1
Q
Which of the following structure is not neighbour of anterior surface of the right kidney? A. Right suprarenal gland B. Right lobe of liver C. Right colic flexure D. Descending colon E. Jejenum
A
D. Descending colon
2
Q
2.Which of the following structure does not cross the abdominal part of left ureter? A. Testicular/ovarian artery B. Root of mesentery C. Left colic artery D. Sigmoid colon E. Sigmoid mesocolon
A
B. Root of mesentery
3
Q
- Which of the following is wrong for the pelvis? A. The angle formed by the two arms of the pubic arch is larger in women (80°-85°) than it is in men (50°-609). B. True conjugate (Conjugata vera) is the diameter between promontory and mid point of pubic symphysis and its dimension is about 11cm. C. The angle between superior pelvic aperture and the horizontal plane is 15 degrees. D. Ischial tuberosity of both sides border the inferior pelvic aperture laterally.
A
C. The angle between superior pelvic aperture and the horizontal plane is 15 degrees.
4
Q
- Which of the following structure is not one of the contents of the superficial perineal space (pouch)? A. Crus of clitoris (penis) B. Bulbospongiosus C Ischiocavernosus D. External urethral sphincter E. Transversus perinei superficialis
A
D. External urethral sphincter
5
Q
- Which of the following layer of scrotum is located deep to the skin? A. External spermatic fascia B. Cremaster muscle and fascia C. Internal spermatic fascia D. Dartos fascia E. Tunica vaginalis
A
D. Dartos fascia
6
Q
- Which of the following ligament stabilize ovary to the lateral walls of the pelvis? A.Proper ovarian ligament B. Suspensory ligament of ovary C. Ovarian fimbria
D.Mesovarium E. Round ligament
A
B. Suspensory ligament of ovary
7
Q
- A 23-year-old pregnant woman visits her gynecologist for her routine fetal ultrasound checkup. Ultrasonographic examination reveals unilateral renal agenesis and oligohydramnios. Which of the following conditions most likely occurred? A. Polycystic kidney disease B. Degeneration of the mesonephros C. Ureteric duplication D. Failure of a ureteric bud to form E. Wilms tumor
A
D. Failure of a ureteric bud to form
8
Q
- A 2-month-old boy is brought to the physician because his parents cannot find one of his testicles. Physical examination confirms the parents’ observation. Which of the following is the most likely medical diagnosis? A. Anorchia B. Cryptorchidism C. Inguinal hernia D. Macroorchidism E. Hermaphrodite
A
B. Cryptorchidism
9
Q
- A 23-year-old man visits nephrologist with diabetes insipidus complaint. In this case, which cell is particularly affected and what is its histological feature? A. Principal cells with numerous basal infoldings. B. Intercalated cells with microplicae on their apical plasmalemma. C. Minor calyx cells with transitional epithelium. D. Ascending thin limb of Henle with simple squamous epithelium. E. Ascending thick limb of Henle with simple cuboidal epithelium.
A
A. Principal cells with numerous basal infoldings.
10
Q
- Which of the following signaling mechanisms plays an important role in mediating *hyperactivation” of sperm motility during capacitation in the female reproductive tract? A.Activation of intracellular guanylate cyclase B. Activation of membrane Na/K ATPase C. Mitochondrial membrane permeability transition D. Opening of membrane Ca2+ channels E. Prostaglandin receptor binding
A
D
11
Q
- Which of the below molecular events play a role in the differentiation of the gonads towards the ovary?
A
SRY ( Sex-determining Region Y) induces SOX 9 expression
Il. SRY activate WNT4 expression
II.
