March 1997 Paper 1 1. a. b. c. d. e. 2. a. b. c. d. e. 3. a. b. c. d. e.

Chromaffin cells Are innervated by pre-ganglionic sympathetic nerve fibres( T ) Are present in the adrenal cortex( F) Are derived from neuro-ectoderm ( T ) Can decarboxylate amino acids ( T ) Are present in celiac ganglia ( T ) The internal pudendal artery Leaves the pelvis through the lesser sciatic foramen ( F ) Lies on the medial wall of the ischiorectal fossa ( F ) Has a branch which pierces t he perineal membrane( T ) Gives rise to the middle rectal artery( F ) Supplies t he upper vagina( F ) The pelvic splanchnic nerves Are derived from the posterior rami of the sacral spinal nerves( F ) Supply afferent fibres( T ) Unite with br anches of the sympathetic pelvic plexus( T ) Supply the ascending colon with mot or fibres( F ) Supply the uterus with parasympathetic fibres( T ) 4. In the anterior abdominal wall a. Rectus muscle is intersected transversely b y three bands( T ) b. The posterior rectus sheath below the arcuate line consist s of transversalis fascia only( T ) c. Above the costal margin the posterior rec tus sheath is deficient( T ) d. The superior epigastric artery arises from the i nternal thoracic artery( T ) e. Te inferior epigastric artery arises from the fe moral artery( F ) 5. a. b. c. d. e. The rectum Is supplied in part by the inferi or rectal artery( T ) Is innervated by the inferior rectal nerve( F ) Is lined b y stratified squamous epithelium( F ) Has its lymphatic drainage to the superfic ial inguinal nodes( F ) Possesses a complete outer layer of longitudinal muscle( T )

6. The obturator nerve a. Emerges from the lateral border of psoas( F ) b. Is fo rmed from the posterior divisions of the second, third, and fourth lumbar nerves ( F ) c. Passes lateral to the internal iliac vessels( T ) d. Lies below the obt urator artery in the obturator foramen( F ) e. Is separated from the normally si ted ovary only by the pelvic peritoneum( T ) 7. In the cerebral cortex a. The le ft visual field is represented in the right cerebral cortex( T ) b. The area dir ectly concerned with movements of the face and hand is larger than that concerne d with movements of legs and trunk( T ) c. In most people, the left side is more concerned with speech then the right side( T ) d. Pyramidal cells are present( T ) e. The blood supply is wholly from branches of the internal carotid arteries ( F ) 8. a. b. c. d. e. 9. a. b. c. d. e. The cervix Consists chiefly of smooth muscle( F ) Has a supravaginal part which is related anteriorly to the ureter( F ) Has a supravaginal part which is covered with peritoneum, anteriorly(F Has pa in sensation carried by the pelvic splanchnic nerves( T ) Is lined in its vagina l part by keratinised epithelium( F ) The right ureter lies in close relation sh ip to Bifurcation of the right common iliac artery( T ) Infundibulopelvic ligame nt( T ) Uterine artery( T ) Inferior mesenteric artery( F ) Parietal attachment of the sigmoid mesocolon( F ) ) 10. The pelvic surface of the sacrum a. Gives origin to the piriformis muscle( T ) b. Gives origin to the levator ani muscle( F ) c. Is broader in the male than in the female( F ) d. Transmits the dorsal rami of sacral nerves( F ) e. Is in contact with the anal canal( F ) 11. In the fetal circulation a. The ductus veno sus delivers blood directly into the superior vena cava( F ) b. The umbilical ar tery returns blood from the placenta( F )

c. The ductus arteriosus carries blood to the lungs( F ) d. Blood returning from the lungs is 90 % saturated with oxygen( F ) e. Blood from the inferior vena ca va is largely directed through the foramen ovale( T ) 12. The ductus venosus a. Is part of the embryonic heart( F ) b. Is a shunt preventing blood from passing to the fetal lungs( F ) c. Gives rises to the ligamentum teres( F ) d. Carries b lood with a higher Po than umbilical arterial blood( T ) e. Is derived from the anterior cardinal vein( F ) 13. The following structures take part in the format ion of the anterior fontanel in the fetal skull a. Lambdoidal suture ( F ) b. Oc cipital suture( F ) c. Sagittal suture( T ) d. Glabella( F ) e. Frontal suture( T ) 14. Concerning the embryology of the urinary tract a. The detrusor has a mes odermal origin( T ) b. The urogential sinus is derived from the cloaca( T ) c. T he allantois gives origin to the lateral umbilical ligaments( F ) d. The metanep hric ducts arise from the mesonephric ducts( T ) e. The mesonephric duct remnant s form the epoophorn in the adult female( T ) 15. The following tissues are pair ed with the appropriate primary germ cell layer of origin a. Mammary duct epithe lium : ectoderm( T ) b. Epithelium of the tongue : mesoderm( F ) c. Pineal gland : ectoderm( T ) d. Ovarian stroma : mesoderm( T ) e. Endometrium : mesoderm( T ) 16. Adrenocorticotrophic hormone a. Production is governed by the hypothalamus ( T ) b. Production is maximal about midnight( F ) c. Is present in the placenta ( T ) d. Is increased in the maternal plasma in pregnancy( T e. Secretion is in hibited by glucocorticoids ( T ) )

17. After the menopause a. The plasma concentration of follicle stimulating horm one increases( T ) b. The plasma progesterone concentration increases( F ) c. Oe strone is the oestrogen found in highest concentration in the plasma( T ) d. The plasma testosterone concentration doubles( F ) e. The plasma prolactin concentr ation increases( F ) 18. Successful lactation is a. Maintained by oestrogens( F ) b. Maintained by progesterone( F ) c. Initiated by a prolactin surge( F ) d. M aintained by human placental lactogen( F e. Inhibited by dopamine( T ) ) 19. In a woman reproductive age ,serum concentrations of the following hormones exhibit a recognised pattern of diurnal variation a. Progesterone( F ) b. Melato nin( T ) c. Cortisol( T ) d. Oestrone( F ) e. Follicle-stimulating hormone( F ) 20. Serum concentrations of the following increase during pregnancy a. Sex hormo ne-binding globulin( T ) b. Prolactin( T ) c. Total thyroxine( T ) d. Follicle-s timulating hormone( F ) e. 17 -hydroxyprogesterone( T ) 21. Luteinizing hormone a . Is required for normal corpus luteum survival( T ) b. Has a half-life in the c irculation of 30 hours( F ) c. Is released in pulses( T ) d. In the male stimula tes testosterone in postmenopausal women( T ) e. Plasma concentrations are incre ased in postmenopausal women (T) 22. The release of catecholamines from the adre nal medulla increases a. During sleep in healthy individuals( F ) b. When the ne rves to the adrenal gland are stimulated ( T ) c. Following an increase in blood sugar ( F ) d. Immediately following a myocardial infarction( T )

e. During acute haemorrhage( T ) 23. Prolactin a. Release is stimulated by thyro trophin-releasing hormone( T ) b. Plasma levels are raised in the first trimeste r of pregnancy( T ) c. Release is increased by suckling( T ) d. May be produced by the decidua( T ) e. Release is inhibited by metoclopramide( F ) 24. Human cho rionic gonadotrophin a. Is not produced by the decidua ( T ) b. Is biochemically indistinguishable from luteinizing hormone ( F ) c. Is active if given to nonpr egnant women ( T ) d. Production rises steadily throughout pregnancy ( F ) e. Ha s no influence upon the production of oestrogens by the placenta ( F ) 25. Human placental lactogen a. Concentration in maternal plasma is directly proportional to the functional mass of the placenta ( T ) b. Has a half-life in blood of les s than 1 hour ( T ) c. Is a steroid hormone ( F ) d. Increase the mobilization o f maternal free fatty acids ( T ) e. Reaches he same concentration in fetal bloo d as in maternal blood at term ( F ) 26. The secretion of growth hormone a. Occu rs in the hypothalamus ( F ) b. Ceases when the adult state is reached ( F c. Is decreased during stress ( F ) d. Is increased during fasting ( T ) e. Is increa sed with exercise ( T ) ) 27. Oxytocin a. Is released episodically (T ) b. Causes decreased renal tubular reabsorption of water ( F ) c. Is responsible for milk ejection ( T ) d. Reduces intestinal peristalsis ( F ) e. Inhibits prolactin secretion ( F ) 28. Hirsutis m in women is characteristically associated with a. Testicular feminisation ( F )

b. c. d. e. Turner syndrome ( F ) Polycystic ovary syndrome ( T Arrhenoblastoma ( T ) Hypopi tuitarism ( F ) ) 29. Parathyroid hormone a. Decreases the renal excretion of phosphate ( F ) b. I ncreases calcium resorption from bone ( T ) c. Depresses pituitary activity ( F ) d. Concentrations in blood are raised when the calcium level falls ( T ) e. In creases renal tubular reabsorption of calcium ( T ) 30. Aldosterone a. Reduces sodium reabsorption in the proximal convoluted tubule ( F ) b. Reduces sodium absorption in the descending loop of Henle ( F ) c. Inc reases sodium absorption in the distal convoluted tubule ( T ) d. Increases pota ssium loss from the tubule ( T ) e. Increases sodium absorption in the collectin g tubule ( T ) 31. Oestradiol-17 a. Is synthesised by aromatisation of testostero ne ( T ) b. Vasodilates the uterine artery ( T ) c. Suppresses uterine activity by upregulating the oxytocin receptor ( F d. Promotes secondary sexual hair grow th in females ( F ) e. Is thrombogenic ( T ) 32. The germination of tetanus spor es in a wound is inhibited by a. Tissue trauma ( F ) b. Oxygen ( T ) c. Injectio n of anti-toxin ( T ) d. Injection of toxoid ( F ) e. Removal of devitalised tis sue ( T ) 33. Proteolytic enzymes are secreted by the following organisms a. Nei sseria meningitides ( F ) b. Salmonella typhi ( F ) c. Streptococcus pyogenes ( T ) d. Mycobacterium tuberculosis ( F ) e. Clostridium perfringens ( Welchii ) ( T ) )

34. Cytomegalovirus a. Is an adenovirus ( F ) b. May be cultured readily in cell -free media (F ) c. Is a cause of cerebral calcification ( T ) d. Causes heamoly tic anaemia in the neonate ( T ) e. May be transmitted in saliva ( T ) 35. The t reponema pallidum immobilisation test is positive in a. Yaws ( T ) b. Infectious mononucleosis ( F ) c. Malaria ( F ) d. Chancroid ( F ) e. Lyme disease ( borre liosis ) (F ) 36. Leptospirosis a. Is caused by a gram-negative coccobacillus ( F ) b. Is frequently transmitted to man from inanimate objects ( F c. Can result in severe form of jaundice ( T ) d. Is a sexually transmitted disease ( F ) e. Is transmitted in pasteurised cows milk ( F ) 37. Mycobacteria a. Are non-sporing ( T ) b. Are all acid-fast in their staining reaction ( T c. Are facultative an aerobes ( F ) d. Are responsible for leprosy ( T ) e. Are all pathogenic in huma ns ( F ) ) ) 38. The following disorders and organisms are correctly paired a. Opthalmia neon atorum : chlamydia trachomatis ( T ) b. Chancroid : haemophilus ducreyii ( T ) c . Sleeping sickness : leishmania donovani ( F ) d. Ringworm : trichinella spiral s ( F ) e. Non-specific uretiritis : toxoplasma gondii ( F ) 39. The following o rganisms are gram-positive a. Mycoplasma hominis ( F ) b. Staphylococcus aureus ( T ) c. Clostridium perfrigens ( T ) d. Klebsiella pneumoniae ( F ) e. Bacteroi des fragilis ( F )

40. Concerning hepatitis B virus infection a. Vertical transmission does not occ ur ( F ) b. Sexual transmission occurs ( T ) c. Core antigenaemia indicates high infectivity ( F ) d. Hepatocellular carcinoma is a recognised complication ( T ) e. An effective vaccine is a available ( T ) 41. The following antibiotics are usually effective against pseudomonas aeruginosa a. Cephradine ( F ) b. Amoxyci llin ( F ) c. Carbenicillin ( T ) d. Gentamicin ( T ) e. Trimethoprim ( F ) 42. Recognised unwanted effects of prostaglandin E include a. Water retention ( F ) b. Increased uterine contractility (T ) c. Increased small bowel peristalsis ( T ) d. Flushing of the skin ( T ) e. Vomiting ( F ) 43. The following substances are sympathomimetic amines a. Amphetamines ( T ) b. Ephedrine ( T ) c. Histamine ( F ) d. Isoprenaline ( T ) e. Chlopromazine ( F ) 44. Subcutaneous atropine in jection characteristically produces. a. An increase in heart rate.( T ) b. An in crease in salivation.( F ) c. Constriction of the pupil. ( F ) d. A hypnotic eff ect. ( F ) e. Decreased bronchiolar secretion. ( T ) 45. The following drugs have anti-cholinergic effect. a. Propantheline bromide.( T ) b. carbachol.( F ) c. distigmine bromide. ( F )

d. benzhexol. ( T ) e. atropine. ( T ) 46. treatment with morphine. a. Cause respiratory depression.( T ) b. Increases gastric motility.( F ) c. Causes side effects which may be reversed by naloxone. ( T d. Increase the secretion of anti-diuretic hormone. ( T ) e. Causes papilla ry dilatation. ( F ) ) 47. Hypokalaemia may be caused by. a. bendrofluoazide.( T ) b. digoxin.( F ) c. spironolactone. ( F ) d. carbenoxolone. ( T ) e. amiloride. ( F ) 48. Concerning heparins. a. Heparin is synthesized in the lungs.( T ) b. Antithr ombin 3 is necessary for standard heparins to exert their anti coagulant effect. ( T ) c. Factor X is inhibited by low molecular weight heparins. ( T ) d. Low mo lecular weight heparin have a longer half life than standard heparins. ( T ) e. Penicillins potentiate the action of low molecular weight heparins. ( F ) 49. The following statistical statements are correct. a. In the normal distribut ion, the value of the mode is 1.73 x that of the median.( F ) b. In a distributi on skew to the right, the mean lies to the left of the median.( F ) c. In the se ries 2;7;5;2;3;2;5;8, the mode is 2. ( T ) d. Students t-test is designed to corr ect for skew distribution . ( F ) e. The chi-squared test may be used when data are not normally distributed. ( T )

March 1997 Paper 2 1. a. b. c. d. e. The following changes in ventilation occur in pregnancy. A decrease in respiratory rate.( F ) A decrease in Pco2 .( T ) A d ecrease in residual volume. ( T ) An increase in tidal volume. ( T ) An increase in Po2. ( F ) 2. a. b. c. d. e. The following are required for haemostatic clot formation. Conversion of prothro mbin to thrombin.( T ) Platelet phospholipids.( T ) Active conversion of plasmin ogen to plasmin. ( F ) Fibrin degradation products. ( F ) antithrombin. ( F ) 3. a. b. c. d. e. Myometrial contractility. Is calcium dependant.( T ) Is associated with phosphor ylation of myosin light chain.( T ) Is independent of cAMP. ( F ) Is mediated by somatic nerves. ( F ) Depends on myometrial gap junctions. ( T ) 4. a. b. c. d. e. The following values fall within the normal range for the addult female bladder. Residual urine of 100ml.( F ) Voiding volume of 250ml.( T ) Bladder capacity of 900ml. ( F ) Intravesical pressure rise of less than 10 cm H2O during early fil ling. ( T ) Maximum urine flow rate of 60 ml per second. ( F ) 5. a. b. c. d. The parenchymal cells of the liver. Can convert fructose to glucose.( T ) Synthe sise urea.( T ) Conjugate bilirubin. ( T ) Excrete bromosulphathaline. ( T )

e. Synthesises cholesterol. ( T ) 6. a. b. c. d. e. In the testis. Maturation form spermatogonia to spermatozoa takes about 29 days. ( F Sertoli cells can mature into spermatids.( F ) Leydig cells produce inhibin. ( F ) LH inhibit secretion of testosterone. ( F ) Large quantities of fructose are present in seminal fluid. ( T ) ) 7. a. b. c. d. e. Functions of the spleen in the healthy adult include. erythropoiesis.( F ) destr uction of erythrocytes.( T ) formation of B-lymphocytes. ( T ) phagocytosis of b acteria. ( T ) production of erythropoietin. ( F ) 8. a. b. c. d. e. Neonatal jaundice may be caused by. Congenital hypothyroidism.( T ) phenylketonu ria.( F ) galactosaemia. ( T ) fructosaemia. ( T ) long acting sulphonamides. ( T ) 9. concerning the vagus nerve. a. When stimulated, it has little direct effect o n the strength of the ventricular contraction.( F ) b. It contains afferent nerv e fibers.( T ) c. Stimulation increase the heart rate. ( F ) d. It innervates th e jejunum. ( T ) e. It is involved in hering-bruer-reflex . ( T ) 10. In normal subjects the following increase ventilation. a. A change in arteri al Po2 from 13.1 Kpa (98mmHG) to 8Kpa (60 mmHG).( T ) b. A change in arterial pH from 7.36 to 7.48.( F ) c. A change in arterial PCo2 from 5.9 Kpa (44mmHG) to 8 Kpa (60 mmHG). ( T )

d. Administration of doxapram. ( T ) e. pregnancy. ( T ) 11. The following statements relate to plasma proteins. a. They create an oncoti c pressure of 3.3 Kpa (25mmHG) across capillary walls .( T ) b. They form a majo r part of plasma cationic pool.( F ) c. All are manufactured in the liver. ( F ) d. Albumin has a low molecular weight than fibrinogen. ( T ) e. Fibrinogen is f reely filtered at the glomerulus. ( F ) 12. In a healthy young non pregnant woman at water.( F ) b. 75% of extracellular fluid is Plasma volume is about 5 litres. ( F ) d. pH he plasma osmolality is about 400 mosmol per rest. a. 80% of the body weight is outside the blood vessels.( T ) c. of plasma is about 7.25. ( F ) e. T litre. ( F )

13. In the normal adult circulation. a. The pressure in the left ventricle durin g diastole is twice atmospheric pressure.( F ) b. The aortic blood pressure duri ng diastole is about two thirds of that during systole.( T ) c. Resistance in pe ripheral blood vessel s is inversely proportional to the fourth power of the ves sel radius. ( T ) d. The arterioles are not subject to sympathetic stimulation e xcept during exercise. ( F ) e. Increased carotid sinus baroreceptor activity in creases the heart rate. ( F ) 14. The heart rate typically increase in response to. a. pain.( T ) b. hypoxia.( T ) c. ventilatory expiration. ( F ) d. increased intracranial pressure. ( F ) e. decreased baroreceptor activity. ( T )

15. in a healthy woman ,renin. a. Is secreted only by the kidney.( F ) b. concentration is greater in the pregnant than in the nonpregnant state.( Plasma concentration is increased by diuretic therapy. ( T ) d. Converts ensinogen into angiotensin ||. ( F ) e. Activity is blocked by captopril.

Plasma T ) c. angiot ( T )

16. .concerning human parturition a. The number of oxytocin receptors in the myo metrium increases before the onset of labour.( T ) b. In the primigravida ,cervi cal dilatation usually precedes cervical effacement.( F ) c. The plasma oxytocin concentration increases at the onset of labour. ( F ) d. Oxytocin stimulates th e synthesis of prostaglandins within the uterus. ( T ) e. Contraction of the mat ernal abdominal muscles is essential for spontaneous vaginal delivery. ( F ) 17. Arterial plasma at 13 weeks of gestation in the normal pregnant woman. a. Has a freezing point of 0.5 C.( F ) b. Has an osmolarity of 190 mosmol/litre .( F ) c . Has a Pco of 4Kpa (30mmHg). ( T ) d. Has a creatinine concentration of 200 mol/ litre (2.26mg/ml). ( F ) e. Has a sodium concentration of 140 mmol/litre(140meq/ litre). ( T ) 18. Recognised effects of pregnancy include . a. Transient impairment of glucose tolerance .( T ) b. A raised glomerular filtration rate.( T ) c. A raised plasm a concentration of free tyrosine. ( F ) d. A reduced plasma concentration of alk aline phosphatase. ( F ) e. An increase secretion of prolactin. ( T ) 19. In the small intestine the following substances are absorbed by active proce sses . a. water.( F ) b. sodium.( T ) c. vitamin K. ( F ) d. amino acids. ( T )

e. chloride. ( T ) 20. collagen . a. has a double helical structure.( F ) b. shows a regular bandin g pattern on electron microscopy.( T ) c. is not formed normally in the absence of ascorbic acid . ( T ) d. is not found within basement membranes. ( F ) e. syn thesis is inhibited by glucocorticoids. ( T ) 21. white cell migration from blood vessels in areas of inflammation involves . a. cell migration occurring between endothelial cells.( T ) b. passive loss of f luid blood elements .( T ) c. cell migration independent of endothelial cell mot ion. ( T ) d. initial emigration of polymorph nuclear neutrophils. ( T ) e. more polymorphs than monocytes after two days . ( F ) 22. carcinoma in situ in epithelium (intraepithelial neoplasia) is charactarised by . a. increased mitotic activity .( T ) b. loss of polarity.( T ) c. increase d adhesiveness to the underlying stroma. ( F ) d. pyknosis. ( F ) e. increased t hickness of the epithelium . ( T ) 23. the following provide conclusive evidence of pregnancy in uterine curettings . a. Decidua compacta.( F ) b. Arias-stella changes in endometrial glands.( F ) c. Spiral arterioles . ( F ) d. Plasma cell infiltration. ( F ) e. Chorionic vil li. ( T ) 24. In acute tubular necrosis of the kidney. a. The lesion is reversible.( T ) b . The kidney is small.( F ) c. 25% of deaths occur in the diuretic phase . ( T ) d. The distal convoluted tubules are mainly affected in mercury poisoning . ( F )

e. Proteinaceous casts are found in the collecting ducts. ( T ) 25. Complication of myocardial infarction include. a. Fibrous pericarditis .( T ) b. Aortic aneurysm.( F ) c. Ventricular mural thrombi . ( T ) d. Coronary athe rosclerosis. ( F ) e. Ventricular aneurysm. ( T ) 26. The pathogenesis of thrombosis . a. Prostacyclin includes platelet aggregati on .( F ) b. Platelets synthesise thromboxane A .( T ) c. Thromboxane A include vasoconstriction. ( T ) d. Contact with subendothelial collagen causes platelet aggregation. ( T e. Thrombin inhibits platelet aggregation. ( F ) ) 27. Characteristic features of addisonian pernicious anaemia include. a. leucocy tosis.( F ) b. inheritance as an autosomal dominant trait.( F ) c. a raised mean corpuscular haemoglobin concentration. ( F ) d. an increased incidence of gastr ic neoplasia. ( F ) e. an increased incidence of primary hypothyroidism . ( T ) 28. immunodeficiency states may be associated with . a. viral infection of T lym phocytes.( T ) b. B cell lymphomas.( T ) c. Glucocorticoid administration. ( T ) d. Haemolytic disease of the newborn. ( F ) e. Untreated Hodgkins lymphoma. ( T ) 29. B lymphocytes . a. Produce tumour necrosis factor .( T ) b. Produce compleme nt .( F ) c. Produce antibodies. ( T ) d. Contribute to delayed hyper sensitivit y. ( F )

e. Produce IgE. ( T ) 30. Antibodies . a. Are proteins .( T ) b. Are formed in the fetus before 12 wee ks of intrauterine life.( F ) c. Have an average molecular weight of around 1000 0 Daltons. ( F ) d. Of the rhesus type are genetically transmitted. ( F ) e. Are produced by the ribosomes of plasma cells. ( T ) 31. Type ||| (immune complex-related)hypersensitivity is charactarised by. a. Da mage localised to a particular cell type.( T ) b. Decreased vascular permeabilit y.( F ) c. Microthrombus formation. ( T ) d. Complement activation. ( T ) e. Med iation by IgE antibodies. ( F ) 32. The following disorders have an X-linked pattern of inheritance. a. Glucose6-phosphate dehydrogenase deficiency.( T ) b. Klinefelter syndrome.( F ) c. Adre nogenital syndrome. ( F ) d. Haemophilia B. ( T ) e. Familial hypercholesterolem ia. ( F ) 33. In the female. a. Only the X chromosome of maternal origin is active.( F ) b . The Barr body is sex chromatin.( T ) c. About 80% of polymorphonuclear leucocy tes have a drumstick of chromatin. ( F ) d. An extra X chromosome is associated wi th two Barr bodies . ( T ) e. An extra X chromosome is associated with below ave rage intelligence. ( T ) 34. In DNA. a. A codon is a sequence of three bases.( T ) b. All codons have an identified function.( F ) c. There is a greater variety f amino acids than there are different codons. ( F )

d. Replication can be initiated at several different points along a chromosome . ( T ) e. Complementary pairing precedes messenger RNA synthesis. ( T ) 35. The following genetic disorders are inherited as autosomal recessives . a. D uchenne muscular dystrophy.( F ) b. Huntingdons chorea.( F ) c. Tay-sachs disease . ( T ) d. retinoblastoma. ( F ) e. achondroblastoma. ( F ) 36. in experimental conditions, ultrasound may produce biological effects on tis sues by the following means . a. acceleration of cell division.( F ) b. heat gen eration .( T ) c. cavitation . ( T ) d. duplication of chromosome numbers . ( F ) e. microstreaming . ( T ) 37. concerning radiation physics . a. an electron has a greater mass than a prot on .( F ) b. a positron has the same charge as an electron .( F ) c. a proton ha s a positive charge . ( T ) d. a neutron has almost the same mass as a proton. ( T ) e. the hydrogen nucleus is a neutron. ( F ) 38. the conversion of glucose to lactic acid. a. Occurs in a single enzymatic re action .( F ) b. Is the only pathway for the synthesis of ATP in the red blood c ells.( F ) c. Is a reversible process in skeletal muscle. ( F ) d. Is inhibited by high cellular concentrations of ATP . ( T ) e. Occurs in skeletal muscle when the availability of oxygen is limited . ( T ) 39. Uric acid. a. Is formed from the breakdown of purines.( T )

b. c. d. e. Is raised in serum during normal pregnancy.( F ) Is increased in serum during th iazide diuretic therapy. ( T Is reabsorbed in the proximal renal tubule. ( T ) I s excreted unchanged in the urine. ( T ) ) 40. adenine. a. Is a pyrimidine base.( F ) b. Forms base pairs with thymine in R NA.( F ) c. Is synthesized attached to ribose phosphate. ( T ) d. Can be convert ed directly to a nucleotide by the action of phosphoribosyltransferase enzymes . ( T ) e. Is degraded by pathway which involves the enzyme xanthine oxydase . ( T ) 41. bilirubin. a. Is a steroid .( F ) b. Is bound to albumin in the circulation .( T ) c. Conjugates iron. ( F ) d. Is conjugated to glycerine. ( F ) e. Facilit ates absorption of fat from the gut . ( F ) 42. Combined salt and water depletion is associated with . a. A high concentrati on of sodium in the urine .( F ) b. A high urine specific gravity .( T ) c. Prerenal uraemia. ( T ) d. A Fall in the central venous pressure . ( T ) e. A high blood urea concentration. ( T ) 43. Normal human seminal fluid. a. Coagulates in vitro.( T ) b. Contains sucrose .( F ) c. Has PH of 5. ( F ) d. May contain 15% of morphologically abnormal spe rmatozoa . ( T e. Is predominantly produced within the testis. ( F ) )

44. Ethanol . a. Consumed in excess stimulates fatty acids oxidation.( F ) b. Su ppresses arginine vasopressin secretion.( T ) c. Promotes gluconeogenesis . ( F ) d. Is oxidised to acetaldehyde. ( T ) e. Is metabolized predominantly by the l iver. ( TT ) 45. glucocorticoids. a. Promote hepatic gluconeogenesis.( T ) b. Suppress uptake of glucose by muscles.( T c. Promote protein breakdown. ( T ) d. Promote fat br eakdown. ( T ) e. Increase glycolysis in adipose tissue. ( F ) ) 46. cholesterol. a. Is an essential dietary requirement.( F ) b. Is present in t he plasma membrane of all human cells.( T ) c. Cannot be synthesised by the live r. ( F ) d. Is transported in the circulation bound to albumin. ( F ) e. Is a pr ecursor for the synthesis of steroid hormones. ( T ) 47. haemoglobin. a. Has four porphyrin rings.( T ) b. Can carry four molecules o f oxygen.( T ) c. Binds carbon monoxide more readily than oxygen. ( T ) d. Is sy nthesized in mature erythrocytes. ( F ) e. Contain two beta chains. ( T ) 48. Fetal haemoglobin(Hbf). a. Is not formed before 20 weeks of intrauterine lif e .( F ) b. Is more resistant than adult haemoglobin to denaturation by alkali.( T ) c. In the fetus constitutes 80-90% of the haemoglobin at birth. ( T ) d. Re present more than 5 %of total haemoglobin 8 weeks after birth. ( T ) e. Is incre ased in adult patient with beta thalassaemia. ( T )

49. fibrinogen. a. Levels are usually low during pregnancy.( F ) b. Is a substra te for thrombin.( T ) c. At elevated plasma levels causes a reduction in the ery throcyte sedimentation rate(ESR). ( F ) d. Is synthesized in the liver . ( T ) e . Is a Bence Jones protein. ( F )

September 1997 Paper 1 1. The obturator artery. a. Branches from the posterior t runk of internal iliac artery.( F ) b. Passes through the greater sciatic forame n.( F ) c. Is crossed by the ureter. ( T ) d. Supplies the hip joint. ( T ) e. M ay be replaced by a branch of the superior gastric artery. ( F ) 2. The spleen. a. Has a notched posterior border.( F ) b. Lies in front of the c osto-diaphragmatic recess.( T ) c. Is in contact with the body of pancreas. ( F ) d. Lies under the cover of 9 to 11 ribs. ( T ) e. Is innervated from the renal plexus. ( F ) 3. The following muscles are inserted into the perineal body. a. bulbospongiosus .( T ) b. ischiocavernosus.( F ) c. obturator internus. ( F ) d. sphincter ani e xternus. ( T ) e. transversus perinei superficialis. ( T ) 4. the ae.( T es the es the ) 5. The adult female urethra. a. Is 7 cm in length.( F ) b. Is lined by columnar epithelium in its proximal half.( F c. Has mucus gland in its distal third. ( T ) d. Passes through the perineal membrane. ( T ) ) inferior vena cava. a. Is formed at the level of the fifth lumbar vertebr ) b. Commences posterior to the right external iliac artery.( F c. Receiv left ovarian vein. ( F ) d. Receives the right renal vein. ( T ) e. Pierc central tendon of the diaphragm. ( T )

e. Is surrounded by smooth muscle in the middle third. ( F ) 6. In the normal human pelvis. a. The promontory of the sacrum is in the upper a nterior border of the first sacral vertebra.( T ) b. The anterior surface of the sacrum have five paired foramina.( F ) c. The joint between the 2 pubic bones i s a synovial joint. ( F ) d. The acetabular fossa is wholly formed from parts of the pubic and ischial bones. ( F ) e. The transverse diameter of the brim is gr eater than the anteroposterior diameter. ( T ) 7. The left ureter in the female. a. Develops from an outgrowth of the parameson ephric duct.( F ) b. When radiologically visualized runs along the tips of the t ransverse processes of the lumbar vertebrae.( T ) c. Is narrowed in caliber as i t crosses the pelvic brim. ( T ) d. Runs medial to the ovary. ( F ) e. Lies ante rior to the vagina as it enters the trigone of the bladder. ( T ) 8. Concerning the abdominal wall. a. The umbilicus is located in the territory o f the L1 dermatome.( F ) b. The rectus abdominis muscle has attachments to the a nterior wall of the rectus sheath.( T ) c. The left and right epigastric arterie s anastomose. ( F ) d. Distended veins radiating from the umbilicus are indicati ve of portal hypertension. ( T ) e. Langers lines run vertically over the lower a bdomen. ( F ) 9. The pituitary gland. a. Lies below the diaphragma sellae.( T ) b. Is develope d from 2 primordia.( T ) c. Communicates with the hypothalamus. ( T ) d. Lies in ferior to optic chiasma. ( T ) e. Is anterior to the sphenoidal sinus. ( F )

10. The obturator nerve. a. Arises from segments L2,3,4.( T ) b. Crosses the sac roiliac joint as it enters the pelvis.( T ) c. Innervates the obturator internus muscle. ( F ) d. Is a lateral relation to the ovary. ( T ) e. Innervates the kn ee joint. ( T ) 11. Concerning cells. a. Glycosylation takes place in the smooth endoplasmic ret iculum.( T ) b. Low density lipoproteins attach to sell membrane receptors.( T ) c. Glycoproteins are present on the cytosol surface of the plasma membrane. ( F ) d. Centrioles are composed of tubulin. ( T ) e. Nuclear hetero chromatin is g enetically inactive. ( T ) 12. The following are derived from the urogenital sinus. a. The bladder trigone. ( F ) b. The ureters .( F ) c. The female urethra. ( T ) d. Greater vestibular g lands. ( T ) e. Paraurethral gland. ( T ) 13. The following statements concerning the uterus are correct . a. Its formed f rom the mesonephric ducts.( F ) b. It has a lymphatic drainage in part to the in guinal glands.( T ) c. The uterine artery passes below the ureter. ( F ) d. The uterine veins communicates with the vesical plexus of veins. ( T ) e. Pain sensa tion from the body of the uterus is carried by the pelvic splanchnic nerves. ( F ) 14. In the fetal cardiovascular system . a. The heart arises from endoderm .( F ) b. The heart is formed by fusion of endocardial tubes.( T ) c. Cardiac pulsati on is present by the 30th day after fertilization. ( T ) d. Oxygenated blood is transferred to the left atrium through the foramen ovale. ( T )

e. The ductus arteriosus closes during the last 4 weeks of pregnancy. ( F ) 15. Concerning growth hormone. a. Plasma levels are reduced by glucose infusion .( T ) b. Maternal plasma levels are directly related to fetal growth .( F ) c. It is active on bone only until the epiphyses fuse. ( F ) d. Its secretion is co ntrolled by the hypothalamus. ( T ) e. Increased activity produces a positive ni trogen balance. ( T ) 16. Arginine vasopressin . a. Reduces the glomerular filtration rate.( F ) b. Co ntrols water loss in the proximal renal tubule.( F ) c. Is synthesised by the po sterior pituitary gland . ( F ) d. Is released in response to a rise in plasma o smolarity. ( T ) e. Is released in response to a fall in circulating plasma volu me. ( T ) 17. Parathyroid hormone. a. Is a polypeptide .( T ) b. Increase bone resorption. ( T ) c. Decrease phosphate excretion in the urine. ( F ) d. Secretion is dimini shed by an increase in serum ionised calcium concentration. ( T ) e. Decreases t he formation of 1,25-dihydroxycholecalciferol. ( F ) 18. renin. a. Is secreted by the zona glomerulus of the adrenal cortex.( F ) b. Is a Proteolytic enzyme.( T ) c. Is secreted at an increased rate if the renal p erfusion pressure falls. ( T ) d. Acts upon circulating angiotensinogen. ( T ) e . Is released in response to an increase in extracellular fluid volume. ( F ) 19. Aldosterone secretion is increased. a. On standing.( T ) b. Following hemorr hage.( T ) c. During pregnancy. ( T )

d. By hypocalcaemia. ( F ) e. On a low sodium diet. ( T ) 20. Insulin secretion is stimulated by . a. gastrin.( T ) b. noradrenaline (nore pinephrine).( F c. somatostatin. ( F ) d. glucagon. ( T ) e. arginine. ( T ) ) 21. concerning thyroid hormones. a. is converted in the tissues to thyroxine.( F ) b. The circulating concentration of thyroid binding globulin increases in pre gnancy.( T ) c. Triiodothyronine acts more rapidly than thyroxine. ( T ) d. Star vation causes plasma Triiodothyronine concentrations to rise. ( F ) e. D-thyroxi ne is more active than L- thyroxine. ( F ) 22. In the human testis. a. Meiosis occurs between the early and late spermatid phases.( F ) b. One spermatogonuim always forms 8 spermatids.( F ) c. The fluid in the seminiferous tubules contains a high concentration of protein. ( F ) d. T he process of spermatogenesis takes 34 days. ( F ) e. Inhibin is produced by pri mary spermatocytes. ( F ) 23. Sex hormone-binding globulin. a. Levels are increased in pregnancy.( T ) b. Is the main binding protein for progesterone.(F ) c. Levels are decreased during oestrogen therapy. ( F ) d. Is the main binding protein for aldosterone. ( F ) e. Has a greater affinity than albumin for testosterone. ( T ) 24. Recognised features of congenital adrenal hyperplasia the female are. a. Acu te hypotension.( T )

b. c. d. e. Enlargement of the clitoris.( T Abnormal karyotype. ( F ) hirsutism. ( T ) absen t uterus. ( F ) ) 25. adrenal androgens. a. Are synthesised in the zona glomerulosa of the adrenal cortex.( F ) b. Are secreted in excessive amounts in the presence of 11-hydroxyl se deficiency .( T ) c. Stimulate protein synthesis. ( T ) d. Consist mainly of testosterone. ( F ) e. Are secreted in increased amounts in response to a rise in Adrenocorticotrophic hormone. ( T )

