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Question 1
Correct
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Maternal serum prolactin levels in pregnancy are highest:
Your Answer: On the 3rd to 4th day postpartum
Explanation:Prolactin is necessary for the secretion of milk by the cells of the alveoli. The level of prolactin in the blood increases markedly during pregnancy, and stimulates the growth and development of the mammary tissue, in preparation for the production of milk. However, milk is not secreted then, because progesterone and oestrogen, the hormones of pregnancy, block this action of prolactin. After delivery, levels of progesterone and oestrogen fall rapidly, prolactin is no longer blocked, and milk secretion begins.
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This question is part of the following fields:
- Physiology
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Question 2
Incorrect
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A serum progesterone value less than 5ng/ml can exclude the diagnosis of viable pregnancy with a certainty of:
Your Answer: 40%
Correct Answer: 100%
Explanation:Serum progesterone has been proposed as a useful test to distinguish a viable pregnancy from a miscarriage or ectopic pregnancy. Low progesterone values are associated with miscarriages and ectopic pregnancies, both considered non-viable pregnancies, and high progesterone concentrations with viable pregnancies. A single progesterone measurement for women in early pregnancy presenting with bleeding or pain and inconclusive ultrasound assessments can rule out a viable pregnancy. The probability of a non-viable pregnancy was raised from 62.9% to 96.8%.
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This question is part of the following fields:
- Physiology
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Question 3
Incorrect
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All of the following factors are associated with umbilical cord prolapse, except?
Your Answer: Cephalo pelvic disproportion
Correct Answer: Anencephaly
Explanation:Anencephaly means the missing of a particular portion of the scalp and brain tissue. The other factors listed are associated with umbilical cord prolapse like multiparity, twin birth, polyhydramnios, premature delivery, long umbilical cord or breech presentation.
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This question is part of the following fields:
- Physiology
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Question 4
Incorrect
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Which of the following is/are needed by women in increased amounts during pregnancy?
Your Answer: Folic acid
Correct Answer: All of the options given
Explanation:The nutritional status of a woman before and during pregnancy is important for a healthy pregnancy outcome. Pregnancy is a state of increased requirement of macro and micronutrients, and malnourishment or inadequate dietary intake before and during pregnancy, can lead to adverse perinatal outcomes. Many nutritional interventions have been proposed for pregnant mothers. These include multiple micronutrients (MMN), iron/folate, balanced protein energy, calcium, zinc and folic acid supplementation.
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This question is part of the following fields:
- Physiology
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Question 5
Incorrect
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Regarding blood volume in pregnancy which of the following statements is TRUE?
Your Answer: Blood volume increases by approximately 10-15%
Correct Answer: Blood volume slowly increases by 40-50%
Explanation:Maternal blood volume expands during pregnancy to allow adequate perfusion of vital organs, including the placenta and foetus, and to anticipate blood loss associated with delivery. The rapid expansion of blood volume begins at 6–8 weeks gestation and plateaus at 32–34 weeks gestation. While there is some increase in intracellular water, the most marked expansion occurs in extracellular fluid volume, especially circulating plasma volume. This expanded extracellular fluid volume accounts for between 8 and 10 kg of the average maternal weight gain during pregnancy. Overall, total body water increases from 6.5 to 8.5 L by the end of pregnancy.
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This question is part of the following fields:
- Physiology
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Question 6
Correct
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Which one of the following statements regarding oestrogen is correct?
Your Answer: It is produced in the corpus luteum
Explanation:Oestrogen is secreted by the corpus luteum and is responsible for the proliferation of the endometrium to prepare it for the implantation of the zygote.
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This question is part of the following fields:
- Physiology
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Question 7
Correct
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Examination of endometrial tissue obtained from a biopsy reveals simple columnar epithelium with no sub-nuclear vacuoles. The stroma is oedematous, & a tortuous gland contains secretions. These findings are consistent with which stage of the menstrual cycle?
Your Answer: Mid-secretory
Explanation:During mid secretory phase, the endometrium cells undergo distension, become more tortuous and are lined by columnar cells.
In the early proliferative phase, the glandular epithelium is cubo-columnar, while in the late proliferative phase, the glands increase in size, becoming tortuous and there is pseudostratification of the epithelium. -
This question is part of the following fields:
- Physiology
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Question 8
Correct
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What is the most common cause of hypercalcaemia?
