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Question 1
Correct
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Changes in the urinary tract system in pregnancy include:
Your Answer: Increase in the glomerular filtration rate (GFR)
Explanation:Pregnancy involves remarkable orchestration of physiologic changes. The kidneys are central players in the evolving hormonal milieu of pregnancy, responding and contributing to the changes in the environment for the pregnant woman and foetus. The functional impact of pregnancy on kidney physiology is widespread, involving practically all aspects of kidney function. The glomerular filtration rate increases 50% with subsequent decrease in serum creatinine, urea, and uric acid values.
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This question is part of the following fields:
- Physiology
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Question 2
Correct
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What kind of biochemical changes occur during the luteal phase of menstrual cycle?
Your Answer: High progesterone levels
Explanation:Menstrual cycle can be divided into the follicular phase and luteal phase. In the luteal phase, there is an increase in progesterone secretion and LH levels are low. If the ova is fertilized, it is implanted in the endometrium. In case of failure in fertilization, there is gradual decrease in progesterone and LH levels.
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This question is part of the following fields:
- Physiology
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Question 3
Incorrect
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What percentage of haemoglobin is HbF by 6 months of age?
Your Answer: 5-10%
Correct Answer:
Explanation:HB gower 1 is the predominant embryonic haemoglobin when the foetus is 6 week old and is replaced by adult haemoglobin by the age of 5 months post natally. Only 2% of the haemoglobin is HbF.
Embryonic Haemoglobin:
Haemoglobin Gower 1 (HbE Gower-1)
Haemoglobin Gower 2 (HbE Gower-2)
Haemoglobin Portland I (HbE Portland-1)
Haemoglobin Portland II (HbE Portland-2)Fetal Haemoglobin (haemoglobin F, HbF)
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This question is part of the following fields:
- Physiology
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Question 4
Correct
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Chief role of the mid-cycle LH surge is:
Your Answer: All are correct
Explanation:LH surge occurs around ovulation and it is this LH surge which results in completion of the 1st meiotic division and ovulation occurs. It enhances the production of androgens and also luteinizes the granulosa cells.
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This question is part of the following fields:
- Physiology
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Question 5
Correct
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Maternal mortality rate is lowest in which age group?
Your Answer: 20 - 30
Explanation:The maternal mortality rate starts low and raises steeply after the age of 30 years. The lowest mortality rate recorded among women is between 19-30 years of age group.
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This question is part of the following fields:
- Physiology
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Question 6
Incorrect
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During wound healing the clotting cascade is activated. Which of the following activates the extrinsic pathway?
Your Answer:
Correct Answer: Tissue Factor
Explanation:The extrinsic pathway is activated by the tissue factor, which converts factor VII to VIIa which later on converts factors X and II to their activated form finally leading to the conversion of fibrinogen to fibrin fibres.
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This question is part of the following fields:
- Physiology
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Question 7
Incorrect
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The test used to diagnose ovulation on day 21 in a 28 days menstrual cycle is:
Your Answer:
Correct Answer: Progesterone
Explanation:After ovulation, the dominant follicle turns into a corpus luteum and begins to secrete progesterone. To confirm ovulation, serum progesterone or its metabolite in urine, can be measured. A single serum progesterone level >3 ng/ml in mid‐luteal phase has been used to retrospectively detect ovulation.
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This question is part of the following fields:
- Physiology
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Question 8
Incorrect
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Normally, pregnancy in 2nd trimester is characterized by all of the following, EXCEPT:
Your Answer:
Correct Answer: Elevated fasting plasma glucose
Explanation:Elevated fasting plasma glucose means gestational diabetes mellitus and is not considered to be in the spectrum of a normal pregnancy. In normal pregnancy however, maternal tissues become progressively insensitive to insulin. This is believed to be caused partly by hormones from the placenta and partly by other obesity and pregnancy related factors that are not fully understood. Gestational diabetes mellitus (GDM) occurs in about 5% of pregnancies but figures vary considerably depending upon the criteria used and demographic characteristics of the population.
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This question is part of the following fields:
- Physiology
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Question 9
Incorrect
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Question 10
Incorrect
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If a sample of cervical mucus is taken on the 12th day of the menstrual cycle and examined under the microscope, what kind of findings would be observed?
Your Answer:
Correct Answer: A fern pattern characteristic of oestrogen
Explanation:Fern test looks for a specific fern like pattern of cervical mucus when observed under light microscope after the sample is dried. It occurs due to the presence of sodium chloride under oestrogen influence whereas progesterone opposes it.
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This question is part of the following fields:
- Physiology
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Question 11
Incorrect
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Regarding cardiac examination during pregnancy which of the following findings should be considered pathological
Your Answer:
Correct Answer: Diastolic murmur
Explanation:Diastolic murmurs should be considered pathological until proven otherwise. The following are common and typically benign findings in pregnancy: A third heart sound after mid-pregnancy. Systolic flow murmurs are common. Left axis deviation on ECG is common, Sagging ST segments and inversion or flattening of the T wave in lead III may also occur
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This question is part of the following fields:
- Physiology
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Question 12
Incorrect
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Question 13
Incorrect
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What is the most common cause of hypercalcaemia?