26. During pregnancy ,the uterine decidua synthesises. a. Human chorionic gonado trophin.( F ) b. Prostaglandin E .( T ) c. Progesterone.( F ) d. Prolactin. ( T ) e. Oxytocin. ( T ) 27. Calcitonin. a. Is synthesised in the parathyroid glands.( F ) b. Is a decape ptide.( F ) c. Secretion is increased at serum calcium level below 1.5 mmol/1 (6 .1mg/100 ml). ( F ) d. Inhibits bone resorption. ( T ) e. Increase renal tubular excretion of calcium. ( T ) 28. The following cell types are present in the human corpus luteum:. a. Endothe lial cells.( T ) b. marcrophages.( T ) c. pericytes. ( T ) d. fibroblasts. ( T ) e. granulosa cells. ( T )

29. Concerning ovarian function:. a. Progesterone is the major steroid of the de veloping follicle.( F ) b. Granulosa cells secrete oestradiol.( T ) c. Oestradio l is derived from androgen precursors. ( T ) d. Insulin-like growth factor (1GF) -1 is not secreted by the ovary. ( F ) e. Circulating inhibin concentrations are a marker of granulosa cell function. ( T ) 30. The following organisms are Gram-positive:. a. Streptococcus Pneumoniae.( T ) b. Neisseria gonorrhoeae.( F ) c. Salmonella typhi. ( F ) d. Lactobacillus. ( F ) e. Pseudomonas Aeruginosa. ( F ) 31. Toxic shock Syndrome in women is. a. Associated with the use of tampons.( T ) b. Due to a toxogenic strain of streptococcus.( F ) c. A consequence of previo us antibiotic therapy. ( F ) d. Infrequently reported outside north america. ( F ) e. Confined to sexually active women. ( F ) 32. Concerning rubella:. a. It has an incubation period of 7 10 days.( F ) b. Re current infection is a common cause of congenital malformation.( F ) c. Specific antibodies occur within 14 days of infection. ( F ) d. Individuals are infectio us before the appearance of the rash. ( T ) e. An attenuated live virus is used in immunisation. ( T ) 33. Actinomyces israelii. a. Is a rickettsia.( F ) b. Forms yellow granules in p us.( T c. Is a commensal in the mouth. ( d. Is a commensal in the vagina. ( e. I s usually resistant to penicillin. ( ) T ) T ) F )

34. Diseases caused by spirochetes include. a. Weils disease.( T ) b. Lymphogranu loma venereum.( F ) c. pinta. ( T ) d. vincents angina. ( T ) e. bilharzia. ( F ) 35. Mycobacterium tuberculosis. a. Is the only mycobacerium which is acid-fast.( F b. Provokes humoral immunity only.( F ) c. Does not form spores. ( T ) d. Is a motile bacillus. ( F ) e. Produces endotoxins. ( F ) ) 36. Candida albicans. a. Is Gram-positive.( T ) b. Is a commensal in the bowel.( T ) c. Is sensitive to miconazole. ( T ) d. Causes secondary infection after tr eatment with broad spectrum antibiotics. ( T ) e. Is cultured on alkaline media . ( F ) 37. The following antibiotics act on bacterial cell walls. a. pencillin.( T ) b. ceftazidime.( T ) c. metronidazole. ( F ) d. clindamycin. ( F ) e. gentamicin. ( F ) 38. listeria monocytoenes. a. Can grow at 6 C.( T ) b. Is a gut commensal.( T ) c. Is a gram-negative bacillus. ( F ) d. Infection is best treated with benzylpe ncillin. ( T ) e. Is a cause of speticaemia in neonates. ( T )

39. metronidazole. a. Is effective against Giardia lamblia.( T ) b. Is effective when administered per rectum .( T ) c. Should not be administered intravenously . ( F ) d. Is usually effective against Entamoeba histolytica. ( T e. Interferes with ethanol metabolism. ( T ) ) 40. Gentamicin. a. Is ineffective systemically when given by mouth.( T ) b. Is m etabolised prior to excretion by the kidney .( F ) c. May cause damage to the ei ghth cranial nerve . ( T ) d. Is a bacteriostatic drug. ( F ) e. Toxicity is pot entiated by frusemide. ( T ) 41. The effectiveness of a combined oral contraceptive may be reduced by. a. bro mocriptine.( F ) b. phenytoin.( T ) c. rifampicin. ( T ) d. ampicillin. ( T ) e. sodium valproate. ( F ) 42. the following agents are bronchodilators. a. salbutamol.( T ) b. atenolol.( F ) c. prostaglandin F . ( F ) d. morphine. ( F ) e. prednisolone. ( T ) 43. neostigmine in therapeutic doses. a. Acts for several days.( F ) b. Inhibits hydrolysis of acetylcholine.( T ) c. Causes paralytic ileus. ( F ) d. Reverses the action of carbachol . ( F ) e. Relieves the effects of myasthenia. ( T )

44. Halothane produces. a. Cardiac arrhythmias.( T ) b. Explosive mixtures with air.( F ) c. Liver damage if given repeatedly. ( T ) d. Myometrial relaxation. ( T ) e. Bronchial irritation. ( F ) 45. The following substances increase the serum uric acid concentration:. a. col chicine.( F ) b. chlorothiazide.( T ) c. allopurinol. ( F ) d. probenecid. ( F ) e. phenylbutazone. ( F ) 46. the therapeutic effect of the first drug is enhanced by the second drug. a. Phenytoin : ethinyloestradiol.( F ) b. Bromocriptine : metoclopramide.( F ) c. P enicillin : probenecid. ( T ) d. Ritodrine : dexamethasone. ( T ) e. Warfarin : phenobarbitone. ( F ) 47. In a sample of 1000 children, the birth weight was normally distributed with a mean of 3.5 kg and a standard deviation of 700 g:. a. 15 infants would be bel ow the 5th centile for weight .( F ) b. The standard error of the birth weight w ould be about 22 g.( T ) c. The 95th centile for birth weight would be 4.2 kg . ( F ) d. No baby would weigh less than 1.4 kg. ( F ) e. The median birth weight would be about 3.5 kg. ( T ) 48. In the statistical analysis of any group of numerical observation . a. The m ean is always less than the mode.( F ) b. The median value always lies at the mi d-point of the range.( F ) c. Standard deviation is always greater than the stan dard error of the mean. ( T ) d. The standard error of the mean is independent o f the total number of observation. ( F )

e. There are the same number of observations greater than and less than the medi an value. ( T ) 49. In a randomized double-blind trial comparing a new drug with a placebo. a. T he patients will be taking either of two active drugs.( F ) b. Patients can choo se their method of treatment.( F ) c. Doctors prescribing treatment decide which patients take the new drug. ( F ) d. A large trial is more likely to give a sta tistically significant result than a small trial. (T ) e. Half of the patients w ill take the new drug . ( F ) 50. In a trial of oral hypoglycemic agents, 42 patients were given drug A and 38 drug B. blood glucose concentrations were measured before and after a single do se of the drug. Drug B apparently caused a greater fall in blood glucose concent ration ( p = 0.06 ). a. These results reach an accepted level of statistical sig nificance.( F ) b. Non-parametric statistical analysis should be used if data ar e not normally distributed.( T ) c. In biological terms drugs A and B have been shown to be equally effective . ( F ) d. 6% more patients responded to drug A th an drug B. ( F ) e. Unequal numbers in the two groups invalidate the trial. ( F )

September 1997 Paper 2 1. a. b. c. d. e. Concerning pH. .( F )In blood, pH is re gulated predominantly by bicarbonate .( F )The higher the pH, the higher the hyd rogen ion concentration . ( F )The pH of gastric acid is 5.5 . ( T )The pH of ur ine decreases after the ingestion of ammonium chloride . ( F )the pH inside cell s is higher than that in plasma 2. Concerning prostaglandins (PG). a. .( T )arachidonic acid is the precursor fo r PG biosynthesis b. .( T )PG synthetase (cyclooxygenase) catalyses arachidonic acid conversion to PG endoperoxides c. . ( F )NSAID inhibit PG dehydrogenase d. . ( T )mefenamic acid is more potent inhibitor of PG synthesis than aspirin e. . ( F )PGF2 alpha is excreted unchanged in urine 3. a. b. c. d. e. Peripheral concentrations of catecholamines increase. .( F )during sleep .( T )w hen the nerves to the adrenal glands are stimulated . ( F )when the blood sugar rises . ( T )immediately following a myocardial infarction . ( F )in the presenc e of phaeochromocytoma 4. a. b. c. d. e. The rate of transfer of a substance into a cell by passive diffusion. .( F )is u nrelated to the concentration gradient .( T )is related to molecular size . ( F )requires energy . ( F )is different for stereo-isomers . ( F )depends on carrie r molecules in the cell wall 5. a. b. c. Vitamin K. .( T )is synthesised by bacteria .( F )is stored in large quantities in the liver . ( T )is necessary for the synthesis of factor VII

d. . ( T )is necessary for the synthesis of factor XI e. . ( T )deficiency cause s hypothrombinaemia 6. Plasma concentrations of the following substances are typically raised in pre gnancy. a. .( T )caeruloplasmin b. .( F )albumin c. . ( F )vitamin B12 d. . ( F )urea e. . ( F )pituitary gonadotrophins 7. a. b. c. d. e. potassium. .( T )is mainly intracellular .( F )plasma levels vary in proportion to intracellular levels . ( F )plasma levels are decreased in Addison s disease . ( T )plasma levels are increased in diabetic ketoacidosis . ( T )deficiency oc curs with prolonged vomiting 8. In the neonates at birth. a. .( T )oxygenated haemoglobin is a less effective buffer than deoxygenated haemoglobin b. .( T )more than 50% of the circulating haemoglobin is haemoglobin F c. . ( T )oxygen dissociation from haemoglobin is p romoted by acidosis d. . ( T )the total haemoglobin concentration is generally a bove 15g/dl e. . ( F )red blood cell 2,3 DPG is absent 9. a. b. c. d. e. triglycerides. .( F )contain glycerol combined with three identical fatty acids .( T )may accumulate in liver cells . ( T )are present in intestinal cells . ( T )are hydrolysed by pancreatic cells . ( F )are not present in chylomicrons 10. RNA. a. .( F )contains deoxyribose

b. c. d. e. .( F .(F .(T .( T )is composed of 2 nucleotide units ) is the main constituent of human chromosome s ) is the main constituent of ribosomes ) is required during protein synthesis 11. In one turn of the tricarboxylic acid cycle , three molecules of. a. .( F ) carbon dioxide (CO2) are produced b. .( T ) reduced (NADH) are produced c. . ( F ) reduced (FADH2) are produced d. . ( F ) guanosine triphosphate (GTP) are prod uced e. . ( F ) acetyl co-enzyme A (acetyl COA) are used Explanation: 1. Before the pyruvates from glycolysis can feed into the citric acid cycle, they must undergo a transition reaction. The pyruvate is converted into a 2-carbon acetyl group as the third carbon is lost as CO2. The acetyl group is attached to coenzy me A to form acetyl-CoA. 2. The 2-carbon acetyl-CoA combines with the 4-carbon o xaloacetate of the citric acid cycle to form 6carbon citrate. 3. Citrate is conv erted to isocitrate. 4. The 6-carbon isocitrate is oxidized by NAD+ to produce r educed NADH and 5-carbon alphaketoglutarate. (One carbon is lost as CO2.) 5. The 5-carbon alpha-ketoglutarate is oxidized by NAD+ to produce reduced NADH and 4carbon succinyl-CoA. (One carbon is lost as CO2.) 6. Oxidation of succinyl-CoA p roduces succinate and one GTP that is converted to ATP. 7. Oxidation of succinat e by FAD produces reduced FADH2 and fumarate. 8. Fumarate is converted into mala te. 9. Oxidation of malate by NAD+ produces reduced NADH and oxaloacetate. The t wo molecules of acetyl-CoA from the transition reaction enter the citric acid cy cle. This results in the formation of 6 molecules of NADH, two molecules of FADH 2, two molecules of ATP, and four molecules of CO2. The NADH and FADH2 molecules then carry electrons to the electron transport system for further production of ATPs by oxidative phosphorylation. 12. Lactose a. .( F ) is a non reducing sugar b. .( T ) may be detected in the u rine of pregnant woman c. . ( F ) is a major constituent of seminal fluid d. . ( T ) is galactosyl glucose e. . ( F ) is catabolised by the liver 13. Concerning carbohydrates. a. .( T ) surose is a disaccharide of glucose and fructose b. .( F ) cereal grains contain less than 40% starch c. . ( F ) cellulo se is a fructose polysaccharide

d. . ( F e. . ( T ) a normal diet contains less than 60 g of carbohydrate daily ) dietary carbohyd rate is oxidised in the body to carbon dioxide and water 14. Muscle glycogen. a. .( tabolism is independent of enerates ATP under aerobic ( T ) is released into the T ) metabolism cannot yield free glucose b. .( F ) me the enzyme phosphorylase c. . ( F ) metabolism only g conditions d. . ( T ) is entirely intracellular e. . circulation in response to glucocorticoids

15. The ultrasound energy used in real time machine for diagnostic imaging. a. . ( T )is pulsed b. .( T )has a velocity measured in metres per second c. . ( T )h as a velocity which is the same in all human tissues d. . ( F )has a frequency m easured in decibels e. . ( F )is entirely dissipated within the tissues 16. The natural decay of radioactive isotopes results in the emission of. a. .( T )alpha particles b. .( T )gamma rays c. . ( F )neutron rays d. . ( F )proton b eams e. . ( T )beta particles 17. The following are inherited as autosomal recessive conditions. a. .( F )tube rous sclerosis b. .( T )phenylketonuria c. . ( F )achondroplasia d. . ( T )sickl e cell anaemia e. . ( T )Von Gierke s disease 18. Genes on sex chromosomes are responsible for the inheritance of. a. .( T )G6 PD deficiency b. .( T )defective colour vision c. . ( T )hairy ear rims

d. . ( F )homocystinuria e. . ( F )hurler syndrome 19. The following genes and chromosomes are correctly paired. a. .( T )HLA: chro mosome 6 b. .( T )clotting factor VIII: X chromosome c. . ( T )G6PD: X chromosom e d. . ( F )testis determining factor: X chromosome e. . ( F)Xg blood group: chr omosome 1 20. In the human a haploid number of chromosomes is found in. a. .( F )red blood cells b. .( F )blastocysts c. . ( F )primary oocyte d. . ( T )the first polar b ody e. . ( T)spermatozoa 21. The following statements relate to familial disease. a. .( T )achondroplasia is a dominant trait b. .( F )babies with down syndrome usually have 47 chromoso mes c. . ( T )congenital pyloric stenosis is commoner in babies of affected pare nts than in general popoulation d. . ( F )all the daughters of a female carrier of red greenn colour blindnesss re them selves carriers e. . ( F )haemophilia oc curs in all sons of an affected father 22. Human immunoglobulin M (IgM). a. .( F )has a molecular weight of 150000 Dalt ons b. .( T )contains j chains c. . ( F )crosses the placenta readily d. . ( F ) fixes complement by the alternative pathway e. . ( F )is a dimer in external sec retions 23. Plasma cells. a. .( T )are increased in myeloma

b. c. d. e. .( .( .( .( T F T T )are characteristic of acute infection )are phagocytic )synthesise immunoglobuli ns )are derived from B lymphocytes 24. Antibodies play an important part in the development of. a. .( T )phagocytos is b. .( F )the mantoux response c. . ( T )erythroblastosis fetalis d. . ( F )hy peremesis gravidarum e. . ( T )anaphylaxis 25. Osteoporosis is associated with. a. .( F )an increase in uncalcified bone ma trix (osteoid tissue) b. .( F )prolonged oestrogen therapy c. . ( F )a normal hi stological bone structure d. . ( T )bone fractures e. . ( F ) irregularity of ep iphyseal plates 26. Steps involved in the identification of restriction fragment length polymorp hisms (RFLP) include. a. .( F )western blotting b. .( T )restriction enzyme dige stion c. . ( T )southern blotting d. . ( T )agarose gel electrophoresis e. . ( F )thin layer chromatography 27. Features of disseminated intravascular coagulation include. a. .( F )thrombo cythaemia b. .( T )petechiae c. . ( T )haemorrhage d. . ( F )reduced circulating fibrin degradation products e. . ( T )small vessel thrombosis

28. Chemical mediators concerned in the production of an inflammatory response i nclude. a. .( T )5-hydroxytryptamine b. .( F )aldosterone c. . ( F )glucocortico ids d. . ( T )bradykinin e. . ( T )leukotrienes 29. In sarcoidosis. a. .( F )lesions are confined to the lung b. .( F )the manto ux test is strongly positive c. . ( T )caseation is not present d. . ( T )the le sion contain giant cells e. . ( T )the Kveim test is a useful adjunct to diagnos is 30. Adenocarcinoma is the commonest type of primary malignant tumour to occur in . a. .( F )bladder b. .( F )lung c. . ( F )oesophagus d. . ( T )fallopian tube e. . ( F )testis 31. The following tumours are correctly paired with likely causative agent. a. . ( T )angiocarcinoma of the liver: vinyl chloride b. .( F )carcinoma of the colon : dietary fibre c. . ( T )hepatoma: aflatoxins d. . ( T )carcinoma of the bronch us: coal dust e. . ( T )carcinoma of the bladder: beta naphthylamine 32. The parathyroid glands. a. .( F )originate from the pharyngeal cleft ectoder m b. .( T )secrete PTH via the chief cells c. . ( F )secrete calcitonin via the oxyphil cells d. . ( T )may become hyperplastic in the presence of intestinal ma labsorption

e. . ( T )may develop adenomas in association with islet cell tumours of the pan creas 33. The concentration of urine. a. .( T )is due to passive reabsorption of water b. .( F )is completed in loop of Henle c. . ( T )occurs progressively along the proximal tubule d. . ( T )is dependant upon Arginine vasopressin e. . ( T )is r elated to the osmolarity of the interstitial fluid of the renal medulla 34. In the human neonate, compared with the adult. a. .( T )the liver has less a bility to conjugate bilirubin b. .( F )the blood brain barrier is less permeable to bilirubin c. . (F )heat regulation is more efficient d. . (T )red blood cell s have greater affinity for oxygen e. . (T )the haemoglobin concentration is gre ater 35. Gastrointestinal absorption of. a. .( F )dietary glucose depends upon intact pancreatic function b. .( F )vitamin B12 requires gastric acid c. . ( F )fats i s accomplished by the transport of chylomicrons from the intestinal lumen d. . ( F )iron may be reduced by vitamin C administration e. . ( T )unhydrolised polys accharides does not occur 36. The menarche. a. .( F )usually follows an ovulatory cycle b. .( T )is preced ed by the thelarche c. . ( F )occurs earlier in girls below normal weight d. . ( T )is preceded by adrenarche e. . ( F )is followed by the growth spurt 37. Concerning platelets. a. .( F )they are the only source of platelet derived growth factor b. .( F )their life span is 90-120 days

c. . (F d. . ( T e. . ( T )average platelet count increases during pregnancy )during aggregation they rele ase serotonin )they contain platelet contractile protein (thromboasthenin) 38. Mast cells. a. .( F )normally form 3% of circulating leucocytes b. .( T )rel ease histamine on degranulation c. . ( T )contain heparin d. . ( F )control mela nin formation in the epidermis e. . ( F )have a specific affinity for antibody o f the IgA class 39. Concerning the absorption of iron. a. .( F ) it occurs mainly in the ileum b . .( T ) it normally represents 5-15% of the oral intake c. . ( F ) its absorpti on is promoted by bile salts d. . ( T ) 10-15 mg dietary iron required daily by a nonpregnant women between 20-40 years of age e. . ( F ) it occurs in the ferric form 40. Characteristic features of Addisonian pernicious anaemia are. a. .( F )leuco cytosis b. .( F )inheritance as an autosomal dominant trait c. . ( F )a raised m ean corpuscular haemoglobin concentration d. . ( T )an increased incidence of ga stric neoplasia e. . ( T )an increased incidence of primary hypothyroidism 41. The vents in normal Micturition in women include. a. .( F )contraction of th e perineal muscles b. .( F )initial relaxation of the detrusor muscle c. . ( T ) a constant increase in intra-abdominal pressure d. . ( F )no change in intravesi cal pressure e. . ( F )urinary flow of a maximum of 5 ml per second 42. The following may occur in uncomplicated haemolytic jaundice. a. .( F )bilir ubinuria

b. c. d. e. .( F .( T .(F .(T )high serum levels of conjugated bilirubin )urobilinuria )high serum levels of a lkaline phosphatase )reticulocytosis 43. During the normal cell cycle. a. .( F ) the principal phase of deoxyribonucl ic acid (DNA) synthesis is G1 b. .( T ) a tetraploid quantity of DNA is present at the end of G2 c. . ( F ) G2 is the post - mitotic resting phase d. . ( T ) ce lls are generally senstive to antimetabolites in the S phase e. . ( F ) the DNA is completely replicated several times 44. In the renin angiotensin system. a. .(T )oestrogen stimulates angiotensinoge n production b. .( F )angiotensin II is converted to angiotensin I c. . ( T )ang iotensinogen is a globulin d. . ( F )renin release is inhibited by sodium restri ction e. . ( T )renin may be produced by deciduas 45. In the fetal circulation. a. .( F ) most of the blood from the superior vena cava passes directly from the right to the left atrium b. .( T ) the output of the right ventricle is greater than that of the left c. . ( T ) blood in the asc ending aorta is more oxygenated than that in the descending aorta d. . ( F ) blo od in the right ventricle is more oxygenated than blood in the left ventricle e. . ( F ) blood in the ductus arteriosus and the right atrium is equally oxygenat ed 46. The adult oxygen-haemoglobin dissociation curve is shifted to the left by. a . .( T ) low temperature b. .( F ) low haemoglobin levels c. . ( F ) high altitu de d. . ( F ) 2,3 DPG e. . ( T ) alkalosis

47. The following factors increase ventilation in normal women. a. .( T ) a rise in PCo2 from 5.3 KPa to 8 KPA (40-50 mmHg) b. .( T ) a fall in Po2 from 13.1 KP a to 11.7 KPa (98-88 mmHg) c. . ( T ) pregnancy d. . ( T ) a fall in pH from 7.4 to 7.3 e. . ( T ) taking a combined oral contraceptive pill 48. Calcium in the serum of a healthy adult. a. .( F )constitutes 15% of total b ody calcium b. .( F )is not involved in the extrinsic system of blood coagulatio n c. . ( T )has a concentration which is lowered by calcitonin d. . ( F )has a c oncentration which normally falls after the menopause e. . ( F )is approximately 90% protein bound 49. The stroke volume of the left ventricle. a. .(F )is equal to the blood volum e in the ventricle at the end of diastole b. .( T )may be increased without incr easing the end diastolic volume of the ventricle c. . ( T )is directly related t o the duration of the previous diastolic pause d. . ( F )is consistently greater than that of the right ventricle e. . ( F )is 20-30 ml in a resting man of aver age size in the supine position 50. The following increase during normal pregnancy. a. .( T ) the basal metaboli c rate b. .( T ) serum cholesterol concentration c. . ( F ) fasting blood glucos e concentration d. . ( F ) serum sodium concentration e. . ( T ) serum fibrinoge n concentration

march 1998 papers 1 1. In the abdominal wall. a. .( T )the rectus abdominis muscle is attached to th e crest of the pubis b. .( F )te posterior border of the external oblique muscle ends in ht e linea semilunaris c. . ( F )the aponeurosis of external oblique mu scle takes part in the formation of the conjoint tendon d. . ( F )the inferior e pigastric artery is a branch of internal iliac artery e. . ( T )the conjoint ten don blends medially with the anterior layer of rectus sheath 2. a. b. c. d. e. The pelvic splanchnic nerves. .( T ) contain parasympathetic fibres .( T )unite with branches of the sympathetic pelvic plexus . ( T )are preganglionic fibres . ( F )supply the bladder sphincter with motor fibres . ( T )supply the uterus wi th vasodilator fibres 3. a. b. c. d. e. the vulva and perineum are supplied by the following nerves. .( F )sciatic .( T )posterior cutaneous nerve of the thigh . ( T )inferior rectal . ( T )ilioinguin al . ( F )obturator 4. a. b. c. d. e. the adult spinal cord. .( F )commences at the foramen rotandum .( T )ends at the level of upper lumbar vertebrae . ( F )lies posterior to the spinal laminae . ( F )is enclosed within a single layer of dura matter . ( F )has a thoracic paras ympathetic outflow 5. The vaginal epithelium at puberty. a. .( T )thickens

b. c. d. e. .( F )devlops goblet cells . ( F )forms cilia . ( T )stores glycogen . ( F )kera tinises 6. a. b. c. d. e. The urinary bladder. .( T )has an epithelium derived from endoderm .( F )has a v enous plexus draining the external iliac veins . ( T )is situated in the abdomen of the young child . ( F )is separated from the symphysis pubis by a fold of pe ritoneum . ( F )has a blood supply from the inferior epigastric artery 7. a. b. c. d. e. the following contribute to the boundaries of the ovarian fossa. .( T )ureter .( T )external iliac vein . ( T )internal iliac vein . ( F )internal pudendal arte ry . ( T )obliterated umbilical artery 8. a. b. c. d. e. The following statements about the adrenal gland are correct. .( T )they lie ant erior to the diaphragm .( T )the left adrenal gland lies behind the pancreas . ( F )lymphatic drainage is to the superficial inguinal nodes . ( F )the adrenal c ortex contains chromaffin cells . ( F )the adrenal medulla is derived from mesod erm 9. a. b. c. d. e. the femoral ring. .( F )is lined by peritoneum .( T )is bounded medially by the lacunar ligament . ( F )is bounded laterally by the femoral artery . ( T )passes deep to the inguinal ligament . ( T )is traversed by lymphnodes 10. in the development of the heart. a. the primitive heart consists of 5 parts. ( T )

b. .( T )the septa are formed within 6 weeks of conception c. . ( F )the septum secundum forms a complete partition in the atrial cavity d. . ( T )obliteration of the right atrioventriclular orifice is frequently associated with a ventricul ar septal defect e. . ( F )anatomical closure of the ductus arteriosus occurs wi thin 1 hour of birth 11. Concerning the development of the nervous system. a. .( F )the posterior neu ropore closes before the anterior neuropore b. .( T )at 3 months of age, the spi nal cord extends the length of the vertebral canal c. . ( T )at birth the spinal cord terminates at L3 d. . ( F )at birth the dura matter extends as far as L3 e . . ( T )myelin formation in the spinal cord is completed before birth 12. The urogenital sinus in the female gives rise to the following. a. .( F )ure ter b. .( T )paraurethral glands c. . ( T )bartholin glands d. . ( F )urachus e. . ( F )gartners duct 13. The mesoderm gives rise to. a. .( T )striated muscle b. .( T )blood c. . ( T )peritoneum d. . ( F )transitional epithelium of the bladder e. . ( T )ovarian stroma 14. Steroid hormones. a. .( F )all contain 20 carbon atoms b. .( T )can be produ ced by structures of urogenital ridge origin c. . ( F )are mostly activated in t he liver d. . ( F )are predominantly excreted unchanged in the urine e. . ( F )m ainly circulate unbound to carrier proteins

15. Human insulin. a. .( T )is composed of 2 chains of amino acids b. .( T )diff ers from pig insulin by 1 amino acid c. . ( F )facilitates glucose uptake by red blood cells d. . ( T )increases protein synthesis in the liver e. . ( T )increa ses triglyceride deposition in the adipose tissue 16. Thyroid hormones. a. .( T )increase oxygen consumption in most metabolically active tissues b. .( F )in the circulation are less than 90 % bound to protein c. . ( F )decrease the rate of absorption of carbohydrate from the gut d. . ( F )increase circulating cholesterol concentrations e. . ( T )are essential for ske letal maturation 17. The interstitial leydig cells of the testis . a. .( F )secretes seminal flui d b. .( T )are stimulated by LH c. . ( F )secretes androgen binding protein d. . ( F )secretes fructose e. . ( T )produce testosterone 18. During the normal ovarian cycle. a. .( T )the principle oestrogen secreted i s 17 B-oestradiol b. .( F )the most potent oestrogen is oestriol c. . ( F ) oest rogen production is maximal by about the 8th day of the cycle d. . ( T ) oestrog ens decrease the secretion of FSH e. . ( F )oestorgens are synthesized primarily by the ovarian stroma 19. Concerning sex hormones. a. .( T )The ovary secretes androstendione b. .( T )The ovary secretes testosterone c. . (F )The ovary secretes dihydrotestosterone d. . (T )sex hormone binding globulin concentrations are higher in woman then m en e. . (F )androgens bound to protein have high biological activity

20. progesterone. a. .( T )is synthesized by trophoblast b. .( F )increases myom etrial ctivity c. . ( F )is predominantly excreted in urine as pregnanteriol d. . ( T )binds to cortisol binding globulin n the circulation e. . ( T )is synthes ised from cholesterol 21. 22.The hypothalamus is the site of synthesis of a. .( T )oxytocin b. .( T )t hyrotrophin releasing hormone c. . (F )alpha melanocyte stimulating hormone d. . (F )lutenising hormone e. . ( T )gonadotrophin releasing hormone 22. during human lactation. a. .( T )oxytocin increase mammary duct pressure b. .( F )oestrogens promote the milk producing effects of prolactin on the breast c . . ( F )human placental lactogen is essential for milk synthesis d. . ( F )prol actin stimulates gonadotrophin release e. . ( T )suckling enhances prolactin rel ease 23. Follicle stimulating hormone. a. .( T )binds to receptor on the cell membran e b. .( T )promotes the expression of LH receptors c. . ( F )is responsible for the degeneration of corpus luteum d. . ( F )is steroid hormone e. . ( F )is synt hesized in the hypothalamus 24. Release of prolactin from the anterior pituitary gland is enhanced by. a. .( F )dopamine b. .( T )thyrotrophin releasing hormone c. . ( T )oestrogens d. . ( T )chlorpromazine e. . ( F )growth hormone

25. Growth hormone . a. .( T )is a protein b. .( F )has a molecular weight of 20 00 Daltons c. . ( F )secretion is stimulated by hyperglycaemia d. . ( T )has gro wth promoted effects mediated through insulin like growth factor e. . ( F )is sy nthesized in the hypothalamus 26. Arginine vasopressin. a. .( T )is produced in the hypothalamus b. .( T )is a polypeptide c. . ( F )is structurally similar to prolactin d. . ( T )controls w ater reabsorption by the kidney e. . ( F )decreases glomerular filtration 27. Hirsutism is associated with. a. .( F )testicular feminization syndrome b. . ( F )turner syndrome c. . ( F )Addisons disease d. . ( T )Sertoli Leydig cell tumo urs e. . ( T )congenital adrenal hyperplasia 28. Parathyroid hormone. a. .( T )increases bone resorption b. .( T )concentrati ons are increased in pregnancy c. . ( F )reduces phosphate excretion in urine d. . ( T )increase the formation of 1,25 di hydroxycholecalciferol e. . ( F )stimu late osteoblasts 29. Calcitonin. a. .( F )suppresses appetite b. .( F )is produce mainly in the t hymus c. . ( T )lowers plasma calcium concentrations d. . ( F )secretion is inhi bited by gastrin e. . ( T )inhibits bone resorption

30. Concerning viruses. a. .( F )the core of every virus contain RNA b. .( F )th ey usually produce intracellular toxins causing cell death c. . ( T )antibodies are directed against capsular proteins d. . ( T )they can only be grown in intac t cells e. . ( F )interferons are synthetic antiviral substances 31. The following are caused by herpes simplex virus. a. .( T )acute gingivostom atitis b. .( T )cold sores c. . ( F )cervical warts d. . ( T )menigeoencephaliti s e. . ( F )shingles 32. pertussis. a. .( F )is a viral infection b. .( T )is transmitted by droplet spread c. . ( T )is associated with lymphocytosis d. . ( F )rarely occurs during the first year of life e. . ( F )is effectively prevented by giving immunoglobu lin 33. pseudomonas aeruginosa. a. .( F )is non motile b. .( F )is gram positive c. . ( T )does not grow anaerobically d. . ( F )ferments glucose e. . ( T )produces pigment 34. in septic shock. a. the causative organisms are invariably Gram-negative.( F ) b. death is characterized by leucocytosis.( F ) c. endotoxins are predominant ly lipopolysaccharides. ( T ) d. antibiotic treatment may aggravate hypotension. ( T ) e. there may be associated disseminated intravascular coagulation. ( T )

35. candia albicans. a. is a commensal organism in the bowel.( T ) b. is gram ne gative.( F ) c. forms pseudohyphae. ( T ) d. is sensitive to gantamicin. ( F ) e . reproduces by budding. ( T ) 36. features of congential rubella include. a. excretion of virus by the neonate .( T ) b. hepatomegaly.( T ) c. excessive production of growth hormone. ( F d. c ataract. ( T ) e. deafness. ( T ) ) 37. leptospirosis ( weils disease ). a. produces a positive Wassermann reaction.( F b. is associated with jaundice.( T ) c. is transmitted to humans from rats. ( T ) d. infection is usually via the skin. ( T ) e. is a rickttesial infection . ( F ) ) 38. fluid retention may be caused by the administration of. a. spironolactone.( F ) b. chlorothiazide.( F ) c. diethylstilboestrol. (T ) d. carbenoxolone. ( F ) e. prednisolone. ( T ) 39. the following have an antiemetic action. a. hyoscine hydrobromide.( T ) b. m orphine sulphate.( F ) c. chlorpropamide. ( F ) d. promethazine hydrochloride. ( T ) e. perphenazine. ( T )

40. oestrogen therapy raises the plasma concentrations of . a. thyroxine-binding globulin.( T ) b. free cortisol.( F ) c. transferrin. ( T ) d. albumin. ( F ) e . folate. ( F ) 41. the following compounds are predominantly progestogens. a. buserelin.( F ) b . dydrogesterone.( T ) c. norrethisterone. ( T ) d. 17 -hydroxyprogesterone. (T ) e. androstenedione. ( F ) 42. clomifene citrate. a. is an anti-androgen.(F ) b. does not stimulate ovulati on directly.(T ) c. can produce visual disturbances. ( T ) d. is generally presc ribed throughout the proliferative phase of the menstrual cycle. (T ) e. in the treatment of anovulation increases the risk of multiple pregnancy. ( T ) 43. the following statements describe the action of drugs on the myometrium: . a . ergometrine stimulates sympathetic alpha receptors.( T ) b. indomethacin inhib its contractions by blocking prostaglandin receptors.( F ) c. prostaglandin E, i s a stimulant or isolated uterine tissue in vitro . ( F ) d. oxytocin requires i onised calcium as a co-factor. ( T ) e. magnesium sulphate is a myometrial stimu lation . (F ) 44. sympathomimetic drugs in therapeutic doses . a. cause tachycardia .( T ) b. cause hypotension .( F ) c. cause a decrease in cardiac output . ( F ) d. cause arrhythmias in association with hydrocarbon anaesthetics. ( T e. are contraindic ated in thyrotoxicosis. ( T ) )

