Download Neet PG Gynecology MCQs Question Bank
2.Bestgasusedforcreating pneumoperitoniumatlaparoscopyis: a)N2 b)02 c)CO2 d)N20Goniometerisused CorrectAnswer-CCO2CO,isthegasusedtocreatepneumoperitoneumduringlaparoscopy.Otheroptionis-N20:Butitisexpensive,lesssolubleinbloodandsupportscombustion.Alsoknow:Instrumentusedforcreatingpneumoperitoneumisveressneedle.FlowRateofCO,forcreatingpneumoperitoneum200-2000ml/min&pressurebetween15-25mmofHg.
3.Gonococcihasaffinityfor: a)Columnarepithelium b)Glandularepithelium c)Stratifiedsqamousepithelium d)Squamousepithelium CorrectAnswer-AColumnarepithelium
4.InacaseofDysgerminomaofovaryoneof thefollowingtumormarkersislikelytoberaised: a)SerumHCG b)Serumalphafetoprotein c)Serumlacticdehydrogenase d)Seruminhibin CorrectAnswer-CAns.isci.e.Serumlacticdehydrogenasehoweverplacentalalkalinephosphateandlactatedehydrogenasearecommonlyproducedbydysgerminomasandmaybeusefulinmonitoringthedisease."
5.Whichofthefollowingovariantumoris mostpronetoundergotorsionduringpregnancy: a)Serouscystadenoma b)Mucinouscystadenoma c)Dermoidcyst d)Thecaluteincyst CorrectAnswer-CAns.isci.e.Dermoidcyst"Abenigncysticteratomaisthemostcommonneoplasmtoundergotorsion,andittotheM/Cbenigntumordiagnosedduringpregnancy."Abenigncysticteratomaissynonymoustodermoidcyst.Remember:Mostcommonovariantumourinpregnancyisserouscystadenomabutmostlyremainsundiagnosed.Incidenceofdermoidcystisincreasedtwofoldduringpregnancyanditisthemostcommonneoplasmdiagnosedduringpregnancy.Hingoranisignseen:-Inovariantumorduringpregnancy.Trendelenburg'spositioncanelicitthegroovebetweentwoseparateswelling.Usedtodistinguishbetweenovariantumourandfibroid.
6.WhichofthefollowinghasLEAST pregnancyfailurerate: a)OCP b)IUCD c)Diaphragm d)Condom CorrectAnswer-AOCP
7.Whichofthefollowingistrueregarding precociouspuberty: a)Sexualmaturityisattainedearly b)Mentalfunctionisincreased c)Noreproductivefunction d)Bodyproportionsareenlarged CorrectAnswer-AAns.isai.e.SexualmaturityisattainedearlyPrecociouspubertyistheappearanceofappropriatesecondarysexualcharactersbeforetheageof8yearsandoccurrenceofmenstruationbefore10yearsofchronologicalage.Alsoknow:Delayedpuberty:isconsidereddelayedwhenthesecondarysexualcharactersdonotappearbytheageof14,andmenarcheisnotestablishedby16yearsofage.
8.Causeofunilateraldysmenorrhea: a)Onehornofmalformeduterus b)Endometriosiswithunilateraldistribution c)Smallfibroidattheuterotubaljunction d)Alloftheabove CorrectAnswer-DAlloftheaboveCausesofunilateraldysmenorrhea:OnehornofmalformeduterusEndometriosiswithunilateraldistributionSmallfibroidattheutero-tubaljunction.OvariandysmenorrheaRightovarianveinsyndromeColonicorcaecalspasm.
9.Progesteroneofchoiceinemergencycontraceptionis? a)Norethisterone b)Medroxyprogesterone c)Oxytocin d)Levonorgestrel CorrectAnswer-DUnprotectedintercoursewithoutregardtothetimeofthemonthcarriesan8%incidenceofpregnancy,anincidencethatcanbereducedto2%bytheuseofemergencycontraceptiveswithin72hoursofunprotectedintercourse.0.75mglevonorgestrelarenowapprovedforpostcoitalcontraceptionandareavailableoverthecounterforwomenaged>17years.Levonorgestrelismoreeffectiveandisassociatedwithfewersideeffectsthanthecombinationestrogen-progestinregimens.Basicallythemethodsusedinterferewiththephysiologicaleventsbeforeimplantation,fore.g.inhibitionordelayingofovulationorinterferencewithpostovulatoryeventsnecessaryforimplantation&longevityoftheblastocyst.Ref:HallJ.E.(2012).Chapter347.TheFemaleReproductiveSystem,Infertility,andContraception.InD.L.Longo,A.S.Fauci,D.L.Kasper,S.L.Hauser,J.L.Jameson,J.Loscalzo(Eds),Harrison'sPrinciplesofInternalMedicine,18e.
10.Whichamongthefollowingisanabsolute contraindicationofHormonereplacementtherapy? a)Endometriosis b)Osteoarthritis c)Heartdisease d)Breastcarcinoma CorrectAnswer-DAbsolutecontraindicationsofhormonereplacementtherapy(HRT):UndiagnosedvaginalbleedingEstrogendependentcancerinthebodySevereliverdiseasePregnancyVenousthrombosisWell-differentiatedandearlyendometrialcancer(oncetreatmentforthemalignancyiscomplete,isnolongeranabsolutecontraindication.)
11.A40yearoldwomanpresentswith abnormalcervicalcytologyonPAPsmearsuggestiveofCINIII(HSIL).Thenextbeststepinmanagementis: a)Hysterectomy b)ColposcopyandLEEP c)ColposcopyandCryotherapy d)Conization CorrectAnswer-BAccordingtoFIGOclassification,cervicalintraepithelialneoplasia3(CIN3)belongtostage0.LoopelectrocauteryexcisionproceduredoneundercolposcopicvisualizationisthemodeoftreatmentforCINIIandCINIIIlesions.Ref:Novak's,14thEdition,Page582,583;William'sGynoecology,1stEdition,Page635;COGDT,10thEdition,Pages841,837;Dewhurst's,6thEdition,Pages575,574.
12.Chlamydiatrachomatisinfection commonlycauses:March2004 a)Infertility b)Postcoitalbleeding c)Amenorrhoea d)Malignancy CorrectAnswer-AAns.Ai.e.Infertility
13.Maindifferencebetweenanorexianervosa andbulimianervosaliesin:March2013 a)Symptomatology b)Weight c)Gender d)Age CorrectAnswer-BAns.Bi.e.WeightAnorexianervosaandbulimiaBothanorexianervosaandbulimiaarecharacterizedbyanovervalueddriveforthinnessandadisturbanceineatingbehavior.Themaindifferencebetweendiagnosesisthatanorexianervosaisasyndromeofself-starvationinvolvingsignificantweightlossof15percentormoreofidealbodyweight,whereaspatientswithbulimianervosaare,bydefinition,atnormalweightorabove.Bulimiaischaracterizedbyacycleofdieting,binge-eatingandcompensatorypurgingbehaviortopreventweightgain.Purgingbehaviorincludesvomiting,diureticorlaxativeabuse.Excessiveexerciseaimedatweightlossoratpreventingweightgainiscommoninbothanorexianervosaandinbulimia.
14.Notseeninanorexianervosa: September2009 a)Osteoporosis b)Refusaltofeeds c)Weightloss d)Menorrhagia CorrectAnswer-DAns.D:MenorrhagiaPhysicalSignsofanorexianervosa*Excessiveweightloss*Scantyorabsentmenstrualperiods*Thinninghair-Dryskin*ColdorswollenhandsandfeetBloatedorupsetstomach*DownyhaircoveringthebodyLowbloodpressure*Fatigue*Abnormalheartrhythms*OsteoporosisPsychologicalandBehavioralSignsinanorexianervosa*Distortedperceptionofself(insistingtheyareoverweightwhentheyarethin)*BeingpreoccupiedwithfoodRefusingtoeat*Inabilitytorememberthings*RefusingtoacknowledgetheseriousnessoftheillnessObsessive-compulsivebehavior*Depression
15.Firstpolarbodyisformedafter? a)Mitosis b)Firstmeiosis c)Secondmeiosis d)Fertilization CorrectAnswer-BAns.is'b'i.e.,FirstmeiosisOogenesisOogenesisreferstotheprocessofformationofovafromtheprimitivegermcells.Unlikefetaltestis(inwhichspermatogenesisbeingsatpuberty),thefetalovarybeginsoogenesisby10weeksofgestation.oThesequenceofeventsinoogenesisare:i)Theprimitivegermcellsundergomitoticdivisionstoformoogonia(diploidOogoniumisuniqueinthatitistheonlyfemalecellinwhichboth'X'chromosomesareactive.ii)Theoogoniaproliferatebymitosistoformprimaryoocytes(diploidcells).iii)Primaryoocytesformedfromtheoogoniaenteraprolongedprophase(diplotenestage)ofthefirstmeioticdivisionandremaininthisstageuntilovulationoccursafterpuberty.iv)Primaryoocytescompletesthefirstmeioticdivisionatpubertyjustbeforeovulationtoformsecondaryoocyte(haploidcell)and1stpolorbody.v)Secondaryoocyteimmediatelybeginssecondmeioticdivisionbutthisdivisionstopsatmetaphaseandiscompletedonlyifthematureovum(ootid)isfertilizedwithsperm.Atthattimesecondpolorbody(polocyte)isextrudedandthefertilizedovumproceedstoformanewindividual.Fertilizationnormallyoccursintheampullaof
fallopiantube.
16.Conceptusentersuterinecavityinwhich cellstage? a)4cells b)8cells c)16cells d)32cells CorrectAnswer-CAns.is'c'i.e.,16cellsFertilizationandimplantationFertilizationreferstofusionofmaleandfemalegametes(i.e.spermatozoonandovum).Ittakesplaceinthemiddlesegment(ampulla)offallopiantube.Beforefertilization,theovumandspermsreachtheampullaforfertilization.Fusionofspermatocyteandovumleadstoformationofzygote.Firstweekofdevelopmentbeginsimmediatelyafterfertilizationandincludes:?i)Cleavageofzygote:Zygote(fertilizedovum)startsdividingimmediatelyandlargezygoteissubdividedintosmallerdaughtercellscalledblastomeres.Blastomeresarestillsurroundedbyzonapellucida.Cleavageoccursinfallopiantube(uterinetube).ii)Formationofmorula:Atabout16cellsstagetheblastomerestightlyalignbytheprocessofcompactiontoformacompactballofcellscalledmorula(mulberry).Thisprocessofcompactionleadstosegregationofcellsintotwogroups(i)innercells(innercellmass),and(ii)outercells(outercellmass).Morulaentersuterinecavity4daysafterfertilization.iii)Formationofblastocyst:Asthemorulaenterstheuterinecavity,uterinefluiddiffusesthroughzonapellucidaandfillssmallintercellulargapsbetweenblastomeres,andmorulaisconvertedto
blastocyst.Blastocystconsistsof:?a)Zonapellucida:Outercovering.b)Embryoblast:Agroupofcenterallylocatedcellsofinnercellmassandlatergiverisetotissuesofembryoproper.c)Trophoblast:Athinouterlayerofcellsformedfromoutercellsmassandlatergiveriseextraembryonictissues.d)Blastocele:Cavityofblastocyst:Theregionofblastocystcontainingembryoblastisknownasembryonicpoleandtheoppositepole,theabembryonicpole.Thetrophoblastsoverlyingtheembryoblastatembryonicpoleiscalledpolartrophoblastandthatoccupyingtherestofwallcalledmuraltrophoblast.Between5-6daysafterfertilization,blastocysthatchesfromzonapellucida,andthisnakedblastocystisreadyforimplantation
17.Implantationoccursonwhichmenstrual cycleday? a)5-7days b)20-22days c)14-18days d)26-28days CorrectAnswer-BAns.is'b'i.e.,20-22daysImplantationoccursat6-7daysafterfertilization.Ovulationoccursat14thdayofmenstrualcycleandfertilizationoccurwithin24hoursafterovulation.Thus,implantationwillcorrespondto20-22daysofmenstrualcycle.
18.Blastocytecomesoutonwhichdayafter fertilization? a)4-7days b)10-12days c)12-15days d)15-20days CorrectAnswer-AAns.is'a'i.e.,4-7daysFreefloatingunimplantedblastocystisseenon4-5days.
19.DMPAisgivenoncein- a)3months b)6months c)9months d)45days CorrectAnswer-AAns.is'a'i.e.,3monthsHORMONALCONTRACEPTIVESThesearehormonalpreparationsusedforreversiblesuppressionoffertility.TypesofmethodsA.OralCombinedpill(monophasicpills)Itcontainsanestrogenandaprogestin.Thisisthemosteffectiveandpopularmethod.Efficacyis98-99%Preparationare-Ethinylestradiol30pg(?03mg)+Norgestrel0.3mgEthinylestradiol50.tg(?05mg)+Levonorgestrel0.25mgEthinylestradiol30pig(?03mg)+Desogestreol0.15mgOnetablet(containingestrogenandprogesterone)istakendailyfor21daysstartingon51"dayofmensturation.PhasedregimensTheestrogendoseiskeptconstant(orvariedslightlybetween30-40mg),whiletheamountofpregestinislowinfirstphaseandprogressielyhigherinthesecondandthirdphases.PreparationsareBiphasicpills
Day1-10Ethinylestradiol35mg+Norethindrone0.5mgDay11-21Ethinylestradiol35mg+Norethindrone1mg.TriphasicpillsDay1-7Ethinylestradiol35mg+Norethindrone0.5mgDay8-14Ethinylestradiol35mg+Norethindrone0.75mgDay15-21Ehinylestradiol35mg+Norethindrone1mgMinipill(progestinonlypill)Alowdoseprogestinpillistakendailywithoutanygap.PreparationsNorethindrone(0.35mg)orNorgestrel75mg.Postcoital(emergency)pills.a)Levonorgestrel0.5mg+ethinylestradiol0.1mg-->within72hoursofunprotectedintercourseandrepeatedafter12hours-Yuzpemethod.b)Levonorgestrelalone0.75mgtakentwicewith12hourgapwithin72hoursofunprotectedintercoursemethodofchoiceforemergencycontraception.c)Mifepristone600mgsingledosewithin72hoursofunprotectedintercourse.B.InjectableTheyaregiveni.m.asoilysolution1.Longactingprogestinalonea)Depotmedroxyprogesteroneacetate(DMPA)150mgat3monthintervals.orb)Norethindrone(norethisterone)enanthate(NEE)200mgat2monthsintervals.c)Themostimportantundesirablepropertyiscompletedisruptionofmensturalbleedingpatternandtotalamenorrhoea(morecommonwithDMPA).2.Longactingprogestin+longactingestrogen-onceamonth.
20.Patientofjuvenilemyoclonicepilepsyon valproatecomestoyouat5monthsofpregnancywithlevelHscannormalwhatwillyouadvise? a)Changethedrug b)Continuethedruginsamedose c)Decreasethedoseofdrug d)Increasethedoseofdrug CorrectAnswer-BAns.is'b'i.e.,ContinuethedruginsamedoseValproicacidhastheriskoffetalmalformationsduringthefirsttrimesterofpregnancy.ThispatienthasnormallevelIIscanat5monthsofpregnancysotheriskperiodofvalproateisalreadyoverandvalproateisthedrugofchoiceinjuvenilemyoclonicepilepsy.Thusthedrugshoudbecontinuedinthesamedoses.
21.GestationalTrophoblasticneoplasmdoes notinclude- a)Choriocarcinoma b)Placentalsitetrophoblastictumour c)Invasivemole d)Partialmole CorrectAnswer-DAns.D.PartialMoleThemaintypesofgestationaltrophoblasticdiseasesare:Hydatidiformmole(completeorpartial)InvasivemoleChoriocarcinomaPlacental-sitetrophoblastictumorEpithelioidtrophoblastictumorNote:Inthegivenbestoptionbestanswercanbepartialaspartialhydatidiformmoleisnotcompletelymentionedinit.
22.Whichvaccineiscontraindicatedin pregnancy: a)Chickenpox b)Rabies c)Tettoxoid d)HepatitisB CorrectAnswer-AAns.A.ChickenpoxAsaruleofthumbthevaccinationwithliveviralorbacterialvaccineiscontraindicatedinpregnancy.Theimportantonesare:?MeaslesMumpsPoliomyelitisRubellaYellowfeverVaricellaBCG
23.45yearsfemalewith3months menorrhagia.USGshowing2cmsubmucosalfibroid.Treatmentoptions. a)Ocpfor3months b)Progesteronefor3months c)Endometrialsampling d)Hysterectomy CorrectAnswer-DAns.D.Hysterectomy YOUNGWOMEN OLDERWOMEN ContraceptiondesiredCombinedOCPs Contraception Ruleoutcancer&uterine Progestogensandother notdesirable pathology hormonesMirena Normaluterus Uterine Progestogens Effective Fails (DUB) pathology Ethamsylate, Minimal Progestogens NSAIDs invasive andothers Estrogen Continue surgery ?Noresponse Tranexamicfor for6?9 Hysterectomy Hysterectomy Surgery 3?4months months with withremovalof GnRH3?4 conservation ovariesafter50 months ofovaries years Removalofanintrauterinecontraceptivedeviceifmedicaltherapyfails.Myomectomy/hysterectomyforuterinefibroids.
Wedgeresection/hysterectomyforadenomyosisoftheuterus.DilatationandcurettagewithbloodtransfusionistheprimarytreatmentofpubertymenorrhagiawithlowHb%Multipara,hypertensivewomanwithmenorrhagiashouldbetreatedwithMIRENAHysterectomywithorwithoutremovaloftheadnexaaccordingtotheageandtheindividualneedsofthepatient.
24.Inlowovarianreserve,antimullerian hormonelevelwillbe: a)<1 b)1-4 c)>7 d)>10 CorrectAnswer-AAns.A.<1AMHandovarianreserveAMHof1.0hasverypoorovarianreserveThecentralconceptforthemeasurementofbloodlevelsofAMHtodetermineovarianreserveisthis:womenwithlowerAMHlevelshavealowerovarianreservethanwomenwithhighAMHlevels.AMHiscurrentlybeingusedbyfertilityspecialiststohelppredictwomenwhomayrespondpoorlytofertilitymedicationsandingeneral,coupleswhoarelesslikelytobesuccessfulwithfertilitytreatment.
25.Presentingdiameteroffullflexedhead: a)Suboccipito-bregmaticdiameter b)Suboccipito-frontaldiameter c)Occipito-frontaldiameter d)Occipito-posteriorposition CorrectAnswer-AAns.A.Suboccipito-bregmaticdiameterSuboccipito-bregmaticdiameter:Thediameterisfromsuboccipitalregiontocentreofthebregma.Diameter=9.5cmFetalheadcircumferenceissmallest(32cm)HeadwellflexedFlexedvertexpresentationSuboccipito-frontaldiameter:Diametercalculatedfromprominenceatmidfrontalbonetotheunder-surfaceoftheoccipitalbonewhereitjoinsneckThediameteris10.5cmVertexispartiallydeflexed.Resultsinoccipito-posteriorposition.Occipito-frontaldiameter:Diameterextendsfromtheprominentpointofmid-frontalbonetothemostprominentpointofoccipitalboneThediameter=11.5cmFetalheadcircumference~34.5cmVertexisdeflexedAssociatedwithDirectoccipito-posteriorposition.Occipito-posteriorposition:Itisavertexpresentationinwhichtheocciputisplacedposteriorly.
26.Whatisthedoseofulipristalacetate? a)300mg b)30mg c)300?g d)30?g CorrectAnswer-BAns.B.30mgUlipristal(Ella)isaprogesteroneagonist/antagonistmarketedforemergencycontraception.Itisavailablebyprescriptiononly.Itsmechanismofactionvariesbasedontimeofadministration.Whentakenbeforeovulation,ulipristaldelaysorinhibitsovulation.Administrationintheearlylutealphasemaydecreaseendometrialthicknessandaffectimplantationofafertilizedegg.Ulipristalislabeledforuseasanemergencycontraceptivefollowingunprotectedsexualintercourseorcontraceptivefailure.Onetablet(30-mgtablet)takenassoonaspossible,within120hours(fivedays)ofunprotectedsexualintercourseorcontraceptivefailure.
27.Prematureejaculationisapartofwhichphaseof sexualdisorders? a)Excitementphase b)Plateauphase c)Orgasmphase d)Refractoryphase CorrectAnswer-CAns.C.OrgasmphaseThemalesexualresponseisdescribedasasequenceofphasesincluding4stages:sexualdesire,arousal,orgasm(ejaculation)andresolution.Themalesexualdysfunctionusuallyoccursinoneormoreofthethreefirststagesofthesexualresponsecycle,including:Dysfunctionsofsexualdesire(e.g.hypoactivesexualdesire)Arousal(e.g.erectiledysfunction)Orgasm/ejaculation(e.g.prematureejaculation,retardedejaculationorinabilitytoejaculate).Prematureejaculationoccursduetotherapidevolutionofthetwofirststagesofthesexualresponsecycleandisnotnecessarilyrelatedtostrongsexualarousalorchangesinerection.PrematureEjaculationseemstobeaneurobiologicalproblemthatisrelatedtolowserotoninlevelsinthoseregionsofthecentralnervoussystemthatregulateejaculation(brainandspinalcord).
