-
Question 1
Correct
-
Which of the following statements is true regarding renal blood flow in pregnancy?
Your 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.
-
This question is part of the following fields:
- Physiology
-
-
Question 2
Correct
-
Regarding cardiac output in pregnancy which of the following statements is TRUE?
Your Answer: Cardiac output increases by approximately 40-50% during pregnancy
Explanation:In a non pregnant adult female the cardiac output is 4.5L/min, by the 20 week of pregnancy the cardiac output increases by 40% to 6.3L/min. During early stages of labour it increases further still by 17% to 7.3L/min.
-
This question is part of the following fields:
- Physiology
-
-
Question 3
Correct
-
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 4
Correct
-
When does ovulation occur?
Your 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.
-
This question is part of the following fields:
- Physiology
-
-
Question 5
Correct
-
Besides infertility, the most common symptoms of a luteal phase defect is:
Your Answer: Early abortion
Explanation:Luteal phase defect is an ovulatory disorder of considerable clinical importance that is implicated in infertility and recurrent spontaneous abortion.
-
This question is part of the following fields:
- Physiology
-
-
Question 6
Correct
-
Regarding cardiac examination during pregnancy which of the following findings should be considered pathological?
Your Answer: Diastolic murmur
Explanation:Diastolic murmurs occur in conditions such as mitral stenosis, tricuspid stenosis and even in carditis. They are always pathological during pregnancy. Systolic murmurs and left axis deviation may be normal during pregnancy due to an increase in the blood volume and load on the heart.
-
This question is part of the following fields:
- Physiology
-
-
Question 7
Correct
-
What is the primary form of haemoglobin in a 6 week old foetus?
Your Answer: Hb Gower 1
Explanation:HB gower 1 is the predominant embryonic haemoglobin when the foetus is 6 weeks old and is replaced by adult haemoglobin by the age of 5 months post natally.
-
This question is part of the following fields:
- Physiology
-
-
Question 8
Correct
-
What is the typical volume increase of a non-pregnant uterus to term uterus?
Your 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.
-
This question is part of the following fields:
- Physiology
-
-
Question 9
Incorrect
-
What is the most common cause of hypercalcaemia?
Your Answer: Myeloma
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 10
Correct
-
What kind of biochemical changes occur during the follicular phase of menstrual cycle?
Your Answer: Endometrial gland proliferation
Explanation:During follicular phase, there is an increase in gonadotrophin hormones and a proliferation of the endometrium occurs. The duration of the cycle depends upon the overall length of the menstrual cycle. The progesterone levels are increased in the luteal phase and not in follicular phase.
-
This question is part of the following fields:
- Physiology
-
-
Question 11
Correct
-
Which of the following is suggestive of ovulation:
Your 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.
-
This question is part of the following fields:
- Physiology
-
-
Question 12
Correct
-
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 13
Incorrect
-
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 14
Correct
-
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: 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.
-
This question is part of the following fields:
- Physiology
-
-
Question 15
Correct
-
In a pregnant lady with polyhydramnios, the cause could be:
Your Answer: Foetus with oesophageal-atresia
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 16
Incorrect
-
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-proliferative
Correct 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
-
-
Question 17
Correct
-
Regarding heart rate in pregnancy which of the following statements is true?
Your 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
-
-
Question 18
Incorrect
-
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 19
Correct
-
In normal pregnancy, the value of β-hCG doubles every:
Your Answer: 2 days
Explanation:During early pregnancy, hCG can be detected in the maternal serum as early as 6 to 8 days after fertilization. hCG levels are dynamically increased and doubled every 48 h in most normal pregnancies, and this pattern is similar in both in vivo or in vitro (IVF) conceptions.
-
This question is part of the following fields:
- Physiology
-
-
Question 20
Correct
-
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 21
Correct
-
Question 22
Correct
-
What is the average lifespan of a basophil (white blood cell)?
Your 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
-
-
Question 23
Correct
-
CTG showing early decelerations is :
Your 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.
-
This question is part of the following fields:
- Physiology
-
-
Question 24
Correct
-
Excessive increased level of β-HCG is expected in:
Your 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.
-
This question is part of the following fields:
- Physiology
-
-
Question 25
Incorrect
-
All of the following statements regarding human chorionic gonadotrophin are true except::
Your Answer: Is reversible for the maintenance of corpus luteum
Correct Answer: It's level doubles every 48 hours in ectopic pregnancy
Explanation:In normal pregnancy the levels of hCG doubles after every 48-72 hours but in case of ectopic pregnancy the levels of hCG are lower than the normal. It is produced by the placenta and its main role is nourishment of the egg after implantation. Its levels reached a peak at 8-10 weeks of pregnancy and after that the levels decreases for the remainder of pregnancy. In hydatiform mole and trophoblastic diseases its the main hormone for diagnosis of the disease because the levels are highly elevated.
