1. The renal medulla is composed of tissue called. 7.

Which of the following match with the definition: a poor

1. Renal pyramids ✔ output of urine?
2. Nephrons 1. Oliguria ✔
3. Renal sinus 2. Pyruia
4. Renal pelvis 3. Enuresis
2. Which of the following is not in the sequence of proper 4. Diuresis
kidney blood flow? The starting point is the renal artery 8. Capillary loops located in the medulla are also known
and the finishing point is the renal vein. as
1. Arciform artery 1. Vasa recta ✔
2. Afferent arteriole 2. Urea collectors
3. Interlobar vein ✔ 3. Trigone
4. Arciform vein 4. Macula densa
3. Which is found in the highest concentration in the 9. The primary function of the descending loop of Henle
urine? in the kidney is?
1. Uric acid 1. Reabsorption of sodium ions
2. Urea ✔ 2. Reabsoption of water by osmosis ✔
3. Glucose 3. Secretion of hydrogen ions
4. Creatinine 4. Secretion of potassium ions
4. The primary function of the ascending loop of Henle in 10. Which Diagnosis and treating abnormalities, diseases,
the kidney is? and disorders of the heart.
1. The active re-absorption of sodium 1. Cardiology ✔
2. The active re-absorption of chloride ions ✔ 2. Urology
3. The passive re-absorption of potassium 3. Nephrology
4. The passive re-absorption of urea 4. Radiology
5. The middle layer of the urinary bladder is identified as 11. Which of the following is used to Diagnosing and
1. Mucous coat treating tumors and cancer.
2. Submucous coat ✔ 1. Gynecology
3. Muscular Coat 2. Urology
4. Sphincter Coat 3. Oncology ✔
6. The micturition reflex center is located in the ? 4. Radiology
1. Pons 12. Which is Similiar to general practice in nature, but
2. Midbrain centering around the family unit.
3. Lumbar plexus 1. Geriatrics
4. Sacral plexus ✔ 2. Pediatrics
3. Family Practice ✔
 4. Obstetrics 18. Which of the following is used to Diagnosing and
13. Which of the following is used to Diagnosing and treating diseases and disorders with Roentgen rays
treating conditions of altered immunologic reactivity ? (x-rays) and other forms of radiant energy.
1. Allergy ✔ 1. Urology
2. Urology 2. Neurology
3. Radiology 3. Cardiology
4. Oncology 4. Radiology ✔
14. Which of the following is used to Diagnosing and 19. Which of the following is used to Diagnosing and
treating diseases and disorders of the female treating disorders of the skin.
reproductive tract; strong emphasis on preventive 1. Radiology
measures. 2. Cardiology
1. Urology 3. Neurology
2. Neurology 4. Dermatology ✔
3. Oncology 20. Which of the following is used to Diagnosing and
4. Gynecology ✔ treating diseases and disorders of the stomach and
15. Which of the following is used to Diagnosing and intestines.
treating diseases and disorders of the central nervous 1. Nephrology
system. 2. Dermatology
1. Nephrology 3. Gastroenterology ✔
2. Urology 4. Gynecology
3. Neurology ✔ 21. The primary function of the descending loop of Henle
4. Gynecology in the kidney is ?
16. Which of the following is used to Diagnosing and 1. Reabsorption of sodium ions
treating disorders and diseases of the ear, nose, and 2. Reabsoption of water by osmosis ✔
throat. 3. Secretion of hydrogen ions
1. Otorhinolaryngology ✔ 4. Secretion of potassium ions
2. Endocrinology 22. Which of the following is not considered a part of the
3. Radiology male urethra?
4. Ophthalmology 1. Prostatic
17. Which of the following is used to Diagnosing and 2. Membranous
treating diseases and disorders of the kidney. 3. Vasapore ✔
1. Oncology 4. Penile
2. Urology 23. When glucose if found in urine it is called.
3. Nephrology ✔ 1. Glucosuria ✔
4. Neurology 2. Uremia
 3. Ureteritis 3. Increase synthesis of Vitamin E
4. Glucose intolerance 4. Increased release of erythropoietin
24. Which of the following is not considered a component 30. Which of the following is an effect of a diuretic?
of kidney stones? 1. Decreased Cardiac Output ✔
1. Calcium phosphate 2. Increased fluid volume
2. Uric Acid 3. Increased sodium re-absorption
3. Calcium oxalate 4. Increased chloride ion re-absorption
4. HCO3 ✔ 31. Which of the following is not considered a loop diuretic
25. The one of the functions occurring at the distal ?
convoluted tubule in the kidney is? 1. Bumetadine (BUMEX)
1. Passive secretion of hydrogen ions 2. Furosemide (LASIX)
2. Passive secretion of potassium ions ✔ 3. Chlorthiazide (DIURIL) ✔
3. Limited re-absorption of water 4. Ethacrynic Acid (EDECRIN)
4. No re-absorption of sodium 32. Which of the following is not one of the key steps in the
26. ADH has which of the following effects on the distal grief process?
convoluted tubule? 1. Denial
1. Decrease water re-absorption 2. Anger
2. Increase water re-absorption ✔ 3. Bargaining
3. Decrease the concentration of urine 4. Rejection ✔
4. Increase the urine volume 33. Which of the following matches the definition: Covering
27. Which of the following is not associated with the role of up a weakness by stressing a desirable or stronger
the kidneys? trait?
1. Release of erythropoietin (hormone) 1. Compensation ✔
2. Release of renin (enzyme) 2. Projection
3. Release of Vitamin E ✔ 3. Rationalization
4. Activate Vitamin D 4. Dysphoria
28. Each kidney contains approximately ______ nephrons. 34. Which of the following waveforms is most commonly
1. 10 million found with light sleepers?
2. 1 million ✔ 1. Theta ✔
3. 100, 000 2. Alpha
4. 10, 000 3. Beta
29. The release of Angiotension II causes which of the 4. Zeta
following to occur? 35. Which of the following months matches with an infant
1. Increased filtration rate ✔ first having the ability to sit-up independently?
2. Decreased glomerular hydrostatic pressure 1. 4 months
 2. 6 months ✔ 4. Zeta
3. 8 months 41. The REM sleep cycle occur approximately every ____
4. 10 months minutes?
36. Object permanence for toddlers develops in this age 1. 45
range? 2. 60
1. 5 − 10 months ✔ 3. 75
2. 10 − 14 months 4. 90 ✔
3. 12 − 24 months 42. Which of the following reflexes is not found at birth?
4. 15 − 24 months 1. Babinski
37. Which of the following matches the definition: 2. Palmar
Attributing of our own unwanted trait onto another 3. Moro
person? 4. Flexion ✔
1. Compensation 43. Parallel play for toddlers develops in this age range?
2. Projection ✔ 1. 5 − 10 months
3. Rationalization 2. 10 − 14 months
4. Dysphoria 3. 12 − 24 months
38. Which of the following matches the definition: The 4. 24 − 48 months ✔
justification of behaviors using reason other than the 44. Which of the following is not a sign of anxiety?
real reason? 1. Dyspnea
1. Compensation 2. Hyperventilation
2. Projection 3. Moist mouth ✔
3. Rationalization ✔ 4. GI symptoms
4. Dysphoria 45. Which of the following best describes a person that is
39. Which of the following matches the definition: completely awake falling asleep spontaneously?
Response to severe emotion stress resulting in 1. Cataplexy ✔
involuntary disturbance of physical functions? 2. Narcolepsy
1. Conversion disorder ✔ 3. Transitional sleep
2. Depressive reaction 4. REM absence
3. Bipolar disorder 46. Which of the following best describes a person that is
4. Alzheimer’s disease unable to tell you were there hand or foot is?
40. Which of the following waveforms is most commonly 1. Autotopagnosia ✔
found when you are awake? 2. Cataplexy
1. Theta 3. Ergophobia
2. Alpha 4. Anosognosia
3. Beta ✔
 47. Which of the following is not a characteristic of a panic 52. All of the following drugs are associated with
disorder? hyperprolactinaemia, apart from:
1. Nausea 1. Reserpine
2. Excessive perspiration 2. Progesterone-only contraceptive pill ✔
3. Urination ✔ 3. Methyldopa
4. Chest pain 4. Ranitidine
48. Which of the following categories would a 70 year old 5. Chlorpromazine.
adult be placed in? 53. All of the following are effects of premature menopause,
1. Intimacy vs. Isolation apart from:
2. Generativitiy vs. Stagnation ✔ 1. Decreased cardiovascular risk ✔
3. Integrity vs. Despair 2. Infertility
4. Longevity vs. Guilt 3. Osteoporosis
49. Which of the following categories would a 60 year old 4. Vasomotor symptoms
adult be placed in? 5. Vaginal dryness.