45. ventilation is increased due to stimulation of central receptors by . a. nik ethamide.( T ) b. hypoxia.( T ) c. doxapram. ( T ) d. phenobarbitone. ( F ) e. s albutamol. ( F ) 46. the following are cytotoxic alkylating agents. a. cyclophosphamide.( T ) b. mercaptopurine.( F ) c. chlorambucil. ( T ) d. fluorouracil. ( F ) e. methotrexa te. ( F ) 47. the following statements are true :. a. suxamethonium is a non-depolarising muscle relaxant.( F ) b. huxamethonium is a ganglion blocker.( F ) c. tubocurari ne is reversed by neostigmine. ( T ) d. streptomycin is absorbed from the gastro intestinal . ( F ) e. thiopentone can be given intramuscularly . ( T ) 48. if a distribution of results is marked skewed to the left . a. the mean is t he same as the 50th centile.( F ) b. the same number of values lie on either sid e of the median.( T ) c. the mode is equal to the medium. ( F ) d. the students test should be used to compare this distribution with another. ( F ) e. logarith mic transformation of the results will produce a distribution closer to the norm al . ( F ) 49. in a trial of a new therapeutic agent, the required sample size varies with the. a. level of statistical significance required .( T ) b. level of acceptance of failing to discover a true effect .( F ) c. type of statistical test to be e mployed . ( F ) d. magnitude of response expected. ( T ) e. experience of the in vestigator. ( F )

50. for international comparisons, the World Health Organization recommends that calculation of the perinatal mortality rate should. a. include all fetuses and infants weighing 1000 g or more.( T ) b. include all fetuses and infants of a ge stational age of more than 20 weeks.( F ) c. include all fetuses and infants wit h a crown rump length of more than 35 cm. ( F ) d. be expressed as deaths per th ousand live births. ( F ) e. include all deaths occurring in the first month of life. ( F )

march 1998 paper 2 1. a. b. c. d. e. The oxidation of pyruvate to carbon dioxide . Occurs exclusively in mitochondria.( T ) Can occur under anaerobic conditions. ( F ) Involves intermediates that are also involved in amino acid catabolism. ( T ) Is regulated by the concentration of acetyl coenzyme A in the cell. ( T ) Is impaired in thiamine deficiency states. ( T ) 2. a. b. c. d. e. Uric acid. Is formed from the breakdown of purines.( T ) Serum concentrations ar e raised during normal pregnancy.( F ) Serum concentrations are increased during thiazide diuretic therapy. ( T Is reabsorbed in proximal renal tubule. ( T ) Is excreted unchanged in the urine. ( T ) ) 3. a. b. c. d. e. Creatinine. Is filtered out by the glomerulus.( T ) Is reabsorbed significantly by the proximal tubules.( F ) Plasma concentration increases after protein inges tion. ( F ) Has a plasma clearance rate equivalent to renal plasma flow. ( F ) P lasma concentration increases during the first trimester of pregnancy. ( F ) 4. a. b. c. d. e. Plasma albumin binds the following. Free fatty acids.( T ) triglycerides.( F ) o estradiol. ( T ) bilirubin. ( T ) iron ions. ( F ) 5. a. b. c. In the digestive system. Polysaccharides are broken down mainly in the stomach.( F ) One molecule of sucrose forms 2 molecules of glucose.( F ) Glucose transpor t into the cell depends upon the active transport of sodium ions. ( T ) d. Fruct ose is mainly absorbed by simple diffusion. ( F ) e. Lactase activity increases during childhood. ( T )

6. a. b. c. d. e. Methionine. Is an essential amino acid.( T ) Is a sulpher containing amino acid. ( T ) Cannot be converted to cystine by the fetal liver. ( T ) Cannot cross the placenta. ( F ) Is reabsorbed in the proximal convoluted tubule in the kidneys. ( T ) 7. a. b. c. d. e. Tetrahydrofolic acid. Is involved in purine synthesis.( T ) Is a precursor of fo lic acid.( F ) Is a coenzyme in amino acid synthesis. ( T ) Catalyses the conver sion of glucose to glucose-6-phosphate. ( F Activity is inhibited by methotrexat e. ( T ) ) 8. a. b. c. d. e. Deficiency of the following substances and diseases correctly matched. Thiamine: pellagra.( F ) Cyanocobalamin: microcytic anaemia.( F ) Niacin: beriberi. ( F ) Folates: sprue. ( T ) Ascorbic acid: night blindness. ( F ) 9. a. b. c. d. e. Fetal pulmonary surfactant. Contains less than 10% lipid.( F ) Can be detected i n amniotic fluid.( T ) Contains phosphatidylglycerol. ( T ) Is predominantly dip almitol-phosphatidyl choline. ( T Is more than 40% albumin. ( F ) ) 10. Standard bicarbonate in blood. a. Is usually more than 30mmol/L.( F ) b. Is increased with chronic carbon dioxide retention.(T c. Is decreased with persiste nt vomiting. ( F ) d. Is decreased in renal failure. ( T ) e. Is decreased in se vere diarrhoea. ( T ) )

11. Hyperkalaemia occurs in association with. a. Chronic diarrhoea.( F ) b. Rena l tubular acidosis.( T ) c. hypoparathyroidism. ( F ) d. hormone secreting tumou rs of the bronchus. (F e. primary hyperaldosteronism. ( F ) ) 12. DNA. a. Contains no cystine.( F ) b. Has a background of ribose.( F ) c. Is usually single stranded in mammalian cells. ( F ) d. Is cleaved by restriction e nzymes. ( T ) e. Is irreversibely damaged in vitro by heating to 75 C. ( T ) 13. Pancreatic glucagon. a. Is secreted by the beta cells.( F ) b. Is a steroid hormone.( F ) c. Secretion is inversely proportional to the blood glucose concen tration. ( T d. Increases the breakdown of liver glycogen. ( T ) e. Increases th e breakdown of triglycerides. ( T ) ) 14. Biochemical abnormalities associated with diabetes mellitus include. a. Incr eases breakdown of protein.( T ) b. Decreased plasma levels of free fatty acids. ( F ) c. Increased serum cholesterol concentrations. ( T ) d. Decreased glycosyl ation of haemoglobin. ( F ) e. A decrease in the plasma concentration of low den sity lipoproteins. ( F ) 15. The following substances are normally synthesized in the liver. a. glucagon. ( F ) b. vitamin A.( T ) c. Cholesterol. ( T ) d. immunoglobulins. ( F ) e. prot hrombin. ( T )

16. radiation damage to tissue. a. Is greatest in tissue with a high mitotic ind ex.( T ) b. Is enhanced in the presence of reduced oxygen tension.(F c. May caus e a non specific immune response. ( T ) d. Does not cause neoplasia. ( F ) e. Ma y cause chromosomal non-disjunction. ( T ) ) 17. Mitochondrial DNA. a. Is located in the nucleus.( F ) b. Inheritance is patr ilineal.( F ) c. Is present in 2 copies per cell. ( F ) d. Mutation causes cysti c fibrosis. (F ) e. Is involved in the control of oxidative phosphorylation. ( T ) 18. Concerning the genetic control of protein synthesis. a. Mature messenger RNA contain introns.( F ) b. A codon has 3 base sequences.( T ) c. Each amino acid has a single codon. ( F ) d. Transfer RNA has anticodon recognition sites. ( T ) e. Each Transfer RNA carries a specific amino acid. (T ) 19. When a man has haemophilia. a. 50% of his daughters would not expect to be c arriers.(F ) b. 25% of his sons would be expected to be affected.( F ) c. Good m edical control of his blood deficiency reduces the risk of the condition in his children. (F ) d. His newborn child is likely to require an urgent blood transfu sion. ( F ) e. His sister has a 50% probability of being a carrier. ( T ) 20. The human major histocompatability complex (MHC). a. Resides on chromosome 1 1.( F ) b. Is composed of HLA genes.( T ) c. Codes for 3 classes of antigens. ( F ) d. Will be identical in dizygotic twins. ( F ) e. Codes for blood group anti gens. ( F )

21. Type 3 hypersensitivity. a. Is mediated by specifically sensitized T lymphoc ytes.( F ) b. Causes myasthenia gravis.( F ) c. Occurs in systemic lupus erythem atosus. ( T ) d. Is a recognized cause of glomerulonephritis. ( F ) e. May cause allergic asthma. ( F ) 22. The following cells are correctly paired with their products. a. Endothelial cell: factor 8 related antigen.( T ) b. Plasma cell: IgG.( T ) c. Salivary glan d epithelial cell: amylase. ( T ) d. Mast cell: IgA. ( F ) e. Decidual stromal c ell: prolactin. ( T ) 23. The following are recognized functions of T lymphocytes. a. Antibody product ion.( F ) b. Cell mediated immunity.( T ) c. Immune supression. ( T ) d. phagocy tosis. ( F ) e. lymphokine production. ( T ) 24. the development of tissue necrosis. a. Can be identified by light microscopy within 1 hour of myocardial infarction.( F ) b. Is recognized by the presence o f karyorrhexis.( T ) c. Is of colliquative type in the kidney. ( T ) d. Occurs i n tertiary syphilis. ( T ) e. Is associated with rupture of lysosomes. ( T ) 25. The following statements relate to embryonic tumours. a. An ovarian teratoma is usually malignant.( F ) b. A nephroblastoma may be benign.( F ) c. A neurobl astoma can arise in the adrenal medulla. ( T ) d. A hamartoma is usually maligna nt. ( F ) e. Choriocarcinoma may arise in a teratoma. ( T )

26. The parathyroid glands. a. Originate from the pharyngeal cleft ectoderm.( F ) b. Secrete parathyroid hormone via the chief cells.( T ) c. Secrete calcitonin via the oxyphil cells. ( F ) d. May become hyperplastic in the presence of inte stinal malabsorbtion. ( T ) e. May develop adenomas in association with islet ce ll tumours of the pancreas. ( T ) 27. The following condition may lead to hydronephrosis. a. Mercury poisoning.( F ) b. Cervical carcinoma.( T ) c. Renal calculi. ( T ) d. Renal vein thrombosis. ( F ) e. Posterior urethral valves. ( T ) 28. The following are X-linked disorders. a. Myotonic dystrophy.( F ) b. Duchenn e muscular dystrophy.( T ) c. Haemophilia A. ( T ) d. Huntington s disease. (F ) e. Fragile X syndrome. ( T ) 29. A metaplastic process is involved in the histogenesis of the following tumou rs. a. Squamous cell carcinoma of the vulva.( F ) b. Squamous cell carcinoma of the bronchus.( T ) c. Scirrhous carcinoma of the breast. ( F ) d. Squamous cell carcinoma of the cervix. ( F ) e. Adenocarcinoma of the oesophagus. ( T ) 30. Amyloid deposition is part of the pathological process in the following dise ases. a. Medullary carcinoma of the thyroid.( T ) b. plasmacytoma.( T ) c. diabe tes mellitus. ( F ) d. chronic pyelonephritis. (T ) e. bronchial asthma. ( F )

31. metastases to lymph nodes are commonly associated with. a. fibrosarcoma.( F ) b. malignant melanoma.( T ) c. medulloblastoma. ( F ) d. seminoma of the testi s. ( T ) e. basal cell carcinoma of the skin. ( F ) 32. adenocarcinoma of the large bowel. a. Most commonly originates ing colon.( F ) b. May develop as a single polyp.( T ) c. May show eatures histologically. (T ) d. Characteristically metastasizes to ore the lymph nodes. ( F ) e. Is a recognized complication of long rative colitis. ( T ) in the ascend signet ring f the liver bef standing ulce

33. Rickets is characterized by the following. a. Mineralization of the perioste um.( F ) b. Deposition of uncalcified osteoid.( T ) c. Abnormal osteoblastic act ivity. ( T ) d. Increased capillary fragility. ( F ) e. Overgrowth of cartilage. ( T ) 34. The following substances are correctly paired with their site of release. a. Acetylcholine: postganglionic parasympathetic nerve endings.( T ) b. Noradrenal ine: pre ganglionic sympathetic nerve endings.( F ) c. Dopamine: hypothalamus. ( T ) d. Oxytocin: posterior pituitary. ( T ) e. Gonadotrophin releasing hormone: anterior pituitary. ( F ) 35. 2,3- diphosphoglycerate. a. Is present at higher concentration in maternal e rythrocytes than fetal erythrocytes.(T ) b. Binds to HbA more avidly than to HbF .( T ) c. Increases the affinity of haemoglobin for oxygen. ( F ) d. Is a phosph olipid. ( F ) e. Is synthesized by the pentose phosphate pathway. ( F )

36. platelets. a. Are approximately 50 micrometers in diameter.( F ) b. Contain myosin.( T ) c. Release a growth factor. ( T ) d. Are formed from myeloblasts. ( F ) e. Are prevented from aggregating by thromboxane A2. ( F ) 37. In uncomplicated homozygous beta thalassaemia there is . a. hypochromasia.( T ) b. a reduction in haemoglobin A2.( F ) c. an increase in haemoglobin F. ( T ) d. no depletion of iron stores. ( T ) e. the presence of megaloblasts in bon m arrow. ( F ) 38. In the nephron, sodium. a. Is mainly reabsorbed in the proximal convoluted t ubules.( T ) b. Reabsorption increases in normal pregnancy.( T ) c. May be reabs orbed in exchange for hydrogen ion. ( T ) d. Reabsorption is increased by spiron olactone. ( F ) e. Reabsorption is increased by atrial natriuretic peptide. ( F ) 39. Concerning normal urinary bladder function. a. The bladder normally fills at a rate of 20 ml per minute.( F ) b. During early filling there is minimal rise in intravesical pressure.( T ) c. A significant increase in intravesical pressur e occurs when the bladder contains 100 ml of urine. ( F ) d. The sensation of bl adder filling is transmitted by the pelvic splanchnic nerves. ( T ) e. Micturiti on is initiated by contraction of the trigone. ( F ) 40. The conjugation of bilirubin. a. Takes place in hepatocytes.( T ) b. Is cata lysed by UDP glucuronyl transferase.( T ) c. Is inhibited by phenobarbitone. ( F ) d. Renders it water souble. ( T )

e. Is impaired in acute biliary obstruction. ( F ) 41. bradykinin. a. Increases capillary permeability.( T ) b. Is a small polypept ide.( T ) c. Is formed by the action of kallikrein. ( T ) d. Is predominantly in activated in the liver. ( F ) e. Is metabolized to kininogen. ( F ) 42. Physiological jaundice of the newborn. a. Is present on the first day of lif e.( F ) b. Is due to ABO incompatibility.( F ) c. Is associated with a raised se rum concentration of gluatmic pyruvic transaminase. ( F ) d. May be due to relat ive glucuronyl transferase deficiency. ( T ) e. Is associated with a raised leve l of unconjugated bilirubin. ( T ) 43. Carbon dioxide. a. Is produced in the body primarily from the decarboxylatio n of ketoacids .( F ) b. Makes up about 1% of the normal atmosphere.( F ) c. Occ urs in normal arterial blood at a partial pressure of 8 KPa(60mmHg). ( F ) d. Is more water soluble than oxygen. ( T ) e. Crosses the placenta at half the rate of oxygen. (F ) 44. The stimulation of adrenergic alpha receptors. a. Does not occur with adrena line.( F ) b. In the blood vessels of the skin leads to vasoconstriction.( T ) c . In the gastrointestinal sphincter muscles leads to relaxation. (F ) d. In the iris leads to constriction of the pupil. ( F ) e. In the blood vessels of the ki dney leads to vasodilatation. ( F ) 45. The following statements relate to lung function in normal pregnancy. a. Vit al capacity is increased by 50%.( F) b. Tidal volume is increased.( T ) c. The s ubcostal angle increases. ( T )

d. The residual volume is reduced. ( T ) e. The respiratory rate is increased. ( F ) 46. Interstitial fluid in a healthy adult. a. Contains virtually no albumin.( F ) b. Makes up about 70% of the total body weight.( F ) c. Is reabsorbed in to th e capillaries by simple diffusion. ( T ) d. Will increase in response to histami ne release. ( T ) e. Accumulates in dependant parts of the body. ( T ) 47. The erythrocyte sedimentation rate is increased . a. Following the infusion of high molecular weight dextran.(T b. When plasma fibrinogen concentrations inc rease.( T ) c. In men compared with women. ( F ) d. In old age. ( T ) e. In poly cythaemia rubra vera. (F ) ) 48. Concerning blood pressure regulation. a. Adrenaline acts primarily upon the vasomotor center.( F b. Prostacyclin lowers blood pressure.( T ) c. Angiotensino gen is inactive without modification. ( T ) d. Bradykinin increases blood pressu re. ( F ) e. Serotonin is vasodilatory. ( F ) ) 49. In normal pregnancy, uterine blood flow. a. Is about 50 ml/minute at term.( F ) b. Within the choriodecidual space is maintained throughout the cardiac cycl e.( T ) c. Is reduced by prostacyclin. ( F ) d. Is increased during uterine cont ractions. ( F ) e. Represents about 10% of the cardiac output by the end of the firs trimester. ( F ) 50. During normal pregnancy. a. Arterial PCO2 decreases.( T ) b. The blood hydro gen ion concentration decreases.( F )

c. The plasma bicarbonate concentrations decrease. ( T ) d. Urine pH falls. ( F ) e. Lactic acid production is increased. ( F )

september 1998 1. a. b. c. d. ventricle.( F s melatonin. ( ylight. ( F )

paper 1 e. The pineal gland. Is situated at the anterior end of the third ) Is innervated by he parasympathetic nervous system.(F ) Produce T ) May be calcified in the adult. ( T ) Is most active during da

2. a. b. c. d. e. The anal canal. Has an upper part which is innervated by the inferior hypogastri c plexus.( T ) Has a lower part which is supplied by the superior rectal artery. ( F ) Drains lymph to the superficial inguinal nodes from its upper part. (F ) H as its internal sphincter innervated by the inferior rectal nerve. ( F) Has a su perficial part of its external sphincter attached to the coccyx. (T ) 3. a. b. c. d. e. The pudendal nerve. Arises from the posterior rami of S2,3 and 4.( F ) Leaves th e pelvis through the lesser sciatic foramen.(F ) Crosses the ischial spine on th e lateral side of the internal pudendal artery. ( F Supplies the levator ani. ( T ) Supplies the clitoris. ( T ) ) 4. a. b. c. d. e. The pelvic splanchnic nerve. Are derived from the posterior rami of the sacral s pinal nerves.( F ) Supply afferent fibres.( T ) Unite with branches of the sympa thetic pelvic plexus. ( T ) Supply the ascending colon with motor fibres. ( F ) Supply the uterus with parasympathetic fibres. ( T ) 5. In the vulva. a. Blood is supplied by the internal pudendal artery.(T ) b. Th e anterior parts of the labia majora are innervated by the obturator nerves.( F ) c. The posterior parts of the labia majora are innervated by the genitofemoral nerve. (F )

d. The lesser vestibular glands lie deep to the bulb of vestibule. ( F ) e. The round ligaments of the uterus terminate in the labia minora. (F ) 6. a. b. c. d. In the ovary. Primordial germ cells are formed.( F ) .( F )primary oocytes have completed the first mitotic division by birth . ( T )the majority of primary ooc ytes become atretic by puberty . ( F )fewer than ten follicles start the process of antrum formation in each ovarian cycle e. . ( F )the second polar body is fo rmed at ovulation 7. a. b. c. d. e. In the human testis. .( T )secondary spermatocytes contain 23 chromosomes .( T ) one secondary spermatocyte forms 2 spermatids . ( F )the seminiferous tubules co ntain motile spermatozoa . ( F )the process of spermatogenesis take 34 days . ( F )inhibin is produced by primary spermatocytes 8. In the female, the ureter. a. .( T )is separated from the sacroiliac joint by the bifurcation of the common iliac artery b. .( F )descends in front of the in ternal iliac artery c. . ( F )passes behind the sigmoid mesocolon in the right s ide d. . ( F )lies 5 cm lateral to the lateral vaginal fornix e. . ( F )crosses superior to the uterine artery in the broad ligament 9. Concerning the urinary bladder. a. .( F )its motor innervations is predominan tly derived from the first sacral spinal segment b. .( T )in the empty adult bla dder the ureteric orifices are about 2.5cm apart c. . ( F )the trigonal epitheli al cells are mainly columnar d. . ( T )nerve plexuses in the detrusor contain ac etylcholinesterase e. . ( F )its arterial supply is derived from the posterior t runk of the internal iliac artery

10. The following structures pass beneath the inguinal ligament. a. .( F )ilioin guinal nerve b. .( T )femoral artery c. . ( T )femoral branch of genitofemoral n erve d. . ( F )superficial epiastric artery e. . ( T )lateral femoral cutaneous nerve 11. The umbilical cord. a. .( T )contains midgut during embryonic development b. .( T )is covered by amnion c. . ( F )consists chiefly of fetal endodermal cells d. . ( F )contain 2 veins and an artery e. . ( T )is approximately 50cm long at term 12. The fetal testes. a. .( F )are morphologically distinguishable 4 weeks after conception b. .( T )contain cells which have migrated from the wall of the yolk sac c. . ( T )are usually intra-abdominal 12 weeks after conception d. . ( T )a re necessary for the persistence of the mesonephric ducts e. . ( T )secrete andr ogens 13. Concerning embryological development. a. .( F )the amnion has an endodermal origin b. .( T )uterine epithelium is developed from the paramesonepphric ducts c. . ( T )the hymen develops at the junction of the synovaginal bulbs and the ur ogenital sinus d. . ( T )the round ligament of the uterus is derived from the gu bernaculum e. . ( F )the adrenal cortex is derived from neural crest cells 14. Glucagon promotes. a. .( T )hepatic gluconeogenesis b. .( F )glucose uptake by muscle c. . ( F )glycogen synthesis by muscle d. . ( T )breakdown of protein e. . ( F )synthesis of fat

15. Insulin secretion. a. .( T )is partly controlled by the direct action of blo od glucose upon the pancreas b. .( F )affects the rate of entry of gucose into t he beta cells of the pancreatic islets c. . ( F )is stimulated by adrenaline d. . ( T )is stimulated by arginine e. . ( F )is stimulated more effectively by glu cose administered intravenously than by glucose administered orally 16. Concerning thyroid function. a. .( T )oestrogen increases the production of thyroxine binding globulin b. .( F )more than 98% of circulating thyroxine is bo und to thyroxine binding globulin c. . ( F )thyrotrophin releasing hormone is a decapeptide d. . ( T )TSH levels are increased in primary hypothyroidism e. . ( T )TSH is a glycoprotein 17. Testosterone . a. .( F )is produced only int eh gonads b. .( F )is mainly ex creted unchanged in the urine c. . ( F )stimulates secretion of lutenising hormo ne d. . ( F )circulates in plasma mainly in the free form e. . ( T )stimulates g rowth of the prostate gland 18. In congenital adrenal cortical hyperplasia. a. .( F )the commonest deficienc y is c18 hydroxylase b. .( F )plasma cortisol concentration is raised c. . ( T ) urinary excretion of 17-oxysteroids is elevated d. . ( T )dexamethasone will sup press the urinary excretion of 17-oxysteroids e. . ( F )there are no virilising effect 19. Therapeutic indications for the use of synthetic progestagens include. a. .( F )induction of abortion b. .( T )contraception c. . ( T )metastatic endometria l carcinoma

d. . ( F )suppression of lactation e. . ( T )endometriosis 20. In hypopituitarism. a. .( T )clinical features of deficiency are usually abs ent until about 70% of the gland has been destroyed b. .( F )TSH is usually the first hormone to be affected c. . ( T )aldosterone secretion is normal d. . ( F )orthosatic hypotension is common e. . ( T )hyppoglycaemia occurs on fasting 21. The following statements concerning the formation of hormones are correct. a . .( T )ACTH is derived from pro-opiomelanocortin b. .( T )oestogens are derived from androgens c. . ( F )prolactin is derived from androgens d. . ( T )melaonin is derived from serotonin e. . ( F )angiotensin 2 is derived from rennin 22. Pulsatile secretion of pituitary luteinising hormone. a. .( T )increase in a mplitude during puberty b. .( T )occurs in first year of life c. . ( F )ceases a t the menopause d. . ( F )is controlled by continuous secretion of gonadotrophin releasing hormone. e. . ( T )is modified by the level of circulating oestogen 23. Adrenaline (epinephrine). a. .( F )stimulates myometrial contractions b. .( F )exerts its action by alpha receptors only c. . ( F )constricts the pupils d. . ( T )causes glycogenolysis e. . ( F )inhibits the mobilization of free fatty a cids 24. Human placental lactogen. a. .( T )is a single chain polypeptide b. .( F )re aches the same concentration in fetal and maternal blood at term

c. . ( F d. . ( F e. . ( T )may be secreted by the decidua )is detectable only after 25th week of pregnancy )is an insulin antagonist 25. Arginine vasopressin. a. .( F )reduces glomerular filtration rate b. .( F )c ontrols water loss in he proximal renal tubules c. . ( F )is synthesized by the posterior pituitary d. . ( T )is released in response to a rise in plasma osmola lity e. . ( T )is released in response to a fall in circulating plasma volume 26. In a healthy adult,serum calcium. a. .( F )constitutes 15% of total body cal cium b. .( F )is not involved in the extrinsic system of blood coagulation c. . ( T )concentration will be lowered by calcitonin d. . ( F )concentration normall y falls after the menopause e. . ( F )is approximately 90% protein bound 27. Concerning the human ovary. a. .( T )aromatase catalyses the conversion of t estosterone to 17B oestradiol b. .( T )relaxin is synthesized in the corpus lute um c. . ( F )inhibin stimulates FSH release from the pituitary gland d. . ( T )p rogesterone decreases the sensitivity of myometrial cells to oxytocin e. . ( F ) cholesterol is converted to androstendione in granulose cells 28. Human chorionic gonadotrohin. a. .( T )is a glycoprotein b. .( F )secretion peaks at 20 weeks of gestation c. . ( F )has intrinsic antithyroid activity d. . ( F )is synthesized by corpus luteum of pregnancy e. . ( T )binds to luteinizin g hormone receptors 29. Gonadotrophin releasing hormone. a. .( F )is a dimeric glycoprotein b. .( T )is synthesized in the hypothalamus

c. . ( T d. . ( T e. . ( F )stimulates synthesis of FSH )secretion is increased following castration )pulsa tile administration inhibits ovarian steroid production 30. The following are RNA containing viruses. a. .( T )coxsackie b. .( T )influe nza c. . ( T )mumps d. . ( F )herpes simplex e. . ( F )cytomegalovirus 31. Concerning viral infections. a. .( T )cytomegalovirus is of the herpes group b. .( F )herpes simplex virus may remain dormant in epithelial cells of the low er genital tract c. . ( T )facial herpes simplex lesions are activated by sunlig ht d. . ( F )coxsackie B virus does not cross the placenta e. . ( T )hepatitis B virus may be sexually transmitted 32. Exotoxins. a. .( F )are derived from gram negative bacteria b. .( T )have a specific action c. . ( T )are more toxic than endotoxins d. . ( T )are neutraliz ed by their homologus antitoxin e. . ( T )can be converted to toxoid 33. Vesical schistosomiasis. a. .( F )is acquired by eating snails b. .( T )caus es intermittent heamaturia c. . ( T )is diagnosed by finding schistosome eggs in the urine d. . ( T )is endemic in south america e. . ( F )is sexually transmitt ed 34. Listeria monocytogenes. a. .( F )is a gram negative bacteria

b. c. d. e. .( T )is sensitive to ampicillin . (T )may cause a transplacental infection . ( F )is sexually transmitted . ( T )can be cultured from a high vaginal swab 35. Actinomyces israelii. a. .( F )is a fungus b. .( T )forms yellow granules in pus c. . (T )is a mouth commensal d. . ( T )occurs in association with intraute rine contraceptive device e. . ( F )is resistant to penicillin 36. Concerning syphilis. a. .( F )the incubation period is usually between 1 and 7 days b. .( T )it has an infectious secondary stage c. . ( F )the primary stag e is characterized by gumma formation d. . ( F )the Wassermann reaction becomes positive in the tertiarystage e. . ( T )haematogenous spread occurs early 37. BCG vaccination of previously uninfected persons. a. .( F )produces local er ythema within 24 hours b. .( T )results in regional lymph node enlargement c. . ( T )produces a visible reaction within 3 days d. . ( F )should be given intramu scularly e. . ( F )is ineffective in the newborn 38. The causative organism of. a. .( F )condyloma lata is Neisseria gonorrhoeae b. .( T )chancroid is haemophilus dureyii c. . ( T )granuloma inguinale is Donov ania granulomatis d. . ( F )primary chancre is Treponema pertenue e. . ( F )Yaws is Gardnerella vaginalis 39. The following infectious disease are arthropod borne. a. .( T )Bubonic plagu e

b. c. d. e. .( T )malaria . ( F )legionnaire s disease . ( T )yellow fever . ( T )epidemic t yphus fever 40. The following drugs may cause enlargement of the fetal thyroid gland. a. .( F )methyl dopa b. .( F )thyroxine c. . ( T )carbimazole d. . ( F )propranolol e. . ( T )propylthiouracil 41. The following substances lower the blood glucose concentration. a. .( F )adr enaline b. .( T )chlorpropamide c. . ( F )chlorothiazide d. . ( T )metformin e. . ( F )thyroxine 42. The following drugs stimulate myometrial contractility. a. .( T )vasopressin b. .( F )nifedipine c. . (F )hydralazine hydrochloride d. . ( F )salbutamol e. . ( F )indomethacin 43. The following are beta mimetic effects. a. .( F )constriction of bronchioles b. .( T )increased heart rate c. . ( F )a decrease in force of cardiac contract ion d. . ( F )constriction of the arterioles of the skin e. . ( T )increased gly cogenolysis in skeletal muscles 44. The following are features of ergometrine maleate. a. .( F )it is inactive w hen administered orally

b. .( F )the onset of action after intravenous injection occurs in approximately 5 minutes c. . ( T )transient hypertension may occur after its administration d . . ( T )parenteral administration may result in vomiting e. . ( F )its use is c ontraindicated in patients with migraine 45. Thiopentone sodium administered intravenously. a. .( F )is a potent muscle r elaxant b. .( T )is predominantly excreted by the kidney c. . ( T )binds to prot ein d. . ( T )is fat soluble e. . ( T )crosses the placenta 46. The following statements about anticoagulants are correct. a. .( T )heparin inhibits the action of thrombin b. .( F )the action of heparin is antagonized by vitamin K c. . ( T )heparin increases antithrombin III activity d. . ( F )the e ffects of coumarin anticoagulants are decreased by metronidazole e. . ( T )warfa rin is greater than 80% protein bound in plasma 47. The following stimulates peristalsis in the large bowel. a. .( F )opiates b. .( T )liquid paraffin c. . ( F )suxamethonium chloride d. . ( T )neostigmine e. . ( T )senna glycoside 48. The following drugs and side effects are associated. a. .( F )carbenoxolone: sodium retension b. .( F )chlorothiazide: hypoglycaemia c. . ( F )salbutamol: b ronchospasm d. . ( T )clonidine: rebound hypertension e. . ( T )phenytoin: folat e deficiency 49. The following drugs and side effects are associated.

a. b. c. d. e. .( T .( F .( T .( T .( F )methyl dopa: depression )paracetamol: thromboembolism )indomethacin: peptic ulc er )prednisolone: osteoporosis )ritodrine: hypoglycaemia 50. A hundred women at high risk of ovarian carcinoma have a pelvic ultrasound s can. The findings after scan and surgery are shown in the table: Pelvic scan abn ormal normal total a. b. c. d. e. .( .( .( .( .( Ovarian cancer present absent 1 5 20 5 60 20 80 total 35 65 100 F )the sensitivity of the scan is 25% T )the specificity of the scan is 75% F )t he prevalence of ovarian carcinoma is 25% T )there are 15 true positive cases T )75% of the patients with ovarian carcinoma had positive scans

september 1998 paper 2 1. Concerning folic acid. a. .( T )it is a water soluble vitamin b. .( T )conversion of dihydrofolate to tetrahydrofolate is inhibited by methotrexate c. . ( T )red cell folate concentration can be reduced by phenytoi n d. . ( T )tetrahydrofolic acid is a carrier of one carbon units e. . ( T )it i s involved in the synthesis of purines 2. 2,3-diphosphoglcerate. a. .( T )is present al erythrocytes than fetal erythrocytes b. .( n A than to haemoglobin F c. . ( F )increases ygen d. . ( T )is a phospholipid e. . ( F )is te pathway 3. a. b. c. d. e. Haematopoiesis in the fetus. .( T )results in nucleated erythrocytes early in de velopment .( T )occurs in the yolk sac in the first month . ( F )does not occur in the bone marrow until term . ( T )is predominantly hepatic during the 4th mon th . ( F )does not require folic acid 4. a. b. c. d. e. iron. .( T .( F .(F .(F .( F )is altered to the ferric state after absorption )is transported by apoferritin )is readily excreted by the kidney )retention in the body is enhanced by chelati ng agents )requirement during normal pregnancy is approximately 1 mg per day 5. a. b. c. d. Cholecalciferol (vitamin D). .( T )promotes the absorption of calcium from the g ut .( T )is 25-hydroxylated in the liver . ( T )is synthesized in the skin . ( T )is 1-hydroxylated in the kidney in higher concentrations in matern T )binds more avidly to haemoglobi the affinity of haemoglobin for ox synthesized by the pentose phospha

e. . ( T )is most active in the 1,25-dihydroxyl form 6. a. b. c. d. e. Excess. .( F )vitamin c causes Haemorrhage .( T )vitamin D causes renal failure . ( F )vitamin K causes thrombosis . ( F )Vitamin E causes azospermia . ( T )vit amin A causes headache 7. a. b. c. d. e. Concerning carbon dioxide. .(F )it is mainly carried in the blood as carbaminoha emoglobin .( F )10-15% is carried in the blood in simple solution . ( T )it diff uses across the placenta more readily than oxygen . ( T )it is displaced more ea sily from fetal blood after oxygenation . ( T )it is more soluble in body fluids than oxygen 8. a. b. c. d. e. Chemicals are solubilised in the liver by. .( T )glucuronide formation .( F )tra nsamination . ( T )bile salt conjugation . ( F )acetylation . ( F )carboxylation 9. Unconjugated bilirubin. a. .( F )is oncentration than conjugated bilirubin o albumin c. . ( T )is not excreted in ood brain barrier e. . ( T )is bound o normally present in the plasma in lower c b. .( T )circulates in the plasma bound t the urine d. . ( F )does not cross the bl specific proteins in the liver cells

10. Messenger ribonucleic acid (m RNA). a. .( F )is a double stranded polymer b. .( T )is transcribed from DNA in the nucleus c. . ( F )is not present in reticu locytes

d. . ( F )contains thymine e. . ( F )is not present in oocytes 11. Glycogen. a. .( T )is a polymer of glucose residues b. .( T )is predominantl y found in cytoplasm c. . ( T )is mainly stored in the liver d. . ( T )is cleave d by phosphorylase to glucose 1 phosphate e. . ( F )breakdown is inhibited by ad renaline 12. Hyperkalemia is a characteristic finding in. a. .( F )primary aldosteronism b. .( T )treatment with spironolactone c. . ( F )hyperparathyroidism d. . ( F )A CTH secreting tumours of the bronchus e. . ( T )renal failure 13. Glucose. a. .( F )is predominantly absorbed in the terminal ileum b. .( F )s timulates the secretion of glucagon c. . ( T )can be synthesized from pyruvate d . . ( F )is a disaccharide e. . ( F )is the only metabolic substrate fro cardiac muscle 14. In an X-linked pedigree. a. .( T )none of the sons of be affected b. .( F )half of the daughters of an affected e gene c. . ( T )half of the sons of carrier females will females are never affected e. . ( F )all of the daughters ll themselves be carriers an affected male will male will not carry th be affected d. . ( F ) of a carrier female wi

