September 2013 MRCOG 1 exam

1- A patient in her first trimester of pregnancy found to have HIV Ab weakly positive, the first confirmative was negative while the second was inconclusive. Your next step would be:

a.reassure her that she does not have HIVb.tell her she has HIVc.repeat confirmative testd.refer her to GUCe.repeat at term

2- A patient pregnant doing her 20-24 weeks screening for diabetes, she is Asian with BMI 36, FBS 5. mmol/l, 2 hrs ppr 7.1 mmol/l. How you interpret her OGTT ?

a. Normalb. Impaired fastingc. Impaired glucose toleranced. Frank diabetese. Gestational diabetes

3- the 2 oncogenes HPV 16 and HPV 18 are responsible for this percentage of cervical cancer:

a. 20%b. 30%c. 50%d. 70%e. 100%

4- this granulated white blood cell has phagocytic action but constitute only 2-3% of total WBC count:

a. Macrophageb. Lymphocytec. Neutrophilsd. Eosinophilse. Acidophils

5- Immunologic factor involved in the pathophysiology of polycystic ovarian syndrome:

a. Complementb. IL 8c. VEGFd. IL2e. TNF

6- The diamond shape Forest graph, lateral angles represents:

a. Probabilityb. Coefficient of variationc. Standard deviationd. The meane. 95% CI

7- calculate the test sensitivity

8- calculate likelihood ratio

9- calculate the absolute risk

10- This phagocytic antigen presenting cell in the cervix:

a. Hofbauerb. T-lymphocytec. Plasma celld. Kuppfer celle. Neutrophil

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11- mechanism of action of letrozole is on this enzyme:

a. Hydroxylaseb. Aromatasec. d. e.

12-vitamin deficiency associated with megalocytic anemia:

a. Vitamin Ab. Vitamin Cc. Vitamin Ed. Folic e. Vitamin K

13- Vasopressin act on increasing water reabsorption at

a. Proximal tubuleb. Loop of henlec. Distal convoluted tubules and collecting ductd.

e.

14- this antimetabolite is the pro-drug for 6-mercaptopurine

a. Cyclophosphamideb. Methotrexatec. Cisplatind. Azathioprinee. Vinblastine

15- commonest type of spread of choriocarcinoma is:

a. Lymphaticb. Direct c. Hematogenicd. Transperitoneale.

16- a patient with primary infertility, presents with 3 months amenorrhea, elevated FSH and prolacten, Bhcg positive

a. Pregnantb. PCOSc. d. e.

17- in a pregnant women suspected to have pulmonary embolism:

a. It is contraindicated to do angiographyb. Diagnosed by venographyc. Diagnosed by ECGd. Diagnosed by FDPe. Ventilation scan should be done

18- best screening method for hemolytic anemia

a. FDPb. Serum ferritinc. Hemoglobin d. e.

19- a patient postoperative serum electrolytes showed normal sodium elevated potassium:

a. Addisonb. Conn’sc. d. e.

20- screening for osteoporosis the following is true:

a. Normal T-score is -1 _ +1, while Z score compares the patient with the bone mass of a person of the same age and sex .

b. c. d. e.

21- Pregnant lady with fever, loin pain, tenderness, GUE +++ pus cell. Your mx.:

a. Outpatient antibioticb. Intravenous fluid c. Admit for intravenous fluid and iv cephalosporind. e.

22- right ureter course in the pelvis

a. Crosses the external iliac artery at the sacroiliac joint

b. Crosses the common iliac artery at sacroiliac joint

c. Crossed by common iliac vessels at sacroiliac joint

d. Crossed by external iliac vessels at e.

23- patient with right iliac fossa pain and tenderness, has history of chlamydial infection that was treated, ultrasound reports a tubular echogenic mass superior to rt ovary, both ovaries look normal. Your diagnosis:

a. Corneal ectopic pregnancyb. Hydrosalpinxc. Ovarian cystd. Mucinous appendix(mucocele)e.

24- which of the following gives a correct idea about incomplete miscarriage?

a. Open os b. c. d. e.

25- patient with 3 missed periods, presents with abdominal pain, Bhcg 1500 iu, ultrasound anexal mass of 2.5 cm. your mx?

a. Urgent laparoscopyb. Laparotomyc. Admit, repeat hcg in 48 hrs (I believe this is

normal early pregnancy with luteal cyst)d. Admit with close observatione.

26- Hip joint is an example of :

a. Synovial jointb. Cartilaginous jointc.

d. e.

27- this structure enters inguinal canal and is identified easily at laparoscopy :

a. Inferior epigastric arteryb. Superior epigastric arteryc. Round ligamentd. e.

28- a bicornuate uterus originates from:

a. Failure of fusion of paramesonephric ductb. c. d. e.