28.60yearwomancomeswith3rddegree uterineprolapse.Whatwillbethemanagement? a)Vaginalhysterectomywithpelvicfloorrepair b)Pelvicfloorrepair c)Sacrospinousfixation d)Pessary CorrectAnswer-AAns.A.VaginalhysterectomywithpelvicfloorrepairUterineprolapsesurgeryisperformedtoremovetheuterusandrepairtheweaktissue.Uterineprolapsefrequentlyoccursinpostmenopausalwomenwho'vehadoneormorevaginaldeliveries.Saggingofthepelvicmuscleswhichleadstouterineprolapsecanoccur:IfsupportivetissuesaredamagedduringpregnancyanddeliveryDuetoestrogenlossAsaresultofstrainingrepeatedlyovertheyears(chroniccough,constipationetc.)DuetogravitationaleffectsDependingonfactorslikeageofthewoman,desireforbecomingpregnantandtheoverallstateofawoman'shealth,thetreatmentplanisdecided.Herethewomanisofoldage(nongestational)andhave3rddegreeofprolapse.SobestmanagementofchoicewillbeVaginalhysterectomywithpelvicfloorrepair.
29.Day20ofmenstrualcyclefallsunder whichphase? a)Menstrualphase b)Follicularphase c)Ovulationphase d)Lutealphase CorrectAnswer-DAns.D.LutealphaseTheentiredurationofaMenstrualcyclecanbedividedintofourmainphases: 1. Menstrualphase(Fromday1to5)2. Follicularphase(Fromday1to13)3. Ovulationphase(Day14)4. Lutealphase(Fromday15to28)
30.Chromosomenumberofpartial hydatidiformmoleis- a)46XX b)45XO c)46XXY d)69XXX CorrectAnswer-DAns.D.69XXApartialhydatidiformmoleisatriploidpregnancywith69insteadof46chromosomesandanotherstrangecomplicationofthereproductiveprocess.Partialhydatidiformmolecanbeidentifiedbyultrasoundshowingplacentatissue,somehygromatouscysts,somefetaloddities,butnoclearfetusstructure.Ultrasoundisstrictlyanindicator.Afterspontaneousabortionordilationandcurettage,tissueneedstobeexaminedbypathologyandcytogeneticsneedstobedetermined.Ifatriploidkaryotypeisdeterminedas69,XXX,69XXY,or69XYY[6],thenapartialmolecanbeconfirmed.
31.Vulvaratrophyanditchingaretreatedby- a)Estrogenointment b)Antihistamines c)Tamoxifen d)None CorrectAnswer-AAns.A.EstrogensointmentAtrophicvaginitis,themedicaltermforthiscondition,occursasaresultofdeteriorationofthevaginaltissue.It'sacommonconditioninpostmenopausalwomenbecauseasestrogenlevelsdrop,thetissuethatlinesthevaginabecomesthinnerandmoreeasilydamaged.Womenwithatrophicvaginitismayalsoexperiencevaginalitching,burning,frequenturination,orvaginaldischarge.Womencantreatthisconditiontopicallywithestrogencreams,tablets(Vagifem),oranestrogen-releasingringplacedinthevagina(Estring).Oralestrogen,availablewithadoctor'sprescription,willalsorestorevaginaltissue.Vaginallubricantsofferanalternativeforwomenwaryofusingestrogen.MoisturizerssuchasReplens,Astroglide,andLubrincanreducesymptomsandmakesexualintercoursemorecomfortable.
32.PGF2alphamaximumdoseinPPHis- a)2000?g b)200?g c)2mg d)20mg CorrectAnswer-CAns.C.2mgDrugdosesformanagementofPPH:15-MethylprostaglandinF2a:Doseandroute:IM:0.25mgContinuingdose:0.25mgevery15minutesMaximumdose:8doses(Total2mg)Precautions/contraindications:Asthma
33.Whichofthefollowingisfalseas physiologicalchangeinpregnancy? a)Increasecardiacoutput b)Increasetotalprotein c)Increaseresidualvolume d)IncreaseGFR CorrectAnswer-CAns.C.IncreaseresidualvolumeTherespiratoryrateisessentiallyunchanged,buttidalvolumeandrestingminuteventilationincreasesignificantlyaspregnancyadvances.Thefunctionalresidualcapacityandtheresidualvolumearedecreasedasaconsequenceoftheelevateddiaphragm.
34.Overtgestationaldiabetesisdefinedas bloodglucosemorethan_? a)>200mg/dl b)>126mg/dl c)>100mg/dl d)>180mg/dl CorrectAnswer-BAns.B.>126mg/dlIffastingis92-125mg/dlitisdiagnosedasGDMandifitis=126mg/dlitisdesignatedasovertDiabetes
35.MgSO4havenoroleinpreventionof- a)Seizuresinseverepre-eclampsia b)Recurrentseizuresineclampsia c)RDSinprematurebaby d)Bradycardia CorrectAnswer-CAns.C.RDSinprematurebabyIndicatedtopreventseizuresassociatedwithpre-eclampsia,andforcontrolofseizureswitheclampsia.Magnesiumsulfate(MgSO4)iscommonlyusedasananticonvulsantfortoxemiaandasatocolyticagentforprematurelaborduringthelasthalfofpregnancy.ToxicityofI/Vmagnesiumsulfateincludescardiacarrhythmias,muscularparalysis,respiratorydepressionandCNSdepressioninmotheraswellastheneonate.
36.Greenfrothyvaginaldischargeis producedby? a)Herpessimplex b)Candidaalbicans c)Trichomonasvaginalis d)Normalvaginalflora CorrectAnswer-CAns.C.TrichomonasvaginalisTrichomoniasis?ItisasexuallytransmitteddiseaseItisalmostentirelyadiseaseofchild-bearingageThevaginaldischargeisfrothy,slightlygreenincolourandprofuse.Therearemultiplepunctatestrawberryspotsonthevaginalvaultandportiovaginalisofcervix.Diagnosis:Cultureis98%reliable
37.Whichofthefollowingisanabsolute CONTRAINDICATIONtoOCPuse: a)Chronicrenaldisease b)DVT c)Diabetesmellitus d)Historyofamenorrhea CorrectAnswer-BAns.B.DVTContraindicationstocombinedoralcontraceptivesTheyaregenerallyacceptedtobecontraindicatedinwomenwithpre-existingcardiovasculardisease,inwomenwhohaveafamilialtendencytoformbloodclots/thrombosis(suchasfamilialfactorVLeiden),womenwithsevereobesityand/orhypercholesterolemia(highcholesterollevel),andinsmokersoverage40.COCParealsocontraindicatedforwomenwithlivertumors,hepaticadenomaorseverecirrhosisoftheliver,andforthosewithknownorsuspectedbreastcancer.
38.Whichofthefollowingstatementis correctaboutacutefattyliverofpregnancy? a)Occursin1in1000pregnancy b)Mostlyseeninlasttrimester c)Commoniffemalefetusispresent d)Maybeassociatedwithdecreaseduricacid CorrectAnswer-BAns.B.MostlyseeninlasttrimesterAcutefattyliverofpregnancyisusuallyseeninobesewoman.Itismorecommonlyseeninwomancarryingamalefoetus.Theneonateisatriskoffattyinfiltrationofliver.ItMorecommonlyoccursin3rdtrimester.ItMaybeassociatedwith?uricacid.
39.Femalewith41wkgestationconfirmedby radiologicalinvestigation,verysureofherLMP,nouterinecontractions,noeffacementandnodilatation.Whatshouldnotbedone? a)Intracervicalfoley's b)PGE1tab c)PGE2gel d)PGF2alpha CorrectAnswer-DAns.D.PGF2alphaPgF2alphaisauterinerelaxantsoitcan'tbeusedininductionoflabour.
40.Doubledeciduasignisseenduring- a)1Sttrimester b)2ndearlytrimester c)2ndlatetrimester d)3rdtrimester CorrectAnswer-AAns.A.1sttrimesterThedoubledecidualsacsign(DDSS)isausefulfeatureonearlypregnancyultrasoundtoconfirmanearlyintrauterinepregnancy(IUP)whentheyolksacorembryoisstillnotvisualized.The"DoubleDecidualSign",firstdescribedbyNybergandco-workersconsistsoftwoechogenicringssurroundingthehypoechoicgestationalsac.Theinnerringrepresentsthechorion,embryonicdiscanddeciduacapsularis.Theouterringrepresentsthedeciduaparietalis.
41.InMedicalterminationofpregnancy, accordingtoFDA,MisoprostolisgivenafterhowmanyhoursofMifepristone? a)24hours b)48hours c)72hours d)96hours CorrectAnswer-BAns.is'b'i.e.,48hoursFDAapprovedprotocol-(Originalprotocol)600mgofmifepristone(i.e.,3tablets)givenorallyonday1followed2days(48hours)laterbyoralmisoprostol400tig(2tablets)onday3.Thetreatmentshouldbestartednomorethan48daysfromthestartofthelastmenstrualperiod.Butaccordingtotherecentprotocol200mgofmifepristone(itisaseffectiveas600mgofmifepristone)isgivenorallyonDay1followed2days(48hours)laterbyvaginalmisoprostol800pg.Thisregimeprovideshighestefficacywithin63daysofamenorrhea.
42.Firstsymptominvulvalcanceris- a)Pain b)Pruritis c)Ulcer d)Blooddischarge CorrectAnswer-BAns.B.PruritisWomenwithWNandyulvarcancercommonlypresentwithpruritusandavisiblelesion.However,pain,bleeding,andulcerationmayalsobeinitialcomplaints'
43.Whichisincreasedinprematureovarian failure: a)Sr.Inhibin b)Sr.FSH c)Sr.Estradiol d)BothAandB CorrectAnswer-BAnswer-B.Sr.FSHInprematureovarianfailure:- 1. FSHlevelincreased(40mIU/mlormore).2. Estrogenisdecreased(E2Level20pg/mlorless)3. InhibinBisdecreased. [RefShaw'sGynaecology10h/ep.74;SperoffsClinicalGynaecologicEndocrinologyandInfertility5th/ep.463]
44.Allofthefollowingaremarkersofovarian reserveexcept- a)InhibinA b)Estradiolconcentration c)InhibinB d)Ovarianvolume CorrectAnswer-AAnswer-A.InhibinABasalFSHandEstradiolconcentrationClomipheneCitrateChallengeTestInhibinBAntimullerianhormoneAntralfolliclecountOvarianvolume
45.MostcommonsiteinvolvedingenitalTB - a)Fallopiantubes b)Endometrium c)Ovaries d)Vulvo-vaginalpart CorrectAnswer-AAnswer-A.FallopiantubesFallopianTubes90-100
46.WhichisnotasideeffectofPOP [Progestinonlypill] a)Ovariancysts b)Venousthromboembolism c)Increasedriskofdiabetesmellitus d)Ectopicpregnancy CorrectAnswer-BAnswer-B.VenousthromboembolismAdverseeffectsofprogestinonlypill(minipill)MensturalirregularitiesHeadache,nausea,dizzinersBloatingorweightgainIncreasedriskofINDDMOvariancystsBreasttendernessAcneEctopicpregnancy
47.Maternalageisnotassociatedwith- a)Pretermlabour b)Postmaturity c)Aneuploidy d)Hydatidiformmole CorrectAnswer-AAnswer-A.PretermlabourRecentevidencehoweversuggestslowestincidenceofpretermlaborbetween18and35yearsofageandhigherriskinlowerandhigheragegroups.
48.Whatistobedoneif2OCPismissedon day17-18ofthecycle- a)Take2pillsonthenext2days b)Usebackupcontraceptive c)Bothaandb d)Continuetakingsinglepillperday CorrectAnswer-BAnswer-B.UsebackupcontraceptiveMissingpillswhileonOCP-Management:Missingonepill(lateupto24hours)-takethemissedpillatonceandcontinuethesameregimen.Missingtwopillsinthefirstweek(days1-7)-taketwopillsoneachofthenexttwodaysandthencontinuetheschedule.Extra-precaution(backup)-alternativecontraceptionMissingtwopillsinthethirdweek(days15-21)orifmorethantwopillsaremissedatanytime-anotherformofcontraception.Startthenextpackwithoutabreak.Missinganyofthe7inactivepills-throwawaythemissedpills.Startthenewpackasusual.
49.Mostcommoncomplicationofdermoid cystis- a)CystRupture b)Torsion c)Malignantdegeneration d)Noneoftheabove CorrectAnswer-BAnswer-B.TorsionTorsionisthemostcommoncomplicationoccurringinDermoidcyst.Becauseofthefatcontentofthecyst,itislighterthanotherovariantumorsandthereforeeasilytorsioned.Almost15%ofdermoidcystsundergotorsion.
50.Managementoftubalectopicpregnancy of2.5x3cmis- a)Medicalmanagement b)Salpingectomy c)Accordingtopresenceoffetalcardiacactivity d)Observation CorrectAnswer-CAnswer-C.AccordingtopresenceoffetalcardiacactivityConservativemanagementMedicalmanagement: 1. Hemodynamicallystable2. SerumhCGlevel<3000IU/L3. Tubaldiameter<4cmwithoutanyfetalcardiacactivity4. Nointraabdominalhaemorrhage Surgicalmanagement: 1. Hemodynamicinstability2. SerumhCGlevel>3000IU/L3. Tubaldiameter>4cm4. Presenceoffetalcardiacactivity
51.Doseofdexamethasoneforfetallung maturityis- a)6mg b)12mg c)18mg d)24mg CorrectAnswer-AAnswer-A.6mgBetamethasone-12mgi.m.24hoursapartfor2dosesDexamethasone-6mgi.m.12hoursapartfor4doses.Betamethasone-Steroidofchoice.
52.Managementofapatientwithcomplete placentapreviaat38weeksgestationwithoutanyvaginalbleedingis- a)Expectantmanagement b)MacafeeandJohnsonregimen c)Electivecaesareansection d)Emergencycaesareansection CorrectAnswer-CAnswer-C.ElectivecaesareansectionAsthispatientismorethan37weeksgestation,activeinterferenceismandatory.Butasthispatientisnotactivelybleedingthereforeelectivecaesareansectioncanbeplanned.
53.Trueaboutnabothiancystisallexcept- a)Squamousepitheliumoccludesthemouthoftheglands b)Itisseeninchronicirritationandinflammation c)Itisapathologyofthecervix d)Itispre-malignant CorrectAnswer-DAnswer-D.Itispre-malignantSeeninchronicinflammationofcervix.Itistheresultofblockageofmouthoftheglandsofthecervix.Duringtheprocessofhealing,thesquamousepitheliumreplacesthecolumnarepithelium.Theblockedglandsbecomedistendedwithsecretionandformsmallcystswhichcanbeseenwiththenakedeye,theso-callednabothianfollicles.Theconditionisneithermalignantnorpre-malignant.
54.Mostcommoncauseofpelvic inflammatorydiseaseis- a)Sexuallytransmitteddisease b)IUCD c)Pelvicperitonitis d)Puerperalsepsis CorrectAnswer-AAnswer-A.SexuallytransmitteddiseaseSexuallytransmitteddiseaseisthemostcommoncause.Gonococcalandchlamydialinfectionsarethemostcommoncause.Postabortalorpuerperalsepsis.IUCDTuberculosisPelvicperitonitis,duetoappendicitisanddiverticulitis.
55.Thereisoverlappingofskullsutures whichcanbereducedwithgentalpressure.Whatisthegradeofmoulding? a)Grade1 b)Grade2 c)Grade3 d)Grade4 CorrectAnswer-BAnswer-B.Grade2Therearethreegradingsofmoulding:Grade1-thebonestouchingbutnotoverlappingGrade2-overlappingbuteasilyseparatedGrade3-fixedoverlapping.
56.Riskfactorforcervicalcarcinomais- a)Smoking b)Humanpapillomavirus c)Lowsocioeconomicstatus d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveHPVinfection.Coitusbefore18years.Multiplesexualpartners.Deliveryofthefirstbabybeforetheageof20years.Multiparitywithpoorbirthspacingbetweenpregnancies.Poorpersonalhygiene.Poorsocioeconomicstatus.Smoking.Immunosupressivedisease.
57.45yrsfemalewithG5P4A0L4withLMP 25.8.15,gestationalagewillbehowmanyweeksondate11.5.15? a)32weeks b)35weeks c)36weeks d)40weeks CorrectAnswer-CAnswer-C.36weeksifthepatient'sLMPis25.8.15thenEDDwouldbe3.6.16.On11.5.15,patientwouldbe23daysleftwouldforEDD,thatis3weeksand2days.Subtractingthisfrom40weeks,thepatientsgestationalagewouldbe36weeksand5days.
58.Whichofthefollowingaboutabdominal pregnancyistrue? a)Primaryabdominalpregnancyismorecommon b)Ifplacentaisdenselyadhered,itshouldbeseparatedalongwith theorganitoverlies c)Around50%ofthefetusreachfulltermandsurvive d)Ifplacentaisleftbehind,infectioncanoccur CorrectAnswer-DAnswer-D.Ifplacentaisleftbehind,infectioncanoccurAbdominalPregnancyA)PrimaryAbdominalPregnancyCriteriatodiagnoseprimaryabdominalpregnancybyStudiford: 1. Boththetubesandovariesarenormalwithoutevidenceofrecent injury 2. Absenceofuteroplacentalfistula3. Presenceofapregnancyrelatedexclusivelytotheperitoneal surfaceandyoungenoughtoeliminatethepossibilityofsecondaryimplantationfollowingprimarynidationinthetubeB)SecondaryAlmostalwayssecondary,theprimarysitesbeingtube,ovaryoreventheuterus-theconceptusescapesoutthroughtherentintheuterinescar.
59.Oxygenconsumptionincreasesin pregnancyby a)10% b)20% c)30% d)40% CorrectAnswer-BAnswer-B.20%Oxygenconsumptionincreasesapproximately20%duringpregnancy,anditisapproximately10%higherinmultifetalgestation.Duringlabour,oxygenconsumptionincreases40-60%.
60.Strokevolumeincreasesinpregnancy by a)20% b)25% c)40% d)45% CorrectAnswer-BAnswer-B.25% Hemodynamicchangesduringpregnancy Pregnancynear Non-pregnant Change term Cardiacoutput 4.5 6.26 +40% (lit/m1)Strokevolume(ml) 65 75 +27% Heartrate(per 70 85 +17% minute) Unaffectedormidpregnancydropofdiastolic Bloodpressure pressureby5-10mmHg8-10cm Venouspressure 20cm +100% (femoral) Colloidoncotic 20 18 -14% pressure(mmHg)Systemicvascular -21% resistancePulmonaryvascular -34% rests
61.Cardiacoutputinpregnancyincreases fromwhichweekofgestation a)5weeks b)15weeks c)25weeks d)35weeks CorrectAnswer-AAnswer-A.5weeksCardiacoutputstartstoincreasefromthe5thweekofgestation,reachesitspeak40-50%at30-34weeks.
62.Whatisthestageofcarcinomacervix involvingbodyofuterus- a)StageI b)StageII c)StageIII d)StageIV CorrectAnswer-AAnswer-A.StageI CervicalCancer-FIGOStagingStage Carcinomainsitu 0StageI IntraepithelialcarcinomaconfinedtothecervixStage Diagnosedonlybymicroscopy IAStage Microinvasivacarcinomawithstromalinvasion<3mminIA1 depth&<7mminwide. Stage Microinvasivacarcinomanotexceeding5mmindepth/7IA2 mminwidth. Stage Clinicallyvisibleormicroscopiclesion>IA2. IBStage Clinicallesionnotexceeding4cmindiameter. IB1Stage Clinicallesionmorethen4cmindiameter. IB2Stage Extensionbeyondthecervixbutnottothepelvicwall. IIStage Involvementofvaginabutnotthelowerthird. IIA
Involvementofvaginabutnotthelowerthird. IIAStage Clinicallyvisiblelesionmorethen4cm. IIA1Stage Clinicallyvisiblelesionmorethen4cm. IIA2Stage Parametrialinvolvementnotreachingthepelcvicsidewall. IIB
63.Therapeuticuseoffolicacidis a)Previouspregnancywithchildhavingneuraltubedefect b)Megaloblasticanaemia c)Hemoglobinopathies d)Alloftheabove CorrectAnswer-BAnswer-B.MegaloblasticanaemiaFolicacidisgiveninallthegivenconditions.Butanswerhearisoptionb.Thisquestionsistricky:-Examinerisaskingabouttherapeuticusesoffolicacid(notpreventive)Inmegaloblasticanemia,folicisgivenfortreatment-->therapeuticusesInpregnancyitisgivenforpreventionofneuraltubedefect-->prophylacticuse(preventiveuse)
64.Mostcommoncauseofdeathincervical canceris- a)Renalfailure b)Infection c)Haemorrhage d)Metastasistovitalorgans CorrectAnswer-AAnswer-A.RenalfailureRenalfailureisthemostcommoncauseofdeathincervicalcancer.RenalfailureincervicalcanceroccursduetoinvolvementofuretersinStage1IIB.ItcanalsooccurduetodirectinvolvementofkidneyasinstageIVB.