-
This question is part of the following fields:
- Physiology
-
-
Question 26
Correct
-
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 27
Correct
-
Which of the following is probably responsible for physiologic hyperventilation during pregnancy?
Your Answer: Increased progesterone production
Explanation:Progesterone gradually increases during the course of pregnancy, from 25 ng⋅mL−1 at 6 weeks’ to 150 ng⋅mL−1 at 37 weeks’ gestation. Progesterone acts as trigger of the primary respiratory centre by increasing the sensitivity of the respiratory centre to carbon dioxide, as indicated by the steeper slope of the ventilation curve in response to alveolar carbon dioxide changes. Progesterone alters the smooth muscle tone of the airways resulting in a bronchodilator effect. It also mediates hyperaemia and oedema of mucosal surfaces, causing nasal congestion.
-
This question is part of the following fields:
- Physiology
-
-
Question 28
Correct
-
Which of the following tests is used to detect antibodies or complement bound to red blood cell antigens in vivo?
Your 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.
-
This question is part of the following fields:
- Physiology
-
-
Question 29
Correct
-
Question 30
Correct
-
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 31
Correct
-
Which of the following statements is true regarding heart rate in pregnancy?
Your Answer: Heart rate increases by 15 beats per minute
Explanation:During the first 12 weeks of pregnancy, cardiac output increases by about 30-50%. To maintain this increase, systemic vascular resistance decreases by 20-30%, while stroke volume and the heart rate increase by 25-30% and 15 beats per minute respectively.
-
This question is part of the following fields:
- Physiology
-
-
Question 32
Correct
-
In normal physiological changes in pregnancy, all of the following are increased, EXCEPT:
Your Answer: Peripheral resistance
Explanation:The heart adapts to the increased cardiac demand that occurs during pregnancy in many ways:
Cardiac output increases throughout early pregnancy, and peaks in the third trimester, usually to 30-50% above baseline.
Oestrogen mediates this rise in cardiac output by increasing the pre-load and stroke volume, mainly via a higher overall blood volume (which increases by 40–50%).
The heart rate increases, but generally not above 100 beats/ minute.
Total systematic vascular resistance decreases by 20% secondary to the vasodilatory effect of progesterone. Overall, the systolic and diastolic blood pressure drops 10–15 mm Hg in the first trimester and then returns to the baseline in the second half of pregnancy.
All of these cardiovascular adaptations can lead to common complaints, such as palpitations, decreased exercise tolerance, and dizzinessA pregnant woman may experience an increase in the size of the kidneys and ureter due to the increased blood volume and vasculature.
Later in pregnancy, the woman might develop physiological hydronephrosis and hydroureteronephrosis, which are normal.
There is an increase in glomerular filtration rate associated with an increase in creatinine clearance, protein, albumin excretion, and urinary glucose excretion.
There is also an increase in sodium retention from the renal tube so oedema and water retention is a common sign in pregnant women -
This question is part of the following fields:
- Physiology
-
-
Question 33
Incorrect
-
The expected date of delivery of a human pregnancy can be calculated as:
Your Answer: 36 weeks after the last menstrual period
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 34
Correct
-
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 35
Correct
-
Lowered haemoglobin during normal pregnancy is a physiological finding which is mainly due to:
Your Answer: Increased plasma volume
Explanation:During pregnancy, anaemia increases more than fourfold from the first to third trimester. It is a well established fact that there is a physiological drop in haemoglobin (Hb) in the mid trimester. This physiological drop is attributed to increase of plasma volume and hence decrease of blood viscosity lead to better circulation in placenta.
-
This question is part of the following fields:
- Physiology
-
-
Question 36
Correct
-
The resting pulse in pregnancy is:
Your 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.
-
This question is part of the following fields:
- Physiology
-
-
Question 37
Incorrect
-
Ovulation may be indicated by all the following, EXCEPT:
Your Answer: Progesterone level > 65ng/ml
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 38
Incorrect
-
Maternal serum prolactin levels in pregnancy are highest:
Your Answer: Just after the delivery of the infant
Correct 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.
-
This question is part of the following fields:
- Physiology
-
-
Question 39
Incorrect
-
In the absence of any gross pelvic abnormality, cephalopelvic disproportion can be correctly diagnosed by?
Your Answer: Pelvic examination
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.
-
This question is part of the following fields:
- Physiology
-
-
Question 40
Correct
-
Immediate delivery of the foetus is recommended at which fetal scalp pH?
Your Answer: 7.18
Explanation:A pH value below than 7.18 indicates acidosis which can result in hypoxic brain injury. In order to prevent brain injury, immediate delivery of the foetus should be planned. The normal range for a term baby is pH: 7.18 – 7.38, preterm pH: 7.14 – 7.4.
-
This question is part of the following fields:
- Physiology
-
SESSION STATS - PERFORMANCE PER SPECIALTY