1. Intimacy vs. Isolation 54. A 32-year-old woman presents to the gynaecology clinic
2. Generativitiy vs. Stagnation ✔ with infrequent periods. A hormone profi le is done and all
3. Integrity vs. Despair of the following are consistent with polycystic ovarian
4. Longevity vs. Guilt syndrome, apart from:
50. Which of the following categories would a 20 year old 1. Increased androgen levels
adult be placed in? 2. Normal FSH
1. Intimacy vs. Isolation ✔ 3. Normal oestradiol
2. Generativitiy vs. Stagnation 4. Decreased LH ✔
3. Integrity vs. Despair 5. Low progesterone levels.
4. Longevity vs. Guilt 55. A 28-year-old woman attends the colposcopy clinic after
51. A 48-year-old woman presents with intermenstrual an abnormal smear test. The smear is reported as severe
bleeding for two months and episodes of bleeding dyskaryosis and she has an intrauterine contraceptive
occurring any time in the cycle. There is no associated device in situ. All of the following statements are likely to
pain. Differential diagnosis for intermenstrual bleeding be true, apart from:
does not include: 1. The cervix is macroscopically normal
1. Endocervical polyp 2. Acetic acid is applied and an irregular white area is
2. Cervical malignancy apparent to the left of the cervical os
3. Endometrial polyp 3. Lugol’s iodine is applied and the same area stains dark
4. Ovarian teratoma ✔ brown while the rest of the cervix stains pale ✔
5. Atrophic vaginitis. 4. A biopsy is taken
 5. The IUCD can stay, as it will not aggravate the cervical
abnormality.
56. 24-year-old woman presents with the absence of periods
for nine months. She started her periods at the age of 13
years and had a regular 28-day cycle until 18 months ago.
The periods then became irregular, occurring every two to
three months until they stopped completely. The following
are all included in the differential diagnosis of secondary
amenorrhoea, apart from:
1. Excessive exercise
2. Hyperprolactinaemia
3. Hyperthyroidism ✔
4. Premature ovarian failure
5. Signifi cant weight loss
57. The following statements regarding adenomyosis are true,
apart from one.
1. It tends to occur in women over 35 years.
2. Risk factors include increased parity, termination and
quick labours. ✔
3. The condition commonly occurs in association with
endometriosis.
4. With each period, bleeding occurs from the endometrial
tissue into the smooth muscle.
5. The diagnosis can be made by ultrasound or magnetic
resonance imaging scan.
58. A 20-year-old woman is referred with a problem of
post-coital bleeding. Over the past two months it has
occurred on six occasions and there has been a small
amount of bright red blood noticed after intercourse.
There is no associated pain. The following investigations
should initially be performed, apart from:
1. Cervical smear
2. Endocervical swab for chlamydia
3. Colposcopy ✔
4. Dndocervical swab for gonorrhoea
5. Speculum examination to observe the cervix.
59. The following are all consistent with the diagnosis of
antiphospholipid syndrome except:
1. Hydatidiform mole ✔
2. Severe early-onset pre-eclampsia
3. Arterial or venous thrombosis
4. Mid-trimester fetal loss
5. Placental abruption.
60. The following are all causes of recurrent miscarriage,
apart from:
1. Parental chromosomal abnormality
2. Activated protein C-resistance
3. Uncontrolled hypothyroidism
4. Chlamydia infection ✔
5. Submucosal fi broids.
61. Which one of the following statements about pituitary
tumours is true?
1. Weight loss is a common feature of pituitary
failure (hypopituitarism) due to a pituitary tumour.
2. Visual fi eld loss in female patients with
prolactin-secreting pituitary tumours
(prolactinoma) is usual.
3. Adrenocorticotrophic hormone (ACTH) secreting
pituitary tumours cause a syndrome of cortisol
excess that can lead to exaggerated vertical
growth in adolescence.
4. Growth hormone defi ciency is a recognised
feature in adult patients presenting with
acromegaly due to a pituitary macroadenoma.
5. A low testosterone level is more common than a
low thyroxine level in men with non-functioning
gonads. ✔
62. Which of the following statements concerning the
anterior pituitary is true?
 1. It develops in the embryo from a down-growth of
the hypothalamus.
2. It secretes antidiuretic hormone (ADH).
3. It is regulated by hypothalamic-releasing
hormones. ✔
4. It secretes its hormones into the pituitary portal
system.
5. It is down-regulated by low oestrogen levels.
63. Which one of the following statements about the
implantation of the human embryo is true?
1. It will occur at any time over a period of about 14
days.
2. It will occur whether or not the zona pellucida is
present.
3. It will occur when the cytotrophoblast contacts the
endometrial epithelium and begins to invade the
maternal tissue.
4. It will occur with the inner cell mass closest to the
endometrium. ✔
5. It will occur even if there is only cytotrophoblast
present.
64. Which one of the following statements about puberty is
true?
1. Puberty is preceded by falling plasma levels of
adrenal androgens. ✔
2. The fi rst menstrual period is called the
adrenarche.
3. The pubertal growth spurt is the fi rst sign of
puberty.
4. Pubic hair growth is stimulated in girls by
oestrogen.
5. Spermatogenesis starts at puberty.
65. Which is the most appropriate statement concerning
pulmonary embolism?
1. It is now rarely fatal, with the introduction of
modern diagnostic tests and treatments.
2. It gives an area of lung which is unventilated on a
ventilationperfusion scan.
3. It does not usually show up on a CT pulmonary
angiogram.
4. It is likely that the patient has symptoms of
deep-vein thrombosis.
5. It may give symptoms similar to pneumonia. ✔
66. One of the following is true. It is recognised that the
positive predictive value of initial mammography for
breast cancer within the national screening programme
in the UK is 16%. This means that:
1. 16% of people who have breast cancer are
detected on initial mammography
2. 84% of people without breast cancer have a
normal mammogram
3. 16% of initial mammograms are abnormal
4. A patient with an abnormal initial mammogram
has a 16% chance of having breast cancer ✔
5. Out of every 100 patients with an abnormal
mammogram,
67. 17. One of the following is true. Successful fertilisation
and subsequent normal embryonic development:-
1. Require at least two spermatozoa
2. Require the retention of the cortical granules in
the oocyte
3. Are most likely when the oocytes have been
ovulated in an immature stage
4. Require exclusion of the second polar body ✔
5. Often occur when the oocyte has lost its zona
pellucida.
68. One of the following is true. The increase in maternal
blood volume in pregnancy occurs as a result of:
1. Peripheral vasoconstriction
 2. A reduction in progesterone
3. Decreased synthesis of vasopressin
4. Increased aldosterone synthesis ✔
5. Reduced renin activity.
69. One of the following is true. Decreased peripheral
resistance in pregnancy has been attributed to an
increase in synthesis of:
1. Angiotensin
2. Endothelin
3. Nitric oxide ✔
4. Renin
5. Thromboxane.
70. A 25-year-old woman on liver enzyme inducers is
requesting contraceptive advice. The method providing
her with the most reliable form of contraception would
be:
1. Combined oral contraceptive pill
2. Depo-Provera injection ✔
3. Diaphragm
4. Male condom
5. Progesterone-only pill.
71. A 35-year-old woman comes requesting long-term
reversible contraception. You advise that the method
that can provide the longest protection is:
1. Contraceptive implant
2. Copper intrauterine device ✔
3. Depo-Provera injection
4. Intrauterine hormonal system (IUS)
5. laparoscopic sterilisation.
72. Regarding cervical cancer, which is the true statement?
1. HPV types 6 and 12 are high risk for developing
cervical cancer.
2. The new vaccines can prevent invasive
carcinoma but not CIN.
3. As soon as the new vaccination is introduced,
cervical screening programmes can cease.
4. HPV types 16 and 18 account for the majority of
cervical cancer in the world. ✔
5. HPV is an oncogenic virus for squamous cell but
not adenocarcinoma of the cervix.
73. Regarding the menstrual cycle, which is the true
statement?
1. Menstruation occurs with vasodilation of the spiral
arteries.
2. The LH surge triggers menstruation.
3. The Graafi an follicle develops during the luteal
phase.
4. Both the follicle and the corpus luteum secrete
oestradiol. ✔
5. Progesterone levels fall after the onset of
menstruation.
74. Regarding Müllerian duct abnormalities which is the
true statement?