65.Duringpregnancyincreasedsizeof pituitaryiscausedbyincreasedsizeofcellswhichsecrete? a)Growthhormone b)Prolactin c)ACTH d)TSH CorrectAnswer-BAnswer-B.ProlactinProlactinlevelsrisegraduallythroughoutpregnancy,preparingthebreastforlactation.Thislactotrophhyperplasiahasimportantimplicationsforthepatientwithaprolactinomawhodesirespregnancy.
66.TreatmentoptionsforCINIIIincludeallof thefollowingexcept- a)LLETZ b)Conization c)Hysterectomy d)Wertheim'shysterectomy CorrectAnswer-DAnswer-D.Wertheim'shysterectomyTreatmentoptionsof(INIII 1. Conservativeablation:coagulation,cryoscrgery,laserablation2. Localexcision:conization,laserconization,lleT2,LEEP,NETZ3. Radicalexcision:Trachelectomy,hystrectomy(withorwithout removalofvaginalcuff).Wertheim'shysterectomyisgenerallynotdoneincasesofCINIIIifvaginaorlymphnodesarenotinvolved.
67.Whatsizeofthehegar'sdilatorifpassed throughtheinternaloscanbelabeledascervicalincompetence? a)4 b)6 c)8 d)10 CorrectAnswer-CAnswer-C.8PassagewithoutresistanceandpainofNo.8Hegar'sdilatorisascreeningtestforcervicalincompetence.
68.Propulsivestageinlabourinmultipara a)10minutes b)20minutes c)40minutes d)1hour CorrectAnswer-BAnswer-B.20minutesSecondstageoflabourhastwophases: 1. Propulsivephase:fromfulldilatationofcervixuntilheadtouches pelvicfloor. 2. Expulsivephase:Sincethetimethereisirresistiblematernaldesire tobeardownuntilthebodyisdelivered.Meandurationofsecondstageis50minutesfornulliparaand20minutesinmultipara.
69.Funnelingincervicogramisseenin- a)Inlabour b)Cervicalincompetence c)Cervicalectopic d)DuringTVS CorrectAnswer-BAnswer-B.CervicalincompetenceCervicogramisdonefordiagnosisofcervicalincompetence.Inotherconditions,cervicogramisnotdone.
70.Incervicalincompetencediameterof internalosofcervixis- a)1cm b)1.5cm c)2cm d)2.5cm CorrectAnswer-AAnswer-A.1cmCervicalsonography:FunellingofthecervixwithchangesintheformofY,V,U.Cervicallength<2.5cm.Funnellingoftheinternalos>1cmSpeculumexamination:Detectionofdilatationofinternaloswithherniationofthemembranes.Cervicalindex=(Funnellength+1)/(endocervicallength).The"+1"allowsanindextobecalculatedwhenfunellingisabsent.Predictorsofpretermbirth:Cervicalindex>0.52.Cervicallength<18mmFunnellength>9mm.Funnelwidth>6mm.
71.Occipitoanteriorposition a)Anteriorfontanalleisposterior b)SagittalsutureisalongtheTransverseplaneofthematernal pelvis c)Coronalsutureisalongtheantero-posteriorplaneofthe maternalpelvis d)Alloftheabove CorrectAnswer-AAnswer-A.AnteriorfontanalleisposteriorIndirectoccipitoanteriorposition,thesagittalsutureofthefetuswillbealongtheantero-posteriorplaneofthematernalpelvisandthecoronalsuturealongthetransversediameter.
72.Methodnotusedforshoulderdystocia a)McRobert'smaneuver b)Hegar'smaneuver c)Zanavellimaneuver d)Wood'smaneuver CorrectAnswer-BAnswer-B.Hegar'smaneuverMcRobert's,ZanavelliandWood'smaneuvers'aremaneuversinthemanagementofshoulderdystocia.
73.Vasapreviaisassociatedwith- a)Marginalplacenta b)Velamentousplacenta c)Battledore d)Placentaprevia CorrectAnswer-BAnswer-B.VelamentousplacentaIfaleashofbloodvesselshappentotraversethroughthemembranesoverlyingtheinternalis,infrontofthepresentingpart,theconditioniscalledasvasapraevia.Itisassociatedwithvelamentousplacenta.Theunsupportedumbilicalvesselsinvelamentousplacenta,liebelowthepresentingpartandrunacrossthecervicalos.Ruptureofmembranesinvolvingtheoverlyingvesselsleadstovaginalbleeding.Asitisentirelyfetalblood,thismayresultinfetalexsanguinationandevendeath.[RefDutta'sObstetrics8th/ep.301]
74.Whichisnotariskfactorforgestational hypertension a)Obesity b)Smoking c)Primigravida d)FactorVLeidenmutation CorrectAnswer-BAnswer-B.SmokingPrimigravida:Youngorelderly(firsttimeexposuretovilli)Familyhistory(hypertension,pre-eclampsia)PlacentalischemiaObesityThrombophilia(antiphospholipidsyndrome),proteinCandSdeficiency,factorVLeidenmutation)Molarpregnancy(earlyonsetpre-eclampsia)
75.Mostcommonbreechpositionis a)Completebreech b)Frankbreech c)Footlingbreech d)Kneepresentation CorrectAnswer-BAnswer-B.FrankbreechFrankbreech(Breechwithextendedlegs)isthemostcommonbreechpresentation.Breechwithextendedlegs(Frankbreech):Thighsareflexedathipandlegsareextendedatknee.Itiscommonlyseeninprimigravidae(70%).Itisthemostcommontypeofbreech.
76.Whenfetusisatstation+2&fetalskull reachespelvicfloor,whichofthefollowingistrue a)Forcepscanbeapplied b)Besttimetogiveepisiotomy c)Calledascrowning d)Mayleadtodeeptransversearrest CorrectAnswer-AAnswer-A.ForcepscanbeappliedWhenthefetalskullhasreachedthelevelofpelvicfloorandstationofheadisat+2ormore,outletforcepscanbeapplied.However,crowningisdefinedasstretchingofthevulva'outletbythemaximumdiameterofthefetalhead(biparietaldiameter)withoutanyrecession.Thusthestationis+5.Besttimetogiveepisiotomyisatthetimeofcrowningofhead.[RefDutta'sObstetrics81h/ep.651]
77.Contractedpelvisisdefinedasshortening ofoneormoreplanesby- a)0.5cm b)1cm c)1.25cm d)1.5cm CorrectAnswer-AAnswer-A.0.5cmAnatomically,contractedpelvisisdefinedasshorteningofoneormoreplanesby0.5cm.
78.Commonmisdiagnosisofpartialmoleis a)Threatenedabortion b)Choriocarcinoma c)Completemole d)Ectopicpregnancy CorrectAnswer-AAnswer-A.ThreatenedabortionTheclinicalpictureofpartialmoleisconfusedwiththreatenedabortionormissedabortionduetopainandbleedingalongwithafetus(usuallydead)inutero.
79.Prolongedsecondstageoflabourmay occurdueto a)Uterineinertia b)Epiduralanalgesia c)Cephalopelvicdisproportion d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveProlongationofsecondstageoflabourcanoccurduetoanyofthefollowingreasons:1)FaultinthepowerUterineinertiaInabilitytobeardownEpiduralanalgesiaConstrictionring2)FaultinthepassageCephalopelvicdisproportion,androidpelvis,contractedpelvisUndueresistanceofthepelvicfloororperineumduetospasmoroldscarringSofttissuepelvictumor.3)FaultinthepassengerMalposition(occipito-posterior)MalpresentationBigbabyCongenitalmalformationofthebaby
80.Mostcommontypeofconjointtwinis- a)Thoracopagus b)Omphalopagus c)Craniopagus d)Rachipagus CorrectAnswer-AAnswer-A.ThoracopagusFourtypesoffusionmayoccur:Thorapagus-MostcommonPyopagus(posteriorfusion)Craniopagus(cephalic)Ischiopagus(caudal)
81.Crowningis a)Biparietaldiameterattheinletofpelvis b)Biparietaldiameterattheischialspine c)Biparietaldiameteratthevulvaloutlet d)BiparietaldiameterjustoutsidethevulvaloutletAnswer- CorrectAnswer-CAnswer-C.BiparietaldiameteratthevulvaloutletCrowning:Afterinternalrotationofthehead,furtherdescentoccursuntilthesubocciputliesunderneaththepubicarch.Atthisstage,themaximumdiameterofthehead(biparietaldiameter)stretchesthevulvaloutletwithoutanyrecessionoftheheadevenafterthecontractionisover-called"crowningofthehead".
82.Uterineheightisgreaterthangestational ageofthepatientinacaseofallexcept- a)Fibroiduterus b)IUGR c)Wrongdates d)Polyhydramnios CorrectAnswer-BAnswer-B.IUGRUterineheightgreaterthangestationalageincaseof:WrongdatesPolyhydramniosPregnancywithfibroiduterusMultiplepregnancy
83.Trueaboutplacentalsitetrophoblastic diseaseis a)HighlyMalignantbehavior b)Hysterectomyfollowedbychemoradiationisthetreatmentof choice c)Secreteshumanplacentallactogen d)Containssyncytiotrophoblastsmainly CorrectAnswer-CAnswer-C.SecreteshumanplacentallactogenPlacentalSiteTrophoblasticTumourArisesfromtheplacentalbedtrophoblastsandinvadesthemyometrium.Followsafull-termnormaldelivery.Tumorcontainsmainlycytotrophoblastswithfewornosyncytiotrophoblasts.Mostofthesetumorsrunabenigncourse,malignancyisrare.[RefShaw'sGynaele/ep.313;Dutta'sObs8thiep.231]
84.Quickeninginmultiparaeisfeltatwhat weeksofgestation? a)14weeks b)16weeks c)18weeks d)20weeks CorrectAnswer-BAnswer-B.16weeksQuickeningisfeelingoflife.Itdenotesperceptionofactivefetalmovementsbythewomen.Itisusuallyfeltaboutthe18thweek,about2weeksearlierinmultiparae.Itsappearanceisanusefulguidetocalculatetheexpecteddateofdeliverywithreasonableaccuracy.
85.Pregnancyiscontraindicatedinwhich cardiacdisease- a)Mitralstenosis b)Primarypulmonaryhypertension c)VSD d)Mitralregurgitation CorrectAnswer-BAnswer-B.PrimarypulmonaryhypertensionPlaceoftherapeuticterminationincaseoffollowingheartdiseases.Consideringhighmaternaldeaths,absoluteindicationsare:PrimarypulmonaryhypertensionEisenmenger'ssyndromePulmonaryveno-occlusivedisease.
86.Malodorousvaginaldischargeisdueto a)Bacterialvaginosis b)Chlamydiatrachomatis c)Trichomonasvaginalis d)Neisseriagonorrhea CorrectAnswer-AAnswer-A.BacterialvaginosisBacterialvaginosisisanalterationofthenormalvaginalflorawithconsequentovergrowthofpathogenicbacteria.Thereisfallintheabsolutenumberofhydrogenperoxide-producinglactobacilli,leadingtoariseinpHandincreaseintheabsolutenumberofG.vaginalis,anaerobicgram-negativerods,Mobiluncusspp.andMycoplasmahominis.
87.Followingdelivery,tearinvolves perineum,externalanalspincterwithintactmucosa,gradeoftearis- a)Firstdegree b)Seconddegree c)Thirddegree d)Fourthdegree CorrectAnswer-CAnswer-C.ThirddegreeThirddegree:Injurytoperineum,involvingtheanalsphinctercomplex(boththeexternalandinternal).3a:ifhalfthicknessexternalanalsphincterinvolved.3b:iffullthicknessexternalanalsphincterinvolved.3c:ifinternalanalsphincterinvoloved.
88.Amselcriteriaisfor a)Bacterialvaginosis b)Antiphospholipidantibodysyndrome c)Ovarianectopicpregnancy d)HELLPSyndrome CorrectAnswer-AAnswer-A.BacterialvaginosisAmselcriteria:ThreeoutoffourofthefollowingshouldbepresentAwhite/grayhomogenousdischargeAvaginaldischargepHof>4.5Apositiveaminetest(dropof10%potassiumhydroxideaddedtodropofdischargeonaslideproducesfishyodour),alsoknownasWhifftest.Microscopydemonstratescluecells.
89.Planeofcleavageduringplacental separationrunsthrough a)Betweencompactandspongylayerofdeciduabasalis b)Betweendeciduabasalisandchorionfrondosum c)Throughdeepspongylayerofdeciduabasalis d)Betweenlayersofchorionfrondosum CorrectAnswer-CAnswer-C.ThroughdeepspongylayerofdeciduabasalisMarkedretractionreduceseffectivelythesurfaceareaattheplacentalsitetoaboutitshalf.Butastheplacentaisinelastic,itcannotkeeppacewithsuchanextentofdiminutionresultinginitsbuckling.Ashearingforceisinstitutedbetweentheplacentaandtheplacentalsitewhichbringsaboutitsultimateseparation.
90.Notacauseofoligohydramnios- a)IUGR b)Renalagenesis c)Amnionnodosum d)Chorioangioma CorrectAnswer-DAnswer-D.ChorioangiomaFetal,ChromosomalorstructuralanamoliesRenalagenesisObstructiveuropathySpontaneousruptureofmembraneIntrauterineinfectionDrugs:PGinhibitors,ACEinhibitorsPostmaturityIUGRAmnionnodosumMaternalHypertensivedisordersUteorplacentalinsufficiencyDehydrationIdiopathic
91.Whichofthefollowingistrueabout ovarianectopicpregnancy? a)Studdifordcriteriaisusedfordiagnosis b)Thereshouldbenorentontheovaryortube c)Absenceofevidenceofpregnancyatanyothersitethan ovarian d)Conservativesurgerycanbedoneifdiagnosedearly CorrectAnswer-DAnswer-D.ConservativesurgerycanbedoneifdiagnosedearlyOvarianectopicisarareentitythatisdifficulttodiagnoseclinically.Itusuallydoesnotproceedpastthefirstfourweeksofpregnancy.Spiegelberg'scriteriaisusedfordiagnosisofovarianpregnancy.Itincludes: 1. Tubeontheaffectedsidemustbeintact.2. Thegestationsacmustbeinthepositionoftheovary.3. Thegestationsacisconnectedtotheuterusbytheovarian ligament. 4. Theovariantissuemustbefoundonitswallonhistological examination.
92.Falseaboutchorionicvinoussampling- a)Isusedforprentalgeneticdiagnosis b)Isperformedonlyinsecondtrimesterofpregnancy c)Villicollectedfromchorionfrondosum d)Cancauselimbdeformities CorrectAnswer-BAnswer-B.IsperformedonlyinsecondtrimesterofpregnancyIsusedforprenatalgeneticdiagnosis.Performedtranscervicallythrough10-12weeks(firsttrimester)andtransabdominallyfrom10weekstoterm.(Advantageoveramniocentesiswhichisperformedinsecondtrimesterofpregnancy)Villiarecollectedfromchorionfrondosum.Cancauseoromandibularlimbdeformitiesorlimbreductiondefectsifperformedbefore10weeksofgestation.
93.Bacteriaresponsibleforectopic pregnancyis a)Staphylococcus b)Chlamydia c)Peptostreptococcus d)Trichomonasvaginalis CorrectAnswer-BAnswer-B.ChlamydiaSalpingitisandPID(PelvicInflammatoryDisease)isthemostimportantriskfactorforectopicpregnancy.ChlamydiatrachomatisinfectionisthemostcommonriskfactorforPIDandsalpingitis.[RefDutta'sObstetrics8th/ep..207]
94.A28yearoldprimigravidawith32weeks ofgestationcomeswithcomplainofthin,frothy,profusedischargethroughthevaginasinceyesterday.ShewasadvisedUSGwhichshowedSingleliveintrauterinegestationalsacwithFLandACcorrespondingtotheweeksofgestationandAFIasadequate.Whatisthediagnosis? a)PPROM b)Trichomoniasis c)Normalfinding d)Candidiasis CorrectAnswer-BAnswer-B.TrichomoniasisPatientsinfectedwithTrichomonasvaginaliscomplainofatypicaldischarge,whichisthin,profuse,frothy,irritating,creamyorslightgreenincolour.Slightgreencolourofthedischargeisoftennotcomplainedbythepatientbutspottedbythephysician.
95.LeFortrepairisdonefor a)Uterovaginaldescent b)Vaultprolapse c)VVF d)RVF CorrectAnswer-AAnswer-A.UterovaginaldescentLeForte'srepairVeryelderlymenopausalwomenAdvancedprolapseUnfitforanymajorsurgicalprocedure[RefShaw'sGynaecology16th/ep.360]
96.Leydigcellsoffetustestissecretes a)hCG b)LH c)Testosterone d)Mullerianinhibitingsubstance CorrectAnswer-CAnswer-C.TestosteroneLeydigcellsinfetaltestisarethecellularsiteoftestosteronesynthesis.Fetaltestisalsosecretesmullerianinhibitingsubstanceproducedbysertolicellswhichactslocallyasaparacrinefactortocausemullerianductregression.Mullerianductregressioncompletesby9to10weeks'gestation,whichismuchbeforetestosteronesecretionhascommenced.
97.Riskfactorsformolargestationareallof thefollowingexcept- a)Orientalcountries b)Disturbedmaternalimmunemechanism c)Higherratioofmaternal/paternalchromosomes d)Faultynutrition CorrectAnswer-CAnswer-C.Higherratioofmaternal/paternalchromosomesRiskfactorsforH.mole: 1. Orientalcountries,highestincidenceinPhilippines.2. Teenagepregnanciesor>35years.3. Faultynutrition.4. Disturbedmaternalimmunemechanism.5. Higherratioofpaternal/maternalchromosomes(not maternal/paternal)Highertheratio,greaterthemolarchange.Completemolesshow2:0paternal/maternalratiowhereaspartialmoleshows2:1ratio.
98.Embryogetsimplantedatwhatstageof development? a)Twocellstage b)Fourcellstage c)Morula d)Blastocyst CorrectAnswer-DAnswer-D.BlastocystAfterthezygoteformation,typicalmitoticdivisionofthenucleusoccursproducingtwoblastomeres.Twocellstageisreachedapproximately30hoursafterfertilization.Theblastomerescontinuetodividebybinarydivisionthrough4,8,16cellstageuntilaclusterofcellsisformedandiscalledmorula,resemblingamulberry.Morulaafterspendingabout3daysintheuterinetubeenterstheuterinecavitythroughthenarrowuterineostium(1mm)onthe4thdayinthe16-64cellstage.Implantationoccursonthe6thdaywhichcorrespondstothe20thdayofregularmenstrualcycle.Implantationoccursthrough4stages:apposition,adhesion,penetrationandinvasion.
99.Poorprognosticfactorforhydatidiform moleis- a)Priormolarpregnancy b)Metastasistolung c)Nopriorchemotherapy d)WHOscore>8 CorrectAnswer-DAnswer-D.WHOscore>8HighRisk(PoorPrognosis):Longdurationofdisease(>4months)InitialserumhCGlevel>40,000mIU/mlBrainorlivermetastasisFailureofpriorchemotherapyFollowingtermpregnancyWHOscore>8
100.Drugsusedinendometriosisis a)Combinedoralcontraceptives b)Letrozole c)Mifepristone d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveCombinedoralcontraceptives-Administeredintermittentlyorcontinuously,oralcontraceptivesmayalleviatethedisease.Oralprogestogens-Exertanti-estrogeniceffectandtheircontinuousadministrationcausesdecidualizationandendometrialatrophy.Danazol-inhibitspituitarygonadotropinsGnRHanalogues-Downregulateandsuppresspituitarygonadotropins.Aromataseinhibitors(letrozole):Anti-estrogenicactionAnti-progestin(mifepristone)
101.Riskofscarruptureinlowersegmentof previousscarpresentis? a)05-1.5% b)15-25% c)2.5-3.5% d)3.5-4.5% CorrectAnswer-AAns.A.05-1.5%
102.Nottrueincompletehydatidiformmole? a)Triploid b)Absenceoffetalparts c)Diffusetrophoblastichyperplasia d)BetaHCG>50,000 CorrectAnswer-AAns,A.TriploidTriploidyanddiploidyareseeninpartialmole.Completemolehas46XXkaryotype.
103.ComponentsofMalaDareallexcept? a)0.03mgEthinylestradiol b)0.15mgdesogestrel c)0.15mglevenogestrel d)Irontablets CorrectAnswer-BAns,B.0.15mgdesogestrel
104.MechanismofactionofIUCDisall except? a)Inhibitovulation b)Inducebiochemicalchangesinendometrium c)Increasetubalmotility d)Inflammatoryresponeinendometrium CorrectAnswer-AAns,A.InhibitovulationActpredominantlyintheuterinecavityanddonotinhibitovulation.
105.Mostcommoninfectioninlongterm IUCDuse- a)Actinomyosis b)Mucormycosis c)Aspergillosis d)Candidiasis CorrectAnswer-AAns.A.ActinomyosisActinomycosisisaninfectioncommoninpatientssinginertIUCDs.