Your Answer:
Correct Answer: Primary hyperparathyroidism
Explanation:Primary hyperparathyroidism is the most common cause of hypercalcaemia with incidence rates in the UK approximately 30 per 100,000 The majority of patients are postmenopausal women.
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This question is part of the following fields:
- Physiology
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Question 14
Incorrect
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In the absence of any gross pelvic abnormality, cephalopelvic disproportion can be correctly diagnosed by?
Your Answer:
Correct Answer: Trial of labour
Explanation:Cephalo-pelvic disproportion exists when the capacity of the pelvis is inadequate to allow the foetus to negotiate the birth canal. This may be due to a small pelvis, a nongynecoid pelvic formation, a large foetus, an unfavourable orientation of the foetus, or a combination of these factors. Diagnosis of CPD may be made when there is failure to progress, but not all cases of prolonged labour are the result of CPD. Use of ultrasound to measure the size of the foetus in the womb is controversial, as these methods are often inaccurate and may lead to unnecessary caesarean section; a trial of labour is often recommended even if size of the foetus is estimated to be large.
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This question is part of the following fields:
- Physiology
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Question 15
Incorrect
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According to the UK food standards agency which of the following RDIs (recommended daily intake) is 3 times higher in pregnancy than the non-pregnant state?
Your Answer:
Correct Answer: Folic Acid
Explanation:Folic Acid should be increased in diet of a pregnant women. Deficiency will lead to neural tube defects i.e. spina bifida.
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This question is part of the following fields:
- Physiology
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Question 16
Incorrect
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In the foetus, the most well oxygenated blood flows into which part of the heart:
Your Answer:
Correct Answer: Right atrium
Explanation:The placenta accepts the blue, unoxygenated blood from the foetus through blood vessels that leave the foetus through the umbilical cord (umbilical arteries, there are two of them). When blood goes through the placenta it picks up oxygen and becomes red. The red blood then returns to the foetus via the third vessel in the umbilical cord, the umbilical vein. The red blood that enters the foetus passes through the fetal liver and enters the right side of the heart.
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This question is part of the following fields:
- Physiology
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Question 17
Incorrect
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What is the average lifespan of a basophil (white blood cell)?
Your Answer:
Correct Answer: 3-4 days
Explanation:Basophils are granulocytic white blood cells. They express IgE antibody on their surface and react to release prostaglandins and leukotrienes to mediate an inflammatory, allergic reaction.
Blood Cell Lifespans:
Red Blood Cells 120 days
Platelets 5-9 days
White blood cells 2-5 daysNeutrophils (up to 5 days)
Basophils (2 to 3 days)
Eosinophils (2 to 5 days)
Monocytes (1 to 5 days)
Lymphocytes (variable) -
This question is part of the following fields:
- Physiology
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Question 18
Incorrect
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Which of the following tests is used to detect antibodies or complement bound to red blood cell antigens in vivo?
Your Answer:
Correct Answer: Direct Coombs
Explanation:When the red cells are coated with immune IgG antibody, the cells do not agglutinate but when anti-IgG antiserum is added to these sensitized cells visible agglutination occurs. This is known as a positive direct coombs test.
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This question is part of the following fields:
- Physiology
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Question 19
Incorrect
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Which one of the following factors will most likely increase the chances of ovulation in female?
Your Answer:
Correct Answer: LH surge
Explanation:Different changes can occur during the menstrual cycle including an increased body temperature at the time of ovulation, thinning of the cervical mucus and few other changes, but it is the LH surge which is the most important factor necessary for ovulation.
Mittelschmerz is characterised by recurrent midcycle pain which occurs around the time of ovulation. -
This question is part of the following fields:
- Physiology
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Question 20
Incorrect
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CTG showing early decelerations is :
Your Answer:
Correct Answer: From increased vagal tone secondary to head compression
Explanation:Early decelerations: a result of increased vagal tone due to compression of the fetal head during contractions. Monitoring usually shows a symmetrical, gradual decrease and return to baseline of FHR, which is associated with a uterine contraction.
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This question is part of the following fields:
- Physiology
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Question 21
Incorrect
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A 25 year old primigravida with a regular cycle had her last menstrual period on June 30th. Therefore the expected date of delivery (EDD) is approximately when the following year:
Your Answer:
Correct Answer: 7-Apr
Explanation:Expected date of delivery (EDD) is a calculated from the first day of the woman’s last menstrual period. If her periods are regular i.e., 28-day menstrual cycle, Naegele’s rule may be used. Naegele’s rule involves a simple calculation: add seven days to the first day of your LMP and then subtract three months. e.g. 30 June + 7 days = 7 July, minus 3 months = 7 April.