1. Occur about 1 in 500
2. The commonest uterine abnormality is septate
uterus ✔
3. Occur not infrequently with gastrointestinal
abnormalities
4. Surgical correction of a septate uterus is followed
by fetal salvage in <60% of cases
5. Longitudinal vaginal septa are more common
than transverseones.
75. Choose the correct statement: Uterine
leiomyosarcomas:
1. Are associated with exposure to tamoxifen ✔
2. Originate from leiomyomas
3. Pelvic radiotherapy has a signifi cant impact on
survival
4. Commonly metastasise to the brain
 5. Anthracycline-based chemotherapy has no place 1. Adenoma
in treatment. 2. Carcinoma
76. Which one of the following statements about the 3. Lymphoma
menopause is correct? 4. Melanoma
1. Progesterone levels rise after the menopause. 5. Sarcoma. ✔
2. LH levels rise after the menopause. ✔ 80. One of the following is true. Affording moral status to a
3. The pituitary stops secreting LH and FSH at the human embryo/fetus means that it now has:
menopause. 1. An inalienable right to life
4. Menstrual cycles remain regular until the last 2. A right to life
menstrual period. 3. A right to consideration
5. The number of oocytes in the ovary remains 4. A right dependent on moral consensus ✔
constant until the menopause. 5. A right not to be harmed.
77. Choose the correct statement: The female reproductive 81. At term amniotic fluid volume is
tract plays important roles in sperm transport by: 1. 800 ml ✔
1. Trapping most spermatozoa in the cervical crypt 2. 500 ml
for many days 3. 400 ml
2. Regulating sperm transport so that cells reach the 4. 600 ml
site of fertilisation around the time of ovulation ✔ 82. what is the principal carbohydrate present in Amniotic
3. Allowing sperm transport at all stages of the fluid ?
ovarian cycle 1. Glucose ✔
4. Preventing spermatozoa from swimming out of 2. Fructose
the peritoneal cavity 3. Mannose
5. Providing an acidic environment to keep the 4. Galactose
spermatozoa active. 83. Oligohydramnios is related which of the following
78. Which one of the following statements is true: Semen condition ?
analysis: 1. Enal Agenesis ✔
1. Identifi es men with high-quality fertile 2. Esophageal atresia
spermatozoa 3. Anencephaly
2. Identifi es men with low sperm ✔ concentrations 4. Down’s syndrome
that might affect fertility 84. Early amniocentesis is done in which period of
3. Can always be used to predict fertility pregnancy
4. Cannot identify abnormal spermatozoa 1. 12-14 wks
5. Identifi es men with hypopituitarism. 2. 14-16 wks ✔
79. One of the following is true. A malignant tumour arising 3. 16-18 wks
in the mesenchymal tissue is called: 4. 9-11 wk
85. Immune rejection of fetus prevented by 92. Cervical changes in pregnancy are all except ?
1. HCG ✔ 1. Increased collagen
2. HPL 2. Increased Hyaluronic acid ✔
3. Oestrogen 3. Increased glands
4. progesterone 4. Increased vascularity
86. what happens to GFR in a case of Pre-eclampsia ? 93. Symptoms of circulatory systemic overload during
1. GFR Decreases ✔ excessive IV fluids include all except
2. GFR increases 1. Oliguria ✔
3. Remains same 2. Increased BP
4. None of the above 3. Anxiety
87. Shortest diameter of pelvic Cavity 4. Pulmonary edema
1. Interspinous ✔ 94. Succinylcholine can produce all except
2. Transverse 1. Induce malignant hyperthermia in susceptible
3. Antero-posterior patients
4. Oblique 2. Prolonged paralysis occurs in case of
88. Large Chorioangioma associated with butyrylcholinesterase abnormalities (as
1. Polyhydroamnios ✔ succinylcholine is not metabolized)
2. Oligohydramnios 3. Tachycardia, particularly in children ✔
3. Both 4. Increase intraocular pressure
4. None 95. Life threatening risks of anesthesia include all except
89. Commonest presentation of Choriocarcinoma 1. Hypoxic brain injury
1. Vaginal bleeding ✔ 2. Myocardial infarction
2. Abdominal pain 3. Postoperative nausea and vomiting ✔
3. Breathlessness 4. Cerebrovascular accident
4. Perforation of the uterus 96. In a lower segment caesarean section, which of the
90. Frog eye appearance is seen in following techniques of anesthesia is desirable
1. Anencephaly ✔ 1. Spinal anesthesia
2. Acardia 2. Caudal anesthesi
3. Down’s syndrome 3. Combined Spinal Epidural ✔
4. Patau’s syndrome 4. General anesthesia
91. what of the following is seen in Partial mole 97. Predictors of difficult intubation include.
1. Triploidy ✔ 1. Short muscular neck
2. Haploidy 2. Prominent upper incisor
3. Polyploidy 3. Protruding mandible
4. Diploidy 4. All of the above ✔
 98. ASA standard monitors include all except 4. Poor Capillary refill
1. Pulse oximeter 105. Balanced General Anesthesia includes
2. CVP ✔ 1. Skeletal muscle relaxant
3. NIBP cuff 2. Loss of consciousness
4. ECG 3. Analgesia
99. Ketamine; all are true except 4. All of the above ✔
1. Induction of anesthesia by IV route 106. Depolarizing block may be done by
2. Induction of anesthesia 1. Atracurium
3. Supplementation of sedation… 2. Neostegmin
4. Decrease cerebral blood flow ✔ 3. Succinylcholine ✔
100. Signs of low perfusion include all except 4. Rocuronuim
1. Hypotension 107. Intravenous regional anesthesia is more commonly
2. Tachycardia used for operations of .
3. High Urine Output ✔ 1. Neck surgeries
4. Poor Capillary refill 2. Lower abdomen
101. Which of the following describes a person using words 3. Upper limbs ✔
that have no known meaning? 4. Lower limbs
1. Neologisms ✔ 108. Regarding morphine, all are true Except
2. Neolithic 1. Respiratory depression … effect
3. Verbalism 2. Can be IV subcutaneously, rectally and epidurally
4. Delusional blocking 3. Can cause nausea and vomiting
102. Which of the following is the mRNA start codon in 4. Less effective against pain of myocardial ischemia ✔
most cases? 109. ASA III is
1. UAA 1. Normal, healthy patient
2. AGU 2. Patient with mild, well controlled systemic disease
3. AUG ✔ 3. Patient with sever systemic disease that limits activity
4. UGA ✔
103. Which of the types of RNA is the smallest? 4. Patient with sever life threatening disease
1. mRNA 110. Premedication that can be given
2. tRNA ✔ 1. Anxiolysis
3. rRNA 2. Anti- emetic
104. Signs of low perfusion include all except. 3. Antacid
1. Hypotension 4. All of the above ✔
2. Tachycardia 111. Mallampati grade suggests difficult intubation
3. High Urine Output ✔ 1. Grade I
 2. Grade II 117. Thiopental (sodium thiopental, Thiopentone, STP)
3. Grade IV ✔ characterized by the following except
4. All of the above 1. Prepares as a pale yellow 10.5 (alkaline)
112. Factor at increase risk of aspiration includes 2. After iv bolus, rapidly …
1. Drinking clear fluids 8 hours before operation 3. Effects include decrease cerebral blood flow and
2. Gastro esophageal reflux ✔ O2 requirements
3. Chewing gum 4. Has good analgesic … ✔
4. Two hours preoperative oral clear fluid 118. An ECG is performed and reveals a progressively
administration increasing PR interval and dropping of QRS complexes at
113. In 70 kg patient one unit of platelet concentrate regular intervals. Which of the following is the most likely
should increase platelet count diagnosis?
1. 2000 – 5000 mm3 1. First-degree heart block
2. 5000 – 10000 mm3 ✔ 2. Second-degree heart block (Mobitz type 2)
3. 10000 – 20000 mm3 3. Second-degree heart block (Mobitz type 1) ✔
4. More than 20000 ;mm3 4. Hyperkalaemia
114. The following are the classical hemolytic 119. What view of the heart do leads V1 and V2 represent?
transfusion reaction in general anesthesia except 1. Inferior
1. Hypotension 2. Septal ✔
2. Wheezing 3. Anterior
3. Hemoglobinuria 4. Lateral
4. Bradycardia ✔ 120. Which artery is most likely to be affected in the context
115. The mean arterial pressure of a blood pressure of of ST elevation being present in leads V3 and V4?
160/80 is 1. Left anterior descending coronary artery ✔
1. 90 mmHg 2. Right coronary artery
2. 100 mmHg 3. All of the above
3. 110 mmHg ✔ 4. Left circumflex coronary artery
4. 120 mmHg 121. What is the most common cause of left axis deviation?