106.AbsolutecontraindicationofOCpillsare allexcept? a)Suspiciousvaginalbleeding b)Cervicalcancer c)Uterineanamoly d)OldSTD CorrectAnswer-DAns.D.OldSTDCurrentSTDisanabsolutecontraindication(notpastSTDs).
107.CopperIUCDasacontraceptivemeasure canbeusedmaximumtillwhattimeaftercontact? a)2days b)3days c)4days d)5days CorrectAnswer-DAns.D.5daysIntroductionofCopperlUDwithinamaximumperiodof5dayscanpreventconceptionfollowingaccidentalunprotectedexposure.
108.Clomiphenecitrateisusedfor? a)Anovulation b)Endometriosis c)Pubertymenorrhagia d)Hormonereplacementtherapy CorrectAnswer-AAnsA.Anovulation
109.FirstlinetreatmentofinfertilityinPCOS is? a)Clomiphene b)FSH c)GnRH d)Assistedreproductivetechniques CorrectAnswer-AAns.A.ClomipheneClomiphenecitrateisthefirstlineoftreatmentofinfertilityinaPCOSwoman.
110.Drugcommonlyusedintreatmentof endometriosisis? a)LH b)GnRH c)MPA d)FSH CorrectAnswer-BAns.B.GnRH
111. Investigationofchoiceinendometriosis ? a)Laproscopy b)Hysteoscopy c)CTscan d)MRI CorrectAnswer-AAns.A.LaproscopyLaproscopyisconsideredasgoldstandardinvestigationfordiagnosisofendometriosis.Itisdiagnosticaswellastherapeutic,
112.Carcinomaendometriumwith involvementofthevaginalwallisincludedinwhichstage? a)IIIA b)IIIB c)IIIC d)IVA CorrectAnswer-BAns.B.IIIB
113.Meigssyndromeisassociatedwith whichtumor? a)Fibroma b)Cystadenoma c)Dysgerminoma d)Teratoma CorrectAnswer-AAns.A.FibromaMeigssyndromecombinationoffibromawithascitesandhydrothorax,usuailyrightsided.Seenin1-5%patients.
114.Sentinellymphnodebiopsyisusedto mapthelymphnodestatusofwhichcancers? a)Breast b)Melanoma c)Vulva d)Alltheabove CorrectAnswer-DAns,D.AlltheaboveLymphaticmappingandsentinellymphnodebiopsyTechniqueusetoknowthelocallymphnodestatusincancersofbreast,vulvaandmelanoma
115.Mostcommontypeoffibroidis? a)Intramural b)Subserosal c)Cervical d)Submucosal CorrectAnswer-AAns.A.Intramural
116.Mostcommoncancerinpregnancy? a)Melanoma b)Breastcarcinoma c)Gastriccarcinoma d)Thyroidcarcinoma CorrectAnswer-BAns.B.BreastcarcinomaBreastcarcinomaisthemostcommoncancerinpregnancyconstituting46%(1:3000to10,000)ofthecasesfollowedbyhematologicalmalignanciesconstituting18-25%oofthecases,
117.Mostcommoncauseofvulvalcarcinoma is? a)HPVinfection b)EBVinfection c)Herpesgenitalisinfection d)Syphilisinfection CorrectAnswer-AAns.A.HPVinfectionHPVinfectionisacommonriskfactorforthedevelopmentofinvasivevulvalcarcinoma.
118.Followingthecriteriaforconservative surgeryinpatientswithovariancarcinomaexcept? a)FIGOstageIIdisease b)Youngpatientwithnoorfewchildren c)Welldifferentiatedseroustumor d)Noinfiltrationofcapsule,lymphaticsormesoovarium CorrectAnswer-AAns.A.FIGOstageIIdiseaseRequirementsforconservativesurgeryinpatientswithovarianCancerare:FIGOstageIAdiseaseWelldifferentiatedserous,mucinous,endometroidorclearcelltumorYoungpatientwithnoorfewchildrenNootherpelvicpathologyprecludingpregnancy
119.Mostcommonovariancysttoundergo torsionis? a)Dysgerminoma b)Benigncysticteratoma c)Ovarianfibroma d)Brenner'stumor CorrectAnswer-BAns,B.BenigncysticteratomaBenigncysticteratomaisthemostcommonovarianneoplasmtoundergotorsion.
120.Mostcommonmalignantovariantumor is? a)Serouscystadenocarcinoma b)Mucinouscysadenocarcinoma c)Malignantteratoma d)Sarcoma CorrectAnswer-AAns,A.Serouscystadenocarcinoma
121.Whichofthefollowingisthemost commonmalignantgermcelltumorofovary? a)Yolksactumor b)Dysgerminoma c)Polyembryoma d)Choriocarcinoma CorrectAnswer-BAns,B.Dysgerminoma
122.Mostcommongermcelltumorofovary is? a)Dysgerminoma b)Serouscystadenoma c)Yolksactumor d)Dermoidcyst CorrectAnswer-DAns.D.Dermoidcyst
123.CallExnerbodiesseenin? a)Granulosacelltumors b)Serouscystadenomas c)Dysgerminoma d)Krukenbergtumor CorrectAnswer-AAns.A.GranulosacelltumorsTheformationofCall-Exnerbodiesisadistinctfeatureofgranulosacellsandcanbereadilyrecognizedincertaintypesofgranulosacelltumours.
124.Inhibinisatumormarkerfor? a)Granulosacelltumor b)Dysgerminoma c)Serouscystadenoma d)Krukenbergtumor CorrectAnswer-AAns.A.Granulosacelltumor
125.ManagementofStageIIAcarcinoma cervixinthirdtrimesterofpregnancyis? a)Radicalhysterectomy,pelviclymphadenetomyafterclassic caesariandelivery b)Periodiccytologyandevaluation c)Conebiopsy d)Chemotherapyandbrachytherapy CorrectAnswer-AAns.A.Radicalhysterectomy,pelviclymphadenetomyafterclassiccaesariandelivery
126.TreatmentofIBIcacervix? a)Wertheim'shysterectomy b)Radiotherapy c)Chemotherapy d)Chemoradiotherapy CorrectAnswer-AAns.A.Wertheim'shysterectomy
127.Whatisthenextstepininvestigatinga 45yrsoldfemalewithpostcoitalbleedingandvisiblecervicalmassonspeculumexamination? a)Dilatationandcurettage b)Conisation c)Colposcopy d)Hysteroscopy CorrectAnswer-CAns.C.Colposcopy
128.Mostcommonmodeofspreadforgenital tuberculosisis? a)Hematogenous b)Lymphatic c)Direct d)Ascending CorrectAnswer-AAns.A.HematogenousFromanyoftheprimarysites,thepelvicorgansinvolvedbyhematogenousspreadinabout90%ofthecases.
129.Estimationoffetalhemoglobinisdone by? a)Gerhardtest b)Kleihauser-BetkeAcidElutionTest c)Grinderstest d)Simpsonstest CorrectAnswer-BAns.B.Kleihauser-BetkeAcidElutionTestModifiedKeihauser-BetkeAcidElutiontest:itkusedtonotethenumberfetalredcellsper0lowpowerfields.Ifthereare80fetalerythrocytein50lowpowerfieldsinmaternalperipheralbloodfilms,itpresentsthetransplacentalhemorrhageof4mloffetalblood.
130.Mostcommonbreechpresentationin primigravidais? a)Flexedbreech b)Frankbreech c)Footlingpresentation d)Incomplete CorrectAnswer-BAns,B.FrankbreechBreechwithextendedlegs/Frankbreech
131.Transverselieiscausedbyallexcept? a)Multiparity b)Prematurity c)Anencephaly d)Placentaprevia CorrectAnswer-CAns,C.AnencephalyEtiologytransverselie:MultiparityTwinsContractedpelvisPelvictumorsIntrauterinedeathPrematurityHydramniosPlacentapreviaCongenitalmalformationofuterus-arcuate,subseptate
132.20yearoldfemalewithprimary amenorrhoeawithnormalpresentationofeverythingexceptnoaxillaryorpubichair.Whatisthediagnosis? a)Testicularfeminizationsyndrome b)Kallmansyndrome c)Turnerssyndrome d)Klienfelterssyndrome CorrectAnswer-AAns,A.TesticularfeminizationsyndromePhenotypicallynormalfemaleswithabsenceofaxillaryandpubichairwithprimaryamenorrhoeahavetwodifferentialdiagnosis:TesticularfeminizingsyndromeandMullerianagenesis.
133. InPIDduetoneiserrieagonorrhea,tubal damageis? a)Peritubal b)Endotubal c)Extratubal d)Juxtatubal CorrectAnswer-BAns.B.EndotubalGonococcalinfectioninvolvesthemucosaandmainlyremainsanendoluminalpathologywhiletheotherbacterialPIDtendtoinvolvedeepertissuesandcanalsoinvolveextratubaltissues.Sothemostprobableanswerisendotubal.
134.Conditionwherethereisingrowthofthe endometrium,bothglandularandstromalcomponentinmyometriumis? a)Adenomyosis b)Courvelaireuterus c)Placentaaccreta d)Uterinefibroid CorrectAnswer-AAns,A.AdenomyosisAdenomyosisisaconditionwherethereisingrowthoftheendometrium,boththeglandularandstromalcomponents,directlyintothemyometrium.
135.Couvelaireuterusisseenin? a)Placentaprevia b)Abruptioplacentae c)Plencentaaccrete d)Velamentousplacenta CorrectAnswer-BAns.B.AbruptioplacentaeCouvelaireuterusAlsocalleduteroplacentalapoplexy.Itisseeninassociationwithsevereformsof"concealedabruptioplacen"
136.Swisscheesepatternisseenin? a)Metropathicahemorrhagica b)Serouscystadenoma c)Mucinouscystadenoma d)Dermoid CorrectAnswer-AAns.A.MetropathicahemorrhagicaMicroscopicappearanceofendometriumshows:Glandularhyperplasiawithcysticdilationoffewglandsofvariablesizesgivingitaswisscheeseappearance.
137.Upperagelimittodiagnoseapatientas havingprimaryamenorrhoeais? a)13years b)14years c)15years d)16years CorrectAnswer-DAns.D.16yearsAyounggirlwhohasnotyetmenstruatedbyher16yearsofagehaspimaryamenonhoearatherthandelayedmetarche.Delayedpubertyisdefinedasfailureofdevelopmentofsignsofsexualdevelopmentbytheageof14yearsinboy.IngirlsdelayedpubertyisdefinedasfailureofbreastbuddingbyI3yearsorabsenceofmenarchebyI5yearorlackofsecondarysexualcharactersbyl7years.
138.Lileyszone3at35weeksgestation managementis? a)Followup b)Intrauterineinfusion c)Pretermterminationofpregnancy d)Cordocentesis CorrectAnswer-CAns,C.PretermterminationofpregnancyAchartthatusesthespectrographicmeasurementofamnioticfluidbilirubinlevelsplottedagainstgestationalagetoestimatetheseverityoffetalhemolysisresultingfromRhisoimmunizntion.
139.Howmuchtimeafterreducedmovement fetalheartstops? a)1hr b)2hrs c)6hrs d)12hrs CorrectAnswer-DAns,D,12hrsOnanaveragefetalheartstopsafter12-48hoursofdiseasedfetalmovementsinintrauterinefetaldeath.
140.Redcellvolumeisincreasedbywhat percentageinpregnancy? a)10-20% b)20-30% c)30-40% d)40-50% CorrectAnswer-BAns.B.20-30%
141.Followingarethecausesof oligohydramniosexcept? a)IUGR b)Postmaturity c)Maternaldehydration d)Labetolol CorrectAnswer-DAns,D.Labetolol
142.Notariskforectopicpregnancy? a)Useofcondom b)OCP c)PID d)Previousectopicpregnancy CorrectAnswer-AAns.A.Useofcondom
143.Riskfactorsfortheectopicpregnancy are? a)IUCD b)Historyofinfertility c)Tubalendometriosis d)Alltheabove CorrectAnswer-DAns,D,Alltheabove
144.34weekspregnancywithlowlying placentaprevia,floatinghead,Hb-11gm%.Whatshouldbethefurtherlineofmanagement? a)Expectantmanagement b)Inductionoflabour c)Caesariansection d)Bloodtransfusion CorrectAnswer-AAns.A.Expectantmanagement
145.Whichofthefollowingisanabsolute indicationforcaesariansection? a)Centralplacentaprevia b)Breechpresentation c)Badobstetrichistory d)Previouscaesariandelivery CorrectAnswer-AAns,A.CentralplacentapreviaAbsoluteindicationsforcaesariansection-CentralplacentapreviaContractedpelvisorcephalopelvicdisproportion(absolute)Pelvicmasscausingobstruction(cervicalorbroadligamentfibroid)
146.Whatisusedtoaididentificationof areasofdysplasiaincolposcopy? a)3-5%aceticacid b)Acetocarminered c)1%formicacid d)1%alcohol CorrectAnswer-AAns.A.3-5%aceticacidColposcopyisthemainstayinthediagnosisofcervicaldysplasiaandprecancerouslesions.
147.Followingaretheultrasounddoppler parametersusedinthediagnosisofintrauterinegrowthrestrictionexcept? a)Abdominalcircumference b)Dopplervelocimetry c)Increaseddiastolicvelocityinmiddlecerebralartery d)Ponderalindex CorrectAnswer-AAns,A.Abdominalcircumference
148.Mostcommoncauseofearlyabortion- a)Genetic b)Maternal c)Immunologic d)Anatomicabnormalities CorrectAnswer-AAns.A.Genetic
149.Followingaretheindicatonsof hysterosalpingographyexcept a)Fallopiantubepatencyininfertility b)Studyuterineanamoly c)Detectuterinesynechiae d)Detectendometriosis CorrectAnswer-DAns,D.DetectendometriosisIndicationsofHysterosaIpingographyTostudythepatencyoffallopiantubesininfertilityandpostoperativetuboplastyToassessthefeasibilityoftuboplastybystudyingtheextentoftubalpathologist.TostudytheuterineanomalysuchasseptateandcornuateuterusTodetectuterinesynechiaeTodetectuterinepolypTostudytheincompetenceofinternalOS
150.Sarcomabotryoidesallaretrueexcept? a)Alsocalledembryonalrhabdomyosarcoma b)Commonlyarisesfromvagina c)Itpresentswithbloodstainedwateryvaginaldischarge d)ItcanbetreatedwithVACregime CorrectAnswer-BAnsB.CommonlyarisesfromvaginaSarcomabotyroides(Embrvonalrhabdomyosarcoma)Specialtypeofmixedmesodermaltumourcommonlyarisingfromcervix,rarelyfromvagina&uterus.
151.Monzygotictwinwithonehealthybaby bornattermandonedeadmummifiedfetusissuggestiveof? a)Fetusacardiacus b)Fetuspapyraceous c)Hydatidiformmole d)Vanishingtwin CorrectAnswer-BAns.B.FetuspapyraceousFetusPaoyraceousorcompressus-Isastatewhichoccursincaseoftwinswhenoneofthefetusesdiesearly.ThedeadfetusisflattenedmummifedandcompressedbetweenthemembranesoflivingfetusanduterinewaII.Itmayoccurinbothvarietiesoftwinsbutismorecommoninmonozygotictwinsandisdiscoveredatdeliveryorearlierbysonography.
152.Mediolateralepisiotomyispreferred because? a)Reducesdamagetoanalsphincterandanalcanal b)Lessbloodloss c)Easytosuture d)Easytechnique CorrectAnswer-AAns,A.ReducesdamagetoanalsphincterandanalcanalMediolateralepisiotomyreducestheriskofdamagetoanalsphincterandanalcanalthoughtitmayslightlyincreasethebleeding.
153.
Whichisnotapartofbasicessentialobstetriccare? a)Bloodtransfusion b)Parenteralantibiotics c)Parenteraloxytocicdrugs d)Parenteralsedativesforeclampsia CorrectAnswer-AAns.A.BloodtransfusionBasicessentialobstetriccareservicesatthehealthcenterlevelshouldincludeatleastthefollowing:ParenteralantibioticsParenteraloxytocicdrugsParenteralsedativesforeclampsiaManualremovalofplacentaManualremovalofretainedproducts
154. Vasapreviaisseeninwhichtypeof placenta? a)Central b)Vilamentous c)Peripheral d)Noneoftheabove CorrectAnswer-BAns.B.VilamentousVasapreviaIfaleashofbloodvesselshappentotraversethroughthemembranesoverlyingtheinternalos,infrontofpresentingpart,theconditioniscalledvasaprevia.Thesearetheunsupportedumbilicalvesselsinvilamentousplacenta.
155. Durationofsecondstageoflabor dependsupon- a)Sizeoffetus b)Mother'sbuild c)Parity d)Lieoffetus CorrectAnswer-CAns,C,ParityThedurationofthenormalsecondstageisusuallyverymuchshorterthanthenormalfirststageoflabour.Aswiththefirststagethedurationofthesecondstagewillmainlydependsonwhetheritisthefirstlabourorthewomanhaspreviouslygivenbirthtoaviableinfanti.e.itdependsontheparitystatusofthemother,
156.Simultaneousadministrationofestrogen andprogesteroneinhormonereplacementtherapyincreasesriskof? a)Ovariancancer b)Breastcancer c)Cervicalcancer d)Bothaandb CorrectAnswer-DAnsD.BothaandbRiskduetobothestrogenandprogesteroneinHRT:-BreastcancerOvariancancerRiskduetoonlyestrogeninHRT:-Endometrialcarcinoma
157.LEEPstandsfor? a)Loopelectrosurgicalexcisionprocedure b)Loopelectromagneticexcisionprocedure c)Loopelectrodiagnosticexcisionprocedure d)Loopelectrochemicalexcisionprocedure CorrectAnswer-AAns,A,LoopelectrosurgicalexcisionprocedureLEEPStandsforLoopElectrosurgicaldiagnosticprocedure.Itisalsoknownaslargeloopexcisionofthetransformationzone(LLETZ).
158.Definitivetreatmentforacaseofsevere preeclampsiais- a)MgS0, b)Deliveryofbaby c)Antihypertensivedrugs d)Rest CorrectAnswer-BAns,B.DeliveryofbabyForalltypesofPIH,irrespectiveofseverity,definitivemanagementisterminationofpregnancy"
159.Anothernameformancehsteroperation foruterineprolapseis? a)Fothergill b)Mercy c)McDonald d)Purandare CorrectAnswer-AAns,A,FothergillManchesteroperationalsocalledFothergill'soperation.
160.Whatistheriskofrecurrenceof anencephalyinsubsequentpregnancy? a)1% b)2% c)3% d)4% CorrectAnswer-BAns,B.2%Theriskofrecurrenceofanencephalyinsubsequentpregnancyis2%.
161.Followingistrueabouttamoxifene except? a)Itisaselectiveestrogenreceptormodulator b)Itisacompetitiveinhibitorofestrogenatreceptorsite c)Itdecreasesriskofvenousthromboembolism d)Itcanbeusedforinductionofovulation CorrectAnswer-CAns,C,Itdecreasesriskofvenousthromboembolism
162.Followingistrueregardingthe managementofintrauterinefetaldeathexcept? a)In50%ofcasesspontaneousexpulsionoccursin2weeks b)Fibrinogenlevelsshouldbecheckedweekly c)Deliverybymedicalinductionispreferredifspontaneous expulsiondoesnotoccur d)Caesariansectionhaslimitedplaceinmanagementof intrauterinefetaldeath CorrectAnswer-AAns,A,In50%ofcasesspontaneousexpulsionoccursin2weeks
163.Sequenceoflochia? a)Rubra-Serosa-Alba b)Serosa-Alba-Rubra c)Alba-Rubra-Serosa d)Alba-Serosa-Rubra CorrectAnswer-AAns,A,Rubra-Serosa-AlbaLochiaItisthevaginaldischargeforthefirstfortnightduringpeurperium.Thedischargeoriginatesfromtheuterinebody,cervixandvagina.
164.Amenorrhoeafollowing hyperprolactinomaiscausedby? a)InhibitionofGnRHpulsesecretion b)Inhibitionofadrenalsteoridogenesis c)Itcauseshypergonadotropichypogonadism d)Itleadstoformationofovariancysts CorrectAnswer-AAns,A.InhibitionofGnRHpulsesecretionProlactininhibitsGnRHpulsesecretionandsuppressesganadotropinlevels.Hyperprolactinemiacausesamenorrhea,anovulationandHypogonadism.
165.Oldcompleteperinealtearisrepairedat ? a)Immediately b)3-6months c)6-9months d)9-12months CorrectAnswer-BAns,B.3-6monthsThedefinitivesurgeryforcompleteperinealtearkrepairoftheanalsphinctercomplex(sphinaeroptasty)withrestorationoftheperinealbody(perineoraphy).Forthefreshinjuriesthebesttimeofrepairiswithin24hoursafireinjury,Foroldperinealtearsthisshouldpreferablebedone3-6monthsfollowinginjury.
