1.Thethicknessofendometriumatthetime ofimplantationis: a)3?4mm b)20?30mm c)15?20mm d)30?40mm CorrectAnswer-AAns.isNone/ai.e.3-4mm"7heEndometriumisinthesecretoryphasecorrespondingto20-21daysofcycle"atthetimeofimplantation."Afterovulation,theendometriumnowdemonstratesacombinedreactiontoestrogenandprogesteroneactivity.Mostimpressiveisthattotalendometrialheightisfixedatroughlyitspreovulatoryextent(5-6mm)despitecontinuedavailabilityofestrogen."Readingtheabovetextitisclearthatendometriumis-5-6mmthickatthetimeofimplantation,whichisnotgivenintheoption.Stillifyouhavetomarkoneansweroption'a'i.e.3-4mmbeingclosestcouldberight.ExtraEdgeImplantationoccurs7-9daysafterovulation?.Inhuman,theblastocystburrowsintheuterinecavitytillwholeofitlieswithinthethicknessofendometrium.Thisiscalledasinterstitialimplantation.Afterimplantationoftheembryotheuterineendometriumiscalledthedecidua".Deciduabasalis-Thepartofdeciduawheretheplacentaistobeformed.DeciduaCapsularis-Thepartofthedeciduathatseparatestheembryofromtheuterinelumen.DeciduaParietalis-Thepartofthe
embryofromtheuterinelumen.DeciduaParietalis-Thepartofthedecidualiningrestoftheuterinecavity.Attheendofpregnancy,thedeciduaisshedoffalongwithplacentaandmembranes.
2.Zygotewithzonapellucidareachesuterine cavityby: a)2days b)4days c)5days d)6days CorrectAnswer-B4days
3.Ligamentumtereaisformedafter': a)Obliterationoftheumbilicalvein b)Obliterationoftheductusvenous c)Obliterationoftheductusarteriosus d)Obliterationofthehypogastricartery CorrectAnswer-AObliterationoftheumbilicalvein
4.Theroleofhumanplacentallactogenis: a)Stimulatemilkproduction b)Fetalbreastdevelopment c)Growthoffetus d)Endocrineregulation CorrectAnswer-CGrowthoffetusFunctions:a)Providefetalnutritionbyantagonizingtheactionofinsulininmaternalcirculation,breakdownoffatsandproteinsandtransportoffattyacidsandaminoacidsfrommaternaltofetacirculation.b)Potentangiogenic,helpsdevelopfetalvasculature.c)Promotesgrowthofbreastforlactation.
5.Commonestcauseforpuerperalsepsisis: a)Streptococci b)Anaerobes c)Gonococci d)Staphylococci CorrectAnswer-AStreptococci
6.Thebestmethodforinducingmidtrimester abortionis: a)InjectionofHypertonicSaline b)Ethacrydine c)Prostaglandins d)DandC CorrectAnswer-CProstaglandinsMidtrimesterterminationofpregnancyA)Medicalmethodsi)Prostaglandins:misoprostol(PGE1)withorwithoutMifepristone,gemeprost(PGE1),dinoprostone(PGE2),carboprost(PGE2)ii)Oxytocin
7.MostcommonsiteofImplantationoftubal pregnancyis: a)Interstitialportionoffallopiantube b)Isthmus c)Ampulla d)Infundibulum CorrectAnswer-CAmpullaMaximumpropensitytorupture-->Isthmicectopicpregnancy.Minimumpropensitytorupture-3Ampullaryectopicpregnancy.
8.DuringwhichgestationalageispeakserumHCGlevelsattained? a)7-9weeks b)11-13weeks c)20weeks d)25weeks CorrectAnswer-AHCGrisesprogressivelyfromconception.Levelsdoubleontheaverage,every30.9hoursuntilvaluesreach6500mIU/ml(6,500IU/L)atapproximatelytheeighthweekafterthelastmenstrualperiod(LMP).Afterthattherateofrisebecomesindividualized,peakingbetweenthe60thand70thday(9to10weeks)LMP.HCGdecreasesslightlybetweenthe12thand16thweekpostLMP,andthenremainsconstantuntilbirth.
9.Theuterinearteryisabranchofwhichofthefollowing? a)Leftcommoniliacartery b)Internaliliacartery c)Internalpudendalartery d)Ovarianartery CorrectAnswer-BUterinearteriesarisefrominternaliliacarteryorhypogastricartery.Itrunsdownwardsandforwardsalongthelateralpelvicwalluntilthebaseofthebroadligament. Note:Duringpregnancytheuterinearterieshypertrophyandtheircourseisstraightened. Ref:CompTextbookofObstetricsandGynecology,SadhanaGupta,2011,Page18
10.
Inwhichpartoffallopiantubeectopicpregnancywillhavelongestsurvival? a)Isthmus b)Ampulla c)Cornua d)Interstitium CorrectAnswer-DAns.D.InterstitiumIftheimplantationoccursintheantimesentericborderintheampulla,thepregnancymaycontinuealittlelongertime.Earliestinterruptionoccursintheisthmialimplantationandpregnancymaycontinueupto3-4monthsininterstitialimplantation.Alsoknow:Isthmicruptureusuallyoccursat6-8weeks,theampullaryoneat8-12weeksandtheinterstitialoneatabout4months.Ref:TextbookofObstetricsbyDCDutta,6thedition,Page181.
11.Whatwouldbethetypeofpresentationwhentheengagingdiameteris mentovertical? a)Face b)Brow c)Vertex d)Breech CorrectAnswer-BInbrowpresentation,theengagingdiameterismentovertical(14cm).Browistherarestvarietyofcephalicpresentationwherethepresentingpartisthebrowandtheattitudeoftheoftheheadisshortofthatdegreeofextensionnecessarytoproducefacepresentation.Infacepresentation,thepresentingpartisface,attitudeofthefetusshowscompleteflexionofthelimbswithextensionofthespine.Thecommonestpositionisleftmentoanterior.Theengagingdiameteroftheheadissubmentobregmatic9.5cminfullyextendedheadorsubmentovertical11.5cminpartiallyextendedhead.Ref:TextbookofObstetricsByD.CDutta,6thedn,page392-3
12.Whichofthefollowingstatementsregardingfetalcirculationiscorrect? a)Theliverandheartofthefetusreceivebloodwithveryhigh oxygensaturation b)PO2offetalbloodleavingtheplacentaisslightlygreaterthan maternalmixedvenousPO2 c)Thepresenceoffetalhemoglobinshiftstheoxyhemoglobin dissociationtotheright d)Theforamenovaleclosesduringthethirdtrimesterunlessthe fetushasanatrialseptaldefect CorrectAnswer-ASincetheliverissuppliedbyumbilicalvenousbloodfromtheplacenta,andtheheartandheadreceivebloodbeforeithasmixedwithsignificantamountsofdesaturatedblood,theseimportantorgansreceivebloodthatisrelativelyhighinsaturatedoxyhemoglobin. ThehighrateofbloodflowattheplacentaandthesignificantresistanceoftheplacentatodiffusionofoxygenresultinbloodintheumbilicalveinthathasalowerPO2(30mmHg)thanthematernalmixedvenousblood. However,theleftshiftinfetaloxyhemoglobinconcentrationandtheBohreffectbothacttoincreasethetransportofoxygentofetaltissues. Anumberofsignificantdifferencesincirculatingpatternsarepresentinthefetus. Theforamenovaleremainsopenuntilafterbirthandasignificantportionofinferiorvenacavaflowisshuntedthroughittotheleft.1/3ofbloodentersdirectlyfromrightatriumtoleftatrium(bypassingrightventricle)throughforamenoval Themajorportionofrightventricularoutputisshuntedthroughtheductusarteriosustotheaorta,notthelungs. Theneteffectoftheseshuntsinthepresenceofhighfetalpulmonaryvascularresistanceisverylowfetalpulmonarybloodflow.
Atbirth,thesepatternsnormallyarequicklychangedtoex-uteropatternswithhighpulmonaryperfusion.Ref:BarrettK.E.,BarmanS.M.,BoitanoS.,BrooksH.L.(2012).Chapter33.CirculationthroughSpecialRegions.InK.E.Barrett,S.M.Barman,S.Boitano,H.L.Brooks(Eds),Ganong'sReviewofMedicalPhysiology,24e.
13.MostcommoncauseofsecondaryPPHis : a)Uterineinertia b)Retainedplacenta c)Episiotomy d)Cervicaltear CorrectAnswer-BRetainedplacentaSecondaryPPHBleedingusuallyoccursbetween8thto14thdayofdelivery.CausesoflatePPH:Retainedbitsofcotyledonormembranes(M.C.)Infectionandseparationofsloughoveradeepcervico-vaginallaceration.Endometritisandsubinvolutionoftheplacentalsite.
14.Themajorcontributionoftheamniotic fluidafter20weeksofgestation: a)Ultrafiltrateandmaternalplasma b)Fetalurine c)Fetallungfluid d)Fetalskin CorrectAnswer-BAns.B.FetalurineTherearetwoprimarysourcesofamnioticfluid:fetalurineandthelungliquid.Afterabout20weeks,fetalurinemakesupmostofthefluid.
15.
IncidenceofscarruptureinasubsequentpregnancyincaseofLowerSegmentCesareanSection(LSCS)is: a)2% b)4% c)5% d)8% CorrectAnswer-A2%Theriskoflowersegmentscar-ruptureislow(0.2-1.5%)andevenifitdoesoccur,maternaldeathismuchlessandtheperinatalmortalityisabout1in8.
16.Thecharacteristicsofcaputsuccedaneum includeallofthefollowingexcept: a)Crossesmidline b)Crossesthesutureline c)Itdoesnotdisappearwithin2-3days d)Itisadiffuseedematousswellingofthesofttissuesofthescalp CorrectAnswer-CItdoesnotdisappearwithin2-3daysLocation-subcutaneousplaneClinicalfeatures-Softengraduallyanddisappearwithin2-3daysDiffusecrossessuturelineilldefinedmargin.Notassociatedwithprolongedjaundice
17.Hydrocephalusisbestdetected antenatelyby: a)X-rayabdomen b)Amniocentesis c)Clinicalexamination d)Ultrasonography CorrectAnswer-DAns.isdi.e.UltrasonographyHydrocephalusisaconditioninwhichthereisanabnormalincreaseincerebrospinalfluidwithintheventricularandsubarachnoidspacesofbrain."Theprenataldiagnosisofhydrocephalusisusuallymadebydemonstrationofadilatedventricularsysteminanultrasoundexamination."Earliestandmostaccuratesonographicsignofhydrocephalus?Enlargedlateralventricles.?Thelateralventricleismeasuredatthelevelofatrium.Normaltransversediameterofatriumis7mm?1mm.(Itremainsconstantduringthesecondandthirdtrimester)Whendiameterofatriumis>10mmitiscalledasVentriculomegaly/Hydrocephalus.OthersignsofhydrocephalusonUSG:Danglingchoroidplexuses.Thinningoutofcerebralcortex.ExtraEdge:Friends,thetermsventriculomegalyandhydrocephalusareoftenusedinterchangeablybuthaveslightlydifferentmeanings.*Ventriculomegaly:Theconditioninwhichlateralventriclesofthe
brainarefilledwithexcessivefluidandenlarge.*Hydrocephalus:Thereisventriculomegalyalongwithanincreaseintheheadcircumference.Normalfetalheadcircumferenceattermrangesbetween32and38cms.Withhydrocephalus,thecircumferenceexceeds50cms.Ventriculomegalycanalsobecausedby?:*Spinabifida?*Chromosomalabnormalities?*Congenitalinfectionslikecytomegalovirus.toxoplasmosis,syphilisandinfluenza.?DandywalkersyndromeincludesHydrocephalus+Posteriorfossacyst?+Defectincerebellarvermis.
18.Subpubicangleis: a)<65? b)65-75? c)85? d)110-120? CorrectAnswer-C85?
19.RuleofHasseisusedtodetermine: a)Theageoffetus b)Heightofanadult c)Raceofaperson d)Identification CorrectAnswer-AAns.isai.e.TheageoffetusHasse'sruleisemployedincalculatingtheageoffetusbyitslengthDuringthefirstfivemonthsofpregnancy,thelengthincmsissquareoftheageinmonthsi.e.Lengthincms=(Ageinmonths)?Ageinmonths=QlengthincmsDuringsecondfivemonthsofpregnancy,lengthincmsdividedby5istheageinmonths.LengthinemsAgeinmonths5
20.Bananaandlemonsignseeninwhich fetalnomalies: a)Neuraltubedefect b)Hydropsfetalis c)Twins d)IUD CorrectAnswer-AAns.isai.e.NeuraltubedefectSignsofSpinabifidaonUltrasoundSmallbiparietaldiameter.Ventriculomegaly.Frontalbonescallopingorthesocalledlemonsign.Elongationanddownwarddisplacementofthecerebellum-thesocalledbananasign.Effacementorobliterationofthecisternamegna.
21.IndicationofAcyclovirinpregnancy: a)Disseminatedherpes b)Chicken-poxinfirsttrimester c)Prophylaxisinrecurrentherpes d)Alloftheabove CorrectAnswer-DAlloftheabove
22.Lovsetmanoeuvreisusedindeliveryof: a)Head b)Breech c)Foot d)Arms CorrectAnswer-DArmsLovset'smaneuverPrinciple:Becauseofthecurvedbirthcanal,whentheanteriorshoulderremainsabovethesymphysispubis,theposteriorshoulderwillbebelowthesacralpromontory.Ifthefetaltrunkisrotatedkeepingthebackanteriorandmaintainingadownwardtraction,theposteriorshoulderwillappearbelowthesymphysispubis.
23.Macrosomiais/areassociatedwith: a)Gestationaldiabetesmellitus b)Maternalobesity c)Hypothyroidism d)A&B CorrectAnswer-DAns.isaandbi.e.GestationaldiabetesandMaternalobesityMacrosomiaisthetermusedtodescribealargefetus.Therecommendeddefinitionisfetal(neonatal)weightexceedingtwostandarddeviationsorabove90thcentilefortheappropriatenormalpopulation.AccordingtoACOG:birthweightof>4500gmiscalledasmacrosomia.InIndiancontextBirthweightof>4000gmiscalledasmacrosomia.
24.Drugwhichiscontraindicatedbefore2nd stageoflaboris:March2009 a)Mifepristone b)Oxytocin c)Misoprostol d)Ergometrine CorrectAnswer-DAns.D:ErgometrineDrugsusedformedicalmethodofinductionoflabourare:MifepristoneOxytocinMisoprostol(ProstaglandinsEl)Ergometrineiscontraindicatedinpregnancy,1ststageoflabour,2ndstageoflabourbeforecrowningoftheheadandinbreechdeliverypriortocrowning.
25.NuchaltranslucencyinUSGcanbe detectedat_____weeksofgestation. a)11-13weeks b)18-20weeks c)8-10weeks d)20-22weeks CorrectAnswer-AAns.A.11-13weeksNuchaltranslucencyisthenormalfluid-filledsubcutaneousspaceidentifiedatthebackofthefetalneckduringthelatefirsttrimesterandearlysecondtrimester(11.3-13.6weeks).
26.Firstlineoftreatmentofmastitisina lactatingmotheris- a)Dicloxacillin b)Cefazolin c)Ceftriaxone d)Ampicillin CorrectAnswer-AAns.A.DicloxacillinThebetalactamase-resistantpenicillinshavebeenrecommendedinthetreatmentofmastitis.Theseincludecloxacillin,dicloxacillin,orflucloxacillin.Becausepenicillinsareacidic,theyarepoorlyconcentratedinhumanmilk,whichisalsoacid.Therefore,cloxacillinanditscongenerstendtotreatcellulitiswell,buttheyarelesseffectiveineradicatingadenitis,themostlikelyprecursorofbreastabscess.Whenpatientsareallergictopenicillins,cephalexinorclindamycinmaybethealternativetoerythromycin.Combinationlikeco-amoxiclavshouldbeavoidedbecauseoffearofinducingMRSA
27.Patientwithrecurrentabortiondiagnosed tohaveantiphospholipidsyndrome.Whatwillbethetreatment? a)Aspirinonly b)Aspirin+LowmolecularweightHeparin c)Aspirin+LowmolecularweightHeparin+Prednisolone d)NoTreatment CorrectAnswer-BAns.B.Aspirin+LowmolecularweightHeparinTherecommendedtreatmentforwomenwithrecurrentpregnancylossassociatedwithantiphospholipidsyndromeincludescombinedAspirinandHeparintherapy.InpregnantSLEpatientswithAntiphospholipidantibodiesandpriorfetalloss,treatmentwithheparin(standardorlow?molecular-weight)pluslowdoseaspirinhasbeenshowninprospectivecontrolledtrialstoincreasesignificantlytheproportionoflivebirths.Combinedaspirinandheparintherapyhasproveneffectivenessandisthepreferredtreatmentforwomenwithrecurrentpregnancylossassociatedwithantiphospholipidsyndrome.
28.Humanplacentais? a)Discoid b)Hemochorial c)Deciduate d)Alltheabove CorrectAnswer-DAns.is'd'i.e.,AlltheaboveThehumanplacentais:Discoid,becauseofitsshape.Hemochorial,becauseofdirectcontactofthechorionwiththematernalbloodandDeciduate,becausesomematernaltissueisshedatparturition.
29.Twinpregnancyofthesameageandsex rulesout? a)Superfetation b)Maternaltwins c)Superfecundation d)Noneoftheabove CorrectAnswer-AAns.is'a'i.e.,SuperfetationSuperfetationItisthesimultaneousoccurrenceofmorethanonestageofdevelopingoffspringinthesameanimal.Inmammals,itmanifestsastheformationofanembryofromadifferentestrouscyclewhileanotherembryoorfetusisalreadypresentintheuterus.
30.Allaretrueaboututeroplacental circulationexcept a)Bloodintheintervillousspaceiscompletelyreplaced3-4 timesperminute b)Thevillidependonthematernalbloodfortheirnutrition c)Amatureplacentahas150mlofbloodinthevillisystemand 350mlofbloodintheintervillousspace d)Intervillousbloodflowattermis500-600mlperminute CorrectAnswer-CAnswer-C.Amatureplacentahas150mlofbloodinthevillisystemand350mlofbloodintheintervillousspaceAmatureplacentahasavolumeofabout500mlofblood;350mlbeingoccupiedinthevillisystemand150mllyingintheintervillousspace.Intervillousbloodflowattermisaround500-600mlperminute.Thebloodintheintervilllousspaceiscompletelyreplacedabout3-4timesperminute.Thevillidependonmaternalcirculationfornutrition,thusitispossibleforthechorionicvillitosurviveforavaryingperiodevenafterthefetusisdead.
31.Uterusisreceptiveforimplantationfor howmanydaysafterfertilization- a)6days b)12days c)6weeks d)12weeks CorrectAnswer-DAnswer-D.12weeksSuperfetationisthefertilizationoftwoovareleasedintwodifferentmenstrualcycles.Thenidationanddevelopmentofonefetusoveranotherfetusistheoreticallypossibleuntilthedecidualspaceisobliteratedby12weeksofpregnancy.
32.Numberofstemvilliatterminhuman placentais a)60 b)120 c)240 d)480 CorrectAnswer-AAnswer-A.60Functionalsubunitiscalledalobulewhichisderivedfromatertiarystemvilli.About60stemvillipersistinhumanplacenta.Thuseachcotyledon(total15-29)contains3-4majorstemvilli.Thevilliarethefunctionalunitoftheplacenta.Thetotalvillisurface,forexchange,approximatelyvariesbetween10to14squaremetres.Thefetalcapillarysystemwithinthevilliisalmost50kmlong.
33.AllareofvalueinmodifiedBishopscore except a)Dilatation b)Effacement c)Cervicallength d)Consistency CorrectAnswer-BAnswer-B.Effacement
34.G2P1L1femalewith1:4antiDtitresat28 weeksgestation,managementis a)MCADoppler b)Caesareansection c)Inductionoflabour d)Amniocentesis CorrectAnswer-AAnswer-A.MCADopplerIfIndirectCoomb'stestispositiveinanantenatalpatientwithRhnegativebloodgroup,andantibodytitres>1:16orAblevel>10IU/ml 1. SerialMCADoppler,every1-2weeksfrom20weeks2. Serialultrasonographyevery2-3weeksfrom20weeks
35.PatientwithNTD,doseoffolicacidinnext pregnancy a)0.5mg b)1mg c)2mg d)4mg CorrectAnswer-DAnswer-D.4mgFolicacidsupplementation4mgdaily1monthbeforeconceptiontoabout12weeksofpregnancy.
36.Kallmanssyndromeisassociatedwithall ofthefollowingexcept a)Amenorrhea b)ExcessstimulationoftheHPOaxis c)Geneticmutation d)Anosmia CorrectAnswer-BAnswer-B.ExcessstimulationoftheHPOaxisWhencongenitalGnRHdeficiencyisassociatedwithanosmiaorhyposmia(anabsentorgrosslyimpairedsenseofsmell),thedisorderisknownasKallmann'ssyndrome.TwogeneticmutationsassociatedwithKallman'sSyndrome: 1. KALgene-X-linkedinheritance(Xp22.3)encodinganosmin-1.2. GeneencodingFGFR1(Fibroblastgrowthfactor-1receptor)- autosomaldominantform.Anosmin-1isaneuraladhesionmoleculethatpromotesmigrationofGnRHneuronsandolfactoryneurons,fromtheolfactoryplacodeintothehypothalamusduringembryonicdevelopment.
37.Hotflushesareexperiencedasaresult of a)Increasednoradrenaline b)Decreasedestrogen c)Increasednoradrenalineanddecreasedestrogen d)Increasednoradrenalineandestrogen CorrectAnswer-CAnswer-C.IncreasednoradrenalineanddecreasedestrogenHotflushesarecausedbynoradrenaline,whichdisturbsthethermoregulatorysystem.Oestrogendeficiencyreduceshypothalamicendorphins,whichreleasemorenorepinephrineandserotonin.Thisleadstoinappropriateheatlossmechanism.Othercausesthatcanbeassociatedwiththesymptomofhotflushesinclude:thyroiddisease,epilepsy,pheochromocytoma,carcinoidsyndromes,autoimmunedisorders,mastcelldisorders,insulinoma,pancreatictumoursandevenleukemias.
38.Cephalicindexis a)BPD/OFD b)BPD/HC c)OFD/BPD d)HC/FL CorrectAnswer-AAnswer-A.BPD/OFDCephalicindex=BPD/OFD(Biparietaldiameterdividedbytheoccipito-frontaldiameter)
39.Ifthesymphysiofundalheightis40cm andthestationoftheheadisat-1,weightofthefetusisapproximately a)3kg b)3.3kg c)4kg d)4.3kg CorrectAnswer-DAnswer-D.4.3kgJohnson'sFormulaforestimationoffetalweight:Heightoftheuterusabovethesymphysispubisincentimetersminus12,ifthevertexisatorabovethelevelofischialspinesorminus11,ifthevertexisbelowthelevelofischialspines-multipliedby155givestheweightingrams.Solution:(40-12)x155=4340gms
40.InMRKHsyndrome,whichamongthe followingisabsent? a)Vagina b)Breastdevelopment c)Pubichairdevelopment d)Testes CorrectAnswer-DAnswer-D.TestesMRKHsyndromeisalsoknownasMURCSsyndrome(Mullerianagenesis,Renalaplasiaandcervicothoracicsomitedysplasia).MRKH(MayerRokitanskyKusterHauser)syndromehasakaryotypeof46,XX.SothegonadspresentareovariesincontrasttoAndrogenInsensitivitySyndromewheretestesarepresent.TheMRKHsyndromeischaracterizedbycongenitalaplasiaoftheuterusandtheupperpart(2/3)ofthevaginainwomenshowingnormaldevelopmentofsecondarysexualcharacteristicsandanormal46,XXkaryotype.
41.Whatisthepreferredtreatmentof completeprolapseinafemalewithcompletedfamily? a)Slingsurgery b)Vaginalhysterectomy c)LeForte'srepair d)Pessary CorrectAnswer-BAnswer-B.VaginalhysterectomyVaginalhysterectomyiscommonlyperformedformajordegreeuterineprolapseinafemalewithcompletedfamily.
42.Whichofthefollowingisnotaprobable signofpregnancy a)Jacquemier'ssign b)Dalrymplesign c)Hegar'ssign d)Palmer'ssign CorrectAnswer-BAnswer-B.DalrymplesignProbablesignsofpregnancy:Jacquemier'ssign/Chadwick'ssignOsiander'ssignGoodell'ssignPiskacek'ssignHegar'ssignPalmer'ssignBraxtor-hickscontractionExternalballotmentAbdominalenlargementOutliningthefetus
43.Polyspermyisinhibitedbywhichion? a)Ca b)Na c)K d)Cl CorrectAnswer-AAns,A.CaThecalciumwaveamplifiesthelocalsignalatthesiteofsperm-oocyteinteractionanddistributesitthroughouttheoocytecytoplasm.Theincreaseincalciumconcentrationisthesignalthatcausestheoocytetoresumecelldivision,initiatingthecompletionofmeiosisIIandsettingofthedevelopmentalprogrammethatleadstoembryogenesis.