116. Indication of rapid sequence anesthesia include all 1. Defects of the conduction system ✔
except 2. Left ventricular hypertrophy
1. Patient ASA I undergoing elective 3. Right ventricular hypertrophy
cholecytectomy. ✔ 4. Atrial septal defects
2. Patient presented with bowel obstruction 122. Which of the following is a common cause of right axis
3. Morbid Obesity Patients deviation?
4. Pregnancy 1. Right ventricular hypertrophy ✔
2. Ventricular septal defect
 3. Left ventricular hypertrophy 4. 100 bpm ✔
4. Atrial septal defect 129. What view of the heart do leads I, aVL, V5 and V6
123. What does ST-elevation suggest? represent?
1. Myocardial infarction ✔ 1. Inferior
2. Heart murmur 2. Septal
3. Heart block – Mobitz type II 3. Lateral ✔
4. Bundle branch block 4. Anterior
124. A patient is noted to have an abnormally shortened 130. An ECG reveals an absence of P-waves and an
PR-interval on their ECG. Which of the following is the most irregular rhythm. Which of the following is the most likely
likely cause? diagnosis?
1. Right bundle branch block 1. 2nd-degree heart block
2. Atrioventricular nodal fibrosis 2. 1st-degree heart block
3. Wolff-Parkinson-White (WPW) syndrome ✔ 3. Atrial fibrillation ✔
4. Left bundle branch block 4. Ventricular tachycardia
125. If ST-elevation was noted in leads II, III and aVF, what 131. What is the duration of a normal PR-interval?
would it suggest? 1. 0.04 – 0.08 seconds (1-2 small squares)
1. A posterior myocardial infarction 2. 0.08 – 0.12 seconds (2-3 small squares)
2. An inferior myocardial infarction ✔ 3. 0.12 – 0.2 seconds (3-5 small squares) ✔
3. A septal myocardial infarction 4. 0.04 – 0.12 seconds (1-3 small squares)
4. An anterior myocardial infarction 132. What view of the heart do leads II, III and aVF
126. What view of the heart do leads V3 and V4 represent ? represent?
1. Anterior✔ 1. Inferior ✔
2. Septal 2. Septal
3. Inferior 3. Lateral
4. Lateral 4. Anterior
127. What is the normal duration of a QRS complex? 133. Which of the following are functions of progesterone?
1. 0.04 seconds (1 small square) 1. Inhibition of oestrogen production
2. 0.08 seconds (2 small squares) 2. Inhibition of LH and FSH production ✔
3. 0.16 seconds (4 small squares) 3. Initiation of the secretory phase of the
4. 0.12 seconds (3 small squares) ✔ endometrium ✔
128. If there were 3 large squares in an R-R interval what 4. Increase in basal body temperature ✔
would the heart rate be? 134. Where are luteinizing hormone (LH) and follicle
1. 70 bpm stimulating hormone (FSH) produced?
2. 80 bpm 1. Hypothalamus
3. 90 bpm 2. Anterior pituitary ✔
 3. Posterior pituitary 4. Absence of menstruation always indicates an
4. Adrenal glands active pregnancy.
135. At which stage in the uterine cycle does the proliferative 140. At which stage of the uterine cycle does the menstrual
phase occur? phase occur?
1. Days 1-5 1. Days 1-5 ✔
2. Days 5-14 ✔ 2. Days 5-14
3. Days 15-28 3. Days 14-28
136. Which of the following symptoms indicate that a woman 141. At which stage in the uterine cycle does the secretory
is about to ovulate? phase occur?
1. Decrease in basal body temperature 1. Days 1-5
2. Increase in basal body temperature ✔ 2. Days 5-14
3. Thickening of cervical mucous 3. Days 14-28 ✔
4. Thinning of cervical mucous 142. Which of the following are functions of luteinizing
137. Where is gonadotrophin-releasing hormone produced? hormone (LH)?
1. Anterior pituitary 1. Formation and maintenance of the corpus luteum
2. Posterior pituitary ✔
3. Hypothalamus ✔ 2. Thinning of the Graafian follicles membrane ✔
4. Adrenal glands 3. Stimulation of follicle development
138. At which point in the menstrual cycle is a woman most 4. Stimulation of GnRH production
fertile? 143. In a normal 28 day menstrual cycle, when would you
1. Days 1-5 expect the LH surge to occur?
2. Days 9-16 ✔ 1. Days 8-10
3. Days 17-21 2. Days 11-13 ✔
4. Days 22-28 3. Days 14-16
139. Which of the following statements are true about 4. Days 17-19
menstruation? 144. Which one of the following is the primary source of
1. In a normal 28 day menstrual cycle you would progesterone in the later stages of pregnancy?
expect menstruation to last approximately 3-5 1. Fetus
days. ✔ 2. Endometrium
2. During menstruation the entire endometrium is 3. Corpus luteum
shed. 4. Placenta ✔
3. During menstruation only the functional layer of 145. Which hormone is the corpus luteum responsible for
the endometrium is shed, with the basal layer producing?
remaining intact. ✔ 1. Oestrogen
2. Progesterone ✔
 3. Follicle-stimulating hormone 151. At 28 weeks gestation where would you expect to feel
4. Luteinizing hormone the uterine fundus?
146. Which of the following are effects of increased levels of 1. Symphysis pubis
oestrogen in the follicular phase of the menstrual cycle? 2. Umbilicus
1. Hair thinning 3. Xiphisternum
2. Thickening of cervical mucous 4. Halfway between xiphisternum and umbilicus ✔
3. Thinning of cervical mucous ✔ 152. Which of the following is thought to be a cause of
4. Thickening of the endometrium ✔ hyperemesis gravidarum?
147. At 22 weeks gestation where would you expect to find
1. High levels of circulating HCG ✔
the uterine fundus?
2. Underlying infection
1. Halfway between umbilicus and xiphisternum
3. Over eating
2. Umbilicus ✔
4. Psychological issues
3. Xiphisternum
153. Which of the following methods is the correct way to
4. Symphysis pubis
calculate the estimated date of delivery (EDD)?
148. Which of the following are causes of postpartum
haemorrhage? 1. First day of LMP + 9 months and 1 week ✔
1. Vaginal or vulval lacerations 2. Last day of LMP + 8 months and 1 week
2. Uterine atony 3. First day of LMP + 9 months
3. Retained placenta 4. First day of last menstrual period (LMP) + 8 months
4. Coagulapathy and 1 week
5. All of Above ✔ 154. Which period of gestation does the 2nd trimester
149. Which of the following are recognised causes of represent?
intrauterine growth restriction (IUGR)? 1. 13-28 weeks ✔
1. Diabetes 2. 15-30 weeks
2. Pre-eclampsia 3. 14-29 weeks
3. Smoking 4. 10-20 weeks
4. Hypertension 155. At 36 weeks gestation where would you expect to find
5. Alcohol the uterine fundus?
6. All of above ✔ 1. Halfway between umbilicus and xiphisternum
150. Which period of gestation does the 3rd trimester 2. Symphysis pubis
represent? 3. Umbilicus
1. 30-41 weeks 4. Xiphisternum ✔
2. 27-39 weeks
156. At what stage of gestation would you expect a
3. 28-40 weeks
nulliparous women to begin to feel fetal movements?
4. 29-40 weeks ✔
1. 14-16 weeks
 2. 18-20 weeks ✔ 162. Which of the following are causes of Addison’s
3. 10-12 weeks disease?