166.Whichofthefollowinghasmaximum diabetogenicpotencyinpregnancy? a)Estrogen b)Progesterone c)Cortisol d)Prolactin CorrectAnswer-CAns,C,Cortisol
167.Roleofergometrinetostoppostpartum hemorrhageisdueto? a)Increaseduterinemuscletone b)Vasoconstriction c)Increasedplateletaggregation d)Increasedcoagulation CorrectAnswer-AAns.A.IncreaseduterinemuscletoneErgometrineactsdirectlyonmyometriumandexcitesuterinecontractions,whichclosesbloodvesselsinbetweenthushelpsincontrollingPPH.VasoconstrictiveactionofergometrinedoesnotcontrolbleedingbutmaycauseriseinB.P.gangreneoftoe,PreciPitatebronchospasm.Option(c)&(d),arenottheactionofergometrine.
168.Continence&incontinenceofurineis seenin? a)VVF b)Vesicoperitoneal c)Ureterovaginal d)Uretrovaginal CorrectAnswer-CAns.C.UreterovaginalContinenceandincontinenceofurineisseeninureterovaginalfistula.
169. Typeofsutureusedincompleteperineal tearis- a)Catgut b)Silk c)Vicryl d)Vicrylandcatgut CorrectAnswer-DAns.D.VicrylandcatgutRectumisdissectedtoclearofscartissue&fresheningofcutedges.Cutedgesofrectumandanusaresuturedwithvicryl.DeepmuscleofperenialbodyandlevatoraniareidentifiedandsuturedwithNol-catgut.Superficialmuscleissuturedwithvicrylcatgutsutures.
170.Uterineruptureismostcommonin- a)Antlowersegment b)ClassicalC.S c)Placentaprevia d)Normallabour CorrectAnswer-BAns.B.ClassicalC.S
171.Chancesofuterineruptureareleastin- a)LSCS b)Classic c)Inverted d)Lowvertical CorrectAnswer-AAns.A.LSCS
172.Ageofmetropathichemorrhagicais? a)20-25 b)50-55 c)60-65 d)40-45 CorrectAnswer-DAns,D.40-45MetropathiahemorrhagicaSpecializedformofDUB.Mostlyseeninpremenopausalwomen.Maximumageincidence:Betweenages40-45years.Patientcomplainsofprolongedamenorrhea(of6-8weeks)followedbyexcessivepainlessbleeding(anovularbleeding).
173.Managementofecclampsiain34weeks ofpregnancyis- a)Continueofconvulsionandwaitfor37wktocomplete b)Waitforspontaneouslabours c)BPcontineu d)Antihypertensive,anticonvulsantandterminationofpregnancy CorrectAnswer-DAns.D.Antihypertensive,anticonvulsantandterminationofpregnancy
174.HematuriainpreviousLSCSpatient indicates- a)Urinarytractinfection b)Placentaprevia c)Ruptureuterus d)None CorrectAnswer-CAns.C.Ruptureuterus
175.Battledoorinsertionofplacenta? a)Cordattachedtothemarginofplacenta b)Placentaattachedtothemargin c)Cordattachedtothemembranes d)Placentaattachedtothecentre CorrectAnswer-CAns.C.CordattachedtothemembranesChangeinfetalheartrate(tachycardia/lossofbeattobeatvariability/decelerations)isearliestsignofimpendingscardehiscence,followedbymaternaltachycardia.
176.Allaretrueaboutconstrictionring except? a)Alsocalledschroeder'sring b)Canbecausedbyinjudiciousoxytocinuse c)Ringcanbepalpatedperabdomen d)Inhalationofamylnitraterelaxesthering CorrectAnswer-CAns,C.Ringcanbepalpatedperabdomen
177.21yrcollegegirlwithmildendometriosis treatment- a)CyclicalOCpill b)ContinuousOcpill c)Progesteroneonlypill d)Danazole CorrectAnswer-AAns,A.CyclicalOCpill
178.Notseeninendometriosis? a)Vaginaldischarge b)Dysparenuria c)Infertility d)Chronicpelvicpain CorrectAnswer-AAns.A.VaginaldischargeClinicalfeaturesofEndometriosisPainInfertilityDysmenonheaDyspareunia(deep)
179.Metrorrhagiaisproducedbythe followingexcept? a)Polyp b)CAendometrium c)IUD d)Intramuralfibroid CorrectAnswer-DAns,D.Intramuralfibroid
180.Bonney'stestisuseddetermine? a)Uterineprolapsed b)Stressurinaryincontinence c)Vesicovaginalfistula d)Utericfistula CorrectAnswer-BAns.B.Stressurinaryincontinence
181.Reddegenerationoffibroidisseenin? a)Earlypregnancy b)Midpregnancy c)Puperium d)Nulliparouswomen CorrectAnswer-BAns.B.Midpregnancy
182.Radicalhysterectomyinstagelbca cervixbetterthanradiotherapyallaretrueexcept? a)Chanceofsurvivalmore b)Chanceofrecurrenceless c)Ovaryfunctioncanbepreserved d)Lesscomplicated CorrectAnswer-AAns,A.Chanceofsurvivalmore
183.Bilateralovariancarcinoma+capsule+ ascitis+paraaorticLN.Whichstage? a)1C b)2C c)3C d)4C CorrectAnswer-AAns.A.1C
184.RadiationtopointAincervixis? a)8000rad b)6000rad c)10000rad d)4000rad CorrectAnswer-AAns.A.8000rad
185.Mostcommonpresentationofcervical canceris- a)Deeppelvicpain b)Rectalpain c)Bleedingpervaginum d)Weightloss CorrectAnswer-CAns,C.Bleedingpervaginum
186.Treatmentofsimplehyperplasiaof endometriumis? a)Progesterone b)Estrogen c)Hysterectomy d)Cryosurgery CorrectAnswer-AAns,A.Progesterone
187.Mostcommonpresentingfeatureof completemoleis? a)Vomiting b)Amenorrhoea c)Amenorrhoea d)Bleedingpervaginum CorrectAnswer-DAns,D.BleedingpervaginumClinicalfeaturesofcompletemoleVaginalbleedingisthemostcommonsymptomcausingpatienttoseektreatmentforcompletemolepregnancy.Abnormaluterinebleedingusuallyduringthefirsttrimesteristhemostcommonpresentingsymptomoccurringinmorethan90%ofpatientswithmolarpregnancies.
188.AndrogenicXXchromosomeis? a)Partialmole b)Completemole c)Turner'ssyndrome d)Steinleventhalsyndrome CorrectAnswer-BAns,B.CompletemoleCharacteristicsofcompleteMoleCompleteH.moleshowsnoevidenceoffetaltissueatall.Completehydatiformmolesexhibitcharacteristicswellingandtrophoblastichyperplasia.Mostcommonkaryotypeis46XX.Themolarchromosomesareentirelyofpaternalorigin,althoughmitochondrialDNAisofmaternalorigin.Thecompletemolearisesfromanovumthathasbeenfertilizedbyahaploidsperm,whichthenduplicatesitsownchromosomescalledAnilrogenesis.Theovumnucleusmaybeeitherabsentorinactivated.
189.Highchanceofruptureintubal pregnancyareseeninwhich? a)Ampulla b)Isthmus c)Interstitial d)Fimbrial CorrectAnswer-BAns.B.IsthmusM.C.siteoftubalrupture=Isthmus
190. Mostcommonsiteofectopicpregnancy is- a)Tubal b)Abdominal c)Ovarian d)Uterine CorrectAnswer-AAns,A.TubalMostcommonsiteofectopicpregnancyisfallopiantube.IntubalpregnancyM.C.siteisampulafollowedbyIsthmus.
191.%ofectopicpregnancyseeninfallopian tubeis? a)75% b)90% c)80% d)67% CorrectAnswer-BAns,B.90%M.C.siteofectopicpregnancy=Fallopiantube(97%).
192.Drugsusedinectopicpregnancy? a)PGE2 b)PGI c)PGF2 d)None CorrectAnswer-CAns.C.PGF2
193.Mostcommoncongenitaluterine anomalyis? a)Bicornuateuterus b)Septateuterus c)Unicornuateuterus d)Arcuateuterus CorrectAnswer-BAns.B.Septateuterus
194.WheniscopperTinserted? a)3daysafterperiodsareover b)Within10daysofstartofmenstrualcycle c)PIDjustbeforemenstruation d)Justaftermenstruation CorrectAnswer-BAns,B.Within10daysofstartofmenstrualcycleldealtimeforinsertionofCu-Tiswithin10daysofthestartofthemenstrualcycleIthastheadvantagethatcervicalcanalisdilated,uterusisrelaxedandchancesofpregnancyareremore.PostPartuminsertionwithin48hoursofdeliveryor6weeksafterdelivery.Post-MTPinsertionimmediatelyfollowingD&E(inearlypregnancy)
195.Mostcommoncauseofannularcervixis ? a)Obstructivelabor b)Prepitatelabor c)Primarycervicaldystocia d)Iatrogenic CorrectAnswer-CAns,C.PrimarycervicaldystociaAnnularcervixisdetachmentofthecervixfollowingprolongedlabourinprimarycervicaldystocia.
196.Intrauterineadhesionsbestseenby? a)USG b)CT c)Hysteroscopy d)MRI CorrectAnswer-CAns.C.HysteroscopyHysteroscopyistheendoscopictechniqueofvisualizingtheinteriorofuterusdirectly,Itisbothdiagnosticandtherapeutic.
197.Insulinresistanceinpregnancyisdueto ? a)Estrogen b)Progesterone c)HPL d)GH CorrectAnswer-A:CAns.C>A.HPL>EstrogenDuringPregnancyinsulinlevelsareincreasedbecauseofincreasedinsulinsecretionaswellasincreaseininsulinresistanceduetoanumberofcontrainsulinfactorsbutthemostimportanthormonecausinginsulinresistanceisHumanplacentallactogen.
198.Gestationaldiabetesmellitus? a)Isfirstrecognizedduringpregnancy b)PrevioushistoryofIUGR c)ThereisnorecurranceofGDMinfuturepregnancy d)Noriskofovertdiabetes CorrectAnswer-AAns.A.IsfirstrecognizedduringpregnancyGestationaldiabetesmellitusisdefinedascarbohydrateintoleranceofvariableseveritywithonsetorfirstrecognitionduringPregnancy.Pregnancyisaformofstressthatcancauselatentdiabetestomanifestjustasdosurgicaloperationsoracuteinfections.Inmostofthecasesthecarbohydrateintolerancerevertsbytheendofpuerperiumbutthismanifestationmaybethefirstindicationofdiabetesyettocome.Morethanhalfthewomenwithgestationaldiabeteswilldevelopfrankdiabeteswithinthenext20years.Howeverinsomeofthesecarbohydrateintolerancemaypersistbeyondthepuerperiumandtheseareinrealitycasesofpre-gestationaldiabeteswhichhavebecomeovertduringpregnancy.
199.Trueaboutgestationaldiabetesis? a)Theseareincreasedchancesofcongenitalmalformation b)Only2%ofwomenpresentwithovertdiabetes c)Thereischanceofmacrosomia d)Usuallydiagnosedinearlypregnancy CorrectAnswer-CAns.C.Thereischanceofmacrosomia
200.Mostcommonpresentingsymptomof TBendometritisis- a)Abdominalpain b)Infertility c)Amenorrhoea d)Vaginaldischarge CorrectAnswer-BAns,B.InfertilityMostcommonsymptomofGenitalTBis:-Infertility(35-60%)iseitherduetoblockageoffallopiantubeorduetolossoftubalfunctioneveniftubesarepatent.
201.PIDafterinsertionofIUDisseeninhow manyweeks? a)3 b)5 c)7 d)14 CorrectAnswer-AAns,A.3TheriskofdevelopingPIDis2-10timesgreateramongtheIIJDusers.Theriskismoreinthefirst3weeks.Infectionwithchlamydiaandactinomycosismostcommon.
202.AcutePID,mostcommonrouteofspread ? a)Descending b)Ascendinginfection c)Lymphatics d)Hematogenous CorrectAnswer-BAns,B,AscendinginfectionM/crouteofspreadofPIDis:-Ascendinginfectionalongwithsperms.AllPIDsaresexuallytransmittedexceptTB.
203.Bestwaytolookatendometrialactivity isby- a)HSG b)Biopsy c)USG d)Colposcopy CorrectAnswer-BAns,B.BiopsyEndometrialsamplingorcurettageorbiopsyisthebestmethodtoassessendometrialactivity.
204.Blockgiveninforcepsdelivery? a)Pudendal b)Ilioinguinal c)Genitofemoral d)Posteriorfemoral CorrectAnswer-AAns,A.PudendalForforcepsoPerationpudendalblockisgivensupplementedbyperinealandlabialinfiltration.
205.Causeofbigbaby? a)Hyperglycemia b)Hyperinsulinemia c)Multiparity d)Postmaturity CorrectAnswer-A:B:C:DAns,AlloftheaboveA,B,C,D
206.Decubitusulceris? a)Duetotrauma b)Duetovenouscongestion c)Duetofrictioncreatedbythighs d)Dueto CorrectAnswer-BAns,B.DuetovenouscongestionDecubitusulcerisatrophiculceralwaysfoundatthedependentpartoftheprolapsedmass(inprolapseduterus).Itisduetodecreasedcirculationduetonarrowingofuterinevesselsbystretchingefectwithadditionalkeratinizations,cracks.
207.Patientwithhistoryofvaginalprolapse withulceronit.Diagnosis? a)Carcinoma b)Pressureerosion c)Syphilis d)Decubitusulcer CorrectAnswer-DAns,D.Decubitusulcer
208.SERMsare? a)Agonistonestrogenreceptor b)Antagonistonestrogenreceptor c)Someareagonistsomeantagonistonestrogenreceptor d)Usedduetoreducedchancesofhotflushes,thromboembolism CorrectAnswer-CAns,C,SomeareagonistsomeantagonistonestrogenreceptorSERM'sareselectiveestrogenreceptormodulatorscalledSERMsblockstheeffectsofestrogeninthebreasttissue.TheyblocktheeffectofestrogenbyactingonestrogenrecePtors.
209.Femalewithhirsutismwith ammenorrhoeaandobesity.Diagnosis? a)PCOD b)Ovariantumor c)Androgeninsensitivitysyndrome d)Turnersyndrome CorrectAnswer-AAns,A.PCODTheclinicalandlaboratoryfeaturesofthepatientdescribedinthequestionmatchwiththoseofPCOSasdepictedinthetable.SothemostappropriateanswerisPCOD.
210.HAIRANsyndromeisseenin? a)PCOD b)Endometeriosis c)CAovary d)Adrenaltumours CorrectAnswer-AAns,A.PCODPCODisalsoknownasHAIRANSyNDROME
211.RegardingPCODallaretrueexcept? a)HighFSH/LH b)HighDHEA c)RaisedLH d)TEstrogen CorrectAnswer-AAns,A.HighFSH/LHPCODisalsoknownasHAIRANSyNDROME
212.WhichhormoneincreasesinPCOD? a)LH b)FSH c)Estrogen d)TSH CorrectAnswer-AAns,A,LHSteinleventhalsyndromeisalsocalled`PolycysticOvarianSyndrome'
213.SteinLevinthalsyndromewhathormone israised? a)LH b)FSH c)GnRH d)Progesterone CorrectAnswer-AAns,A.LH
214.Whatshouldnotbedoneduringdelivery ofRhnegative? a)IVFluids b)Externalversion c)Manualremovalofplacentashouldbedonegently d)Ergometiretobewithheldatdeliveryofant.shoulder CorrectAnswer-AAns,A.IVFluids
215.Historyofyellowgreenwaterydischarge andpruritus? a)Trichomonasvaginalis b)Candida c)Bacterialvaginosis d)Clamydiatracomatis CorrectAnswer-BAns.B.CandidaDuringRhPregnancfstePsshouldbetakentopreventfetomaternalbleeding;-PrecautionsduringcaesariansectiontopreventbloodspillingintoperitonealcavityProphylacticergometinewithdeliveryofantshouldertobewithheld.Amniocentesisshouldbedoneaftersonographic.Localizationofplacentatopreventplacentalinjury.Forcibleattemptforexternalversionshouldnotbedone.Manualremovalofplacentashouldbedonegently.Torefrainfromabdominalpalpationinabruptionplacenta.
216.Mostcommongenitalinfectionin pregnancyis? a)Candida b)Gonorrhea c)Trachoma d)Cytomegalovirus CorrectAnswer-AAns,A.CandidaSeventypercentshowtypicaldischarge,whichisprofuse,thin,creamyorslightlygreenincolour,irritatingandfrothy.Thevaginalwallsaretender,angrylookingandthedischargecausespruritusandinflammationofthevulva.
217.Decreasedfetalheartsoundisdueto whichdrug- a)Oxytocin b)Sodiumbicarbonate c)IVfluids d)Iron CorrectAnswer-AAns,A,OxytocinVaginitisduetocandidaismorecommonthantrichomonasandismoreprevalentinDiabeticpregnancy.Treatmentismiconazolevaginalcreamfor7days.
218.DoseofmifepristoneinMTPis? a)10mg b)20mg c)100mg d)200mg CorrectAnswer-AAns,A.10mgDecreasedfetalheartrateorfetaldistressisduetofetalhypoxia.
219.Ayoungsexuallyactivefemalehas intensivepruritusandwaterydischarge,smearshows? a)Trichomonasvaginalis b)Candidavaginitis c)Gardenllavaginalis d)HIV CorrectAnswer-DAns,D.HIV
220.Treatmentfortrichomonasvaginalisis? a)Metronidazole b)Azithromycin c)Ciprofloxacin d)None CorrectAnswer-AAns.A.MetronidazoleThedrugofchoiceforTrichomonasvaginitsisMetronidazole.
221.Whichorganismcausespuerperalsepsis ? a)CMV b)Toxoplasmagondii c)GroupAbetahemolyticstreptococci d)GroupBbetahemolyticstreptococci CorrectAnswer-CAns,C.GroupAbetahemolyticstreptococciMostcommoncauseofpuerperalsepsisisGroupAstreptococcus.Otherorganismsthatareimplicatedare:StriptococcusgroupB,CandG,staphylococcusaureus,E.coli,Enterobacterspeciesandchlamydiatrachomatis.
222.Theprostaglandinmostcommonlyused attermforinductionoflaboris? a)PGI2 b)PGE1 c)PGE2 d)PGF2a CorrectAnswer-CAns.C.PGE2PGE2ismostcommonlyusedattermforinductionoflabor.
223.HCGlevelsatwhichExpectant managementofEctopicpregnancycanbedone: a)10000IU/L b)1000IU/L c)2500IU/L d)5000IU/L CorrectAnswer-BAns.B.1000IU/LInitialHCGlevels<1000IU/l&subsequentlevelsarefalling.
224.MCcauseofPrimaryAmenorrheais? a)Constitutional/idiopathic b)RMKHsyndrome c)Ovariandysgenesis d)Noneoftheabove CorrectAnswer-CAns,C.OvariandysgenesisMCcauseofprimaryamenorrheaisovariandysgenesis/Turnersyndrome.
225.Aninfertilewomanhasbilateraltubal blockatcornuadiagnosedonhysterosalpingography.Nexttreatmentofchoiceis? a)IVF b)Laparoscopyandhysteroscopy c)Tuboplasty d)Hydrotubation CorrectAnswer-BAns.B.LaparoscopyandhysteroscopyLaparoscopy(withchromopertubationwithmethylenebluedye):Bestinvestigationfortubalpatency,astubalpatencycanbeconfirmedundervision,andbesides,anypathologycansimultaneouslybecorrectedwithoperativelaparoscoPy.
226.Fetalkaryotypingcanbedonebyall, EXCEPT? a)Cordocentesis b)Amniocentesis c)CVS d)Fetalskinbiopsy CorrectAnswer-DAns.D.FetalskinbiopsyPercutaneousumbilicalbloodsampling(PUBS)isalsoknownascordocentesisisperformedafter16weeks'gestation'underUSGguidanceaneedleisinsertedintoumbilicalvein.Thistechniqueapartfromkaryotypingisalsousefulforevaluatingfetalmetabolismandhematologicabnormalities.
227.55yearoldladycomplaintsofmassin thevagina,whichisreducible&increasesondefecation.Thediagnosisis? a)Rectalprolapse b)Uterineprolapse c)Cervicalfibroid d)Vaginalcancer CorrectAnswer-BAns.B.UterineprolapseProlapseisdefinedasthedisplacementofanorganfromitsnormalanatomicalposition.GenitalprolapseoccursduetoweaknessofthesuPPorts.
228.Moschowit'ssurgeryisdonefor- a)Cervicalcancer b)Fundalfibroids c)Uterineprolapse d)Enteroceleprevention CorrectAnswer-DAns.D.EnterocelepreventionEnteroceleformatiolcanbepreventedbyMoschowit'sorHalban'ssurgeries,inboththePODisobliterated.
229. Whichofthefollowingisusedin quantifyinghirsutism? a)Bishopscore b)Rotterdamcriteria c)Ferriman-Gallweyscore d)Alloftheabove CorrectAnswer-CAns.C.Ferriman-GallweyscoreTheFerriman-Gallweyscoreisamethodofevaluatingandquantifyinghirsutisminwomen.Themethodwasoriginallypublishedinl96lbyD.FerrimanandJ.D.GallweyintheJournalofClinicalEndocrinology.
