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Tim Chard • Richard Lilford
MRCOG Part I
Second Edition
Springer-Verlag London Ltd.
Tim Chard, MD, FRCOG
Professor of Obstetrics, Gynaecology and Reproductive Physiology,
Joint Academic Unit of Obstetrics, Gynaecology and Reproductive
Physiology, St Bartholomew's Hospital Medical College and The
London Hospital Medical College, Department of Reproductive
Physiology, St Bartholomew's Medical College, West Smithfield,
London ECIA 7BE
Richard Lilford, MB, BCh, MRCOG, MRCP, PhD
Professor of Obstetrics and Gynaecology, Department of Obstetrics and
Gynaecology, University of Leeds, St James' University Hospital,
Beckett Street, Leeds LS9 7TF, West Yorkshire
Publisher's note: The "Brainscan" logo is reproduced by courtesy of
The Editor, Geriatric Medicine, Modem Medicine GB Ltd.
ISBN 978-3-540-67724-6
British Library Cataloguing in Publication Data
Chard, T.
MRCOG Part 1. -2Rev. ed. -(Brain Scan Series)
I. Title II. Lilford, Richard J. III. Series
610.246181
ISBN 978-3-540-67724-6 ISBN 978-1-4471-3884-6 (eBook)
DOI 10.1007/978-1-4471-3884-6
Library of Congress Cataloging-in-Publication data
A record for this title is available from the Library of Congress
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© Springer-Verlag London 1992
Originally published by Springer-Verlag London Limited in 1992
First published 1987
Second edition 1992
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not imply, even in the absence of a specific statement, that such names
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Preface
This book is intended as a companion to our Basic Sciences for
Obstetrics and Gynaecology, 3rd edn. It covers the same
material in the same order as that text, and the answer to
each question includes a reference to the appropriate page
number or numbers in which further information may be
found. The overall aim is to give candidates for the Part I
MRCOG as close as possible a flavour of the examination,
though clearly it is not possible to include all the facts which
might be addressed.
It is worth while emphasising some general points about
the type of "fact" which may be asked in an MCQ. First, the
fact must be as near as possible unambiguous, at least to the
extent that this can be achieved in a biological science. By
necessity, this excludes vast amounts of often very important
information and concepts. Second, even apparently
immutable facts are subject to occasional revision. We have
attempted to present the "state-of-the-art": most of the
material is generally if not universally accepted. A particular
problem arises with num:erical information. Virtually every
common parameter in physiology and biochemistry has been
the subject of numerous studies, each of which yields
somewhat different results. This applies even to widely used
clinical tests, where every laboratory may have its own
normal range. Thus, with a few exceptions, most of the
numbers given have a "correction interval" of plus or minus
50%. For example, if a figure of 10 U per litre is given as the
normal level of substance X, it is likely that any figure
between 5 and 15 would be acceptable. Examiners would be
unlikely to set a "false" statement which did not lie well
outside these limits.
London and Leeds Tim Chard
April 1992 Richard Lilford
Contents
1. Cell Biology, Embryology and the Placenta .............. 2
2. Anatomy ..................................................................... 26
3. General Physiology and Biochemistry .......... .......... 42
4. Endocrinology..... ........ ........... ... ...................... .......... 54
5. Pathology ............. ........ ... ........... ........... ........... .......... 84
6. Microbiology.............. ........... ........... .............. ............ 98
7. Pharmacology .......................................................... 108
8. Statistics .................................................................... 122
9. Ultrasound ............................................................... 126
1. Cell Biology, Embryology
and the Placenta
Questions
Q.l.l Mitochondria
a. have a bilayer membrane
b. are the principal site of protein synthesis within the cell
c. contain the enzymes of the Krebs cycle
d. have DNA arranged in circles
e. have DNA inherited from the father
Q.l.2 DNA
a. is found outside as well as inside the cell nucleus
b. is found in the nucleosomes
c. is found in papilloma virus
d. is replicated mostly during the prophase of cell division
e. replicates simultaneously in all parts of the chromosome
Q.l.3 Gap junctions between cells
a. are known as desmosomes
b. transmit molecules of molecular weight greater than 100 000
c. are found between granulosa cells
d. are found between granulosa cells and the oocyte
e. are found between Sertoli cells
For answers see over
3
Answers
A.I.I a. F-Mitochondria have inner and outer bilayer membranes.