44.Whichofthefollowingispresentin normalvagina? a)Trichomonasbuccalis b)Trichomonashominis c)Trichomonasvaginalis d)Trichomonasbovis CorrectAnswer-CAns.C.Trichomonasvaginalis
45.Maximumamnioticfluidat? a)32weeks b)34weeks c)36weeks d)40weeks CorrectAnswer-CAns,C.36weeks
46.At20weeksofgestationamnioticfluid volumeis? a)200ml b)400ml c)600ml d)800ml CorrectAnswer-BAns,B.400ml
47.Fertilizedovumreachestheuterusatwhat dayofmenstrualcycle? a)6th b)14th c)20th d)25th CorrectAnswer-CAns,C.20thImplantationofthefertilizedovumoccursintheendometriumoftheanteriororposteriorwallofthebodynearthefundusonthe&ilayoffertilizationwhichcorrespondstothe20thdayoftheregularmenstrualcycle.
48.
Fertilizationusuallyoccursinwhichpartoffallopiantube? a)Fimbrialend b)Ampulla c)Interstitium d)Isthmus CorrectAnswer-BAns.B.AmpullaFertilizationistheprocessoffusionofthespermatozoonwiththematureovum.Itbeginswithspermeggcollisionandendswithproductionofamononucleatedsinglecellcalledthezygote.Itsobjectivesare: 1. Toinitiatetheembryonicdevelopmentoftheeggand2. Torestorethechromosomenumberofthespecies. Almostalways,fertilizationoccursintheampullarypartoftheuterinetube.
49.Physiologicchangeinleukocytenumbers inpregnancyis a)Neutrophilicleukocytosis b)Lymphocyticleukocytosis c)Neutropenia d)Basophilicleukocytosis CorrectAnswer-AAns.A.NeutrophilicleukocytosisPhysiologicalchangeobservedinleukocytenumbersinpregnancyisneutrophilicleukocytosis.Itoccurstothetuneof8000/mm3andmayupto20,000/mm3inlabour.Theincreasemaybeduetotheriseinlevelsofestrogenandcortisol.
50.Weightofuterusattermis? a)400-500gm b)600-700gm c)800-900gm d)900-1000gm CorrectAnswer-DAns.D.900-1000gmTheuterusinthenon-pregnantstateweightisabout60gm,withacavityof5-70mlandmeasuresabout7.5cminlength.Attermitweighsabout900-1000gmandmeasures35cminlength.
51.Duringpregnancyestrogencauseswhich ofthefollowing? a)Growthofductsofbreasts b)Growthofalveoliofbreasts c)Bothaandb d)Noneoftheabove CorrectAnswer-CAns.C.BothaandbTheincreasedsizeofthebreastsisevidentintheearlyweeksofpregnancy.Theincreaseinsizeisduetohypertrophyandproliferationoftheductsandthealveoli.Estrogenisresponsibleforthehypertrophyandproliferationoftheductsandalveoliwhileprogesteroneisonlyresponsibleforthehypertrophyandproliferationofthealveoli.
52.Maternalsidelayeroftheplacentais called? a)Deciduabasalislayer b)Deciduacapsularislayer c)Deciduaparietalis d)Deciduaspongiosa CorrectAnswer-AAns.,A.DeciduabasalislayerDeciduabasalis(Decidualplate)isthepartofendometriumrelatedtoembryonicpoleofconceptusandformsthematernalpartofplacenta.
53.Whichofthefollowingisnota physiologicalchangeofpregnancyinurinarybladder? a)Edematousmucosa b)Increasedfrequencyat14weeks c)Stressincontinence d)Pressureonbladderinlatepregnancy CorrectAnswer-BAns.B.Increasedfrequencyat14weeksPhysiologicalchangesinbladderinpregnancyMarkedcongestionandhypertrophyofthemusclesandelastictissuesofthebladderwall.Edematousbhddermucosainlatepregnancyespeciallyinprimigravida.Increasedfrequencyofmicturitionat6-8weekswhichsubsidesby12weeksandreappearsinlatepregnancyduetopressureofthegraviduterusonbladder.Stressurinaryincontinenceinlatepregnancy.
54.Urinaryretentionearliestinpregnancyis seenat? a)10weeks b)18weeks c)22weeks d)34weeks CorrectAnswer-AAns,A.10weeksUrinaryretentioninpregnancyisrareItisclassicallydescribedinsomewomenwithretroverteduterus,whichbecomesimpactedinthepelvis,usuallyseenearliestbetween8-12weeksofpregnancyandcausesoutflowobstruction.
55.BetaHCGisdetectedearliestbywhich dayofconception? a)8days b)15days c)21days d)30days CorrectAnswer-AAns,A.8dayshCGisaglycoproteinproducedbythesyncytiotrophoblast.hCG-cisidenticaltothecsubunitofLH,FSH,andTSH.Itspresenceintheurineinearlypregnancyisthebasisofthevariouslaboratorytestsforpregnancy,anditcansometimesbedetectedintheurineasearlyas14dafterconceptionandinserumasearlyas8-9days,
56.DoublingtimeofbetaHCGinearly pregnancyis? a)24hrs b)48hrs c)72hrs d)96hrs CorrectAnswer-BAns,B.48hrsBetahCGusuallydoubleaboutevery2days(48hours)duringfirstfourweakofpregnancy.Aspregnancyprogresses,doublingtimebecomeslonger.By6-7weeksbetahCGlevelsmaytakeaslongas3.5daystodouble.
57.Tubalpatencytestinwhichphaseofthe menstrualcycle? a)Menstrual b)Preovulatory c)Leuteal d)Premenstrual CorrectAnswer-BAns,B.PreovulatoryThetestingoftubalpatencyanddetectingtubalpathologyaredoneinpre-ovulatoryphaseofthemenstrualcycle.Ifperformedinthepost-ovulatoryperiod,insufflationmightdisturbanimplantedorfertilizedovumandmayalsocausepelvicendometriosis.
58.Followingphysiologicalchangesareseen invaginainpregnancyexcept? a)Jacquimierssign b)Increasedlengthofanteriorvaginalwall c)pHacidic d)Decreasednumberofnavicularcells CorrectAnswer-DAns,D.DecreasednumberofnavicularcellsThevaginalwallsbecomehypertrophied,edematousandmorevascular.Increasedbloodsupplytovenousplexussurroundingthewallsgivesbluishcolorationofthemucosa(Jacquemier'ssign).Thelengthoftheanteriorvaginalwallisincreased.Thesecretionofvaginabecomescopious,thinandcurdywhite,duetomarkedexfoliatedcellsandbacteria.ThepHbecomesacidic(3.5-6)duetomoreconversionofglycogenintolacticacidbylactobacillusacidophilusconsequentonhighestrogenlevel.TheacidicpHpreventsmultiplicationofpathogenicorganisms.Thereispredominanceofnavicularcellsinclusterandplentyoflactobacilli.
59.FHScanbeusuallyheardbystethoscope at? a)14weeks b)18weeks c)22weeks d)26weeks CorrectAnswer-BAns,B.18weeksFetalheartsound(FHS)ismostconclusiveclinicalsignofpregnancy.Withanordinarystethoscopeitcanbedetectedbetween18-20weeksofPregnancY.
60.Whatisthefetoplacentalrelationshipat 24weeksofgestation? a)3 b)4 c)5 d)6 CorrectAnswer-AAns,A.3Therelationshipbetweenthefetalandplacentalweightscanbestudiedbythesocalledfetoplacentalrelationship(fetalweight/placentalweightratio).Thefetoplacentalrelationshipincreasesasthepregnancyadvances.
61.Downsyndromeisearliestdiagnosedat? a)8-10weeks b)10-12weeks c)12-14weeks d)14-16weeks CorrectAnswer-BAns.B.10-12weeksEarliestdiagnosisofgeneticdefectscanbedonebyuseofchorionicvilloussampling.Chorionicvilloussamplingiscarriedouttranscervicallyat10-12weeksandtransabdominallyfrom10weekstoterm.
62.Chorionicvillusbiopsyisdoneearliestin whichweekofgestation? a)9weeks b)11weeks c)13weeks d)15weeks CorrectAnswer-BAns,B.11weeksItiscarriedouttranscervicallybetween7O-12weeksandtransabdominallyfrom10weekstoterm.
63.Whenisfolicacidstartedinpregnancy? a)4weekspriortoconception b)8weekspriortoconception c)4weeksafterconception d)8weeksafterconception CorrectAnswer-AAns.A.4weekspriortoconceptionFolicacidsupplementation(4mg/day)isstated4weekspriortoconceptionandcontinuedupto12weeksofpregnancy.Thiscanreducetheincidenceofneuraltubedefects.
64.TermplacentaweighttoBabyweightratio is? a)1:3 b)1:4 c)1:5 d)1:6 CorrectAnswer-DAns,D.1:6ThetermPlacentaPlacentaattermisacirculardiscwithadiameterof15-20cm.Ithasthicknessof3cmatcenterandthinsoftowardstheedges.Itfeelsspongyandweighsabout500gm.Theratioofplacematweightattermandthebabyweightis1:6.Itoccupiesabout30%oftheuterinewall.
65.Firsttrimesterdiagnosisforanencephaly isbyincreased? a)Alphafetoproteininmaternalserum b)Alphafetoproteininamnioticfluid c)BetaHCGinmaternalserum d)BetaHCGinamnioticfluid CorrectAnswer-BAns,B.AlphafetoproteininamnioticfluidInthefirsthalfofthepregnancythediagnosisofanencephalyismadebyelevatedalphafetoproteininamnioticfluidandconfirmedbysonography.
66.WhichofthefollowingistrueaboutEDD? a)Lessthan10%ofdeliveriesoccuronEDD b)Lessthan20%ofdeliveriesoccuronEDD c)80%ofthedeliveriesoccuronEDD d)90%ofthedeliveriesoccuronEDD CorrectAnswer-AAns,A.Lessthan10%ofdeliveriesoccuronEDDFewerthan5%ofallthepregnanciesendontheexpecteddateofdelitery(EDD).13%ofthebirthsoccurpreterm.5-7%ofthepregnanciesaredeliveredpostterm.Majorityofthedeliveriesoccurwithin7daysofEDD.
67.a)Mostcommonpositionofengagement invertexpresentation? a)LOA b)ROA c)LOP d)ROP CorrectAnswer-AAns,A.LOAVertexoccupyingtheleftanteriorquadrantofthepelvisisthecommonestandiscalledleftoccipito-anteriorposition.
68.Whichistheengagingdiameterin occipitoposteriornresentation? a)Suboccipitofrontal b)Mentovertical c)Submentovertical d)Bitrochanteric CorrectAnswer-AAns,A.Suboccipitofrontal
69.Whichisthemostcommonpresentation intwinpregnancy? a)Vertex-vertex b)Vertex-breech c)Breech-Breech d)Vertex-Footling CorrectAnswer-AAns.A.Vertex-vertex
70.DirectOccipitoposteriorpositionisa favourablepositioninwhichtypeofpelvis? a)Anthropoid b)Androidpelvis c)Gynaecoid d)Mongoloid CorrectAnswer-AAns,A.AnthropoidDirectOccipitoposteriorpositionisafavourablepositioninanthropoidtypeofpelvis.
71.PersistentOPpositionismostcommonin whichpelvis? a)Android b)Gynaecoid c)Anthrpoid d)Mixed CorrectAnswer-AAns,A.AndroidWithandroidtypeofpelvistheoccipitoPosteriorpositioniscommonduetofunnelshapeofthepelvis.
72.Contraindicationforinductionoflabouris allexcept? a)Hypertensivediseaseofpregnancy b)Heartdiseaseofpregnancy c)Pelvictumor d)Vasaprevia CorrectAnswer-AAns.A.HypertensivediseaseofpregnancyHypertensivediseaseofpregnancyisanindicationforinductionoflabour.Otherthreearecontraindications.
73.Medicalmanagementofectopic pregnancyhasdecreasedsuccessif? a)Gestationalsac<3cm b)Durationofgestation<5weeks c)Cardiacactivitypresent d)BetaHCG<8000IU/L CorrectAnswer-CAns.C.CardiacactivitypresentMedicalmanagementofanectoPicPregnancyisdonewhen:PatientishemodynamicallystableNoevidenceofacuteintraabdominalbleedingReadytocomplywithfollowupcareSerumbetaHCG<10,000IU/LAbsentembryonicheartactivityDiameterofectopicgestationalmasslessthan4cm.
74.AllaretheprognosticfactorsofBoer- meiselsystemexcept- a)Extentofadhesions b)Thicknessoftubalwall c)Sizeofhydrosalpinx d)Infectingorganism CorrectAnswer-DAns,D.InfectingorganismBoer-meiselsystemofprognosticclassificationforchronicpelvicinflammatorydiseaseincludes:ExtentofadhesionsNatureofadhesionsflimsyordenseSizeofhydrosalpinxMacroscopicconditionofhydrosalpinxThicknessoftubalwall
75.Pregnantuteruswillcompressuretersat ? a)Pelvicbrim b)Uterovesicaljunction c)Trigone d)Ureterovesicaljunction CorrectAnswer-AAns,A.PelvicbrimUretersbecomeatonicduetohighprogesteronelevelinpregnancy,Dilatationoftheureterabovethepelvicbrimwithstasisismarkedontherightsideespeciallyintheprimigravidae.Itisduetodeoxtrorotationoftheuteruspressingtherightureteragainstthepelvicbrimandaboduetopressurebyrightovarianvein,whichcrossestherightureteratrightangle.
76.Followingisgiventoapatientwithpre termlabourexept- a)Glucocorticoids b)Tocolyticdrugs c)Antibiotics d)Betablocker CorrectAnswer-DAns.D.BetablockerTocolyticdrugs[Note:betamimeticandnotbetablockerisatocolytic]
77.Mostcommoncauseoftenthdaypost partumbleeding? a)Retainedbitsofmembrane b)Infection c)Endometritis d)Bloodcoagulopathy CorrectAnswer-AAns.A.RetainedbitsofmembranePostpartumhemorrhage(PPH)isdefinedasbloodlossofmorethan500mlfollowingbirthofbaby.
78.Amultgravida4kgfetusisinlaboursince 15hoursandhas5cmdilationofcervixforlast8hours.Whatisthefurthermanagementofthispatient? a)Waitandwatch b)Amniotomy c)InjectionOxytocin d)Caesariansection CorrectAnswer-DAns.D.Caesariansection
79.Thetreatmentofchoiceforbartholincyst is? a)Marsupilisation b)Aspiration c)Observe d)Curettageandclosure CorrectAnswer-AAns.A.MarsupilisationBartholin'scystBartholin'scystisformedwhenductofbartholinsglandisblockedeitherbyinflammationorbyinspissatedsecretion.Itappearsasaswellingontheinnersideofthejunctionoftheanteriortwo-thirdswiththeposteriorone-thirdofthelabiummajus.Asmallcystremainsasymptomatic,butalargeronebulgesacrossthevaginalintroitusandcausesdyspareunia,discomfortandmaygetinfectedwhenitneedsexcisionormarsupialization
80.Gartner'scystareseenat? a)Anterolateralvaginalwall b)Antero-lateralcervix c)Posterolateralvaginalwall d)Posterolateralcervix CorrectAnswer-AAns,A,'.AnterolateralvaginalwallGartnersductcystarisesfromtheremnantsofthemesotephricductandliesintheanterolateralaspectofvaginalwall.
81.Mostcommoncauseofdeathofbabyin vasapreviais? a)Infection b)Maternalexanguination c)Fetalexanguination d)Bothbandc CorrectAnswer-CAns,C.FetalexanguinationVasapreviaInitaleashofbloodvesselshappentotraversethroughthemembranesoverlyingtheinternalos,infrontofpresentingpart.Ruptureofmembranesinvolvingtheoverlyingvesselsleadstovaginalbleeding.Asitisentirelyfetalblood,thismayresultinfetalexanguinationandevendeath.
82.Sheehansyndromeis? a)Pitutaryadenoma b)Pitutarynecrosis c)Adrenalnecrosis d)Adrenaladenoma CorrectAnswer-BAns.,B.PitutarynecrosisSheehan'ssyndromeisanteriorpituitorynecrosisfollowingseverePPH,shockorsevereinfection.
83.Mostcommoncauseofmenorrhagiain adolescents? a)Thyroiddisorder b)Coagulationdisorders c)Leiomyomas d)Polyps CorrectAnswer-BAns,B.CoagulationdisordersInadolescentagegroup,abnormaluterinebleedingresultsfromanovulationandcoagulationdefectsatdisproportionatelyhigherratescomparedwitholderreproductive-agedwomenCoagulationdisordersaccountfor20%ofcasesofmenorrhagiainadolescents.
84.Notassociatedwithendometrial hyperplasia? a)PCOD b)Glucoseintolerance c)HRT d)Unopposedexposuretoprogesterone CorrectAnswer-DAns.D.UnopposedexposuretoprogesteroneFollowingarethecausesofendometrialhyperplasiaFollicularcystsofovaryPCODGranulosaandthecacelltumorsofovaryHRTGlucoseintoleranceUnopposedexposuretoestrogen(endogenousorexogenous)
85. Followingarethecausesofmaternal deathsinpatientswithhypertensive disorderofpregnanacyexcept? a)Cardiacfailure b)ARDS c)Chronicrenalfailure d)Cerebralhemorrhage CorrectAnswer-CAns.C.ChronicrenalfailureCausesofmaternaldeathsincasesofhypertensivedisordersofpregnancyareCardiacfailureCerebralhemorrhageARDSPuerperalsepsisPulmonaryedemaAcuterenalfailurePulmonaryembolismAspirationand/orsepticpneumoniaCardio-pulmonaryarrestPost-partumshock
86.Classicalnameofmidcycleabdominal painwithvaginalbleedingiscalled? a)Endometriosis b)Mittelschmez c)Meteropathiahemorrhagica d)Menometrorrhagia CorrectAnswer-BAns.B.MittelschmezMittelschmerzisamid-cyclepain,notlastingmorethan12-24hours,aroundovulation.Painislocatedinoneoftheiliacfossaandmaybeaccompaniedwithvaginalbleeding.
87.Followingistrueaboutleuteomaof pregnancy? a)Usuallybilateral b)Itisabenignselflimitingcondition c)Itconsistsofleutenizedcells d)Alltheabove CorrectAnswer-DAns.D.AlltheaboveLeuteomaofPregnancyItusuallyappearsasbilateral,multinodular,solidmassesinovaries.ItischaracterizedbyreplacementofnormalovarianparenchymabysolidproliferationofleutenizedstromalcellsunderinfluenceofhumanchorionicgonadotroPin.Itisbenignself-limitingconditionandrequiresnotreatment.
88.ClinicalalarmingsignofMgSO4toxicityis ? a)Lossofkneejerk b)Lossofsuperficialabdominalreflexes c)Lossofpinpricksensation d)Lossofproprioception CorrectAnswer-AAns.A.Lossofkneejerk
89.FalseaboutMgSo4is? a)Notusedasantihypertensive b)Itsdoseisdifferentforeclampsiaandpreeclampsia c)Deeptendonreflexesismonitoredfortoxicity d)Itactsasamembranestabilizerandneuroprotector CorrectAnswer-BAns.B.ItsdoseisdifferentforeclampsiaandpreeclampsiaDoseofmagnesiumsulphateformanagementofpre-eclampsiaandeclampsiaisthesame.
90.18weekspregnancyofalady,lasttwo timeshistoryofmidtrimesterabortion,whichwaspainless.Whatisthediagnosis? a)Incompetentos b)Chromosomalabnormality c)Bivalveuterus d)Progesteronedeficiency CorrectAnswer-AAns.A.IncompetentosMostcommoncauseofsecondtrimesterpregnancylossiscervicalincompetence,inwhichpatientpresentswithrecurrentpainlessabortion.
91.Followingarethefeaturesoftruelabour pain? a)Uterinecontractionsatregularintervals b)Progressiveeffacementanddilationofcervix c)Formationofbagofmembranes d)Alltheabove CorrectAnswer-DAns.D.AlltheaboveFeaturesoftruelabourPainsUterinecontractionsatregularintervalsFrequencyofcontractionsincreasegraduallyIntensityanddurationofcontractionsincreaseprogressivelyAssociatedwithshowProgressiveeffacementanddilationofcervixDescentofthepresentingpartFormationofbagofforewatersNotrelievedbyenemaandsedatives
92.HRTimproves? a)Bonedensity b)Demetia c)Coronaryarterydisease d)Endometrialcancer CorrectAnswer-AAns,A.BonedensityHormonereplacementtherapyimprovesbonedensity,
93.Mostcommonriskfactorforruptureof scarreduterusis a)Useofoxytocininlabour b)Grandmultiparity c)Forcepsapplication d)Obstructedlabour CorrectAnswer-AAns,A.UseofoxytocininlabourThemostcommoncauseofruptureofscarreduteruskuseofhighdosesofoxytocinfortheaugmuntationoflabour.
94.Invalueabletoolinthediagnosisof chronicpelvicpainis? a)Endometrialbiopsy b)Ultrasound c)Laparoscopy d)Colposcopy CorrectAnswer-CAns,C.LaparoscopyLaproscopyisaninvalueablediagnostictoolintheinvestigationofchronicpelvicpain.
95.Mostcommonsiteofectopicpregnancyis ? a)Ovary b)Fallopiantube c)Peritoneum d)Cervix CorrectAnswer-BAns.B.Fallopiantube
96.Leastcommonsiteofectopicpregnancy infallopiantubesis? a)Interstitium b)Ampulla c)Infundibulum d)Isthumus CorrectAnswer-AAns,A.InterstitiumMostcommonsiteforectopicpregnancyfallopiantubes,
97.CriteriaforPuerperalpyrexiais temperature? a)100.4degreesFontwoseparateoccasions b)101degreesFontwoseparateoccasions c)100.4degreesFonthreeseparateoccasions d)101degreesFonthreeseparateoccasions CorrectAnswer-AAns,A.100.4degreesFontwoseparateoccasionsPuerperalpyrexiaAriseoftemperaturereaching100.4degreesF(38degreesC)ormore(measuredorally)ontwoseparateoccasionsat24hoursapart(excludingfirst24hours)withinfirst10daysfollowingdeliveryiscalledpuerperalpyrexia.
98.Investigationofchoicefordiagnosisof PIDis? a)Laparoscopy b)Colposcopy c)Hysteroscopy d)Ultrasonography CorrectAnswer-AAns,A.LaparoscopyLaparoscopyisconsideredtheinvestigationofchoiceforthediagnosisofpelvicinflammatorydisease.
99.Whichdrugispreferredforthetreatement of21hydroxylasedeficientfemalefetustopreventgenitalvirilization? a)Materalcortisol b)Maternaldexamethasone c)Maternalhydrocortisone d)Maternalmethylprednisolone CorrectAnswer-BAns,b.MaternaldexamethasoneFetusisatriskofCAHmaternaldexamethasonetherapycansuppressthefetalHPAaxisandpreventgenitalvirilizationinaffectedfemalefetus.
100.Speilbergcriteriaisusedfor? a)Ovarianpregnancy b)Ovarianmalignancy c)Cervicalpregnancy d)Cervicalmalignancy CorrectAnswer-AAns,A.Ovarianpregnancy
101.Mainfactorresponsibleforincreased perinatalmortalityintwinpregnancyis? a)Prematurity b)IUGR c)Polyhydramnios d)Uterinerupture CorrectAnswer-AAns,A.Prematurity
102.Cryptomenorrhoeaisafeatureof? a)Vaginalatresia b)Turnersyndrome c)Emptysellasyndrome d)Gonadalagenesis CorrectAnswer-AAns,A.Vaginalatresia
103..Whichofthefollowingantiepileptic drugisassociatedwithcausingcongenitalheartdiseaseinfetus? a)Barbiturates b)Valproate c)Carbamazepine d)Phenytoin CorrectAnswer-AAns.A.Barbiturates
104.Engagementofheadinlabourmeans? a)Smallesthorizontalplaneofthepresentingparthascrossedthe pelvicbrim b)Greatesthorizontalplaneofthepresentingparthascrossedthe pelvicbrim c)Smallesthorizontalplaneofthepresentingparthascrossedthe pelvicoutlet d)Greatesthorizontalplaneofthepresentingparthascrossedthe pelvicoutlet CorrectAnswer-BAns.B.GreatesthorizontalplaneofthepresentingparthascrossedthepelvicbrimWhenthegreatesthorizontalplaneofthepresentingparthaspassedtheplaneofpelvicbrimthepresentingpartissaidtobeengaged.
105.USGof28weeksgestationshowing oligohydramniosislikelytobedueto? a)Gastroinstestinalobstruction b)Renalpathwayobstruction c)Anencephyaly d)Neuromusculardisorder CorrectAnswer-BAns,B.RenalpathwayobstructionUrinarytractobstructionisanimportantcauseofoligohydramnios.