29- in a 25 years old lady with 4 previous miscarriages , the most useful investigation would be:

a. Mother karyotypeb. Father karyotypec. Conceptus cytogenetic studyd. Thrombophilia screen (as 15%-25% would have

APLS 5% would have antithrombinIII factor V def.)

e. Hysterosalpingography

30- Bifurcation of aorta at this level:

a. Uppermost edge of iliac crestb. Anterior superior iliac spinec. Anterior inferior iliac spined. Sciatic notche. Ischial spine

31- Perinatal mortality is defined as :

a. Stillbirth and death in first 24 hoursb. Stillbirth and death in first 7 daysc. Death in first monthd. e.

32- a pregnant women in first trimester has nausea and vomiting with 4+ ketone in urine, the correct management:

a. Glucose waterb. Ringer lactate and antiemetic as inpatient (as u

cant replace with glucose until correcting thiamine def. as it worsens it)

c. d. e.

33- CTG finding of pt. in labor with 6 cm dilatation: no acceleration, no deceleration, 20 beat variability, variable deceleration. If the scalp blood ph 7.25, next step:

a. Repeat blood sampling nowb. Repeat blood sampling in 30 minutes

c. Do emergency cesareand. Do not repeat sampling unless CTG deteriorates (

this is suspicious CTG)e.

34 – a patient with severe wound infection of cesarean section is best managed:

a. Outpatient antibioticsb. Urgent wound debridementc. Admit and cover iv antibiotics (although

debridement would be temptive but this is the right thing to do first I believe)

d. e.

35- wound infection caused by this microorganism shows sulfur granules under microscopy:

a. Clostridia welchib. Pseudomonasc. Streptococcusd. Actinomycosis israeliie. Staphylococcus

36- failure risk of vasectomy:

a. 0.5/1000b. 1/1000c. 0.5/100d. 1/100e. 10/100

37- B HCG in pregnancy would peak at :

a. 1-6 weeksb. 8-12 weeksc. 12-20 weeksd. 20-28 weekse. 28-36 weeks

38- consists the lateral wall of ischiorectal fossa:

a. Levator ani muscleb. Obturator fasciac. Internal oblique muscled. e.

39- muscles of the pelvic diaphragm

a. Levator ani and coccygeusb. Levator ani and puborectalisc. d. e.

40- nerve supply to posterior 2/3 of labia majora

a. perineal nerve (br.of pudendal)b. perineal n of S4c. pudendald. e.

41- blood supply to rectus abdominis muscle below umbilicus

a. Superior epigastricb. Inferior epigastricc. d. e.

42- this structure is attached to anterior superior iliac spine

a. Inguinal ligamentb. c. d. e.

43- Intramuscular adrenaline dose for anaphylaxis :

a. 1:1000 (im dose)b. 1:10000 (iv dose)c. d. e.

44- recommended method for delivery of placenta

a. Controlled cord tractionb. c.

d. e.

45- down syndrome finding on screening

a. Elevated HCG / elevated inhibin /decreased unconjugated estriol E3 /decreases AFP

b. c. d. e.

46- this step occurring in the mitochondria releasing ATP:

a. Kreps cycleb. Glycolysisc. Oxidative phosphorylationd. e.

47- major phospholipid constituting amniotic fluid

a. DHPalmitateb.

c. d. e.

48- Amphipathic criteria of a drug to cross placenta:

a. Water solubleb. Increased ionizationc. Lipid solubled. e.

49- multiparous women with descent of uterus(prolapsed) may had injury to:

a. Cardinal/uterosacral ligamentsb. Round ligs.c. d. e.

50-a phase of the cell cycle where DNA replication occurs:

a. S phaseb. G1c. G2d. M phasee.

51- Alkylating agents like vincristine act against

a. Cell membrane

b. Mitochondriac. DNAd. Tubules e.

52- a patient who is BRCA 1 positive has the following risk

a. 30% breast ca 10% ovarianb. 70% breast ca 30% ovarianc. 80% breast ca 40%ovariand. 90% breast ca 60%ovariane.

53- DMPA is associated loss of bone mass in first 6 months of:

a. 1%b. 5%c. 10%d. 20%e. 50%

54- most important anion in urine

a. Albuminb. Phosphatec. Chlorided. Bicarbonatee.

55- active form of vitamin D:

a. 1,25 cholcalciferolb. Calcitriolc. 1-cholcaciferold. e.

56- main action of glucagon in hypoglycemia

a. Glycogenolysisb. Gluconeogenesisc. d. e.

57- the renal tubules develop from

a. Pronephrosb. Metanephrosc. PMDd. Mesonephrose.

58- the sperm at fertilization penetrates the:

a. Tunica albugina b. Corona radiatec. Zona pellucidad. e.

59- women aborting after corpus luteum removal is due to loss this hormone:

a. HCGb. Estrogenc. Progesteroned. e.

60- treatment for MRSA

a. Vancomycinb. c. d. e.