15. In the neonate, the appearance of the external genitalia may ot correspond w ith the genotype in the presence of . a. .( T )adrenogenital syndrome b. .( T )t esticular feminization syndrome

c. . ( F )renal agenesis (potter s syndrome) d. . ( F )trisomy 21 e. . ( T )seve re hypospadias 16. Chromosome analysis. a. .( T )can be performed more quickly from chorionic v illus sampling than from amniotic fluid sampling b. .( F )is based entirely on a ssessment of chromosome size c. . ( T )is carried out at the metaphase stage of mitosis d. . ( T )of a classical hydatidiform mole is usually 46XX e. . ( F )of the fetus will be abnormal in about 80% of cases of exomphalos 17. Concerning inheritable disease. a. .( T )Huntington s chorea is transmitted by a dominant gene b. .( T )phenylketonuria is transmitted by a recessive gene c . . ( F )Haemophilia is an autosomal dominant condition d. . ( F )Von Willebrand s disease is a sex-linked condition e. . ( F )Cystic fibrosis is transmitted by an X-linked recessive gene 18. Concerning immunoglobulins in pregnancy. a. .( F )maternal IgM is responsibl e for rhesus isoimmunization in the fetus b. .( F )IgA concentration in cord blo od is higher than that in maternal blood c. . (F )IgE crosses the placenta readi ly d. . ( T )IgG crosses the placenta readily e. . ( F )Fetal IgM is dimeric 19. Immunodeficiency state may be associated with. a. .( T )viral infection of T -lymphocyte b. .( T )B cell lymphomata c. . ( T )glucorticoid administration d. . ( F )haemolytic disease of the newborn e. . ( T )Hodgkin s lymphoma 20. Early blood borne dissemination is a characteristic feature of. a. .( F )car cinoma of the endometrium

b. c. d. e. .( T .( T .( F .( T )osteosarcoma )basal cell carcinoma )carcinoma of the cervix )choriocarcinoma

22. The following cells may be phagocytic. a. .( T )neutrophils b. .( T )Kupffer cells c. . ( T )monocytes d. . ( T )Hofbauer cells e. . ( F )plasma cells 23. Metastatic calcification may be seen in the following conditions. a. .( T )o ld pulmonary tuberculosis b. .( T )degenerating leiomyomata c. . ( T )multiple m yeloma d. . ( T )hyperparathyroidism e. . ( T )sarcoidosis 24. In healing by primary intention, the following events occur. a. .( F )format ion of a fibrin free haematoma b. .( T )an acute inflammatory reaction c. . ( T )migration of epithelial cells within 6 hours d. . ( T )phagocytosis e. . ( T )i nvasion by capillary buds within 3 days 25. Amyloid. a. .( F )is predominantly intracellular

21. In tissue pigmentation the d conjugated bilirubin b. .( T n c. . ( F )melanosis coli and er deposition in the cornea e.

following are associated. a. .( F )Kernicterus an )Addison s disease and increased cutaneous melani bile pigments d. . ( T )Wilson s disease and copp . ( T )corpus luteum and carotenoids

b. c. d. e. .( F .(F .( T .( T )contains fibrils )is enzymatic )can be found in nerve tissue )deposits occur wi th chronic sepsis 26. The following are premalignant conditions. a. .( F )diverticular disease of the large bowel b. .( T )ulcerative colitis c. . ( T )pulmonary asbestosis d. . ( T )paget s disease of the bone e. . ( F )Condylomata lata of the vulva 27. Tetany may occur as a complication of. a. .( F )osteoporosis b. .( F )hyperc apnia c. . ( F )respiratory acidosis d. . ( F )peripheral neuropathy e. . ( F )u ntreated hyperparathyroidism 28. In tumours of bone. a. .( F )primary malignancy is more common than secondar y malignancy b. .( F )osteoma rarely present in skull bones c. . ( T )osteosarco ma is associated with Paget s disease of bone d. . ( T )lymph node metastases ar e unusual e. . ( F )simple bone cysts have a strong tendency to recur 29. Acquired diverticular disease of the colon. a. .( T )is present in at least 15% of Caucasians over the age of 50 years b. .( F )is due to a congenital abnor mality of the bowel wall c. . ( T )is associated with increased intraluminal pre ssure d. . ( F )is associated with muscular thickening e. . ( T )may result in i ntestinal obstruction 30. Stored blood which is to be used for transfusion. a. .( T )is kept at -4 C

b. c. d. e. .( F .(F .( T .( T )must be used within 1 week )is tested for complement content before transfusion )may be used for platelet replacement )contains an acid antioagulant 31. In uncomplicated homozygous beta thalassaemia there is. a. .( T )hypochromas ia b. .( F )a reduction in haemoglobin A2 c. . ( T )an increase in haemoglobin F d. . ( F )megaloblastic erythropoiesis e. . ( F )red cell sickling 32. The following tissues are capable of cellular regeneration. a. .( F )spinal cord b. .( T )liver c. . ( T )epidermis d. . ( F )myocardium e. . ( T )bone marr ow 33. Concerning oxygenation of fetal blood. a. .( T )the fetal maternal PcO2 grad ient facilitates maternal-fetal oxygen transfer b. .( T )fetal haemoglobin is le ss influenced by 2,3-diphosphoglyceric acid concentration than adult haemoglobin c. . (F )the fetal blood oxygen dissociation curve lies to the right of the mat ernal curve d. . ( T )the uptake of oxygen decreases fetal red cell buffering ca pacity e. . ( F )uptake of oxygen by fetal blood is associated with a shift of c hloride into fetal red cells 34. Concerning the fetal cardiovascular system. a. .( F )more than 80% of the ca rdiac output flows through the placenta b. .( F )oxygen saturation in the caroti d and renal arteries is the same c. . ( F )umbilical venous blood has a lower PO 2 than renal arterial blood d. . ( F )blood from the inferior vena cava passes d irectly into the left ventricle e. . ( T )the pulmonary circulation has a high r esistance

35. The leydig cells of the testis. a. .( F )secrete seminal fluid b. .( T )are stimulated by lutenising hormone c. . ( T )are active in intrauterine life d. . ( F )secrete fructose e. . ( T )produce androstendione 36. In the lungs of a healthy male adult at rest. a. .( F )alveolar air contain 40% nitrogen b. .( F )about 3 litres of air are in the alveoli at the end of a q uiet expiration c. . (T )about 150ml of inspire air in each breath do not reach alveoli d. . (F )the oxygen tension of blood in the pulmonary vein is about 5.3 KPa(about 40mmHg) e. . ( F )inspiration is brought about by relaxation of the in tercostal muscles 37. In the non pregnant woman, during the cardiac cycle. a. .( F )atrial contrac tion occurs in the early stages of ventricular filling b. .( T )adrenergic stimu lation increases the heart rate c. . ( F )the first sound is caused by closure o f the aortic valves d. . ( F )stroke volume at rest is 200ml e. . ( F )the peak pressure in the pulmonary arterial system is less than one-tenth of that in the systemic circulation 38. Intracellular concentration of free calcium. a. .( F )is greater than that o f extracellular free calcium b. .( T )may be influenced by voltage gated membran e channels c. . ( T )may be influenced by the activity of inositol triphosphate d. . ( T )binds to calmodulin e. . ( F )inactivates trophonin 39. The blood concentrations of the following are lowered in pregnancy. a. .( T )bicarbonate b. .( F )transferrin c. . ( T )sodium d. . ( T )albumin e. . ( F )f ibrinogen

40. Plasminogen is. a. .( F )a globulin b. .( F )activated by alpha 2 macroglobu lin c. . ( F )inhibited by streptokinase d. . ( F )formed from plasmin e. . ( F )released from plasma cells 41. Concerning a AB b. .( T )her up A or O d. . ( have group A or ood woman with blood group type A. a. .( F )she may have a genotype father may be group O c. . ( T )All of her children will be gro T )if her husband has blood group A, all of their children will O blood e. . ( F )she can be transfused safely with group AB bl

42. Bile. a. .( F b. .( F c. . ( F d. . ( T e. . ( F )production is inhibited after vagal stimulation )is concentrated under the infl uence of secretin )has a pH f 5.5 )is expelled from the gall bladder under the i nfluence of cholwcystokinin )normally contains high concentrations of free chole sterol 43. During normal pregnancy, the maternal pituitary gland. a. .( T )becomes heav ier b. .( F )doubles its production of FSH c. . ( F )increases is secretion of a lpha melanocyte stimulating hormone d. . ( T )decrease its rate of production of TSH e. . ( T )releases arginine vasopressin in response to an infusion of a hyp ertonic solution 44. Thromboxane A2. a. .( T )induces platelet aggregation b. .( F )has a half li fe of about 30 minutes c. . ( T )causes vasoconstriction d. . ( F )is synthesize d by the lipoxygenase pathway

e. . ( T )synthesis is inhibited by aspirin 45. Angiotensin II. a. .( T )is a vasoconstrictor b. .( F )reduces aldosterone p roduction c. . ( T )is mainly found in the lungs d. . ( F )is a decapeptide e. . ( T )is produced when the extracellular fluid volume is reduced 46. Bicarbonate. a. .( T )ions are reabsorbed from renal tubular fluid b. .( T ) plasma concentration rises in respiratory acidosis c. . ( T )plasma concentratio n falls in pregnancy d. . ( F )in blood is predominantly carried by red cells e. . ( F )is one of the unmeasured anions causing the anion gap 47. Total body water. a. .( T )forms a smaller proportion of body water in fat t han thin persons b. .( T )can be measured by a deuterium oxide dilution techniqu e c. . ( T )normally comprises 45-65% of body weight d. . ( F )is a smaller prop ortion of body weight in men than in women e. . ( T )is predominantly intracellu lar 48. Cardiac output in adult. a. .( F )is greater from the left ventricle than fr om the right b. .( T )varies with physiological changes in the heart rate c. . ( F )is reflexly reduced in a hot environment d. . ( T )increases in the first tr imester of pregnancy e. . ( T )varies with the stroke volume when the heart rate is constant 49. During normal pregnancy the daily urinary excretion of. a. .( T )glucose is increased b. .( F )total amino acids is decreased c. . ( F )total protein is dec reased d. . ( T )vitamin B12 increased

e. . ( F )folate is decreased 50. Physiological changes associated with pregnancy include. a. .( T )a rise in erythrocyte sedimentation rate b. .( T )a rise in total body haemoglobin c. . ( F )a fall in plasma fibrinogen concentration d. . ( T )an increase in the total number of leucocytes e. . ( F )an increase in blood urea concentration within th e first trimester

march 1999 paper 1 1. a. b. c. d. e. In the pituitary gland. .( F )the anterior lobe is smaller than the posterior lobe .( T )the posterior lobe is ectodermal i n origin . ( F )the acidophil cells produce oxytocin . ( F )the basophil cells p roduce growth hormone . ( T )the blood supply is derived from the internal carot id artery 2. a. b. c. d. e. The following statements concerning the pelvic vessels are correct. .( T )the in ferior gluteal artery passes through the greater sciatic foramen .( F )the infer ior vesical artery supplies the fundus of the bladder . ( T )the middle rectal a rtery supplies the rectal mucosa . ( T )the uterine venous plexus communicates w ith the rectal plexus . ( F )the vesical venous plexus drains into the external iliac artery 3. a. b. c. d. e. The obturator artery. .( F )branches from the posterior trunk of the internal il iac artery .( F )passes through the greater sciatic foramen . ( T )is crossed by the ureter . ( T )supplies the hip joint . ( F )may be replaced by a branch of the superior epigastric artery 4. a. b. c. d. e. The obtrurator nerve. .( F )arises from the sacral plexus .( T )descends through the psoas major muscle . ( F )leaves the pelvis through the greater sciatic for men . ( F )mainly supplies the abductor muscles of the thigh . ( F )innervates t he obturator internus muscle 5. a. b. c. d. e. The pelvic splanchnic nerve. .( F )supply the ascending colon .( T )contribute t o the inferior hypogastric plexus . ( F )are motor to the internal sphincter of the bladder . ( F )contain afferent fibres of the ovary . ( F )conduct pain from the body of the uterus

6. a. b. c. d. e. The normal human preovulatory follicle. .( F )reaches a diameter of 40-60mm befo re rupture .( T )requires LH for development . ( F )is lined by theca interna ce lls on its inner surface . ( F )contains a zona denuded oocyte . ( F )contains f luid rich in progesterone 7. a. b. c. d. e. In the pelvis, the ureter. .( T )is supplied by the uterine artery .( T )is cros sed inferiorly by he uterine artery . ( F )lies more than 5 cm lateral to the su pravaginal cervix . ( F )is derived from the urogenital sinus . ( F )has sensory fibres passing in the pelvic splanchnic nerves 8. a. b. c. d. e. In the femoral triangle, the femoral artery is. .( F )crossed by the superior ci rcumflex iliac artery .( F )posterior to the femoral branch of the genitofemoral nerve . ( F )medial to the long saphenous vein . ( F )posterior to the femoral vein at the apex of the triangle . ( T )medial to the femoral nerve 9. a. b. c. d. e. The cervix. .( F )consists predominantly of smooth muscle .( T )is derived from the mesoderm . ( F )is covered by the peritoneum on its anterior aspect . ( T )i s innervated by the pelvic splanchnic nerves . ( F )is lined by keratinized epit helium 10. The bladder. a. .( F )develops from the lower part of the urogenital sinus b . .( F )is supplied in part by the inferior epigastric artery c. . ( F )drains l ymph to the superficial inguinal nodes d. . ( T )is innervated by sympathetic fi bres from segments T11 to L2 e. . ( F )has a capacity of at least 1000 ml

11. The followings are derivatives of the mesonephros. a. .( F )appendix of the testis b. .( T )efferent ductules of the testis c. . ( T )gartner s duct cyst d. . ( F )gubernaculums testis e. . ( F )prostatic utricle 12. The following are present in the developing umbilical cord. a. .( T )allanto is b. .( T )extra-embryonic mesoderm c. . ( T )intestinal loops d. . ( T )2 umbi lical arteries e. . ( T )yolk sac stalk 13. During development of the female reproductive system. a. .( T )primordial ge rm cells arise in the yolk sac b. .( F )ovarian development is dependant upon oe strogen activity c. . ( T )the paramesonephric ducts give rise to the cervix d. . ( T )the greater vestibular glands arise from the urogenital sinus e. . ( F )d ifferentiation of the external genitalia is dependent upon ovarian activity 14. The fetal testis. a. .(F )are morphologically distinguishable 4 weeks after conception b. .( T )contain cells which have migrated from the wall of the yolk sac c. . ( T )are usually intra-abdominal 12 weeks after conception d. . ( T )ar e necessary for the persistence of the mesonephric ducts e. . ( T )secrete andro gens 15. In a neonate at birth. a. .( T )closure of the ducts arteriosus is due to in creased arterial oxygen tension b. .( F )the ductus arteriosus closes before the lungs are expanded c. . ( T )pressure in the inferior vena cava falls d. . ( F )the foramen oval seals immediately e. . ( F )closure of the foramen oval is due to increased carbon dioxide tension in venous blood

16. iodine. a. .( F )requirements are unchanged by pregnancy b. .( T )uptake by the thyroid gland is increased by TSH c. . ( T )is excreted by the kidney d. . ( T )is bound to tyrosine in the thyroid gland e. . ( T )may inhibit thyroxine sy nthesis 17. The physiological action of oestradiol depends upon. a. .( F )metabolism to a more potent substance b. .( T )binding to an intracellular receptor c. . ( T ) alteration of gene expression d. . ( F )active transport of the hormone into cel ls e. . ( F )cyclic AMP production 18. Testosterone in the human male. a. .( T )depresses pituitary secretion of LH b. .( F )promotes growth of scalp hair c. . ( T )promotes union of long bone ep iphyses d. . ( F )is a more potent androgen than dihydrotestosterone e. . ( F )i s secrete maximally in the evening 19. In congenital adrenal hyperplasia. a. .( T )the commonest cause is a deficie ncy of 21 hydroxylase b. .( F )the plasma cortisol concentration is increased c. . ( T )there may be excessive secretion of 17 alpha hydroxyl progesterone d. . ( F )sodium retention is characteristic e. . ( F )blood catecholamine concentrat ions are increased 20. The corpus luteum of pregnancy produces. a. .( T )relaxin b. .( T )progester one c. . ( T ) 17 alpha hydroxyl progesterone d. . ( F )human chorionic gonadotr ophin e. . ( T )oestradiol

21. Concerning puberty in the female. a. .( T )the development of secondary sexu al characteristics is preceded by increased production of adrenal androgens b. . ( T )puberty is associated with the nocturnal release of LH c. . ( F )the ovarie s are not sensitive to gonadotrophins before puberty d. . ( T )appearance of pub ic hair usually precedes menarche e. . ( F )appearance of pubic hair precedes th e onset of breast development 22. menopause. a. .( F )is due to failure of the endometrium to respond to oestr ogens b. .( F )is associated with cessation of steroidogenesis within the ovary c. . ( F )is associated with a fall in circulating LH d. . ( F )is preceded by a period of enhanced fertility e. . ( T )results in atrophy of the epithelium of the distal urethra 23. Products of human decidua include. a. .( F )alpha feto protein b. .( T )prol actin c. . ( F )human chorionic gonadotrophin d. . ( F )human placental lactogen e. . ( T )prostaglandin F2 alpha 24. Plasma levels of FSH are elevated in. a. .( T )adults with Klinefelter syndr ome b. .( F )women taking oral contraceptive preparations c. . ( T )postmenopaus al women d. . ( T )adults with Turner syndrome(45XO) e. . (F )pregnancy 25. Pituitary gonadotrophins. a. .( T )release is dependant upon hypothalamic fu nction b. .( F )secretion increases during pregnancy c. . (F )blood levels are r aised during lactational amenorrhea d. . ( T )release in the puerperium is enhan ced by bromocriptine e. . ( F )release is inhibited by oxytocin

26. The release of catecholamines from the adrenal medulla increases. a. .( F )d uring sleep in healthy individuals b. .( T )when the nerves to the adrenal gland are stimulated c. . ( F )when the blood sugar rises d. . ( T )following myocard ial infarction e. . ( T )in the presence of phaeochromocytoma 27. prolactin. a. .( F )is secreted by the hypothalamus b. .( T )plasma levels a re raised in the first trimester of pregnancy c. . ( F )is identical to placenta l lactogen d. . ( F )controls milk ejection e. . ( T )release is inhibited by do pamine 28. Human chorionic gonadotrophin. a. .( F )has a half life in blood of 2 hours b. .( F )contains beta chain indistinguishable from that of human LH c. . ( T )i s produced by the preimplantation blastocyst d. . ( T )is responsible for the ma intenance of the corpus luteum in early pregnancy e. . ( T )may be produced in t issues other than trophoblast 29. Growth hormone. a. .( T )promoted protein synthesis b. .( T )facilitates the hepatic synthesis of somatomedin C c. . ( F )promotes insulin mediated uptake o f glucose d. . ( T )increases circulating free fatty acids e. . ( F )stimulate e piphyseal fusion 30. Antidiuretic hormone. a. .( T )is normally synthesized in the hypothalamus b . .( T )is secretes by the posterior pituitary gland c. . ( F )exerts its effect by reducing the GFR d. . ( T )is an oligopeptide e. . ( F )secretion is increas ed when plasma osmolality falls

31. calcitonin. a. .( F )lowers the basal metabolic rate b. .( T )concentration is increased in pregnancy c. . ( F )is released when the blood phosphate level r ises d. . ( T )is produced in the thyroid gland e. . ( T )release is stimulated by high calcium ion levels 32. The following hormones bind to receptors on the cell membrane. a. .( F )cort icosterone b. .( T )adrenaline c. . ( T )LH d. . ( F )oestradiol e. . ( T )GnRH 33. Schistosoma haematobium. a. .( F )is a snail b. .( T )is prevalent in china c. . ( F )infestation may affect the uterine cervix d. . ( T )gives rise to chro nic granulomatous lesion e. . ( T )infestation predisposes to carcinoma 34. Chlamydia organisms. a. .( F )are motile b. .( T )are intracellular c. . ( F )infect squamous cells d. . ( T )are found in birds e. . ( T )cause trachoma 35. Candida albicans. a. .( T )gives a positive reaction with gram stain b. .( F )is an anaerobic organism c. . ( T )is associated with diabetes mellitus d. . ( F )is characterized by flagella e. . ( F )is inhibited by oral tetracycline the rapy

36. Concerning Neisseria. a. .( T )N.meningitidis can be a nasopharyngeal commen sal b. .( F )N.gonorrhoeae will grow in anaerobic conditions c. . ( T ) N.gonorr hoeae culture is inhibited at low temperature d. . ( T ) N.gonorrhoeae is identi fied within the cytoplasm of polymorphs e. . ( T ) N.gonorrhoeae infection can c ause an arthropathy 37. Mycobacteria are. a. .( T )acid fast b. .( F )spore formers c. . ( F )facult ative anaerobes d. . ( F )motile e. . ( F )obligate intracellular parasites 38. The following diseases and organisms are correctly paired. a. .( F )chancroi d: Treponema pallidum b. .( T )granuloma inguinale: Donovani granulomatis c. . ( F )lymphogranuloma venereum: Haemophilus ducreyi d. . ( F )gas gangrene: Clostr idium tetani e. . ( T )infectious mononucleosis: Epstein Barr virus 39. The following diseases are correctly paired with their vectors. a. .( T )tox oplasmosis: domestic cat b. .( F )leishmaniasis: house fly c. . (T )yellow fever : mosquito d. . ( T )epidemic typhus: body louse e. . ( T )leptospirosis: brown rat 40. An oncogenic DNA virus. a. .( F )contain reverse transcriptase b. .( T )indu ces cellular transformation c. . ( T )is implicated in the pathogenesis of Burki tt s lymphoma d. . ( T )integrates into the host genome e. . ( T )induces squamo us papillomas of the skin in humans

41. Cyproterone acetate. a. .( F )is an oestrogen b. .( F )is used for the treat ment of amenorrhoea c. . ( T )binds to androgen receptors d. . ( F )increases li bido e. . ( T )inhibits spermatogenesis 42. propranolol. a. .( F )is a selective beta adrenergic blocking agent b. .( F )is not secreted in breast milk c. . ( T )given In pregnancy slows the maternal heart rate d. . ( T )causes bad dreams e. . ( T )antagonizes the tocolytic effec t of salbutamol 43. Aspirin. a. .( T )inhibits cyclooxygenase b. .( F )is the treatment of choic e in childhood fever c. . ( F )is contraindicated in gout d. . ( T )should be av oided in women on anticoagulant therapy e. . ( F )has little anti-platelet activ ity when given in low doses 44. Parenteral administration of atropine in therapeutic doses to a normal perso n causes. a. .( T )impaired visual accomadation b. .( F )diarrhoea c. . ( F )con striction of the bronchi d. . ( T )an increase in heart rate e. . ( T )a reducti on in bronchial secretion 45. The following statements about morphine are true. a. .( T )all of its pharma cological actions are reversed by naloxone b. .( T )it is transferred into breas t milk c. . ( F )it does not cross the placenta in significant manner d. . ( F ) its analgesic effects last about 1 hour e. . ( F )it causes pupilary dilatation

46. Lignocaine used as a local anesthetic. a. .( F )causes tachycardia if given as a systemic injection b. .( F )has a longer lasting action than bupivicaine c. . ( F )is used in combination with adrenaline for ring block d. . ( F )causes v asoconstriction e. . ( T )is a weak base 47. The following statements about drug interactions are correct. a. .( T )antac ids decrease intestinal absorption of tetracyclines b. .( F )the effects of warf arin are potentiated by combined oral contraceptives c. . ( F )the action of hep arin is opposed by vitamin K d. . ( T )alcohol metabolism is impaired by metroni dazole e. . ( F )the effects of bromocriptine are potentiated by chlorpromazine 48. The following anti-hypertensive agents are correctly paired with their mode of action. a. .( T )captopril: angiotensin converting enzyme inhibitor b. .( T ) phentolamine: alpha adrenoceptor blockade c. . ( F )methyldopa: ganglion blockad e d. . ( F )hydralazine hydrochloride: angiotensin 2 inhibition e. . ( T )sodium nitroprusside: vasodilatation 49. In a sample of 1000 children, the birth weight was normally distributed with a mean of 3.5 Kg and a standard deviation of 700 g. a. .( F )15 infants would b e below the 5th centile for weight b. .( T )the standard error of the birth weig ht would be about 22 g c. . ( F )the 95th centile for birth weight would be 4.2K g d. . ( F )no baby would weigh less than 1.4Kg e. . ( T )the median birth weigh t would be about 3.5 Kg 50. In a clinical trial, randomized allocation of patients to treatment groups. a. .( T )eliminates investigator bias b. .( F )reduces the placebo effect c. . ( F )usually controls for known confounding variables d. . ( F ) usually controls for unknown confounding variables

e. . ( F )is best achieved by alternate allocation of subjects

march 1999 paper 2 1. a. b. c. d. e. The conversion of glucose to lactic acid. . (F )occurs in a single enzymatic reaction .( T )is the only pathway for the synt hesis of ATP in the red blood cell . ( F )is a reversible process in skeletal mu scle . ( T )is inhibited by high cellular concentrations of ATP . ( T )occurs in skeletal muscle when the availability of oxygen is limited 2. a. b. c. d. e. Ketone bodies. .( T )can be utilized by the fetal brain .( T )includes acetoacet ate . ( T )are water soluble . ( F )are synthesized in skeletal muscle . ( T )ca n be utilized during starvation 3. a. b. c. d. e. Noradrenaline. .( F )is a derivative of arginine .( T )is a precursor of adrenal ine . ( T )acts predominantly on alpha receptors . ( T )is catabolised to vanill ylmandelic acid . ( T )is meabolised by catechol-O-methyl transferase 4. a. b. c. d. e. ABO antigens are. .( T )glycoproteins .( F )found only on erythrocytes . ( F )ma jor histocompatibility antigens . ( F )not immunogenic during pregnancy . ( T )l ocated on membranes 5. a. b. c. d. e. Nitrogen balance is. .( T )positive during pregnancy .( F )positive during prolo nged immobilization . ( T )negative during protein starvation . ( T )negative in the untreated diabetic . ( T )positive during recovery from debilitating diseas e

6. a. b. c. d. e. In the fetal lung. .( F )bronchial cartilage formation commences at 18-24 weeks of gestation .( F )type 2 alveolar cells appear at 16-20 weeks of gestation . ( F )sphingomyelin is the most common phospholipid present at term . ( T )phosphol ipid release is increased by endogenous adrenaline . ( F )phospholipid productio n is decreased by exogenous corticosteroids 7. Concerning acidosis. a. .( T )the ratio of bicarbonate ions to carbonic acid in extracellular fluid is decreased b. .( F )in respiratory acidosis there is re duced renal hydrogen ion secretion c. . ( T )in respiratory acidosis there is an increased concentration of carbon dioxide in the blood d. . ( T )loss of bicarb onate in diarrhoea causes a metabolic acidosis e. . ( F )in compensating metabol ic acidosis, PCo2 is increased 8. a. b. c. d. e. Fetal haemoglobin. .( T )contains four polypeptide chains .( F )does not contain iron . ( F )has no alpha chains . ( T )is more resistant to alkaline denaturati on than is adult haemoglobin . ( F )has the same structure as adult myoglobin 9. a. b. c. d. e. The intestinal absorption of calcium is. .( T )decreased in renal failure .( T ) decreased by the ingestion of large amounts of some cereals . ( F )increased by the oral intake of phosphate . ( T )increased by 1,25-dihydroxycholecalciferol . ( T )decreased in the presence of steatorrhoea 10. The following are aminoacids found in human proteins. a. .( T )serine b. .( T )methionine c. . ( F )thyramine d. . ( F )histamine

e. . ( T )arginine 11. Iron ions. a. .( F )diffuse passively into eryhtropoietic cells b. .( T )bin d to transferrin c. . ( T )are taken up by hepatocytes d. . ( T )are necessary f or cytochrome synthesis e. . ( F )are absorbed predominantly by the ileum 12. Folic acid. a. .( F )requires gastric intrinsic factor for its absorption b. .( F )daily requirement is about 40 mg c. . ( T )is found in higher concentrati on in fetal blood than in maternal blood d. . ( F )deficiency leads to microcyti c anaemia e. . ( F )is fat soluble 13. Concerning immunoglobulins in pregnancy. a. .( F )the concentration of IgG i s ten times greater in the maternal circulation than it is in the fetal circulat ion at term b. .( F )the concentration of IgA in cord blood is higher than that in maternal blood c. . ( F )IgE crosses the placenta readily d. . ( T )the four classes of IgG cross the placenta readily e. . ( T )fetal IgM is dimeric 14. The conjugation of bilirubin. a. .( T )takes place in hepatocytes b. .( T )i s catalysed by UDP glucuronyl trnasferase c. . ( F )is inhibited by phenobarbito ne d. . ( T )renders its water soluble e. . ( F )is impaired in acute biliary ob struction 15. In radiotherapy. a. .( T )1 Gray is equivalent to 1 joule per kilogram

b. .( T )the skin usually receives a greater dose of radiation than the underlyi ng tissues c. . ( F )the major effect of radiation energy is to damage the cytop lasm of the cell d. . ( F )cells in tissues which are hypoxic are more vulnerabl e to radiation e. . ( T )radiation induced changes in tissues may take 6 weeks t o develop 16. In uncomplicated homozygous beta thalassaemia there is. a. .( T )hypochromas ia b. .( F )a reduction in haemoglobin A2 c. . ( T )an increase in haemoglobin F d. . ( F )megaloblastic eryhtropoiesis e. . ( F )red cell sickling 17. Concerning the genetic control of protein synthesis. a. .( F )mature mRNA co ntains introns b. .( T )a codon has 3 base sequences c. . ( F )each amino acid h as a single codon d. . ( T )transfer RNA has anticodon recognition sites e. . ( T )each tRNA carries a specific amino acid 18. Concerning chromosomal errors. a. .( T )structural variations may not have a phenotypic consequences b. .( F )trisomy indicates the presence of 3 haploid co mponents within a cell c. . ( T )nondisjunction during mitosis can contribute to mosaicism d. . ( T )a trisomic parent can produce normal gametes e. . ( T )trip loidy is rarely detected in neonates at term 19. The following conditions are hereditary. a. .( T )polyposis coli b. .( T )re tinoblastoma c. . ( T )xeroderma pigmentosa d. . ( F )Burkitt s lymphoma e. . ( F )osteosarcoma

20. Immunoglobulin M. a. .( F )fixes complement by the alternative pathway b. .( F )crosses the placenta readily c. . ( F )fixes to mast cells d. . ( T )is prod uced by plasma cells e. . ( F )is smaller than immunoglobulin E 21. Lymphocytes in health. a. .( F )form about 2% of the white cell count b. .( T )play an essential role in cell mediated immunity c. . ( T )can change into pl asma cells d. . ( T )have proportionately more nuclear material than cytoplasm e . . ( F )have a life span of about 30 days 22. In anaphylactic shock in humans. a. .( T )IgE is a mediator b. .( T )there i s degranulation of mast cells c. . ( F )complement is required d. . ( T )histami ne release occurs e. . ( F )the principle response is in the gastrointestinal tr act 23. Concerning the adrenal gland. a. .( F )the cortex is derived from the neural crest cells b. .( F )the zona fasiculata secretes aldosterone c. . ( T )cortica l adenomas may cause cushing syndrome d. . ( T )neuroblastoma arise in medulla e . . ( T )Addison s disease may result from autoimmune destruction of the cortex 24. The following are autosomal recessive disease. a. .( F )neurofibromatosis b. .( T )cystic fibrosis c. . ( T )phenylketonuria d. . ( F )polyposis coli e. . ( T )sickle cell anaemia

25. The following are examples of type 3 hypersensitivity (immune complex) disea se. a. .( F )autoimmune haemolytic anaemia b. .( T )systemic lupus eryhtematosus c. . ( F )glomerulonephritis d. . ( F )tuberculosis e. . ( F )sarcoidosis 26. The following tumours produce characteristic blood marker. a. .( F )clear ce ll carcinoma b. .( T )choriocarcinoma c. . ( F )osteogenic sarcoma d. . ( T )yol k sac tumour e. . ( F )transitional cell tumour 27. Uterine fibroids. a. .( F )are defined histologically as fibromyxomas b. .( F )arise from endometrial stroma c. . ( T )may be associated with polycyathaemia d. . ( F )predispose to endometrial hyperplasia e. . ( F )are liable o sarcomat ous change in about 5% of cases

29. Obstruction of the lower end of the common bile duct is suggested by. a. .( T )an elevated serum conjugated bilirubin concentration b. .( F )a reduced serum alkaline phosphatase concentration c. . ( F )the presence of urobilinogen in ur ine d. . ( T )increased conjugated bilirubin in the urine e. . ( F )increased se rum cholesterol concentration

28. The following pairs ein-Barr virus: Burkitt arcinoma c. . ( F )wood etrial carcinoma e. . (

indicate correct pathological association. a. .( T )Epst s lymphoma b. .( T )Peutz-jeghers syndrome: intestinal c dust: pleural mesothelioma d. . ( F )progestagens: endom T )aniline dyes: bladder carcinoma

30. Growth of the following tumours is hormone dependent. a. .( F )squamous cell carcinoma of the cervix b. .( T )breast adenocarcinoma c. . ( T )uterine leiomy oma d. . ( T )prostatic adenocarcinoma e. . ( F )testicular carcinoma 31. Osteomalacia is characterized by. a. .( F )mineralization of the periosteum b. .( T )deposition of uncalcified bone matrix c. . ( F )normal osteoblastic act ivity d. . ( F )increased capillary fragility e. . ( F )normal calcification of bone 32. The following cause platelet aggregation. a. .( T )ADP b. .( F )prostacyclin c. . ( F )serotonin d. . ( F )antithrombin III e. . ( F )thromboxane A2 33. oxygen. a. .( F )binds to trivalent iron in the haem molecule b. .( T )is ca rried as four molecules per molecule of haemoglobin c. . ( F )haemoglobin dissoc iation is linear d. . ( T )uptake reduces red cell buffering capacity e. . ( F ) is released from haemoglobin when the concentration of 2.3 DPG is decreased 34. Displacement of oxyhaemoglobin dissociation to the right. a. .( F )means a g reater avidity of haemoglobin for oxygen b. .( T )occurs immediately on ascent t o high altitude c. . ( T )occurs with a rise in temperature d. . ( T )occurs wit h a fall in pH e. . ( F )occurs with a fall n Pco2

35. Plasma osmolarity in the human. a. .( T )is normally about 290 milliosmoles per Kg in the non-pregnant state b. .( F )increases during the first trimester o f pregnancy c. . ( F )is closely controlled by plasma protein concentration d. . ( T )is regulated by arginine vasopressin e. . ( T ) regulates the sensation of thirst 36. Gastrointestinal absorption of. a. .(F )dietary glucose depends upon intact pancreatic function b. .( F )vitamin B12 requires gastric acid c. . ( F )fat is accomplished by the transport of chylomicrons from the intestinal lumen d. . ( F )iron may be reduced by vitamin C administration e. . ( T )unhydrolised polysac charides does not occur 37. In the healthy adult kidney. a. .( F )glucose resorption predominantly occur s in the loop of henle b. .( F )water is reabsorbed in the proximal tubule by ac tive transport c. . ( F )the glomerular filtration rate is 25 ml per minute d. . ( T )resorption of sodium is increased by aldosterone e. . ( T )urinary pH can vary between 4.5 and 8.5 38. Plasma proteins. a. .( F )which combine with drugs enhance their pharmacolog ical activity b. .( F )play no role in the plasma buffering system c. . ( T )com bine with lipids to facilitate transport d. . ( F )are restored within 24 hours after haemorrhage e. . ( F )are normally present in a concentration of about 7g/ L 39. surfactant. a. .( F )is formed mainly in the placenta b. .( F )levels in amn iotic fluid diminish after 33 weeks of gestation c. . ( T )formation can be infe rred from the lecithin-sphingomyelin ratio in amniotic fluid d. . ( T )contains palmitic acid e. . ( T )decreases the surface tension in pulmonary alveoli