106.AnovulatoryDUBisdueto? a)Absenceofprogesterone b)Excessofestrogen c)Hypothalmicpitutarydefect d)Highprogesterone CorrectAnswer-AAns.A.AbsenceofprogesteroneNoprogesteroneisproducedwhenovulationdoesnotoccur,andthusproliferativeendometriumpersists.Atthetissuelevel,persistentproliferativeendometriumisoftenassociatedwithstromalbreakdown,decreasedspiralarterioledensity,andincreaseddilatedandunstablevenouscapillaries.Atthecellularlevel,theavailabilityofarachidonicacidisreduced,andprostaglandinproductionisimpaired.Forthesereasons,bleedingassociatedwithanovulationisthoughttoresultfromchangesinendometrialvascularstructureandinprostaglandinconcentration,andfromanincreasedendometrialresponsivenesstovasodilatingprostaglandins.
107.Incarcinomacervixsurgerytoretain conceptionisdoneinwhichstage? a)1B1 b)1B2 c)2A d)2B CorrectAnswer-AAns.A.1B1ConceptsisretaineduptotermonlyinstageIA1.Inotherstages,hysterectomyisdonewithfetusleftinsitu(ifitisnotviable);ordeliveryoffetusbyclassiccesareanhysterectomyfollowedbyradiation(iffetusisviable).
108.Bishopscoringisdonefor? a)Exchangetransfusioninnewborn b)Inductionoflabour c)VentilationofNewborn d)GestationofNewborn CorrectAnswer-BAns.B.InductionoflabourBishopscore,alsoBishop'sscore,alsoknownascervixscoreisapre-laborscoringsystemtoassistinpredictingwhetherinductionoflaborwillberequired.
109.Teratozoospermiarefersto? a)Absenceofsemen b)Absenceofsperm c)Alldeadspermsinejaculate d)Morphologicallydefectivesperms CorrectAnswer-DAns.D.Morphologicallydefectivesperms
110.Bispinousdiameterinanatomicoutlet? a)10.5cm b)11cm c)11.5cm d)12cm CorrectAnswer-BAns.B.11cmAnatomicaloutletAntero-posterior(13cm)Distancebetweenlowerborderofsymphysispubistothetipofcoccyx.Transversediameter(bispinous-11cm)DistancebetweentheinnerbordersofischialtuberositiesPosteriorsagittaldiameter(8.5cm)Distancebetweensacroccygealjointandanteriormarginofanus.
111.Mostsuitabletypeofpelvisinfemale? a)Gynaecoid b)Android c)Anthropoid d)Platypelloid CorrectAnswer-AAns.A.GynaecoidGynaecoidpelvisroundinshape&ismostspacious.
112.WhichpelvisisassociatedwithDTA? a)Android b)Antrhropoid c)Platypelloid d)Gynaecoid CorrectAnswer-AAns.A.Android
113.Inobstructivelabormostimportant parameteris? a)Diameterofpelvicinlet b)Diameterofpelvicoutlet c)Biparietaldiameter d)Bitemporaldiameter CorrectAnswer-BAns.B.DiameterofpelvicoutletThenarrowestdiameterforthefetustopassthroughispelvicoutlet.
114.Maximumdiameterthatpassedthrough maternalpelvis? a)Suboccipitalbregmatic b)Biparietal c)Suboccipitalfrontal d)Occipitofrontal CorrectAnswer-BAns,B.BiparietalOccipitofrontalislargediameteranddeflexedheadmaycomplicateasdeeptransversearrestandobstructedlabour.Incaseofspaciousgynaecoidandanthropoidpelvisitendsupinfacetopubisdelivery.Mento-verticalisthelargestdiameterbutitcannotpassthroughthematernalpelvis.
115.Semenexaminationcanbedone? a)Immediatelyinsemisolidform b)Afterliquefaction c)Within15-30minutesofliquefaction d)11/2-2hrirrespectiveofliquefaction CorrectAnswer-DAns.D.11/2-2hrirrespectiveofliquefactionSemenanalysisBestspecimenobtainedbymasturbation3-5daysofabstinenceisbest,notmorethanthatSpecimenshouldbeexaminedwithin11/2-2hrLiquefactionusuallycompleteswithin15-20minandifdelayeditindicatesprostaticdysfunction.Thusduringsemenanalysistimingofliquefactionisimportantbuttimingofanalysisisnotsetaccordingtoliquefaction.
116.Lithotomypositionincreasesvaginal openingbyhowmanycm- a)1cm b)2cm c)3cm d)4cm CorrectAnswer-BAns.B.2cmIndorsallithotomyposition,theantero-posteriordiameteroftheoutletmaybeincreasedto1.5-2cm.Furthermore,thecoccyxispushedbackwhiletheheadilescendsdowntotheperineum.
117.Endometrialbiopsyisusuallydoneat? a)Justbeforemenstruation b)10-12daysaftermenstruation c)Justaftermenstruation d)Atthetimeofovulation CorrectAnswer-AAns.A.Justbeforemenstruation
118.Oligomenorrhoeameans? a)Cycle<20days b)Cyclemorethan45days c)Cyclemorethan28days d)Cyclemorethan35days CorrectAnswer-DAns.D.Cyclemorethan35daysnee
119.Magnificationobtainedbycolposcopyis ? a)1-2times b)5-6times c)15-25times d)10-20times CorrectAnswer-DAns.D.10-20timesColposcopeprovidesamagnificationof10-20times.Colpomicroscopeprovidesamagnification100-300times.
120.OnwhichdayLH&FSHshouldbe measured? a)1-3rdday b)7thday c)14thday d)10thday CorrectAnswer-AAns.A.1-3rddayLevelofthehormoneFSH,LHandestradiolarcmeasuredonday3ininfertilityworkup.AnelevatedFSHlevelonday3isanindicationofpoorovarianreserve.HormonalassessmentFSH/LHdevelopingfollicleproducesestrogenwhichsignalsthehypothalamustoincreaseorreducetheamountofFSHproducedbythepituitarygland.WhengoodfolliclesarenotdevelopingestrogenlevelsarelowerandmoreFSHisproduced.ThisleaktohigherlevelofFSHonday3.Day3FSHfertilitytestbnottheonlyparameterusedtoassessovarianreserve.
121.Bestparameterforestimationoffetal agebyultrasoundin3rdtrimesteris? a)Femurlength b)BPD c)Abdominalcircuference d)Intraocculardistanc CorrectAnswer-AAns.A.FemurlengthBestparametersforestimationoffetalagebyultrasound1sttrimester?CrownRumplength(CRL)2ndtrimester-Correctedbiparietaldiameter(cBPD)orheadcircumference(HC)3dtrimester-HeadcircumferenceandfemurlengthOverall-Crownrumplength
122.Commonestvarietyofcompound presentationis? a)Headwithhand b)Headwithfoot c)Headwithbothfoot d)Head,hand&foot CorrectAnswer-AAns.A.HeadwithhandWhenacePhalicpresentationiscomplicatedbythepresenceofahandorafootorbothalongsidetheheadorpresenceofoneorbothhandsbythesideofthebreechitiscalledcompoundpresentation.Commonestvarietyofcompoundpresentation-HeadwithhandRarestvarietyofcompoundpresentation-Headwithhandandfootboth.
123.Hegarsign? a)Uterinecontraction b)Quickening c)Bluishdiscolorationofvagina d)Softeningofisthmus CorrectAnswer-DAns.D.SofteningofisthmusHegarssignPresentin2/3ofcases.Demonstratedin6-10weekSignsisbasedonthefadthat: 1. Upperpartofthebodyoftheuterusisenlargedbygrowingfetus.2. Lowerpartofthebodyisemptyandextremelysoft(justabovethe cervix) 3. Cervixiscomparativelyfirm. Becauseofvariationinconsistentonbimanualexamination(twofingersinanteriorfornixandtheabdominalfingersbehindtheuterus)theabdominalandvaginalfingersseemtoopposebelowthebodyoftheuterus.
124.Pregnantwomengoingforlongjourney &prolongedsittingisassociatedwithdangerof? a)Thromboembolism b)Seatbeltcompression c)Pretermlabor d)Bleeding CorrectAnswer-AAns.A.ThromboembolismProlongedsittingincaroraeroplaneisavoidedduetovenousstasisorthromboembolism.
125.Headofbabyisremovedinbreech deliverybywhichmaneuver? a)Lovsetsmaneover b)Pinardsmaneover c)Prague d)BurnMarshallmethod CorrectAnswer-DAns.D.BurnMarshallmethod
126.Praguemanueverisusedfor? a)Aftercomingheadinbreech b)Deeptransverseassest c)Extractionofextendedarms d)Externalcephalicversion CorrectAnswer-AAns.A.AftercomingheadinbreechSometimestheheadrotatesposteriorlyso,thatthefaceisbehindthepubis.Deliveryinthispositionisdifficultand'Praguemaneuver'maybetried.
127.
Trialoflabourinpreviouscaseariansectioncanbedonein? a)PlacentapreviatypeIII b)Previoustwoclassicalcaseariansection c)SuspectedCPD d)Previouscaesariansectionwithadequatepelvis CorrectAnswer-DAns.D.PreviouscaesariansectionwithadequatepelvisAdequatepelvisisanindicationoftrialoflabour.Otherthreeoptionsarecontraindications.
128.Hematomaduringlabourisnotdueto? a)Improperhaemostasis b)Extensionofcervicallaceration c)Ruptureofparavaginalvenousplexus d)Obliterationofdeadspacewhilesuturingvaginalwall CorrectAnswer-DAns.D.ObliterationofdeadspacewhilesuturingvaginalwallFailureofobliterationofdeadspacecauseshematoma(notobliterationofdeadspace).
129.Treatmentofjaundiceinthirdtrimester? a)Terminationofpregnancy b)Terminationat42weeks c)Terminationat38weeks d)Waitforspontaeouslabour CorrectAnswer-CAns,C.Terminationat38weeksInpatientsofintrahepaticcholestasisofpregnancythereisincreasedperinatalmortality.HencefetalsurveillanceisdonewithbiweeklyNST.Conventionalantepartumtestingdoesnotpredictfetalmortalityasthereissuddendeathincholestasisduetoacutehypoxia.Hencedeliveryisrecommendedat37-38weeks.InthosepatientswithjaundicewithSbilirubin>1.8mg%,terminationofpregnancyshouldbedoneat36weeks.
130.Rateofturnoverofamnioticfluidis? a)500cc/h b)1L/hr c)1500cc/h d)2L/h CorrectAnswer-AAns.A.500cc/hSpecificgravityofAmnioticfluid:1.008to1.010Osmolality:250mosm/LCompletelyreplacedin3hours.Rateofamnioticfluidturnoveris500cc/hr.
131.Maximumamountofamioticfluidisseen athowmanyweeks? a)16 b)30 c)12 d)38-40 CorrectAnswer-DAns.D.38-40
132.Uteruspostpregnancybecomesapelvic organin? a)4weeks b)6weeks c)12weeks d)2week CorrectAnswer-DAns,D.2weekBytheendof2weeks-uterusisapelvicorgan.Bythemdof6week-uterusreturnsalmosttoitsnormalsize(prepregnantsize).
133.Assistedheaddeliveryisdonein? a)Browpresentation b)Facepresentation c)Persistentoccipitoposteriorposition d)Twinpresentation1522.%of CorrectAnswer-CAns.C.PersistentoccipitoposteriorpositionOccipitoposteriorpositions"Inpracticeabout5-1O%ofwomenadmittedinlabourwithcephalicpresentationspresentwithoccipito-posteriorpresentations.Giventimeandpatience,manyofthesewillrotateandgetcorrectedtooccipito-anteriorpositionanddelivernormally.
134.%ofwomendeliveringontheirEDDis? a)25% b)50% c)4% d)15% CorrectAnswer-CAns.C.4%BasedontheNoegelesfomulalabourstartsapproximatelyon:-Expecteddate?4%
135.Innercellmassdifferentiatesinto? a)Chorion b)Trophoectoderm c)Embryo d)Alloftheabove CorrectAnswer-CANs.C.EmbryoBlastocystenlarges&thezonapellucidaundergoeslysis,thisiscalledzonahatching.Thecellsontheoutersidebecometrohoectodermwhichdifferentiatesintochorion.Thecellsontheinnersideforminnercellmasswhichdifferentiatesintoembrvo.
136.Embryoiscalled"fetus"afterhowmany weekspostfertilization/conception? a)6 b)8 c)10 d)12 CorrectAnswer-BAns.B.8Embryonicperiodbeginsat3rdweekfollowingovulation/fertilization&extendsupto8weekspostconception(10weeksfromLMP).Fetalperiodbeginsafter8weekspostconception(10weeksfromLMP)&endsindelivery.
137.Utero-placentalcirculationis establisheddaysafterfertilization? a)5 b)10 c)15 d)20 CorrectAnswer-BAns.B.10TheuteroPlacentalcirculationisestablished9-10daysafterfertilization.Fetoplacentalcirculationisestablished2ldayspostfertilization.
138.Pregnancyiscontraindicatedinallofthe followingexcept- a)PrimaryPulmonaryHypertension b)Eisenmenger'ssyndrome c)Marfan'swithaorticrootdilation d)WPWsyndrome CorrectAnswer-DAns,D.WPWsyndrome
139.Whichheartdiseasehastheworst prognosis/maximummortalityinpregnancy? a)MS b)AS c)PDA d)Eisenmenger'ssyndrome CorrectAnswer-DAns.D.Eisenmenger'ssyndrome
140.Ovariancyclecanbecorrelatedwithall except? a)Endometrialsampling b)Vaginalcytology c)Bloodhormonallevels d)Estrouscycle CorrectAnswer-DAns.D.EstrouscycleEstrouscycledoesnotoccurinhumanbeings.
141.Endometrialbiopsytodetectovulationis doneonwhichdayofthemenstualcycle? a)Day8-9 b)Day13-15 c)Day21-23 d)Day3-5 CorrectAnswer-CAns.C.Day21-23EndometrialBiopsy:Rarelydonenowadaysforthepurposeofiletectingovulation.
142.Theuterinebloodflowattermis- a)50mL/min b)100-150mL/min c)350-375mL/min d)500-750mL/min CorrectAnswer-DAns.D.500-750mL/minUteroplacentalbloodflowincreasesprogressivelyduringpregnancyandrangesfrom5N)-800mL/minatterm.
143.Godell'ssignis? a)Duskyhueofthevestibule b)Softeningofthecervix c)Increasedpulsationsfeltthroughthelateralfornices d)Regularandrhythmiccontractionsduringbimanualexamination CorrectAnswer-BAns.B.Softeningofthecervix
144.Infetus,insulinproductionbeginat weeksofgestation- a)4-6 b)8-12 c)14-18 d)24-28 CorrectAnswer-BAns.B.8-12Reaching8to10weeksintodevelopment,thepancreasstartsproducinginsulin,glucagon,somatostatin,andpancreaticpolypeptide.
145.Limbbudappearatwhatweeksof gestation? a)3 b)4 c)6 d)9 CorrectAnswer-BAns.B.4Theupperextremityisfirstdiscretelyvisibleasabulgeorlimbbudthatdevelopsontheventrolateralwalloftheembryoonday26(4-mmcrown-to-rumplength).
146.Featuresofnonsevere/mildpre ecampsiaareallecxept- a)DiastolicBP<100mmHg b)SystolicBP<160mmHg c)MildIUGR d)Nopremonitorysymptoms CorrectAnswer-CAns.,C.MildIUGR
147.FERNINGisdueto? a)Estogen&sodiumchloride b)Progesterone&sodiumchloride c)HCG d)Alloftheabove CorrectAnswer-AAns,A,Estogen&sodiumchlorideCervicalmucusisrelativelyrichinsodiumchloridewhenestrogen(butnotprogesterone)isbeingproduced.
148.Secondwaveoftrophoblasticinvasion occursatweeksofgestation? a)8-11 b)10-12 c)12-15 d)16-20 CorrectAnswer-CAns,C.12-15Thetimingofthedevelopmentoftheuteroplacentalvesselshasbeendescribedinwaves,orstages,overthecourseofgestation.Thefirstwaveoccursbefore12weekspost-fertilizationandconsistsofinvasionandmodificationofthespiralarteriesofthedecidua.Between12and16weekspos-fertilization,thesecondworeoccurs.Thisinvolvesinvasionoftheintramyometrialpartsofthespiralarteries,convertingnarrowlumen,muscularspiralarteriesintodilated,low-resistanceuteroplacentalvessels.
149.Abstinenceperiodbeforesemen analysisis? a)1-2days b)3-5days c)5-7days d)7-9days CorrectAnswer-BAns.B.3-5daysTheidealspecimenforexaminationisafter3-5daysofabstinence.
150.Engagingdiameterinfacepresentation is- a)Suboccipitobregmatic b)Mentovertical c)Submentobregmatic d)Occipitofrontal CorrectAnswer-CANs,C.Submentobregmatic
151.Leastlikelytocausedysmenorrhea- a)Endometriosis b)Adenomyosis c)Uterinepolyp d)Cervicalpolyp CorrectAnswer-DAns,D.Cervicalpolyp
152.LHsurgeisdueto? a)Progesterone b)Estrogen c)AMH d)Alloftheabove CorrectAnswer-BAns,B.Estrogen3-4daysbeforetheovulation,estrogenlevelcrossesacertainlimit(thresholdlevel).
153.Menopauseisdefinedas? a)Presenceofhotflushes b)Cessationofmensesfor1year c)Cessationofmensesfor6months d)Cessationofmensesfor2years CorrectAnswer-BAns,B.Cessationofmensesfor1yearMenopauseisdefinedasthepermanentcessationofmensesfor7yearandisphysiologicallycorrelatedwiththedeclineinestrogensecretionresultingfromthelossoffollicular/ovarianfunction.
154.Symptomsofmenopauseareallexcept? a)Hotflushes b)Nightsweats c)Decreaselibido d)Intermittenthypotension CorrectAnswer-DAns,D.IntermittenthypotensionHotflushesTheclassicsymPtomassociatedwithestrogendeficiencyisthehotflash,alsoknownashotflushThissymptomisdescribedas'recurrent,transientperiodsofflushing,sweatingandasensationofheat,oftenaccompaniedbypalpations,feelingofanxietyandsometimesfollowedbychills".
155.MENOPAUSEisdiagnosedby? a)Estradiol<20pg/ml b)Progesterone<40ng/dl c)FSH>40IU/L d)LH>20IU/L CorrectAnswer-CAns,C.FSH>40IU/LAspertheAmericanAssociationofclinicalEndocrinologists,thediagnosisofmenopauseisconfirmedbyFSHlevels>40IU/L.
156.Thevelocityofspermis? a)1-2cm/hr b)2-4cm/min c)1-4mm/min d)1-4mm/hr CorrectAnswer-CAns.C.1-4mm/minThevelocityofasperminfluidmediumisusually1-4mm/min.Thisallowsthespermtomovetowardsanovuminordertofertilizeit.
157.Afterejaculationsemenliquefiesin? a)10minutes b)30minutes c)75minutes d)120minutes CorrectAnswer-BAns.B.30minutesFollowingejaculation,thesemenformsagelwhichprovidesprotectionforthespermfromtheacidicenvironmentofthevagina.Thegelisliquefiedwithin20-30minutebyenzymesfromtheprostategland.
158.Duringpregnancy,truestatementabout CVSis? a)Cardiacoutputdecreases b)Rightaxisdeviation c)Increaseinleftventricularenddiastolicdiameter d)Alloftheabove CorrectAnswer-CAns,C.Increaseinleftventricularenddiastolicdiameter2Decho:Increaseinleftventricularenddiastolicdiameter.Increaseinleftandrightatrialdiameters.
159.MCsiteofimplantationis? a)Fallopiantubeamullarypart b)Fallopiantubeisthmus c)Fundusofuterus d)Cornuofuterus CorrectAnswer-CAns,C.FundusofuterusImplantationoccursintheendometriumontheanteriororposteriorwallofthebodynearthefundusonthesixthdayfollowingfertilization(correspondingtothe20thdayofthemenstrualcycle).
160.AlphasubunitofhCGissimilarto? a)FSH b)LH c)TSH d)Alloftheabove CorrectAnswer-DAns,D.AlloftheaboveHumanchorionicGonadotropin(hcG)isstructurallyrelatedtothreeotherglycoproteinhormonesLH,FSH,andTSH.
161.Placentalhormonewithhighest carbohydratecontentis- a)HCG b)Humanpregnancyspecificbetaglycoprotein c)HPL d)Relaxin CorrectAnswer-AAns,A.HCGHCGhasthehighestcarbohydratecontentofanyhumanhormone-30%.
162. Thepelvicinletusuallyisconsideredto becontractedifitsshortest anteroposteriordiameterislessthan- a)12cm b)10cm c)8cm d)14cm CorrectAnswer-BAns.B.10cmThepelvicinletusuallyisconsideredtobecontractedifitsshortestanteroposteriordiameterislessthan10cmorifthegreatesttransversediameterislessthan12cm
163.AzoospermiawithnormalFSHwould indicate? a)Hypothalamicfailure b)Testicularfailure c)Obstructionofvasdefrens d)Alloftheabove CorrectAnswer-CAns,C,Obstructionofvasdefrens
164.Causesofmaleinfertility? a)Idiopathic b)Varicocele c)Yq11microdeletion d)Alloftheabove CorrectAnswer-DAns,D.Alloftheabove
165.Fetalthyroidglandisabletosynthesize hormonesbyweeksofgestation? a)6-7 b)7-8 c)10-12 d)12-14 CorrectAnswer-CAns,C.10-12Fetalthyroidglandisabletosynthesizehormonesby10-12weeksofgestation.
166.PoorprognosisinfirsttrimesterUSGis ? a)Nofetalpoleat5weeks b)Nocardiacactivityat5weeks c)Nogestationalsacat4weeks d)Nocardiacactivityat8weeksofgestation CorrectAnswer-DAns,D.Nocardiacactivityat8weeksofgestationAbsenceofembryowithheartbeat22weeksafterascanthatshowedagestationalsacwithoutayolksac
167.Allaretrueaboutpostpartum depressionexcept- a)Symptomsresolvein10-12days b)Affectsbothsexes c)SSRIsareeffective d)Noneoftheabove CorrectAnswer-AAns,A.Symptomsresolvein10-12days
168.NerveinjuredinMcRobertsmaneuveris ? a)Lumbosacraltrunk b)Obturatornerve c)Femoralnerve d)Pudendalnerve CorrectAnswer-CAns,C.FemoralnerveMcRobertsmaneuveristobedoneincasesofshoulderdystocia.Whenthematernalthighsaremarkedlyflexedandabducted,pressurefromtheoverlyinginguinaliigamentmayleadtofemoralnerveinjury.
169.Mostconclusiveclinicalsignof pregnancyis? a)Uterineenlargement b)Cervicalsoftening c)Amenorrhea d)Fetalheatsoundauscultation CorrectAnswer-DAns.D.FetalheatsoundauscultationFHSauscultationisthemostconclusiveclinicalsignofpregnancy.
170.CRLwhencardiacactivitycanbe detectedearliestbyTVS- a)1-4mm b)1cm c)6-7mm d)2-4cm CorrectAnswer-AAns,A.1-4mmFetalheartbeatcanbedetectedasearlyasjustunder6weeksgestationongoodquality,highfrequencytransvaginalultrasound,asacrownrumplength(CRL)ofaslittleas1-2mm.
171.Kamla,30yearsold,P2L2with3.2x4.1 cmfibroiduterus,complainsofmenorrhagiaandisonsymptomatictreatmentsince6months.Thepatientrefusessurgery.Nextlineofmanagementis? a)GnRHanalogs b)Danazol c)Myomectomy d)Uterinearteryembolization CorrectAnswer-DAns,D.UterinearteryembolizationUAEcanbeusedasatherapyforsymptomaticpatientswhorefuseorwanttoavoidsurgery.Afterembolization,thereis60-65%decreaseinsizeoffibroidsoveraperiodof6-9months,andsothepatient'ssymPtomsmaydecreaseordisaPPear.Ifthepatientisstillsymptomaticafter1year,thensurgeryshouldbeconsidered.
172.Livingligatureoftheuterusis? a)Endometrium b)Middlelayerofmyometrium c)Innerlayerofmyometrium d)Parametrium CorrectAnswer-BAns,B.MiddlelayerofmyometriumMiddlecrisscrossfibresactaslivingligatureduringinvolutionoftheuterusandpreventbloodloss.
173.Inpartogramsrecommendedby'WHO' thedistancebetweenthealertandactionlinesis? a)1hour b)2hours c)4hours d)5hours CorrectAnswer-CAns.C.4hoursTheconceptofalertline'and`actionline'wasintroducedbyPhilpottandCastlein1972.Theactionlinecanbeplacedat2?4hoursintervaltotherightandparalleltoalertline.Inpartogramsrecommendedby'WH0'thedistancebetweenthealertandactionlinesis4hours.
174.Surgicalexcisionofcorpusluteum beforeweeksofgestation,resultsinmiscarriage a)6-7 b)9-11 c)11-12 d)12-14 CorrectAnswer-AAns,A,6-7Surgicalexcisionofcorpusluteum(luteoctomy)before7weeksofgestation,uniformlyprecipitatedanabruptdecreaseinserumprogesteroneconcentrationfollowedbymiscarriage
175.Factorsresponsiblefordevelopmentof OHSSinclude? a)Histamine b)Cytokines c)VascularEndothelialGrowthFactor d)Alloftheabove CorrectAnswer-DAns,D.AlloftheaboveVEGFisconsideredtobethemostimportant.
