MRCOG Part 1 Mock Exam - Paper 2

1. Cytochrome p450 enzymes are involved in biotransformation of drugs. CytP450 is present in –

A. Peroxisome
B. Nucleus
C. Cytoplasm
D. Smooth endoplasmic reticulum.
E. Golgi apparatus.

2. In sickle cell anemia, glutamic acid is replaced by valine at 6^th position. This mutation is defective in which structural organization of protein.

A. Primary
B. Secondary
C. Tertiary
D. Quaternary
E. None of the above.

3. Catecholamines are synthesised from –

A. Tyrosine
B. Tryptophan
C. Alanine
D. Arginine
E. Glutamine

4. Monosaccharide derived from hydrolysis of milk sugar is-

A. Galactose
B. Fructose
C. Mannose
D. Ribose
E. Ribulose

5. All of the following compounds act as coenzyme except-

A. Thiamine pyrophosphate
B. Calcitriol
C. Adenosyl cobalamin
D. NAD-NADH2
E. FAD-FADH2.

6. Which of the following statement about the glycogen metabolism is incorrect?

A. Glucose moiety from UDP-glucose will be added to glycogenin primer sequentially to build up the highly branched glycogen molecule.
B. During well fed state, Insulin activates the biosynthesis of glycogen by activating the glycogen synthase and glycogen phosphorylase enzymes.
C. Glycogen is stored in liver and skeletal muscles.
D. In fasting state, glucagon activates phosphorylase kinase, which phosphorylates glycogen phosphorylase and glycogen breakdown.
E. Liver glycogen provides glucose to extrahepatic tissue as the muscle lacks glucose 6-phosphatase and cannot release free glucose from glycogen.

7. Co-factor for the free radical scavenging enzyme glutathione peroxidase is-

A. Zinc
B. Iron
C. Selenium
D. Molybdenum
E. Copper.

8. Hormones mediated by cAMP as second messenger are all except-

A. FSH
B. LH
C. HCG
D. Catecholamine.
E. NO

9. The lipoprotein which is synthesized in the intestinal mucosa, containing high concentration of triacylglycerol and apo B48 protein, and transports dietary lipids to extrahepatic tissue is-

A. Chylomicrons
B. Very low-density lipoprotein
C. Intermediate density lipoprotein
D. Low-density lipoprotein
E. High-density lipoprotein.

10. Ketone bodies are produced from the acetyl CoA. Identify the correct statement about ketone bodies.

A. Ketone bodies are stored the adipose tissue.
B. Ketogenesis occurs in extrahepatic tissue.
C. High rate of fatty acid oxidation in mitochondria leads to the ketogenesis.
D. Ketone bodies are used to generate energy in liver.
E. Increased insulin: glucagon ratio favours the ketogenesis.

11. 75- year-old farmer visited general practitioner with weakness, diarrhoea, decreased vision, and purulent discharge from eyes. On examination, there were subcutaneous haemorrhage in the arms and legs. Eyes showed marked inflammation and dilatation of conjunctiva vessels and margins of eyelid, fissure at the angle of the mouth, tongue was sore and swollen. Deep tendon reflexes were diminished. Which vitamin deficiency causes changes in the eye?

A. Thiamine
B. Riboflavin
C. Niacin
D. Ascorbic acid
E. Biotin.

12. Nonsteroidal anti-inflammatory drug (NSAID) aspirin inhibits which enzyme?

A. Cyclooxygenase
B. Prostacyclin synthase
C. Thromboxane synthase
D. Isomerase.
E. Lipoxygenase

13. Identify the compound X in the reaction shown below. The deficiency of it leads to folate trap and homocystinuria.

A. ATP
B. PLP
C. Cobalamin
D. Biotin
E. Niacin

14. In which compartment does the complete oxidation of acetyl Co A occur as shown in 2^nd reaction, indicated by red arrow?

A. Cytoplasm
B. Peroxisome
C. Endoplasmic reticulum
D. Mitochondria
E. Nucleus

15. What is the name of the metabolic pathway indicated by red arrow?

A. EMP pathway.
B. Rapaport Leubering cycle
C. Cori’s cycle
D. Cahill cycle
E. HMP pathway.

16. Which of the mineral is required for the oxidative phosphorylation?

A. Phosphorus
B. Copper
C. Iodine
D. Molybdenum
E. Magnesium.

17. All of the following are uncouplers of oxidative phosphorylation except-

A. 2,4-dinitrophenol (2,4-DNP)
B. 2,4-dinitrocresol (2,4-DNC)
C. Glycogenin
D. Thyroxine.
E. Thermogenin

18. Post Translational modification of protein catalysed by vitamin K-

A. Gamma carboxylation
B. Hydroxylation
C. Proteolytic cleavage
D. Acetylation
E. Phosphorylation.

19. All the steroid hormones are derived from –

A. Pregnenolone
B. 17-hydroxypregnenolone
C. Dehydroepiandrosterone
D. Cholesterol
E. 11-deoxycholesterol.

20. Copper containing enzymes are all except-

A. Ceruloplasmin
B. Hephaestin.
C. Tyrosinase.
D. Lysyl oxidase.
E. ALA dehydratase.

21. Six-Year Follow-up of a Trial of Antenatal Vitamin D for Asthma Reduction was conducted. 441 women received vitamin D of 4400 IU/day. Mean age at enrolment was 27 years and the SD was 2.1. Calculate the Confidence interval of age?