40. The normal human erythrocyte. a. .( F )has an average volume of 70 fl b. .( F )is spherical c. . (F )has a diameter of 10micrometers d. . (T )has a survival time of about 120 days e. . (T )has a haemoglobin content of less than 40% 41. Concerning nitrogen metabolism. a. .( T )ingestion of complex proteins is es sential for the maintenance of nitrogen balance b. .( T )there are eight essenti al amino acids c. . ( T )the minimum daily requirements of each essential amino acid is 0.3-1 g d. . ( T )amino acid nitrogen is largely excreted as urea e. . ( F )a protein poor but energy sufficient diet will cause a decreased excretion o f creatinine 42. A woman has the following blood gas profile: pH=7.6, Pco2=2.7KPa(20 mm Hg), standard bicarbonate=27 mmol/L. a. .( F )these figures are compatible with norma l pregnancy b. .( T )she could be hyperventilating c. . ( F )she could have diab etic ketoacidosis d. . ( F )the alveolar Pco2 would be 6.3 KPa (47mmHg) e. . ( F )the plasma hydrogen ion concentration would be 0,000076 mmol/L 43. Nerve impulses. a. .( F )can only travel in one direction along an axon b. . ( T )require energy c. . ( F )are conducted at approximately the speed of light d. . ( F )are conducted at the same speed in small and large axons e. . ( F )are not delayed at the synapse before transmission 44. Intracellular fluid differs from extracellular fluid in that. a. .( T )it fo rms the major proportion of total body water b. .( F )its volume can be measured easily c. . ( T )it has a higher concentration of potassium than of sodium

d. . ( F e. . ( T )its volume is regulated primarily by the kidneys )it has a higher phosphate con centration 45. In the conducting system of the normal heart. a. .( F riginates in the AV node b. .( F )the AV node is situated onary sinus c. . ( T )Purkinje fibres are modified muscle bundle lies in the interventricular septum e. . ( T )the upply each ventricle )the cardiac impulse o in the wall of the cor cells d. . ( T )the Av AV bundle divides to s

46. Hypotension causes. a. .( T )diminished urine production b. .( F )inhibition of rennin secretion c. . ( T )stimulation of aldosterone secretion d. . ( T )st imulation of angiotensin II production e. . ( F )increased excretion of sodium 47. During the 5th month of pregnancy, fetal red cell production normally occurs in the . a. .( F )lymph bglands b. .( F )Kupffer cells of the liver c. . ( T )b one marrow d. . ( T )spleen e. . ( F )placenta 48. Myometrial activity in pregnancy is. a. .( T )increased by oestrogens b. .( F )increased by progesterone c. . ( T )stimulated by vasopressin d. . ( F )inhib ited by ergot alkaloid e. . ( T )inhibited by salbutamol 49. By the 12th week of pregnancy, the following alterations have occured. a. .( T )an increase in urea excretion b. .( T )a decrease in serum creatinine concen tration

c. . ( F d. . ( F e. . ( F )diminished excretion of water soluble vitamins )a doubling of 24 hour urinary v olume )an increase in serum urate concentration 50. In pregnancy. a. .( T )red cell mass increases b. .( F )serum iron binding l evels are reduced c. . ( T )plasma folate levels are reduced d. . ( F ) respirat ion rate is increased e. . ( T ) lung tidal volume is increased

September 1999 paper 1 1. a. b. c. d. e. Concerning oogenesis. .( T )the primary oogonia undergoes mitotic divisions prior to meiosis .( F )the primary oocyte e nters meiosis at puberty . ( F )at birth, primary oocytes have completed the fir st meiotic division . ( T )DNA synthesis does not take place as part of the seco nd meiotic division . ( F )secondary oocytes complete the second meiotic divisio n at ovulation 2. a. b. c. d. e. In the vulva. .( F )sebaceous glands are not present in the labia minora .( T )a pocrine glands are present in the labia majora . ( F )both surfaces of the hymen are covered by keratinized epithelium . ( T )the Bartholin s glands are mucus s ecreting . ( F )the clitoris is covered by columnar epithelium 3. a. b. c. d. e. The anal canal. .( T )has an upper part which is innervated by the inferior hypo gastric plexus .( F )has a lower part which is supplied by the superior rectal a rtery . ( F )drains lymph to the superficial inguinal nodes from its upper part . ( F )has its internal sphincter innervated by the inferior rectal nerve . ( T )has a superficial part of its external sphincter attached to the coccyx 4. a. b. c. d. e. The adult pituitary gland. .( F )contains the paraventricular nuclei .( T )is re lated to the sphenoid bone . ( T )lies inferiorly to the optic chiasma . ( F )co ntains a pars tuberalis inferiorly . ( T )is entirely ectodermal in origin 5. a. b. c. d. e. The right ovarian artery. .( F )arises from the abdominal aorta above the renal artery .( T )passes posterior to the third part of the duodenum . ( F )passes po sterior to the genitofemoral nerve . ( T )supplies the right ureter . ( T )anast omoses with the right uterine artery

6. a. b. c. d. e. The obturator nerve. .( T )is derived in pat from the second lumbar nerve .( T ) supplies both hip and knee joints . ( F )runs superficial to the common iliac ve ssels . ( F )leaves he pelvis through the greater sciatic foramen . ( F )supplie s the abductor muscles of the thigh 7. Regarding the innervations of the genital tract. a. .( F )pre ganglionic symp athetic nerves to the cervix arise from S2,S3 and S4 b. .( T ) )pre ganglionic s ympathetic nerves to the body of uterus arise from T12 and L1 c. . ( T )sensory nerves from the body of uterus enter T11 and T12 d. . ( T )sensory nerves from t he cervix enter S2,S3 and S4 e. . ( F )sensory nerves from the vagina enter L5 a nd S1 8. a. b. c. d. e. The extradural(epidural) space. .( F )contains the internal vertebral plexus .( F )lies between the pia matter and dura matter . ( T )contains no cerebrospinal fluid . ( F )ends at the level of the second lumbar vertebra . ( T )does not ext end laterally through the intervertebral foramina 9. The mature ovary. a. .( F )is attached to the anterior aspect of the broad li gament by the mesovarium b. .( T )is covered by a thick capsule c. . ( T )has a surface layer of germinal epithelium d. . ( F )on the right side drains venous b lood to the renal vein e. . ( F )has lymphatics which pass to the external iliac nodes 10. The vagina. a. .( F )has an anterior wall longer than the posterior wall b. .( F )contains mucus secreting glands in its epithelium c. . (F )is related in i ts lower third to the bladder base d. . (T )during reproductive life has an acid pH

e. . (F )is derived from the mesonephric duct 11. The right ureter. a. .( F )is approximately 50 cm in length b. .( T )is part ly covered by the duodenum c. . (T )crosses the genitofemoral nerve d. . (F )ent ers the bladder anteromedially e. . (T )receives part of its blood supply from t he uterine artery 12. Concerning the inguinal canal. a. .( T )it transmits the ilioinguinal nerve b. .( F )the deep inguinal ring lies below the midpoint of the inguinal ligament c. . ( T )the superficial inguinal ring overlies the pubic tubercle d. . ( T )m edially the anterior wall is made up of the external oblique aponeurosis e. . ( F )laterally the posterior wall is formed by the conjoint tendon 13. After birth. a. .( T )the allantois forms the median umbilical ligament b. . ( F )the umbilical vein forms the medial umbilical ligament c. . ( T )the umbili cal artey forms the superior vesical artery d. . ( F )the ductus venosus forms t he ligamentum teres e. . ( F )the ductus arteriosus forms the arch of the aorta 14. The normal neonate delivered at term has. a. .( F )a head circumference of b etween 40 and 50 cm b. .( T )a liver palpable on abdominal examination c. . ( F )a blood glucose concentration above 1.66 mmol/L(30g/dl) d. . ( T )brown adipose tissue e. . ( F )no adult haemoglobin 15. In spermatogenesis. a. .( T )primary spermatocytes undergo reduction divisio n b. .( T )each spermatocyte ultimately gives rise to 4 spermatids c. . ( F )the whole process of spermatogenesis in man takes 6-7 days d. . ( T )grossly abnorm al spermatozoa may be found in the fertile semen

e. . ( T )spermatids are haploid 16. Corticotrophin releasing hormone. a. .( T )is a polypeptide b. .( T )is rele ased from the median eminence of the hypothalamus c. . ( T )acts on the basophil cells of the anterior pituitary d. . ( T )release has a circadian variation e. . ( T )release is increased by painful stimuli 17. inhibin. a. .( F )is structurally identical to relaxin b. .( F )is released in pulses c. . ( F )is a steroid d. . ( T )is produced by the ovarian follicle e . . ( T )inhibits the release of FSH 18. In one b. le for opment the human male, dihydrotestosterone. a. .( F )is a precursor of .( F )has one tenth of the potency of testosterone c. . ( F )is involution of the mullerian system d. . ( T )is responsible for of the male external genitalia e. . ( T )binds to intracellular testoster responsib the devel receptors

19. In human lactation. a. .( T )oestrogens promote development of breast lobule s b. .( F )oestrogens promote the milk producing effect of prolactin on the brea st c. . ( F )human placental lactogen is essential for milk synthesis d. . ( F ) prolactin stimulates gonadotrophin release e. . ( T )oxytocin cause milk ejectio n 20. aldosterone. a. .( F )secretion is increased by a low potassium intake b. .( F )production is reduced in normal pregnancy c. . ( F )secretion is entirely re gulated by the rennin angiotensin system d. . ( T )is the principle mineralocort icoid secreted by the adrenal gland

e. . ( T )in the kidney, acts on the distal convoluted tubules 21. In the rennin angiotensin system. a. .( T )decreased renal blood flow causes increased rennin production b. .( T )rennin is secreted by the juxta glomerular cells of the kidney c. . ( T )rennin causes production of angiotensin 1 d. . ( T )angiotensin 1 is a decapeptide e. . ( F )angiotensin II suppresses aldosteron e secretion 22. Concerning insulin. a. .( F )the half life of endogenous insulin in the circ ulation is 30 minutes b. .( F )the kidney is a major site of insulin degradation c. . ( F )it facilitates glucose uptake by the brain d. . ( F )fasting concentr ations are lower in pregnant women at term than they are in nonpregnant women e. . ( T )it is formed when C-peptide is separated from proinsulin 23. During normal pregnancy. a. .( T )plasma thyroid binding globulin concentrat ion increases b. .( F )plasma total thyroxine concentration falls c. . ( F )plas ma TSH concentration increases d. . ( F )triiodothyronine readily crosses the pl acenta to the fetus e. . ( F )fetal thyroid function is largely dependant upon t he function of the maternal thyroid 24. Concerning testicular hormones. a. .( entrations b. .( F )inhibin stimulates LH rmed in the testis d. . ( T )testosterone 5 alpha reductase e. . ( F )testosterone bumin T )testosterone reduces plasma LH conc production c. . ( T )oestrogens are fo is converted to dihydrotestosterone by in plasma is predominantly bound to al

25. Deficient adrenocortical function causes an increase in. a. .( F )blood pres sure b. .( F )blood glucose

c. . ( T )skin pigmentation d. . ( F )serum sodium e. . ( F )plasma lipids 26. progesterone. a. .( T )is a C-21 peptide b. .( T )is synthesized by the ovar y before ovulation c. . ( T )increases ventilation d. . ( T )raises basal body t emperature e. . ( T )binds to corticotrophin binding globulin 27. Leutenising hormone. a. .( T )is a glycoprotein b. .( F )has a molecular wei ght of approximately 4000 Daltons c. . ( T )stimulates androgen production by th e ovary d. . ( F )concentrations in the circulation are high in girls before pub erty e. . ( T )concentrations in the circulation are raised in untreated adults with turner syndrome 28. Serum concentrations of FSH are. a. .( T )increased in Kleinefelter syndrome b. .( F )decreased in primary hypogonadism c. . ( F )decreased following the me nopause d. . ( F )increased with oestrogen therapy e. . ( T )increased following male castration 29. tly lly 7th Human chorionic gonadotrophin. metabolized in the kidney c. . similar to the beta subunit of week of pregnancy e. . ( T )is a. .( F )is ( F )has an LH d. . ( F secreted in a steroid hormone b. .( T )is par alpha subunit which is antigenica )reaches peak concentrations at 1 trophoblastic disease

30. The secretion of growth hormone. a. .( F )occurs in the hypothalamus

b. c. d. e. .( .( .( .( F F F T )decrease during sleep )is decreased during stress )is decreased with hypoglycae mia )opposes the action of insulin 31. In the human, oxytocin. a. .( F )promotes milk synthesis in the breast b. .( T )release is inhibited by alcohol c. . ( T )action on the uterus is enhanced b y oestrogens d. . ( F )release is inhibited by dopamine e. . ( F )in excess caus es dehydration 32. calcitonin. a. .( F )increases the basal metabolic rate b. .( F )increases t he blood calcium level c. . ( F )is a steroid hormone d. . ( F )is produced in t he parathyroid glands e. . ( F )release is stimulated by low calcium ion levels 33. The pineal gland. a. .( F )lies anteriorly to the third ventricle b. .( F )i s innervated by the parasympathetic nervous system c. . ( T )produces melatonin d. . ( F )increases in size at puberty e. . ( T )activity is related to day leng th 34. The following are RNA containing viruses. a. .( T )coxsackie b. .( T )influe nza c. . ( T )mumps d. . ( F )herpes simplex e. . ( F )cytomegalovirus 35. Concerning viral infection. a. .( T )cytomegalovirus is of herpes group

b. .( F )Herpes simplex virus may remain dormant in epithelial cells of the lowe r genital tract c. . ( T )facial herpes simplex lesions are activated by sunligh t d. . ( F )Coxsackie B virus does not cross the placenta e. . ( T )Hepatitis B virus may be sexually transmitted 36. Bacteroids organisms. a. .( F )are motile b. .( T )do not produce spores c. . ( F )grow in aerobic culture d. . ( T )are synergistic coliforms e. . ( T )are characteristically resistant to penicillin 37. Staphylococcus aureus. a. .( T )produce coagulase b. .( F )is motile c. . ( F )produce spores d. . ( T )produce pigmented colonies e. . ( T )produces toxins 38. mycoplasmas. a. .( T )are the smallest known free living organisms b. .( F ) have a typical bacterial cell wall c. . ( F )are sensitive to penicillin d. . ( F )are resistant to tetracycline e. . ( F )can only be grown in tissue culture c ells 39. Actinomyces israelii. a. .( F )is a fungus b. .( T )forms yellow granules in pus c. . ( T )is a mouth commensal d. . ( T )occurs in association with IUCD e. . ( F )is resistant to penicillin 40. Concerning syphilis.

a. b. c. d. e. .( F .( T .(F .( F .( T )the incubation period is usually between 1 and 7 days )it has an infectious sec ondary stage )the primary stage is characterized by gumma formation )the regain test becomes positive in the tertiary stage )haematogenous spread occurs early 41. The discharge associated with bacterial vaginosis. a. .( T )contains clue ce lls b. .( F )contains large numbers of polymorphs c. . ( T )has a pH above 4.5 d . . ( F )is frothy e. . ( T )has an odour 42. The following factors enhance the transplacental passage of drugs. a. .( T ) lipid solubility b. .( F )a high degree of ionic dissociation c. . ( F )high mol ecular weight d. . ( F ) protein binding e. . ( F )uterine contractions 43. The following drugs are potassium sparing diuretics. a. .( T )amiloride hydr ochloride b. .( T )triamterene c. . ( T )spironolactone d. . ( F )chlorothiazide e. . ( F )frusemide 44. metronidazole. a. .( F )is a folic acid antagonist b. .( F )is ineffective w hen given per rectum c. . ( F )should not be administered intravenously d. . ( T )is effective against Entamaeba histolytica e. . ( T )interferes with ethanol m etabolism 45. The following agents inhibit uterine activity.

a. b. c. d. e. .( .( .( .( .( T T F T T )magnesium sulphate )ritodrine hydrochloride )oxprenolol hydrochloride )fenotero l hydrobromide )indomethacin 46. The following drugs diminish detrusor contractions. a. .( T )atropine b. .( F )carbachol c. . ( T )propantheline d. . ( F )nifedipine e. . ( F )distigmine 47. The following drugs are beta sympathomimetic agonists. a. .( T )adrenaline b . .( T )noradrenaline c. . ( F )phenylephrine d. . ( T )ritodrine hydrochloride e. . ( F )oxprenolol hydrochloride 48. The following drug combinations have been shown to interact to produce the s tated effects. a. .( T )ampicillin enhances the anticoagulant function of warfar in b. .( F )acyclovir diminishes the effect of oral contraceptives c. . ( T )Cim etidine inhibits the metabolism of phenytoin d. . ( F )aspirin diminishes the ac tion of ritodrine e. . ( T )tamoxifen increases the anticoagulant effect of warf arin 49. The following substances lower the blood glucose concentration. a. .( F )adr enaline b. .( T )chlorpropamide c. . ( F )chlorothiazide d. . ( T )metformin e. . ( F )thyroxine

50. Concerning the analysis of clinical trials. a. .( T )the 95% confidence inte rval indicates the range within which 19 out of 20 values will lie b. .( T )the P value illustrates how often the result would be expected to occur by chance c. . ( F )the conventional level of statistical significance is set at p 0.005 d. . ( F )in a randomized trial, there must be equal numbers of recruits in each arm of the study e. . ( F )a relative risk reduction of 60% is significant irrespec tive of the value of P

September 1999 paper2 1. a. b. c. d. e. Epidermal growth factor. .( T )is mitoge nic .( T )synthesis is stimulated by oestradiol . ( F )is steroid molecule . ( T )is found in endometrium . ( F )binds to a receptor on the nuclear membrane 2. a. b. c. d. e. Intracellular fluid differs from extracellular fluid in that. .( T )it forms the larger proportion of total body water .( F )its volume can be more readily meas ured . ( T )it has a higher concentration of potassium . ( F )its volume is more directly regulated by the kidneys . ( T )it has a lower concentration of sodium 3. a. b. c. d. e. Injected histamine produces. .( T )a fall in blood pressure .( F )decreased gast ric secretion of hydrochloric acid . ( F )bronchodilation . ( F )bradycardia . ( F )peripheral vasoconstriction 4. a. b. c. d. e. The following are disaccharides. .( F ) glucose .( T ) maltose .( T ) sucrose .( F ) fructose .( T ) lactose 5. The following are actively transportedacross the placenta from the maternal t o the fetal circulation. a. .( T ) histidine b. .( F ) alcohol c. .( T ) ascorbi c acid d. .( T ) iron e. .( F ) intrinsic factor

6. a. b. c. d. e. urea. .( F )is formed mainly in the kidney .( T ) contains 2 amino group .( F ) is formed from transamination from ketogluterate .( T ) is an end product of nit rogen metabolism in the fetus .( F ) excretion is unrelated to protein intake 7. a. b. c. d. Concerning amniotic fluid. .( F )it has a protein concentration similar to that of maternal plasma .( F ) it is mainly a filtrate of maternal plasma during seco nd half of pregnancy .( F ) the highest bilirubin concentrations occur during th e last trimester .( F ) there is an increase in the alpha fetoprotein concentrat ion throughout pregnancy e. .( F ) it contains cells of maternal origin 8. a. b. c. d. e. Concerning the absorption of fats. .( F )there is a major degree of lipase activ ity in the stomach .( T )pancreatic lipase is he most important enzyme for fat d igestion . ( T )bile salts contribute to the formation of micelles . ( F )Micell es have a hydrophobic coat . ( T )chylomicrons have a core of triglycerides 9. a. b. c. d. e. Ketone bodies. .( F )are synthesized in the brain .( T )include acetoacetate . ( T )are water soluble . ( F )are synthesized in skeletal muscle . ( T )can be ut ilized during starvation 10. Serum alkaline phosphatase activity characteristically is raised in. a. .( F )senile osteoporosis b. .( T )intrahepatic cholestasis c. . (T )extensive Paget s disease of bone d. . ( F )prostatic carcinoma e. . ( T )pregnancy

11. Vitamin A. a. .( F )can be synthesized in the skin b. .( T )is derived from B-carotene c. . ( T )is toxic to tissues in high doses d. . ( T )is a teratogen e. . ( T )is required for rhodopsin synthesis 12. The normal metabolic response to an operation includes. a. .( F )increased d ieresis during the first 24 hours b. .( T ) renal retention of sodium c. .( F ) a rise in plasma sodium level d. .( T ) increased renal excretion of nitrogen e. .( T ) increased renal excretion of potassium 13. Folic acid. a. .( T )deficiency causes a megaloblastic bone marrow b. .( F ) is hydroxycobolamin c. .( T ) is present in green vegetables d. .( F ) is predo minantly absorbed from the large intestine e. .( T ) is destroyed by boiling wat er 14. In iodine metabolism. a. .( F )a daily intake of 100 mg of iodine is require d to prevent goitre b. .( T ) inorganic iodine is actively trapped by the thyroi d gland c. .( T ) iodine trapping is stimulated by TSH d. .( F ) iodine trapping is stimulated by perchlorate ion e. .( F ) clearance of iodine by the thyroid i s decreased during pregnancy 15. The following are essential amino acids. a. .( T )valine b. .( F ) thiamine c. .( F ) cystamine d. .( F ) glycine e. .( T ) lysine

16. Potassium depletion causes. a. .( F )extramuscular acidosis b. .( T ) muscul ar acidosis c. .( F ) diarrhoea d. .( T ) cardiac arrhythmias e. .( F ) renal tu bular damage 17. Doppler ultrasound. a. .( T )is used to monitor fetal breathing b. .( T ) is used in fetal heart rate monitors c. .( T ) can be used to measure blood veloci ty in the fetus d. .( F ) measures proton relaxation times e. .( F ) requires in jection of contrast agents 18. The following are structural aberrations of chromosomes. a. .( T )deletions b. .( T ) inversions c. .( F ) aneuploidy d. .( F ) polyploidy e. .( T ) translo cations 19. Messenger RNA. a. .( T )synthesis is dependant on RNA polymerase b. .( F ) i s an exact copy of sense DNA c. .( T ) contains exons d. .( F ) is measured by w estern analysis e. .( F ) translation occurs in the nucleus 20. A woman who has a rhesus genotype of Cde/CDe. a. .( F )could develop anti-C antibodies b. .( T ) could safely be transfused with D positive blood c. .( T ) may develop anti-E antibodies d. .( F ) should receive anti-D immunoglobulin aft er giving birth to RH (D) positive infant e. .( F ) is Rh negative

21. In diseases determined by dominant genes. a. .( F )a sibling of an affected person will always be affected b. .( T ) homozygous affected parents will always produce affected offspring c. .( F ) the parents of affected persons have an in creased rate of consanguineous marriage d. .( T ) normal children of affected pa rents have normal offspring e. .( T ) new cases can arise by spontaneous mutatio n 22. Autoantibodies are found in. a. .( T )systemic lupus erythematosus b. .( T ) rheumatoid arthritis c. .( T ) pernicious anaemia d. .( F ) bronchial asthma e. .( T ) chronic active hepatitis 23. Concerning immunoglobulins in pregnancy. a. .( F e for rhesus iso-immunisation in the fetus b. .( F ) rd blood is higher than that in maternal blood c. .( a readily d. .( T ) IgG crosses the placenta readily ric )maternal IgM is responsibl the IgA concentration in co F ) IgE crosses the placent e. .( T ) fetal IgM is dime

24. The biological effects of complement in the human include. a. .( T )opsonisa tion b. .( T ) cell membrane lysis c. .( F ) participation in the blood coagulat ion process d. .( F ) promotion of sperm motility e. .( F ) prevention of immune rejection of trophoblast 25. T lymphocyte. a. .(T )differentiate in the thymus b. .( T ) are involved in the generation of both cell mediated and immoral immune response c. .( F ) are t he predominant lymphoid population in decidua d. .( T ) are the predominant lymp hoid population in peripheral blood

e. .( F ) are the major cell type in the germinal centres of lymph nodes 26. Natural killer cells. a. .( F )are related to B cells b. .( T ) have large g ranular lymphocyte morphology c. .( T ) have receptors for HLA class 1 molecules d. .( T ) are presnt in large numbers in deciduas during first trimester e. .( F ) express CD3 on their surface 27. Early blood borne dissemination is a characteristic feature of. a. .( F )car cinoma of the endometrium b. .( T ) osteosarcoma c. .( F ) basal cell carcinoma d. .( F ) carcinoma of the cervix e. .( T ) choriocarcinoma 28. In tissue pigmentation, the following are associated. a. .( F )kernicterus a nd conjugated bilirubin b. .( T ) Addison s disease and increased cutaneous mela nin c. .( F ) melanosis coli and bile pigments d. .( T ) Wilson s disease an cop per deposition in the cornea e. .( T ) corpus luteum and carotenoids 29. The following cells may be phagocytic. a. .( T )neutrophils b. .( T ) kupffe r cells c. .( T ) monocytes d. .( T ) hofbauer cells e. .( F ) plasma cells 30. In healing by primary intension, the following events occur. a. .( F )format ion of fibrin free haematoma b. .( T ) an acute inflammatory reaction c. .( T ) migration of epithelial cells within 6 hours d. .( T ) phagocytosis

e. .( T ) invasion by capillary buds within 3 days 31. The following are premalignant conditions. a. .( F )diverticular disease of the large bowel b. .( T ) ulcerative colitis c. .( T ) pulmonary asbestosis d. . ( T ) paget s disease of the bone e. .( F ) condylomata lata of the vulva 32. In tumours of bone. a. .( F )primary malignancy is more common than secondar y malignancy b. .( F ) osteoma rarely present in skull bones c. .( T ) osteosarc oma is associated with Paget s disease of bone d. .( T ) lymph node metastases a re unusual e. .( T ) simple bone cysts have a strong tendency to recur 33. In beta thalassaemia. a. .( F )the erythrocytes will sickle at low oxygen te nsion b. .( T ) a homozygous fetus is usually anemic c. .( F ) stainable iron st ores in the marrow are usually decreased d. .( T ) target cells may be found in the peripheral blood e. .( F ) erythrocyte survival time is increased 34. The following are adverse effects of blood transfusion. a. .( T )hypothermia b. .( T ) haemoglobinuria c. .( T ) hypocalcaemia d. .( F ) hypokalaemia e. .( F ) thrombocytosis 35. Bradykinin. a. .( T )causes vasodilatation b. .( T ) increases vascular perm eability c. .( T ) is formed by the action of kallikrein d. .( T ) is predominan tly inactivated in the lungs

e. .( F ) is metabolized to kininogen 36. The peripheral pressure of carbon dioxide in arterial blood may be raised in . a. .( F )residence at high altitude b. .( T ) gross obesity c. .( F ) acidaemi a due to renal failure d. .( F ) hyperventilation e. .( F ) pregnancy 37. Pain . a. .( T )is transmitted along the same pathways in the spinal cord as temperature b. .( T ) arises from the stimulation of free nerve endings c. .( F ) is transmitted in nerves which synapse in spinal ganglia d. .( F ) sensitivit y is absent from the parietal peritoneum e. .( T ) fibres from the uterus accomp any autonomic nerve fibres 38. A fall in plasma osmotic pressure. a. .( T )is a normal feature of early pre gnancy b. .( F ) stimulates vasopressin release c. .( T ) may result in pulmonar y oedaema d. .( F ) increases thirst e. .( F ) results in a reduction in urine v olume 39. Concerning lecithins. a. .( F )they are polypeptides b. .( F ) amniotic flui d levels diminish after 33 weeks of pregnancy c. .( F ) their formation can be i nferred from the sphingomyelin level in amniotic fluid d. .( T ) they contain pa lmitic acid e. .( T ) they act by decreasing surface tension in pulmonary alveol i 40. Glomerular filtration increases. a. .( T )when renal blood flow increases b. .( F ) when plasma oncotic pressure increases c. .( T ) in the remaining kidney following contralateral nephrectomy

d. .( F ) following ipsilateral ureteric obstruction e. .( T ) following plasma volume expansion 41. During the production of urine. a. .( T )the proximal renal tubules return a bout 75% of the water entering them to the blood b. .( F ) the proximal renal tu bules present 30-0 litres of water daily to the loops of Henle c. .( F ) the osm otic pressure of the filtrate in the renal cortex is higher than that in the med ulla d. .( T ) ADH increases the permeability of the walls of the collecting duc ts to water e. .( F ) in pregnancy, the glomerular filtration rate decreases 42. Mast cells. a. .( F )normally constitute 3% of circulating leucocytes b. .( F ) are formed in the liver c. .( T ) contain cytoplasmic granules d. .( T ) pro duce heparin e. .( T ) have receptors for immunoglobulin 43. The conjugation of bilirubin. a. .( T )takes place in hepatocyes b. .( T ) i s catalysed by UDP glucuronyl transferase c. .( F ) is inhibited by pheenobarbit one d. .( T ) renders it water soluble e. .( F ) is impaired in acute biliary ob struction 44. chylomicrons. a. .( F )are synthesized in adipose sites b. .( F ) are a majo r component of bile c. .( T ) contain triglycerides d. .( F ) are predominantly composed of free fatty acids e. .( F ) are not found in the peripheral circulati on

45. Metabolic acidosis. a. .( F )results in an elevation of the plasma bicarbona te concentration b. .( T ) may result from methanol ingestion c. .( T ) stimulat es ventilation d. .( F ) decreases the ionised fraction of plasma calcium e. .( T ) results in a fall in urinary pH 46. During a normal adult cardiac cycle. a. .( F )the mitral valve is closed in the late diastole b. .( F ) atrial contraction is responsible for 70% of ventric ular filling c. .( T ) ventricular ejection slows down as systole progresses d. .( T ) peak right ventricular pressure is less than peak left ventricular pressu re during systole e. .( T ) at the end of the systole each ventricle contains ab out 50 ml of blood 47. In the brachial artery. a. .( F )the pulse waves travels to the wrist at the same speed as the arterial blood b. .( T ) the pulse pressure rises with increa sing age c. .( F ) the main contribution to systolic blood pressure is skeletal muscle tone d. .( F ) mean pressure rises when the hand is raised above heart le vel e. .( F ) the pulse pressure is normally about 120 mmHg 48. The sympathetic nervous system supplies. a. .( T )dilator fibres to the bron chial tree b. .( T ) constrictor fibres to the coronary artery c. .( F ) constri ctor fibres to the ciliary artery d. .( T ) inhibitory fibres to the detrusor mu scle e. .( F ) constrictor fibres to the muscles of the small intestine 49. In the maternal haematological response to pregnancy. a. .( T )the total whi te cell count is increased b. .( F ) the platelet count is increased c. .( F ) t he mean red cell haemoglobin concentration is increased d. .( T ) the red cell m ass is increased e. .( F ) the reticulocyte count is decreased

50. During normal pregnancy, the daily urinary excretion of. a. .( T )lactose is increased b. .( F ) total amino acids is decreased c. .( F ) total protein is d ecreased d. .( T ) vitamin B12 is incerased e. .( F ) folate is decreased

march 2000 paper 1 1. a. b. c. d. e. The obturator nerve. .( F )is a branch of t he sacral plexus .( F )emerges from the lateral border of he psoas major . ( F ) supplies the pelvic parietal peritoneum . ( T )supplies the hip joint . ( F )sup plies the lateral side of the thigh 2. a. b. c. d. e. The following are sites of anastomosis between systemic and portal veins. .( T ) lower third of the oesophagus .( F )sigmoid colon . ( T )umbilicus . ( T )termin al rectum . ( F )ureters at the pelvic brim 3. a. b. c. d. Concerning the spinal cord and its meninges. .( F )the pain pathways run in the posterior columns .( T )the pathway for discriminative touch run in the posterio r columns . ( F )the cord in the adult terminates at the level of the third lumb ar vertebra . ( F )the dural sac (lumbar cistern)terminates at the level of the lumbosacral junction e. . ( T )the anterior corticospinal tract carries uncrosse d motor fibres 4. a. b. c. d. e. The right ovarian artery. .( F ) arises from the abdominal aorta above the renal artery .( T ) passes posterior to the third part of the duodenum .( F ) passes posterior to the genitofemoral nerve .( T ) supplies the right ureter .( T ) ana stomoses with the right uterine artery 5. a. b. c. d. e. The ureter. .( T ) is supplied in part by the ovarian artery .( F ) lies lateral to the transverse processes of the lumbar vertebrae .( T ) passes above the gen itofemoral nerve .( F ) is lined by a simple columnar epithelium .( T ) passes b elow the uterine artery

6. Concerning the rectus sheath. a. .( T )above the costal margin rectus abdomin is lies on the costal cartilages b. .( F ) below the arcuate line the internal o blique splits to enclose rectus abdominis c. .( F ) it contains the musculophren ic artery d. .( F ) it s innervated by the ilioinguinal nerve e. .( T ) pyramida lis is innervated by the subcostal nerve 7. a. b. c. d. e. The obturator internus muscle. .( F )leaves the pelvis through the obturator for amen .( T ) is inserted onto the greater trochanter of the femur .( F ) forms th e roof of the ischiorectal fossa .( F ) is innervated by the femoral nerve .( T ) has a fascia on its pelvic surface which gives origin to the levator ani 8. Concerning the diaphragm. a. .( T )the vena caval opening lies within the cen tral tendon b. .( F )it has an aperture for the oesophagus at the level of the 1 2th thoracic vertebra c. . ( T )it is attached to the pericardium d. . ( F )moto r innervations is received from the lower six intercostals nerves e. . ( F )sens ory innervations are derived solely from the anterior primary rami of the 3rd, 4 th and 5th cervical nerves 9. a. b. c. d. e. The ent by tal external iliac artery. .( F )enters the thigh anterior to the inguinal ligam .( T )at its origin is crossed by the ureter . ( T )at its origin is crossed the ovarian vessels . ( F )lies medial to the external iliac vein at its dis end . ( F )gives rise to the deep external pudendal artery

10. In the femoral triangle, the femoral artery is. a. .( T )crossed by the supe rficial circumflex iliac vein b. .( F )posterior to the femoral branch of the ge nitofemoral nerve c. . ( F )medial to the long saphenous vein

d. . ( F e. . ( T )posterior to the femoral vein at the apex of the triangle )medial to the femora l nerve 11. The seminal vesicle. a. .( F )contain spermatids b. .( F )secrete hyaluronid ase c. . ( F )secrete acid phosphatase d. . ( T )secrete fructose e. . ( T )secr ete prostaglandins 12. The female urinary bladder. a. .( T )is in contact with the supravaginal ute rine cervix b. .( T ) is joined to the umbilicus by the urachus c. .( F ) is sep arated from the posterior surface of the pubis by peritoneum d. .( F ) is connec ted laterally to the tendinous arch of the pelvic fascia e. .( F ) receives visc eral afferent innervations from the pudendal nerve 13. The ductus venosus. a. .( F ) is part of the embryological heart b. .( F ) i s a shunt preventing blood from passing to the fetal lungs c. .( F ) gives rise to ligamentum teres d. .( T ) carries blood with a higher Po2 than umbilical art erial blood e. .( F ) is derived from the anterior cardinal vein 14. Concerning gonadal development. a. .( T )the histological appearance of the primitive gonad is similar in both sexes until 42 days after fertilisation b. .( F ) the ovary develops in the medulla of the primitive gonad c. .( F ) the hist o-differentiation of the testis begins later than that of the ovary d. .( F ) pr imary sex cells (gonocytes) have a haploid number of chromsomes e. .( F ) mitosi s in oogonia is not completed by the end of the first year of life 15. Trophoblast . a. .( T )develops from the blastocyst b. .( F ) gives rise to the fetal blood vessels in the placenta

c. .( T ) enters the maternal circulation during normal pregnancy d. .( T ) repl aces endothelium of pregnant spiral arterioles e. .( F ) is genetically identica l to deciduas 16. prolactin. a. .( T )release is stimulated by thyrotropin releasing hormone b . .( T ) plasma levels are raised in the 1st trimester of pregnancy c. .( F ) is identical to human placental lactogen d. .( F ) controls milk ejection e. .( F ) release is inhibited by metoclopramide 17. Concerning growth hormone. a. .( T )plasma levels are reduced by glucose inf usion b. .( F ) maternal plasma levels are directly related to fetal growth c. . ( F ) it is active on bone only until the epiphysis fuse d. .( T ) its secretion is controlled by the hypothalamus e. .( T ) increased activity produces a posit ive nitrogen balance 18. Arginine vasopressin. a. .( F )reduces glomerular filtration rate b. .( F ) controls water loss in the proximal renal tubule c. .( F ) is synthesized by the posterior pituitary gland d. .( T ) is released in response to a rise in plasma osmolality e. .( T ) is released in response to a fall in circulating plasma vo lume 19. In the human testis. a. .( F )the main site of testosterone secretion is the Sertoli cell b. .( F ) testosterone synthesis is stimulated by FSH c. .( F ) th e predominant androgen product is androstenedione d. .( T ) the Leydig cells syn thesise testosterone e. .( T ) inhibin is synthesised by the Sertoli cell 20. Actions of insulin include stimulation of. a. .( F )glycogenolysis by the li ver b. .( T ) cellular uptake of amino acids

c. .( F ) entry of glucose into neurons d. .( T ) entry of glucose into adipose tissue e. .( T ) cellular uptake of potassium 21. Insulin secretion is stimulated by. a. .( T )gastrin b. .( F ) noradrenaline c. .( F ) somatostatin d. .( T ) glucagon e. .( T ) arginine 22. The following statements about testicular hormones are true. a. .( T )testos terone reduces plasma LH levels b. .( F ) inhibin increases plasma FSH levels c. .( T ) oestrogens are formed in the testis d. .( T ) testosterone s excreted in urine as 17-ketosteroids e. .( T ) testosterone in plasma is partly bound to al bumin 23. Sex hormone binding globulin. a. .( T )levels are increased in pregnancy b. .( F ) is the main binding protein for progesterone c. .( F ) levels are decreas ed during oestrogen therapy d. .( F ) is the main binding protein for aldosteron e e. .( T ) has a greater affinity than albumin for testosterone 24. The following substances are steroids. a. .( T )aldosterone b. .( F ) FSH c. .( T ) vitamin D d. .( F ) inhibin e. .( F ) thyroxine 25. During pregnancy, the uterine deciduas synthesises. a. .( F )HCG b. .( T ) P rostaglandin E2

c. .( F d. .( T e. .( T ) progesterone ) prolactin ) oxytocin 26. The actions of growth hormone include. a. .( T )promotion of protein synthes is b. .( T ) facilitation of hepatic synthesis of somatomedin C c. .( F ) promot ion of insulin uptake of glucose d. .( T ) stimulation of lipolysis e. .( T ) st imulation of growth spurt at the onset of puberty 27. calcitonin. a. .( F )is synthesised in the parathyroid glands b. .( F ) is a decapeptide c. .( F ) secretion is increased at serum calcium levels below 1.5m mol/L (6.1 mg/100ml) d. .( T ) inhibits bone resorption e. .( T ) increases rena l tubular excretion of calcium 28. vasopressin. a. .( T )is a nanopeptide b. .( F ) is synthesised in the poste rior pituitary gland c. .( T ) release is increased when plasma osmolality rises d. .( T ) release is increased by haemorrhage e. .( F ) plasma concentration is reduced in pregnancy 29. Concerning androgens in normal premenopausal women. a. .( F )95% of circulat ing testosterone is derived from peripheral conversion of androstenedione b. .( F ) the ovaries and adrenals contribute equally to circulating androgen concnent rations c. .( T ) DHEAS is derived almost exclusively from the adrenal glands d. .( F ) about 50% of circulating testosterone is bound to sex hormone binding gl obulin e. .( F ) testosterone promotes the synthesis of SHBG