SRY stimulates the steroidogenesis factor (SF-1)
12
Q
- Which of the following biological processes accounts for the transformation of a primary to a secondary ovarian follicle? A. Deposition of the extracellular matrix B. Follicular fluid accumulation C. Formation of a second polar body D. Maturation of the zona pellucida E. Proliferation of tissue macrophages
A
B. Follicular fluid accumulation
13
Q
- An active mammary gland shows alveolar cell& with large spherical lipid droplets. Which of the following types of secretion best describes the manner in which these lipid droplets are released into milk during lactation? A. Apocrine B. Eccrine C. Endocrine D.Holocrine E.Merocrine
A
A. Apocrine
14
Q
- A vaginal smear is obtained from a 32-year-old woman who is undergoing in vitro fertilization. Which of the following cytologic features characterizes vaginal epithelial cells that are stimulated by estrogen during the menstrual cycle? A. Apical membrane microvilli B. Dense secretory granules C.Glycogen-filled vacuoles D.Intracellular lipid droplets E. Lamellar bodies
A
C.Glycogen-filled vacuoles
15
Q
- Which of the following is most appropriate for a female suffering from insulin dependent diabetes mellitus with a pH of 7.2, HCO3-: 17 mmol/L and pCO2: 20 mmHg? (Normal levels are 22-26 molL and 35-45 mmHg, respectively) A. Respiratory Acidosis B. Metabolic Alkalosis C. Metabolic Acidosis D. Respiratory Alkalosis E. Decreased renal glutaminase activity
A
A
16
Q
- Which of following enzyme activity is expected to increase in estrogenization condition? A. Amylase B. Lyase C. Isomerase D. Aromatase E. Adipose tissue lipoprotein lipase
A
D. Aromatase
17
Q
- Which substance is the precursor in the biosynthesis of gonadal sex hormones? A. Inhibin B. Cholesterol C. Activin D. Arachidonic acid E. Carnitine
A
B. Cholesterol
18
Q
- What is the most important hormone in order to prepare the uterine wall and maintenance of the pregnancy? A. Inhibins B. Testosteron C. Estrogen D. Progesteron E. Activins
A
D. Progesteron
19
Q
- Diethylstilbestrol (DES) should never be used in pregnant women because it is associated with which of the following? A. Infertility and development of vaginal cancer in female offspring B. Feminization of the external genitalia of male offspring C. Deep vein thrombosis D. Miscarriages E. Virilization of the external genitalia of female offspring
A
Infertility and development of vaginal cancer in female offspring
20
Q
- A male patient is placed on a new medication and notes that his breasts have become enlarged and tender to the touch. Which medication is the most likely taking? A. Furosemide B. Spironolactone C. Hydrochlorothiazide D. Triamterene E. Chlorthalidone
A
B. Spironolactone
21
Q
- A 70-year-old retired businessman with a history of chronic heart failure has been taking digoxin and furosemide. He is now admitted with a history of vomiting, acute decom- pensated heart failure, and metabolic derangements. He has marked peripheral edema and metabolic alkalosis (pH: 7.50; pCO2: 45; HCO3: 36; Na: 140). Which of the following drugs is most appropriate for the treatment of his edema? A. Tolvaptan B. Digoxin C. Eplerenone D. Hydrochlorothiazide E. Acetazolamide
A
E. Acetazolamide
22
Q
- An elderly patient with a history of heart disease has difficulty breathing and is diagnosed with acute pulmonary edema. Which treatment is indicated? A. Acetazolamide B. Chlorthalidone C. Furosemide D. Spironolactone E.Hydrochlorothiazide
A
C. Furosemide
23
Q
- A 58-year-old woman with lung cancer has abnormally low serum osmolality and hyponatremia. Which drug increases the formation of dilute urine and is used to treat syndrome of inappropriate ADH secretion (SIADH)? A.Acetazolamide B.Amiloride C.Desmopressin D. Tolvaptan E.Spironolactone
A
D. Tolvaptan
24
Q
- What acid-base disorder would you expect in patients with “propofol infusion syndrome”? A. Metabolic alkalosis B. Metabolic acidosis C. Respiratory acidosis D. Respiratory alkalosis E. Normal blood gas pH level
A
B. Metabolic acidosis
25
25. A 58-year-old man is given a glucose tolerance test. In the test, the plasma glucose concentration is increased and glucose reabsorption and excretion are measured. When the plasma glucose concentration is higher than occurs at transport maximum (Tm). Which of the following statements is true? A. Clearance of glucose is zero B. Excretion rate of glucose equals the filtration rate of glucose C. Reabsorption rate of glucose equals the filtration rate of glucose D. Excretion rate of glucose increases with increasing plasma glucose concentrations E. Renal vein glucose concentration equals to the renal artery glucose concentration
D. Excretion rate of glucose increases with increasing plasma glucose concentrations
26
26. A 35-year-old woman suffers from acute liver failure due to liver cancer. She is jaundiced and edematous. Which of the following Starling forces in the kidney are likely to be primarily and secondarily affected by her condition?