230.MCheartdiseaseinpregnancyis? a)MS b)AS c)MR d)WPWsyndrome CorrectAnswer-AAns.A.MSMitralstenosisistheMCvalvularheartdiseaseinpregnancy.
231.Rateofcervicaldilatationinprimigravida is? a)0.8cm/hour b)1.2cm/hour c)1.5cm/hour d)2cm/hour CorrectAnswer-AAns.A.0.8cm/hourThenormalrateofcervicaldilatationinactivephaseis1.2cm/hourinprimigravidaeand1.5cm/hourinmultiparae.
232.Complicationsofpreeclampsiaareall except? a)Postdatism b)DIC c)Blindness d)Noneoftheabove CorrectAnswer-AAns.A.Postdatism
233.Whatismonitoredinapatientofpre eclamsia? a)Uricacid b)Plateletcount c)LFT d)Alloftheabove CorrectAnswer-DAns.D.Alloftheabove
234.Notanabsolutecontraindicationfor methylergometrineuseis? a)Eclampsia b)Heartdisease c)Rhincompatibility d)Afterdeliveryoffirstbabyintwinpregnancy CorrectAnswer-CAns.C.RhincompatibilityMethylergometrine(Methergin)canbeusedinthepreventionandtreatmentofPPH.AbsolutecontraindicationstotheuseofMetherginare: 1. Chronichypertension/preeclampsia/eclampsia2. Heartdiseaseinpregnancy3. Afterthedeliveryofthefirstbabyofthetwins.
235.Aladywith35weeksofpregnancyis admittedinviewoffirstepisodeofpainlessboutofbleedingyesterday.OnexaminationHb10g%,BP120/70mmHg,uterusrelaxed,andcephalicfloating.FHSregular.Nextlineofmanagementis? a)Cesareansection b)Inductionoflabor c)Waitandwatch d)Bloodtransfusion CorrectAnswer-CAns.C.WaitandwatchThisisacaseofplacentaprevia(painlessbleeding,relaxeduterus,andfloatingheadallpointtoplacentaprevia).Inthiscase,allthecriteriaforconservativemanagementarefulfilledandthereforetheansweriswaitandwatchforfetallungmaturity.
236.G3P2L2withprevious2LSCSwith anteriorplacentapreviahasgotaveryhighriskofwhichcomplication? a)Placentaacreta b)Vasaprevia c)Abruption d)Noneoftheabove CorrectAnswer-AAns.A.PlacentaacretaThetermplacentaaccretaisusedtodescribeanyplacentalimplantationinwhichthereisabnormallyfirmadherencetotheuterinewall.Theincidenceofplacentaaccreta,increta,andpercretahasincreased,mostlikelybecauseoftheincreasedcesareandeliveryrate.
237.B-Lynchsutureisappliedon? a)Cervix b)Uterus c)Fallopiantubes d)Ovaries CorrectAnswer-BAns.B.UterusDescribedfirstbyChristopher,B-LynchisacompressionsutureplacedonuterusinthemanagementofatonicPPHwhenthemedicalmethodsfail.
238.A28-year-oldprimigravidawith33weeks ofpregnancysuddenlycomplainsofheadache,oliguria,andblurredvision.HerBPis180/110andurinealbuminis+3.Thelineoffurthermanagementis? a)Waitandwatch b)LSCS c)Inductionoflabor d)Anticonvulsant+antihypertensivetherapy CorrectAnswer-DAns.D.Anticonvulsant+antihypertensivetherapyThepatientisacaseofseverepreeclampsia,withimpendingeclampsia.Magnesiumsulfateisthedrugofchoiceforeclampsiaandalsoforimpendingeclampsia.
239.Whichofthefollowingstatements concerningabdominalpregnancyiscorrect? a)Gastrointestinalsymptomsarequiteoftenverysevere b)Fetalsurvivalisapproximately80% c)Aggressiveattemptsshouldbemadetoremovetheplacentaat thetimeofinitialsurgery d)Placentacanbeleftinsituatthetimeofsurgery CorrectAnswer-DAns.D.PlacentacanbeleftinsituatthetimeofsurgeryAlthoughleavingtheplacentaintheabdomenfollowingsurgicaldeliverypredisposestoriskesofpostoperativeinfections,theriskismuchlessseverethanthehemorrhageassociatedwithattemptsofremovalofplacentaatthetimeofprimarysurgery.
240.Completevesicularmoleisassociated Thecaleutincsytsinwhatpercentageofcases? a)<5 b)5-15 c)20-40 d)60-70 CorrectAnswer-CAns.C.20-40Theca-luteincysts:Inmanycasesofhydatidiformmole,theovariescontainmultipletheca-luteincysts.
241.Patientwith3monthsamenorrhoea,c/o hyperemesisandvaginalbleedingsinceonemonth.O/E=uterus16weekswithabsentfetalheartsound.Thediagnosisis? a)Vesicularmole b)Ectopicpregnancy c)IUFD d)Abruptioplacentae CorrectAnswer-AAns.A.VesicularmoleVesicularmoleisanabnormalconditionofplacentawherethereishydropicdegenerationandproliferativechangesintheyoungchorionicvilli.Itisabenignconditionwithmalignantpotential.Uterinebleedingisalmostuniversalandmayvaryfromspottingtoprofusehemorrhage.ItistheMCpresentingfeature.Thedischargehas'whitecurrantinredcurrantjuice'appearance.
242.Patientwithchoriocarcinoma&jaundice, treatmentofchoiceis? a)Methotreaxate b)ActinomycinD c)Suctionevacuation d)Combinationofall CorrectAnswer-BAns.B.ActinomycinD
243.EMACOregimeisfor? a)Cacervix b)Caendometrium c)Caovary d)Choriocarcinoma CorrectAnswer-DAns.D.Choriocarcinoma
244.Stagelbcervicalcancerisdiagnosedin ayoungwoman.Assumingthatthecancerisconfirmedtothecervixandthatintraoperativebiopsiesarenegative,whichofthefollowingstructurewouldnotberemovedduringtheradicalhysterectomy? a)Uterosacralanduterovesicalligaments b)Pelvicnodes c)Theentireparametriumonbothsidesofthecervix d)Bothovaries CorrectAnswer-DAns.D.BothovariesPreservationoftheovariesisgenerallyacceptable,particularlyinyoungerwomen.
245.Invaginalhysterectomy,thefirstclamp includes: a)Uterineartery b)Fallopiantube&roundligament c)Uterosacralligament d)Noneoftheabove CorrectAnswer-CAns.C.UterosacralligamentVaginalhysterectomywithpelvicfloorrepairisdoneforvaginouterineprolapseinperi/postmenopausalwomen.Firstclampincludesuteroscaral&Macenrodt'sligament.Secondclampincludesuterineartery.Thirdclampincludescornualstructures.
246.Therapeuticconizationisindicatedin? a)Microinvasivecarcinomacervixstagelal b)CINIII c)Unsatisfactorycolposcopywithcervicaldysplasia d)Cervicalmetaplasia CorrectAnswer-AAns.A.MicroinvasivecarcinomacervixstagelalInstage1A1,thereisnolymphnodeinvolvement.Therapeuticconizationisthesurgeryofchoiceforstage1A1inyoungpatientswhoaredesirousoffuturechildbearing
247.CervicalcancerIIIBtreatmentis? a)Wertheim'soperation b)Radiotherapy c)Chemotherapy d)Chemoradiation CorrectAnswer-DAns.D.ChemoradiationCisplatinisgivenbeforeRTasaradiosensltizer,hencethepreferredterminologyisCTRT(concurrentchemoandradiotherapyalsoknownaschemoradiation).
248.Wertheim'shysterectomyisdonefor? a)1A1cervicalcancer b)IBcervicalcancer c)Germcellovariancancer d)Alloftheabove CorrectAnswer-BAns.B.IBcervicalcancerStagesofCacervixthatareoperable(radical/Wertheim'shysterectomy)are1A2,IB,andIIA.
249.RadioisotopeusedinCacervix Brachytherapy? a)Cobalt b)Iridium c)Cesium d)Alloftheabove CorrectAnswer-DAns.D.Alloftheabove
250.Cavulvaspreadstoallexcept? a)Urethra b)Deepinguinalnodes c)Superficialinguinalnodes d)Paraaorticnodes CorrectAnswer-DAns.D.ParaaorticnodesModesofspreadofca.vulva 1. Direct:Urethra,Vagina,Rectum,pelvicbones2. Lymphatic:MCrouteofspread.3. Lymphaticsoflabiatosuperficial,thendeepinguinalnodes&then pelvicnodes 4. Hematogenousrouterare&mayoccurinadvancedcases
251.Whichovariantumourcanpresentwith menorrhagia? a)Demoidcyst b)Epithelialovariancancer c)Granulosacelltumour d)Yolksactumour CorrectAnswer-CAns.C.GranulosacelltumourGranulosacelltumours(orgranulosa-thecacelltumours)aretumoursthatarisefromgranulosacells.Thesetumoursarepartofthesexcordgonadalstromaltumourornon-epithelialgroupoftumours.
252.Allareriskfactorsforectopicpregnancy except? a)Pasthistory b)Tuballigationfailure c)IVF d)LNGIUCD CorrectAnswer-DAns.D.LNGIUCDIUCD:ThemoderncopperIIJDdoesnotincreasetherkkofectopicpregnancy.However,thereisarelativeincreaseintubalpregnancy(7timesmore)shouldpregnancyoccurwithIUCDinsitu.Studieshavedemonstratedthatuptol%ofpregnanciesachievedthroughIVForGIFTcanresultinaheterotopicgestation.
253.A21-year-oldfemalepresentsto emergencywardwith2monthsofamenorrheawithpaininabdomenandshock.BP90/60mmHgandHb6gm%.Urinepregnancytestisfoundpositive.Nextimmediatelineoftreatmentis? a)Laparotomy b)IVfluids&crossmatch c)Medicalmanagement d)Laparoscopy CorrectAnswer-BAns.B.IVfluids&crossmatchThisisacaseofrupturedectopicpregnancy.PositiveUrinePregnancyTestindicatesthattheamenorrheaisduetopregnancy.Painandshockinearlypregnancyaremostlyalwaysduetorupturedectopic.
254.DOCformedicalmanagementofectopic pegnancy? a)ActinomycinD b)IntramuscularMethotrexate c)IntramuscularMethotrexate d)PGf2alpha CorrectAnswer-BAns.B.IntramuscularMethotrexate
255.WhatisnotusedinPCOS? a)OCpills b)Cyclicalprogesterones c)Myoinositol d)Danazol CorrectAnswer-DAns.D.DanazolInsulinsensitizersarealsousedtotackleinsulinresisitance.DanazolhasnoroleinPCOS.
256.Pearlnecklaceappearanceis characteristicof? a)Ectopicpregnancy b)PCOS c)Endometriosis d)PID CorrectAnswer-BAns.B.PCOSUSGfeaturesofpolycysticovariansyndrome(PCOS)Greaterthan12folliclesmeasuringbetween2mmand9mmindiameterlocatedperipherally,resultinginapearlnecklaceappearance.Increasedechogenicityofovarianstromaand/orovarianvolumegreaterthan10ml.
257.Violinstringadhesion[violentstring sign]isseenin? a)PCOS b)Endometriosis c)Fitz-high-curtissyndrome d)Rupturedectopicpregnancy CorrectAnswer-CAns.C.Fitz-high-curtissyndromeLaparoscopyisperformed,thelivercapsulewillappearinflamed,withclassicviolinstringadhesionsintheperietalperitoneumbeneaththediaphragm.Fivepercentto10%ofwomenwithacutePIDdevelopsymptomsofperihepaticinflammation,theFitz-High-Curtissyndrome.
258.Dysgerminomaspreadsmainlyvia? a)Hematogenousroute b)Lymphaticroute c)Directspread d)Doesnotspread CorrectAnswer-BAns.B.LymphaticrouteDysgerminomasarethemostcommonmalignantgermcelltumors,accountingforabout30%to40%ofallovariancancersofgermcellorigin.Inthe25%ofpatientswhopresentwithmetastaticdisease,thetumormostcommonlyspreadsviathelymphatics.
259.Triadofsymptomsofendometriosisare allexcept? a)Infertility b)Dysmenorrhea c)Dyspareunia d)Cyclicalhematuria CorrectAnswer-DAns.D.CyclicalhematuriaEndometriosisisdefinedasthepresenceofnormalfunctionalendometrialmucosa(glandsandstroma)abnormallyimplantedinlocationsotherthantheuterinecavity.ItwasfirstdescribedbyVonRokitanskyAboutonethirdofwomenwithendometriosisremainasymptomatic.
260.ComplicationofBenignOvarianCystsis ? a)Torsion b)Intracystichemorrhage c)Pseudomyxomaperotonei d)Alloftheabove CorrectAnswer-DAns.D.Alloftheabove
261.Level1supportofuterus&vaginais? a)levatorani b)Perinealbody c)Uterosacralligaments d)Alloftheabove CorrectAnswer-CAns.C.UterosacralligamentsDelancey'sthreelevelsofpelvic(uterus,vagina)support=Level1:Theuterosacral-cardinalligamentcomplexprovidesattachmentoftheuterusandvaginalvaulttothesacrum.Uterineprolapseoccurswhenthisligamentcomplexbreaksorisattenuated.
262.MCpresentingsymptomoffibroidis? a)Menorrhagia b)Infertility c)Lump d)Compression CorrectAnswer-AAns.A.Menorrhagia
263.Medicalmanagementoffibroidsiswith allexcept- a)Progesterone b)Mifepristone c)Ulipristalacetate d)Misoprostol CorrectAnswer-DAns.D.Misoprostol
264.Endometriosisis? a)Endometriumwithinthemyometrium b)Functionalendometriumoutsidetheuterus c)Myometriumwithintheendometrium d)RaresquamousvarietyofCAendometrium CorrectAnswer-BAns.B.FunctionalendometriumoutsidetheuterusEndometriosisDefinition:Presenceoffunctionalendometriumatplacesotherthanuterus(ectopicendometrialtissue)
265. Samson'stheoryforDevelopmentof Endometriosisis? a)Celomicmetaplasia b)Hematogenousspread c)Lymphaticspread d)Retrogrademenstruation CorrectAnswer-DAns.D.RetrogrademenstruationTheoriesforDevelopmentofEndometriosis 1. Samson'stheoryofretrogrademenstruation:themostaccEpted theory 2. IvanoffandMeyer:Celomicmetaplasia3. HematogenoussPread4. Lymphaticspread(Halban'stheory)5. Directimplantation.
266.Examinationofa26yearsoldobese infertilefemalereveals.Fixedretroverteduterus&Nodularityoftheuterosacralligaments.Themostlikelydiagnosisis? a)PCOS b)Endometriosis c)Adenomyosis d)TB CorrectAnswer-BAns.B.EndometriosisPelvicexaminationofendometriosis:Maybenormalormayrevealthefollowing:FixedretroverteduterusPelvictendernessNodulesinthePODNodularityoftheuterosaoalligamentsUnilateralorbilateraladnexalmassSpeculumexaminationmayrevealbluishnodulesinposteriorfornix.
267.Investigationofchoiceforendometriosis ? a)USG b)CA125 c)MRI d)Laparoscopy CorrectAnswer-DAns.D.LaparoscopyLaparoscopyistheInvestigationofChoice.
268.Powderburntlesionseenin? a)PID b)PCOS c)Endometriosis d)Alloftheabove CorrectAnswer-CAns.C.EndometriosisLaparoscopyfindingsinendometriosisare:ChocolatecystsBlueberrylesionRed/flamelesionPowderburnsPotsRed/purpleraspberrylesionSubovarianadhesionsMatchstickburntsPotsWhitelesion.
269.Treatmentofchoiceinpatientwith infertility&endometriosis? a)IUI b)Surgery c)Danozol d)Ovulationinduction CorrectAnswer-BAns.B.SurgerySurgicalManagement 1. Patientswithinfertility:laparoscopicovariancystectomy, adhesiolysis,andelectrocoagulationofendometrioticimplants. 2. Ifthefamilyiscompleteandthepatienthasseverepainor menstrualcomplaints:hysterectomywithbilateralsalpingooophorectomy.GenerallycombinedapproachisadoptedwherelaparoscopicsurgeryisfollowedbyGnRHa.
270.Surgeryofchoicein42yearoldP3L3 withdiffuseendometriosisis? a)Ovariancystectomy&adhesiolysis b)Hysterectomy c)HysterectomywithBSOwithresectionofendometrialimplants d)Ovariancystectomy&adhesiolysis&resectionofimplants CorrectAnswer-CAns.C.HysterectomywithBSOwithresectionofendometrialimplantsIfthefamilykcompleteandthepatienthasseverepainormenstrualcomplaints:Hystetectomywithbilateralsalpingo-oophorectomywithresectionofallendometrioticimplants.
271.ThemostcommonMulleriananomalyis? a)Mullerianagenesis(RMKH) b)Unicornuateuterus c)Bicornuateuterus d)Septateuterus CorrectAnswer-DAns.D.SeptateuterusSeptateuterusistheMCMulleriananomaly.
272.SEAMusedinDUBis? a)Clomiphene b)Raloxifene c)Ormiloxifene d)Mifepristone CorrectAnswer-CAns.,C.OrmiloxifeneOrmeloxifeneisathirdgenerationbenzopyranSERMwhichblocksthecytosolreceptorsbyitscompetitivebindingandselectivelyactsonestrogenrecePtorsasagonistandantagonistindifferentreproductivetissues.
273.Choiceofadjuvanttreatmentfor endometrialcarcinomastageIA,gradeIis? a)Radiotherapy b)Chemotherapy c)Chemotherapyplusradiotherapy d)Notreatment CorrectAnswer-DAns.D.NotreatmentManagementofCaendometriumA)Stagel=1:Surgery(totalabdominalhysterectomywithbilateralsalpingo-oophorectomywithlymphnodesampling),followedbyradiotherapy.Onlypatientswithstage1A,grades1and2donotrequirepostoperativeradiotherapy.B)Stage2:Modifiedradicalhysterectomy,bilateralsalpingo-oophorectomywithlymphnodedissection,followedbyradiotherapy.C)Stages3and4:Debulkingsurgeryfollowedbyradiotherapy.
274.A46-year-oldP3L3complainsof menorrhagiasince3months.Nextlineofmanagementis? a)D&C b)Progesteronex6months c)OCpillsx6months d)Hysterectomy CorrectAnswer-AAns.A.D&CInPatientswithmenorrhagiainperimenopausalagegroup(40+),alwaysmakethediagnosisfirstbeforeproceedingwithanytreatment.Itisnecessarytoruleoutendometrialhyperplasiaandcancerinthisagegroup.Hence,histopathologicalexaminationofendometriumisrequired,andthereforeD6Cshouldbedonefirst.
275.Simplehyperplasiawithatypiawill progresstocaendometriumin%ofcases? a)1-2 b)3-4 c)8-9 d)20 CorrectAnswer-CAns.C.8-9
276.Grade1Caendometrium,thereis presenceof%nonsqoumaousgrowth? a)<5 b)6-25 c)25-50 d)>50 CorrectAnswer-AAns.A.<5FIGOGradingofEndometrialCarcinomaHistopathologicdegreeofdifferentiation:Gl:<5%nonsquamousornonmorulargrowthpattern.
277.Definitivetreatmentofadenomyosisis? a)OCpills b)NSAIDS c)Endometrialablation d)Hysterectomy CorrectAnswer-DAns,D.HysterectomyHysterectomyTheonlywaytocompletelycurethisconditionistohaveahysterectomy.
278.MCcauseforhysterectomyis? a)Prolapse b)Fibroids c)Caendometrium d)AcutePID CorrectAnswer-BAns.B.FibroidsAhysterectomyisanoperationtoremovetheuterus.Awomanmayhaveahysterectomyfordifferentreasons,including:Uterinefibroidsthatcausepain,bleeding,orotherproblems.
279.Prolongedsurgerytimeofvaginal hysterectomywouldleadtodamagetowhichnerve? a)Obturator b)Pudendal c)Peroneal d)Sural CorrectAnswer-CAns.C.PeronealMostcommonlyinjuredlowerextremitynerveinpatientsundergoingsurgeryinlithotomypositionisthecommonparonealnerve(LA-S2).
280.
WhichofthefollowingisnotapartofPID- a)Endometritis b)Cervicitis c)Tuboovarianabcess d)Peritonitis CorrectAnswer-BAns.B.CervicitisPIDisaspectrumofinfection&inflammationofuppergenitaltractorgansinvolvinguterus,fallopiantubes,ovaries,pelvicperitoneum¶metrium.Cervicitisisnotincluded.
281.TriadforclinicaldiagnosisPIDincludes allexcept? a)Fever b)Lowerabdominalpain c)Cervicalmotiontenderness d)Bilateraladnexaltenderness CorrectAnswer-AAns.A.FeverDiagrosisofPIDisoftendifficult.The"goldstandard"fordiagnosisreliesonthelaparoscopicappearanceofFallopiantubeinflammationbutcostandlimitedavailabilityofthetechniqueoftenprecludeitsuse.Intheabsenceoflaparoscopy,thetriadoflowerabdominalpain,cervicalmotiontenderness,andbilateraladnexaltendernesshasbeenadvocatedastheminimalcriterionforclinicaldiagnosisofPID.
