MRCOG Part 1 – FREE Trial Questions

A 33 year old woman attends for her routine smear test examination. On bimanual examination the uterus is identified to be on a retroverted position. Which ligament supports the cervix to its anatomical position?

Broad ligament

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Cardinal ligament

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Infundibulopelvic (IP) ligament

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Ovarian ligament

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Round ligament

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Which is the widest diameter of the bony pelvis?

Pelvic inlet, transverse diameter

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Pelvic inlet, antero-posterior diameter

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Pelvic midcavity, transverse diameter

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Pelvic outlet, transverse diameter

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Pelvic outlet, antero-posterior diameter

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Which of the following biochemical techniques is used in non-invasive prenatal testing for Trisomy 21?

Fluorescence in situ hybridisation

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Northern blotting

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Polymerase chain reaction

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Southern blotting

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Western blotting

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You are reviewing the following biochemistry results in pre-operative clinic:

Serum calcium	Phosphate	Vitamin D Level	PTH
Low	High	Low	High

What is the likely diagnosis?

Hypoparathyroidism

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Primary hyperparathyroidism

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Pseudohypoparathyroidism

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Secondary hyperparathyroidism

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Tertiary hyperparathyroidism

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Failure of the primitive streak to regress properly can lead to which of the following conditions?

Anencephaly

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Gastroschisis

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Holoprosencephaly

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Sacrococcygeal teratoma

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Spina bifida

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At what stage of development are primary oocytes arrested in until ovulation occurs?

Metaphase I

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Metaphase II

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Prophase I

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Prophase II

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Telophase I

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You are conducting a study and want to compare the mean haemoglobin levels before and after treatment in the same group of anaemic pregnant women. Which parametric test should be used?

ANOVA

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Chi-square test

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Paired t-test

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Student's t-test

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Wilcoxon signed-rank test

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A screening test for gestational diabetes is performed on 500 pregnant women. The test correctly identifies 150 women with gestational diabetes (true positives) and correctly excludes 300 women without the condition (true negatives). What is the specificity of the test?

50%

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60%

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75%

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80%

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85%

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A 26-year-old woman presents complaining of acne and hirsutism. Her periods were very irregular, and she wants to understand if there is an issue. Her GP has organised a pelvic ultrasound scan for her which she will have next week but has told her he suspects that she has polycystic ovaries. What investigations should be considered as a first line assessment of biochemical hyperandrogenism?

Androstenedione

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Dehydroepiandrosterone sulphate (DHEAS)

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Free testosterone and free androgen index

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Sex Hormone Binding Globulin

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Total testosterone

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You are reviewing the results of a dexamethasone suppression test which is reported as follows:

Cortisol: normal levels after low and high dose dexamethasone

ACTH: undetectable

What is the likely diagnosis?

Cushing’s syndrome

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Cushing’s disease

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Ectopic ACTH syndrome

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Ectopic corticotropin-releasing hormone syndrome

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Pseudo-Cushing’s syndrome

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A 30 year old woman is referred from screening with a higher chance combined screening result at 12 weeks gestation. The nuchal translucency is 6mm with a combined screening result of 1 in 5 for Trisomy 21 and 1 in 140 for Trisomy 13/18. What is the next most appropriate investigation?

Amniocentesis

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Chorionic villous sampling

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Non-invasive prenatal testing

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Fetal anatomy scan at 16 weeks

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Fetal echocardiography at 16 weeks

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A 22 year woman books for antenatal care at 8 weeks gestation. She and her partner are both sickle cell trait carriers and her booking bloods show HbsAG +ve, AntiHBc +ve, HBsAb -ve with viral load of 9log₁₀. She wishes to have prenatal diagnosis to ascertain the sickle cell status of her pregnancy. What is the most appropriate option?

Amniocentesis at 14+0

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Amniocentesis at 15+0

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Chorionic villous sampling at 9+6

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Chorionic villous sampling at 10+6

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Chorionic villous sampling at 11+6

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What does a Z-score indicate in a DEXA report?

The comparison of a patient’s bone density to that of a healthy young adult

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The patient’s fracture risk based on clinical factors

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The comparison of a patient’s bone density to the average of age-matched peers

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The total amount of calcium in the bones

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The change in bone density over time

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Which of the following radiopharmaceuticals is most commonly used in PET imaging?

18F-fluorodeoxyglucose (FDG)

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99mTc-methoxyisobutyl isonitrile (MIBI)

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131I-sodium iodide

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201Tl-thallous chloride

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68Ga-DOTATATE

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You are assisting with a Caesarean section for abnormal cardiotocography with suspected fetal compromise. Which of the following features is abnormal on cardiotocography?

Baseline rate of 165bpm

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Late decelerations in over 50% of contractions for 20 minutes

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Single prolonged deceleration lasting 5 minutes

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Variability of less than 5bpm for 15 minutes

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Variable decelerations for 90 minutes

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A woman has a vaginal delivery and sustains a perineal tear. On examination, the injury affects the skin and perineal muscles and more than 50% of the external anal sphincter is torn. What classification of perineal tear is this?