176.MVAsyringeisusedfor? a)FirsttrimesterMTP b)2ndtrimesterMTP c)Vacuumdelivery d)Alloftheabove CorrectAnswer-AAns,A,FirsttrimesterMTPManualvacuumaspiration(MvA)isasafeandeffectivemethodofabortionthatinvolvesevacuationoftheuterinecontentsbytheuseofahand-heldplasticaspirator.Itisappropriatefortreatmentofincompleteabortionforuterinesizesupto12weeksfromthelastmenstrualperiod(includingmiscarriage,spontaneousabortionandremovalofretainedproductsfromaninducedabortion),first-trimesterMTPandendometrialbiopsy.
177.Diihrssenincisionistakenon- a)Fallopiantube b)Ovary c)Incompletelydilatedcervix d)Fullydilatedcervix CorrectAnswer-CAns,C,IncompletelydilatedcervixOccasionallnespeciallywithsmallpretermfetuses,theincompletelydilatedcervixwillnotallowvaginaldeliveryoftheafter-comingheadofthebreech.Insuchcases,Duhrssenincisionsareusuallynecessary(cutthecervixatl0and2o'clockpositions).
178.A27-year-oldfemalewithplacentaprevia hadseverebleeding.Whatisthemostlikelyoutcomepostdelivery? a)Galactorrhea b)Diabetes c)Absenceofmenstrualcycle d)Cushingsyndrome CorrectAnswer-CAns.c.AbsenceofmenstrualcycleSheehansyndrome,alsoknownaspostpartumhypopituitarismorpostpartumpituitarynecrosis,ishypopituitarismcausedbynecrosisduetobloodlossandhypovolemicshockduringandafterchildbirth.MostcommoninitialsymptomsofSheehansyndromeareagalactorrhea(absenceoflactation)underdifficultieswithlactation.Manywomenalsoreportamenorrheaoroligomenorrheaafterdelivery.
179.Womanhas100mlbloodlossevery30 days.Thisiscalledas? a)Menorrhagia b)Polymenorrhea c)Hypomenorrhea d)Normalmenses CorrectAnswer-AAns.A.MenorrhagiaNormalbloodlossduringmensesisaround35ml(20-80ml)Bloodlossmorethan80mlismenorrhagia
180.Menometrorrhagiais? a)Heavyperiods b)Intermenstrualbleeding c)Heavy&irregularbleeding d)Uterinebleedingoccurringatregularintervalsoflessthan21 days CorrectAnswer-CAns.C.Heavy&irregularbleeding
181.Prevalenceofbreechpresentationatfull termis? a)10% b)6-7% c)3-4% d)1-2% CorrectAnswer-CAns.C.3-4%
182.Theshortestconjugateis? a)Trueconjugate b)Obstetricconjugate c)Diagonalconjugate d)Anatomicalconjugate CorrectAnswer-BAns.B.ObstetricconjugateObstetricconjugate(10cm)DistancebetweenmidpointofsacralPromontorytotheprominentbonyprojectioninthemidlineoninnersurfaceofsymphysispubis.
183.Shortesttransversediameteris? a)BPD b)Bitemporaldiameter c)Bimastoiddiameter d)Allareequalinlength CorrectAnswer-CAns.C.BimastoiddiameterBimastoiddiameter=7.5cmOccipitofrontaldiameter11.5cm
184.Withreferencetofetalheartrate,a nonstresstestisconsideredreactivewhen? a)Twofetalheartrateaccelerationsarenotedin20minutes b)Onefetalheartrateaccelerationisnotedin20minutes c)Twofetalheartrateaccelerationsarenotedin10minutes d)Threefetalheartrateaccelerationsarenotedin30minutes CorrectAnswer-AAns.A.Twofetalheartrateaccelerationsarenotedin20minutesReactive(Reassuring)NSTTwoormoreaccelerationsof>15beats/minuteabovethebaseline,lastingfor>75secondsarcpresentin20-4Ominutesobservationperiod.
185.Variabledecelerationisseenin? a)Headcompression b)Uteroplacentalinsufficiency c)Cordcompression d)Noneoftheabove CorrectAnswer-CAns,C.CordcompressionVariabledecelerationsareduetocordcompression(oligohydramniosinlabor)
186.ModifiedBIOPHYSICALPROFILEis? a)NST+FETALTONE b)FETALTONE+AFI c)NST+AFI d)NST+FETALTONE+AFI CorrectAnswer-CAns,C.NST+AFIModifiedBPP=NST&AFIBPPhas5components
187.Iffetusishavinghypoxia,whichofthe BPPparameterwillbeaffectedlast? a)Fetaltone b)Fetalbreathingmovement c)Fetalmovements d)NST CorrectAnswer-AAns.A.FetaltoneFirstactivitytoappear,FetalToneatabout7.5-8.5weeks,isalsopresumablythelastactivitytodisappearwithprogressivelyworseninghypoxia.
188. Testusedtodetectgeneticabnormality inembryo,beforetransferringittothe uterusinIVFis? a)Embryocellbiopsy b)CVS c)ICSI d)Alloftheabove CorrectAnswer-AAns,A.EmbryocellbiopsyPGD,involvesremovingacellfromanIVFembryototestitforaspecificgeneticcondition(cysticfibrosis'forexample)beforetransferringtheembryototheuterus.
189.InIVF,embryosaretransferredbackto uterinecavityatcellsstage? a)2 b)2-4 c)4-8 d)8-16 CorrectAnswer-CAns,C.4-8Typicallyembryosatetransferredatthecleavagestage(Day2or3afteroocyteretrieval).Daythreeembryosatecalledcleavagestageembryosandhaveapproximately4-8cells.
190.Azoospermicpatientcanbeafatherofa child,bywhichofthefollowing? a)IUI b)ZIFT c)ICSI d)Notpossible&counselregardingadoption CorrectAnswer-CAns.C.ICSIPESA=percutaneousepididymalspermaspirationMESA=microscopicepididymalspermaspirationTESA=testicularspermasPirationTESE=testicularspermextraction(testicularbiopsy)
191.Aprimigravidawith36weeksof pregnancyisinlaborwith3cmdilatationandminimaluterinecontraction.Onruptureofmembranes,freshbleedingisnotedwithlatefetaldecelerationupto50beats/min.ThepatientwastakenforLSCSbutfetuscouldnobesaved.Noabruptioorplacentapreviawasseen.Thelikelydiagnosisis? a)Placentaprevia b)Revealedabruptio c)Circumvallateplacenta d)Vasaprevia CorrectAnswer-DAns.D.VasapreviaVasaprevia(l:2500)isarareconditioninwhichfetalbloodvesselsareinfrontofthepresentingpartandcrossthecervix.Theconditionhasahighfetalmortalityrate(50-95%).Thisisattributedtorapidfetalexsanguination,resultingfromthevesselstearingwhenthecervixdilates,membraneruPture.
192.AllarecomponentsofActive ManagementoftheThirdStageofLaborexcept? a)Uterotonicagentwithin1minuteofbirth b)Massageofuterusbeforecontrolcordtraction c)Controlcordtraction d)Noneoftheabove CorrectAnswer-BAns.B.MassageofuterusbeforecontrolcordtractionAdministeranuterotonicdrugatthedeliveryoftheanteriorshoulderorafterwards,withinoneminuteofthebaby'sbirth.BeforeperformingAMTSL,gentlypalpatethewoman'sabdomentoruleoutthepresenceofanotherbaby.Atthispoint,donotmassagetheuterus.PerformcontrolledcordtractionMassagetheuterusimmediately
193.Withwhichofthefollowingevents,the fetomaternalhaemorrhageriskistheleast? a)Amniocentesis b)Cordocentrsis c)Chorionicvillussampling d)Abruption CorrectAnswer-DAns.D.Abruption
194.Infertilityisdefinedas? a)Inabilitytoconceiveafter1yearofregularunprotected intercourse b)Inabilitytoconceiveafter1yearofmarriage c)Inabilitytoconceiveafter2yearsofmarriage d)Inabilitytoconceiveinspiteof2yearsofregularunprotected intercourse CorrectAnswer-AANS.A.Inabilitytoconceiveafter1yearofregularunprotectedintercourseInfertilityisdefinedasaninabilitytoconceiveinspiteof1yearofregularunprotectedintercourse
195.Cordprolapseisleastlikelywith- a)Transverselie b)Footlingbreech c)Oligohydroamnios d)Floatinghead CorrectAnswer-CAns.C.OligohydroamniosCordprolapsehasbeendefinedasthedescentoftheumbilicalcordthroughthecervixalongside(occult)orpastthepresentingpart(overt)inthevaginaoroutsidethevulvainthepresenceofrupturedmembranes
196.IdealtimetodoGlucosechallengetestin pregnancyis? a)12-16weeks b)20-24weeks c)24-28weeks d)30-34weeks CorrectAnswer-CAns.C.24-28weeksO'sullivanBloodSugarScreeningTest(GlucoseChallengeTest)Theidealtimetodothistestis24-28weeksofgestation(asinsulinresistanceinpregnancyismaximumat28weeksofgestation)
197.AfterIUFD,whendoesthemother developDIC- a)48hours b)1-2weeks c)3-4weeks d)6weeks CorrectAnswer-CAns.C.3-4weeksThromboplastinfromthedeadfetuscanenterthematernalsystemandcauseDIC.Thisonlyhappenswhenthedeadfetusisretainedinsidefor3-4weeks.
198.Folicacidrequiredinfirsttrimesterof normalpregnancy- a)100microgram b)400-500microgram c)4mg d)5mg CorrectAnswer-BAns,B,400-500microgramSomeNTDsareassociatedwithaspecificmutationinthemethylenetetrahydrofolatereductasegene,theadverseeffectsofwhichcanbelargelyovercomebypericonceptionalfolicacidsupplementation.MorethanhalfofNTDscouldbepreventedwithdailyintakeof400microgramoffolicacidthroughoutthepericonceptionalperiod.Awomanwithapriorpregnancycomplicatedbyaneuraltubedefectcanreducethe23%recurrenceriskbymorethan70%ifshetakes4mgoffolicacidforthemonthbeforeconceptionandforthefirsttrimesterofpregnancy.
199.A30-year-oldis14weekspregnant.She hadtwopainlessdeliveriesat16weeksearlier.Nextlineofmanagementis? a)Cervicalencerclage b)Evaluationfordiabetesmellitusandthyroiddisorders c)Cervicallengthassessment d)Tocolytics CorrectAnswer-CAns,C.CervicallengthassessmentThepatienthadtwopainlessabortionsat16weeksinthepast,somostlyitisacaseofincompetentos.Nextlineofmanagementinthesepatientsisfrequentcervicallengthassessment:clinicallyorbyUSG.Thepatientisevaluatedmorefrequentlyandifthecervixisshort(lessthan2.5cm)thancervicalencerclagehastobedone.Cervicalencerclageisthesurgeryofchoiceforincompetentos,butthesurgeryitselfcanleadtocomplicationssuchasuterinecontractions,abortions,andPROM.Sothesurgeryisonlytobedoneifitisindicated.
200.Uppertwo-thirdanteriorvaginalwall prolapseis? a)Cystocele b)Urethrocele c)Rectocele d)Enterocele CorrectAnswer-AAns.A.Cystocele
201.EarliestsignafterIUFDis? a)Overlappingofskullbones b)Hyperflexionofspine c)Gasingreatvessel d)Overcrowdingofribs CorrectAnswer-CAns.C.GasingreatvesselRobertsign(gasingreatvessels)-12hrsafterdeath.
202.TrueaboutGartnerscystis? a)RetentioncystinremnantsofWolffianduct b)Arisesfrommullerianduct c)Commonlyarisesfromcervix d)Impulseoncoughing CorrectAnswer-AAns,A.RetentioncystinremnantsofWolffianduct
203.Iftheanalspincterisinjured,itiswhich degreeofPerinealTear? a)First b)Second c)Third d)Fourth CorrectAnswer-CAns,C.ThirdPerinealTearsareclassifiedintofourcategoriesFirst-degreetear:lacerationislimitedtothefourchetteandsuperficialperinealskinorvaginalmucosa.Second-degreetear:lacerationextendsbeyondfourchette,perinealskinandvaginalmucosatoperinealmusclesandfascia,butnottheanalsphincter.Third-degreetear:fourchette,perinealskin,vaginalmucosa,muscles,andanalsphincteraretorn
204.Iftherectalmucosaisinjured,itiswhich degreeofPerinealTear? a)First b)Second c)Third d)Fourth CorrectAnswer-DAns,D.FourthRectalmucosaltearisfourthdegreetear.
205.Cryptomenorrheaoccursin? a)Fibroids b)PCOS c)Imperforatehymen d)Alloftheabove CorrectAnswer-CAns,C.ImperforatehymenCongenitalImperforatehymen:ItisduetofailureofdisintegrationofthecentralcellsofMullerianeminencethatprojectintourogenitalsinusTransversevaginalsePtumAtresiaofvagina,cervix.
206.Bestindicatorforovarianreserveis? a)AMH b)LH/FSHratio c)FSH d)Estradiol CorrectAnswer-AAns.A.AMHAMHbloodlevelsarethoughttoreflectthesizeoftheremainingeggsupplyor"ovarianreserve"
207.HPLhasactivitysimilartowhich hormone? a)Oxytocin b)Growthhormone c)Insulin d)Alloftheabove CorrectAnswer-BAns.B.GrowthhormoneHumanplacentalactogen(hPL)wasnamedso,becauseofitspotentlactogenic&growthhormonelikebioactivityaswellasimmunochemicalresemblancetohumangrowthhormone'
208.Whichofthefollowingisnotasoft tissuemarkerofDownsyndromeonUSG? a)IncreaseNT b)Absentnasalbone c)Exomphalos d)Polydactyly CorrectAnswer-DAns.D.Polydactyly
209.Inacaseofrecurrentspontaneous abortionthefollowinginvestigationisunwanted? a)Hysteroscopy b)Testingforantiphospholipidantibodies c)TestingforTORCHinfections d)Thyroidfunctiontests CorrectAnswer-CAns.C.TestingforTORCHinfectionsTestingforTORCHinfectionsisnowthoughttobeunwarranted.
210.Dilatation&evacuationisdoneforall ecxept? a)Inevitableabortion b)Incompleteabortion c)Threatenedabortion d)Noneoftheabove CorrectAnswer-CAns.C.ThreatenedabortionInevitableabortionmeanstheprocessofexpulsionofproductsofconceptionhasbecomeirreversible.Theexpulsionofproductsofconceptionhasnotoccurredbutitisboundtohappenandnothingcanbedonetostopthisprocess.Whentheentireproductsarenotexpelled,partofitisleftinsidetheuterinecavity,itiscalledincompleteabortion.
211.WHOnormalHbvalueforanonpregnant adultfemaleis? a)10gm/di b)11gm/dl c)12gm/dl d)13gm/dl CorrectAnswer-CAns.C.12gm/dl
212.Outcomesofoccipitoposteriorposition? a)Deeptransversearrest b)Occipitosacralarrest c)Facetopubisdelivery d)Alloftheabove CorrectAnswer-DAns,D.Alloftheabove
213.RMPcanperformMTPinfirsttrimesterif hehasassistedinMTPs- a)5 b)15 c)25 d)50 CorrectAnswer-CAns,C.25Aregisteredmedicalpractitionershallhaveoneormoreofthefollowingexperienceortrainingingynecologyandobstetricsnamely=Ifhehasassistedaregisteredmedicalpractitionerintheperformanceoftwenty-fivecasesofmedicalterminationofpregnancyofwhichatleastfivehavebeenperformedindependently,
214.Cryingoffetusinuteroiscalledas? a)Vagitusuterinus b)Firstcry c)Uterovaginalis d)Vagitusvagina CorrectAnswer-AAns,A.Vagitusuterinus
215.Trueaboutcephalhematomais: a)Crossesthesuturelines b)Alwayspresentatbirth c)Ventousedeliveryisariskfactor d)Alloftheabove CorrectAnswer-CAns.C.VentousedeliveryisariskfactorTheusualcausesofacephalohematomaareaprolongedsecondstageoflabororinstrumentaldelivery,particularlyventouse.
216.Allarecausesofanovulatory amenorrhoeaexcept? a)PCOD b)Hyperprolactemia c)Gonadaldysgenesis d)Drugs CorrectAnswer-CAns.C.GonadaldysgenesisCausesofanovulatoryamenorrheaPCODHyperprolactinaemiaWeightloss,stress,exerciseDrugsChestwallstimulation
217. Whatisfalseaboutpostmenopausal state? a)LowLH b)Lowestrogen c)HighFSH d)Highandrogen CorrectAnswer-AAns.A.LowLHHormonalchangesinpost-menoPausalstateFSHlevelisincreasedOestrogenlevelisdecreased&mostofitissynthesisedperipherallybyconversionofandrogentooestrogenAndrogenlevelisslightlyincreased
218.Inapostmenopausalfemale,which hormoneincreases? a)FSH b)Estrogen c)GH d)Noneoftheabove CorrectAnswer-AAns,A.FSH
219.Roleoflactobacilliinvaginalsecretions a)TomaintainalkalinepH b)TomaintainacidicpH c)Nutrition d)None CorrectAnswer-BAns.,B.TomaintainacidicpHTheimportanceofDoderlein'sbacillusisthatitspresenceisassociatedwithproductionoflacticacidcontainedinthevaignaandthisacidityinhibitsthegrowthofotherorganisms."Doderlein'sbacillusistheonlyorganismwhichwillgrowatthepHof4-4.5(normalpHofvagina).
220.Hegarsignallaretrueexcept? a)Bimanualpalpationmethod b)Difficultinobese c)Canbedoneat14weeks d)Presentin2/3rdofcases CorrectAnswer-CAns.C.Canbedoneat14weeksHegar'ssign:Presentin2/3rdofcases.Demonstratedbetween6-10weeks,alittleearlierinmultipara.Thissignisbasedonthe2facts(1)upperpartofthebodyofuterusisenlargedbygrowinguterusandlowerpartisemptyandsoftandcervixiscomparativelyfilm.Thereforeonbimannualexamination(2fingersintheanteriorfornixandabdominalfingersbehindtheuterus),abdominalandvaginalfingersseemtoapposebelowthebodyoftheuterus.
221.Hegarsignisseeninhowmanyweeks? a)6-10weeks b)10-14weeks c)14-18weeks d)18-22weeks CorrectAnswer-AAns.A.6-10weeks
222.Palmersignisrelatedto? a)Contractionofuterus b)Duskyhueofantvaginalwall c)Bluishdiscolourationofantvaginalwall d)Increasedpulsationsfeltthroughlateralfornix CorrectAnswer-AAns,A,ContractionofuterusPalmersign:-regularandrhythmiccontractionscanbeelicitedduringbimanualexaminationasearlyas4-8weeks.
223.Newborncanbegivenbreastmilkafter howmuchtimefollowingnormaldelivery? a)Halfhour b)1hours c)2hours d)3hours CorrectAnswer-AAnsA.HalfhourAhealthybabyisputtothebreastimmediatelyoratmost%to1hrfollowingnormaldelivery.Followingcaesareansectionsaperiodof4-6hoursmaybesufficientforthemothertofeedherbaby.
224.4monthamenorrhoeawithincreased FSH,LH&decreasedestrogenina35yrsold? a)Prematuremenopause b)Menopause c)Latemenopause d)Perimenopause CorrectAnswer-AAns,A.PrematuremenopausePrematuremenopauseisdefinedasovarianfailureoccurring2SDinyearsbeforethemeanmenopausalageinapopulation.Itisclinicallydefinedassecondaryamenorrheaforatleast3monthswithraisedFSHlevel,raisedFSH:LHratio&lowE2levelinawomenunder40yrsofage."
225.35yroldwith4monthsamenorrheawith increasedFSH,decreasedestrogen.Whatisthediagnosis? a)Prematureovarianfailure b)PCOD c)Pituitaryfailure d)Hypothalamicfailure CorrectAnswer-AAns.A.PrematureovarianfailureItisacaseofprematuremenoPause(prematureovarianfailure)'
226.Contractionstresstestfalseis? a)Oxytocinnotused b)Invasivemethod c)Detectsfetalwellbeing d)Negativetestisassociatedwithgoodfetaloutcome CorrectAnswer-AAns,A.OxytocinnotusedContractionstresstest(CST)(syn:Oxytocinchallengetest):Itisaninvasivetesttoassesfetalrespiratorywellbeingduringpregnancy.ItdetectsalterationinFHRinresponsetouterinecontractioninducedbyoxytocinindicatinghypoxia.InterpretationsNegativetestindicatedgoodoutcome
227.NST,whatisseenexcept? a)Variability b)Acceleration c)Timeperiod d)Oxytocin CorrectAnswer-DAns,D.OxytocinThenon-stresstest(NST)measuresfetalheartrate,whichismonitoredwithanexternaltransducerforatleast20minutes.Duringfetalmovement,tracingisobservedforheartrateacceleration.Testispositiveiftwoormorefetalheartrateaccelerationsoccursin20minuteperiod.
228.Menstrualregulationeffectiveupto? a)14days b)21days c)4weeks d)6weeks CorrectAnswer-AAns,A.14daysMenstrualregulation(lnduction/Aspiration)Aspirationofendometrialcavitywithinl4daysofmissedperiodinawomanwithpreviousnormalcycle.DoneasanOPDprocedure.Helpstodetectfailedabortion,molarpregnancyorectopicPregnancy.Contraindicatedinadvancedpregnancy&inpresenceoflocalpelvicinflammation.
229.pHofvaginainpregnantwomanis usually? a)4.0 b)4.5 c)5 d)>5 CorrectAnswer-AAns.A.4.0Thevaginalacidityisduetolacticacid.ThenormalpHinthehealthywomenofthechildbearingagegroupis4.5
230.VaginalpHbeforepubertyis? a)7 b)6 c)4.5 d)5 CorrectAnswer-AAns.A.7
231.Decidualreactionisduetowhich hormone? a)Progesterone b)Estrogen c)LH d)FSH CorrectAnswer-AAns.A.ProgesteroneIncreasedstructural&secretoryactivityoftheendometriumthatbroughtaboutinresponsetoprogesteronefollowingimplantationisknownasDecidualreaction".
232.Inhibinlevelsarecheckedonwhichday ofmenstrualcycle? a)Day3 b)Day4 c)Day5 d)Day6 CorrectAnswer-AAns.A.Day3Ovarianreservetestisdesignedtoassessboththenumberofimmatureeggsintheovariesandtheirquality,whichgivesanindicationofwoman'spotentialfertility.Itworksbydetectingthelevelsofthreefemalehormones,usingabloodsampletakenondaythreeofmenstrualcycle: 1. Folliclestimulatinghormone(FSH)2. Anti-mullerianhormone(AMH)3. Inhibin-B
233.Besttestforovulation? a)Serumestrogen b)Serumprogesterone c)Both d)None CorrectAnswer-BAns.B.SerumprogesteronePlasmaconcentrationofprogesteronerisesafterovulation&reachespeakof15ng/mlatmidlutealphase&thendeclinesasthecorpusluteumdegenerates".
234.Cardiacoutputincreasesmaximumat whichweek? a)26-28wks b)30-32wks c)32-34wks d)34-36wks CorrectAnswer-CAns.C.32-34wksCardiacoutput:Startstoincreasefrom5thweekofpregnancy,reachesitspeak40-50%atabout30-34weeks.
235.Inpregnancyplasmavolumeincreased maximumatwhatgestationalage? a)10wks b)20wks c)25wks d)30wks CorrectAnswer-DAns,D.30wksPlasmavolumeisincreased.Startingtoincreaseat6weeks&reachingmaxupto50%at30weeks.Totalplasmavolumeincreasestotheextentof1.25litres.
236.5monthpregnantfemale,whichofthe followingistrue? a)50%havesoftsystolicmurmur b)Cardiacoutputisreduced c)Systemicvascularresistanceisincreased d)IncreaseinCVP CorrectAnswer-AAns.A.50%havesoftsystolicmurmurAnatomicalchangesduringpregnancyHeartispushedupwards&outward.Apexbeatisshiftedin4thintercostalsspace.Asystolicmurmurcanbeheardinapicalorpulmonaryarea.Mammarymurmurisacontinuoushissingmurmuraudibleovertricuspidareainleft2nd&3rdiintercostalsspace.ECGshowsleftaxisdeviation.53andrarely54canbeheard.
237.Spinnbarkeitismaximumshownat whichphase? a)Menstrualphase b)Ovulatory c)Postovulatory d)Prefollicular CorrectAnswer-BAns.B.OvulatorySpinnbarkeittest(ThreadtestorFerntest)AsPecimenofcervicalmucuswhenseenunderlowpowermicroscope,showsacharacteristicfernformation.Donetoseetheestrogenicactivityinovulatoryphaseofmenstrualcycle.
238.Rarestpresentationis? a)Cephalic b)Breech c)Shoulder d)Vertex CorrectAnswer-CAns.C.Shoulder
239.Fertileperiodoffemaleismeasuredby? a)LH b)FSH c)Estrogen d)Oxytocin CorrectAnswer-AAns,A.LH"LHsurgefromtheanteriorpituitaryglandoccurs24hourspriortoovulation.Radioimmunoassaysofthemorningsampleofurine&bloodgivesresultsin3hours.NotonlydoestheLHsurgehelpinpredictingovulation,buttheapproximatetimeofovulationcanbegauged&coitusaroundthistimecanimprovethechancesofconception."