Your 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 9
Correct
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During normal pregnancy, a weight gain is anticipated. The average weight gain is approximately:
Your Answer: 10-15 kg
Explanation:Institute of Medicine Weight Gain Recommendations for Pregnancy: Recommends a gestational weight gain of 16.8–24.5 kg (37–54 lb) for women of normal weight, 14.1–22.7 kg (31–50 lb) for overweight women, and 11.3–19.1 kg (25–42 lb) for obese women.
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This question is part of the following fields:
- Physiology
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Question 10
Incorrect
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Physiological changes in the reproductive system include:
Your Answer: Oestrogen has no role in the changes that occur during pregnancy
Correct Answer: The uterus 1st enlarges by hyperplasia then by hypertrophy
Explanation:Although uterine growth during the first few weeks of pregnancy is accomplished by increased numbers of smooth muscle cells (i.e. hyperplasia) and a smaller contribution from increased cell size (i.e. hypertrophy), the predominant growth of the uterus during pregnancy is by way of stretch‐induced myometrial hypertrophy. This ongoing process of stretch‐induced tissue remodelling and smooth muscle hypertrophy is accompanied by the lack of uterine contractions during most of gestation to accommodate the developing foetus (phase 0 of parturition). Phase 1 of parturition represents myometrial activation. The final stages of pregnancy are characterized by increases in spontaneous low‐amplitude contractions that gradually increase in frequency, rhythmicity and strength, normally culminating in labour and delivery of the foetus at term (phase 2 of parturition).
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This question is part of the following fields:
- Physiology
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Question 11
Incorrect
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During pregnancy, maternal oestrogen levels increase markedly. Most of this oestrogen is produced by the:
Your Answer: Adrenals
Correct Answer: Placenta
Explanation:The placenta does not have all the necessary enzymes to make oestrogens from cholesterol, or even progesterone. Human trophoblast lack 17-hydroxylase and therefore cannot convert C21-steroids to C19-steroids, the immediate precursors of oestrogen. To bypass this deficit, dehydroisoandrosterone sulphate (DHA) from the fetal adrenal is converted to estradiol-17ί by trophoblasts. In its key location as a way station between mother and foetus, placenta can use precursors from either mother or foetus to circumvent its own deficiencies in enzyme activities.
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This question is part of the following fields:
- Physiology
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Question 12
Incorrect
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During wound healing collagen alignment along tension lines is part of which phase?
Your Answer: Proliferation
Correct Answer: Remodelling
Explanation:Realignment of collagen is part of the remodelling phase. Remodelling is usually underway by week 3. Maximum tensile wound strength is typically achieved by week 12.
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This question is part of the following fields:
- Physiology
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Question 13
Incorrect
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Which of the following statements is true regarding renal blood flow in pregnancy?
Your Answer: Remains constant
Correct Answer: Increases by approximately 50%
Explanation:Glomerular filtration rate (GFR) rises immediately after conception and increases by about 50 per cent overall, reaching its maximum at the end of the first trimester. GFR then falls by about 20 per cent in the third trimester, returning to pre-pregnancy levels within 12 weeks of delivery.
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This question is part of the following fields:
- Physiology
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Question 14
Correct
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All the following are possible causes of polyhydramnios, EXCEPT:
Your Answer: IUGR
Explanation: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 15
Incorrect
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Ovulation may be indicated by all the following, EXCEPT:
Your Answer: Changing of cervical mucous to thick and scanty
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 16
Incorrect
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The resting pulse in pregnancy is:
Your Answer: Increased by 20 bpm
Correct Answer: Increased by 10 to 15 bpm
Explanation:During pregnancy cardiac output increases by 30 to 50%. As a result, the resting pulse speeds up from a normal of about 70 bpm to 80 or 90 bpm.
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This question is part of the following fields:
- Physiology
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Question 17
Correct
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What is the most common cause of hypercalcaemia?
Your Answer: Primary hyperparathyroidism
Explanation:Primary hyperparathyroidism is the most common cause of hypercalcemia. It is usually caused by a tumour of the parathyroid gland. Symptoms are related to increased calcium levels which can cause kidney stones, abdominal groans, psychiatric overtones and bones disease such as osteoporosis,osteomalacia and arthritis.