282.Acutesalpingitisismostcommonly causedby? a)N.gonorrhoeae b)Chlamydiatrachomatis c)Mycoplasma d)Staphylococcus CorrectAnswer-BAns,B.ChlamydiatrachomatisOptionBisnowadaysslightlymorecommonerthanoptiona)&hencethebestoptiontomarkIfpolymicrobial/mixedinfection,isintheoption,thenthatistheanswer.
283. Tumormarkerforgermcellmalignancy areallexcept? a)LDH b)Alkalinephosphatase c)AFP d)CA-125 CorrectAnswer-DAns.D.CA-125
284.Acutepelvicpaincouldbedueto? a)Ectopicpregnancy b)PID c)Corpusluteumhematoma d)Alloftheabove CorrectAnswer-DAns.D.Alloftheabove
285.Nugentscoreincludesallexcept- a)Lactobacillus b)Gardnerella c)Mobiluncus d)Gonococcus CorrectAnswer-DAns.D.GonococcusNugent'scriteriafordiagnosisofbacterialvaginosisManyuseNugent'scriteriatoquantifyorgradebacteriaviaGramstainofvaginalsamples.Inbrief,Nugent'scriteriaevaluated3typesofbacteriaviaGramstain:Lactobacillus,Bacteroides/Gardnerella,andMobiluncus.
286.Cluecellsareseenin? a)Bacterialvaginosis b)Candidiasis c)Chlamydiasis d)Trichomoniasis CorrectAnswer-AAns.A.BacterialvaginosisBacterialvaginosis/vaginitis(BV)isacommonvaginalinfection.Cluecells(vaginalepithelialcellscoveredwithcoccobacilliandthecellsappearasstippledorgranular).CIuecellsarediagnosticofBV.
287.HSGfindingssuggestiveofgenitalkoch ? a)Beadedtubes b)Honeycombuterus c)Golfclubtube d)Alloftheabove CorrectAnswer-DAns.D.AlloftheaboveInactivetuberculosis,HSGiscontraindicated.
288.Apregnantladypresentswithgenital warts.Thebestmanagementforheris? a)Imiquimod b)Trichloroaceticacid c)Podophyllin d)Cryotherapy CorrectAnswer-DAns,.D.CryotherapyForreasonsunknowngenitalwartsincreaseinsizeandnumberduringpregnancy.Treatmentoptionsduringpregnancyincludecryotherapyandtrichloroaceticacid(TCA).Outofthetwo,cryosurgeryismoreeffectivethanTCAandhenceisprefnred.
289.28yearoldfemalecomplaintsoffoul smellingyellowishurethraldischargesince4days.Historyofburningmicturation.Historyofsexualcontactwithmultiplepartners2daysbeforetheonsetofsymptoms.Mostlikelydiagnosisis? a)Syphilis b)Chancroid c)Gonococcalurethritis d)Non-infectiveurethritis CorrectAnswer-CAns.C.GonococcalurethritisHistoryoffoulsmellingmucopurulentdischarge,&shortincubationperiodwithhighriskexposureclinchesthediagnosis
290.Twin-peaksignisseenin? a)AllMonozygotictwins b)Monochorionictwins c)Dichorionictwins d)Siamesetwins CorrectAnswer-CAns.C.Dichorionictwins
291.IncaCervixtreatment,pointAreceives? a)3000cGy b)5000cGy c)7000cGy d)10,000cGy CorrectAnswer-CAns.C.7000cGyPointAandPointBareinrelationtoradiotherapyforCaCervix.
292.Ashermanssyndromeischaracterized by? a)Amenorrhea b)Menorrhagia c)Polymenorrhea d)Alloftheabove CorrectAnswer-AAns.A.AmenorrheaIntra-uterineadhesionsAshermansyndromewasidentifiedin1948asuterinesynechiae.Theseintra-uterineadhesions(IUA)areoftenassociatedwithamenorrheaorinfertility.
293.GARDASILvaccineisfor- a)HPV16,18 b)HSV c)HPV6,11,16,18 d)HepatitisB CorrectAnswer-CAns.C.HPV6,11,16,18
294.LNGcontentofMirenais- a)20gms b)20mg c)52gms d)52mgs CorrectAnswer-DAns.D.52mgsMirena/LNGIUD/LNG2O/levonova/LNGIUSMirenacontainsatotalof52mglevonorgestrel(LNG).LNGisreleasedintotheuterinecavityatarateofapproximtely20pg/day.
295.Whichofthefollowingdecreasestherisk ofPelvicInflammatoryDisease? a)CuT b)Spermicidalagents c)O.C.pills d)Todayvaginalsponge CorrectAnswer-CAns.C.O.C.pillsSeveralstudieshaveshownthatregularO.C.pillusersareprotectedfromPIDstotheextentof50%.
296.Patientwith45XO,whatHRTtobe given? a)Growthhormone+E+P b)Estrogene c)NoHRTNeeded d)HRTonlyafter45years CorrectAnswer-AAns.A.Growthhormone+E+PGrowthhormone(GH)therapyhasbecomethestandardofcareforgirlswithturnersyndromeandshouldbeconsideredassoonasdecreasedlineargrowthvelocityisapparent.Initialhormonereplacementinvolveslowdoseestrogenmonotherapy.Progestagenreplacementisgenerallyadded1-2yearsafterstartingestrogenoruponbreakthroughbleeding.
297.Tamoxifendecreasestheriskofwhich cancer? a)Breast b)Endometrium c)Ovary d)Alloftheabove CorrectAnswer-AAns.A.BreastTamoxifenhasbeenusedformorethan30yearstotreatpatientswithbreastcancer.Tamoxifenworksagainstbreastcancer,inpart,byinterferingwiththeactivityofestrogen,afemalehormonethatpromotesthegrowthofbreastcancercells.InOctober1998,theU.S.FoodandDrugAdministration(FDA)approvedtheuseoftamoxifentoreducetheincidenceofbreastcancerinwomenatincreasedriskofthedisease.
298.Raloxifenedecreasestheriskofwhich cancer? a)Breast b)Cervix c)Ovary d)Alloftheabove CorrectAnswer-AAns.A.BreastAfteranaverageof81months,raloxifenereducesriskofinvasivebreastcancerbyabout38percentcomparedtotamoxifenreducingbreastcancerbyabout50percent.
299.Leastfailurerate? a)CuT b)MIRENA c)DMPA d)O.C.PILLS CorrectAnswer-BAns.B.MIRENA
300.Nuvaringcontains? a)EE+etonogestrel b)LNG+EE c)LNG d)EE+drosperinone CorrectAnswer-AAns.A.EE+etonogestrelContraceptiveringsNuvaRing:Itisasoftvaginalringthatreleases15microgramEEand120microgramENG,etonogestrel,theactivemetaboliteofdesogestrel,perdayasacontrolleddeliverysystem.
301.Whichdrugusedforendometriosiscan causeincreaseinhepaticenzyme&adverselipidprofile- a)0.C.pills b)GnRhanalogues c)Bothoftheabove d)Noneoftheabove CorrectAnswer-AAns.A.0.C.pillsO.C.pills(progesteronecomponent)area/wincreaseinLDL&decreaseinHDLcholesterolbutestrogenshaveoppositeeffect.Cholestasis&cholestaticjaundiceareoccasionalsideeffectsofO.C.pills.
302. NorgestimateinOCpillshasthe followingadvantage? a)Reducesvenousthrombosis b)IscheaperthanstandardOCpills c)Reducesacneandhirsutism d)Usefulinheartdisease CorrectAnswer-CAns.C.ReducesacneandhirsutismThreenewerprogestogens,namelydesogestrel,gestodene,andnorgestimatecandecreasetheameanilhirsutismascomparedtoolderprogesterones,whichactuallycancauseoilyskinandacne.
303.Whichofthefollowingisnotanideal candidateforIUCDinsertion? a)PreviousLSCS b)Lactatingmother c)AcutePID d)Alloftheabove CorrectAnswer-CAns.C.AcutePID
304. Betamethasonegiventopretermpatient forallexcept? a)Fetallungmaturity b)Decreaseintraventricularhemorrhage c)Preventsperiventricularleukomalacia d)PreventPPH CorrectAnswer-DAns.D.PreventPPHSteroids(dexamethasoneorbetamethasone)aregiventoenhancefetallungmaturityandtheyalsodecreasetheincidenceintraventricularhemorrhage.
305.A32-year-oldfemalewithmild hypertension.Twodaysafternormaldelivery,shedevelopseizures,headache.Noproteinuriawasthere.Onimagingshewasfoundtohaveparasagittalinfarctionandhematoma3x2cm.Themostprobablecauseis? a)Eclampsia b)Superiorsagittalsinusthrombosis c)Pituitaryapoplexy d)Subarachnoidhemorrhage CorrectAnswer-BAns.B.SuperiorsagittalsinusthrombosisThevariousetiologiesforduralsinusthrombosisare: 1. Thrombophilia(factorVLeidenmutation,prothrombingene mutation20210,deficienciesofantithrombin,proteinCandproteinS,APLAsyndrome,hyperhomorysteinemia) 2. Pregnancy3. Postpartumstate
306.Penicillamineuseinpregnancyis associatedwiththisfetalcomplication? a)Conradisyndrome b)Renalanomalies c)Thymushypolplasia d)Cutislaxa CorrectAnswer-DAns.D.CutislaxaPencillamineinterfereswithsynthesisofcollagen&elastin&cancause:elastosisperforansserpiginosaandlocalizedcutislaxa.
307.DOCformalariainpregnancy? a)Chloroquin b)Quinine c)Primaquin d)Artesunate CorrectAnswer-AAns,A.ChloroquinDrugsfortreatmentofmalariainpregnancy-Malariacanbelifethreateningduringpregnancy.Chloroquinis1stchoiceofdrug.Ifresistanttochloroquin,quinineshouldbegivenundersupervision.Primaquin(forradicalcure)shouldbewithhelduntilthepregnancyisover.Artesunateisthe1stchoiceincaseofcomplicatedmalaria.
308.Prophylacticmethergingivenfor? a)Inductionoflabour b)Inductionofabortion c)Tostopexcessbleedingfromuterus d)Alloftheabove CorrectAnswer-CAns,C.TostopexcessbleedingfromuterusMethergin(methyl-ergo-novine)isasemisyntheticergotderivativederivedfromlysergicacid.IndicationsProphylactic:-Activemanagementof3rdstageoflabourtopreventexcessbleedingfollowingdelivery.Therapeutic:-Tostopatonicuterinebleeding.
309.6yearoldsonofpregnantwomenis sufferingfromchickenpox.Whichofthefollowingisgiventopregnantwomen? a)Acyclovir b)Acyclovir+immunoglobulin c)Onlyimmunoglobulin d)Vaccination CorrectAnswer-BAns.B.Acyclovir+immunoglobulinVaricelladuringpregnancyTheriskofcongenitalmalformationsisnearlyabsentwhenmaternalinfectionoccursafter20weeks.VariceIavaccineisnotrecommendedinpregnancy.Varicellazosterimmunoglobulin(VZIG)shouldbegiventoexposednon-immuneasitreducesthemortality.Oralacyclovirissafeinpregnancy&reducesthedurationofillnesswhengivenwithin24hrsofrashbutitcannotpreventcongenitalinfection.
310.Maximumchanceoftransmissionduring delivery? a)HSV b)CMV c)VZV d)Rubella CorrectAnswer-AAns.A.HSV"TransplacentalinfectionbyHSVisnotusual.Thefetusbecomesaffectedbyvirusshedfromthecervixorlowergenitaltractduringvaginaldelivery."
311. Drugofchoiceforpneumocystiscarinii inpregnancy? a)SMZ/TMP b)Primaquine c)Dapsone d)Pentamidine CorrectAnswer-AAns,A.SMZ/TMP
312.Apregnantwomaninfirsttrimesterhas fourfoldriseinIgGagainsttoxoplasmosis.itindicates? a)Protectiveantibodies b)Acuteinfection c)Chronicinfection d)Noneoftheabove CorrectAnswer-BAns,B.AcuteinfectionAcuteinfectionisdetectedbydetectingIgMspecificantibodyhightitreofIgGantibody&detectionofsero-conversionforIgGfromnegativetopositive
313.HRTisgivenin? a)Symptomaticpostmenopausalwomen b)Followinghysterectomy c)Gonadaldysgenesis d)Alloftheabove CorrectAnswer-DAns,D.AlloftheaboveIndicationsofHRT 1. Symptomaticwomensufferingfromoestrogendeficiency.2. Highriskcasesofmenopausalcomplicationssuchascardiovascular disease,osteoporosis,stroke,Alzheimerdisease&coloniccancer(prophylactic). 3. Prematuremenopause,spontaneousorfollowingsurgery (prophylactic). 4. Gonadaldysgenesisinadolescents.(therapeutic)
314.Metherginisgivenforprophylaxisof? a)Anaemia b)Cardiacdisease c)Renaldisease d)Lungdisease CorrectAnswer-AAns,A.AnaemiaMethergin(methyl-ergo-novine)isasemisyntheticergotderivativederivedfromlysergicacid.Indications 1. Prophylactic:Activemanagementof3rdstageoflabourtoprevent excessbleedingfollowingdelivery(note-bleedingcausesanemia). 2. Therapeutic:Tostopatonicuterinebleeding.
315.Allofthefollowingoccursbecauseof prostaglandinuseexcept? a)Excesswaterretention b)Flushes c)Increasedmotilityofbowel d)Nausea CorrectAnswer-AAns,A.ExcesswaterretentionDisadvantages&sideeffectsofprostaglandins 1. Cost2. Nausea,vomiting,diarrhea,pyrexia,bronchospasm,tachycardia& chills 3. Cervicallacerations(PGF-2alpha)4. Tachysystole(hyperstimulation)ofuterus5. Riskofuterineruptureincaseofuterinescar.
316.DefiniteuseforPGE2isallexcept? a)Contraception b)Induceslabour c)Therapeuticabortion d)KeepspatencyofPDA CorrectAnswer-AAns.A.Contraception
317.Whichoffollowingmostcommonly clinicallyused? a)Diagonalconjugate b)Antpostdiameterofinlet c)Transversediameterofoutlet d)Obliquediameterofpelvis CorrectAnswer-AAns,A.DiagonalconjugateMostcommonlyusedclinicalconjugateisDiagonalconjugate.
318.Leastdiameterofinletofgynecoidpelvis is? a)Transverse b)Oblique c)Diagonalconjugate d)Obstetricconjugate CorrectAnswer-DAns,D.Obstetricconjugate
319.Tdapvaccineisgiveinbetweenwhich weeksofpregnancy? a)10-16weeks b)17-22weeks c)22-26weeks d)27-36weeks CorrectAnswer-DAns,D.27-36weeksWomenshouldgetadulttetanus,diphtheriaandacellularpertussisvaccine(Tdap)duringeachpregnancy.Ideally,thevaccineshouldbegivenbetween27and36weekesofpregnancy".
320.If300microgramantiDisgivento mother,amountofblooditwillneutralise? a)30m1 b)40m1 c)50m1 d)60m1 CorrectAnswer-AAns,A.30m1
321.Maximumsuccessafterreversaloftubal ligation? a)Cauterization b)Pomeroy'stechnique c)Clipmethod d)Fimbriectomy CorrectAnswer-CAns,C.ClipmethodTheFalopesialisticringdestroys2-3cmfallopiantube.TheHulka&Filshieclipsdestroyasmallersegment(3-4mm)'thuspreservingthepotentialofsuccessfulreversalofsurgery.Thefailureratevariesbetween.2and15%"
322.FailurerateofPomeroy'smethodof tuballigationis? a)0.2% b)0.4% c)0.6% d)0.8% CorrectAnswer-BAns,B.0.4%Thefailurerateis0.4%anditkmainlyduetospontaneouscanalization".
323.Leastfailurerateisof? a)OCpills b)IUDs c)Condom d)DMPA CorrectAnswer-AAns.A.OCpillsOralcontraceptivepillshaveleastchancesofpregnancyastheyhaveminimumfailurerate(evaluatedbypearlindex).
324.Cholestasisofpregnancyfalseis? a)Bilirubinlevel>2mg% b)Mostcommoncauseofjaundiceinpregnancy c)Oestrogenisinvolved d)Manifestationsusuallyappearinlasttrimester CorrectAnswer-BAns.B.Mostcommoncauseofjaundiceinpregnancy
325.I-pillisusedwhen? a)Accidentalsexualexposure b)OCPforgotten c)Ofchoiceinyoung d)Alloftheabove CorrectAnswer-AAns.A.AccidentalsexualexposureI-pilll-pillisanemergencycontraceptivePillcontaininglevonorgestrel.AsingledoseofIpillprovidesasafeandeasywaytopreventanunintendedpregnancy,afterunprotectedsexorcontraceptivefailure.Itshouldbetakei-pillassoonaspossible,preferablywithin12hoursandnolaterthan72hoursofunprotectedintercourse.Singledosetablettobetakenorallyafterameal.
326.Emergencycontraceptiveshouldmust bestartedwithinhowmuchtimeafterunprotectedintercourse? a)24hrs b)48hrs c)72hrs d)96hrs CorrectAnswer-CAns,C.72hrsMorningaftnpill:ethinyl-estrediol2.5mg,premarin15mg,thedrugistakenorallytwicedailyfor5days.Beginningsoonaftere4tosurebutnotlatcrthan72hrs."
327. 35yearoldwithhistoryofrepeatedD&C. Shenowhassecondaryamenorrhea. Whatisyourdiagnosis? a)Hypothyroidism b)Kallmansyndrome c)Sheehan'ssyndrome d)Asherman'ssyndrome CorrectAnswer-DAns,D.Asherman'ssyndrome
328.Asherman'ssyndromefalseis? a)Associatedwithmenstrualirregularities b)Progesteronechallengetestispositive c)Synechiaeformationinuterus d)MaybesecondarytoTB CorrectAnswer-BAns,B.Progesteronechallengetestispositive
329.Mostcommonsiteofendometriosis- a)Ovary b)FT c)Colon d)LSCSScar CorrectAnswer-AAns,A.Ovary
330.Goldstandarddiagnostictechniquefor diagnosisofendometriosis? a)Laproscopy b)Ca125level c)Ultrasound d)MRI CorrectAnswer-AAns,A.LaproscopyInvestigationsforendometriosesLaproscopyisconsideredasgoldstandard.Usedasbothdiagnosticaswellastherapeutictechnique. 1. CA-f25israised>35u/ml2. Ultrasound3. CT&MRI4. ColorDoPPler5. CYstoscoPY
331.TButerusallistrueexcept? a)Mostlysecondary b)Increaseincidenceofectopicpregnancy c)Involvementofendosalpinx d)Mostcommonisascendinginfection CorrectAnswer-DAns,D.Mostcommonisascendinginfection
332.Fallopiantubetuberculosis? a)MostcommontypeofgenitalTB b)Sizeofthetubesisunchanged c)Isasymptomatic d)Primaryfocusofinfectionisalwaysinfallopiantubes CorrectAnswer-A:CAns,A>C.Isasymptomatic>MostcommontypeofgenitalTBMostcommontypeofgenitalTB>IsasymPtomatic
333.Initialdrugforovariancancer? a)Cisplatin b)Doxorubicin c)Ifosfamide d)Methotrexate CorrectAnswer-AAns,A,Cisplatin
334.Diagnosisofadenomyosisismadeby? a)Histopathology b)Ultrasound c)MRI d)Laproscopy CorrectAnswer-DAns,D.Laproscopy
335.Endometrialcarcinomainvolvingcervix, stageis? a)1 b)2 c)3 d)4 CorrectAnswer-BAns,B.2
336.Hydronephrosisisseeninwhichstage ofCacervix? a)2a b)2b c)3a d)3b CorrectAnswer-DAns,D.3b
337.Bartholin'scysttreatmentofchoice- a)Excision b)Antibiotics c)Marsupialisation d)Drainage CorrectAnswer-CAns.C.Marsupialisation
338. DefinitivemanagementofAdenomyosis is? a)GNRHanalogue b)Danazole c)LH d)Hysterectomy CorrectAnswer-DAns,D.HysterectomyHysterectomyisthetreatmentofchoice.Localresectioncanbetriedinyoungerwomeninwhomitislocalized.MedicaltreatmentoPtionsareNSAIDS&hormonaltherapy,thoughnotmucheffectiveGnRH,danazole,MirenaIUCDformenorrhagea&pain.
339.Mostcommondegenerationoffibroids? a)Calcareous b)Hyaline c)Red d)Cystic CorrectAnswer-BAnsB.HyalineMostcommondegenerationoverall_hyaline
340.Whichofthefollowingcannotbetreated bylaparoscopy- a)Ectopicpregnancy b)Sterilization c)Nondescentofuterus d)Genitalprolapsed CorrectAnswer-CAns,C.Nondescentofuterus
341.Whichisleastinjuredingynaecological procedures? a)Ureteratpelvicbrim b)Renalpelvis c)Urinarybladder d)Ureteratinfundibulopelvicligament CorrectAnswer-BAns.B.RenalpelvisUrinarybladder&pelvicureterarevulnerabletoinjuryduringgynecologicalsurgery.