Oncotic pressure decrease
Hydrostatic pressure increase
27
27. After eating a meal that is very high in sodium (3,000 mg), plasma hyperosmolarity triggers which of the following change to the thirst response, antidiuretic hormone (ADH) secretion,and ultimately urine output?
Thirst response: Increase
ADH secretion: Increase
Urine output: Increase
28
28. All of the following factors contribute to establishing or maintaining the medullary interstitial concentration gradient except: A. Distal tubule sodium reabsorption B. NKCC-2 cotransporters on the thick ascending limb of Henle C. Solute-free water reabsorption in the descending limb of Henle D. The counter-current multiplier effect E.Urea recycling
A. Distal tubule sodium reabsorption
29
29. A 17-year-old male presents with urethral burning following urination. He is asked to provide a urine sample and swabbed to test for a possible bacterial infection. Which of the following is responsible for initiating micturition when providing a urine sample? A. Pontine micturition center B. Uroepithelial mechanoreceptors C. Spontaneous detrusor contractions D. Rising intravesical pressure E. Internal urethral sphincter relaxation
A. Pontine micturition center
30
Which of the following changes is not characteristic of the effects of testosterone? A. Sex organs grow and function B. Increase in muscle mass C. Voice deepens D. Broadening of the pelvis E. Hair growth on face and body
Broadening of the pelvis
31
31. The blood level of luteinizing hormone (LH) is measured daily in a 23-year-old healthy woman over a 28-day menstrual cycle (day 1 is the first day of menstrual bleeding) and plotted in the image. At times A and B, the blood levels of various hormones were measured, Which of the following hormones is expected to have the highest B/A blood concentration ratio? A. Dihydrotestosterone B. Estradiol C. Follicle-stimulating hormone D. Progesterone E. Testosterone
D. Progesterone
32
32. A 41-week pregnant woman presents to the hospital because of uterine contractions. She is frustrated because she has experienced uterine contractions for several days. Her cervix is only 3 centimeters dilated, and the amniotic sac is intact. During the evaluation, she experiences mild contractions every 6-10 minutes, each lasting 15-20 seconds. A synthetic analogue of which of the following could be given to increase the strength and frequency of her contractions? A.Cortisol B.Estrogen C. Oxytocin D. Prolactin E. Prostocyclin
C. Oxytocin
33
33. Which one below is a gene that is associated with Y chromosome infertility? A. AZFa, azoospermia factor region a B. AZFb, azoospermia factor region b C. AZFc, azoospermia factor region c D. USP9Y, ubiquitin specific peptidase 9 Y-linked E.Ch 21, chromosome number 21
D. USP9Y, ubiquitin specific peptidase 9 Y-linked
34
34. Which one below is low sperm count? A.1-5 million sperm per MI 5-25 million sperm per mL C.25-50 million sperm per mL D.50-75 million sperm per mL E. 75-100 million sperm per mL
A.1-5 million sperm per MI
35
35. Empiric treatment of an asymptomatic UTI is not recommended. What is the one exception to this rule? A. Children under 18 years of age
B. Elderly men 75+ C. Elderly women 75+ D. Pregnant women E. Young women of childbearing age
D. Pregnant women
36
36. All of the following are common causes of urethritis in men except: A. Gardnerella vaginalis B. Mycoplasma genitalium C. Neisseria gonorrhoeae D. Chlamydia trachomatis E. Ureaplasma urealyticum
A. Gardnerella vaginalis
37
37.Each of the following statements concerning rubella is except
A. Congenital abnormalities occur primarily when a pregnant woman is infected during
the first tirmester. B. Women who say that they have never had rubella can, nevertheless, have
neutralizing antibody in their serum C. In a 6-year-old child, rubella is a mild, self limited disease with few complications. D. Acyclovir is effective in the treatment of congenital rubella syndrome. E. Postnatal infection with rubella has an excellent prognosis.