4. 22-24 weeks 1. Tuberculosis ✔
157. What is the most common cause of postpartum 2. Autoimmune destruction of the adrenal cortex
haemorrhage? ✔
1. Vulval or vaginal lacerations 3. Adrenoleukodystrophy ✔
2. Retained placenta 4. Pyelonephritis
3. Uterine atony ✔ 163. What is the most common cause for the
4. Uterine rupture overproduction of growth hormone in acromegaly?
158. Which period of gestation does the 1st trimester 1. Hyperplasia of the pituitary stalk
represent? 2. Pituitary adenoma ✔
1. 1-12 weeks ✔ 3. Hypothalamic lesion
2. 1-13 weeks 4. Pituitary lesion
3. 1-11 weeks 164. Which one of the following hormones binds to the
4. 1-10 weeks pituitary and stimulates the release of luteinizing
159. Which of the following are risk factors for pre-eclampsia? hormone (LH) and follicle stimulating hormone (FSH)?
1. First pregnancy 1. Gonadotrophin releasing hormone (GnRH) ✔
2. Family history of pre-eclampsia in mother or sisters 2. Adrenocorticotropic hormone (ACTH)
3. Obesity (BMI >35) 3. Corticotropic releasing hormone (CRH)
4. Maternal age > 40 165. Which one of the following statements describes the
5. Change of partner underlying pathology of Grave’s disease?
6. All of Above ✔ 1. Inflammation of the thyroid gland due to
160. Which of the following is a prostaglandin commonly used lymphocytic infiltration causes the stored
in induction of labour? thyroid hormones to be released into the
1. Labetalol circulation leading to hyperthyroidism.
2. Atenolol 2. An autoimmune disease directed against
3. Misoprostol ✔ thyroid stimulating hormone (TSH) receptors.
161. At 12 weeks gestation where would you expect to feel The autoantibodies stimulate the TSH receptors
the uterine fundus? causing increased T3 and T4 production. ✔
1. Xiphisternum 3. A benign tumour of the thyroid gland which
2. Halfway between umbilicus and xiphisternum produces excessive amounts of thyroid
3. Symphysis pubis ✔ hormones.
4. Umbilicus 4. Consumption of ground beef which has been
contaminated with thyroid tissue. The thyroid
 tissue contains metabolically active thyroid
hormones which causes hyperthyroidism.
166. Which one of the following statements is true
regarding the prevalence of acromegaly?
1. Acromegaly affects twice as many men than it
does women
2. Acromegaly effects a similar number of men
and women ✔
3. Acromegaly affects twice as many women than
men
167. Which of the following statements best describes
Cushing’s syndrome?
1. Cushing’s syndrome refers to a disease
process caused by abnormally low levels of
aldosterone
2. Cushing’s syndrome refers to a disease
process caused by abnormally low levels of
cortisol
3. Cushing’s syndrome refers to a disease
process caused by abnormally high levels of
aldosterone
4. Cushing’s syndrome refers to a disease
process caused by abnormally high levels of
cortisol ✔
168. Which of the following statements regarding
Cushing’s syndrome is correct?
1. Men are more likely to develop Cushing’s
syndrome
2. Women are more likely to develop Cushing’s
syndrome ✔
3. The incidence of Cushing’s syndrome is
distributed equally between sexes
169. Which one of the following statements best describes
an Addisonian crisis?
1. Dangerously high levels of testosterone
2. Severe adrenal insufficiency resulting in
dangerously low serum testosterone levels
3. Severe adrenal insufficiency resulting in
dangerously low serum cortisol levels ✔
4. Dangerously high serum cortisol levels
170. Which of the following hormones are produced in the
anterior pituitary gland?
1. Follicle-stimulating hormone (FSH) ✔
2. Growth hormone (GH)✔
3. Oxytocin
4. Thyroid-stimulating hormone (TSH) ✔
5. Vasopressin (antidiuretic hormone)
6. Adrenocorticotrophic hormone (ACTH) ✔
7. Prolactin ✔
8. Luteinizing hormone (LH) ✔
171. In males which hormone stimulates Leydig cells to
produce testosterone?
1. Luteinizing hormone (LH) ✔
2. Follicle stimulating hormone (FSH)
172. Which of the following statements correctly describes
the pathophysiology of Cushing’s disease?
1. Cushing’s disease results from a benign
adrenal adenoma secreting excess ACTH. High
levels of ACTH in turn cause increased
production of cortisol from the adrenal cortex.
2. Cushing’s disease results from a benign
adrenal adenoma secreting excess levels of
cortisol.
3. Cushing’s disease results from a benign
pituitary adenoma secreting excess levels of
cortisol.
4. Cushing’s disease results from a benign
pituitary adenoma secreting excess ACTH.
 High levels of ACTH in turn causes increased 5. Mutations in vasopressin gene
production of cortisol from the adrenal cortex. 6. Sheehan’s syndrome
✔ 7. Lithium ✔
173. Which of the following are Sertoli cells responsible for 177. Which one of the following is the main function of
producing? aldosterone?
1. Testosterone 1. Increase in blood volume ✔
2. Gonadotrophin releasing hormone (GnRH) 2. Decrease in blood volume
3. Androgen binding globulin (ABG) ✔ 178. Which of the following investigations is the gold
4. Oestrogen standard for diagnosing acromegaly?
174. Which one of the following is acromegaly caused by? 1. Growth hormone measurement
1. Overproduction of gonadotrophin releasing 2. Growth hormone releasing hormone
hormone (GnRH) measurement
2. Overproduction of vasopressin (antidiuretic 3. Oral glucose tolerance test + Growth hormone
hormone) measurement ✔
3. Overproduction of adrenocorticotropic hormone 4. Serum IGF1 measurement
(ACTH) 179. Which of the following statements best describes
4. Overproduction of growth hormone (GH) ✔ diabetes insipidus?
175. Which of the following are symptoms of Addison’s 1. Diabetes insipidus is a disease characterised
disease? by the passage of large volumes of dilute urine
1. Weight gain ✔
2. Diplopia 2. Diabetes insipidus is a disease characterised
3. Hyperpigmentation✔ by the passage of small volumes of
4. Weight loss✔ concentrated urine
5. Striae 3. Diabetes insipidus is a disease characterised
6. Postural hypotension✔ by the passage of small volumes of dilute urine
7. Moon face 4. Diabetes insipidus is a disease characterised
8. Fatigue✔ by the passage of large volumes of
176. Which of the following are causes of nephrogenic concentrated urine
diabetes insipidus? 180. What is the most common cause of Cushing’s
1. Post obstructive uropathy ✔ syndrome?
2. Amyloidosis ✔ 1. Glucocorticoid treatment (iatrogenic) ✔
3. Atenolol 2. Pituitary adenoma
4. Mutations in the vasopressin (ADH) receptor 3. Adrenal adenoma
gene ✔ 4. Ectopic ACTH production
181. Which of the following are not causes of neurogenic
diabetes insipidus?
1. Trauma
2. Sheehan’s syndrome
3. Meningitis
4. Mutatations in the vasopressin gene
5. Polycystic kidney disease ✔
6. Pituitary adenoma
7. Mutatations in the vasopressin (ADH) receptor
gene ✔
182. Which of the following does the adrenal cortex
produce?
1. Cortisol ✔
2. Adrenaline
3. Noradrenaline
4. Aldosterone ✔
183. Which of the following statements best describes
Hashimoto’s thyroiditis?
1. Inflammation of the thyroid gland as the result
of a virus. The disease is often preceded by an
upper respiratory tract infection.
2. A destructive autoimmune disease caused by
auto-reactive antibodies against thyroglobulin.
✔ The autoantibodies stimulate the TSH receptors
3. Iodine deficiency
184. In regard to the investigation of hyperthyroidism,
which one of the following antibodies is specific to
Grave’s disease?
1. TSH receptor antibodies ✔
2. Thyroid peroxidase antibody
3. Thyroglobulin antibody
185. Which of the following causes of Cushing’s syndrome
does the phrase “Cushing’s disease” specifically refer to
? 3. Weight gain
1. Pituitary adenoma ✔
2. Ectopic ACTH production
3. Adrenal adenoma
4. Iatrogenic
186. Which of the following is not a symptom of Cushing’s
syndrome?
1. Easy bruising
2. Stretch marks
3. Increased pigmentation of skin ✔
4. Acne
5. Weight gain
187. What of the following statements best describes a
toxic thyroid adenoma?
1. Inflammation of the thyroid gland due to
lymphocytic infiltration causing stored thyroid
hormones to be released into the circulation
leading to hyperthyroidism.
2. A malignant tumour of the thyroid gland which
produces excessive amounts of thyroid
hormones. These arise from the follicular cells
of the thyroid gland.
3. An autoimmune disease directed against
thyroid stimulating hormone (TSH) receptors.
causing increased T3 and T4 production
4. A benign tumour of the thyroid gland which
produces excessive amounts of thyroid
hormones. These arise from the follicular cells
of the thyroid. ✔
188. Which of the following are common symptoms of
hyperthyroidism?
1. Urinary frequency
2. Diarrhoea ✔
 4. Weight loss✔
5. Heat intolerance ✔
6. Tremor ✔
189. Which age group does acromegaly most commonly
affect?
1. 55-70 years
2. 10-25 years
3. 30-50 years ✔
4. 25-40 years
190. What is Addison’s disease?
1. Addison’s disease involves the overproduction
of cortisol and aldosterone by the adrenal
cortex.