A. 25 to 29
B. 24.9 to 29.1
C. 22.8 to 31.2
D. 26.8 to 27.2
E. 26 to 28

22. In a multicenter, randomized, noninferiority trial, they compared two threshold values for treatment of asymptomatic moderate hypoglycemia. Mean ± SEM of threshold value of glucose in lower threshold group was 61±0.5 mg/dl. What is the confidence interval of glucose?

A. 59-61
B. 57-63
C. 60-62
D. 59.5-62.5
E. 60.5-61.5

23. A 34-Year-Old Woman with severe Hyperglycemia was evaluated for its cause. During frequent visits, glucose was measured. Following were the recordings: 330, 331, 332, 331, 331mg/dl. What was the mean glucose?

A. 330
B. 331
C. 332
D. 333
E. 330.5

24. A randomized experiment was done in pregnant women by randomly assigning each participant either to walk for half an hour three times a week or to sit quietly reading a book for half an hour three times a week. At the end of a year the change in participants’ blood pressure over the year was measured, and the change was compared for the two groups. This is a randomized experiment rather than an observational study because

A. Blood pressure was measured at the beginning and end of the study.
B. The two groups were compared at the end of the study.
C. The participants were randomly assigned to either walk or read, rather than choosing their own activity.
D. A random sample of participants was used.
E. The women were followed up

25. Which one of the following variables is not categorical?

A. Age of a person.
B. Gender of a person
C. Choice on a test item
D. Marital status of a person
E. Socioeconomic status

26. Which one of these statistics is unaffected by outliers?

A. Mean
B. Interquartile range
C. Standard deviation
D. Range
E. Average

27. A list of 5 pulse rates is: 70, 64, 80, 74, 92. What is the median for this list?

A. 74
B. 76
C. 77
D. 80
E. 50

28. In a study the Iron levels were estimated. They were 100,100,99,101,100. Which among the following statement is true?

A. Mean = 99
B. Median = 99
C. Mode = 99
D. Mean = 100
E. Median =101

29. Which of the following statement is correct if a characteristic is normally distributed in a population?

A. 5% of individuals will be more than two standard deviations from the mean
B. The mean will be greater than the median
C. The median will be less than the mean
D. The mode will be greater than the median
E. The numbers of individuals above and below the mean will be equal

30. Which of the following describes the observation that occurs with the greatest frequency?

A. Correlation
B. Mean
C. Median
D. Mode
E. Variance

31. Which of the following statement is correct regarding statistical distribution?

A. The mode is the value that occurs the most frequently
B. The median is that point on the scale of measurement above which lie exactly half the values and below which lie the other half
C. Of a normally distributed variable, the probability of attaining a value higher than two standard deviations above the mean is approximately 1 in 40(p = approximately 0.025)
D. Having a normal distribution, approximately 95% of the values will lie within the range between (mean +2 standard deviations) and (mean -2 standard deviations)
E. All the above

32. Which of the following is true regarding the standard deviation?

A. SD = SEM/(square root of n)
B. The SD equals the SEM in non-parametric tests
C. The SD is a measure of observation variability
D. The SEM determines the accuracy of measurement of the observations
E. The standard deviation (SD) is equal to the standard error of the mean (SEM)

33. Which of the following is true if a characteristic is normally distributed in a population?

A. The median will be less than the mean
B. The mean will be of lesser value than the mode
C. The numbers of individuals above and below the mean will be equal
D. This implies that most of the population comprises of normal individuals
E. 20% of individuals will be more than two standard deviations from the mean

34. Which of the following is true regarding the standard deviation of a group?

A. Is the square of the variance
B. Is a valid statistical parameter for observations that do not have a normal distribution
C. Is numerically equal to the standard error of the mean
D. Can be used for the calculation of Chi squared test
E. Is a measure of the scatter of observations about the mean

35. A report of a clinical trial of a new post-operative analgesic states, “In a comparison between the new drug and a placebo, a higher proportion of patients taking the new drug obtained relief from pain (p <0.05)”. In consequence, which of the following statements is correct?

A. The trial was well designed
B. Amongst 100 patients treated with the drug five would be expected to have a placebo response
C. The result may have occurred by chance alone in less than one in 20 occasions
D. The probable error of the observations is +/- 5%
E. The result should be regarded as not reaching conventional levels of statistical significance

36. A diagnostic test has a sensitivity of 90% and a specificity of 95%. Which of the following statements is likely to be true in this case?