30. Concerning ovarian function. a. .( F )progesterone is the major steroid of d eveloping follicle b. .( T ) granulose cells secrete oestradiol c. .( T ) oestra diol is derived from androgen precursors d. .( F ) somatomedin C (insulin like g rowth factor) is not secreted by the ovary e. .( T ) circulating inhibin concent rations are a marker of granulosa cell function 31. Human chorionic gonadotrophin. a. .( T )is a glycoprotein b. .( F ) secretio n peaks at 20 weeks of gestation c. .( F ) has intrinsic anti-thyroid activity d . .( F ) is synthesised by the corpus luteum of pregnancy e. .( T ) binds to LH receptors 32. The following are caused by herpes simplex virus. a. .( T )acute gingivostom atitis b. .( T ) cold sores c. .( F ) cervical warts d. .( T ) meningeoencephali tis e. .( F ) shingles 33. The germination of tetanus spores in a wound is inhibited by. a. .( F )tissu e trauma b. .( T ) oxygen c. .( T ) injection of anti-toxin d. .( F ) injection of toxoid e. .( T ) removal of devitalized tissue 34. cytomegalovirus. a. .( F )is an adenovirus b. .( F ) may be cultured readily in cell free media c. .( T ) is a cause of fetal cerebral calcification d. .( T ) causes haemolytic anaemia in the neonate e. .( T ) may be transmitted in sali va

35. Concerning rubella. a. .( F )it has an incubation period of 7-10 days b. .( F ) recurrent infection is a common cause of congenital malformation c. .( F ) s pecific antibodies occur within 14 days of infection d. .( T ) individuals are i nfectious before the appearance of the rash e. .( T ) an attenuated live virus i s used in immunisation 36. Actinomyces israelii. a. .( F )is a rickettsia b. .( T ) forms yellow granul es in pus c. .( T ) is a commensal in the mouth d. .( T ) is a commensal in the vagina e. .( F ) is usually resistant to penicillin 37. Diseases caused by spirochetes include. a. .( T )Weil s disease b. .( F ) ly mphogranuloma venereum c. .( T ) pinta d. .( T ) Vincent s angina e. .( F ) bilh arzia 38. The following antibiotics act on bacterial cell walls. a. .( T )penicillin b . .( T ) ceftazidime c. .( F ) metronidazole d. .( F ) clindamycin e. .( F ) gen tamycin 39. Listeria monocytogenes. a. .( T )can grow at 6 C b. .( T ) is a gut commensa l c. .( F ) is a gram negative bacillus d. .( T ) infection is best treated with benzyl penicillin e. .( T ) is a cause of septicaemia in neonates

40. The following antibiotics are usually effective against Pseudomonas aerugino sa. a. .( F )cephradine b. .( F ) amoxycillin c. .( T ) carbenicillin d. .( T ) gentamicin e. .( F ) trimethoprim 41. metronidazole. a. .( T )is effective against giardia lamblia b. .( T ) is ef fective when administered per rectum c. .( F ) should not be administered intrav enously d. .( T ) is usually effective against Entamoeba histolytica e. .( T ) i nterferes with ethanol metabolism 42. The following have an anti-emetic action. a. .( T )hyoscine hydrobromide b. .( F ) morphine sulphate c. .( F ) chlorpropamide d. .( T ) promethazine hydroch loride e. .( T ) perphenazine 43. Beta sympathomimetic drugs may. a. .( F )cause bronchospasm b. .( T ) reduce the frequency of uterine contractions c. .( F ) cause heart block d. .( T ) red uce diastolic blood pressure e. .( T ) increase blood glucose concentration 44. The following substances are sympathomimetic amines. a. .( T )amphetamines b . .( T ) ephedrine c. .( F ) histamine d. .( T ) isoprenaline e. .( F ) chlorpro mazine

45. The following drugs can cause bronchoconstriction. a. .( T )propranolol b. . ( F ) atropine c. .( F ) morphine d. .( F ) ritodrine e. .( T ) aspirin 46. The following drugs have anticholinergic effects. a. .( T )propantheline bro mide b. .( F ) carbachol c. .( F ) distigmine bromide d. .( T ) benzhexol e. .( T ) atropine 47. Thiopentone sodium administered intravenously. a. .( F )is a potent muscle r elaxant b. .( T ) is predominantly excreted by the kidney c. .( T ) binds to pro tein d. .( T ) is fat soluble e. .( T ) crosses the placenta 48. Hypokalaemia may be caused by. a. .( T )bendrofluazide b. .( F ) digoxin c. .( F ) spironolactone d. .( T ) carbenoxolone e. .( F ) amiloride 49. The following statistical statements are correct. a. .( F )in the normal dis tribution the value of the mode is 1.73 x that of the median b. .( F ) in a dist ribution skewed to the right, the mea lies to the left of the medium c. .( T ) i n the series: 2;7;5;2;3;2;5;8, the mode is 2 d. .( F ) Students T-test is desig ned to correct for skewed distribution e. .( T ) the Chi-square test may be used when data are not normally distributed

50. In a randomized double blind trial comparing a new dug with a placebo. a. .( F ) the patients will be taking either of 2 active drugs b. .( F ) patients can choose their method of treatment c. .( F ) doctors prescribing treatment decide which patient stake the new drug d. .( T ) a large trial is more likely to give a statistically significant result than a small trial e. .( F ) half of the pat ients will take the new drug

march 2000 paper2 1. a. b. c. d. e. Concerning pH. .( F d predominantly by bicarbonate .( F )the higher the pH, ion concentration . ( F )the pH of gastric juice is 5.5 ecreases after the ingestion of ammonium chloride . ( F higher than that in plasma 2. a. b. c. d.

)in blood pH is regulate the higher the hydrogen . ( T )the pH of urine d )the pH inside cells is

In the adrenal cortex. .( T )ACTH controls the hydroxylation of cholesterol to p regnenolone .( T )oestradiol can be formed from testosterone . ( T )androstenedi one and testosterone are interconvertible . ( F )17 alpha hydroxyl progesterone is a breakthrough product of corticosterone e. . ( T )aldosterone is formed from corticosterone 3. a. b. c. d. e. The conversion of glucose to lactic acid. .( F )occurs in a single enzymatic rea ction .( T )is the only pathway for the synthesis of ATP in the red blood cell . ( F )is a reversible process in skeletal muscle . ( T )is inhibited by high cel lular concentrations of ATP . ( T )occurs in skeletal muscle when the availabili ty of oxygen is limited 4. a. b. c. d. e. glucagon. .( T ) is a polypeptide hormone .( F ) is secreted by the beta cells o f pancreatic islets .( F ) causes muscle glycogenolysis .( T ) has a half life o f 5-10 minutes in the circulation .( T ) secretion is stimulated by cortisol 5. Concerning prostaglandins. a. .( T ) arachidonic acid is a precursor for PG b iosynthesis b. .( T ) PG synthetase (cyclooxygenase) catalyses arachidonic acid conversion to PG endoperoxides c. .(F ) non steroidal anti inflammatory drugs in hibit PG dehydrogenase d. .( T ) mefenamic acid is a potent inhibitor of PG synt hesis than aspirin

e. .( F ) PGF2alpha is excreted unchanged in urine Amniotic fluid. .(F )at term is hyoerosmolar compared to fetal plasma .( F ) nor mally contais maternal and fetal cells .( T ) contains a higher concentration of alpha feto protein at 16 weeks than at term d. .( T ) contains bilirubin e. .( T ) contains phospholipids 6. a. b. c. 7. a. b. c. d. e. oestradiol. .( T )is formed by aromatization of testosterone .( F ) does not bin d to albumin .( T ) is formed in tissues other than ovaries .( T ) is the most a bundant oestrogen in late pregnancy .( F ) binds to a specific cell surface rece ptor 8. 2,3-DPG (diphosphoglycerate). a. .( T )is present at higher concentrations in maternal erythrocytes than fetal eryhtroctes b. .( T )binds more avidly to haem oglobi A than haemoglobin F c. . ( F )increases the affinity of haemoglobin for oxygen d. . ( F )is a phospholipid e. . ( F )is synthesised by the pentose phosp hate pathway 9. a. b. c. d. e. ethanol. .( F )consumed in excess stimulates fatty acid oxidation .( T )suppress es arginine vasopressin secretion . ( F )promotes gluconeogenesis . ( T )is oxid ized to acetaldehyde . ( T )is metabolized predominantly by the liver 10. glucocorticoids. a. .( T )promotes hepatic gluconeogenesis b. .( T )suppress uptake of glucose by muscles

c. . ( T )promote protein breakdown d. . ( T )promote fat breakdown e. . ( F )in crease glycolysis in adipose tissue 11. fibrinogen. a. .( F )levels are usually low during pregnancy b. .( T )is a s ubstrate for thrombin c. . ( F )at elevated plasma levels causes a reduction in the erythrocyte sedimentation rate d. . ( T )is synthesised in the liver e. . ( F )is a Bence Jones protein 12. Concerning maternal-fetal placental transfer. a. .( F )oxygen transfer is fa cilitated by the fetal oxygen dissociation curve being to the right of that of t he mother b. .( F ) bicarbonate ions diffuse across the placenta more easily tha n carbon dioxide c. .( F ) glucose is transferred by simple diffusion d. .( T ) IgG crosses the placenta e. .( F ) the placenta is impermeable to maternal keton e bodies 13. Vitamin K. a. .( T ) is synthesised by bacteria b. .( F ) is stored in large quantities in the liver c. .( T ) is necessary for the synthesis of factor VII d. .( T ) is necessary for the synthesis of factor IX e. .( T ) deficiency cause s hypothrombinaemia 14. Plasma concentrations of the following substances are typically raised in pr egnancy. a. .( T )caeruloplasmin b. .( F ) albumin c. .( F ) vitamin B12 d. .( F ) urea e. .( F ) pituitary gonadotrophins

15. In one turn of the tricarboxylic acid cycle. a. .( F )three molecules of car bon dioxide are produced b. .( T ) reduced NADH are produced c. .( T ) reduced F ADH2 are produced d. .( T ) GTP is produced e. .( T ) Acetyl coA is used 16. lactose. a. .( F )is a non reducing sugar b. .( T ) may be detected in the u rine of a normal pregnant woman c. .( F ) is a major constituent of seminal flui d d. .( T ) is galactosyl-glucose e. .( T ) is catabolised by the liver 17. Plasma low density lipoproteins. a. .( F )are less dense than chylomicrons b . .( F ) predominantly contain non-esterified fatty acids c. .( T ) are the main source of cholesterol for steroid synthesis d. .( F ) contain more protein by d ry weight than high density lipoproteins e. .( T ) attach to specific cell membr ane receptors 18. The ultrasound energy used in real time machine for diagnostic imaging. a. . ( T )is pulsed b. .( T ) has a velocity measured in metres per second c. .( T ) has a velocity which is the same in all human tissues d. .( F ) has a frequency measured in decibels e. .( F ) is entirely dissipated within the tissues 19. In the human. a. .( F )haploid cells contain homologus pairs of chromosomes b. .( T ) polypoid cells contain extra sets of chromosomes c. .( F ) monosomic c ells contain an extra chromosome d. .( T ) haploid cells contain 22 autosomes e. .( F ) chromosomes divide during the S phase of cell cycle

20. The following are inherited as autosomal recessive conditions. a. .( F )tube rous sclerosis b. .( T ) phenylketonuria c. .( F ) achondroplasia d. .( T ) sick le cell anaemia e. .( T ) Von Gierke s disease 21. Chromosomes. a. .( F )are found in the same number in all mammalian cells b. .( T ) can be analysed more quickly from a blood sample than from an amniotic f luid sample c. .( F ) can be reliably identified by their lengths d. .( F ) the Y chromosome is larger than the X chromosome e. .( T ) DNA content is doubled du ring the S phase of cell cycle 22. In DNA. a. .( T )a codon n identified funcion c. .( F e are different codons d. .( nt points along a chromosome RNA synthesis is a sequence of 3 bases b. .( F ) al codons have a ) there is a great variety of amino acids than ther T ) replication can be initiated at several differe e. .( T ) complementary pairing precedes messenger

23. Type III (immune complex) hypersensitivity is characterized by. a. .( F )dam age localized to a particular cell type b. .( F ) decreased vascular permeabilit y c. .( T ) microthrombus formation d. .( T ) complement activation e. .( F ) me diation by IgE antibodies 24. Steps involved in the identification of restriction fragment length polymorp hisms (RFLP) include. a. .( F )western blotting b. .( T ) restriction enzyme dig estion c. .( T ) southern blotting d. .( T ) agarose gel electrophoresis

e. .( F ) thin layer chromatography 25. The following are causes of hypokalaemia. a. .( F )ACE inhibitors b. .( F ) Addison s disease c. .( T ) diarrhoea d. .( F ) digoxin overdose e. .( T ) metab olic alkalosis 26. Features of disseminated intravascular coagulation include. a. .( F )thrombo cythaemia b. .( T ) petechiae c. .( T ) haemorrhage d. .( F ) reduced circulatin g fibrin degradation products e. .( T ) small vessel thrombosis 27. Granulation tissue contains the following. a. .( F )elastin fibres b. .( T ) inflammatory cells c. .( T ) capillaries d. .( F ) epithelioid cells e. .( T ) fibroblasts 28. In sarcoidosis. a. .( F )lesions are confined to the lung b. .( F ) the mant oux test is strongly positive c. .( T ) caseation is not present d. .( T ) the l esions contain giant cells e. .( T ) the Kveim test is useful adjunct to diagnos is 29. Wound healing is delayed by. a. .( F )insulin b. .( F ) ultraviolet light c. .( T ) zinc deficiency d. .( T ) low temperature

e. .( T ) glucocorticosteroids 30. Adenocarcinoma is the commonest type of primary malignant tumour to occur in the. a. .( F )bladder b. .( F ) lung c. .( F ) oesophagus d. .( T ) fallopian t ube e. .( F ) testis 31. The following provide conclusive evidence of pregnancy in uterine curettings . a. .( F )decidua compacta b. .( F ) Arias-Stella changes in endometrial glands c. .( F ) spiral arterioles d. .( F ) plasma cell infiltration e. .( T ) chorio nic villi 32. The parathyroid glands. a. .( F )originate from the pharyngeal cleft ectoder m b. .( T ) secrete PTH via the chief (principal) cells c. .( F ) secrete calcit onin via the oxyphyll cells d. .( T ) may become hyperplastic in the presence of intestinal malabsorption e. .( T ) may develop adenomas in association with isl et cell tumours of the pancreas 33. Complications of myocardial infarction include. a. .( T )fibrinous pericardi tis b. .( F ) aortic aneurysm c. .( T ) ventricular mural thrombus d. .( F ) cor onary atherosclerosis e. .( T ) ventricular aneurysm 34. Granulomatous inflammation occurs in. a. .( F )lobar pneumonia b. .( T ) pul monary tuberculosis

c. .( T ) sarcoidosis d. .( F ) staphylococcal infection e. .( T ) temporal arte ritis 35. The concentration of urine. a. .( T )is due to passive Reabsorption of water b. .( F ) is completed in the loop of Henle c. .( T ) occurs progressively alon g proximal tubule d. .( T ) is dependent upon arginine vasopressin e. .( T ) is reelaed to osmolarity of the interstitial fluid of the renal medulla 36. Concerning haematological changes during normal pregnancy. a. .( T )plasma v olume increases b. .( F ) the red cell mass decreases c. .( T ) ESR is increased d. .( F ) mean cell volume decreases e. .( T ) total iron binding capacity incr eases 37. Myometrial contractility. a. .( T )is calcium dependent b. .( T ) is associa ted with phosphorylation of myosin light chain c. .( F ) is independent of cycli c AMP d. .( F ) is mediated by somatic nerves e. .( T ) depends on myometrial ga p junctions 38. Brown adipose issue in the human infant is. a. .( T )more vascular than norm al adipose tissue b. .( T ) a site of heat production c. .( F ) found predominan tly in the abdominal wall d. .( T ) innervated e. .( F ) deficient in mitochondr ia 39. Angiotensin II. a. .( T )is a vasoconstrictor b. .( F ) decreases aldosteron e production

c. .( T d. .( F e. .( T ) is formed mainly in the lungs ) is a decapeptide ) is produced when the circul ating blood volume is reduced 40. A reduced arterial PCo2. a. .( T )occurs in normal pregnancy b. .( T ) occur s at altitudes over 2500 metres c. .( F ) increases cerebral blood flow d. .( T ) leads to a more alkaline urine e. .( F ) reduces blood pH 41. Gastrointestinal absorption of. a. .( F )dietary glucose depends upon intact pancreatic function b. .( F ) vitamin B12 requires gastric acid c. .( F ) fats is accomplished by the transport of chylomicrons from the intestinal lumen d. .( F ) iron may be reduced by vitamin C administration e. .( T ) unhydrolised poly saccharides does not occur 42. Mast cells. a. .( F )normally form 3% of circulating leucocytes b. .( T ) re lease histamine on degranulation c. .( T ) contain heparin d. .( F ) control mel anin formation in the epidermis e. .( F ) have a specific affinity for antibody of the IgA class 43. Characteristic features of Addisonian pernicious anaemia are. a. .( F )leuco cytosis b. .( F ) inheritance as autosomal dominant trait c. .( F ) a raised mea n corpuscular haemoglobin concentration d. .( T ) an increased incidence of gast ric neoplasia e. .( T ) an increased incidence of primary hypothyroidism

44. The events in normal Micturition in women include. a. .( F )contraction of t he perineal muscles b. .( F ) initial relaxation of detrusor muscle c. .( T ) a constant increase in intravesical pressure d. .( F ) no change in intravesical p ressure e. .( F ) urinary flow of a maximum of 5 ml per second 45. The following may occur in uncomplicated haemolytic anaemia. a. .( F )biliru binuria b. .( F ) high serum levels of unconjugated bilirubin c. .( T ) urobilin uria d. .( F ) high serum levels of alkaline phosphatase e. .( T ) reticulocytos is 46. During the normal cell cycle . a. .( F )the principal phase of deoxyribonucl eic acid (DNA) synthesis is G1 b. .( F ) a tetraploid quantity of DNA is present at the end of G2 c. .( F ) G2 is the post mitotic phase d. .( T ) cells are gen erally sensitive to anti-metabolites in the S phase e. .( F ) the DNA is complet ely replicated several times 47. In the fetal circulation. a. .( F )most of the blood from the superior vena cava passes directly from the right to the left atrium b. .( T ) the output of t he right ventricle is greater than that of the left c. .( T ) blood in the ascen ding aorta is more oxygenated than that in the descending aorta d. .( F ) blood in the right ventricle is more oxygenated than blood in the left ventricle e. .( F ) blood in the ductus arteriosus and the right atrium is equally oxygenated 48. The adult oxygen-haemoglobin dissociation curve is shifted to the left by. a . .( T )low temperature b. .( F ) low haemoglobin levels c. .( F ) high altitude d. .( F ) 2,3 DPG

e. .( T ) alkalosis 49. In a healthy woman, renin. a. .( F )is secreted only by the kidney b. .( T ) concentration is greater than in the non pregnant state c. .( T ) concentration is increased by diuretic therapy d. .( F ) converts angiotensinogen into angiot ensin II e. .( T ) activity is blocked by captopril 50. In the small intestine the following substances are absorbed by active proce sses. a. .(F )water b. .( T ) sodium c. .( F ) vitamin K d. .( T ) amino acids e . .( T ) chloride

september 2000 paper 1 1. a. b. c. d. e. The internal pudendal artery. .( F )lea ves the pelvis through the greater sciatic foramen .( F )lies on the medial wall of the ischiorectal fossa . ( T )has a branch which pierces the perineal membra ne . ( F )gives rise to the middle rectal artery . ( F )supplies the upper vagin a 2. a. b. c. d. e. The obturator artery. .( F )branches from the posterior trunk of internal iliac artery .( F )passes through the greater sciatic foramen . ( T )is crossed by the ureter . ( T )supplies the hip joint . ( F )may be replaced by a branch of the superior epigastric artery 3. a. b. c. d. e. The adult pituitary gland. .( F )contains the paraventricular nuclei .( T )is re lated to the sphenoidal bone . (T )lies inferior to the optic chiasma . (F )cont ains a pars tuberalis inferiorly . (T )is entirely ectodermal in origin 4. a. b. c. d. e. The following statements about the adrenal glands are correct. .(T ) the adrenal glands are anterior to the diaphragm .( T ) the right adrenal vein drains direc tly into the inferior vena cava .( F ) the lymphatic drainage is to the superfic ial inguinal nodes .( F ) the adrenal cortex contains chromaffin cells .( F ) th e adrenal medulla develops from mesoderm 5. a. b. c. d. e. The anal canal. .( T ) has an upper part which is innervated by the inferior hyp ogastric plexus .( F ) has a lower part which is supplied by the superior rectal artery .( F ) drains lymph to the superficial inguinal nodes from its upper par t .( F ) has its internal sphincter innervated by inferior rectal nerve .( T ) h as a superficial part of its external sphincter attached to the coccyx

6. a. b. c. d. e. The obturator nerve. .( F )emerges from the lateral border of the psoas .( F ) i s formed from the posterior division of the 2nd, 3rd, and 4th lumbar nerves .( T ) passes lateral to the internal iliac vessels .( F ) lies below the obturator artery in the obturator foramen .( T ) is separated from the normally sited ovar y only by the pelvic peritoneum 7. a. b. c. d. e. The hypothalamus. .( F )forms part of the mid-brain .( T ) is closely related to the optic chaisma .( T ) contains the paraventricular nuclei .( T ) is a centre for appetite control .( F ) has nerve connections with the anterior lobe of the pituitary gland 8. a. b. c. d. e. The ampulla of the fallopian tube. .( T )is the longest portion of the tube .( T )is developed from the paramesonephric duct . ( T )has complex folding of the m ucosa . ( F )is lined exclusively by ciliated columnar epithelium . ( F )has an internal longitudinal muscle coat 9. In the inguinal canal. a. .( F )the iliohypogastric nerve passes through the canal b. .( F )the inferior epigastric artery lies at the lateral boundary of th e deep inguinal ring c. . (T )the medial umbilical ligament crosses deep to the posterior wall d. . (F )the roof is formed by the external oblique muscle e. . ( T )the posterior wall is reinforced medially by the conjoint tendon 10. The pudendal nerve. a. .( F )contains fibres from the first sacral nerve b. .( F )lies lateral to the internal pudendal artery as it exits from the pelvis c . . ( T )contains sensory fibres from the lower vagina d. . ( T )contains sensor y fibres from the skin of the labium majus e. . ( F )innervates obturator intern us

11. The following are derived from the urogenital sinus. a. .( F )the bladder tr igone b. .( F )the ureters c. . (T )the female urethra d. . (T )greater vestibul ar glands e. . ( T )paraurethral glands 12. In the fetal circulation. a. .( F )the ductus venosus delivers blood directl y into the superior venal cava b. .( F ) the umbilical artery returns blood from the placenta c. .( F ) the ductus arteriosus carries blood to the lungs d. .( F ) blood returning from the lungs is 90% saturated with oxygen e. .( T ) blood f rom the inferior vena cava is largely directed through the foramen ovale 13. Following fertilization in the human. a. .( F ) the first polar body is form ed b. .( F ) the first cleavage division occurs within 12 hours c. .( F ) the zo na pellucid is shed at the second cleavage division d. .( T ) cleavage divisions are mitotic e. .( T ) the mean cell volume decreases with each cleavage divisio n 14. Parathyroid hormone. a. .( T )is a polypeptide b. .( T ) increases bone reso rption c. .( F ) decreases phosphate excretion in urine d. .( T ) secretion is d iminished by an increase in serum ionized calcium concentration e. .( F ) decrea ses the formation of 1,25 dihydroxycholecalciferol 15. In the renin angiotensin system. a. .( T )renin is an enzyme b. .( F ) angio tensin II is converted to angiotensin I c. .( T ) angiotensinogen is a globulin d. .( F ) renin release is inhibited by sodium restriction

e. .( T ) renin is present in amniotic fluid 16. Concerning thyroid function. a. .( F )thyroid binding globulin is found enti rely within the thyroid gland b. .( F ) triiodothyronine is mainly in the free f orm in the circulation c. .( T ) triiodothyronine acts more rapidly than thyroxi ne d. .( F ) a fall in thyroid binding globulin causes hypothyroidism e. .( T ) thyroxine is a major precursor of triiodothyronine 17. thyroxine. a. .(F )exists in the free state in the thyroid gland b. .( T ) i s more than 99% protein bound in plasma c. .( T ) is released by the fetal thyro id d. .( F ) in the unbound state in plasma is approximately equal in concentrat ion to unbound triiodothyronine e. .( F ) is actively transported across the pla centa 18. Recognized features of congenital adrenal hyperplasia in the female are. a. .( T )acute hypotension b. .( T ) enlargement of the clitoris c. .( F ) abnormal karyotype d. .( T ) hirsutism e. .( F ) absent uterus 19. Concerning sex hormones. a. .( T )the ovary secretes androstenedione b. .( T ) the ovary secretes testosterone c. .( F ) the ovary secretes dihydrotestoster one d. .( T ) SHBG concentrations are higher in women than in men e. .( F ) andr ogens bounds to protein have high biological activty 20. Adrenal androgens. a. .( F )are synthesised in the zona glomerulosa of the a drenal cortex b. .( T ) are secreted in excessive amounts in the presence of 11 B hydroxylase defeciency

c. .( T ) stimulate protein synthesis d. .( F ) consist mainly of testosterone e . .( T ) are secreted in increased amounts in response to a rise in ACTH 21. After the menopause. a. .( T )the plasma concentration of FSH increases b. . ( F ) the plasma progesterone concentration increases c. .( T ) oestrone is the oestrogen found in highest concentration in the plasma d. .( F ) the plasma test osterone concentration increases e. .( F ) the plasma prolactin concentration in creases 22. Serum concentrations of the following increase during pregnancy. a. .( T )SH BG b. .( T ) prolactin c. .( T ) total thyroxine d. .( F ) FSH e. .( T ) cortico trophin-releasing hormone 23. The release of catecholamines from the adrenal medulla increases. a. .( F )d uring sleep in healthy individuals b. .( T ) when the nerves to the adrenal glan d are stimulated c. .( F ) following an increase in blood sugar d. .( T ) immedi ately following a myocardial infarction e. .( T ) during acute haemorrhage 24. Human chorionic gonadotrophin. a. .(T )is not produced by the decidua b. .( F ) is biochemically indistinguishable from LH c. .( T ) is active if given to n onpregnant women d. .( F )production rises steadily throughout pregnancy e. .( F ) has no influence upon the production of oestrogens by the placenta 25. Human placental lactogen. a. .(T )concentration in maternal plasma is direct ly proportional to the functional mass of the placenta

b. c. d. e. .( T ) has a half life in the blood of less than 1 hour .( F ) is a steroid horm one .( T ) increases the mobilization of maternal free fatty acids .( F ) reache s the same concentration in fetal blood as in maternal blood at term 26. The secretion of growth hormone. a. .( F )occurs in the hypothalamus b. .( F ) ceases when the adult state is reached c. .( F ) is decreased during stress d . .( T ) is increased during fasting e. .( T ) is increased with exercise 27. Arginine vasopressin. a. .( T )is produced in the hypothalamus b. .( F ) is a polypeptide c. .( F ) is structurally similar to prolactin d. .( T ) controls water resorption by the kidney e. .( F ) decreases glomerular filtration 28. oxytocin. a. .( T )is released episodically b. .( F ) causes decreased renal tubular Reabsorption of water c. .( T ) is responsible for milk ejection d. .( F ) reduces intestinal peristalsis e. .( F ) inhibits prolactin secretion 29. The following agents cause myometrial contractions. a. .( F )magnesium sulph ate b. .( F ) nifedipine c. .( F ) progesterone d. .( F ) salbutamol e. .( F ) s odium nitroprusside 30. renin.

a. b. c. d. e. .( F .( T .( T .( T .( F )is secreted by the zona glomerulosa of the adrenal cortex ) is a proteolytic en zyme ) is secreted at an increased rate if the renal perfusion pressure falls ) acts upon circulating angiotensinogen ) is released in response to an increase i n extracellular fluid volume 31. Concerning viruses. a. .( F )the core of every virus contains RNA b. .( F ) the y usually produce intracellular toxins causing cell death c. .( T ) antibodi es are directed against capsular proteins d. .( T ) the y can only be grown in i ntact cells e. .( F ) interferons are synthetic antiviral substances 32. The following organisms are gram positive. a. .( T )streptococcus pneumoniae b. .( F ) Neisseria gonorrhoeae c. .( F ) salmonella typhi d. .( T ) lactobacil lus e. .( F ) Pseudoomonas aeruginosa 33. leptospirosis. a. .( F )is caused by a gram negative coccobacillus b. .( F ) is frequently transmitted to man from inanimate objects c. .( T ) can result in a severe form of jaundice d. .( F ) is a sexually transmitted disease e. .( F ) is transmitted in pasteurized cow s milk 34. The following disorders and organisms are correctly paired. a. .( T )ophthal mia neonatorum: Chlamydia trachomatis b. .( T ) chancroid: Haemophilus ducreyii c. .( F ) sleeping sickness: Leishmania donovani d. .( F ) ring worm: Trichinell a spiralis e. .( F ) non-specific urethritis: Toxoplasma gondii 35. Candida albicans.

a. b. c. d. .( T )is gram positive .( T ) is a commensal in the bowel .( T ) is sensitive to miconazole .( T ) causes secondary infection after treatment with broad spectru m antibiotics e. .( F ) is cultured on alkaline media 36. Concerning hepatitis B virus infection. a. .( F )vertical transmission does not occur b. .( T ) sexual transmission occurs c. .( F ) core antigenaemia indic ates high infectivity d. .( T ) hepatocellular carcinoma is a recognized complic ation e. .( T ) an effective vaccine is available 37. Pseudomonas aeruginosa. a. .( F )is non-motile b. .( F ) is gram positive c. .( T ) does not grow anaerobically d. .( F ) ferments lactose e. .( T ) produce s pigment 38. Oestrogen therapy raises the plasma concentrations of. a. .( T )thyroxine bi nding globulin b. .( F ) free cortisol c. .( T ) transferrin d. .( F ) albumin e . .( F ) folate 39. The following agents are bronchodilators. a. .( T )salbutamol b. .( F ) aten olol c. .( F ) prostaglandin F 2 alpha d. .( F ) morphine e. .( T ) prednisolone

40. Subcutaneous atropine injection characteristically produces. a. .( T )an inc rease in heart rate b. .( F ) an increase in salivation c. .( F ) constriction o f the pupil d. .( F ) an hypnotic effect e. .( T ) decreased bronchiolar secreti on 41. Concerning heparins. a. .(T )heparin is synthesised in the lungs b. .( T ) a ntithrombin III is necessary for standard heparins to exert their anticoagulant effect c. .( T ) Factor X is inhibited by low molecular weight heparins d. .( T ) low molecular weight heparins have a longer half life than standard heparins e . .( F ) penicillins potenitate the action of low molecular weight heparins 42. The following substances exert their diuretic actions upon the distal convol uted tubules. a. .(T )bedrofluaside b. .( F ) fusemide c. .( F ) bumetanide d. . ( F ) mannitol e. .( F ) alcohol 43. Clomifene citrate. a. .( F )is an anti-androgen b. .( T ) does not stimulate ovulation directly c. .( T ) can produce visual disturbances d. .( T ) is gener ally prescribed through out the proliferative phase of the menstrual cycle e. .( T ) in the treatment of anovulation, increases the risk of multiple pregnancy 44. The therapeutic effect of the first drug is enhanced by the second drug. a. .( F )phenytoin: ethinyloestradiol b. .( F ) bromocryptine: metoclopramide

c. .( T d. .( T e. .( F ) penicillin: probenecid ) ritodrine: dexamethasone ) warfarin: phenobarbitone 45. The following cytotoxic drugs are correctly classified. a. .(F )methotrexate : alkylating agent b. .( T ) cyclophosphamide: alkylating agent c. .( F )vinblas tine: antimetabolite d. .( T ) mercaptopurine: antimetabolite e. .( F ) fluoraci l: antibiotic 46. Halothane produces. a. .(T )cardiac arrhythmias b. .( F ) explosive mixtures with air c. .( T ) liver damage if given repeatedly d. .( T ) myometrial relaxa tion e. .( F ) bronchial irritation 47. In a sample of 1000 children, the birth weight was normally distributed with a mean of 3.5 Kg and a standard deviation of 700g. a. .( F )15 infants would be below the 5th centile for weight b. .( T ) the standard error of the birth weig ht would be about 22 g c. .( F ) the 95th centile for birth weight would be 4.2K g d. .( F ) no baby would weigh less than 1.4 Kg e. .( T ) the median birth weig ht would be about 3.5 Kg 48. If a distribution of results is markedly skewed to the left. a. .( F )the me an is the same as the 5oth centile b. .( T ) the same number of values lies on e ither side of the median c. .( F ) the mode is equal to the median d. .( F ) the student s t test should be used to compare this distribution with another e. .( F ) logarithmic transformation of the results will produce a distribution close r to the normal 49. In the statistical analysis of any group of numerical observations.