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This question is part of the following fields:
- Physiology
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Question 22
Incorrect
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The expected date of delivery of a human pregnancy can be calculated as:
Your Answer:
Correct Answer: 40 weeks after last menstrual period
Explanation:Expected date of delivery/estimated due date (EDD) is a calculated date (i.e., an estimation), determined by counting forward 280 days (40 weeks) from the first day of the woman’s last menstrual period.
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This question is part of the following fields:
- Physiology
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Question 23
Incorrect
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Polyhydramnios is associated with which one of the following conditions?
Your Answer:
Correct Answer: Tracheo-oesophageal fistula
Explanation:Oesophageal atresia/TE fistula may be suspected prenatally with ultrasound findings of polyhydramnios, absence of fluid in the stomach, small sized abdomen, or the presence of a dilated proximal oesophageal pouch. An underlying disease is only found in 17 % of cases in mild polyhydramnios. In contrast, an underlying disease is detected in 91 % of cases in moderate to severe polyhydramnios. The literature lists the following potential aetiologies: fetal malformations and genetic anomalies (8–45 %), maternal diabetes mellitus (5–26 %), multiple pregnancies (8–10 %), fetal anaemia (1–11 %), other causes, e.g. viral infections, Bartter syndrome, neuromuscular disorders, maternal hypercalcemia. Viral infections which can lead to polyhydramnios include parvovirus B19, rubella, and cytomegalovirus. Other infections, e.g. toxoplasmosis and syphilis, can also cause polyhydramnios.
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This question is part of the following fields:
- Physiology
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Question 24
Incorrect
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Skin changes during pregnancy should include:
Your Answer:
Correct Answer: All of the options given
Explanation:Skin signs during pregnancy may include: dark spots on the breasts, nipples and inner thighs, melasma (chloasma), linea nigra, stretch marks, acne, spider telangiectasis and varicose veins.
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This question is part of the following fields:
- Physiology
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Question 25
Incorrect
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Ovulation may be indicated by all the following, EXCEPT:
Your Answer:
Correct Answer: Mid-cycle elevation in prolactin
Explanation:An elevation in serum PRL is associated with a variety of reproductive disorders, including amenorrhea, oligomenorrhea, anovulation and/or luteal phase defects with subsequent infertility.
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This question is part of the following fields:
- Physiology
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Question 26
Incorrect
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In pregnancy, the following lung function value remains unchanged:
Your Answer:
Correct Answer: FEV1
Explanation:The biochemical and mechanical effects of progesterone and the enlarging uterus are responsible for some changes in lung function during pregnancy.
Progesterone increases the sensitivity of the respiratory centre to arterial carbon dioxide while also causing hyperaemia in the airway leading to nasal obstruction. As a result, minute ventilation and tidal volume increase by 50% to allow greater arterial oxygen saturation.
The enlarging uterus displaces the diaphragm upwards, and also limits the movement of the thoracic cage, thereby decreasing the functional residual capacity (FRC) and the expiratory reserve volume (ERV) by 20%.
Functional Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC) remain unchanged in pregnancy.
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This question is part of the following fields:
- Physiology
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Question 27
Incorrect
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Which of the following factors is fetal nutrition dependant on?
Your Answer:
Correct Answer: All of the options given
Explanation:Fetal nutrition is dependant upon multiple factors such as maternal nutritional state, quality of maternal diet, malnutrition, anorexia nervosa, metabolic rate of the mother or whether they suffer from malabsorption syndrome or other related conditions.
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This question is part of the following fields:
- Physiology
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Question 28
Incorrect
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Excessive increased level of β-HCG is expected in:
Your Answer:
Correct Answer: Twin pregnancy
Explanation:Human chorionic gonadotropin levels dynamically increase during early gestation and the levels are significantly greater in viable pregnancies than in ectopic gestation, biochemical pregnancy, or spontaneous abortions. Similarly, the hCG concentrations are significantly higher in multiple pregnancy as compared with singleton.
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This question is part of the following fields:
- Physiology
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Question 29
Incorrect
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Regarding heart rate in pregnancy which of the following statements is true?
Your Answer:
Correct Answer: Heart rate increases by 15 beats per minute
Explanation:The following cardiovascular changes occur during pregnancy:
– Blood volume slowly increases by 40-50%
– Heart rate rises by 15 beats/min above baseline
– Stroke volume increases by 25-30%
– Cardiac output increases by approximately 30-50%
– Systemic vascular resistance (SVR) decreases by 20-30%
– Diastolic blood pressure consequently decreases between 12 and 26 weeks but increases again to pre-pregnancy levels by 36 weeks.
As most of the changes occur in the first 12 weeks of gestation cardiac problems are likely to present in early pregnancy -
This question is part of the following fields:
- Physiology
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Question 30
Incorrect
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Spinnbarkheit is a term which means:
Your Answer:
Correct Answer: Threading of the cervical mucous
Explanation:Spinnability (or Spinnbarkeit), which measures the capacity of fluids to be drawn into threads, represents an indirect measurement of the adhesive and elastic properties of mucus.
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This question is part of the following fields:
- Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