2nd degree tear

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3rd degree tear – 3A

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3rd degree tear – 3B

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3rd degree tear – 3C

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4th degree tear

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A 36 year old primiparous woman is seen in antenatal clinic at 28 weeks gestation. She is known to have essential hypertension and is taking methyldopa 250mg BD. Her blood pressure is 128/76 and her urine dip is negative. She has routine antenatal blood tests and is found to be anaemic.

*Investigation*	*Result*	*Normal Range*
Haemoglobin	90	110 – 140 g/L
White cell count	10 x 10⁹/L	6 – 16 x 10⁹/L
Platelets	376 x 10⁹/L	150-400 x 10⁹/L
MCV	94 fL	83-101 fL
Reticulocytes	6%	0.5-2.5%
Serum Iron	28	11-32 mol/L
Ferritin	150	12-200mg/L
TIBC	60	42-80mol/L
Vitamin B12	190	>150mg/L
Folate	6	>2mg/L
Sodium	140 mmol/L	130 – 140 mmol/L
Potassium	4.1 mmol/L	3.3 – 5.1 mmol/L
Urea	3.8 mmol/L	2.2 – 4.3 mmol/L
Creatinine	50 mmol/L	34 – 82 mmol/L
ALT	8 IU/L	6 – 32 IU/L
ALP	380 IU/L	30 – 300 IU/L
Bilirubin	45 mmol/L	3 – 14 mmol/L
Albumin	31 g/L	28 – 37 g/L
Uric acid	0.24 mmol/L	0.14 – 0.38 mmol/L

What is the likely diagnosis?

Aplastic anaemia

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Haemolytic anaemia

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HELLP syndrome

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Iron deficiency anaemia

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Thalassaemia trait

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A 23 year old attends with secondary amenorrhoea for 6 months. She is nulliparous with a BMI of 31 and her periods have been irregular for the last three years with cycles varying between 2 and 4 months apart. A urinary pregnancy test is negative. Her past medical history includes irritable bowel syndrome for which she takes regular antispamodics and metoclopramide. Her blood test results are shown below:

FSH – 10.5 (1.0-11.0 IU/L)

LH – 8.5 (0.5-14.5 IU/L)

Testosterone – 1.8 (0.8-3.1 nmol/L)

Prolactin – 996 (90-520 mu/L)

TSH – 2.1 (0.5-7.0 mu/L)

Free T4 – 20 (11-23 pmol/L)

What is the next most appropriate investigation?

CT Head

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MRI Head

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MRI Pituitary

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Pituitary hormone profile

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Repeat prolactin levels

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Which of the following occurs in haemolytic transfusion reactions?

Antibody-mediated hypersensitivity (type II)

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Contact hypersensitivity (type IV)

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Delayed hypersensitivity (type IV)

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Immediate hypersensitivity (type I)

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Immune complex hypersensitivity (type III)

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Which of the following HLA class is primarily involved in the presentation of antigens to CD8+ cytotoxic T cells?

HLA Class I

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HLA Class II

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HLA Class III

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HLA-DP

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HLA-DR

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A 28 year old primiparous woman is confirmed to have parvovirus B19 infection at 20 weeks gestation.What is the optimum surveillance method on ultrasound to screen for fetal anaemia?

Middle cerebral artery Doppler peak systolic velocity (PSV)

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Middle cerebral artery Doppler pressure index (PI)

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Middle cerebral artery Doppler resistance index (PI)

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Umbilical artery Doppler pressure index (PI)

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Umbilical artery Doppler resistance index (PI)

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A pregnant woman is found to be positive for hepatitis B surface antigen (HBsAg) and hepatitis B envelope antigen (HbeAg). What is the recommended intervention to prevent vertical transmission to the newborn?

Hepatitis B vaccine

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Hepatitis B immunoglobulin (HBIG)

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Hepatitis B vaccine and Hepatitis B immunoglobulin (HBIG)

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Lamivudine

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Ribavirin

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A 35 year old pregnant woman is admitted to intensive care with acute pancreatitis at 26 weeks gestation. Which of the following terms best describes the pathological process that occurs in acute pancreatitis?

Caseous necrosis

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Coagulative necrosis

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Colliquative necrosis

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Fat necrosis

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Gangrene

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Which of the following is the most common type of cervical cancer?

Adenocarcinoma

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Clear cell carcinoma

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Small cell carcinoma

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Squamous cell carcinoma

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Transitional cell carcinoma

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Which of the following is not an absolute contraindication to the combined oral contraceptive pill?

BRCA1 gene mutation

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Current venous thromboembolism

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Factor V Leiden mutation

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History of migraine with aura

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Previous transient ischaemic attack

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A 28-year-old woman with a history of recurrent urinary tract infections (UTIs) is prescribed cefalexin. What is the primary mechanism of action of cefalexin?

Disruption of bacterial DNA replication

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Inhibition of bacterial cell wall synthesis

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Inhibition of bacterial folate synthesis

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Inhibition of bacterial gyrase

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Inhibition of protein synthesis

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MRCOG Part 1 – FREE Trial Questions

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