342.Definitivetreatmentforpreeclampsia? a)Deliveryofbaby b)Antihypertensivedrugs c)Rest d)Diet CorrectAnswer-AAns,A.Deliveryofbaby
343.Besttodiagnoseunrupturedectopic pregnancy? a)Scopy b)UPT c)USG d)Culdocentesis CorrectAnswer-AAns,A.Scopy
344.Mostofectopicpregnanciesareat ampullaas? a)Itisthenarrowestpart b)Tubalmovementsareleasthere c)Salpingitisproducesleastcryptshere d)Plicaearemostnumeroushere CorrectAnswer-DAns,D.Plicaearemostnumeroushere
345. Prolapsedofuterusinnulliparous women,treatmentis? a)Slingusedinvolvingrectussheath b)Anteriorcolporrhaphy c)Posteriorcolporrhaphy d)Manchesteroperation CorrectAnswer-AAns.,A.Slingusedinvolvingrectussheath
346.ExclusivelyFetalbloodlossoccursin? a)Vasaprevia b)Placentapraevia c)Polyhydramnios d)Oligohydramnios CorrectAnswer-AAns.A.Vasaprevia
347.Placentaprevia,falseis? a)MostcommoncauseofAPH b)Painfulvaginalbleeding c)Usgistheinvestigationofchoice d)Increasedmaternalageisariskfactor CorrectAnswer-AAns.A.MostcommoncauseofAPH
348.45yroldfemalepatientunderwent hysterectomy,on7thpostopdaycomplaintsaboutcontinuousdribblingofurineandfever.Micturitionwasnotvoluntary,whatdiagnosis? a)Vesicovaginalfistula b)Ureterovaginalfistula c)Vesicouterinefistula d)Urethravaginalfistula CorrectAnswer-CAns,C.VesicouterinefistulaFetalcomplicationsofvacuumdeliverySuPerficialscalloPabrasionsSub-aPoneurotichaemorrhageRetinalhaemorrhage
349.Vacuumdeliveryproduces? a)Chingon b)Cephalhematoma c)Both d)None CorrectAnswer-CAns,C.Both
350.HTindicatedinmenopausalwomen a)Hotflash b)Cabreast c)Endometriosis d)Uterinebleeding CorrectAnswer-AAns.A.HotflashHormoneTherapy(HT)isoneofthegovernment-approvedtreatmentsforreliefofmenopausalsymptoms.Thesesymptoms,causedbylowerlevelsofestrogenatmenopause,include:Hotflashes,Sleepdisturbances,andVaginaldryness.HTisalsoapprovedforthepreventionofosteoporosis.
351.InUterineprolapsehowtoknowifringis inplace? a)Ifnotexpelledafterincreasedabdominalpressure b)IfBleedingdoesnotoccur c)Ifpatientfeelsdiscomfort d)None CorrectAnswer-AAns.A.IfnotexpelledafterincreasedabdominalpressureAvaginalpessaryisaremovabledeviceplacedintothevagina.Itisdesignedtosupportareasofpelvicorganprolapse.Avarietyofpessariesareavailable,includingtheringpessariesIfnotexpelledafterincreasedabdominalpressureringpessaryissupposedtobeplacedinplace
352.Drugthatisusedforfetallungmaturity is: a)Dexamethasone b)Folicacid c)Beclomethasone d)None CorrectAnswer-AAns.A.DexamethasoneBetamethasoneanddexamethasonearecorticosteroids,alsocalledglucocorticoids,thataregivenbeforebirth(antenatally)tospeedupapretermfetuseslungdevelopment.Eitherisusedwhenamotherisinpretermlaborandbirthmayoccurin24to48hours.
353.Besttimetodoquadrupletest a)8-12weeks b)11-15weeks c)15-20weeks d)18-22weeks CorrectAnswer-CAns.C.15-20weeksThequadscreenisdoneinthesecondtrimester,usuallybetween15and20weeksofpregnancy.Ideally,thetestshouldbeperformedinconjunctionwithfirst-trimesterscreeningtests.
354.WhichOneofthefollowingisnota causeofsecondaryPostpartumHaemorrhage? a)Placentaprevia b)Retainedbitsofplacenta c)Endometritis d)Polyp CorrectAnswer-AAns.A.PlacentapreviaCausesofsecondaryPostpartumHaemorrhageare:RetainedbitsofplacentaPostpartuminfectionInfectionofCervicalandVaginalTearsPuerperalInversionofUterusUterinePolyporFibroid:UndiagnosedcarcinomaofcervixChorion-epithelioma
355.RDAofiodineinlactationinmicrogram- a)150 b)220 c)100 d)250 CorrectAnswer-DAns.D.250Toaccommodateincreasediodineneedsduringpregnancyandlactation,theiodineRDAis220mcg/dayforpregnantwomenand250mcg/dayforlactatingwomen
356.Paget'sisassociatedwithwhichother cancer: a)Vulva b)Vagina c)Cervix d)Uterus CorrectAnswer-AAns.A.VulvaExtramammaryPaget'sdisease(EMPD),alsoextramammaryPagetdisease,isarare,slow-growing,usuallynoninvasiveintraepithelial(intheskin)adenocarcinomaoutsidethemammaryglandandincludesPaget'sdiseaseofthevulvaandtheextremelyrarePaget'sdiseaseofthepenis.
357.Fimbriectomyprocedureisknownas- a)Uchidamethod b)Irvingmethod c)Madlenertechnique d)Kroenermethod CorrectAnswer-DAns.D.KroenermethodUchidatechnique--Asalinesolutionisinjectedsubserosalinthemidportionofthetubetocreateableb.Irvingmethod--Thetubeisligatedoneithersideandmidportionofthetube(betweentheties)isexcised.Madlenertechnique-Itistheeasiestmethod.Theloopofthetubeiscrushedwithanarteryforceps.Kroenermethodoffimbriectomyisnotacommonprocedure
358.Establishmentoffetoplacental circulationseenat- a)11to13days b)20to22days c)7days d)25to26days CorrectAnswer-BAns.B.20to22daysImportantEventsFollowingFertilization 0'hour Fertilization(day-15fromLMP) 30hours 2cellstage(blastomeres) 40?50hours 4cellstage 72hours 12cellstage 96hours 16cellstage.Morulaenterstheuterinecavity 5thday Blastocyst 4?5thday Zonapellucidadisappears 5?6thday Blastocystattachmenttoendometrialsurface 6?7thday Differentiationofcytoandsyncytiotrophoblastlayers 10thday SynthesisofhCGbysyncytiotrophoblast 9?10thday Lacunarnetworkforms 10?11thday TrophoblastsinvadeendometrialsinusoidsestablishinguteroplacentalcirculationInterstitialimplantationcompletedwithentiredecidualcoverage 13thday Primaryvilli 16thday Secondaryvilli
16thday Secondaryvilli 21stday Tertiaryvilli 21st?22nd Fetalheart.Fetoplacentalcirculation day
359.Dilatation&curettage(D&C)is contraindicatedin- a)Pelvicinflammatorydisease(PID) b)Endometriosis c)Ectopicpregnancy d)None CorrectAnswer-AAns.A.Pelvicinflammatorydisease(PID)PredisposingriskfactorsforPIDare:SexualcontactHistoryofSTIProceduresinvolvingtheupperfemalegenitaltractincluding:Dilatation&curettage(D&C)Recentintrauterinedevice(IUD)insertionTherapeuticabortion(T/A)
360.Anteversionofuterusismaintainedby? a)Cardinalligament b)Uterosacralligament c)Pubocervicalligament d)Roundligament CorrectAnswer-DAns.D.RoundligamentInmostwomen,theuterusisantevertedandanteflexed.Thefunctionoftheroundligamentismaintenanceoftheanteversionoftheuterus(apositionwherethefundusoftheuterusisturnedforwardatthejunctionofcervixandvagina)duringpregnancy.Normally,thecardinalligamentiswhatsupportstheuterineangle(angleofanteversion).
361.WhatistheeffectofProgesteroneonly pills? a)Completelysuppressesovulation b)Thinliningofuterus c)Thickcervicalmucus d)Alloftheabove CorrectAnswer-DAnswer:D.AlloftheaboveProgestogen-onlypills/Progestin-onlyPills(POP)/Morningafterpills-ContraceptivepillsContainonlysyntheticprogestins&doesn'tcontainestrogen.Mechanism:Mucusthickeningintheneckofthewomb:Penetrationofspermtoreacheggandwombbecomesdifficult.Preventsovulation:TheliningoftheuterusbecomesthinFertilizedeggimplantationispreventedAdvantages:Doesn'tinterferewithbreastfeedingAlsohelpsinpremenstrualsymptomsandpainfulperiods
362.Long-standingpelvicinflammationmay leadtowhichofthefollowingconditions? a)Pyometra b)Uterinepolyposis c)Pseudopregnancy d)Cysticendometrialhyperplasia CorrectAnswer-AAns.A.PyometraPyometraiscollectionofpusduetoobstructionofflowintheuterinecavity.ItmaybeduetoLong-standingPIDorsecondarytocervicalstenosis.
363.Meiosisoccursin a)Adultovary b)Prepubertaltestis c)Atbirthinovary d)All CorrectAnswer-AAns.is.A.AdultovaryMeiosis1iscompletedatpubertyhenceanswerisadultovaryTotalnumberofoocytesat20weeksofintrauterinelifeisabout6?7million.Atbirth,thetotalnumberofprimordialfolliclesisestimatedtobeabout2million.Theprimaryoocytesdonotfinishthefirstmeioticdivisionuntilpubertyisreached.Spermatogenesisoccursatpubertysoitcannothappeninprepubertaltestis.
364.Prolactinsecretedmaximumat- a)24hrsafterdelivery b)REM c)2hrsrunning d)24hourafterOvulation CorrectAnswer-AAns.A.24hrsafterdeliveryProlactinismaximum24hrsafterdelivery.Prolactinsecretionalsoincreasesduringstrenuousexerciseandsleep(NREM).24hrsafterovulationestrogenhasanegativefeedbackeffectonprolactinwhichdecreasesthelevelofprolactin.
365.Asexuallyactivefemalewiththeprofuse frothyfoul-smellingdischargewithintenseitching.Strawberrycervixrevealedonexamination.Whatwillbethediagnosis? a)Trichomonasvaginalis b)Bacterialvaginosis c)Candidiasis d)None CorrectAnswer-AAnswer:a.TrichomonasvaginalisTrichomonasvaginitis:ClinicalFeatures:Thereissuddenprofuseandoffensivevaginaldischargeoftendatingfromthelastmenstruation.Irritationanditchingofvaryingdegreeswithinandaroundtheintroitusarecommon.Thereisthepresenceofurinarysymptomssuchasdysuriaandfrequencyofmicturition.TheremaybehistoryofprevioussimilarattacksOnExamination:Thereisthin,greenish-yellowandfrothyoffensivedischargepervaginum.Thevulvaisinflamedwithevidencesofpruritus.Vaginalexaminationmaybepainful.Thevaginalwallsbecomeredandinflamedwithmultiplepunctatehemorrhagicspots.Similarspots
arealsofoundoverthemucosaoftheportiovaginalispartofthecervixonspeculumexaminationgivingtheappearanceof`strawberry'Ref:DuttaGynaecology6theditionPageno.163-164
366.18-year-oldgirlpresentswith6months ofamenorrheawithh/olow-gradefever,weightloss,painabdomen,generalizedweaknesses.OnPRexamination,palpableleft-sidedpelvicmassfelt...Diagnosisis a)Fibroidwithdegeneration b)TBpelviswithTuboovarianmass c)Ectopicpregnancy d)Granulosacelltumour CorrectAnswer-BAns.B.TBpelviswithTuboovarianmassThetuberclesbursttopourthecaseousmaterialinsidethelumenproducingtubercularpyosalpinx,whichmayadheretotheovariesandthesurroundingstructures.Oftentheinfectionspreadsoutwardsproducingperisalpingitiswithexudation,causingdenseadhesionswiththesurroundingstructurestuberculartubo-ovarianmass.Clinicaldiagnosticfeatures:Weakness,low-gradefever,anorexia,anemiaornightsweatsmaybepresent.Infertility:ItmaybeprimaryorsecondaryChronicpelvicpainVaginaldischarge--postcoitalbleedingorablood-staineddischarge.Constitutionalsymptomssuchaslossofweight,malaise,anorexia,
pyrexia,andanemiaarepresentintheacutephaseofthedisease.Menstrualabnormality:Inabout50percent,themenstrualfunctionisnormal.PresenceofpelvicmasswithnodulesinthepouchofDouglaspalpableRef.GynaecologyDuttaed.6thPageno.139-142
367.ApregnantfemalehadMeconium stainedliquorandunderwentemergencyLSCS.Afewdayslaterherconditiondeteriorated.USGshowededematousbowels.What'sthecause? a)Meconiumperitonitis b)Paralyticileus c)Adhesiveintestinalobstruction d)Intra-abdominalabscess CorrectAnswer-BAns.B.ParalyticileusPOSTOPERATIVECOMPLICATIONSOFLSCS:Intestinalobstruction:Theobstructionmaybemechanicalduetoadhesionsorbands,orparalyticileusfollowingperitonitis.ParalyticileusisanadynamicobstructioninwhichthereisafailureoftransmissionofperistalticwavesClinicalfeatures:Theresultantstasisleadstothefollowing:AccumulationoffluidandgasinthebowelWithassociateddistension:markedandtympaniticVomiting(effortless)AbsenceofbowelsoundsAbsoluteconstipationDuttaobstetricsed.8thPageno.678Bailey&Love'sShortPracticeofSurgery-27thEdition(Pageno1297)
368.Besttreatmentoptionforseptateuterus- a)TompkinsMetroplasty b)Jonesmetroplasty c)Strassmannmetroplasty d)Transcervicalhysteroscopicresectionoftheseptum CorrectAnswer-DAns.D.TranscervicalhysteroscopicresectionoftheseptumHysteroscopicmetroplastyismorecommonlydone.Resectionoftheseptumcanbedoneeitherbyaresectoscopeorbylaser.Advantagesare: 1. Highsuccessrate(80?89%),2. Shorthospitalstay3. Reducedpostoperativemorbidity(infectionoradhesions)4. Subsequentchanceofvaginaldeliveryishighcomparedto abdominalmetroplastywherethecesareansectionismandatory.Othermethods:Abdominalmetroplastycouldbedoneeitherbyexcisingtheseptum(Strassman,Jones,andJones)orbyincisingtheseptum(Tompkins).Ref.DuttaGynaecologyed.6thpageno.47
369.Distensionmediausedforhysteroscopy withbipolarcautery? a)Glycine b)NS c)Co2 d)Dextran70 CorrectAnswer-BAns.B.NSThedistendingmediacommonlyusedinhysteroscopyisnormalsaline--Theuterinecavityisdistendedwithamediatoseparatetheuterinewallsandtohaveapanoramicview.Themediausedcouldbeeitheragasoraliquid.Carbondioxide(CO2)--iscommonlyusedfordiagnosticpurposes.Itissolubleinbloodandissafe.Hysteroflatorprovidesagasflowrateofamaximumof100mLperminuteandamaximumpressureof100mmHg.Liquidmediaisusedforoperativeprocedures.Normalsalinecanbeusedissuitableforbipolarcauterybutnotsuitableformonopolarelectrosurgery.Constantflowistobemaintainedtoflushtheoperativearea.Ref.DuttaGynaecologyed.6thpageno.620,624
370.MostcommonsiteforFertilizationis- a)Ampulla b)Isthmus c)Intramural d)Fimbriae CorrectAnswer-AAns.A.AmpullaFertilizationistheprocessoffusionofthespermatozoonwiththematureovum.Itbeginswithspermeggcollisionandendswiththeproductionofamononucleatedsinglecellcalledthezygote.Itsobjectivesare:ToinitiatetheembryonicdevelopmentoftheeggandTorestorethechromosomenumberofthespecies.Almostalways,fertilizationoccursintheampullarypartoftheuterinetube.Reference:DuttaObstetricsed.8thPageno23
371.A22-year-oldprimigravidavisitsANC OPDwith20weeksPOG.Onexaminationuterineheightrevealsa16-weeksize.USGshowsreducedliquor.Whatwillbethediagnosis? a)Renalagenesis b)Fetalanemia c)Barter'ssyndrome d)Liddlesyndrome CorrectAnswer-AAns.A.RenalagenesisThequestionstatesreducedliquorthatmeansoligohydramniosisseen.Oligohydramniosisdefinedasanamnioticfluidindexof5cmorless.Itisalmostalwayspresentwhenthereiseitherobstructionofthefetalurinarytractorrenalagenesis.WilliamsObstetricsed24thpage237
372.Whichofthefollowingisnotan estrogen-dependentpubertalchange? a)Hairgrowth b)Menstruation c)VaginalCornification d)Cervicalmucus CorrectAnswer-BAns.B.MenstruationPubarcheordevelopmentofaxillaryandpubichairisduetotestosterone(inboththesexes).Pubertyinfemales:Involvesthebeginningofmenstrualcycles(menarche),breastdevelopment(thelarche),andanincreaseinadrenalandrogensecretion(adrenarche).Estradiolinducesthedevelopmentofsecondarysexcharacteristics,includingthebreastsandreproductivetract,andincreasedfatinthehips.Estrogensalsoregulatethegrowthspurtatpuberty,vaginalcornification,andcervicalmucusproduction,induceclosureoftheepiphyses,haveapositiveeffectinmaintainingboneformation,andcanantagonizethedegradingactionsofparathyroidhormoneonbone.Reference:RhoadesandTanner'sMedicalPhysiology,2ndedition(Pageno:680)
373.Amotherbroughther16-year-old daughtertoGynaecologyOPDwithacomplaintofnotattendingmenarche.ShegivesH/Ocyclicabdominalpain.Onfurtherexaminationmidline,abdominalswellingseen.Perrectalexaminationrevealsabulgingmassinthevagina.Whichofthefollowingcanbemostcommonlyseen? a)Imperforatehymen b)Transvaginalseptum c)Vaginalagenesis d)MRKH CorrectAnswer-AAns.A.ImperforatehymenAccordingtotheclinicalcase,patientssufferfromprimaryamenorrheaandcryptomenorrhea(cyclicabdominalpain).Thegirlisagedabout14?16years.Thechiefcomplaintsareperiodiclowerabdominalpain,whichmaybecontinuous,primaryamenorrheaandurinarysymptoms,suchasfrequency,dysuriaorevenretentionofurine.Infact,insignificantcases,thepresentingfeaturemaybetheretentionofurine.Thecauseofretentionisduetotheelongationoftheurethra.Anabdominalexaminationrevealsasuprapubicswelling,whichmay
beuterineorfullbladder.Priorcatheterizationrevealsthetruestate.VulvalinspectionrevealsatensebulgingmembraneofbluishcolorationRef.DuttaGynaecologyed.6thpageno.42
374.13yroldchildvisitgynaecologyOPD withacomplaintofnotattainingmenarchewithkaryotype46XX.Onexamination,clitoromegalyisseen.Whichenzymeismostlikelytobedeficientintheabovecondition? a)21alpha-hydroxylase b)11beta-hydroxylase c)17alpha-hydroxylase d)3beta-hydroxysteroiddehydrogenase CorrectAnswer-AAns.A.21alpha-hydroxylaseTheconditiondescribedaboverepresentstheCongenitaladrenalhyperplasia."Morethan90%ofCAHcasesarecausedby21-hydroxylasedeficiency"Congenitaladrenalhyperplasia:Itisduetoaninbornerrorofadrenalsteroidmetabolism,commonlydueto21-hydroxylase(95%)andrarelydueto11-hydroxylaseor3hydroxysteroiddehydrogenasedeficiency.ClinicalpresentationAnambiguityofsexatbirthHirsutismandamenorrheamaybethepresentingfeaturesaroundpubertyinamilderform.Thekaryotypeis46,XX.Ref.DuttaGynaecologyed.6thpageno.440
375.Inearlypregnancyclinicalsignsof feelingthecervixandthebodyofbulkyuterusseparatedbecauseofsoftenedisthmusat6-8weeksofgestation: a)Goodell'ssign b)Chadwick'ssign c)Piskacek'ssign d)Hegar'ssign CorrectAnswer-DCorrectAns:D.Hegar'ssignAt6to8weeksmenstrualage,thefirmcervixcontrastswiththenowsofterfundusandthecompressibleinterposedsoftenedisthmus--Hegarsign
376.Misoprostolusedintheinductionof labourisananalogueofwhichofthefollowingtypeofprostaglandin? a)PGE1 b)PGE2 c)PGI2 d)PGF2alpha CorrectAnswer-ACorrectAns:A.PGE1MisoprostolisamethylesterofPGE1.IndicationsofMisoprostol:Itisusedforcervicalripening.Transvaginallyitisusedforinductionoflabour.UsesofProstaglandinsinObstetrics:InductionofabortionTerminationofmolarpregnancyInductionoflabourCervicalripeningpriortoinductionoflabourAccelerationoflabourManagementofatonicpostpartumhemorrhageMedicalmanagementoftubalectopicpregnancy
This post was last modified on 23 November 2021