240.Externalversionisdoneafter? a)34weeks b)36weeks c)38weeks d)40weeks CorrectAnswer-BAns.B.36weeksThemaneuveriscarriedoutafter36weeksinlabour-deliverycomplex."
241.Leastcommonpresentationoftwins? a)Bothvertex b)Bothbreech c)Bothtransverse d)Firstvertexand2ndtransverse CorrectAnswer-CAns.C.BothtransverseLie-Presentationintwinpregnancy:Themostcommonlieinthefetusesislongitudinal(90%).Thecombinationofpresentationoffetusesare:Bothvertex(50%)Firstbreechsecondvertex(10%)Firstvertexandsecondtransverse(rare)Firstyertexandsecondbreech(30o/o)Bothbreech(10%)Bothtransverse(rarest).
242.
Presentingpartintransverselie? a)Shoulder b)Face c)Vertex d)Brow CorrectAnswer-AAns.A.Shoulder'Whenthelongaxisofthefetusliesperpendicularothematernalspineorcentraliseduterineaxis,itiscalledtransverselie.Butmorecommonly,fetalaxisliesobliquetothematernalspine&isthencalledobliquelie.Ineitheroftheconditionsshoulderusuallypresentsoverthecervicalopeningduringlabour&botharecollectivelycalledshoulderpresentations."
243.Severelyanaemicpregnantpatientin cardiacfailure.Choiceoftransfusion? a)Platelets b)Packedcells c)Wholeblood d)Exchangetransfusion CorrectAnswer-BAns.B.Packedcells
244.Hydropsfetalisisdueto? a)Rhmismatch b)Hyperproteinemia c)Placentalhypoplasia d)Alloftheabove CorrectAnswer-AAns.A.Rhmismatch
245.Caputsuccedaneumindicatesthatfetus wasalivetill? a)Immediatelyafterbirth b)Till2-3daysafterbirth c)2-3weeksafterbirth d)2-3monthsafterbirth CorrectAnswer-AAns.A.ImmediatelyafterbirthCaPutsuccedaneumFormationofswellingduetostagnationoffluidinthelayersofscalpbeneaththegirdleofcontact.Boggydiffuseswelling,notlimitedtomidline.Disappearsspontaneouslywithin24hours.Usuallyoccursafterruptureofmembranes.
246.Caputsuccedeumissaidtooccurin baby? a)Within24hrs b)2-3days c)2-3weeks d)2-3months CorrectAnswer-AAns.A.Within24hrs
247.Foruterineprolapseinpregnancy,Ring pessarycanbeinsertedupto? a)12weeks b)14weeks c)16weeks d)18weeks CorrectAnswer-DAns.D.18weeksPessarytreatmentforProlaPseItdoesnotcuretheprolapse,onlygivessymptomaticreliefbystretchingthehiatusgenitalis,thuspreventingtheuterine&vaginaldescent.IndicationsofPessarYEarlYPregnancy-uPto18weeksPuerPeriumPatientsabsolutelyunfitforsurgeryPatientsunwillingforoperationWhilewaitingforsurgeryAdditionalbenefitslikeimprovementofurinarysymptoms
248.Notamethodfordeliveryofafter-coming headofbreech? a)Forcepsmethod b)BurnsandMarshallmethod c)Malarflexionandshouldertraction d)Halfhandmethod CorrectAnswer-DAns.D.HalfhandmethodMethodsofdeliveryofaftercomingheadareBurns-MarshallmethodForcePsdeliveryMalarflexionandshouldertraction(modifiedMauriceau-Smellie-Veittechnique)
249.Investigationofchoiceinpost menopausalbleeding? a)PAPsmear b)Laproscopy c)Fractionalcurettage d)Ultrasound CorrectAnswer-CAns.,C.Fractionalcurettage
250.PreferredIUDformenorrhagea? a)NOVAT b)CuIUD c)Mirena d)Gynefix CorrectAnswer-CAns.C.Mirena
251.Preferredtreatmentformenorrhageain reproductiveagegroup? a)NOVAT b)CuIUD c)OCPs d)Hysterectomy CorrectAnswer-CAns.C.OCPs
252.Drugnotusedcommonlyfor menorrhagea? a)Methergin b)Clomiphene c)GnRH d)NSAIDS CorrectAnswer-AAns.A.Methergin
253.Drugcausingabruptionplacenta? a)Methadone b)Cocaine c)Amphetamine d)Fluoxetine CorrectAnswer-BAns.B.Cocaine
254.
ClassicalCsectionindicatedin? a)CACervix b)Centralplacentapraevia c)Failedinduction d)Fetaldistress CorrectAnswer-AAns.A.CACervix
255.DefinitiveindicationofLSCS? a)Mentoant b)Contractedpelvis c)Occipitoposterior d)Vertex CorrectAnswer-BAns,B.Contractedpelvis
256.Afterdeliveryuptowhichweekisknown aspuerperium? a)2weeks b)4weeks c)6weeks d)8weeks CorrectAnswer-CAns.C.6weeksImmediatepuerperium:24hEarlypuerperium:upto1weekRemotepuerperium:upto6weeks
257.Whichofthesestepsisfollowedfirstfor themanagementofshoulderdystociaafterMcRobertsmaneuver? a)Sharpflexionofhipjointstowardsabdomen b)Suprapubicpressure c)90degreerotationofposteriorshoulder d)Emergencyc-section CorrectAnswer-BAns.B.SuprapubicpressureApplyingagentlesuprapubicpressureisthefirststepinmanagementofshoulderdystociaafterMcRobertsmaneuver.Mnemonic"HELPERR"asaguidefortreatingshoulderdystocia:"H"standsforhelp"E"standsforevaluateforepisiotomy."L"standsforlegs(pullyourlegstowardyourstomachMcRobertsmaneuver)"P"standsforsuprapubicpressure"E"standsforentermaneuvers(internalrotationofbaby'sshoulders)"R"standsforremovetheposteriorarmfromthebirthcanal."R"standsforrollthepatient.
258.Peripartumcardiomyopathyoccursat- a)Within7days b)Within6weeks c)Within24months d)Within5months CorrectAnswer-DAns.D.Within5monthsPPCMisastructuralheartmusclediseasethatoccursinwomeneitherattheendofpregnancyoruptofivemonthsaftergivingbirth.Pearson'sdiagnosticcriteriaforperipartumcardiomyopathy:Developmentofcardiacfailureinthelastmonthofpregnancyorwithin5monthsafterdeliveryAbsenceofanidentifiablecauseforthecardiacfailureAbsenceofrecognizableheartdiseasepriortothelastmonthofpregnancy,andLeftventricularsystolicdysfunctiondemonstratedbyclassicechocardiographiccriteria,suchasdepressedejectionfractionorfractionalshorteningalongwithadilatedleftventricle.
259.Nervemostlycompressedinpregnancy puerperium: a)Radialnerve b)Mediannerve c)Femoralnerve d)Facialnerve CorrectAnswer-CAnsC.FemoralnerveThemostcommonpostpartumnerveinjuryisfootdropduetoinjurytotheperonealnerveandinjurytothelateralfemoralcutaneousnerve.Obstetriciansmayconsiderfrequentpositionchangesinlabor,avoidanceofprolongedhipflexion,andshorteningthepushingtimebyallowingforpassivedescentofthefetusbeforepushingbeginsasmeansofavoidinglateralfemoralcutaneousnerveinjury.
260.Inpregnancywhichofthefollowinglevel isalteredmostly: a)TotalT3 b)FreeT3 c)FreeT4 d)TSH CorrectAnswer-AAnsA.TotalT3TotalT3levelsarealteredthroughoutpregnancy.Hormonesduringpregnancy: Increased Decreased Unchanged GrowthHormone Luteinizinghormone ADHFollicle-stimulating Free hormone T3,FreeT4 Di-Hydro Prolactin EpiAndroSterone TotalT3,TotalT4 Aldosterone Testosterone,Androstenodione andcortisolInsulin(duetoinsulinresistance) Estrogen Progesterone TotalT3andtotalT4increaseduetostimulationofthyroidtissuebyhCGduringtheearlyperiodofgestation.ButthereisnochangeinfreeT3andT4duetoincreaseinTBG.ThisleadstotransientfallinTSHduringanearlyweeksofgestation.
ThelevelofTSHreachesnormallevelduringsecondandthirdtrimester.
261.WhatismeantbySuperfecundation? a)Fertilizationoftwoormoreovainoneintercourse b)Fertilizationoftwoormoreovaindifferentintercoursesinsame menstrualcycle c)Fertilizationofovaandthenit'sdivision d)Fertilizationofsecondovumfirstbeingimplanted CorrectAnswer-BAns.B.FertilizationoftwoormoreovaindifferentintercoursesinsamemenstrualcycleSuperfecundationisthefertilizationoftwoormoreovafromthesamecyclebyspermfromseparateactsofsexualintercourse,whichcanleadtotwinbabiesfromtwoseparatebiologicalfathers.Thetermsuperfecundationisderivedfromfecund,meaningtheabilitytoproduceoffspring.
262.Acutefattylivercommonlyseenin pregnancyat- a)3rdtrimester b)1sttrimester c)Immediatepostpartum d)Intrapartum CorrectAnswer-AAns.A.3rdtrimesterAcutefattyliverofpregnancy(AFLP)isarare,potentiallyfatalcomplicationthatoccursinthethirdtrimesterorearlypostpartumperiod.Acutefattyliverofpregnancyismorecommonlyassociatedwith:MalefetusFirstpregnancyMaternalobesityItisduetodefectinthelong-chain-3-hydroxyacyl-CoA-dehydrogenasepathway.Itisuncommoninsubsequentpregnancies.
263.Fetalheartstartscontractingat- a)10-12days b)10-12weeks c)3-5weeks d)3-5month CorrectAnswer-CAns.C3-5weeksThefetalheartstartscontractingatapproximately23daysofgestation.
264.Whichofthefollowingiscorrect regardingplacenta? a)Placentalarteryprovidesnutrientsthroughumbilicalcordto baby b)PlacentahasWharton'sjelly c)Placentahas2veinsand1artery d)Estrogenissecretedbyplacenta CorrectAnswer-BAns.B.PlacentahasWharton'sjellyTheumbilicalcordisastructurethatprovidesvascularflowbetweenthefetusandtheplacenta.Itcontainstwoarteriesandonevein,whicharesurroundedandsupportedbygelatinoustissueknownasWharton'sjelly.
265.
Anesthesiaofchoiceforcesareansectioninseverepre-eclampsia: a)Spinal b)GA c)Epidural d)Spinal+epidural CorrectAnswer-CAns.C.EpiduralContinuousEpiduralAnesthesiaisthefirstchoiceforpatientswithpreeclampsiaduringlabour,Vaginaldeliveryandcesareansection.Preeclampsiapatientshaveariskofsevereairwayedema,whichmakesintubationdifficultContinuousEpiduralAnesthesiacanimproveuteroplacentalperfusionandalsodecreasecatecholaminesecretions.
266.Whichofthefollowingisnotahigh-risk pregnancy? a)Previoushistoryofmanualremovalofplacenta b)Anemia c)Diabetes d)Obesity CorrectAnswer-AAns.A.PrevioushistoryofmanualremovalofplacentaHighRiskPregnancyisseenin:Cardiovascularandrenalfactors:ModeratetoseverepreeclampsiaChronichypertensionSevereheartfailure(classII-IV,NYHAclassification)ModeratetosevererenaldisordersMetabolicdisorders:ObesityInsulin-dependentdiabetesPreviousendocrineablationObstetrichistory:FetalexchangetransfusionbecauseofRhincompatibilityStillbirthLateabortion(16?20wk)Post-termpregnancy(>42wk)Pretermnewborn(<37wkand<2500g)Intrauterinegrowthrestriction(weight<10thpercentileforestimatedgestationalage)PolyhydramniosMultifetalpregnancy
PreviousbrachialplexusinjuryAbnormalfetalpositionOtherdisorders:AbnormalcervicalcytologicfindingsSicklecelldiseaseSevereanemiaThrombophiliaAutoimmunedisordersAnatomicabnormalities:UterinemalformationInsufficient(incompetent)cervixExposuretoteratogens:GroupBstreptococcalinfectionsSmoking>10cigarettes/day(associatedwithprematureruptureofmembranes)Currentpregnancycomplications:Pretermlaborat<37WksPretermprematureruptureofmembranesModeratetoseverepreeclampsiaPolyhydramnios(hydramnios)oroligohydramniosPost-term(>42wk)UterinerupturePlacentapreviaAbruptioplacentaeChorioamnionitisProlapsedcordFetalbradycardiafor>30minFetaltachycardiafor>30minFetalweight<2.5kgFetalweight>4kgFetalacidosispH7
267.Whichofthefollowingisnotusedin preeclampsia? a)Methyldopa b)Atenolol c)Labetalol d)Hydralazine CorrectAnswer-BAns.B.AtenololChoiceofanti-hypertensivesinpregnancyPIH/pre-eclampsia/severepre-eclampsia:LabetalolAcuteHypertension/Hypertensioncrisis:IVlabetalol>Nifedipine>HydralazineChronicHypertensioninpregnancy:Labetalol>Methyldopa.
268.Postmenopausalwomen1stlineofdrug forosteoporosisis- a)OCP b)Bisphosphonates c)Raloxifene d)Strontium CorrectAnswer-BAns.is.B.BisphosphonatesFirstlineofmanagementofosteoporosis?Bisphosphonatesfemales.Alendronate,etidronate,pamidronate,andIbandronatearebisphosphonateswhichinhibitboneresorption,andareveryeffectiveforbothosteoporosispreventionandtreatment.Uses:FirstlinedrugsfortreatingpostmenopausalosteoporosisPaget'sdiseaseOsteolyticbonemetastasis.Raloxifene:Itisaselectiveestrogenreceptormodulatorwhichisalsousefulinmanagementofosteoporosisbutitisahormonalpreparation.
269.A36-weekoldpregnantladywith previoustwindelivery.WhatistheOvarianscore? a)G2P1 b)G2P2 c)G3P2 d)G3P3 CorrectAnswer-AANS.A.G2P1Gravidaincludesallconfirmedpregnancies.Eachpregnancyisonlycountedonetime,evenifthepregnancywasmultiplegestations,suchastwinsortripletsParityreflectsthetotalnumberofbirthsafter20weeks,notthetotalnumberofinfantsborn.Ref.OBSDutta8thedPageno.107
270.DCDAtwins,38wks,firsttwinbreech motherhasBP140/96,1+proteinuriawhat'sthemanagement a)ImmediateLSCS b)Inductionat40weeks c)Immediateinductionanddelivery d)Inductionifsignsofpreeclampsia CorrectAnswer-AANS.A.ImmediateLSCSCASEDISCUSSION:ThepatienthasmildpreeclampsiawithBP140/96,soTOPis37weeks.Thispatientis38weekssoimmediateterminationofpregnancyisrequired.ThefirsttwinisbreechsothemodeofdeliveryisLSCShencetheanswerisA.INDICATIONSOFCESAREANSECTION:Theindicationsarebroadlydividedinto:ObstetricPlacentapreviaPreeclampsiaPreviouscesareansectionCordprolapseofthefirstbabyAbnormaluterinecontractionsContractedpelvis.Fortwins:Boththefetusesoreventhefirstfetuswithnoncephalic(breechor
transverse)presentationTwinswithcomplications:IUGR,conjoinedtwinsMonoamniotictwinsMonochorionictwinswithTTTSThecollisionofboththeheadsatbrimpreventingengagementofeitherhead.Ref.OBSDutta8thedPageno.244
271.A32-year-oldwomancomplainsof amenorrheasincethedeliveryofababy15monthspreviously,despitethefactthatshedidnotbreastfeedherbaby.Thedeliverywascomplicatedbyexcessivehemorrhagethatrequiredatransfusionof2.5litersofblood.Shehasalsobeenfatiguedandhasgainedanadditional4.5Kgsincethebabywasborn.Laboratorydatashowthefollowing:SerumLH<1IU/L(normal,4-24IU/L)Serumestradiol5pg/mL(normal,20-100pg/mL)SerumTSH0.1mU/L(normal,0.5-5mU/L)SerumGH3ng/mL(normal,<5ng/mL)SerumACTH28pg/mL(normal,10-50pg/mL)Serumprolactin2ng/mL(normal,Injectionof500gofTRHfailedtoproducetheexpectedriseinbothserumTSHandprolactin.Whichofthefollowingdiagnosesmostlikelyexplainsthefindingsinthispatient? a)Hashimoto'sthyroiditis b)Isolatedgonadotropindeficiency
b)Isolatedgonadotropindeficiency c)Primaryamenorrhea d)Sheehan'ssyndrome CorrectAnswer-DAns.D.Sheehan'ssyndromeSheehan'ssyndromeItishypopituitarismduetoischemicdamagetothepituitaryresultingfromexcessivehemorrhageduringparturition.Thepituitaryisenlargedduringpregnancy;itismoremetabolicallyactive,andmoresusceptibletohypoxemia.Furthermore,thebloodvesselsinthepituitarymaybemoresusceptibletovasospasmbecauseofthehighestrogen.Inabout30%ofwomenwhohemorrhageexcessivelyduringparturition,somedegreeofhypopituitarismeventuallybecomesmanifest.Thesymptomsdependonhowmuchofthepituitaryisdamagedandwhatcelltypesaredestroyed.Thepatientdescribedaboveexhibitedpersistentamenorrheaafterthedeliveryofherinfant.Thisisduetothedestructionofpituitarygonadotrophsanddiminishedsecretionofgonadotropins(LH).TherealsoappearstohavebeensignificantdestructionoflactotrophssinceTRHinjectionfailedtoinduceanincreaseinprolactin.Hadthewomenattemptedtobreastfeedherinfant,afailuretolactatemostlylikelywouldhaveoccurred.Thiscaseisalsocharacterizedbysecondaryhypothyroidism.ThelowTSHandfailuretorespondtoTRHinjectionareconfirmatory.CorticotrophsappeartohavebeensparedsinceplasmaACTHisnormal.Itisnotclearwhethersomatotrophsweredamaged.FurthertestingwouldbeneededtoseeifGHreserveisdiminished.
Ref.WilliamObs.ed.24thpageno.798,1163DuttaGynaecology6thed.Pageno.465
272.A7weekspregnantladyhas1accidental exposuretox-ray.Whichofthefollowingshouldbedone? a)Continuepregnancy b)Terminatepregnancy c)Chromosomeanalysis d)Preinvasivediagnostictesting CorrectAnswer-AAns.A.ContinuepregnancyExposuretoX-rayhasaverylowrangeofradsoingivencasescenarioPregnancywillbecontinued.Exposure>15radduringthesecondandthirdtrimesteror>5radinthefirsttrimesterneedspatientcounseling.Electiveterminationofpregnancymaybeconsidered.Ref.OBSDutta8theditionPageno.740William'sObs24theditionPageno.931Tableno46-5
273.InModernobstetrics,forsensitizedRh- negativemotherwhatshouldbedonetoevaluatetheconditionofthemother? a)MCAdopplerpeaksystolicvolume b)Fetalblood c)Amniocentesis d)Biophysicalprofile CorrectAnswer-AAns.A.MCAdopplerpeaksystolicvolumeDopplerultrasound:SerialDopplerstudyofthemiddlecerebralartery(MCA)-peaksystolicvelocity(PSV)isthemainstaytoassessfetalanemia.Avalue>1.5multiplesofthemedian(MOMs)forthecorrespondinggestationalage,predictsmoderatetoseverefetalanemia.Thisvalue(between24weeksand35weeksofgestation),isanindicationforcordocentesisandfetaltransfusionMostcentershavereplacedserialamniocentesiswithserialMCADopplerstudies.Ref.OBstetricsDuttaed.8thpg.391
274.Apatientdeliveredathomewitha completeperinealtearcametothehospitalafter2weeks.Whatmanagementwillyouprefer? a)Immediaterepair b)Repair3weekspost-delivery c)Repair6weekspost-delivery d)Repair3monthspost-delivery CorrectAnswer-DAns.D.Repair3monthspost-deliveryTherecenttearsshouldberepairedimmediatelyfollowingthedeliveryoftheplacenta.Thisreducesthechanceofinfectionandminimizesbloodloss.Incasesofdelaybeyond24hours,therepairistobewithheld.Antibioticsshouldbestartedtopreventinfection.Thecompletetearshouldberepairedafter3monthsifdelayedbeyond24hours.Incaseofanydoubttothegrade3rd-degreetear,itisadvisabletoclassifytoahigherdegreeratherthanalowerdegree.Ref.ObsDutta24theditionPageno.490
275.Allareusedforpostcoitalcontraception except- a)CuT b)Ru486 c)Highdoseestrogen d)Danazol CorrectAnswer-DAns.D.DanazolEMERGENCYCONTRACEPTIVES: Drug Dose PREGNANCYRATE Levonorgestrel 0.75mgstatand 0?1 after12hours Ethinylestradiol50?g+ 2tabstatand2after 0?2 norgestrel0.25mg 12hours Ethinylestradiol 2.5mgBd?5days 0?0.6 Mifepristone 100mgsingledose 0?0.6 CopperIuds(Goldstandard) Insertionwithin5 0?0.1 days (RU486Mifepristone) 30mgPO 0?1 (ulipristalacetate) Ref:DUTTAGYNAECOLOGYED.6THPAGENO.492
276.33yroldfemalewithheavymenstrual bleedingfor6monthscomestothegynaecologyOPD.Onexamination,noabnormalitywasseen.USGalsoappearednormal.Thepatientwastriedtobemanagedonnon-hormonaltreatmentbutitfailed.Whatwillbethenextmanagementstep? a)Hormonaltherapy b)Endometrialsampling c)Hysterectomy d)Hysterectomy CorrectAnswer-BAns.B.EndometrialsamplingBeforestartingHormonaltherapyendometrialsamplingisdoneasifhormonaltherapyprecedessamplingthesamplingresultswillbealtered.AsalreadymentionedinquestiontheUSGandclinicalexaminationshownoabnormalityhencethediagnosiscan'tbemadeonthatsofordiagnosisweneedtodoendometrialsamplingandseethehormonalpattern.Thenwecanproceedwithhormonaltherapy.Ref.DuttaGynaecologyed.6thpageno.120
embryofromtheuterinelumen.DeciduaParietalis-Thepartofthedecidualiningrestoftheuterinecavity.Attheendofpregnancy,thedeciduaisshedoffalongwithplacentaandmembranes.
2.Zygotewithzonapellucidareachesuterine cavityby: a)2days b)4days c)5days d)6days CorrectAnswer-B4days
3.Ligamentumtereaisformedafter': a)Obliterationoftheumbilicalvein b)Obliterationoftheductusvenous c)Obliterationoftheductusarteriosus d)Obliterationofthehypogastricartery CorrectAnswer-AObliterationoftheumbilicalvein
4.Theroleofhumanplacentallactogenis: a)Stimulatemilkproduction b)Fetalbreastdevelopment c)Growthoffetus d)Endocrineregulation CorrectAnswer-CGrowthoffetusFunctions:a)Providefetalnutritionbyantagonizingtheactionofinsulininmaternalcirculation,breakdownoffatsandproteinsandtransportoffattyacidsandaminoacidsfrommaternaltofetacirculation.b)Potentangiogenic,helpsdevelopfetalvasculature.c)Promotesgrowthofbreastforlactation.
5.Commonestcauseforpuerperalsepsisis: a)Streptococci b)Anaerobes c)Gonococci d)Staphylococci CorrectAnswer-AStreptococci
6.Thebestmethodforinducingmidtrimester abortionis: a)InjectionofHypertonicSaline b)Ethacrydine c)Prostaglandins d)DandC CorrectAnswer-CProstaglandinsMidtrimesterterminationofpregnancyA)Medicalmethodsi)Prostaglandins:misoprostol(PGE1)withorwithoutMifepristone,gemeprost(PGE1),dinoprostone(PGE2),carboprost(PGE2)ii)Oxytocin
7.MostcommonsiteofImplantationoftubal pregnancyis: a)Interstitialportionoffallopiantube b)Isthmus c)Ampulla d)Infundibulum CorrectAnswer-CAmpullaMaximumpropensitytorupture-->Isthmicectopicpregnancy.Minimumpropensitytorupture-3Ampullaryectopicpregnancy.
8.DuringwhichgestationalageispeakserumHCGlevelsattained? a)7-9weeks b)11-13weeks c)20weeks d)25weeks CorrectAnswer-AHCGrisesprogressivelyfromconception.Levelsdoubleontheaverage,every30.9hoursuntilvaluesreach6500mIU/ml(6,500IU/L)atapproximatelytheeighthweekafterthelastmenstrualperiod(LMP).Afterthattherateofrisebecomesindividualized,peakingbetweenthe60thand70thday(9to10weeks)LMP.HCGdecreasesslightlybetweenthe12thand16thweekpostLMP,andthenremainsconstantuntilbirth.