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This question is part of the following fields:
- Physiology
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Question 18
Incorrect
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Question 19
Correct
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The expected date of delivery of a human pregnancy can be calculated as:
Your 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 20
Incorrect
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Regarding electronic fetal monitoring, which one of the following statements is true?
Your Answer: Has high specificity but low sensitivity
Correct Answer: Has low specificity but high sensitivity
Explanation:There are different ways of monitoring fetal heart rate during pregnancy. It can be done by just auscultation or by electronic fetal heart rate monitoring which is done with the help of an ultrasound machine and has a low specificity but high sensitivity.
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This question is part of the following fields:
- Physiology
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Question 21
Incorrect
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Which of the following is suggestive of ovulation:
Your Answer: Day 21 oestrogen level is elevated
Correct Answer: Regular cycle with dysmenorrhea
Explanation:Ovulation in the menstrual cycle usually occurs over 4 days. There is an increase in basal body temperature at the time of ovulation due to the effect of progesterone.
A high Day 21 progesterone level indicates ovulation and the release of an egg.
Dysmenorrhea is described as painful menstruation. The symptoms start at the time of ovulation and persist till menstruation.
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This question is part of the following fields:
- Physiology
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Question 22
Incorrect
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In pregnancy, the following lung function value remains unchanged:
Your Answer: ERV
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 23
Correct
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Polyhydramnios is associated with which one of the following conditions?
Your 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
Correct
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If a hyalinised mass is formed from an involuted corpus leuteum, it is known as:
Your Answer: Corpus albicans
Explanation:Corpus albicans is the regressed form of the corpus leuteum. It is formed when the corpus leuteum is engulfed by macrophages and a scar or fibrous tissue is formed, called the corpus albicans.
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This question is part of the following fields:
- Physiology
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Question 25
Correct
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During the inflammatory phase of wound healing what is the predominant cell type found in the wound during days 3-4?
Your Answer: Macrophages
Explanation:Wound healing is initiated when inflammation begins. Macrophages predominate after neutrophils and peak 3-4 days after inflammation begins. They destroy and phagocytose the organism and debris using enzymes. The next step is the resolution of inflammation and healing of the wound.
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This question is part of the following fields:
- Physiology
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Question 26
Incorrect
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Which one of the following features indicates fetal asphyxia?
Your Answer: Deep type I deceleration in the 2nd stage of labour
Correct Answer: Type II (late) decelerations with tachycardia
Explanation:A type II deceleration is due to placental insufficiency which can result in fetal distress and asphyxia. The fetal heart rate is lowest at the start of the contraction and returns to normal after the contraction is complete.
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This question is part of the following fields:
- Physiology
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Question 27
Incorrect
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What is the typical volume increase of a non-pregnant uterus to term uterus?
Your Answer: 40ml to 1200ml
Correct Answer: 10ml to 5000ml
Explanation:Uterine blood flow increases 40-fold to approximately 700 mL/min at term. The uterus is 50–60 g with a volume of approximately 10ml prior to pregnancy and 1000 – 1200 g with a volume of 5000ml by term.
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This question is part of the following fields:
- Physiology
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Question 28
Correct
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During the inflammatory phase of wound healing what is the predominant cell type found in the wound during days 3-4?
Your Answer: Macrophages
Explanation:PMNs phagocytise debris and kill bacteria via free radicals (AKA respiratory burst). They also break down damaged tissue. PMNs typically undergo apoptosis after 48 hours. They are then engulfed and degraded by macrophages. Macrophages therefore become the predominant cell type in the wound on days 3-4.
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This question is part of the following fields:
- Physiology
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Question 29
Incorrect
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When does ovulation occur?
Your Answer: Immediately after LH surge
Correct Answer: 36 hours after LH surge
Explanation:Ovulation occurs in the mid stage of the menstrual cycle, usually 36 hours after the LH surge. It is this LH surge which is necessary for the ovulation to occur.
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This question is part of the following fields:
- Physiology
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Question 30
Correct
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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: 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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SESSION STATS - PERFORMANCE PER SPECIALTY