The inner membrane has numerous folds (cristae).
b. F-The ribosomes are the principal site of protein synthesis.
c. T- The inner membrane of the mitochondria contains the
enzymes and cytochromes of the Krebs cycle.
d. T-Mitochondrial DNA is self-replicating and arranged in
circles.
e. F-Mitochondrial DNA is inherited exclusively from the
maternal oocytes.
pI
A.I.2 a. T-It is found in mitochondria. This DNA is entirely
maternal in origin.
b. T- Nucleosome beads occur where DNA is wound around
four pairs of core histone molecules.
c. T-Papilloma is a DNA virus.
d. F-DNA is replicated during the S phase of the cell cycle.
e. F-The DNA in heterochromatin replicates late.
pp 1,4-6
A.I.3 a. F-Desmosomes are areas where cell membranes are fused
by filaments or filamentous material. They are seen in
epithelia and other tissues and hold cells together.
b. F-Nevertheless, larger molecules than are able to penetrate
membranes are transmitted between cells. Molecules up
to molecular weight 1500 can pass through gap junctions.
c. T-They are also found in the early embryo from 8 cells
onward and in smooth muscles including the uterus and
heart.
d. T- Cytoplasmic processes penetrate the zona pellucid a and
transmit an anti-meiotic factor.
e. F-Tight junctions (closely apposed cell membranes) are
found between cytoplasmic processes of the Sertoli cells
and in the small intestine, where they form a permeability
barrier.
p2
4
Questions
Q.l.4 Chromosome 21
a. is the second largest chromosome in the human
b. is submetacentric
c. carries the gene for growth hormone
d. is in the B group of chromosomes
e. has a nucleolar organiser
Q.l.5 Heterochromatin
a. is genetically inert
b. consists mostly of unique sequences of DNA
c. remains densely coiled during interphase
d. makes up the p arms of the acrocentric chromosomes
e. is increased in certain sex chromosome abnormalities
Q.l.6 In the structure of deoxyribonucleic acid (DNA)
a. the chain consists of linked nucleic acids
b. there is a terminal phosphate group at only one end of the
chain
c. there is a terminal carboxyl group at one end of the chain
d. if one chain has the sequence -AGGTCG- then the other
chain has the sequence -TCCTCA-
e. most coils are right-handed
For answers see over
5
Answers
A.l.4 a. F-It is the shortest.
b. F-It is acrocentric, i.e. the centromere is near the end of one
arm.
c. F-The gene for growth hormone is on chromosome 17.
d. F-It is in the G group - the smallest chromosomes.
e. T- These "nucleolar organisers" are adjacent to the satellites
and are translated into nucleolar RNA.
p4
A.l.S a. T- Heterochromatin is the inert segment of the chromosome
adjacent to the centromere.
b. F-It consists mostly of highly repetitive sequences.
c. T-Euchromatin only becomes coiled during mitosis or
meiosis.
d. T- Hence they are lost without harmful effect in balanced
Robertsonian translocation.
e. F-The inactive heterochromatin of the Barr body, which is
increased when more than two X chromosomes are
present, is referred to as facultative heterochromatin.
p4
A.l.6 a. F-The backbone of the chain isa lternately molecules of
pentose sugar and phosphate groups.
b. T-This is attached to the 5-carbon atom of the pentose (5').
c. F-There is a phosphate at one end and a hydroxyl group
(3') at the other end.
d. F-The sequence must be -TCCAGC- (adenine-thymine;
cytosine-guanine)
e. T- But have short left-handed segments (Z-form).
p5
6