D. Acyclovir is effective in the treatment of congenital rubella syndrome.
38
38. Which one of the below choices is associated with high risk for renal neoplasms ?
A. Autosomal dominant (adult) polycystic kidney disease
B. Acquired cystic kidney disease
C. Autosomal recessive (childhood) polycystic kidney disease
D. Simple kidney cyst
E. Nephronophthisis
B. Acquired cystic kidney disease
39
39. A 5 years old boy was taken to a pediatrician with complaints of puffy eyes, swollen face, puffy hands and feet, and sudden weight gain. Laboratory workup revealed proteinuria of 5g/day, plasma albumin level of 2.5g/dL and lipiduria. The patient has anasarea type edema but no hypertension. Kidney biopsy revealednormal glomeruli under the light microsopy and diffuse effacement of the foot processes of the podocytes in electrone microscopy. What is the most likely diagnosis of the clinical syndrome and diğsease pair in this case ?
A. Acute kidney injury-Membranoploliferative glomerulonephritis
B. Nephritic nsyndrome-Focal segmental glomerulosclerosis
C. Nephrotic syndrome-Minimal change disease
D. Uremia-Medullary cystic disease
E. Chronic kidney disease- Membranous nephropathy
C. Nephrotic syndrome-Minimal change disease
40
40.Which one of the below neoplasms has malignant blastemal , epithelial and stromal components?
A. Low grade papillary urothelial carcinoma
B. Oncocytoma of the kidney
C. Renal cell carcinoma
D. Chromophobe renal carcinoma
E. Wilms Tumor ( Nephroblastoma)
E. Wilms Tumor ( Nephroblastoma)
41
41.Which of the below conditions is a precursor lesion for prostate cancer ?
A. High grade prostatic intraepithelial neoplasia
B. Chronic pelvic pain syndrome C. Granulomatous prostatitis D. Prostatic hypoerplasia E. Corpora amylacea
A. High grade prostatic intraepithelial neoplasia
42
42.What is the name of the vulvar disease defined by light microscopic findings of “thinned
epidermis with loss of rele pegs, underlined by a zone of acellular i homogenized dermal
fibrosis and a bandlike mononuclear inflammatory cell infiltrate “?
A. Lichen simplex chronicus B. Lichen Sclerosus C. Condylomata accuminata D. Lichen atrophicus E. Condylomata lata
B. Lichen Sclerosus
43
43. When an uterine subserosal smooth muscle neoplasm extends out an attenuated stalk
and becomes attached to surrounding organs,what is it named ?
A. Metastatic leiomyoma B. Submucosal leiomyoma C. Intramural leiomyoma D. Parasitic leiomyoma E. Leiomyosarcoma
D. Parasitic leiomyoma
44
44.What is the name of the condition in a breast biopsy described as “dilated large ducts with
fibrous walls which contain accumulated lipid-rich detriuts in the lumen and do not have
accompanying apithelial hyperplasia or apocrine metaplasia ?
A. Fibrocystic disease B. Adenosis C. Gynecomastia D. Acute Mastitis E. Mammary duct ectasia
E. Mammary duct ectasia
45
45.Which of the following explains the oncogenic effect of high-risk HPV virus that infects the
cervical epithelium ?
Viral oncoproteis E6 and E7 inhibit cyclin-dependent kinase inhibitors epithelial cells and stop epithelial cell proliferation.
in cervical
Viral oncoproteins E6 and E7 logether increase the surface receptoes on the epithelial cell membrane to which the virus will bind
C.
Viral oncoprotein E6 enhances the apoptotic effect of E7 in epithelial cells.
D. Viral oncoproteins E6 and E7 impair the epithelial cell's ability to repair DNA damage and promote cell cycle progression
^
E. Viral oncoproteins E6 and E7 not only promote cell cycle progression but also cause disruption of tight junctions between epithelial cells.
Viral oncoproteins E6 and E7 impair the epithelial cell's ability to repair DNA damage and promote cell cycle progression
46
46. In the pap smear test taken during routine gynecological control of a 49-year-old woman, cytomorphologically , koilocytotic changes (perinuclear halo and mild nuclear membrane irregularity ) are observed in the superficial cells. Colposcopic biopsy performed a year later shows dysplastic changes in ⅓ of the cervical epithelium.The patient has no clinical complaints.According to these findings , what is your most likely diagnosis and what should be done in the patient according to these findings , what is your most likely diagnosis and what should be done in the patient according to this diagnosis ?