2. Addison’s disease involves the overproduction
of androgens by the adrenal medulla.
3. Addison’s disease is a long-term endocrine
disorder in which the adrenal glands do not
produce enough steroid hormones. ✔
4. Addison’s disease involves the underproduction
of androgens by the adrenal medulla.
191. Which of the following is the underlying problem in
neurogenic diabetes insipidus?
1. Overproduction of oxytocin
2. Overproduction of prolactin
3. Lack of prolactin
4. Lack of oxytocin
5. Overproduction of vasopressin (antidiuretic
hormone)
6. Lack of vasopressin (antidiuretic hormone) ✔
192. Which is a more sensitive measure of thyroid
function?
1. Thyroid stimulating hormone (TSH) ✔
2. Free T4
3. Free T3
193. Which of the following are symptoms of acromegaly?
1. Headache ✔
2. Visual changes (double vision, reduced vision,
tunnel vision) ✔
3. Abdominal distention
4. Vomiting
5. Excessive sweating (hyperhidrosis) ✔
6. Widespread rash
7. Increased finger ring size ✔
8. Deepening voice ✔
9. Diarrhoea
10. Paresthesia and weakness in the hands ✔
194. What is the most common cause of hyperthyroidism?
1. Grave’s disease ✔
2. Toxic thyroid adenoma
3. Toxic multinodular goitre
4. Thyroiditis
195. Which of the following hormones are stored in the
posterior pituitary gland?
1. Luteinizing hormone (LH)
2. Growth hormone (GH)
3. Thyroid stimulating hormone (TSH)
4. Follicle stimulating hormone (FSH)
5. Adrenocorticotropic hormone (ACTH)
6. Oxytocin ✔
7. Prolactin
8. Vasopressin (antidiuretic hormone) ✔
196. Which of the following are correct regarding the
effects of increased levels of growth hormone in
acromegaly?
1. Increased levels of growth hormone stimulate
increased production of insulin like growth
factor one (IGF1) from the adrenal glands
 2. Increased levels of growth hormone stimulate 4. Dipsogenic diabetes insipidus is caused by a
increased production of vasopressin from the defect or damage to the pituitary stalk causing
adrenal glands malfunction of the hunger mechanism.
3. Increased levels of growth hormone stimulate 200. Which of the following hormones are produced by the
increased production of vasopressin from the adrenal cortex?
liver 1. Epinephrine (adrenaline)
4. Increased levels of growth hormone stimulate 2. Aldosterone ✔
increased production of insulin like growth 3. 5-DHEA ✔
factor one (IGF1) from the liver ✔ 4. Cortisol ✔
197. What do Leydig cells produce? 5. Norepinephrine (noradrenaline)
1. Testosterone ✔ 201. In males which hormone stimulates Sertoli cells to produce
2. Semen androgen binding globulin (ABG)?
3. Androgen binding globulin 1. Luteinizing hormone (LH)
4. Oestrogen 2. Follicle stimulating hormone (FSH) ✔
198. Which of the following are common symptoms of 3. Oxytocin
hypothyroidism? 4. Gonadotrophin releasing hormone (GnRH)
1. Weight gain ✔ 202. At what age should a child be referred to a paediatrician if
2. Hyporeflexia ✔ they have not begun to walk?
1. 18 months ✔
3. Hair loss ✔
2. 12 months
4. Oily skin
3. 15 months
5. Excessive hair growth
4. 9 months
6. Weight loss
203. A resurgence of which hormone precipitates puberty?
7. Dry skin ✔
1. Oestrogen
199. Which one of the following statements best defines
2. GnRH ✔
dipsogenic diabetes insipidus? 3. Testosterone
1. Dipsogenic diabetes insipidus is caused by a 4. LH
defect or damage to the pituitary gland causing 5. FSH
malfunction of the thirst mechanism. 204. How is the seasonal flu vaccination usually administered in
2. Dipsogenic diabetes insipidus is caused by a children aged 2 and 3?
defect or damage to the pituitary stalk causing 1. SC injection
malfunction of the thirst mechanism. 2. Orally
3. Dipsogenic diabetes insipidus is caused by a 3. Rectally
defect or damage to the hypothalamus causing 4. Nasally ✔
malfunction of the thirst mechanism. ✔ 5. EIM injection
205. Which of the following sentences best describes 210. Which of the following should be avoided when weaning a
meconium? child of 7 months?
1. The first stool when a child has been fully weaned. 1. Wheat
2. green stool. 2. Formula milk
3. The first stool passed by a child. ✔ 3. Honey ✔
4. The first stool after introduction of wheat. 4. Meat-containing products
5. The first stool after introduction of feeds. 5. Breastmilk
206. Around what age should a child be able to build a tower of 211. Which of the following is an example of “Double-syllable
three building blocks? babble” displayed by an infant around 9-12 months?
1. 21 months 1. Ma-da
2. 18 months ✔ 2. Ba-ma
3. 15 months 3. Ma-ba
4. 9 months 4. Ba-da
5. 12 months 5. Ba-ba ✔
207. At what age should a child develop a mature pincer grip? 212. What type of cardiomyopathy is most commonly
1. 3-6 months associated with the sudden death of young athletes?
2. 2 years 1. Hypertrophic cardiomyopathy ✔
3. 9-12 months ✔ 2. Restrictive cardiomyopathy
4. 6-9 months 3. Dilated cardiomyopathy
5. 12-18 months 213. What are the classic signs of a cardiac tamponade?
208. In normal fine motor development, which of the following 1. Hypotension, muffled heart sounds, increased
should occur first? jugular venous distension (JVD) ✔
1. Copying a triangle 2. Tachycardia, dyspnoea, fever
2. Copying a circle ✔ 3. Bradycardia, weakness in arms, diaphoresis
3. Drawing a square 4. Hypertension, palpitations, chest pain
4. Tripod pencil grip 214. Ventricular septal defect (VSD) is the most common
5. Copying a cross congenital heart defect, what condition is it most likely to be
209. What is the cut-off for an acceptable weight loss in the first associated with?
7 days of life? 1. Congenital rubella
1. 7% 2. Down’s syndrome
2. 10% ✔ 3. Fetal alcohol syndrome ✔
3. 5% 4. Maternal diabetes
4. 20% 215. What are the characteristics of stable angina?
5. 15% 1. Chest pain that occurs with exertion and/or
emotional stress ✔
 2. Severe and crushing chest pain (>20 mins) 1. Left-sided heart failure ✔
3. Chest pain that occurs at rest 2. Chronic lung disease (Cor Pulmonale)
4. Bradycardia 3. Hypothyroidism
216. What is the most frequent etiologic agent of acute 221. What gross histological change correlates with white
infective endocarditis in IV drug abusers? blood cells’ (WBCs) invasion into cardiac tissue during the
1. Streptococcus viridans first week after an MI?
2. Staphylococcus aureus ✔ 1. Yellow pallor ✔
3. Staphylococcus epidermidis 2. Dark discolouration
4. Streptococcus bovis 3. White scar
217. What is the key complication in the first 24 hours of an 4. Red border around yellow pallor
MI? 222. What is the most common cause of sudden cardiac
1. Fibrinous pericarditis death (SCD)?
2. Coronary artery aneurysm 1. Cocaine abuse
3. Arrhythmia ✔ 2. Mitral valve prolapse
4. Mitral insufficiency 3. Cardiomyopathy
218. What is the most commonly involved coronary artery in 4. Ventricular arrhythmia ✔
myocardial infarction (MI) ? 223. What heart condition is Turner’s syndrome associated
1. Right coronary artery (RCA) with?
2. Left anterior descending artery (LAD) ✔ 1. Tricuspid atresia
3. Left circumflex artery (LCA) 2. Truncus arteriosus
4. Posterior descending artery (PDA) 3. Coarctation of the aorta ✔
219. What is the best description of Eisenmenger’s 4. Patent ductus arteriosus
syndrome? 224. What is the main complication of the macrophage phase
1. It occurs when a right to left shunt becomes left to (4 to 7 days) after an MI?
right due to a build-up of pressure on the left side 1. Fibrinous pericarditis
of the heart. 2. Arrhythmia
2. It is due to failure of the aorticopulmonary septum 3. Aneurysm / Mural thrombus / Dressler’s
to spiral. syndrome
3. It is due to lack or aorticopulmonary septum 4. Cardiac tamponade / Shunt through the
formation. ventricular wall / Mitral insufficiency ✔
4. An initial left to right shunt becomes right to left 225. Choose the complete and accurate grouping of right to
due to increased pulmonary blood flow and left shunts
eventual right ventricular hypertrophy (RVH). ✔ 1. Atrial septal defect (ASD), Patent ductus
220. What is the most common cause of right-sided heart arteriosus (PDA), Ventricular septal defect (VSD)
failure?
