues
- A.
- 5.
What is the absorbed dose of ionising radiation for a chest x-ray in a pregnant patient?
- A.
1 mGy
- B.
0.1 mGy
- C.
0.01 mGy
- D.
10 mGy
- E.
100 mGy
- A.
- 6.
Known side-effect(s) of ultrasound scans is/are…
- A.
Doppler Shift
- B.
Cavitation, heating, microsteaming
- C.
Cavitation, microsteaming, heating, cellular destruction
- D.
Cavitation, microsteaming
- E.
Cavitation, heating
- A.
- 7.
Listening to the fetal heartbeat is feasible due to which effect?
- A.
Sonic auscultation
- B.
Power velocity
- C.
Pulse reflection
- D.
Doppler shift
- E.
Colour flow
- A.
- 8.
Which best describes the ways that an ultrasound wave will react with tissues?
- A.
Reflection, diffraction, absorption, Doppler and scatter
- B.
Reflection, refraction, diffraction, absorption and scatter
- C.
Reflection, refraction, absorption and scatter
- D.
Reflection, refraction, diffraction and absorption
- E.
Reflection, refraction, diffraction, absorption and scatter
- A.
- 9.
A 16 weeks pregnant woman with a history of preterm birth attends an appointment for transvaginal ultrasound assessment of her cervical length. What is the frequency range for transvaginal ultrasounds?
- A.
2–6 MHz
- B.
7–9 MHz
- C.
20–60 MHz
- D.
70–90 MHz
- E.
2–15 MHz
- A.
- 10.
A 14 weeks pregnant woman has experienced abdominal pain and PV spotting. What is the frequency range for transabdominal ultrasounds?
- A.
2–6 MHz
- B.
7–9 MHz
- C.
20–60 MHz
- D.
70–90 MHz
- E.
2–15 MHz
- A.
- 11.
Acoustic impedance is best described as:
- A.
An estimate of mean velocity of flow within a vessel
- B.
The bending of waves around the corners of an obstacle
- C.
The ultrasound behaviour within a tissue
- D.
A phenomenon arising when a wave confronts an impediment with a diameter equivalent to its wavelength
- E.
The difference between transmitted and received frequency
- A.
Chapter 14: Statistics and Evidence-Based Health Care Questions
- 1.
A study is looking at whether all women in the population have regular periods. 34 women aged 18 to 24 were questioned, and it was found that all of them had periods at intervals of 26 to 42 days. The study therefore surmised that all women in the population had periods at 26 to 42 days. This is an example of:
- A.
Under-powered study
- B.
Type 1 error
- C.
Type 2 error
- D.
Unclear hypothesis
- E.
Multiple influence
- A.
- 2.
What is the definition of a type 2 error?
- A.
When ‘the sample’ used in your experiment fails to generate a significant result for your hypothesis, but there would not have been a significant result if you had performed the experiment on ‘the population’
- B.
When ‘the sample’ used in your experiment generates a significant result for your hypothesis, but there would have been a significant result if you had performed the experiment on ‘the population’
- C.
When ‘the sample’ used in your experiment generates a significant result for your hypothesis, but there would not have been a significant result if you had performed the experiment on ‘the population’
- D.
When ‘the sample’ used in your experiment fails to generate a significant result for your hypothesis, but there would have been a significant result if you had performed the experiment on ‘the population’
- E.
When studies have been sampled in a non-random fashion, differences between the results from the sample and the true population can arise
- A.
- 3.
A patient is asking about her scan review. The fetal growth falls on the 30th centile. She is concerned that it is not sitting on the black dot in the centre and is therefore undergrown. What is the best explanation of this?
- A.
Using confidence intervals within a population, we can estimate that 95% of all babies will fall outside the lines, and thus, your baby falls within the remits of normal.
- B.
Using confidence intervals within a sample, we can estimate that 95% of all babies will fall between the lines, and thus, your baby falls within the confidence intervals of normal.
- C.
Using type 2 errors within a population, we can estimate that 95% of all babies will fall between the lines, and thus, your baby falls within the confidence intervals of normal.
- D.
Using confidence intervals within a population, we can estimate that 95% of all babies will fall between the lines, and thus, your baby falls within the confidence intervals of normal.
- E.
Using confidence intervals within a sample, we can estimate that 95% of all babies will fall outside the lines, and thus, your baby falls within the confidence intervals of normal.
- A.
- 4.
In a study looking at menorrhagia, the data is sorted into three groups – mild bleeding, moderate bleeding and severe bleeding. What type of data is this?
- A.
Ordinal
- B.
Categorised
- C.
Qualitative
- D.
Binary
- E.
Continuous
- A.
- 5.
Which of the following is NOT a type of mathematical distribution used in statistics?
- A.
Binomial
- B.
Poisson
- C.
Binary
- D.
Normal
- E.
Chi-squared
- A.
- 6.
Which presentation method is not appropriate for qualitative data?
- A.
Scatter plots
- B.
Line plots
- C.
Box plots
- D.
Bar charts
- E.
Histograms
- A.
- 7.
In an audit looking at the age of women presenting at the early pregnancy clinic on a certain day the following ages were recorded:
29, 30, 22, 45, 31, 22, 17, 38 and 36.
What is the median?
- A.
22
- B.
29
- C.
30
- D.
36
- E.
39
- A.
- 8.
The below table looks at the outcome of early pregnancy scans in smokers for early embryonic demise and the management plans.
| MANAGEMENT OF MISCARRIAGE | SMOKER | NON-SMOKER | TOTAL |
|---|---|---|---|
| Surgical | 3 | 6 | 9 |
| Conservative | 4 | 3 | 7 |
| Total | 7 | 9 | 16 |
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