A. Carcinoma in situ - Histerectomy
B. HSIL- Radiotherapy C. LSIL-Careful observation,if persistent in follow-up,cone biopsy D. LSIL-Hysterectomy E. LSIL-cone biopsy and chemotherapy
C. LSIL-Careful observation,if persistent in follow-up,cone biopsy
47
47.In the abdominopelvic ultrasonography of a 23-year-old female patient with dysmenorrhea
since menarche, a mass of 10cm in diameter containing semi-solid and cystic areas
associated with the right and left ovaries, and hydroureteronephrosis as a result of the
pressure of this mass on the ureter , is detected. Histomorphological examination of the
resected mass reveals extensive bleeding areas, tubular gland structures lined with
proliferated epithelium within the fibrovascular ovarian stroma, and special stroma around the
glands. A large number of hemosiderin-laden macrophages are observed in the sampling
from cystic areas . What is your probable diagnosis based on these findings?
A. Struma ovarii B. Brenner Tumor C. Endometrioid Tumor D. Benign cystic teratoma E. Low-grade serous carcinoma
50. Which of the following is not true regarding prognostic factors in invasive breast
carcinoma ?
A. Mature cystic teratoma B. Endometriosis C. Adenomyosis D. follicle cyst E. choriocarcinoma
B. Endometriosis
48
48.During the routine examination of healthy 3-year-old boy who has no complaints, it is
determined that the left testicle is not in the scrotum and there is a swelling in the left inguinal
region.What is the possible diagnosis of this patient and what are the risks associated with
the diagnosis ?
A. Phirnosis-Testicular torsion and growth retardation B. Variocele-Infertility and scrotal tumor C. Balanoposthitis-testicular tumor-Hydrocele D. Hypospadias-Urinary tract obstruction-Infertility E. Cryptorchidism-Infertility -Testicular tumor
E. Cryptorchidism-Infertility -Testicular tumor
49
49.What is the possible diagnosis for an ovarian mass, which is usually located unilaterally
and often tends to be in the right ovary,histomorphoogically originating from three germ
sheets, containing mature tissues such as teeth,skin and appendages,bronchial and
gastrointestinal epithelium ?
A. Struma ovarii B. Brenner Tumor C. Endometrioid Tumor D. Benign cystic teratoma E. Low-grade serous carcinoma
D. Benign cystic teratoma
50
Which of the following is not true regarding prognostic factors in invasive breast
carcinoma ?
A. Carcinomas with high proliferation rates have a better prognosis but are less
responsive to chemotherapy. B. The risk of axillary lymph node metastasis increases with the size of the primary
tumor. C. Breast cancers presenting with breast erythema and skin thickening have a very poor
prognosis. D. Invasive carcinomas with histological grade are highly associated with disease-free
and overall survival.
E. Lymph node metastasis is a poor prognostic factor for overall survival
Carcinomas with high proliferation rates have a better prognosis but are less
responsive to chemotherapy.
51
51. What is not true for hypovolemia ?
A. Hypothalamic thirst center is stimulated
B. Renin angiotensin axis is stimulated
C. Atrial natriuretic peptide is stimulated
D. Antidiuretic hormone is stimulated
E. Bradykinin is decreased
C. Atrial natriuretic peptide is stimulated
52
presence of chronic kidney disease can not be defined in :
A. Presence of micoalbuminuria longer than 3 months
B. Glomerular filtration rate 85 ml/minute without evidence of kidney disease
C. Good functioning kidney graft after kidney transplantation
D. Presence of horseshoe kidney with normal glomerular filtration rate
E. Persistent hypokalemia due to renal tubular dysfunction
Glomerular filtration rate 85 ml/minute without evidence of kidney disease
53
53.Which one below is not related to prereanl kidney insufficiency ?
A. Cyclosporine use
B. Hypercalcemia
C. Hepatorenal syndrome
D. Anaphylaxis
E. Amphotericin B
Amphotericin B use
54
.In urine test, which one is diagnostic for glomerular disease ?