 2. Truncus arteriosus, Transposition of great atrophy. She is treated with corticosteroids. What disease
vessels, Tricuspid atresia, Tetralogy of Fallot, does the patient have?
Total anomalous pulmonary venous return 1. Polymyositis
(TAPVR) ✔ 2. X- linked muscular dystrophy
3. ASD, TAPVR, VSD 3. Dermatomyositis ✔
4. PDA, Truncus arteriosus, tetralogy of fallot 4. Rheumatoid arthritis
226. What is the most common cause of mitral stenosis? 231. What bone tumour is associated with lifting of
1. Chronic rheumatic valve disease ✔ periosteum off bone producing the Codman triangle and a
2. Acute rheumatic fever sunburst appearance on X-ray?
3. Congestive heart failure 1. Osteosarcoma ✔
4. Infective endocarditis 2. Osteoma
227. What does the ECG show in prinzmetal angina? 3. Ewing sarcoma
1. ST segment elevation ✔ 4. Chondroma
2. ST segment depression 232. On biopsy, a mosaic pattern of lamellar bone is
3. Absent P waves revealed. What disease is associated with these results?
4. Prolonged PR interval 1. Osteoporosis
228. Which of the following conditions is Marfan’s syndrome 2. Sickle cell disease
most commonly associated with? 3. Paget’s disease of bone ✔
1. Endocarditis 4. Osteopetrosis
2. Restrictive cardiomyopathy 233. Select the cause/s of vitamin D deficiency.
3. Arrhythmia 1. Minimal sun exposure ✔
4. Aortic dissection ✔ 2. Poor diet ✔
229. What bone disorder is caused by an autosomal 3. Liver failure and renal failure ✔
dominant defect in the synthesis of collagen type 1? 4. Malabsorption ✔
1. Osteogenesis imperfecta ✔ 234. Acute gout presents as painful inflammation of the big
2. Achondroplasia toe which is referred to as podagra. What is an acute
3. Osteopetrosis treatment for gout?
4. Osteomyelitis 1. Allopurinol
230. A patient presents with a heliotrope rash, a malar rash 2. Probenecid
and Gottron’s papules on the elbows and knees. She 3. Febuxostat
cannot comb her hair or climb the stairs due to muscle 4. Colchicine ✔
weakness. Lab results show an increased creatine kinase, 235. What are the key lab features in osteomalacia?
positive antinuclear antibody (ANA) and anti-Jo-1 antibody. 1. Normal serum calcium, normal serum phosphate,
Biopsy reveals perimysial inflammation with perifascicular normal PTH, normal alkaline phosphatase
 2. ↑ serum calcium, ↓serum phosphate, ↑PTH,
↑alkaline phosphatase
3. ↓ serum calcium, ↓ serum phosphate, ↑ PTH, ↑
alkaline phosphatase ✔
4. ↓ serum calcium , ↑ serum phosphate , ↑PTH,
↑alkaline phosphatase
236. Synovial fluid was sampled for a joint condition and
rhomboid shaped crystals with weak positive birefringence
under polarised light were found. What joint disease is this
an indicator of?
1. Pseudogout ✔
2. Gout
3. Rheumatoid arthritis
4. Osteoarthritis
237. Achondroplasia is a disorder of bone whereby there is a
mutation in the fibroblast growth factor receptor 3 (FGFR3)
gene leading to impaired cartilage proliferation in the growth
plate. Why is it that affected children have a normal sized
head and vertebral column whilst arms and legs are
shortened?
1. Growth hormone and insulin like growth factor 1
levels only affect long bones
2. Intramembranous bone formation (flat bones) vs
endochondral bone formation (long bones) ✔
3. Flat bones are less susceptible to fracture
4. Difference in bone density
238. What is the pathogenesis of osteopetrosis (marble bone
disease)?
1. Poor osteoclast function due to a carbonic
anhydrase II mutation ✔
2. Defective mineralization of osteoid
3. Reduction in trabecular bone mass
4. Imbalance between osteoclast and osteoblast
activity with an osteoclastic phase, a mixed
osteoclastic- osteoblastic phase followed by an
osteoblastic phase
239. Which joint disease is associated with morning stiffness
that improves with activity?
1. Osteoarthritis
2. Gout
3. Rheumatoid arthritis (RA)D ✔
4. Ankylosing spondylitis
240. What is the pathogenesis of pemphigus vulgaris?
1. IgG antibody against desmoglein ✔
2. IgG antibody against hemidesmosome
components
3. Autoimmune deposition of IgA at tips of dermal
papillae
4. DEnzyme defect in tyrosinase
241. What condition is associated with this presentation? A
pink pearly nodule with telangiectasias, ulceration and
rolled borders on the upper lip.
1. Squamous cell carcinoma
2. Basal cell carcinoma ✔
3. Melanoma
4. Eczema
242. How does impetigo present?
1. Golden honey coloured crust over an
erythematous base✔
2. Salmon coloured plaque with silvery scale
3. Comedones, pustules and nodules
4. Flesh coloured papule with a rough surface
243. What is the pathogenesis of vitiligo?
1. Congenital lack of pigmentation
2. Increase in the number of melanosomes
3. Autoimmune destruction of melanocytes✔
4. Benign proliferation of melanocytes
244. What disease is associated with dermatitis
herpetiformis?
 1. Herpes 1. Penicillin and sulphonamides
2. Coeliac disease ✔ 2. Systemic lupus erythematosus
3. Atopic dermatitis 3. HSV infection ✔
4. Melanoma 4. Malignancy
245. What childhood infection is associated with Koplik 251. What is the most common mole found in adults?
spots? 1. Junctional nevus
1. Measles✔ 2. Compound nevus
2. Rubella 3. Intradermal nevus ✔
3. Varicella 4. Congenital nevus
4. Fifth disease 252. What condition is associated with acanthosis nigricans?
246. What type of melanoma is often seen in dark skinned 1. Type 2 diabetes and gastric adenocarcinoma ✔
individuals? 2. Rubella
1. Superficial spreading 3. Varicella zoster
2. Lentigo maligna melanoma 4. Basal cell carcinoma
3. Nodular 253. What disorder is characterised by an initial ‘herald patch’
4. Acral lentiginous✔ which is then followed by scaly erythematous plaques usually
247. What is the best indicator of prognosis for a melanoma? in a ‘Christmas tree’ distribution?
1. Asymmetry 1. Pityriasis rosea ✔
2. Colour 2. Herpes
3. Diameter 3. Varicella zoster virus
4. Invasion of the dermis ✔ 4. Erysipelas
248. How does lichen planus present clinically? 254. What is the infective agent implicated in acne?
1. Salmon coloured plaques with silvery scale 1. Staphylococcus aureus
2. Pruritic, red, oozing rash with edema 2. Streptococcus pyogenes
3. Golden coloured crusts 3. Staphylococcus epidermidis
4. Pruritic, purple, polygonal, planar papules and 4. Propionibacterium acnes ✔
plaques ✔ 255. What is a precursor to squamous cell carcinoma (SCC)?
249. What are the histological findings of psoriasis? 1. Keratoacanthoma
1. Inflammation of the dermal-epidermal junction 2. Actinic keratosis ✔
2. Peripheral palisading of basal cells 3. Leser-Trélat sign
3. Acanthosis, Parakeratosis and Munro 4. Measles
microabscesses ✔ 256. What is Leser-Trélat sign?