a. b. c. d. .( F )the mean is always less than the mode .( F ) the median value always lies at the mid-point of the range .( T ) standard deviation is always greater than t he standard error of the mean .( F ) the standard error of the mean is independe nt of the total number of observations e. .( T ) there are the same number of ob servations greater than and less than the median value 50. In a trial of oral hypoglycaemic agents, 42 patients were given drug A and 3 8 drug B. Blood glucose concentrations were measured before and after a single d ose of the drug. Drug B apparently caused a greater fall in blood glucose concen tration (P=0.06) . a. .( F )these results reach an accepted level of statistical significance b. .( T ) non-parametric statistical analysis should be used if da ta are not normally distributed c. .( F ) in biological terms, drugs A and B hav e been shown to be equally effective d. .( F ) 6% more patients responded to dru g A than drug B e. .( F ) unequal numbers in the two groups invalidate the trial

september 2000 paper 2 1. a. b. c. d. e. The oxidation of pyruvate to carbon dio xide. .( T )occurs exclusively in the mitochondria of the cell .( F )can occur u nder anaerobic conditions . ( T )involves intermediates which are also involved in amino acid catabolism . ( T )is regulated by the concentration of acetyl co A in the cell . ( T )is impaired in thiamine deficiency states 2. a. b. c. d. e. Enzyme activity can be modified by. .(T )concentration of the substrate .( T )co ncentration of the product . ( T )pH . ( T )temperature . ( T )concentration of coenzymes 3. a. b. c. d. e. The rate of transfer of a substance into a cell by active transport. .( T )may b e unrelated to concentration gradient .( F )is dependent upon molecular size . ( T )is temperature dependent . (T )has a fixed upper limit . (F )is not reduced b y the presence of a structurally similar substance 4. a. b. c. d. e. Fatty acids reaching the liver from the fat stores may be. .(T ) converted to gl ucose .( F ) conjugated with sulphate .( T ) metabolized in the tricarboxylic ac id cycle .( T ) incorporated into the endogenous triglyceride .( T ) converted i nto ketones 5. Concerning folic acid. a. .(T ) it is a water soluble vitamin b. .( T ) conve rsion of dihydrofolate to tetrahydrofolate is inhibited by methotrexate c. .( T ) red cell folate concentration can be reduced by phenytoin d. .( T ) tetrahydro folic acid is a carrier of 1 carbon units e. .( T ) it is involved in synthesis of purines

6. a. b. c. d. e. Effects of insulin include. .(T )increase in cellular growth .( T ) increased he patic glycogen synthesis .( F ) decreased glycogen synthesis in muscle .( T ) in creased uptake of potassium in muscle .( T ) increased uptake of potassium ions in adipose tissue 7. a. b. c. d. e. surfactant. .( F )is a carbohydrate .( F ) contains significant amount of 2,3 DP G .( T ) is produced by type II alveolar epithelial cells .( F ) is present in t he fetal lung at 24 weeks of gestation .( T ) production in the fetus is increas ed by glucocorticoids 8. a. b. c. d. e. histamine. .( F )is identical to bradykinin .( T )is a derivative of histidine . ( T )increases capillary permeability . ( T )promotes gastric acid secretion . ( F )inhibits the secretion of pepsin 9. a. b. c. d. e. Cholesterol is. .( T )synthesised in the liver .( F )a c-19 compound . (T )synth esised from acetate . (F )a major constituent of high density lipoprotein . (F ) predominantly excreted unchanged in the urine 10. Vitamin K is involved in the formation of. a. .(F )fibrinogen b. .( F )facto r VIII c. . (T )factor IX d. . ( T )prothrombin e. . ( F )heparin

11. Plasma albumin binds the following. a. .(T )free fatty acids b. .( F )trigly cerides c. . ( T )oestradiol d. . ( T )bilirubin e. . ( F )iron ions 12. Within 48 hours of a major surgical operations there is an increase in. a. . ( T )ACTH secretion b. .( T ) aldosterone secretion c. .( T ) Arginine vasopress in secretion d. .( F ) sodium excretion e. .( T ) potassium excretion 13. Metabolic acidosis. a. .( F ) can result from potassium deficiency b. .( F ) can result from excess consumption of sodium bicarbonate c. .( T ) leads to an alteration in plasma bicarbonate levels d. .( T ) occurs after the administratio n of ammonium chloride e. .( F ) can be caused by persistent vomiting 14. Conjugated bilirubin. a. .( F )is produced from haemoglobin b. .( F ) is a c onstituent of amniotic fluid in the second trimester c. .( F ) is lipid soluble d. .( F ) is conjugated by the action of alkaline phosphatase e. .( F ) has a no rmal blood level of about 5oo mg/l 15. RNA. a. .( F )contains deoxyribose b. .( F ) is composed of 2 nucleotide uni ts c. .( F ) is the main constituent of the chromosomes d. .( T ) is the main co nstituent of the ribosomes e. .( T ) is required during protein synthesis

16. Alkalosis can be caused by. a. .( T )excessive vomiting b. .( F ) cardiac fa ilure c. .( T ) hyperventilation d. .( T ) hyperaldosteronism e. .( F ) therapeu tic doses of magnesium trisilicate 17. Concerning radiotherapy. a. .(T )A Gray (100 rads) is a unit of energy absor ption b. .( F ) liver parenchyma is more radiosensitive than intestinal epitheli um c. .( F ) cells with a slow reproductive capacity are usually the most radios ensitive d. .( F ) the concentration of intracellular oxygen is inversely propor tional to the susceptibility of the cell to radiation damage e. .(T ) well diffe rentiated tumours show higher radiosensitivty than anaplastic tumours 18. The following disorders have an X-linked pattern of inheritance. a. .( T )G6 PD deficiency b. .( F ) Kleinfelter syndrome c. .( F ) adrenogenital synrome d. .( T ) haemophilia B e. .( F ) familial hypercholesterolaemia 19. In the female. a. .( F )only the X chromosome of maternal origin is active b . .( T ) the Barr body is sex chromatin c. .( F ) about 80% of PNL have a drumst ick of chromatin d. .( T ) an extra X chromosome is associated with 2 Barr bodie s e. .( T ) an extra X chromosome is associated with below average intelligence 20. The following statements relate to familial diseases. a. .( T )achondroplasi a is a dominant trait b. .( F ) babies with Down syndrome usually have 46 chromo somes c. .( T ) congenital pyloric stenosis is commoner in babies of affected pa rents than in general population

d. .(F ) all the daughters of a female carrier of red green colour blindness are themselves carriers e. .( F ) haemophilia occurs in all sons of an affected fat her 21. The following genetic disorders are inherited as autosomal recessives. a. .( F )Duchenne muscular dystrophy b. .( F ) Huntington s chorea c. .( T ) Tay-Sach s disease d. .( F ) retinoblastoma e. .( F ) achondroplasia

22. The following are structural abnormalities of chromosomes. a. .( T )deletion s b. .( T ) duplications c. .( F ) aneuploidy d. .( F ) polyploidy e. .( T ) tra nslocations 23. Concerning immunoglobulins. a. .( T )IgM contains 2 heavy chains b. .( T ) I gM is produced before IgG in the immune response c. .( F ) IgE is the principal immunoglobulin secreted by mucous membranes d. .( F ) IgA is the principal immun oglobulin involved in allergic reactions e. .( T ) IgA is secreted in breast mil k 24. B lymphocytes may. a. .( T )produce tumour necrosis factor b. .( F ) produce complement c. .( T ) present antigens to T cells d. .( T ) contribute to delaye d hypersensitivity e. .( T ) produce IgE 25. Antibodies play an important part in the development of. a. .( T )phagocytos is b. .( F ) the mantoux response

c. .( T d. .( F e. .( T ) erythroblastosis fetalis ) hyperemesis gravidarum ) anaphylaxis 26. The following agents are correctly paired with the named tumours. a. .( F )a drenergic steroids: vaginal clear cell adenocarcinoma b. .( T ) aflatoxins: live r cell carcinoma c. .( F ) B-naphthylamine: bronchial carcinoma d. .( T ) asbest os: peritoneal mesothelioma e. .( T ) vinyl chloride: hepatic angiosarcoma 27. The following are examples of type III hypersensitivity (immune complex) dis ease. a. .( F )autoimmune haemolytic anaemia b. .( T ) systemic lupus erythemato sus c. .( F ) glomerulonephritis d. .( F ) tuberculosis e. .( F ) sarcoidosis 28. Chemical mediators concerned in the production of an inflammatory response i nclude. a. .( T )5-hydroxytryptamine b. .( F ) aldosterone c. .( F ) glucocortic oids d. .( T ) bradykinin e. .( T ) leukotrienes 29. In cystic fibrosis, abnormalities are seen in the. a. .( T )pancreas b. .( T ) salivary glands c. .( F ) brain d. .( F ) kidneys e. .( T ) ileum 30. Immunodeficiency states may be associated with. a. .( T )viral infection of T lymphocytes

b. c. d. e. .( T .( T .( F .( T ) B cell lymphomas ) glucocorticoids administration ) haemolytic disease of the newborn ) untreated Hodgkin s lymphoma 31. The following statements relate to embryonic tumours. a. .(F )an ovarian ter atoma is usually malignant b. .( F ) a nephroblastoma may be benign c. .( T ) a neuroblastoma can arise in the adrenal medulla d. .( F ) a hamartoma is usually malignant e. .( T ) choriocarcinoma may arise in a teratoma 32. The parathyroid glands. a. .( F )originate from the pharyngeal cleft ectoder m b. .( T ) secrete parathyroid hormone via the chief cells c. .( F ) secrete ca lcitonin via the oxyphil cells d. .( T ) may become hyperplastic in the presence of intestinal malabsorption e. .( T ) may develop adenomas in association with islet cell tumours of the pancreas 33. The following conditions may lead to hydronephrosis. a. .( T )mercury poison ing b. .( T ) cervical carcinoma c. .( T ) renal calculi d. .( T ) renal vein th rombosis e. .( T ) posterior urethral valves 34. The following changes in ventilation occur during pregnancy. a. .( F )a decr ease in respiratory rate b. .( T ) a decrease in PCo2 c. .( T ) a decrease in re sidual volume d. .( T ) an increase in tidal volume e. .( T ) an increase in PO2 35. The following are required for haemostatic clot formation.

a. b. c. d. e. .( T .( T .( F .( F .( F )conversion of prothrombin to thrombin ) platelet phospholipids ) active convers ion of plasminogen to plasmin ) fibrin degradation products ) antithrombin 36. In the human neonate compared with the ility to conjugate bilirubin b. .( F ) the to bilirubin c. .( F ) heat regulation is lls have greater affinity for oxygen e. .( greater adult. a. .( T )the liver has less ab blood brain barrier is less permeable more efficient d. .( T ) red blood ce T ) the haemoglobin concentration is

37. In the cardiac cycle of a healthy adult at rest. a. .(T )the stroke volume i s about 70 ml b. .( F ) the duration of ventricular systole is about 10 times as long as that of ventricular diastole c. .( T ) the first heart sound correspond s to the closure of the atrioventricular valves d. .( F ) the apex beat can be f elt in the seventh intercostal space e. .( F ) the contraction is initiated by t he atrioventricular node 38. 2,3-DPG. a. .( T )is present at higher concentrations in maternal erythrocyt es than fetal erythrocytes b. .( T ) binds to HbA more avidly than to HbF c. .( F ) increases the affinity of haemoglobin for oxygen d. .( F ) is a phospholipid e. .( F ) Is synthesised by the pentose phosphate pathway 39. Digestive function in a healthy adult involves. a. .( F )decreased productio n of saliva following parasympathetic activity b. .( F ) voluntary oesophogeal c ontractions c. .( T ) release of gastrin from the antral portion of the stomach d. .( T ) delayed gastric emptying after a fatty meal e. .( T ) increased pepsin secretion with vagal stimulation

40. At puberty. a. .(F )the menarche is followed by the growth spurt b. .( T ) e arly menstrual cycles are frequently anovulatory c. .( F ) the germ cells in the ovary increases in number during this time d. .( T ) the age of menarche is ass ociated with the state of nutrition e. .( F ) the relative size of uterine body and cervix remains unaltered 41. The following values fall within er. a. .(F )residual urine of 100 ml ) bladder capacity of 900 ml d. .( T 0 cm H2O during early filling e. .(F nd the normal range for the adult female bladd b. .( T ) voiding volume of 250 ml c. .( F ) intravesical pressure rise of less than 1 ) maximum urine flow rate of 60 ml per seco

42. The parencymal cells of the liver. a. .( T )can convert fructose to glucose b. .( T ) synthesise urea c. .( T ) conjugate bilirubin d. .( T ) excrete bromsu lphthalein e. .( T ) synthesise cholesterol 43. In the testis. a. .( F )maturation from spermatogonia to spermatozoa takes a bout 29 days b. .( F ) sertoli calls can mature into spermatids c. .( F ) Leydig cells produce inhibin d. .( F ) LH inhibits the secretion of testosterone e. .( T ) large quantities of fructose are present in seminal fluid 44. Concerning the vagus nerve. a. .( T )when stimulated, it has little direct e ffect on the strength of the ventricular contraction b. .( T ) it contains affer ent nerve fibres c. .( F ) stimulation increases the heart rate

d. .( T e. .( T ) it innervates the jejunum ) it is involved in the Hering-Breuer reflex 45. In the normal subjects the in arterial PO2 from 13.1 KPa arterial pH from 7.36 to 7.48 (4 mmHg) o 8KPa (60mmHg) d. .( y following increase (98 mmHg) to 8 KPa c. .( T ) a change T ) administration ventilation. a. .( T )a change (60mmHg) b. .( F ) a change in in arterial PCO2 from 5.9 KPa of doxapram e. .( T ) pregnanc

46. Calcium in the serum of a healthy adult. a. .( F )constitutes 15% of total b ody calcium b. .( F ) is not involved in the extrinsic system of blood coagulati on c. .( T ) concentration is lowered by calcitonin d. .( F ) concentration norm ally falls after the menopause e. .( F ) is approximately 90% protein bound 47. In a healthy water b. .( T ) ) plasma volume ( F ) the plasma young, nonpregnant woman at rest. a. .(F )80% of body weight is 75% of extracellular fluid is outside the blood vessels c. .( F is about 5 litres d. .( F ) the pH of plasma is about 7.25 e. . osmolality is about 400mosmol/l

48. In the normal adult circulation. a. .( F )the pressure in the left ventricle during diastole is twice atmospheric pressure b. .( T ) the aortic blood pressu re during diastole is about two-thirds of that during systole c. .( T ) resistan ce in peripheral blood vessels is inversely proportional to the 4th power of the vessel radius d. .( F ) the arterioles are not subject to sympathetic stimulati on except during exercise e. .( F ) increased carotid sinus baroreceptors activi ty increases the heart rate

49. Recognized effects of pregnancy include. a. .( T )transient impairment of gl ucose tolerance b. .( T ) a raised glomerular filtration rate c. .( F ) a raised plasma concentration of free tyrosine d. .( F ) a reduced plasma concentration of alkaline phosphatase e. .( T ) an increased secretion of prolactin 50. The following substances are correctly paired with their site of release. a. .( T )acetylcholine: post-ganglionic parasympathetic nerve endings b. .( F ) no radrenaline: preganglionic sympathetic nerve endings c. .( T ) dopamine: hypotha lamus d. .( T ) oxytocin: posterior pituitary e. .( F ) GNRH: anterior pituitary

march 2001paper 1 1. a. b. c. d. e. The anal canal. .( T )has an upper part whic h is innervated by the inferior hypogastric plexus .( F )has a lower part which is supplied by the superior rectal artery . ( F )drains lymph to the superficial inguinal nodes from its upper part . ( F )has its internal sphincter innervated by the inferior rectal nerve . ( T )has a superficial part of its external sphi ncter attached to the coccyx 2. a. b. c. d. e. The pelvic splanchnic nerves. .( F )are derived from the posterior rami of the s acral spinal nerves .( T )supply afferent fibres . ( T )mix with branches of the sympathetic pelvic plexus . ( F )supply the ascending colon with motor fibres . ( T )supply the uterus with parasympathetic fibres 3. a. b. c. d. e. Concerning histological consequences. .( T )the round ligament contain smooth mu scle fibres .( T )the bladder epithelium has no mucus glands . (F )the whole of the urethra is lined by squamous epithelium . ( T )the sacroiliac joint has a sy novial membrane . ( F )skene s gland are present in the clitoris 4. a. b. c. d. e. The following statements about the diaphragm are correct. .( F ) the greater sci atic nerves pierce the central tendon .( T ) the aortic aperture transmits the t horacic duct .( F ) the vena caval aperture transmits the left phrenic nerve .( T ) the oesophogeal aperture transmits the vagus nerves .( F ) motor fibre suppl y is by the intercostals nerves 5. a. b. c. d. e. The pudendal nerve. .( F eaves the pelvis through pine on the lateral side ator ani .( T ) supplies ) arises from the posterior rami of S2,3 and 4 .( F ) l the lesser sciatic foramen .( F ) crosses the ischial s of the internal pudendal artery .( T ) supplies the lev the clitoris

6. a. b. c. d. e. The cervix. .( F )consists chiefly of smooth rt which is related anteriorly to the ureter h is covered with peritoneum anteriorly .( T pelvic splanchnic nerves .( F ) is lined in thelium 7. a. b. c. d. In the ovary. .( F )primordial germ cells are formed .( F ) primary oocytes have completed the first mitotic division by birth .( T ) the majority of primary oo cytes become atretic by puberty .( F ) fewer than 10 follicles start the process of antrum formation in each ovarian cycle e. .( F ) the second polar body is fo rmed at ovulation 8. a. b. c. d. e. The right ureter lies in close relationship to the. .( T )bifurcation of the rig ht common iliac artery .( T )infundibulopelvic ligament . ( T )uterine artery . ( F )inferior mesenteric artery . ( F )parietal attachment of the sigmoid mesoco lon 9. a. b. c. d. e. The adult female urethra. .( F )is 7cm in length .( F )is lined with columnar ep ithelium in its proximal half . (T )has mucus glands in its distal third . ( T ) passes through the perineal membrane . ( F )is surrounded by smooth muscle in it s middle third 10. The pelvic surface of the sacrum. a. .( T )gives origin to the piriformis mu scle b. .( F )gives origin to the levator ani muscle c. . (F )is broader in the male than in the female d. . ( F )transmits the dorsal rami of sacral nerves e. . ( F )is in contact with the anal canal muscle .( F ) has a supravaginal pa .( F ) has a supravaginal part whic ) has pain sensation carried by the its vaginal part by keratinized epi

11. Concerning the thigh. a. .( F )rectus femoris forms the lateral boundary of the femoral triangle b. .( F )the femoral nerve enters the thigh within the femo ral sheath c. . ( T )the ilioinguinal nerve innervates skin over its medial aspe ct d. . ( T )both the saphenous nerve and the femoral artery pass through the ad ductor canal e. . ( T )the lacunar ligament is the medial border of the femoral ring 12. Concerning the abdominal wall. a. .( F )the umbilicus is located in the terr itory of the L1 dermatome b. .( T ) the rectus abdominis muscle has attachments to the anterior wall of the rectus sheath c. .( F ) the left and right epigastri c arteries anastomose d. .( T ) distended veins radiating from the umbilicus are indicative of portal hypertension e. .( F ) Langer s lines run vertically over the lower abdomen 13. Concerning the embryology of the urinary tract. a. .( T ) the detrusor has a mesodermal origin b. .( T ) the urogenital sinus is derived from the cloaca c. .( F ) the allantois gives origin to the lateral aumbilical ligaments d. .( T ) the ureteric bud arises from the mesonephric duct e. .( T ) the mesonephric duct remnants forms the epoophoron in the adult female 14. In the fetal cardiovascular system. a. .( F )the heart arises from endoderm b. .( T ) the heart is formed by fusion of endocardial tubes c. .( T ) cardiac p ulsation is present by the 30th day after fertilization d. .( F ) oxygenated blo od is transferred from the left atrium through the foramen ovale e. .( F ) the d uctus arteriosus closes during the last 4 weeks of pregnancy 15. Glucagon promotes. a. .( T )hepatic gluconeogenesis

b. c. d. e. .( F .( F .( T .( F ) glucose uptake by muscle ) glycogen synthesis by muscle ) breakdown of protein ) synthesis of fat 16. Human insulin . a. .(T )is composed of 2 chains of amino acids b. .( T ) dif fers from pig insulin by 1 amino acid c. .( F ) facilitates glucose uptake by re d blood cell d. .( T ) increases protein synthesis in the liver e. .( T ) increa ses triglyceride deposition in adipose tissue 17. Thyroid hormones. a. .(T )increase oxygen consumption in most metabolically active tissue b. .( F ) in the circulation are less than90% bound to protein c. .( F ) decrease the rate of absorption of carbohydrates from the gut d. .( F ) i ncreases circulating cholesterol concentrations e. .( T ) are essential for skel etal maturation 18. In congenital adrenal cortical hyperplasia. a. .( F )the commonest deficienc y is C18 hydroxylase b. .( F ) plasma cortisol concentration is raised c. .( T ) urinary excretion of 17-oxysteroids is elevated d. .( T ) dexamethasone will su ppress the urinary excretion 17-oxysteroids e. .( F ) there are no virilising ef fects 19. The corpus luteum of pregnancy produces. a. .( T )relaxin b. .( T ) progeste rone c. .( T ) 17 alpha hydroxyprogesterone d. .(F ) human chorionic gonadotroph in e. .( T ) oestradiol

20. The hypothalamus is the site of synthesis of. a. .( T )oxytocin b. .( T ) th yrotrophin releasing hormone c. .( F ) alpha melanocyte stimulating hormone d. . ( F ) LH e. .( T ) gonadotrophin releasing hormone 21. Successful lactation is. a. .( F )maintained by oestrogens b. .( F ) maintai ned by progesterone c. .( F ) initiated by a prolactin surge d. .( F ) maintaine d by human placental lactogen e. .( T ) inhibited by dopamine 22. FSH. a. .( T b. .( T c. .( F d. .( F e. .( F )binds to a receptor on the cell membrane ) promotes the expression of LH recept ors ) is responsible for the degeneration of the corpus luteum ) is a steroid ho rmone ) is synthesised in the hypothalamus 23. Hirsutism in women is characteristically associated with. a. .( F )testicula r feminisation b. .( F ) Turner syndrome c. .( T ) the polycystic ovary syndrome d. .( T ) arrhenoblastoma e. .( F ) hypopituitarism 24. Parathyroid hormone. a. .( F )decreases the renal excretion of phosphate b. .( T ) increases calcium resorption from bone c. .( F ) depresses pituitary acti vity d. .( T ) concentrations in blood are raised when the calcium level falls e . .( T ) increases renal tubular Reabsorption of calcium

25. aldosterone. a. .( F )reduces sodium Reabsorption in the proximal convoluted tubules b. .( F ) reduces sodium absorptionin the descending loop of Henle c. . ( T ) increased sodium absorption in the distal convoluted tubules d. .( T ) inc reases potassium loss from the tubule e. .( T ) increases sodium absorption in t he collecting tubule 26. Human chorionic gonadotrophin. a. .( T )is a glycoprotein b. .( F ) secretio n peeks at 20 weeks of gestation c. .( F ) has intrinsic anti-thyroid activity d . .( F ) is synthesised by the corpus luteum of pregnancy e. .( T ) binds to LH receptors 27. Concerning the renin angiotensin system. a. .( F )renin is secreted by the p roximal tubule b. .( F ) renin is responsible for the conversion of angiotensin I to angiotensin II c. .( T ) angiotensin II is a potent pressor agent d. .( T ) the pressor effect of angiotensin II is suppressed in normal pregnancy e. .( T ) angiotensin II increases the secretion of aldosterone from the adrenal cortex 28. Ovaries secrete. a. .( T )progesterone b. .( T ) androstendione c. .( T ) te stosterone d. .( T ) 17B-oestradiol e. .( F ) aldosterone 29. Oestradiol-17B. a. .( T )is synthesised by aromatization of testosterone b. .( F ) can be administered orally c. .( F ) suppresses uterine activity by upreg ulating the oxytocin receptor d. .( F ) promotes secondary sexual hair growth in females e. .( T ) is thrombogenic

30. Concerning the hypothalamopituitary axis. a. .( F )secretion of LH is indepe ndent of gonadotrophin releasing hormone b. .( T ) GnRH neurons are absent in Ka llaman syndrome c. .( T ) oestradiol has an acute positive feedback effect on go nadotrophin secretion d. .( T ) oestradiol has a chronic negative feedback actio n on gonadotrophin secretion e. .( T ) the preovulatory rise in gonadotrophin re leasing hormone secretion is due to an increase in gonadotrophin releasing hormo ne pulse frequency 31. The following are RNA containing viruses. a. .( T )coxsackie b. .( T ) influ enza c. .( T ) mumps d. .( F ) herpes simplex e. .( F ) cytomegalovirus 32. exotoxins. a. .( F )are derived from gram negative bacteria b. .( T ) have a specific action c. .( T ) are more toxic than endotoxins d. .( T ) are neutrali zed by their homologus antitoxin e. .( T ) can be converted to toxoid 33. Candida albicans. a. .( T )is a commensal organism in the bowel b. .( F ) is gram negative c. .( T ) forms pseudohyphae d. .( F ) is sensitive to gentamicin e. .( T ) reproduces by budding 34. Listeria monocytogenes. a. .( F )is a gram negative organism b. .( T ) is se nsitive to ampicillin c. .( T ) may cause a transplacental infection

d. .( F e. .( T ) is sexually transmitted ) can be cultured from a high vaginal swab 35. Leptospirosis (Weil s disease). a. .( F )produces a positive Wasserman react ion b. .( T ) is associated with jaundice c. .( T ) is transmitted to humans fro m rats d. .( T ) infection is usually via the skin e. .( F ) is a Rickettsial in fection 36. BCG vaccination of previously uninfected person. a. .( F )produces local ery thema within 24 hours b. .( T ) results in regional lymph node enlargement c. .( T ) produces visible reaction within 3 days d. .( F ) should be given intramusc ularly e. .( F ) is ineffective in the newborn 37. The causative organism of. a. .( F )condyloma lata is Neisseria gonorrhoea b . .( T ) chancroid is Haemophilus ducreyii c. .( T ) granuloma inguinale is Dono vania granulomatis d. .( F ) primary chancre is Treponema pertenue e. .( F ) Yaw s is Gardnerella vaginalis 38. The following organisms are gram positive. a. .(F )Mycobacterium tuberculosi s b. .( T ) Staphylococcus epidermidis c. .( T ) Closteridium perfringens d. .( F ) Klebsiella pneumoniae e. .( F ) Bacteroides fragilis 39. The following drugs should be avoided in renal impairment. a. .( T )cephalot hin b. .( T ) cisplatin c. .( F ) noresthisterone

d. .( F e. .( T ) dopamine ) gentamicin 40. The following compounds are predominantly progestogens. a. .( F )busereline b. .( T ) dydrogesterone c. .( T ) norethisterone d. .( T ) 17 alpha hydroxyprog esterone e. .( F ) androstenedione 41. The following substances lower the blood glucose concentration. a. .( F )adr enaline b. .( T ) chlorproamide c. .( F ) chlorothiazide d. .( T ) metformin e. .( F ) thyroxine 42. The following drugs stimulate myometrial contractility. a. .( T )vasopressin b. .( F ) nifedipine c. .( F ) hydralazine hydrochloride d. .( F ) salbutamol e . .( F ) indomethacin 43. The following are beta-sympathomimetic effects. a. .( F )constriction of bro nchioles b. .( T ) increased heart rate c. .( F ) a decrease in the force of car diac contraction d. .( F ) constriction of arterioles in the skin e. .( T ) incr eased glycogenolysis in skeletal muscle 44. The following statements about anticoagulants are correct. a. .( T )heparin inhibits the action of thrombin

b. c. d. e. .( F .( T .( F .( T ) the action of heparin is antagonized by vitamin K ) heparin increases antithro mbin III activity ) the effects of coumarin anticoagulants are decreased by metr onidazole ) warfarin is greater than 80% protein bound in plasma 45. The following stimulate peristalsis in large bowel. a. .( F )opiates b. .( T ) liquid paraffin c. .( F ) suxamethonium chloride d. .( T ) neostigmine e. .( T ) senna glycoside 46. The following drugs and side effects are associated. a. .( T )methyl dopa: d epression b. .( F ) paracetamol: thromboembolism c. .( T ) indomethacin: peptic ulcer d. .( T ) prednisolone: osteoporosis e. .( F ) ritodrine: hypoglycaemia 47. Co-trimoxazole. a. .( T )contains 2 different drugs b. .( T ) inhibits folic acid synthesis c. .( T ) potentiates the action of warfarin d. .( F ) is bacter iostatic e. .( T ) displaces methotrexate from protein binding sites 48. One hundred women at high risk of ovarian carcinoma have a pelvic ultrasound scan. The findings after scan and surgery are shown in table:. Pelvic scan Abno rmal Normal total a. .(F Ovarian cancer present Absent 15 20 5 60 20 80 total 35 65 100 )the sensitivity of the scan is 25%

b. c. d. e. .( T .( F .( T .( T ) the specificity of the scan is 75% ) the prevalence of ovarian carcinoma is 25 % ) there are 15 true positive cases ) 75% of patients with ovarian carcinoma ha d positive scans 49. Concerning the analysis of clinical trials. a. .( T )the 95% confidence inte rval indicates the range within which 19 out of 20 values will lie b. .( T ) the P value illustrates how often the result would be expected to occur by chance c . .( F ) the conventional level of statistical significance is set at P0.005 d. . ( F ) in a randomized trial, there must be equal numbers of recruits in each arm of the study e. .( F ) a relative risk reduction of 60% is significant irrespec tive of the value of P 50. Concerning the ability of a test to predict a disease. a. .(T )sensitivity i s the ability to predict those with disease correctly b. .( F ) sensitivity is t he same as positive predictive value c. .( F ) the confidence interval must cros s 1 to prove significance d. .( F ) an odds ratio of 1:3 implies a risk of 33% e . .( F ) an odds ratio of 2 indicated a halving of risk

March 2001 paper2 1. a. b. c. d. e. Uric acid. .( T )is formed from the breakdow n of purines .( F )serum concentrations are raised during normal pregnancy . ( T )serum concentrations are increased during thiazide dieuretic therapy . ( T )is reabsorbed in the proximal renal tubule . ( T )is excreted unchanged in the uri ne 2. a. b. c. d. e. The level of serum uric acid characteristically. .( T )falls with starvation .( T )is higher in men than in women . ( F )rises on taking corticosteroid therapy . ( F )falls on treatment with 5 g of aspirin daily . ( T )increases in acute le ukaemia 3. a. b. c. d. e. Renal sodium retention is favoured by. .( T )a high glomerular filtration rate . ( T )increased secretion of renin . ( T )haemoconcentration . ( F )expansion of plasma volume . ( T )a low renal blood flow 4. a. b. c. d. e. Deficiency of the following substances and diseases are correctly matched. .( F ) thiamine: pellagra .( F ) cyanocobalamin: microcytic anaemia .( F ) niacin: be riberi .( T ) folates: sprue .( F ) ascorbic acid: night blindness 5. a. b. c. d. e. Fetal pulmonary surfactant. .( F ) contains less than 10% lipid .( T ) can be de tected in amniotic fluid .( T ) contains phosphaidylglycerol .( T ) is predomina ntly dipalmitol-phosphatidylcholine .( F ) is more than 40% albumin

6. a. b. c. d. e. Potassium. .( T ) is mainly intracellular .( F ) plasma levels vary in proportio n to intracellular levels .( F ) plasma levels are decreased in Addison s diseas e .( T ) plasma levels are increased in diabetic ketoacidosis .( T ) deficiency occurs with prolonged vomiting 7. In the neonate at birth. a. .( T )oxygenated haemoglobin is a poorer buffer t han deoxygenated haemoglobin b. .( T ) more than 50% of the circulating haemoglo bin is haemoglobin F c. .( T ) oxygen dissociation from haemoglobin is promoted by acidosis d. .( T ) the total haemoglobin concentration is generally above 15g /dl e. .( F ) red blood cell 2,3 DPG acid is absent 8. a. b. c. d. e. DNA. .( F )contains no cytosine .( F )has a back bone of ribose . ( F )is usuall y single stranded in mammalian cells . ( T )is cleaved by restriction enzymes . ( T )is irreversibly damaged in vitro by heating to 75 C 9. a. b. c. d. e. glycogen. .( T )is a polymer of glucose residues .( T )is predominantly found in cytoplasm . ( T )is mainly stored in the liver . ( T )is cleaved by phosphoryla se . ( F )breakdown is inhibited by adrenaline 10. Biochemical abnormalities associated with diabetes mellitus include. a. .( T )increased breakdown of protein b. .( F )decreased plasma levels of free fatty acids c. . ( T )increased serum cholesterol concentrations d. . ( F )decreased g lycosylation of haemoglobin e. . ( F )a decrease in the plasma concentration of low density lipoprotein

11. Concerning carbohydrates. a. .( T )sucrose is a disaccharide of glucose and fructose b. .( F )cereal grains contain less than 40% starch c. . (F )cellulose is a fructose polysacharide d. . (F )a normal diet contains less than 60 g of ca rbohydrate daily e. . (T )dietary carbohydrate is oxidized in the body to carbon dioxide and water 12. Muscle glycogen. a. .( T )metabolism cannot yield free glucose b. .( F ) met abolism is independent of the enzyme phosphorylase c. .( F ) metabolism only gen erates ATP under anaerobic conditions d. .( T ) is entirely intracellular e. .( T ) is released into the circulation in response to glucocorticoids 13. The following result in metabolic acidosis. a. .( T ) ketoacidosis b. .( F ) muscular exercise c. .( T ) renal failure d. .( F ) hypoxia e. .( F ) acute res piratory failure 14. L-glucose is. a. .( F )a pentose b. .( T ) an aldose c. .( F ) a ketose d. . ( T ) a mirror image of D-glucose e. .( F ) identical in biological activity to D-glucose 15. glucose. a. .( F )is predominantly absorbed in terminal ileum b. .( F ) stim ulates the secretion of glucagon c. .( T ) can be synthesised from pyruvate d. . ( F ) is a disaccharide e. .( F ) is the only metabolic substrate for cardiac mu scle

16. Concerning radiation physics. a. .( F )an electron has a greater mass than a proton b. .( F ) a positron has the same charge as an electron c. .( T ) a prot on has a positive charge d. .( T ) a neutron has almost the same mass as a proto n e. .( F ) the hydrogen nucleus is a neutron 17. Messenger RNA (mRNA). a. .( T )synthesis is catalysed by RNA polymerase b. . ( T ) is an exact copy of sense DNA c. .( T ) contains exons d. .( F ) is measur ed by western analysis e. .( F ) translation occurs in the nucleus 18. Concerning the genetic control of protein synthesis. a. .( F )mature messeng er RNA contains introns b. .( T ) a codon has 3 base sequences c. .( F ) each am ino acid has a single codon d. .( T ) transfer RNA has anticodon recognition sit es e. .( T ) each transfer RNA carries a specific aminoacid 19. In an X-linked pedigree. a. .( T )none of the sons of an l be affected b. .( F ) half of the daughters of an affected the gene c. .( T ) half of the sons of carrier females will ) females are never affected e. .( F ) all of the daughters will themselves be carriers affected father wil male will not carry be affected d. .( F of a carrier female

20. The following genes and chromosomes are correctly paired. a. .( T )HLA: chro mosome 6 b. .( T ) clotting factor 8: X chromosome c. .( T ) G6PD: X chromosome d. .( F ) testis determining factor: X chromosome e. .( F ) Xg blood group type: chromosome 1

21. In the human a haploid number of chromosomes is found in. a. .( F )red blood cells b. .( F ) blastocysts c. .( F ) primary oocytes d. .( T ) the first polar body e. .( T ) spermatozoa 22. Plasma cells. a. .( T )are increased in myeloma b. .( T ) are characteristic of acute infection c. .( F ) are phagocytic d. .( T ) synthesises immunoglobuli ns e. .( T ) are derived from B lymphocytes 23. The following are recognized functions of T lymphocytes. a. .( F )antibody p roduction b. .( T ) cell mediated immunity c. .( T ) immune regulation d. .( F ) phagocytosis e. .( T ) cytokine production 24. Tissue macrophages. a. .( T )are found in placental villous stroma b. .( F ) express HLA class I but not HLA class II surface antigens c. .( T ) have role i n protection against intracellular pathogens d. .( T ) are phagocytic e. .( F ) are derived from circulating plasma cells 25. Osteoporosis is associated with. a. .( F )an increase in uncalcified bone ma trix b. .( F ) prolonged oestrogen therapy c. .( T ) long term heparin treatment d. .( T ) bone fractures e. .( F ) irregularity of epiphyseal plates