9.Theuterinearteryisabranchofwhichofthefollowing? a)Leftcommoniliacartery b)Internaliliacartery c)Internalpudendalartery d)Ovarianartery CorrectAnswer-BUterinearteriesarisefrominternaliliacarteryorhypogastricartery.Itrunsdownwardsandforwardsalongthelateralpelvicwalluntilthebaseofthebroadligament. Note:Duringpregnancytheuterinearterieshypertrophyandtheircourseisstraightened. Ref:CompTextbookofObstetricsandGynecology,SadhanaGupta,2011,Page18
10.
Inwhichpartoffallopiantubeectopicpregnancywillhavelongestsurvival? a)Isthmus b)Ampulla c)Cornua d)Interstitium CorrectAnswer-DAns.D.InterstitiumIftheimplantationoccursintheantimesentericborderintheampulla,thepregnancymaycontinuealittlelongertime.Earliestinterruptionoccursintheisthmialimplantationandpregnancymaycontinueupto3-4monthsininterstitialimplantation.Alsoknow:Isthmicruptureusuallyoccursat6-8weeks,theampullaryoneat8-12weeksandtheinterstitialoneatabout4months.Ref:TextbookofObstetricsbyDCDutta,6thedition,Page181.
11.Whatwouldbethetypeofpresentationwhentheengagingdiameteris mentovertical? a)Face b)Brow c)Vertex d)Breech CorrectAnswer-BInbrowpresentation,theengagingdiameterismentovertical(14cm).Browistherarestvarietyofcephalicpresentationwherethepresentingpartisthebrowandtheattitudeoftheoftheheadisshortofthatdegreeofextensionnecessarytoproducefacepresentation.Infacepresentation,thepresentingpartisface,attitudeofthefetusshowscompleteflexionofthelimbswithextensionofthespine.Thecommonestpositionisleftmentoanterior.Theengagingdiameteroftheheadissubmentobregmatic9.5cminfullyextendedheadorsubmentovertical11.5cminpartiallyextendedhead.Ref:TextbookofObstetricsByD.CDutta,6thedn,page392-3
12.Whichofthefollowingstatementsregardingfetalcirculationiscorrect? a)Theliverandheartofthefetusreceivebloodwithveryhigh oxygensaturation b)PO2offetalbloodleavingtheplacentaisslightlygreaterthan maternalmixedvenousPO2 c)Thepresenceoffetalhemoglobinshiftstheoxyhemoglobin dissociationtotheright d)Theforamenovaleclosesduringthethirdtrimesterunlessthe fetushasanatrialseptaldefect CorrectAnswer-ASincetheliverissuppliedbyumbilicalvenousbloodfromtheplacenta,andtheheartandheadreceivebloodbeforeithasmixedwithsignificantamountsofdesaturatedblood,theseimportantorgansreceivebloodthatisrelativelyhighinsaturatedoxyhemoglobin. ThehighrateofbloodflowattheplacentaandthesignificantresistanceoftheplacentatodiffusionofoxygenresultinbloodintheumbilicalveinthathasalowerPO2(30mmHg)thanthematernalmixedvenousblood. However,theleftshiftinfetaloxyhemoglobinconcentrationandtheBohreffectbothacttoincreasethetransportofoxygentofetaltissues. Anumberofsignificantdifferencesincirculatingpatternsarepresentinthefetus. Theforamenovaleremainsopenuntilafterbirthandasignificantportionofinferiorvenacavaflowisshuntedthroughittotheleft.1/3ofbloodentersdirectlyfromrightatriumtoleftatrium(bypassingrightventricle)throughforamenoval Themajorportionofrightventricularoutputisshuntedthroughtheductusarteriosustotheaorta,notthelungs. Theneteffectoftheseshuntsinthepresenceofhighfetalpulmonaryvascularresistanceisverylowfetalpulmonarybloodflow.
Atbirth,thesepatternsnormallyarequicklychangedtoex-uteropatternswithhighpulmonaryperfusion.Ref:BarrettK.E.,BarmanS.M.,BoitanoS.,BrooksH.L.(2012).Chapter33.CirculationthroughSpecialRegions.InK.E.Barrett,S.M.Barman,S.Boitano,H.L.Brooks(Eds),Ganong'sReviewofMedicalPhysiology,24e.
13.MostcommoncauseofsecondaryPPHis : a)Uterineinertia b)Retainedplacenta c)Episiotomy d)Cervicaltear CorrectAnswer-BRetainedplacentaSecondaryPPHBleedingusuallyoccursbetween8thto14thdayofdelivery.CausesoflatePPH:Retainedbitsofcotyledonormembranes(M.C.)Infectionandseparationofsloughoveradeepcervico-vaginallaceration.Endometritisandsubinvolutionoftheplacentalsite.
14.Themajorcontributionoftheamniotic fluidafter20weeksofgestation: a)Ultrafiltrateandmaternalplasma b)Fetalurine c)Fetallungfluid d)Fetalskin CorrectAnswer-BAns.B.FetalurineTherearetwoprimarysourcesofamnioticfluid:fetalurineandthelungliquid.Afterabout20weeks,fetalurinemakesupmostofthefluid.
15.
IncidenceofscarruptureinasubsequentpregnancyincaseofLowerSegmentCesareanSection(LSCS)is: a)2% b)4% c)5% d)8% CorrectAnswer-A2%Theriskoflowersegmentscar-ruptureislow(0.2-1.5%)andevenifitdoesoccur,maternaldeathismuchlessandtheperinatalmortalityisabout1in8.
16.Thecharacteristicsofcaputsuccedaneum includeallofthefollowingexcept: a)Crossesmidline b)Crossesthesutureline c)Itdoesnotdisappearwithin2-3days d)Itisadiffuseedematousswellingofthesofttissuesofthescalp CorrectAnswer-CItdoesnotdisappearwithin2-3daysLocation-subcutaneousplaneClinicalfeatures-Softengraduallyanddisappearwithin2-3daysDiffusecrossessuturelineilldefinedmargin.Notassociatedwithprolongedjaundice
17.Hydrocephalusisbestdetected antenatelyby: a)X-rayabdomen b)Amniocentesis c)Clinicalexamination d)Ultrasonography CorrectAnswer-DAns.isdi.e.UltrasonographyHydrocephalusisaconditioninwhichthereisanabnormalincreaseincerebrospinalfluidwithintheventricularandsubarachnoidspacesofbrain."Theprenataldiagnosisofhydrocephalusisusuallymadebydemonstrationofadilatedventricularsysteminanultrasoundexamination."Earliestandmostaccuratesonographicsignofhydrocephalus?Enlargedlateralventricles.?Thelateralventricleismeasuredatthelevelofatrium.Normaltransversediameterofatriumis7mm?1mm.(Itremainsconstantduringthesecondandthirdtrimester)Whendiameterofatriumis>10mmitiscalledasVentriculomegaly/Hydrocephalus.OthersignsofhydrocephalusonUSG:Danglingchoroidplexuses.Thinningoutofcerebralcortex.ExtraEdge:Friends,thetermsventriculomegalyandhydrocephalusareoftenusedinterchangeablybuthaveslightlydifferentmeanings.*Ventriculomegaly:Theconditioninwhichlateralventriclesofthe
brainarefilledwithexcessivefluidandenlarge.*Hydrocephalus:Thereisventriculomegalyalongwithanincreaseintheheadcircumference.Normalfetalheadcircumferenceattermrangesbetween32and38cms.Withhydrocephalus,thecircumferenceexceeds50cms.Ventriculomegalycanalsobecausedby?:*Spinabifida?*Chromosomalabnormalities?*Congenitalinfectionslikecytomegalovirus.toxoplasmosis,syphilisandinfluenza.?DandywalkersyndromeincludesHydrocephalus+Posteriorfossacyst?+Defectincerebellarvermis.
18.Subpubicangleis: a)<65? b)65-75? c)85? d)110-120? CorrectAnswer-C85?
19.RuleofHasseisusedtodetermine: a)Theageoffetus b)Heightofanadult c)Raceofaperson d)Identification CorrectAnswer-AAns.isai.e.TheageoffetusHasse'sruleisemployedincalculatingtheageoffetusbyitslengthDuringthefirstfivemonthsofpregnancy,thelengthincmsissquareoftheageinmonthsi.e.Lengthincms=(Ageinmonths)?Ageinmonths=QlengthincmsDuringsecondfivemonthsofpregnancy,lengthincmsdividedby5istheageinmonths.LengthinemsAgeinmonths5
20.Bananaandlemonsignseeninwhich fetalnomalies: a)Neuraltubedefect b)Hydropsfetalis c)Twins d)IUD CorrectAnswer-AAns.isai.e.NeuraltubedefectSignsofSpinabifidaonUltrasoundSmallbiparietaldiameter.Ventriculomegaly.Frontalbonescallopingorthesocalledlemonsign.Elongationanddownwarddisplacementofthecerebellum-thesocalledbananasign.Effacementorobliterationofthecisternamegna.
21.IndicationofAcyclovirinpregnancy: a)Disseminatedherpes b)Chicken-poxinfirsttrimester c)Prophylaxisinrecurrentherpes d)Alloftheabove CorrectAnswer-DAlloftheabove
22.Lovsetmanoeuvreisusedindeliveryof: a)Head b)Breech c)Foot d)Arms CorrectAnswer-DArmsLovset'smaneuverPrinciple:Becauseofthecurvedbirthcanal,whentheanteriorshoulderremainsabovethesymphysispubis,theposteriorshoulderwillbebelowthesacralpromontory.Ifthefetaltrunkisrotatedkeepingthebackanteriorandmaintainingadownwardtraction,theposteriorshoulderwillappearbelowthesymphysispubis.
23.Macrosomiais/areassociatedwith: a)Gestationaldiabetesmellitus b)Maternalobesity c)Hypothyroidism d)A&B CorrectAnswer-DAns.isaandbi.e.GestationaldiabetesandMaternalobesityMacrosomiaisthetermusedtodescribealargefetus.Therecommendeddefinitionisfetal(neonatal)weightexceedingtwostandarddeviationsorabove90thcentilefortheappropriatenormalpopulation.AccordingtoACOG:birthweightof>4500gmiscalledasmacrosomia.InIndiancontextBirthweightof>4000gmiscalledasmacrosomia.
24.Drugwhichiscontraindicatedbefore2nd stageoflaboris:March2009 a)Mifepristone b)Oxytocin c)Misoprostol d)Ergometrine CorrectAnswer-DAns.D:ErgometrineDrugsusedformedicalmethodofinductionoflabourare:MifepristoneOxytocinMisoprostol(ProstaglandinsEl)Ergometrineiscontraindicatedinpregnancy,1ststageoflabour,2ndstageoflabourbeforecrowningoftheheadandinbreechdeliverypriortocrowning.
25.NuchaltranslucencyinUSGcanbe detectedat_____weeksofgestation. a)11-13weeks b)18-20weeks c)8-10weeks d)20-22weeks CorrectAnswer-AAns.A.11-13weeksNuchaltranslucencyisthenormalfluid-filledsubcutaneousspaceidentifiedatthebackofthefetalneckduringthelatefirsttrimesterandearlysecondtrimester(11.3-13.6weeks).
26.Firstlineoftreatmentofmastitisina lactatingmotheris- a)Dicloxacillin b)Cefazolin c)Ceftriaxone d)Ampicillin CorrectAnswer-AAns.A.DicloxacillinThebetalactamase-resistantpenicillinshavebeenrecommendedinthetreatmentofmastitis.Theseincludecloxacillin,dicloxacillin,orflucloxacillin.Becausepenicillinsareacidic,theyarepoorlyconcentratedinhumanmilk,whichisalsoacid.Therefore,cloxacillinanditscongenerstendtotreatcellulitiswell,buttheyarelesseffectiveineradicatingadenitis,themostlikelyprecursorofbreastabscess.Whenpatientsareallergictopenicillins,cephalexinorclindamycinmaybethealternativetoerythromycin.Combinationlikeco-amoxiclavshouldbeavoidedbecauseoffearofinducingMRSA
27.Patientwithrecurrentabortiondiagnosed tohaveantiphospholipidsyndrome.Whatwillbethetreatment? a)Aspirinonly b)Aspirin+LowmolecularweightHeparin c)Aspirin+LowmolecularweightHeparin+Prednisolone d)NoTreatment CorrectAnswer-BAns.B.Aspirin+LowmolecularweightHeparinTherecommendedtreatmentforwomenwithrecurrentpregnancylossassociatedwithantiphospholipidsyndromeincludescombinedAspirinandHeparintherapy.InpregnantSLEpatientswithAntiphospholipidantibodiesandpriorfetalloss,treatmentwithheparin(standardorlow?molecular-weight)pluslowdoseaspirinhasbeenshowninprospectivecontrolledtrialstoincreasesignificantlytheproportionoflivebirths.Combinedaspirinandheparintherapyhasproveneffectivenessandisthepreferredtreatmentforwomenwithrecurrentpregnancylossassociatedwithantiphospholipidsyndrome.
28.Humanplacentais? a)Discoid b)Hemochorial c)Deciduate d)Alltheabove CorrectAnswer-DAns.is'd'i.e.,AlltheaboveThehumanplacentais:Discoid,becauseofitsshape.Hemochorial,becauseofdirectcontactofthechorionwiththematernalbloodandDeciduate,becausesomematernaltissueisshedatparturition.
29.Twinpregnancyofthesameageandsex rulesout? a)Superfetation b)Maternaltwins c)Superfecundation d)Noneoftheabove CorrectAnswer-AAns.is'a'i.e.,SuperfetationSuperfetationItisthesimultaneousoccurrenceofmorethanonestageofdevelopingoffspringinthesameanimal.Inmammals,itmanifestsastheformationofanembryofromadifferentestrouscyclewhileanotherembryoorfetusisalreadypresentintheuterus.
30.Allaretrueaboututeroplacental circulationexcept a)Bloodintheintervillousspaceiscompletelyreplaced3-4 timesperminute b)Thevillidependonthematernalbloodfortheirnutrition c)Amatureplacentahas150mlofbloodinthevillisystemand 350mlofbloodintheintervillousspace d)Intervillousbloodflowattermis500-600mlperminute CorrectAnswer-CAnswer-C.Amatureplacentahas150mlofbloodinthevillisystemand350mlofbloodintheintervillousspaceAmatureplacentahasavolumeofabout500mlofblood;350mlbeingoccupiedinthevillisystemand150mllyingintheintervillousspace.Intervillousbloodflowattermisaround500-600mlperminute.Thebloodintheintervilllousspaceiscompletelyreplacedabout3-4timesperminute.Thevillidependonmaternalcirculationfornutrition,thusitispossibleforthechorionicvillitosurviveforavaryingperiodevenafterthefetusisdead.
31.Uterusisreceptiveforimplantationfor howmanydaysafterfertilization- a)6days b)12days c)6weeks d)12weeks CorrectAnswer-DAnswer-D.12weeksSuperfetationisthefertilizationoftwoovareleasedintwodifferentmenstrualcycles.Thenidationanddevelopmentofonefetusoveranotherfetusistheoreticallypossibleuntilthedecidualspaceisobliteratedby12weeksofpregnancy.
32.Numberofstemvilliatterminhuman placentais a)60 b)120 c)240 d)480 CorrectAnswer-AAnswer-A.60Functionalsubunitiscalledalobulewhichisderivedfromatertiarystemvilli.About60stemvillipersistinhumanplacenta.Thuseachcotyledon(total15-29)contains3-4majorstemvilli.Thevilliarethefunctionalunitoftheplacenta.Thetotalvillisurface,forexchange,approximatelyvariesbetween10to14squaremetres.Thefetalcapillarysystemwithinthevilliisalmost50kmlong.
33.AllareofvalueinmodifiedBishopscore except a)Dilatation b)Effacement c)Cervicallength d)Consistency CorrectAnswer-BAnswer-B.Effacement
34.G2P1L1femalewith1:4antiDtitresat28 weeksgestation,managementis a)MCADoppler b)Caesareansection c)Inductionoflabour d)Amniocentesis CorrectAnswer-AAnswer-A.MCADopplerIfIndirectCoomb'stestispositiveinanantenatalpatientwithRhnegativebloodgroup,andantibodytitres>1:16orAblevel>10IU/ml 1. SerialMCADoppler,every1-2weeksfrom20weeks2. Serialultrasonographyevery2-3weeksfrom20weeks
35.PatientwithNTD,doseoffolicacidinnext pregnancy a)0.5mg b)1mg c)2mg d)4mg CorrectAnswer-DAnswer-D.4mgFolicacidsupplementation4mgdaily1monthbeforeconceptiontoabout12weeksofpregnancy.
36.Kallmanssyndromeisassociatedwithall ofthefollowingexcept a)Amenorrhea b)ExcessstimulationoftheHPOaxis c)Geneticmutation d)Anosmia CorrectAnswer-BAnswer-B.ExcessstimulationoftheHPOaxisWhencongenitalGnRHdeficiencyisassociatedwithanosmiaorhyposmia(anabsentorgrosslyimpairedsenseofsmell),thedisorderisknownasKallmann'ssyndrome.TwogeneticmutationsassociatedwithKallman'sSyndrome: 1. KALgene-X-linkedinheritance(Xp22.3)encodinganosmin-1.2. GeneencodingFGFR1(Fibroblastgrowthfactor-1receptor)- autosomaldominantform.Anosmin-1isaneuraladhesionmoleculethatpromotesmigrationofGnRHneuronsandolfactoryneurons,fromtheolfactoryplacodeintothehypothalamusduringembryonicdevelopment.
37.Hotflushesareexperiencedasaresult of a)Increasednoradrenaline b)Decreasedestrogen c)Increasednoradrenalineanddecreasedestrogen d)Increasednoradrenalineandestrogen CorrectAnswer-CAnswer-C.IncreasednoradrenalineanddecreasedestrogenHotflushesarecausedbynoradrenaline,whichdisturbsthethermoregulatorysystem.Oestrogendeficiencyreduceshypothalamicendorphins,whichreleasemorenorepinephrineandserotonin.Thisleadstoinappropriateheatlossmechanism.Othercausesthatcanbeassociatedwiththesymptomofhotflushesinclude:thyroiddisease,epilepsy,pheochromocytoma,carcinoidsyndromes,autoimmunedisorders,mastcelldisorders,insulinoma,pancreatictumoursandevenleukemias.
38.Cephalicindexis a)BPD/OFD b)BPD/HC c)OFD/BPD d)HC/FL CorrectAnswer-AAnswer-A.BPD/OFDCephalicindex=BPD/OFD(Biparietaldiameterdividedbytheoccipito-frontaldiameter)
39.Ifthesymphysiofundalheightis40cm andthestationoftheheadisat-1,weightofthefetusisapproximately a)3kg b)3.3kg c)4kg d)4.3kg CorrectAnswer-DAnswer-D.4.3kgJohnson'sFormulaforestimationoffetalweight:Heightoftheuterusabovethesymphysispubisincentimetersminus12,ifthevertexisatorabovethelevelofischialspinesorminus11,ifthevertexisbelowthelevelofischialspines-multipliedby155givestheweightingrams.Solution:(40-12)x155=4340gms
40.InMRKHsyndrome,whichamongthe followingisabsent? a)Vagina b)Breastdevelopment c)Pubichairdevelopment d)Testes CorrectAnswer-DAnswer-D.TestesMRKHsyndromeisalsoknownasMURCSsyndrome(Mullerianagenesis,Renalaplasiaandcervicothoracicsomitedysplasia).MRKH(MayerRokitanskyKusterHauser)syndromehasakaryotypeof46,XX.SothegonadspresentareovariesincontrasttoAndrogenInsensitivitySyndromewheretestesarepresent.TheMRKHsyndromeischaracterizedbycongenitalaplasiaoftheuterusandtheupperpart(2/3)ofthevaginainwomenshowingnormaldevelopmentofsecondarysexualcharacteristicsandanormal46,XXkaryotype.
41.Whatisthepreferredtreatmentof completeprolapseinafemalewithcompletedfamily? a)Slingsurgery b)Vaginalhysterectomy c)LeForte'srepair d)Pessary CorrectAnswer-BAnswer-B.VaginalhysterectomyVaginalhysterectomyiscommonlyperformedformajordegreeuterineprolapseinafemalewithcompletedfamily.
42.Whichofthefollowingisnotaprobable signofpregnancy a)Jacquemier'ssign b)Dalrymplesign c)Hegar'ssign d)Palmer'ssign CorrectAnswer-BAnswer-B.DalrymplesignProbablesignsofpregnancy:Jacquemier'ssign/Chadwick'ssignOsiander'ssignGoodell'ssignPiskacek'ssignHegar'ssignPalmer'ssignBraxtor-hickscontractionExternalballotmentAbdominalenlargementOutliningthefetus
43.Polyspermyisinhibitedbywhichion? a)Ca b)Na c)K d)Cl CorrectAnswer-AAns,A.CaThecalciumwaveamplifiesthelocalsignalatthesiteofsperm-oocyteinteractionanddistributesitthroughouttheoocytecytoplasm.Theincreaseincalciumconcentrationisthesignalthatcausestheoocytetoresumecelldivision,initiatingthecompletionofmeiosisIIandsettingofthedevelopmentalprogrammethatleadstoembryogenesis.
44.Whichofthefollowingispresentin normalvagina? a)Trichomonasbuccalis b)Trichomonashominis c)Trichomonasvaginalis d)Trichomonasbovis CorrectAnswer-CAns.C.Trichomonasvaginalis
45.Maximumamnioticfluidat? a)32weeks b)34weeks c)36weeks d)40weeks CorrectAnswer-CAns,C.36weeks
46.At20weeksofgestationamnioticfluid volumeis? a)200ml b)400ml c)600ml d)800ml CorrectAnswer-BAns,B.400ml
47.Fertilizedovumreachestheuterusatwhat dayofmenstrualcycle? a)6th b)14th c)20th d)25th CorrectAnswer-CAns,C.20thImplantationofthefertilizedovumoccursintheendometriumoftheanteriororposteriorwallofthebodynearthefundusonthe&ilayoffertilizationwhichcorrespondstothe20thdayoftheregularmenstrualcycle.
48.
Fertilizationusuallyoccursinwhichpartoffallopiantube? a)Fimbrialend b)Ampulla c)Interstitium d)Isthmus CorrectAnswer-BAns.B.AmpullaFertilizationistheprocessoffusionofthespermatozoonwiththematureovum.Itbeginswithspermeggcollisionandendswithproductionofamononucleatedsinglecellcalledthezygote.Itsobjectivesare: 1. Toinitiatetheembryonicdevelopmentoftheeggand2. Torestorethechromosomenumberofthespecies. Almostalways,fertilizationoccursintheampullarypartoftheuterinetube.
49.Physiologicchangeinleukocytenumbers inpregnancyis a)Neutrophilicleukocytosis b)Lymphocyticleukocytosis c)Neutropenia d)Basophilicleukocytosis CorrectAnswer-AAns.A.NeutrophilicleukocytosisPhysiologicalchangeobservedinleukocytenumbersinpregnancyisneutrophilicleukocytosis.Itoccurstothetuneof8000/mm3andmayupto20,000/mm3inlabour.Theincreasemaybeduetotheriseinlevelsofestrogenandcortisol.
50.Weightofuterusattermis? a)400-500gm b)600-700gm c)800-900gm d)900-1000gm CorrectAnswer-DAns.D.900-1000gmTheuterusinthenon-pregnantstateweightisabout60gm,withacavityof5-70mlandmeasuresabout7.5cminlength.Attermitweighsabout900-1000gmandmeasures35cminlength.
51.Duringpregnancyestrogencauseswhich ofthefollowing? a)Growthofductsofbreasts b)Growthofalveoliofbreasts c)Bothaandb d)Noneoftheabove CorrectAnswer-CAns.C.BothaandbTheincreasedsizeofthebreastsisevidentintheearlyweeksofpregnancy.Theincreaseinsizeisduetohypertrophyandproliferationoftheductsandthealveoli.Estrogenisresponsibleforthehypertrophyandproliferationoftheductsandalveoliwhileprogesteroneisonlyresponsibleforthehypertrophyandproliferationofthealveoli.
52.Maternalsidelayeroftheplacentais called? a)Deciduabasalislayer b)Deciduacapsularislayer c)Deciduaparietalis d)Deciduaspongiosa CorrectAnswer-AAns.,A.DeciduabasalislayerDeciduabasalis(Decidualplate)isthepartofendometriumrelatedtoembryonicpoleofconceptusandformsthematernalpartofplacenta.
53.Whichofthefollowingisnota physiologicalchangeofpregnancyinurinarybladder? a)Edematousmucosa b)Increasedfrequencyat14weeks c)Stressincontinence d)Pressureonbladderinlatepregnancy CorrectAnswer-BAns.B.Increasedfrequencyat14weeksPhysiologicalchangesinbladderinpregnancyMarkedcongestionandhypertrophyofthemusclesandelastictissuesofthebladderwall.Edematousbhddermucosainlatepregnancyespeciallyinprimigravida.Increasedfrequencyofmicturitionat6-8weekswhichsubsidesby12weeksandreappearsinlatepregnancyduetopressureofthegraviduterusonbladder.Stressurinaryincontinenceinlatepregnancy.