A. Isomorphic crytrocytes
B. Hyalene casts
C. Calcium carbonate crystals
D. Red blood cell cast
E. Granular casts
D. Red blood cell cast
55
.60 years old, male,36kg,serum creatinine level 2.0mg/dL. Calculate creatinine clearance ?
A. 20 mL/min
B. 40 mL/min
C. 60 mL/min
D. 80 mL/min
E. 120 mL/min
A. 20 mL/min
56
Which of the below definitions define acute kidney injury in children ?
I. 2-fold increase of serum creatinine II. 3-fold increase of serum creatinine
III. GFR decreases >50% IV. GFR decreases >75%
A. Only I
B. I and II
C. I and III
D. II and IV
E. I and IV
C. I and III
57
57. Which of the following is not related with chronic kidney disease mineral bone disease ?
A. Decline in Ia hydroxyls activity
B. Decreased production of activated vitamin D
C. Secondary hyperparathyroidism
D. Hypophosphatemia
E. Increased bone resorption
. Hypophosphatemia
58
58.During the first urinary tract infection in children which of the following imaging method should be primarily chosen ?
A. Sonogram
B. Staticscintiography (DMSA)
C. Voiding cystourethrogram
D. Dynamic scintigraphy (DTPA)
E. MAC3 scintigraphy
A. Sonogram
59
59.What is the most frequent cause of urinary obstruction in old men ?
A. Ureteral stone
B. Bladder stone
C. Congenital malformation
D. Benign prostatic hyperplasia
E. Urinary tract infections
. Benign prostatic hyperplasia
60
What is the most common cause of bladder pain ?
A. Infection (cystitis)
B. Bladder stone
C. Benign prostatic hyperplasia
D. Kidney stone referral pain E. Bladder tumors
A. Infection (cystitis)
61
61.What is dysuria ?
A. Bloody urine
B. Gas flow during urination
C. Burning felt during urination ( Painful urination )
D. Intermittent urination
E. No urine output
C. Burning felt during urination ( Painful urinati
62
62.What is the most common bacteria in cystitis in women ?
A. Streptococci
B. Ureaplasma
C. E.coli
D. Mycoplasma
E. Chlamydia
C. E.coli
63
63. Which is not a symptom of benign prostatic hyperplasia ?
A. Hesitancy
B. Lower urination power
C. Longer urination time
D. Residual urine feeling
E. Perineal pain
Perineal pain
64
64.Which of the following is not a predictor for ovulation evaluation ?
A. Mid-luteal phase serum progesterone level
B. Basal body temperature rise
C. Endometrial Polyps
D. Urinary LH concentration
E. Cyclis menses, Breast tenderness, Mittelschmerz
C. Endometrial Polyps
65
65. Which of the following is an exogenous factor for abnormal uterine bleeding ?
A. Intrauterine device
B. Ectopic pregnancy
C. Obesity
D. Leiomyoma
E. Cervical cancer
A. Intrauterine device
66
66.Which of the following does not affect the ovarian reserve ?
A. Advancing age
B. Prior ovarian surgery
C. Duration of infertility
D. Chemotherapy
E. Smoking
C. Duration of infertility
67
67.Which of the following is a structural cause for abnormal uterine bleeding ?
A. Hyperprolactinemia
B. Congenital adrenal hyperplasia
C. Hepatorenal insufficiency
D. Endometrioial polyps
E. Thyroid disease
D. Endometrioial polyps
68
Patient with abdominal pain and vomiting. Which answer best describes the X-ray appearances and what does the anatomical landmark marked on image represent ?
A. Normal , psoas edges B. Normal , normal bowel gas C. Pneumoperitoneum, Rigler’s double wall sign D. Kidney’s, staghorn renal calculus E. Thumbprinting, ulcerative colitis
A. Normal , psoas edges
69
69.What is the cause of the area of increased density in the pelvis ?
A. Calcified abdominal lymph node
B. Calcified pelvic kidney
C. Calcified uterine field
D. Ingested barium
E. Calcified adrenal gland
C. Calcified uterine field
70
70. What is the article in which sexual dysfunction are claimed as a ground for divorce according to the civil code ?
A. Adultery
B. Intruding on life , very bad or dishonorable life C. Committing a crime and leading a dishonorable life D. Abondenment E. Disruption of the marriage union
E. Disruption of the marriage union
303
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