4. Keratin pseudocysts 1. Sudden appearance of multiple seborrhoeic keratoses
250. What is the most common causative agent of erythema and is an indicator of a gastrointestinal tract carcinoma.
multiforme (EM)? ✔
 2. A left supraclavicular node associated with gastric 262. What tumour is characterised by findings of ‘Schiller
carcinoma Duval bodies’ on histology and raised levels of AFP on
3. Metastasis of gastric carcinoma to the periumbilical blood tests?
region 1. Yolk sac tumour ✔
4. Metastasis of gastric carcinoma to the bilateral ovaries 2. Embryonal carcinoma
257. What skin condition is caused by poxvirus? 3. Teratoma
1. Verruca 4. Sertoli cell tumour
2. Molluscum contagiosum ✔ 263. What is the most common congenital male reproductive
3. Impetigo disorder?
4. Cellulitis 1. Hydrocoele
258. An elderly lady presents to her doctor with a raised, round 2. Testicular torsion
discoloured plaque, ‘stuck on appearance’ on her face. What 3. Peyronie’s disease
skin condition is this? 4. Cryptorchidism ✔
1. Rubella 264. What are the risk factors for developing germ cell
2. Seborrheic keratosis ✔ tumours?
3. Basal cell carcinoma 1. Orchitis
4. Melasma 2. Hydrocoele and varicocele
259. What is the grading system for prostatic cancer? 3. Klinefelter syndrome and cryptorchidism ✔
1. Breslow thickness 4. Hypospadias and epispadias
2. Bloom Richardson 265. How does testicular torsion typically present?
3. Gleason ✔ 1. Sudden pain in the scrotum and an absent
4. Fuhrman cremasteric reflex ✔
260. What is priapism? 2. Swelling of the scrotum and fever
1. Inability to void the bladder 3. A painless testicular mass that cannot be
2. Abnormal curvature of the penis transilluminated
3. Painful erection lasting > 4 hours ✔ 4. ‘Bag of worms’ appearance of the scrotum
4. Cyst due to a dilated testicular duct 266. Are testicular tumours usually biopsied?
261. What area does prostate cancer spread to most 1. Yes
frequently? 2. No ✔
1. Brain 267. What type of testicular tumour fits this description? A
2. Lung homogenous and painless mass with the absence of
3. Pancreas haemorrhage. On histology, findings include large cells in
4. Lumbar spine ✔ lobules with clear cytoplasm ‘fried egg appearance’.
1. Teratoma
2. Choriocarcinoma
 3. Leydig cell tumour 275. The superior part of the tympanic membrane is known
4. Seminoma ✔ as the pars flaccida.
268. What is the causative agent of condyloma acuminatum? 1. True ✔
1. Chlamydia trachomatis 2. False
2. HPV 6 or 11 ✔ 276. The bones of the ear from the outside to inside are:
3. HSV 1. Incus
4. E-coli 2. Stapes
269. Do varicoceles typically appear on the right side or the 3. Malleus
left side? 1. True
1. Right 2. False ✔
2. Left ✔ 277. The ‘cone of light’ is a reflection of light on the tympanic
270. What is hypospadias? membrane that points superiorly.
1. Opening of urethra on the ventral surface of the 1. True
penis ✔ 2. False ✔
2. Opening of urethra on dorsal surface of the penis 278. The Eustachian tube connects the eye to the nose.
3. Inflammation of the testicles 1. True
4. Benign warty growth on genital skin 2. False ✔
271. What is the best description for the area of the prostate 279. The tensor tympani is the only muscle present in the
that the carcinoma usually affects? inner ear.
1. Posterior and peripheral region ✔ 1. True
2. Anterior and peripheral region 2. False ✔
3. Periurethral region 280. The tongue is partially innervated by the facial nerve
4. Entire anterior region 1. True ✔
272. The vocal cords are attached anteriorly by the arytenoid 2. False
cartilage. 281. The cochlea is responsible for balance.
1. True 1. True
2. False ✔ 2. False ✔
273. The bridge of the nose is made out of cartilage. 282. A 28-year-old man presents to his GP with a 4cm
1. True mobile anterior neck mass. A fine needle aspirate is
2. False ✔ performed which reveals cells with ‘orphan Annie eye’
274. Waldeyer’s ring is the ring that surrounds the tympanic nuclei and psammoma bodies.
membrane. What is the most likely diagnosis?
1. True 1. Thyroglossal duct cyst
2. False ✔ 2. Follicular carcinoma
3. Medullary carcinoma
 4. Papillary carcinoma ✔
5. Lingual thyroid
283. What is the most common type of thyroid carcinoma?
1. Follicular carcinoma
2. Papillary carcinoma ✔
3. Medullary carcinoma
4. Anaplastic carcinoma
284. Which of the following features is NOT typical for
Graves disease?
1. Hyperplasia of the follicles
2. Scalloping of the colloid
3. Irregular shaped follicles
4. Infiltration of mononuclear cells into retro-orbital
connective tissues
5. Extensive infiltration of the mononuclear cells into
the thyroid parenchyma ✔
285. A 37-year-old woman presents to the clinic with 2 days
of sudden onset pain in the anterior neck radiating to the
jaw. She is otherwise well having reported a full recovery
from a ‘cold’ a week ago.
What findings are NOT consistent with her diagnosis?
1. Plasma cells aggregating around damaged
thyroid follicles
2. Dense fibrosis of the thyroid gland ✔
3. Neutrophilic infiltration of the thyroid
4. Formation of microabscesses
5. Multinucleated giant cells encapsulating colloid
fragments
286. A 62-year-old gentleman presents to the clinic with a
5cm painless neck mass as well as diarrhoea for the past 3
months. A biopsy is taken and he is subsequently
diagnosed with medullary carcinoma.
Which of the following features is consistent with a
medullary carcinoma?
1. Grossly soft and tender mass
2. Diagnosis of MEN-1 syndrome
3. Haematologic metastatic spread
4. High levels of calcitonin ✔
5. Localised amyloid deposits
287. Which of the following features is NOT consistent with
follicular carcinoma?
1. Malignant proliferation of follicular cells
2. Follicular carcinomas are diagnosed via fine
needle aspiration ✔
3. More common in women than men
4. Commonly have PI-3K/AKT signalling pathway
mutations
5. Uniform cells forming small colloid containing
follicles
288. A 46-year-old female presents to the preadmission clinic
and is found to have a 3cm anterolateral firm painless neck
mass along with a minor decrease in calcium serum levels.
What is the most likely diagnosis?
1. Anaplastic carcinoma
2. Medullary carcinoma ✔
3. Follicular carcinoma
4. Papillary carcinoma
5. Parathyroid carcinoma
289. Which of the following features are NOT consistent with
anaplastic carcinoma?
1. Large, pleomorphic giant cells
2. Occasional osteoclast-like multinucleated giant
cells
3. Spindle cells
4. Poor prognosis
5. Positive thyroglobulin markers ✔
290. What thyroid cancer has the worst prognosis? (choose
the answer that shows the correct descending order, the
first being the cancer with the worst prognosis and the last
being the one with the best prognosis)
 1. anaplastic > medullary > follicular > papillary ✔ 296. The most aggressive and destructive cyst is ?
2. anaplastic > medullary > papillary > follicular 1. Periapical cyst
3. anaplastic > papillary > medullary > follicular 2. Dentigerous cyst✔
4. medullary > anaplastic > papillary > follicular 3. Globulomaxillary cyst
5. medullary > anaplastic > follicular > papillary 4. Nasopalatine cyst
291. An 18-year-old female presents with a painless 1cm 297. Standard treatment of ameloblastoma ?
mass in the anterior neck region. A biopsy is taken 1. Segmental resection with 1 cm of normal bone ✔
revealing fluid contained within pseudostratified columnar 2. Enbloc resection
epithelium. 3. Enucleation
What is the most likely diagnosis? 4. Enucleation with cauterization
1. Follicular adenoma 298. The most common odontogenic cyst is ?
2. Branchial cyst 1. Primordial cyst
3. Thyroglossal duct cyst ✔ 2. Dentigerous cyst
4. Thyroid cystitis 3. Radicular cyst ✔
5. Parotid tumour 4. Mucocele
292. Conjoint tendon is formed by ? 299. Cyst arising from dental lamina ?
1. External and internal oblique 1. Radicular cyst
2. External oblique and transversus abdominis 2. Paradental cyst
3. Internal oblique and transversus abdominis ✔ 3. Eruption cyst
4. Internal oblique 4. Glandular odontogenic cyst ✔
293. Multiple bilateral dentigerous cysts are seen in ? 300. Adenomatoid odontogenic tumour is characterized
1. Down’s syndrome histologically by ? (1)
2. Maroteaux lamy syndrome ✔ 1. Polyhedral epithelial cells
3. Teacher collin syndrome 2. Tubular / duct like cells ✔
4. Gorlin Goltz syndrome 3. Stellate shaped cells
294. COC is now called as? 4. Stratified squamous epithelial cells
1. Odontogenic ghost cell tumor
2. Dentinogenic ghost cell tumor ✔
3. Keratcysticodontogenic tumour
4. A & C
295. Facial nerve paralysis is common with?
1. Pleomorphic adenoma
2. Epidermoid carcinoma
3. Warthin’s stumour
4. Lymphoepithelial carcinoma ✔