A. 10% of positive tests are false positive
B. 5% of negative tests are false negative
C. Sensitivity is equal to true positives / (true positives + false negatives)
D. Sensitivity indicates the test will be negative in disease.
E. Specificity indicates the test will be positive in non-diseases state

37. In a clinical trial of a new drug treatment for inflammatory bowel disease, the following results are obtained: 46 patients improved with new drug, 14 did not improve with new drug; 34 patients improved with placebo, 26 patients did not improve with placebo. Which of the following statement is true concerning this data?

A. Data can be evaluated by computing a Chi-squared test
B. Data can be evaluated using a Student’s t-test
C. If the statistical probability that the difference between drug and placebo is 0.1 then the drug can be introduced into clinical practice
D. Pearson’s coefficient of linear correlation could be used to test significance
E. The superiority of the drug over placebo is so obvious that formal statistical testing is unnecessary

38. Which of the following is not a continuous variable?

A. Blood pressure
B. Gender
C. Haemoglobin concentration
D. Height
E. Plasma glucose concentration

39. Which of the following is a standard method of reporting the results in a case control study?

A. Mean, standard deviation, and 95% confidence intervals
B. Median, range, and interquartile ranges
C. Odds ratio and 95% confidence interval
D. Rate and 95% confidence interval
E. Risk difference

40. Which of the following is true in significance testing?

A. Type I error is to reject the alternative hypothesis when it should be accepted
B. A Type II error is to accept the alternative hypothesis when it should be rejected
C. The probability associated with a Type I error is the significance level
D. The significance level is always set to 5%
E. The significance level is determined at the end of significance test

41. A cohort study suggests a statistical link between drinking a specific local herbal tea and the development of oesophageal cancer. Which of the following would suggest that the link is causative?

A. An odds ratio of 8:1
B. The finding of similar results in a number of studies
C. The finding that increasing consumption is associated with an increased rate of disease
D. All the above
E. None of the above

42. Which of the following is true about normal distribution?

A. In a positively skewed distribution, the mean always lies to the left of the median
B. In distributions which are markedly skewed, the arithmetic mean is a more appropriate measure than median
C. In a negatively skewed distribution, the mean always lies to the right of the median
D. 95% lies within mean ± 2SD
E. 60% lies within mean ±1 SD

43. What is true regarding the confidence interval?

A. Can only be used in parametric data
B. It is a test of the null hypothesis
C. If zero difference lies within the 95% when comparing two groups to a treatment, it indicates the treatment is very effective
D. Is not useful when comparing data with another population
E. It is calculated at ±1.96 times the standard error of the mean

44. In comparing confidence intervals with P values, which of the following statements is correct?

A. 95% confidence intervals are equivalent to a P value of 0.95
B. As the sample size increases, the confidence interval will increase
C. Confidence intervals refer to the target population
D. The confidence interval is approximately equal to the standard deviation
E. 95% confidence intervals are equivalent to a P value of 0.05

44. In a double-blind placebo control clinical trial, which of the following statements is correct?

A. Some of the patients are not treated
B. All the patients receive a placebo
C. The patients do not know which treatment they receive
D. Everybody receives both treatments
E. The clinician assessing the effects of the treatment knows which treatment the patient has been given

46. Which of the following is true when evaluating a report of a clinical trial?

A. Control and treatment groups must be equivalent in size
B. Even if randomisation is conducted properly, chance differences are inevitable
C. Adequate sample size commonly produces false positives and false negatives
D. Results are invalid if the trial is not of double-blind construction
E. Withdrawal of patients from a trial by the investigator does not cause any bias

47. A random selection of 1,200 adults agrees to participate in a study of the possible effects of drug X. They are followed prospectively for a period of five years to see if there is an association between the incidence of cataract and the use of drug X. What type of study is this?

A. Case-control study
B. Cohort study
C. Cross-over study
D. Cross-sectional study
E. Randomised controlled clinical trial

48. Which of the following is not true concerning the use of a placebo in a clinical trial?

A. Is associated with no effects
B. Should be identical in appearance to the drug being studied
C. Placebo studies are undertaken in patients with cancer
D. Is pharmacologically inert
E. Is best administered by a person who is unaware of the drug’s identity

49. In a diagnostic accuracy study to determine thrombosis, sensitivity reported was 95% and specificity was 90%. A cross sectional study revealed that the prevalence of thrombotic disease in pregnancy in local population was 10%. What is the positive predictive value of the test?

A. 100
B. 95
C. 90
D. 51.3
E. 31.5

50. In a diagnostic accuracy study to determine thrombosis, sensitivity reported was 95% and specificity was 90%. A cross sectional study revealed that the prevalence of thrombotic disease in pregnancy in local population was 10%. What is the negative predictive value of the test?

A. 100
B. 95
C. 90
D. 51.3
E. 99.3

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MRCOG Part 1 Mock Exam – Paper 2

MRCOG Part 1 Mock Exam – Paper 2

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