54.Urinaryretentionearliestinpregnancyis seenat? a)10weeks b)18weeks c)22weeks d)34weeks CorrectAnswer-AAns,A.10weeksUrinaryretentioninpregnancyisrareItisclassicallydescribedinsomewomenwithretroverteduterus,whichbecomesimpactedinthepelvis,usuallyseenearliestbetween8-12weeksofpregnancyandcausesoutflowobstruction.
55.BetaHCGisdetectedearliestbywhich dayofconception? a)8days b)15days c)21days d)30days CorrectAnswer-AAns,A.8dayshCGisaglycoproteinproducedbythesyncytiotrophoblast.hCG-cisidenticaltothecsubunitofLH,FSH,andTSH.Itspresenceintheurineinearlypregnancyisthebasisofthevariouslaboratorytestsforpregnancy,anditcansometimesbedetectedintheurineasearlyas14dafterconceptionandinserumasearlyas8-9days,
56.DoublingtimeofbetaHCGinearly pregnancyis? a)24hrs b)48hrs c)72hrs d)96hrs CorrectAnswer-BAns,B.48hrsBetahCGusuallydoubleaboutevery2days(48hours)duringfirstfourweakofpregnancy.Aspregnancyprogresses,doublingtimebecomeslonger.By6-7weeksbetahCGlevelsmaytakeaslongas3.5daystodouble.
57.Tubalpatencytestinwhichphaseofthe menstrualcycle? a)Menstrual b)Preovulatory c)Leuteal d)Premenstrual CorrectAnswer-BAns,B.PreovulatoryThetestingoftubalpatencyanddetectingtubalpathologyaredoneinpre-ovulatoryphaseofthemenstrualcycle.Ifperformedinthepost-ovulatoryperiod,insufflationmightdisturbanimplantedorfertilizedovumandmayalsocausepelvicendometriosis.
58.Followingphysiologicalchangesareseen invaginainpregnancyexcept? a)Jacquimierssign b)Increasedlengthofanteriorvaginalwall c)pHacidic d)Decreasednumberofnavicularcells CorrectAnswer-DAns,D.DecreasednumberofnavicularcellsThevaginalwallsbecomehypertrophied,edematousandmorevascular.Increasedbloodsupplytovenousplexussurroundingthewallsgivesbluishcolorationofthemucosa(Jacquemier'ssign).Thelengthoftheanteriorvaginalwallisincreased.Thesecretionofvaginabecomescopious,thinandcurdywhite,duetomarkedexfoliatedcellsandbacteria.ThepHbecomesacidic(3.5-6)duetomoreconversionofglycogenintolacticacidbylactobacillusacidophilusconsequentonhighestrogenlevel.TheacidicpHpreventsmultiplicationofpathogenicorganisms.Thereispredominanceofnavicularcellsinclusterandplentyoflactobacilli.
59.FHScanbeusuallyheardbystethoscope at? a)14weeks b)18weeks c)22weeks d)26weeks CorrectAnswer-BAns,B.18weeksFetalheartsound(FHS)ismostconclusiveclinicalsignofpregnancy.Withanordinarystethoscopeitcanbedetectedbetween18-20weeksofPregnancY.
60.Whatisthefetoplacentalrelationshipat 24weeksofgestation? a)3 b)4 c)5 d)6 CorrectAnswer-AAns,A.3Therelationshipbetweenthefetalandplacentalweightscanbestudiedbythesocalledfetoplacentalrelationship(fetalweight/placentalweightratio).Thefetoplacentalrelationshipincreasesasthepregnancyadvances.
61.Downsyndromeisearliestdiagnosedat? a)8-10weeks b)10-12weeks c)12-14weeks d)14-16weeks CorrectAnswer-BAns.B.10-12weeksEarliestdiagnosisofgeneticdefectscanbedonebyuseofchorionicvilloussampling.Chorionicvilloussamplingiscarriedouttranscervicallyat10-12weeksandtransabdominallyfrom10weekstoterm.
62.Chorionicvillusbiopsyisdoneearliestin whichweekofgestation? a)9weeks b)11weeks c)13weeks d)15weeks CorrectAnswer-BAns,B.11weeksItiscarriedouttranscervicallybetween7O-12weeksandtransabdominallyfrom10weekstoterm.
63.Whenisfolicacidstartedinpregnancy? a)4weekspriortoconception b)8weekspriortoconception c)4weeksafterconception d)8weeksafterconception CorrectAnswer-AAns.A.4weekspriortoconceptionFolicacidsupplementation(4mg/day)isstated4weekspriortoconceptionandcontinuedupto12weeksofpregnancy.Thiscanreducetheincidenceofneuraltubedefects.
64.TermplacentaweighttoBabyweightratio is? a)1:3 b)1:4 c)1:5 d)1:6 CorrectAnswer-DAns,D.1:6ThetermPlacentaPlacentaattermisacirculardiscwithadiameterof15-20cm.Ithasthicknessof3cmatcenterandthinsoftowardstheedges.Itfeelsspongyandweighsabout500gm.Theratioofplacematweightattermandthebabyweightis1:6.Itoccupiesabout30%oftheuterinewall.
65.Firsttrimesterdiagnosisforanencephaly isbyincreased? a)Alphafetoproteininmaternalserum b)Alphafetoproteininamnioticfluid c)BetaHCGinmaternalserum d)BetaHCGinamnioticfluid CorrectAnswer-BAns,B.AlphafetoproteininamnioticfluidInthefirsthalfofthepregnancythediagnosisofanencephalyismadebyelevatedalphafetoproteininamnioticfluidandconfirmedbysonography.
66.WhichofthefollowingistrueaboutEDD? a)Lessthan10%ofdeliveriesoccuronEDD b)Lessthan20%ofdeliveriesoccuronEDD c)80%ofthedeliveriesoccuronEDD d)90%ofthedeliveriesoccuronEDD CorrectAnswer-AAns,A.Lessthan10%ofdeliveriesoccuronEDDFewerthan5%ofallthepregnanciesendontheexpecteddateofdelitery(EDD).13%ofthebirthsoccurpreterm.5-7%ofthepregnanciesaredeliveredpostterm.Majorityofthedeliveriesoccurwithin7daysofEDD.
67.a)Mostcommonpositionofengagement invertexpresentation? a)LOA b)ROA c)LOP d)ROP CorrectAnswer-AAns,A.LOAVertexoccupyingtheleftanteriorquadrantofthepelvisisthecommonestandiscalledleftoccipito-anteriorposition.
68.Whichistheengagingdiameterin occipitoposteriornresentation? a)Suboccipitofrontal b)Mentovertical c)Submentovertical d)Bitrochanteric CorrectAnswer-AAns,A.Suboccipitofrontal
69.Whichisthemostcommonpresentation intwinpregnancy? a)Vertex-vertex b)Vertex-breech c)Breech-Breech d)Vertex-Footling CorrectAnswer-AAns.A.Vertex-vertex
70.DirectOccipitoposteriorpositionisa favourablepositioninwhichtypeofpelvis? a)Anthropoid b)Androidpelvis c)Gynaecoid d)Mongoloid CorrectAnswer-AAns,A.AnthropoidDirectOccipitoposteriorpositionisafavourablepositioninanthropoidtypeofpelvis.
71.PersistentOPpositionismostcommonin whichpelvis? a)Android b)Gynaecoid c)Anthrpoid d)Mixed CorrectAnswer-AAns,A.AndroidWithandroidtypeofpelvistheoccipitoPosteriorpositioniscommonduetofunnelshapeofthepelvis.
72.Contraindicationforinductionoflabouris allexcept? a)Hypertensivediseaseofpregnancy b)Heartdiseaseofpregnancy c)Pelvictumor d)Vasaprevia CorrectAnswer-AAns.A.HypertensivediseaseofpregnancyHypertensivediseaseofpregnancyisanindicationforinductionoflabour.Otherthreearecontraindications.
73.Medicalmanagementofectopic pregnancyhasdecreasedsuccessif? a)Gestationalsac<3cm b)Durationofgestation<5weeks c)Cardiacactivitypresent d)BetaHCG<8000IU/L CorrectAnswer-CAns.C.CardiacactivitypresentMedicalmanagementofanectoPicPregnancyisdonewhen:PatientishemodynamicallystableNoevidenceofacuteintraabdominalbleedingReadytocomplywithfollowupcareSerumbetaHCG<10,000IU/LAbsentembryonicheartactivityDiameterofectopicgestationalmasslessthan4cm.
74.AllaretheprognosticfactorsofBoer- meiselsystemexcept- a)Extentofadhesions b)Thicknessoftubalwall c)Sizeofhydrosalpinx d)Infectingorganism CorrectAnswer-DAns,D.InfectingorganismBoer-meiselsystemofprognosticclassificationforchronicpelvicinflammatorydiseaseincludes:ExtentofadhesionsNatureofadhesionsflimsyordenseSizeofhydrosalpinxMacroscopicconditionofhydrosalpinxThicknessoftubalwall
75.Pregnantuteruswillcompressuretersat ? a)Pelvicbrim b)Uterovesicaljunction c)Trigone d)Ureterovesicaljunction CorrectAnswer-AAns,A.PelvicbrimUretersbecomeatonicduetohighprogesteronelevelinpregnancy,Dilatationoftheureterabovethepelvicbrimwithstasisismarkedontherightsideespeciallyintheprimigravidae.Itisduetodeoxtrorotationoftheuteruspressingtherightureteragainstthepelvicbrimandaboduetopressurebyrightovarianvein,whichcrossestherightureteratrightangle.
76.Followingisgiventoapatientwithpre termlabourexept- a)Glucocorticoids b)Tocolyticdrugs c)Antibiotics d)Betablocker CorrectAnswer-DAns.D.BetablockerTocolyticdrugs[Note:betamimeticandnotbetablockerisatocolytic]
77.Mostcommoncauseoftenthdaypost partumbleeding? a)Retainedbitsofmembrane b)Infection c)Endometritis d)Bloodcoagulopathy CorrectAnswer-AAns.A.RetainedbitsofmembranePostpartumhemorrhage(PPH)isdefinedasbloodlossofmorethan500mlfollowingbirthofbaby.
78.Amultgravida4kgfetusisinlaboursince 15hoursandhas5cmdilationofcervixforlast8hours.Whatisthefurthermanagementofthispatient? a)Waitandwatch b)Amniotomy c)InjectionOxytocin d)Caesariansection CorrectAnswer-DAns.D.Caesariansection
79.Thetreatmentofchoiceforbartholincyst is? a)Marsupilisation b)Aspiration c)Observe d)Curettageandclosure CorrectAnswer-AAns.A.MarsupilisationBartholin'scystBartholin'scystisformedwhenductofbartholinsglandisblockedeitherbyinflammationorbyinspissatedsecretion.Itappearsasaswellingontheinnersideofthejunctionoftheanteriortwo-thirdswiththeposteriorone-thirdofthelabiummajus.Asmallcystremainsasymptomatic,butalargeronebulgesacrossthevaginalintroitusandcausesdyspareunia,discomfortandmaygetinfectedwhenitneedsexcisionormarsupialization
80.Gartner'scystareseenat? a)Anterolateralvaginalwall b)Antero-lateralcervix c)Posterolateralvaginalwall d)Posterolateralcervix CorrectAnswer-AAns,A,'.AnterolateralvaginalwallGartnersductcystarisesfromtheremnantsofthemesotephricductandliesintheanterolateralaspectofvaginalwall.
81.Mostcommoncauseofdeathofbabyin vasapreviais? a)Infection b)Maternalexanguination c)Fetalexanguination d)Bothbandc CorrectAnswer-CAns,C.FetalexanguinationVasapreviaInitaleashofbloodvesselshappentotraversethroughthemembranesoverlyingtheinternalos,infrontofpresentingpart.Ruptureofmembranesinvolvingtheoverlyingvesselsleadstovaginalbleeding.Asitisentirelyfetalblood,thismayresultinfetalexanguinationandevendeath.
82.Sheehansyndromeis? a)Pitutaryadenoma b)Pitutarynecrosis c)Adrenalnecrosis d)Adrenaladenoma CorrectAnswer-BAns.,B.PitutarynecrosisSheehan'ssyndromeisanteriorpituitorynecrosisfollowingseverePPH,shockorsevereinfection.
83.Mostcommoncauseofmenorrhagiain adolescents? a)Thyroiddisorder b)Coagulationdisorders c)Leiomyomas d)Polyps CorrectAnswer-BAns,B.CoagulationdisordersInadolescentagegroup,abnormaluterinebleedingresultsfromanovulationandcoagulationdefectsatdisproportionatelyhigherratescomparedwitholderreproductive-agedwomenCoagulationdisordersaccountfor20%ofcasesofmenorrhagiainadolescents.
84.Notassociatedwithendometrial hyperplasia? a)PCOD b)Glucoseintolerance c)HRT d)Unopposedexposuretoprogesterone CorrectAnswer-DAns.D.UnopposedexposuretoprogesteroneFollowingarethecausesofendometrialhyperplasiaFollicularcystsofovaryPCODGranulosaandthecacelltumorsofovaryHRTGlucoseintoleranceUnopposedexposuretoestrogen(endogenousorexogenous)
85. Followingarethecausesofmaternal deathsinpatientswithhypertensive disorderofpregnanacyexcept? a)Cardiacfailure b)ARDS c)Chronicrenalfailure d)Cerebralhemorrhage CorrectAnswer-CAns.C.ChronicrenalfailureCausesofmaternaldeathsincasesofhypertensivedisordersofpregnancyareCardiacfailureCerebralhemorrhageARDSPuerperalsepsisPulmonaryedemaAcuterenalfailurePulmonaryembolismAspirationand/orsepticpneumoniaCardio-pulmonaryarrestPost-partumshock
86.Classicalnameofmidcycleabdominal painwithvaginalbleedingiscalled? a)Endometriosis b)Mittelschmez c)Meteropathiahemorrhagica d)Menometrorrhagia CorrectAnswer-BAns.B.MittelschmezMittelschmerzisamid-cyclepain,notlastingmorethan12-24hours,aroundovulation.Painislocatedinoneoftheiliacfossaandmaybeaccompaniedwithvaginalbleeding.
87.Followingistrueaboutleuteomaof pregnancy? a)Usuallybilateral b)Itisabenignselflimitingcondition c)Itconsistsofleutenizedcells d)Alltheabove CorrectAnswer-DAns.D.AlltheaboveLeuteomaofPregnancyItusuallyappearsasbilateral,multinodular,solidmassesinovaries.ItischaracterizedbyreplacementofnormalovarianparenchymabysolidproliferationofleutenizedstromalcellsunderinfluenceofhumanchorionicgonadotroPin.Itisbenignself-limitingconditionandrequiresnotreatment.
88.ClinicalalarmingsignofMgSO4toxicityis ? a)Lossofkneejerk b)Lossofsuperficialabdominalreflexes c)Lossofpinpricksensation d)Lossofproprioception CorrectAnswer-AAns.A.Lossofkneejerk
89.FalseaboutMgSo4is? a)Notusedasantihypertensive b)Itsdoseisdifferentforeclampsiaandpreeclampsia c)Deeptendonreflexesismonitoredfortoxicity d)Itactsasamembranestabilizerandneuroprotector CorrectAnswer-BAns.B.ItsdoseisdifferentforeclampsiaandpreeclampsiaDoseofmagnesiumsulphateformanagementofpre-eclampsiaandeclampsiaisthesame.
90.18weekspregnancyofalady,lasttwo timeshistoryofmidtrimesterabortion,whichwaspainless.Whatisthediagnosis? a)Incompetentos b)Chromosomalabnormality c)Bivalveuterus d)Progesteronedeficiency CorrectAnswer-AAns.A.IncompetentosMostcommoncauseofsecondtrimesterpregnancylossiscervicalincompetence,inwhichpatientpresentswithrecurrentpainlessabortion.
91.Followingarethefeaturesoftruelabour pain? a)Uterinecontractionsatregularintervals b)Progressiveeffacementanddilationofcervix c)Formationofbagofmembranes d)Alltheabove CorrectAnswer-DAns.D.AlltheaboveFeaturesoftruelabourPainsUterinecontractionsatregularintervalsFrequencyofcontractionsincreasegraduallyIntensityanddurationofcontractionsincreaseprogressivelyAssociatedwithshowProgressiveeffacementanddilationofcervixDescentofthepresentingpartFormationofbagofforewatersNotrelievedbyenemaandsedatives
92.HRTimproves? a)Bonedensity b)Demetia c)Coronaryarterydisease d)Endometrialcancer CorrectAnswer-AAns,A.BonedensityHormonereplacementtherapyimprovesbonedensity,
93.Mostcommonriskfactorforruptureof scarreduterusis a)Useofoxytocininlabour b)Grandmultiparity c)Forcepsapplication d)Obstructedlabour CorrectAnswer-AAns,A.UseofoxytocininlabourThemostcommoncauseofruptureofscarreduteruskuseofhighdosesofoxytocinfortheaugmuntationoflabour.
94.Invalueabletoolinthediagnosisof chronicpelvicpainis? a)Endometrialbiopsy b)Ultrasound c)Laparoscopy d)Colposcopy CorrectAnswer-CAns,C.LaparoscopyLaproscopyisaninvalueablediagnostictoolintheinvestigationofchronicpelvicpain.
95.Mostcommonsiteofectopicpregnancyis ? a)Ovary b)Fallopiantube c)Peritoneum d)Cervix CorrectAnswer-BAns.B.Fallopiantube
96.Leastcommonsiteofectopicpregnancy infallopiantubesis? a)Interstitium b)Ampulla c)Infundibulum d)Isthumus CorrectAnswer-AAns,A.InterstitiumMostcommonsiteforectopicpregnancyfallopiantubes,
97.CriteriaforPuerperalpyrexiais temperature? a)100.4degreesFontwoseparateoccasions b)101degreesFontwoseparateoccasions c)100.4degreesFonthreeseparateoccasions d)101degreesFonthreeseparateoccasions CorrectAnswer-AAns,A.100.4degreesFontwoseparateoccasionsPuerperalpyrexiaAriseoftemperaturereaching100.4degreesF(38degreesC)ormore(measuredorally)ontwoseparateoccasionsat24hoursapart(excludingfirst24hours)withinfirst10daysfollowingdeliveryiscalledpuerperalpyrexia.
98.Investigationofchoicefordiagnosisof PIDis? a)Laparoscopy b)Colposcopy c)Hysteroscopy d)Ultrasonography CorrectAnswer-AAns,A.LaparoscopyLaparoscopyisconsideredtheinvestigationofchoiceforthediagnosisofpelvicinflammatorydisease.
99.Whichdrugispreferredforthetreatement of21hydroxylasedeficientfemalefetustopreventgenitalvirilization? a)Materalcortisol b)Maternaldexamethasone c)Maternalhydrocortisone d)Maternalmethylprednisolone CorrectAnswer-BAns,b.MaternaldexamethasoneFetusisatriskofCAHmaternaldexamethasonetherapycansuppressthefetalHPAaxisandpreventgenitalvirilizationinaffectedfemalefetus.
100.Speilbergcriteriaisusedfor? a)Ovarianpregnancy b)Ovarianmalignancy c)Cervicalpregnancy d)Cervicalmalignancy CorrectAnswer-AAns,A.Ovarianpregnancy
101.Mainfactorresponsibleforincreased perinatalmortalityintwinpregnancyis? a)Prematurity b)IUGR c)Polyhydramnios d)Uterinerupture CorrectAnswer-AAns,A.Prematurity
102.Cryptomenorrhoeaisafeatureof? a)Vaginalatresia b)Turnersyndrome c)Emptysellasyndrome d)Gonadalagenesis CorrectAnswer-AAns,A.Vaginalatresia
103..Whichofthefollowingantiepileptic drugisassociatedwithcausingcongenitalheartdiseaseinfetus? a)Barbiturates b)Valproate c)Carbamazepine d)Phenytoin CorrectAnswer-AAns.A.Barbiturates
104.Engagementofheadinlabourmeans? a)Smallesthorizontalplaneofthepresentingparthascrossedthe pelvicbrim b)Greatesthorizontalplaneofthepresentingparthascrossedthe pelvicbrim c)Smallesthorizontalplaneofthepresentingparthascrossedthe pelvicoutlet d)Greatesthorizontalplaneofthepresentingparthascrossedthe pelvicoutlet CorrectAnswer-BAns.B.GreatesthorizontalplaneofthepresentingparthascrossedthepelvicbrimWhenthegreatesthorizontalplaneofthepresentingparthaspassedtheplaneofpelvicbrimthepresentingpartissaidtobeengaged.
105.USGof28weeksgestationshowing oligohydramniosislikelytobedueto? a)Gastroinstestinalobstruction b)Renalpathwayobstruction c)Anencephyaly d)Neuromusculardisorder CorrectAnswer-BAns,B.RenalpathwayobstructionUrinarytractobstructionisanimportantcauseofoligohydramnios.
106.AnovulatoryDUBisdueto? a)Absenceofprogesterone b)Excessofestrogen c)Hypothalmicpitutarydefect d)Highprogesterone CorrectAnswer-AAns.A.AbsenceofprogesteroneNoprogesteroneisproducedwhenovulationdoesnotoccur,andthusproliferativeendometriumpersists.Atthetissuelevel,persistentproliferativeendometriumisoftenassociatedwithstromalbreakdown,decreasedspiralarterioledensity,andincreaseddilatedandunstablevenouscapillaries.Atthecellularlevel,theavailabilityofarachidonicacidisreduced,andprostaglandinproductionisimpaired.Forthesereasons,bleedingassociatedwithanovulationisthoughttoresultfromchangesinendometrialvascularstructureandinprostaglandinconcentration,andfromanincreasedendometrialresponsivenesstovasodilatingprostaglandins.
107.Incarcinomacervixsurgerytoretain conceptionisdoneinwhichstage? a)1B1 b)1B2 c)2A d)2B CorrectAnswer-AAns.A.1B1ConceptsisretaineduptotermonlyinstageIA1.Inotherstages,hysterectomyisdonewithfetusleftinsitu(ifitisnotviable);ordeliveryoffetusbyclassiccesareanhysterectomyfollowedbyradiation(iffetusisviable).
108.Bishopscoringisdonefor? a)Exchangetransfusioninnewborn b)Inductionoflabour c)VentilationofNewborn d)GestationofNewborn CorrectAnswer-BAns.B.InductionoflabourBishopscore,alsoBishop'sscore,alsoknownascervixscoreisapre-laborscoringsystemtoassistinpredictingwhetherinductionoflaborwillberequired.
109.Teratozoospermiarefersto? a)Absenceofsemen b)Absenceofsperm c)Alldeadspermsinejaculate d)Morphologicallydefectivesperms CorrectAnswer-DAns.D.Morphologicallydefectivesperms
110.Bispinousdiameterinanatomicoutlet? a)10.5cm b)11cm c)11.5cm d)12cm CorrectAnswer-BAns.B.11cmAnatomicaloutletAntero-posterior(13cm)Distancebetweenlowerborderofsymphysispubistothetipofcoccyx.Transversediameter(bispinous-11cm)DistancebetweentheinnerbordersofischialtuberositiesPosteriorsagittaldiameter(8.5cm)Distancebetweensacroccygealjointandanteriormarginofanus.
111.Mostsuitabletypeofpelvisinfemale? a)Gynaecoid b)Android c)Anthropoid d)Platypelloid CorrectAnswer-AAns.A.GynaecoidGynaecoidpelvisroundinshape&ismostspacious.
112.WhichpelvisisassociatedwithDTA? a)Android b)Antrhropoid c)Platypelloid d)Gynaecoid CorrectAnswer-AAns.A.Android
113.Inobstructivelabormostimportant parameteris? a)Diameterofpelvicinlet b)Diameterofpelvicoutlet c)Biparietaldiameter d)Bitemporaldiameter CorrectAnswer-BAns.B.DiameterofpelvicoutletThenarrowestdiameterforthefetustopassthroughispelvicoutlet.
114.Maximumdiameterthatpassedthrough maternalpelvis? a)Suboccipitalbregmatic b)Biparietal c)Suboccipitalfrontal d)Occipitofrontal CorrectAnswer-BAns,B.BiparietalOccipitofrontalislargediameteranddeflexedheadmaycomplicateasdeeptransversearrestandobstructedlabour.Incaseofspaciousgynaecoidandanthropoidpelvisitendsupinfacetopubisdelivery.Mento-verticalisthelargestdiameterbutitcannotpassthroughthematernalpelvis.
115.Semenexaminationcanbedone? a)Immediatelyinsemisolidform b)Afterliquefaction c)Within15-30minutesofliquefaction d)11/2-2hrirrespectiveofliquefaction CorrectAnswer-DAns.D.11/2-2hrirrespectiveofliquefactionSemenanalysisBestspecimenobtainedbymasturbation3-5daysofabstinenceisbest,notmorethanthatSpecimenshouldbeexaminedwithin11/2-2hrLiquefactionusuallycompleteswithin15-20minandifdelayeditindicatesprostaticdysfunction.Thusduringsemenanalysistimingofliquefactionisimportantbuttimingofanalysisisnotsetaccordingtoliquefaction.
116.Lithotomypositionincreasesvaginal openingbyhowmanycm- a)1cm b)2cm c)3cm d)4cm CorrectAnswer-BAns.B.2cmIndorsallithotomyposition,theantero-posteriordiameteroftheoutletmaybeincreasedto1.5-2cm.Furthermore,thecoccyxispushedbackwhiletheheadilescendsdowntotheperineum.