26. The following are X-linked disorders. a. .( F )myotonic dystrophy b. .( T ) Duchenne muscular dystrophy c. .( T ) haemophilia A d. .( F ) Huntington s disea se e. .( T ) fragile X syndome 27. A metabolic process is involved in the histogenesis of the following tumours . a. .( F )squamous cell carcinoma of the vulva b. .( T ) squamous cell carcinom a of the bronchus c. .( F ) scirrhous carcinoma of the breast d. .( F ) adenocar cinoma of the cervix e. .( F ) adenocarcinoma of the ovary 28. Amyloid. a. .( F )is predominantly intracellular b. .( F ) contains fibrils c. .( F ) is enzymatic d. .( T ) can be found in nerve tissue e. .( T ) deposits occur with chronic sepsis 29. The following tumours are correctly paired with likely causative agents. a. .( T )angiocarcinoma of the liver: vinyl chloride b. .( F ) carcinoma of the col on: dietary fibre c. .( T ) hepatoma: aflatoxins d. .( T ) carcinoma of the bron chus: coal dust e. .( T ) carcinoma of the bladder: beta naphthylamine 30. Tetany may occur as a complication of. a. .( F )osteoporosis b. .( F ) hyper capnia c. .( F ) respiratory acidosis d. .( F ) peripheral neuropathy e. .( F ) untreated hyperparathyroidism

31. Stored blood which is to be used for transfusion. a. .( F )is kept at -4 C b . .( F ) must be used within 1 week c. .( F ) is tested for complement content b efore transfusion d. .( F ) may be used for platelet replacement e. .( T ) conta ins an acid anticoagulant 32. In uncomplicated homozygous beta thalassaemia there is. a. .( T )hypochromas ia b. .( F ) a reduction in haemoglobin A2 c. .( T ) an increase in haemoglobin F d. .( F ) megaloblastic erythropoiesis e. .( F ) red cell sickling 33. Neutrophil polymorphs at the site of inflammation are capable of the followi ng. a. .( T )phagocytosis b. .( T ) production of oxygen free radicals c. .( F ) replication d. .( F ) fusion to form giant cells e. .( F ) antibody production 34. The following are consequences of pulmonary embolism. a. .( T )pulmonary inf arction b. .( T ) fibrinous pleurisy c. .( T ) right ventricular hypertrophy d. .( T ) sudden death e. .( T ) haemoptysis 35. Apoptosis. a. .( F )causes necrotic cell death b. .( T ) is involved in embr yonic remodelling c. .( F ) releases proinflamatory mediators d. .( T ) is chara cterized by condensation of nuclear chromatin e. .( T ) is associated with endon uclease activity

36. Concerning cells. a. .( F )glycosylation takes place in the smooth endoplasm ic reticulum b. .( T ) low density lipoproteins attach to cell membrane receptor s c. .( F ) glycoproteins are present on the cytosol surface of the plasma membr ane d. .( T ) centrioles are composed of tubulin e. .( T ) nuclear heterochromat in is genetically inactive 37. Concerning oxygenation of fetal blood. a. .( T )the feto-maternal PCo2 gradi ent facilitates maternal-fetal oxygen transfer b. .( T ) fetal haemoglobin is le ss influenced by 2,3 DPG concentration than adult haemoglobin c. .( F ) the feta l blood oxygen dissociation curve lies to the right of the maternal curve d. .( T ) the upyake of oxygen decreases fetal red cell buffering capacity e. .( F ) u ptake of oxygen by fetal blood is associated with a shift of chloride into fetal red cells 38. The Leydig cells of the testis. a. .( F )secrete seminal fluid b. .( T ) are stimulated by LH c. .( T ) are active in intrauterine life d. .( F ) secrete fr uctose e. .( T ) produce androstenedione 39. In the non-pregnant woman during cardiac cycle. a. .( F )atrial contraction occurs in early stages of ventricular filling b. .( T ) adrenergic stimulation i ncreases the heart rate c. .( F ) the first heart sound is caused by closure of the aortic valves d. .( F ) stroke volume at rest is 200ml e. .( F ) the peak pr essure in the pulmonary arterial system is less than one-tenth of that in the sy stemic circulation 40. The blood concentration of the following are lowered in pregnancy. a. .( T ) bicarbonate b. .( F ) transferrin

c. .( T ) sodium d. .( T ) albumin e. .( F ) fibrinogen 41. Plasminogen is. a. .( F )alpha globulin b. .( F ) activated by alpha 2-macro globulin c. .( F ) inhibited by streptokinase d. .( F ) formed from plasmin e. . ( F ) released from plasma cells 42. The conjugation of bilirubin. a. .( T )takes place in hepaocytes b. .( T ) i s catalysed by UDP glucuronyl transferase c. .( F ) is inhibited by phenobarbito ne d. .( T ) renders it water soluble e. .( F ) is impaired in acute biliary obs truction 43. Angiotensin II. a. .(T )is a vasoconstrictor b. .( F ) reduces aldosterone p roduction c. .( T ) is mainly found in the lungs d. .(F ) is a decapeptide e. .( T ) is produced when the extracellular fluid volume is reduced 44. The following factors increase ventilation in normal women. a. .( T )a rise in PCo2 from 5.3 KPa to 8 KPA (40-50 mmHg) b. .( T ) a fall in Po2 from 13.1 KPa to 11.7 KPa (98-88 mmHg) c. .( T ) pregnancy d. .( T ) a fall in pH from 7.4 to 7.3 e. .( T ) taking a combined oral contraceptive pill 45. The stroke volume of the left ventricle.

a. .( F )is equal to the blood volume in the ventricle at the end of diastole b. .( T ) may be increased without increasing the end diastolic volume of the vent ricle c. .( T ) is directly related to the duration of the previous diastolic pa use d. .( F ) is consistently greater than that of the right ventricle e. .( F ) is 20-30 ml in a resting man of average size in supine position 46. In normal pregnancy, uterine blood flow. a. .( F )is about 50 ml/minute at t erm b. .( T ) within the choriodecidual space is maintained throughout the cardi ac cycle c. .( F ) is reduced by prostacyclin d. .( F ) is increased during uter ine contractions e. .( F ) represents about 10% of the cardiac output by the end of the first trimester 47. The following increase during normal pregnancy. a. .( T )the basal metabolic rate b. .( T ) serum cholesterol concentration c. .( F ) fasting blood glucose concentration d. .( F ) serum sodium concentration e. .( T ) serum fibrinogen co ncentration 48. Physiological changes associated with pregnancy include. a. .( T )a rise in ESR b. .( T ) a rise in total body haemoglobin c. .( F ) a fall in plasma fibrin ogen concentration d. .( T ) an increase in the total number of leucocytes e. .( F ) an increase in blood urea concentration within the first trimester 49. Concerning human parturition. a. .( T )the number of oxytocin receptors in t he myometrium increases before the onset of labour b. .( F ) in the primigravida cervical dilatation usually precedes cervical effacement c. .( F ) the plasma o xytocin concentration increases at the onset of labour d. .( T ) oxytocin stimul ates the synthesis of prostaglandin within the uterus

e. .( F ) contraction of the maternal abdominal muscles is essential foe spontan eous vaginal delivery 50. In normal pregnancy. a. .(F )trophoblast cells initially invade uterine spir al arterioles at 16-18 weeks of gestation b. .( T ) villous cytotrophoblast form s a layer beneath the syncytiotrophoblast in early pregnancy c. .( F ) the syncy tiotrophoblast is the only cellular layer between maternal and fetal blood d. .( F ) syncytial knots in the placenta are composed of aggregates of cytotrophobla st e. .( T ) trophoblast cells invade the myometrium

September 2001 pithelium .( T peritoneum in nal iliac vein

paper1 1. a. b. c. d. e. The vagina. .( T )is lined by squamous e )is supplied in part by the uterine artery . ( F )is covered with its upper anterior aspect . ( T )has venous drainage to the exter . ( T )is supplied in part by the pudendal nerve

2. a. b. c. d. e. The following muscles are inserted into the perineal body. .( T )bulbospongiosus .( F )ischiocavernosus . (F )obturator internus . ( T )external anal sphincter . ( T )superficial transverse perineal 3. In the abdominal wall. a. .( T )the rectus abdominis muscle is attached to th e crest of the pubis b. .( F )the posterior border of the external oblique muscl e ends in the linea semilunaris c. . (F )the aponeurosis of the external oblique muscle takes part in the formation of the conjoint tendon d. . (F )the inferior epigastric artery is a branch of the internal iliac artery e. . ( T )the conjoi nt tendon bends medially with the anterior layer of the rectus sheath 4. a. b. c. d. e. In the pituitary gland. .( F ) the anterior lobe is smaller than the posterior . ( T ) the posterior lobe is ectodermal in origin .( F ) the acidophil cells prod uce oxytocin .( F ) the basophil cells produce growth hormone .( T ) the blood s upply is derived from the internal carotid artery 5. a. b. c. The pineal gland. .( F ) is situated at the anterior end of the third ventricle .( F ) is innervated by the parasympathetic nervous system .( T ) produces melat onin

d. .( T e. .( F ) may be calcified in adult ) is most active during daylight 6. a. b. c. d. e. The pelvic splanchnic nerves. .( F )are derived from the posterior rami of the s acral spinal nerves .( T ) supply afferent fibres .( T ) intermingle with branch es of the sympathetic pelvic plexus .( F ) supply the ascending colon with motor fibres .( T ) supply the uterus with parasympathetic fibres 7. a. b. c. d. e. The parasympathetic nervous system supplies. .( F )dilator fibres to the bronchi oles .( T ) constrictor fibres to the small intestine .( T ) inhibitory fibres t o the myocardium .( F ) dilator fibres to the sphincter pupillae .( T ) constric tor fibres to the detrusor muscle 8. a. b. c. d. e. The ovary. .( F )is attached to the anterior surface of the broad ligament .( F )lies on the genitofemoral nerve . ( T )lies in the angle between the ureter and the external iliac vessels . ( F )has visceral afferent fibres from the pelvic splanchnic nerves . (F )has lymphatic drainage to the superficial inguinal lymph nodes 9. a. b. c. d. e. The ureter. .( T )is supplied in part by the ovarian artery .( T )lies lateral t o the transverse processes of the lumbar vertebrae . ( T )passes above the genit ofemoral nerve . ( F )is lined by simple columnar epithelium . ( T )passes benea th the uterine artery 10. In the normal human pelvis. a. .( T )the promontory of the sacrum is the upp er anterior border of the first sacral vertebra b. .( F )the anterior surface of the sacrum has five paired foramina

c. . ( F )the joint between the 2 pubic bones is a synovial joint d. . ( F )the acetabular fossa is wholly formed from parts of the pubic and ischial bones e. . ( T )the transverse diameter of the brim is greater than the anteroposterior di ameter 11. The femoral ring. a. .( F )has the pectineal ligament lying medial to it b. .( F )is in contact with the femoral artery c. . ( F )has the lacunar ligament l ying anterior to it d. . ( T )contains a lymph node that drains the clitoris e. . ( F )has the femoral sheath lying anterior, posterior and medial to it 12. Concerning the uterus. a. .( F )I is formed from the mesonephric ducts b. .( T ) it has a lymphatic drainage in part to the inguinal glands c. .( F ) the ut erine artery passes below the ureter d. .( T ) the uterine veins communicate wit h the vesical plexus of veins e. .( F ) pain sensation from the body of the uter us is carried by the pelvic splanchnic nerves 13. The mesoderm gives rise to. a. .( T ) striated muscle b. .( T ) blood c. .( T ) peritoneum d. .( F ) transitional epithelium of the bladder e. .( T ) ovaria n stroma 14. Concerning embryological development. a. .( F )the amnion has an endodermal origin b. .( T ) uterine epithelium is developed from the paramesonephric duct c . .( F ) the ducts of Bartholin s glands open above the hymen d. .( T ) the roun d ligament of the uterus is derived from the gubernaculum e. .( F ) the adrenal cortex is derived from neural crest cells

15. Concerning insulin. a. .( F )the half life of endogenous insulin in the circ ulation is 30 minutes b. .( F ) the kidney is a major site of insulin degradatio n c. .( F ) it facilitates glucose uptake by the brain d. .( F ) fasting concent rations are lower in pregnant women at term than they are in nonpregnant women e . .( T ) it is formed when C-peptide is separated from proinsulin 16. Iodine . a. .( F )requirements are unchanged by pregnancy b. .( T ) uptake b y the thyroid gland is increased by TSH c. .( T ) is excreted by the kidney d. . ( T ) is bound o tyrosine in the thyroid gland e. .( T ) may inhibit thyroxine s ynthesis 17. Concerning thyroid function. a. .( T )oestrogen increases the production of thyroxine binding globulin b. .( F ) more than 98% of the circulating thyroxine is bound to thyroxin binding globulin c. .( F ) thyrotrophin releasing hormone i s a decapeptide d. .( T ) TSH levels are increased in primary hypothyroidism e. .( T ) TSH is a glycoprotein 18. The interstitial Leydig cells of the testis. a. .( F )secrete seminal fluid b. .( T ) are stimulated by LH c. .( F ) secrete androgen binding protein d. .( F ) secrete fructose e. .( T ) produce testosterone 19. During the normal ovarian cycle. a. .( T )the principal oestrogen secreted i s 17B-oestradiol b. .( F ) the most potent oestrogen is oestradiol c. .( F ) oes trogen production is maximal by about the 8th day of the cycle d. .( T ) oestrog ens decrease the secretion of FSH e. .( F ) oestrogens are synthesised primarily by the ovarian stroma

20. testosterone. a. .( F )is produced only in the gonads b. .( F ) is mainly ex creted unchanged in the urine c. .( F ) stimulates secretion of LH d. .( F ) cir culates in the plasma mainly in the free form e. .( T ) stimulates growth of the prostate gland 21. progesterone. a. .( T )is synthesised by trophoblast b. .( F ) increases myo metrial activity c. .( F ) is predominantly excreted in the urine as pregnanetri ol d. .( T ) binds to cortisol binding globulin in the circulation e. .( T ) is synthesised from cholesterol 22. During human lactation. a. .( T )oxytocin increases mammary duct pressure b. .( F ) oestrogens promote the milk producing effects of prolactin on the breast c. .( F ) human placental lactogen is essential for milk synthesis d. .( F ) pr olactin stimulates gonadotrophin release e. .( T ) suckling enhances prolactin r elease 23. The following statements concerning the formation of hormones are correct. a . .( T )ACTH is derived from pro-opiomelanocortin b. .( T ) oestrogens are deriv ed from androgens c. .( F ) prolactin is derived from dopamine d. .( T ) melaton in is derived from serotonin e. .( F ) angiotensin II is derived from rennin 24. Pituitary gonadotrophin. a. .( T )release is dependent on hypothalamic funct ion b. .( F ) secretion increases during pregnancy c. .( F ) blood levels are ra ised during lactational amenorrhoea d. .( T ) release in the puerperium is enhan ced by bromocriptine e. .( F ) release is inhibited by oxytocin

25. Adrenaline (epinephrine). a. .( F )stimulates myometrial contractions b. .( F ) exerts its action by alpha receptors only c. .( F ) constricts the pupils d. .( T ) causes glycogenolysis e. .( F ) inhibits the mobilization of free fatty acids 26. Prolactin . a. .( T )release is stimulated by thyrotrophin releasing hormone b. .( T ) plasma levels are raised in the 1st trimester of pregnancy c. .( T ) release is increased by suckling d. .( T ) may be produced by the decidua e. .( F ) release is inhibited by metoclopramide 27. Growth hormone. a. .( T )is a protein b. .( F ) has a molecular weight of 20 00 Daltons c. .( F ) secretion is stimulated by hyperglycaemia d. .( T ) has gro wth promoting effects mediated through insulin like growth factors e. .( F ) is synthesised in the hypothalamus 28. Arginine vasopressin. a. .( F )reduces glomerular filtration rate b. .( F ) controls water loss in the proximal renal tubule c. .( F ) is synthesised by the posterior pituitary gland d. .( T ) is released in response to a rise in plasma osmolality e. .( T ) is released in response to a fall in circulating plasma vo lume 29. Parathyroid hormone. a. .( T )increases bone resorption b. .( T ) concentrat ions are increased in pregnancy c. .( F ) reduces phosphate excretion in urine d . .( T ) increases the formation of 1,25 dihydroxycholecalciferol e. .( F ) stim ulates osteoblasts

30. The following hormones bind to receptors on the cell membrane. a. .( F )cort icosterone b. .( T ) adrenaline c. .( T ) LH d. .( F ) oestradiol e. .( T ) gona dotrophin releasing hormone 31. Steroid hormones. a. .( F )all contain 20 carbon atoms b. .( T ) can be prod uced by structures of urogenital ridge origin c. .( F ) are mostly activated in the liver d. .( F ) are predominantly excreted unchanged in the urine e. .( F ) mainly circulate unbound to carrier proteins 32. bacteroids. a. .( F )are motile b. .( T ) do not produce spores c. .( F ) gr ow in aerobic culture d. .( T ) are synergistic coli forms e. .( T ) are charact eristically resistant to penicillin 33. In septic shock. a. .( F )the causative organisms are invariably gram negati ve b. .( F ) death is characterized by leucocytosis c. .( T ) endotoxins are pre dominantly lipopolysaccharides d. .( T ) antibiotic treatment may aggravate hypo tension e. .( T ) there may be associated disseminated intravascular coagulation 34. Toxic shock syndrome in women. a. .( T )is associated with the use of tampon s b. .( F ) is due to toxigenic strain of streptococcus c. .( T ) has induction of nitric oxide as a pathogenic feature d. .( F ) is infrequently reported outsi de north America e. .( F ) is confined to sexually active women

35. Chlamydia organisms. a. .( F )are motile b. .( T ) are intracellular c. .( F ) infects squamous cells d. .( T ) are found in birds e. .( T ) cause trachoma 36. mycobacteria. a. .( T )are non-sporing b. .( T ) are all acid fast in their staining reaction c. .( F ) are facultative anaerobes d. .( T ) are responsible for leprosy e. .( F ) are all pathogenic in humans 37. Concerning viral infections. a. .( T )cytomegalovirus is of the herpes group b. .( F ) herpes simplex virus may remain dormant in epithelial cells of the lo wer genital tract c. .( T ) facial herpes simplex lesions are activated by sunli ght d. .( F ) Coxsackie B virus does not cross the placenta e. .( T ) hepatitis B virus may be sexually transmitted 38. Concerning Neisseria. a. .( F )N.meningitidis can be a nasopharyngeal commen sal b. .( F ) N.gonorrhoea will grow in anaerobic conditions c. .( T ) N.gonorrh oea culture is inhibited at low temperature d. .( T ) N.gonorrhoea is identified within the cytoplasm of polymorphs e. .( T ) N.gonorrhoea infection can cause a n arthropathy 39. The following drugs are potassium sparing diuretics. a. .( T )amiloride hydr ochloride b. .( T ) triamterene c. .( T ) spironolactone d. .( F ) chlorothiazid e e. .( F ) frusemide

40. The following drugs may cause enlargement of the fetal thyroid gland. a. .( F )methyldopa b. .( F ) thyroxine c. .( T ) carbimazole d. .( F ) propranolol e. .( T ) propylthiouracil 41. The following statements describe the action of drugs on the myometrium. a. .( T )ergometrine stimulates sympathetic alpha receptors b. .( F ) indomethacin inhibits contractions by blocking prostaglandin receptors c. .( F ) prostaglandi n E1 is a stimulant of isolated uterine tissue in vitro d. .( T ) oxytocin requi res ionized calcium as a cofactor e. .( F ) magnesium sulphate is a myometrial s timulant 42. The following are cytotoxic alkylating agents. a. .( T )cyclophosphamide b. .( F ) mercaptopurine c. .( T ) chloarambucil d. .( F ) flourouracil e. .( F ) m ethotrexate 43. Treatment with morphine. a. .(T )causes respiratory depression b. .( F ) inc reases gastric motility c. .( T ) causes side effects all of which may be revers ed d. .( T ) increases the secretion of ADH e. .( F ) causes pupillary dilatatio n 44. The following substances increase the serum uric acid concentration. a. .( F )colchicine b. .( T ) chlorothiazide c. .( F ) allopurinol d. .( F ) probenecid

e. .( F ) phenylbutazone 45. The following statements are true. a. .( F )suxamethonium is a non-depolaris ing muscle relaxant b. .( T ) hexamethonium is a ganglion blocker c. .( T ) tubo curarine is reversed by neostigmine d. .( F ) streptomycin is absorbed from the gastrointestinal tract e. .( T ) thiopentone can be given intramuscularly 46. The following are features of ergometrine maleate. a. .( F )it is inactive w hen administered orally b. .( F ) the onset of action after intravenous injectio n occurs in approximately 5 minutes c. .( T ) transient hypertension may occur a fter its administration d. .( T ) Parenteral administration may result in vomiti ng e. .( F ) its use is contraindicated in patients with migraine 47. A normal distribution of values. a. .( T )is symmetrical about the mode b. . ( F ) has a median which is greater than the mean c. .( T ) has 75% of its value s below the upper quartile d. .( T ) may contain negative values e. .( T ) allow s calculation of the standard deviation 48. The following statistical statements are correct. a. .( F )in the normal tribution, the value of the mode is 1.73 x that of the median b. .( F ) in a tribution skewed to the right, the mean lies to the left of the median c. .( in the series, 2;7;5;2;3;2;5;8, the mode is 2 d. .( F ) student s t test is igned to correct for skew distribution e. .( T ) the Chi-squared test may be d when data are not normally distributed dis dis T ) des use

49. In a clinical trial, randomized allocation of patients to treatment groups. a. .( T )eliminate the investigator s bias b. .( F ) reduces the placebo effect

c. .( F ) usually controls for known confounding variables d. .( T ) usually con trols for unknown confounding variables e. .( F ) is best achieved by alternate allocation of subjects 50. In randomized double blind trial comparing a new drug with a placebo. a. .( F )the patients will be taking either of the 2 active drugs b. .( F ) patients c an choose their method of treatment c. .( F ) doctors prescribing treatment deci de which patients take the new drug d. .( T ) a large trial is more likely to gi ve a statistically significant result than a small trial e. .( F ) exactly 50% o f the patients will take the new drug

September 2001 paper2 1. a. b. c. d. e. Ketone bodies. .( T )can be utilized by the fetal brain .( T )include aceto-acetate . ( T )are water soluble . ( F )are synthesised in skeletal muscle . ( T )can be utilized during starvation 2. a. b. c. d. e. Intracellular fluid differs from extracellular fluid in that. .( T )it forms the larger proportion of total body water .( F )its volume can be more readily meas ured . ( T )it has a higher concentration of potassium . ( F )its volume is more directly regulated by the kidneys . ( T )it has a lower concentration of sodium 3. a. b. c. d. e. The oxidation of pyruvate to carbon dioxide. .( T )occurs exclusively in mitocho ndria .( F )can occur under anaerobic conditions . ( T )involves intermediates t hat are also involved in amino acid catabolism . ( T )is regulated by the concen tration of acetyl coenzyme A in the cell . ( T )is impaired in thiamine deficien cy states 4. a. b. c. d. e. creatinine. .( T ) is filtered out by the glomerulus .( F ) is reabsorbed signif icantly by the proximal tubules .( F ) plasma concentrations increases after pro tein ingestion .( F ) has a plasma clearance rate equivalent to renal plasma flo w .( F ) plasma concentration increases during the first trimester of pregnancy 5. a. b. c. d. e. ABO antigens are. .( T ) glycoproteins .( F ) found only on erythrocytes .( F ) major histocompatibility antigens .( F ) not immunogenic during pregnancy .( T ) located on membranes

6. a. b. c. d. e. haemoglobin. .( T )has 4 porphyrin rings .( T ) can carry 4 molecules of oxygen .( T ) binds carbon monoxide more readily than oxygen .( F ) is synthesised in m ature erythrocytes .( T ) contains 2 beta chains 7. a. b. c. d. e. iron. .( T .( F .( F .( F .( F ) is altered to the ferric state after absorption ) is transported by apoferriti n ) is readily excreted by the kidney ) retention in the body is enhanced by che lating agents ) requirement during normal pregnancy is approximately 1 mg per da y 8. a. b. c. d. e. Cholecalciferol (vitamin D). .( T )promotes the absorption of calcium from the g ut .( T )is 25 hydroxylated in the liver . (T )is synthesised in the skin . (T ) is 1 hydroxylated in the kidney . ( T )is most active in 1,25 dihydroxyl form 9. a. b. c. d. e. Excess . .( F )vitamin C causes haemorrhage .( T ) vitamin D causes renal failur e . ( F ) vitamin K causes thrombosis . ( F ) vitamin E causes azospermia . ( T ) vitamin A causes headache 10. Folic acid. a. .( F )requires gastric intrinsic factor for its absorption b. .( F )daily requirement is about 40mg c. . ( T )is found in higher concentratio n in fetal blood than in maternal blood d. . ( F )deficiency leads to microcytic anaemia e. . ( F )is fat soluble

11. The conjugation of bilirubin. a. .( T )takes place in hepatocytes b. .( T )i s catalysed by UDP glucuronyl transferase c. . ( F )is inhibited by phenob arbit one d. . ( T )renders it water soluble e. . ( F ) is impaired in acute biliary o bstruction 12. Messenger RNA (mRNA). a. .( F )is a double stranded polymer b. .( T ) is tra nscribed from DNA in the nucleus c. .( F ) is not present in reticulocytes d. .( F ) contains thymine e. .( F ) is not present in oocytes 13. Concerning glycolysis. a. .( F ) it is the mobilization of stored glucose un its b. .( F ) most of the reactions occur in the mitochondria c. .( T ) 2 molecu les of ATP are consumed per molecule of glucose d. .( F ) there is net gain of 2 ATP molecules from the conversion of a glucose molecule to 2 pyruvate molecules e. .( T ) the glucose to pyruvate pathway is present in all tissues 14. The following substances are normally synthesised in the liver. a. .( F )glu cagon b. .( T ) vitamin A c. .( T ) cholesterol d. .( F ) immunoglobulins e. .( T ) prothrombin 15. Hyperkalaemia is a characteristic finding in. a. .( F )1ry aldosteronism b. .( T ) treatment with spironolactone c. .( F ) hyperparathyroidism d. .( F ) ACT H secreting tumours of the bronchus e. .( T ) renal failure

16. The natural decay of radioactive isotopes results in the emission of. a. .( T )alpha particles b. .( T ) gamma rays c. .( T ) neutron rays d. .( T ) proton beams e. .( T ) beta particles 17. In radiotherapy. a. .( T )one Gray is equivalent to one joule per kilogram b . .( T ) the skin usually receive a greater dose of radiation than the underlyin g tissues c. .( F ) the major effect of radiation energy is to damage the cytopl asm of the cell d. .( F ) cells in tissues which are hypoxic are more vulnerable to radiation e. .( T ) radiation induced changes in tissues may take 6 weeks to develop 18. A woman who has a rhesus genotype of Cde/CDe. a. .( F )could develop anti-C antibodies b. .( T ) could safely be transfused with D positive blood c. .( T ) may develop anti-E antibodies d. .( F ) should receive anti-D immunoglobulin aft er giving birth to a RH (D) positive infant e. .( F ) his sister has a 50% proba bility of being a carrier 19. When a man has haemophilia. a. .( F )50% of his daughters would not expect t o be carriers b. .( F ) 25% of his sons would be expected to be affected c. .( F ) good medical control of his blood deficiency reduces the risk of the conditio n in his children d. .( F ) his newborn child is likely to require an urgent blo od transfusion e. .( T ) his sister has a 50% probability of being a carrier 20. In the neonate, the appearance of the external genitalia may not correspond with the genotype in the presence of. a. .( T )adrenogenital syndrome

b. c. d. e. .( T .( F .( F .( T ) testicular feminization syndrome ) renal agenesis (potter syndrome) ) trisomy 21 ) severe hypospadius 21. Concerning inheritable disease. a. .( T )Huntington s chorea by a dominant gene b. .( T ) phenylketonuria is transmitted by a c. .( F ) haemophilia is an autosomal dominant condition d. .( F d s disease is sex linked condition e. .( F ) cystic fibrosis is an X-linked recessive gene is transmitted recessive gene ) Von Willebran transmitted by

22. Concerning the genetic control of protein synthesis. a. .( F )mature mRNA co ntain introns b. .( T ) A codon has 3 base sequences c. .( F ) each amino acid h as a single codon d. .( T ) transfer RNA has anticodon recognition sites e. .( T ) each tRNA caries a specific amino acid 23. The human major histocompatibility complex (MHC) genes. a. .( F )map to chro mosome 11 b. .( T ) are composed of HLA genes c. .( F ) are the most polymorphic in the human genome d. .( F ) will be identical in dizygotic twins e. .( F ) co de for blood group antigens 24. The following cells are correctly paired with their products. a. .( T )endot helial cells: factor VIII-related antigen b. .( T ) plasma cell: IgG c. .( T ) s alivary gland epithelial cell: amylase d. .( F ) mast cell: IgA e. .( T ) decidu al stromal cell: prolactin 25. Immunodeficiency states may be associated with. a. .( T )viral infection of T lymphocytes

b. c. d. e. .( T .( T .( F .( T ) B cell lymphomas ) glucocorticoid administration ) haemolytic disease of the n ewborn ) Hodgkin s lymphoma 26. The following are autosomal recessive disease. a. .( F )neurofibromatosis b. .( T ) cystic fibrosis c. .( T ) phenylketonuria d. .( F ) polyposis coli e. .( T ) sickle cell anaemia 27. The following cells may be phagocytic. a. .( T )neutrophils b. .( T ) Kupffe r cells c. .( T ) monocytes d. .( T ) Hoff bauer cells e. .( F ) plasma cells 28. The following tumours produce characteristic blood markers. a. .( F )clear c ell carcinoma b. .( T ) choriocarcinoma c. .( F ) osteogenic sarcoma d. .( T ) y olk sac tumour e. .( F ) transitional cell tumour 29. The following pairs indicate correct pathological association. a. .( T )Epst ein-Barr virus: Burkitt s lymphoma b. .( T ) Peutz-Jeghers syndrome: intestinal carcinoma c. .( F ) Wood dust: pleural mesothelioma d. .( F ) progestogens: endo metrial carcinoma e. .( T ) aniline dyes: bladder carcinoma 30. Growth of the following tumours is hormone dependent. a. .(F )squamous cell carcinoma of the cervix

b. c. d. e. .( T .( T .( T .( F ) breast adenocarcinoma ) uterine leiomyoma ) prostatic adenocarcinoma ) testicu lar carcinoma 31. Rickets is characterized by the following. a. .(F )mineralization of the per iosteum b. .( T ) deposition of uncalcified osteoid c. .( T ) abnormal osteoblas tic activity d. .( F ) increased capillary fragility e. .( T ) overgrowth of car tilage 32. The following tissues are capable of cellular regeneration. a. .( F )spinal cord b. .( T ) liver c. .( T ) epidermis d. .( F ) myocardium e. .( T ) bone mar row 33. oxygen. a. .( F )binds to trivalent iron in the haem molecule b. .( T ) is c arried as 4 molecules per molecule of haemoglobin c. .( F ) haemoglobin dissocia tion is linear d. .( T ) uptake reduced red cell buffering capacity e. .( F ) is released from haemoglobin when the concentration of 2,3 DPG is decreased 34. Intracellular concentration of free calcium. a. .( F )is greater than that o f extracellular free calcium b. .( T ) may be influenced by voltage gated membra ne channels c. .( T ) may be influenced by the activity of inositol triphosphate d. .( T ) binds to calmodulin e. .( F ) inactivates protein C 35. Displacement of oxyhaemoglobin dissociation to the right.

a. b. c. d. e. .( F .( T .( T .( T .( F )means a greater avidity of haemoglobin for oxygen ) occurs immediately on ascen t to high altitude ) occurs with a rise in temperature ) occurs with a fall in p H ) occurs with a fall in PCo2 36. platelets. a. .( F )are approximately 50 micrometers in diameter b. .( T ) c ontain myosin c. .( T ) release a growth factor d. .( F ) are formed from myelob lasts e. .( F ) are prevented from aggregating by thromboxane A2 37. In uncomplicated homozygous beta thalassaemia there is. a. .( T )hypochromas ia b. .( F ) a reduction in haemoglobin A2 c. .( T ) an increase in haemoglobin F d. .( T ) no depletion of iron stores e. .( F ) the presence of megaloblasts i n bone marrow 38. In the nephron, sodium. a. .( T )is mainly reabsorbed in the proximal convol uted tubules b. .( T ) Reabsorption increases in normal pregnancy c. .( T ) may be reabsorbed in exchange for hydrogen ions d. .( F ) Reabsorption is increased by spironolactone e. .( F ) Reabsorption is increased by atrial natriuretic pept ide 39. bile. a. .( F b. .( F c. .( F d. .( T e. .( F )production is inhibited after vagal stimulation ) is concentrated under the inf luence of secretin ) has a pH of 5.5 ) is expelled from the gall bladder under t he influence of cholecystokinin ) normally contains high concentrations of free cholesterol 40. bradykinin.

a. b. c. d. e. .( T .( T .( T .( F .( F )increases capillary permeability ) is a small polypeptide ) is formed by the ac tion of kallikrein ) is predominantly inactivated in the liver ) is metabolized to kininogen 41. Physiological jaundice of the newborn. a. .( F )is present on the first day of life b. .( F ) is due to ABO incompatibility c. .( F ) is associated with a r aised serum concentration of glutamic pyruvic transaminase d. .( T ) may be due to relative glucuronyl tranferase deficiency e. .( T ) is associated with a rais ed level of unconjugated bilirubin 42. The stimulation of adrenergic alpha receptors. a. .( F )does not occur with noradrenaline b. .( T ) in the blood vessels of the skin leads to vasoconstricti on c. .( F ) in the gastrointestinal sphincter muscles leads to relaxation d. .( F ) in the iris leads to constriction of the pupil e. .( F ) in the blood vesse ls of the kidney leads to vasodilatation 43. In a normal man breathing quietly at rest, the partial pressure of . a. .( F )carbon dioxide in alveolar air is about 3 times greater than in room air b. .( F ) nitrogen is greater in expired air than in inspired air c. .( F ) water vap our in alveolar air is less than in room air d. .( T ) carbon dioxide in the blo od of the pulmonary arteries is greater than in alveolar air e. .( T ) oxygen is less in the pulmonary veins than in alveolar air 44. Total body water. a. .( T )forms a smaller proportion of body water in fat t han thin persons b. .( T ) can be measured by a deuterium oxide dilution techniq ue c. .( T ) normally comprises 45-65% of body weight d. .( F ) is a smaller pro portion of body weight in men than in women e. .( T ) is predominantly intracell ular

45. Concerning blood pressure regulation. a. .( F )adrenaline acts primarily upo n the vasomotor centre b. .( T ) prostacyclin lowers blood pressure c. .( T ) an giotensinogen is inactive without modification d. .( F ) bradykinin increases bl ood pressure e. .( F ) serotonin is vasodialtory 46. During normal pregnancy. a. .(T )arterial PCo2 decreases b. .( F ) the blood hydrogen ion concentration decreases c. .( T ) plasma bicarbonate concentration decrease d. .( F ) urine pH falls e. .( F ) lactic acid production is increased 47. Concerning the fetal cardiovascular system. a. .(F )more than 80% of the car diac output flows through the placenta b. .( F ) oxygen saturation in the caroti d and renal arteries is the same c. .( F ) umbilical venous blood has a lower PC o2 than renal arterial blood d. .( F ) blood from the inferior vena cava passes directly into the left ventricle e. .( T ) the pulmonary circulation has a high resistance 48. The partial pressure of carbon dioxide in arterial blood may be raised in. a . .( F )residence at high altitude b. .( T ) gross obesity c. .( F ) acidaemia d ue to renal failure d. .( F ) hyperventilation e. .( F ) pregnancy 49. In the lungs of a healthy male adult at rest. a. .( F )alveolar air contains 40% nitrogen b. .( T ) about 2 litres of air are in the alveoli at the end of a quiet expiration c. .( T ) about 150ml of inspired air in each breath do not re ach the alveoli d. .( F ) the oxygen tension of blood in the pulmonary vein is a bout 5.3 KPa (40mmHg) e. .( F ) inspiration is brought about by relaxation of th e intercostals muscles

50. Lung function in normal pregnancy. a. .( F )vital capacity is increased by 5 0% b. .( T ) tidal volume is increased c. .( T ) the subcostal angle is increase d d. .( T ) residual volume is reduced e. .( F ) the respiratory rate is decreas ed