117.Endometrialbiopsyisusuallydoneat? a)Justbeforemenstruation b)10-12daysaftermenstruation c)Justaftermenstruation d)Atthetimeofovulation CorrectAnswer-AAns.A.Justbeforemenstruation
118.Oligomenorrhoeameans? a)Cycle<20days b)Cyclemorethan45days c)Cyclemorethan28days d)Cyclemorethan35days CorrectAnswer-DAns.D.Cyclemorethan35daysnee
119.Magnificationobtainedbycolposcopyis ? a)1-2times b)5-6times c)15-25times d)10-20times CorrectAnswer-DAns.D.10-20timesColposcopeprovidesamagnificationof10-20times.Colpomicroscopeprovidesamagnification100-300times.
120.OnwhichdayLH&FSHshouldbe measured? a)1-3rdday b)7thday c)14thday d)10thday CorrectAnswer-AAns.A.1-3rddayLevelofthehormoneFSH,LHandestradiolarcmeasuredonday3ininfertilityworkup.AnelevatedFSHlevelonday3isanindicationofpoorovarianreserve.HormonalassessmentFSH/LHdevelopingfollicleproducesestrogenwhichsignalsthehypothalamustoincreaseorreducetheamountofFSHproducedbythepituitarygland.WhengoodfolliclesarenotdevelopingestrogenlevelsarelowerandmoreFSHisproduced.ThisleaktohigherlevelofFSHonday3.Day3FSHfertilitytestbnottheonlyparameterusedtoassessovarianreserve.
121.Bestparameterforestimationoffetal agebyultrasoundin3rdtrimesteris? a)Femurlength b)BPD c)Abdominalcircuference d)Intraocculardistanc CorrectAnswer-AAns.A.FemurlengthBestparametersforestimationoffetalagebyultrasound1sttrimester?CrownRumplength(CRL)2ndtrimester-Correctedbiparietaldiameter(cBPD)orheadcircumference(HC)3dtrimester-HeadcircumferenceandfemurlengthOverall-Crownrumplength
122.Commonestvarietyofcompound presentationis? a)Headwithhand b)Headwithfoot c)Headwithbothfoot d)Head,hand&foot CorrectAnswer-AAns.A.HeadwithhandWhenacePhalicpresentationiscomplicatedbythepresenceofahandorafootorbothalongsidetheheadorpresenceofoneorbothhandsbythesideofthebreechitiscalledcompoundpresentation.Commonestvarietyofcompoundpresentation-HeadwithhandRarestvarietyofcompoundpresentation-Headwithhandandfootboth.
123.Hegarsign? a)Uterinecontraction b)Quickening c)Bluishdiscolorationofvagina d)Softeningofisthmus CorrectAnswer-DAns.D.SofteningofisthmusHegarssignPresentin2/3ofcases.Demonstratedin6-10weekSignsisbasedonthefadthat: 1. Upperpartofthebodyoftheuterusisenlargedbygrowingfetus.2. Lowerpartofthebodyisemptyandextremelysoft(justabovethe cervix) 3. Cervixiscomparativelyfirm. Becauseofvariationinconsistentonbimanualexamination(twofingersinanteriorfornixandtheabdominalfingersbehindtheuterus)theabdominalandvaginalfingersseemtoopposebelowthebodyoftheuterus.
124.Pregnantwomengoingforlongjourney &prolongedsittingisassociatedwithdangerof? a)Thromboembolism b)Seatbeltcompression c)Pretermlabor d)Bleeding CorrectAnswer-AAns.A.ThromboembolismProlongedsittingincaroraeroplaneisavoidedduetovenousstasisorthromboembolism.
125.Headofbabyisremovedinbreech deliverybywhichmaneuver? a)Lovsetsmaneover b)Pinardsmaneover c)Prague d)BurnMarshallmethod CorrectAnswer-DAns.D.BurnMarshallmethod
126.Praguemanueverisusedfor? a)Aftercomingheadinbreech b)Deeptransverseassest c)Extractionofextendedarms d)Externalcephalicversion CorrectAnswer-AAns.A.AftercomingheadinbreechSometimestheheadrotatesposteriorlyso,thatthefaceisbehindthepubis.Deliveryinthispositionisdifficultand'Praguemaneuver'maybetried.
127.
Trialoflabourinpreviouscaseariansectioncanbedonein? a)PlacentapreviatypeIII b)Previoustwoclassicalcaseariansection c)SuspectedCPD d)Previouscaesariansectionwithadequatepelvis CorrectAnswer-DAns.D.PreviouscaesariansectionwithadequatepelvisAdequatepelvisisanindicationoftrialoflabour.Otherthreeoptionsarecontraindications.
128.Hematomaduringlabourisnotdueto? a)Improperhaemostasis b)Extensionofcervicallaceration c)Ruptureofparavaginalvenousplexus d)Obliterationofdeadspacewhilesuturingvaginalwall CorrectAnswer-DAns.D.ObliterationofdeadspacewhilesuturingvaginalwallFailureofobliterationofdeadspacecauseshematoma(notobliterationofdeadspace).
129.Treatmentofjaundiceinthirdtrimester? a)Terminationofpregnancy b)Terminationat42weeks c)Terminationat38weeks d)Waitforspontaeouslabour CorrectAnswer-CAns,C.Terminationat38weeksInpatientsofintrahepaticcholestasisofpregnancythereisincreasedperinatalmortality.HencefetalsurveillanceisdonewithbiweeklyNST.Conventionalantepartumtestingdoesnotpredictfetalmortalityasthereissuddendeathincholestasisduetoacutehypoxia.Hencedeliveryisrecommendedat37-38weeks.InthosepatientswithjaundicewithSbilirubin>1.8mg%,terminationofpregnancyshouldbedoneat36weeks.
130.Rateofturnoverofamnioticfluidis? a)500cc/h b)1L/hr c)1500cc/h d)2L/h CorrectAnswer-AAns.A.500cc/hSpecificgravityofAmnioticfluid:1.008to1.010Osmolality:250mosm/LCompletelyreplacedin3hours.Rateofamnioticfluidturnoveris500cc/hr.
131.Maximumamountofamioticfluidisseen athowmanyweeks? a)16 b)30 c)12 d)38-40 CorrectAnswer-DAns.D.38-40
132.Uteruspostpregnancybecomesapelvic organin? a)4weeks b)6weeks c)12weeks d)2week CorrectAnswer-DAns,D.2weekBytheendof2weeks-uterusisapelvicorgan.Bythemdof6week-uterusreturnsalmosttoitsnormalsize(prepregnantsize).
133.Assistedheaddeliveryisdonein? a)Browpresentation b)Facepresentation c)Persistentoccipitoposteriorposition d)Twinpresentation1522.%of CorrectAnswer-CAns.C.PersistentoccipitoposteriorpositionOccipitoposteriorpositions"Inpracticeabout5-1O%ofwomenadmittedinlabourwithcephalicpresentationspresentwithoccipito-posteriorpresentations.Giventimeandpatience,manyofthesewillrotateandgetcorrectedtooccipito-anteriorpositionanddelivernormally.
134.%ofwomendeliveringontheirEDDis? a)25% b)50% c)4% d)15% CorrectAnswer-CAns.C.4%BasedontheNoegelesfomulalabourstartsapproximatelyon:-Expecteddate?4%
135.Innercellmassdifferentiatesinto? a)Chorion b)Trophoectoderm c)Embryo d)Alloftheabove CorrectAnswer-CANs.C.EmbryoBlastocystenlarges&thezonapellucidaundergoeslysis,thisiscalledzonahatching.Thecellsontheoutersidebecometrohoectodermwhichdifferentiatesintochorion.Thecellsontheinnersideforminnercellmasswhichdifferentiatesintoembrvo.
136.Embryoiscalled"fetus"afterhowmany weekspostfertilization/conception? a)6 b)8 c)10 d)12 CorrectAnswer-BAns.B.8Embryonicperiodbeginsat3rdweekfollowingovulation/fertilization&extendsupto8weekspostconception(10weeksfromLMP).Fetalperiodbeginsafter8weekspostconception(10weeksfromLMP)&endsindelivery.
137.Utero-placentalcirculationis establisheddaysafterfertilization? a)5 b)10 c)15 d)20 CorrectAnswer-BAns.B.10TheuteroPlacentalcirculationisestablished9-10daysafterfertilization.Fetoplacentalcirculationisestablished2ldayspostfertilization.
138.Pregnancyiscontraindicatedinallofthe followingexcept- a)PrimaryPulmonaryHypertension b)Eisenmenger'ssyndrome c)Marfan'swithaorticrootdilation d)WPWsyndrome CorrectAnswer-DAns,D.WPWsyndrome
139.Whichheartdiseasehastheworst prognosis/maximummortalityinpregnancy? a)MS b)AS c)PDA d)Eisenmenger'ssyndrome CorrectAnswer-DAns.D.Eisenmenger'ssyndrome
140.Ovariancyclecanbecorrelatedwithall except? a)Endometrialsampling b)Vaginalcytology c)Bloodhormonallevels d)Estrouscycle CorrectAnswer-DAns.D.EstrouscycleEstrouscycledoesnotoccurinhumanbeings.
141.Endometrialbiopsytodetectovulationis doneonwhichdayofthemenstualcycle? a)Day8-9 b)Day13-15 c)Day21-23 d)Day3-5 CorrectAnswer-CAns.C.Day21-23EndometrialBiopsy:Rarelydonenowadaysforthepurposeofiletectingovulation.
142.Theuterinebloodflowattermis- a)50mL/min b)100-150mL/min c)350-375mL/min d)500-750mL/min CorrectAnswer-DAns.D.500-750mL/minUteroplacentalbloodflowincreasesprogressivelyduringpregnancyandrangesfrom5N)-800mL/minatterm.
143.Godell'ssignis? a)Duskyhueofthevestibule b)Softeningofthecervix c)Increasedpulsationsfeltthroughthelateralfornices d)Regularandrhythmiccontractionsduringbimanualexamination CorrectAnswer-BAns.B.Softeningofthecervix
144.Infetus,insulinproductionbeginat weeksofgestation- a)4-6 b)8-12 c)14-18 d)24-28 CorrectAnswer-BAns.B.8-12Reaching8to10weeksintodevelopment,thepancreasstartsproducinginsulin,glucagon,somatostatin,andpancreaticpolypeptide.
145.Limbbudappearatwhatweeksof gestation? a)3 b)4 c)6 d)9 CorrectAnswer-BAns.B.4Theupperextremityisfirstdiscretelyvisibleasabulgeorlimbbudthatdevelopsontheventrolateralwalloftheembryoonday26(4-mmcrown-to-rumplength).
146.Featuresofnonsevere/mildpre ecampsiaareallecxept- a)DiastolicBP<100mmHg b)SystolicBP<160mmHg c)MildIUGR d)Nopremonitorysymptoms CorrectAnswer-CAns.,C.MildIUGR
147.FERNINGisdueto? a)Estogen&sodiumchloride b)Progesterone&sodiumchloride c)HCG d)Alloftheabove CorrectAnswer-AAns,A,Estogen&sodiumchlorideCervicalmucusisrelativelyrichinsodiumchloridewhenestrogen(butnotprogesterone)isbeingproduced.
148.Secondwaveoftrophoblasticinvasion occursatweeksofgestation? a)8-11 b)10-12 c)12-15 d)16-20 CorrectAnswer-CAns,C.12-15Thetimingofthedevelopmentoftheuteroplacentalvesselshasbeendescribedinwaves,orstages,overthecourseofgestation.Thefirstwaveoccursbefore12weekspost-fertilizationandconsistsofinvasionandmodificationofthespiralarteriesofthedecidua.Between12and16weekspos-fertilization,thesecondworeoccurs.Thisinvolvesinvasionoftheintramyometrialpartsofthespiralarteries,convertingnarrowlumen,muscularspiralarteriesintodilated,low-resistanceuteroplacentalvessels.
149.Abstinenceperiodbeforesemen analysisis? a)1-2days b)3-5days c)5-7days d)7-9days CorrectAnswer-BAns.B.3-5daysTheidealspecimenforexaminationisafter3-5daysofabstinence.
150.Engagingdiameterinfacepresentation is- a)Suboccipitobregmatic b)Mentovertical c)Submentobregmatic d)Occipitofrontal CorrectAnswer-CANs,C.Submentobregmatic
151.Leastlikelytocausedysmenorrhea- a)Endometriosis b)Adenomyosis c)Uterinepolyp d)Cervicalpolyp CorrectAnswer-DAns,D.Cervicalpolyp
152.LHsurgeisdueto? a)Progesterone b)Estrogen c)AMH d)Alloftheabove CorrectAnswer-BAns,B.Estrogen3-4daysbeforetheovulation,estrogenlevelcrossesacertainlimit(thresholdlevel).
153.Menopauseisdefinedas? a)Presenceofhotflushes b)Cessationofmensesfor1year c)Cessationofmensesfor6months d)Cessationofmensesfor2years CorrectAnswer-BAns,B.Cessationofmensesfor1yearMenopauseisdefinedasthepermanentcessationofmensesfor7yearandisphysiologicallycorrelatedwiththedeclineinestrogensecretionresultingfromthelossoffollicular/ovarianfunction.
154.Symptomsofmenopauseareallexcept? a)Hotflushes b)Nightsweats c)Decreaselibido d)Intermittenthypotension CorrectAnswer-DAns,D.IntermittenthypotensionHotflushesTheclassicsymPtomassociatedwithestrogendeficiencyisthehotflash,alsoknownashotflushThissymptomisdescribedas'recurrent,transientperiodsofflushing,sweatingandasensationofheat,oftenaccompaniedbypalpations,feelingofanxietyandsometimesfollowedbychills".
155.MENOPAUSEisdiagnosedby? a)Estradiol<20pg/ml b)Progesterone<40ng/dl c)FSH>40IU/L d)LH>20IU/L CorrectAnswer-CAns,C.FSH>40IU/LAspertheAmericanAssociationofclinicalEndocrinologists,thediagnosisofmenopauseisconfirmedbyFSHlevels>40IU/L.
156.Thevelocityofspermis? a)1-2cm/hr b)2-4cm/min c)1-4mm/min d)1-4mm/hr CorrectAnswer-CAns.C.1-4mm/minThevelocityofasperminfluidmediumisusually1-4mm/min.Thisallowsthespermtomovetowardsanovuminordertofertilizeit.
157.Afterejaculationsemenliquefiesin? a)10minutes b)30minutes c)75minutes d)120minutes CorrectAnswer-BAns.B.30minutesFollowingejaculation,thesemenformsagelwhichprovidesprotectionforthespermfromtheacidicenvironmentofthevagina.Thegelisliquefiedwithin20-30minutebyenzymesfromtheprostategland.
158.Duringpregnancy,truestatementabout CVSis? a)Cardiacoutputdecreases b)Rightaxisdeviation c)Increaseinleftventricularenddiastolicdiameter d)Alloftheabove CorrectAnswer-CAns,C.Increaseinleftventricularenddiastolicdiameter2Decho:Increaseinleftventricularenddiastolicdiameter.Increaseinleftandrightatrialdiameters.
159.MCsiteofimplantationis? a)Fallopiantubeamullarypart b)Fallopiantubeisthmus c)Fundusofuterus d)Cornuofuterus CorrectAnswer-CAns,C.FundusofuterusImplantationoccursintheendometriumontheanteriororposteriorwallofthebodynearthefundusonthesixthdayfollowingfertilization(correspondingtothe20thdayofthemenstrualcycle).
160.AlphasubunitofhCGissimilarto? a)FSH b)LH c)TSH d)Alloftheabove CorrectAnswer-DAns,D.AlloftheaboveHumanchorionicGonadotropin(hcG)isstructurallyrelatedtothreeotherglycoproteinhormonesLH,FSH,andTSH.
161.Placentalhormonewithhighest carbohydratecontentis- a)HCG b)Humanpregnancyspecificbetaglycoprotein c)HPL d)Relaxin CorrectAnswer-AAns,A.HCGHCGhasthehighestcarbohydratecontentofanyhumanhormone-30%.
162. Thepelvicinletusuallyisconsideredto becontractedifitsshortest anteroposteriordiameterislessthan- a)12cm b)10cm c)8cm d)14cm CorrectAnswer-BAns.B.10cmThepelvicinletusuallyisconsideredtobecontractedifitsshortestanteroposteriordiameterislessthan10cmorifthegreatesttransversediameterislessthan12cm
163.AzoospermiawithnormalFSHwould indicate? a)Hypothalamicfailure b)Testicularfailure c)Obstructionofvasdefrens d)Alloftheabove CorrectAnswer-CAns,C,Obstructionofvasdefrens
164.Causesofmaleinfertility? a)Idiopathic b)Varicocele c)Yq11microdeletion d)Alloftheabove CorrectAnswer-DAns,D.Alloftheabove
165.Fetalthyroidglandisabletosynthesize hormonesbyweeksofgestation? a)6-7 b)7-8 c)10-12 d)12-14 CorrectAnswer-CAns,C.10-12Fetalthyroidglandisabletosynthesizehormonesby10-12weeksofgestation.
166.PoorprognosisinfirsttrimesterUSGis ? a)Nofetalpoleat5weeks b)Nocardiacactivityat5weeks c)Nogestationalsacat4weeks d)Nocardiacactivityat8weeksofgestation CorrectAnswer-DAns,D.Nocardiacactivityat8weeksofgestationAbsenceofembryowithheartbeat22weeksafterascanthatshowedagestationalsacwithoutayolksac
167.Allaretrueaboutpostpartum depressionexcept- a)Symptomsresolvein10-12days b)Affectsbothsexes c)SSRIsareeffective d)Noneoftheabove CorrectAnswer-AAns,A.Symptomsresolvein10-12days
168.NerveinjuredinMcRobertsmaneuveris ? a)Lumbosacraltrunk b)Obturatornerve c)Femoralnerve d)Pudendalnerve CorrectAnswer-CAns,C.FemoralnerveMcRobertsmaneuveristobedoneincasesofshoulderdystocia.Whenthematernalthighsaremarkedlyflexedandabducted,pressurefromtheoverlyinginguinaliigamentmayleadtofemoralnerveinjury.
169.Mostconclusiveclinicalsignof pregnancyis? a)Uterineenlargement b)Cervicalsoftening c)Amenorrhea d)Fetalheatsoundauscultation CorrectAnswer-DAns.D.FetalheatsoundauscultationFHSauscultationisthemostconclusiveclinicalsignofpregnancy.
170.CRLwhencardiacactivitycanbe detectedearliestbyTVS- a)1-4mm b)1cm c)6-7mm d)2-4cm CorrectAnswer-AAns,A.1-4mmFetalheartbeatcanbedetectedasearlyasjustunder6weeksgestationongoodquality,highfrequencytransvaginalultrasound,asacrownrumplength(CRL)ofaslittleas1-2mm.
171.Kamla,30yearsold,P2L2with3.2x4.1 cmfibroiduterus,complainsofmenorrhagiaandisonsymptomatictreatmentsince6months.Thepatientrefusessurgery.Nextlineofmanagementis? a)GnRHanalogs b)Danazol c)Myomectomy d)Uterinearteryembolization CorrectAnswer-DAns,D.UterinearteryembolizationUAEcanbeusedasatherapyforsymptomaticpatientswhorefuseorwanttoavoidsurgery.Afterembolization,thereis60-65%decreaseinsizeoffibroidsoveraperiodof6-9months,andsothepatient'ssymPtomsmaydecreaseordisaPPear.Ifthepatientisstillsymptomaticafter1year,thensurgeryshouldbeconsidered.
172.Livingligatureoftheuterusis? a)Endometrium b)Middlelayerofmyometrium c)Innerlayerofmyometrium d)Parametrium CorrectAnswer-BAns,B.MiddlelayerofmyometriumMiddlecrisscrossfibresactaslivingligatureduringinvolutionoftheuterusandpreventbloodloss.
173.Inpartogramsrecommendedby'WHO' thedistancebetweenthealertandactionlinesis? a)1hour b)2hours c)4hours d)5hours CorrectAnswer-CAns.C.4hoursTheconceptofalertline'and`actionline'wasintroducedbyPhilpottandCastlein1972.Theactionlinecanbeplacedat2?4hoursintervaltotherightandparalleltoalertline.Inpartogramsrecommendedby'WH0'thedistancebetweenthealertandactionlinesis4hours.
174.Surgicalexcisionofcorpusluteum beforeweeksofgestation,resultsinmiscarriage a)6-7 b)9-11 c)11-12 d)12-14 CorrectAnswer-AAns,A,6-7Surgicalexcisionofcorpusluteum(luteoctomy)before7weeksofgestation,uniformlyprecipitatedanabruptdecreaseinserumprogesteroneconcentrationfollowedbymiscarriage
175.Factorsresponsiblefordevelopmentof OHSSinclude? a)Histamine b)Cytokines c)VascularEndothelialGrowthFactor d)Alloftheabove CorrectAnswer-DAns,D.AlloftheaboveVEGFisconsideredtobethemostimportant.
176.MVAsyringeisusedfor? a)FirsttrimesterMTP b)2ndtrimesterMTP c)Vacuumdelivery d)Alloftheabove CorrectAnswer-AAns,A,FirsttrimesterMTPManualvacuumaspiration(MvA)isasafeandeffectivemethodofabortionthatinvolvesevacuationoftheuterinecontentsbytheuseofahand-heldplasticaspirator.Itisappropriatefortreatmentofincompleteabortionforuterinesizesupto12weeksfromthelastmenstrualperiod(includingmiscarriage,spontaneousabortionandremovalofretainedproductsfromaninducedabortion),first-trimesterMTPandendometrialbiopsy.
177.Diihrssenincisionistakenon- a)Fallopiantube b)Ovary c)Incompletelydilatedcervix d)Fullydilatedcervix CorrectAnswer-CAns,C,IncompletelydilatedcervixOccasionallnespeciallywithsmallpretermfetuses,theincompletelydilatedcervixwillnotallowvaginaldeliveryoftheafter-comingheadofthebreech.Insuchcases,Duhrssenincisionsareusuallynecessary(cutthecervixatl0and2o'clockpositions).
178.A27-year-oldfemalewithplacentaprevia hadseverebleeding.Whatisthemostlikelyoutcomepostdelivery? a)Galactorrhea b)Diabetes c)Absenceofmenstrualcycle d)Cushingsyndrome CorrectAnswer-CAns.c.AbsenceofmenstrualcycleSheehansyndrome,alsoknownaspostpartumhypopituitarismorpostpartumpituitarynecrosis,ishypopituitarismcausedbynecrosisduetobloodlossandhypovolemicshockduringandafterchildbirth.MostcommoninitialsymptomsofSheehansyndromeareagalactorrhea(absenceoflactation)underdifficultieswithlactation.Manywomenalsoreportamenorrheaoroligomenorrheaafterdelivery.
179.Womanhas100mlbloodlossevery30 days.Thisiscalledas? a)Menorrhagia b)Polymenorrhea c)Hypomenorrhea d)Normalmenses CorrectAnswer-AAns.A.MenorrhagiaNormalbloodlossduringmensesisaround35ml(20-80ml)Bloodlossmorethan80mlismenorrhagia
180.Menometrorrhagiais? a)Heavyperiods b)Intermenstrualbleeding c)Heavy&irregularbleeding d)Uterinebleedingoccurringatregularintervalsoflessthan21 days CorrectAnswer-CAns.C.Heavy&irregularbleeding
181.Prevalenceofbreechpresentationatfull termis? a)10% b)6-7% c)3-4% d)1-2% CorrectAnswer-CAns.C.3-4%
182.Theshortestconjugateis? a)Trueconjugate b)Obstetricconjugate c)Diagonalconjugate d)Anatomicalconjugate CorrectAnswer-BAns.B.ObstetricconjugateObstetricconjugate(10cm)DistancebetweenmidpointofsacralPromontorytotheprominentbonyprojectioninthemidlineoninnersurfaceofsymphysispubis.
183.Shortesttransversediameteris? a)BPD b)Bitemporaldiameter c)Bimastoiddiameter d)Allareequalinlength CorrectAnswer-CAns.C.BimastoiddiameterBimastoiddiameter=7.5cmOccipitofrontaldiameter11.5cm
184.Withreferencetofetalheartrate,a nonstresstestisconsideredreactivewhen? a)Twofetalheartrateaccelerationsarenotedin20minutes b)Onefetalheartrateaccelerationisnotedin20minutes c)Twofetalheartrateaccelerationsarenotedin10minutes d)Threefetalheartrateaccelerationsarenotedin30minutes CorrectAnswer-AAns.A.Twofetalheartrateaccelerationsarenotedin20minutesReactive(Reassuring)NSTTwoormoreaccelerationsof>15beats/minuteabovethebaseline,lastingfor>75secondsarcpresentin20-4Ominutesobservationperiod.
185.Variabledecelerationisseenin? a)Headcompression b)Uteroplacentalinsufficiency c)Cordcompression d)Noneoftheabove CorrectAnswer-CAns,C.CordcompressionVariabledecelerationsareduetocordcompression(oligohydramniosinlabor)
186.ModifiedBIOPHYSICALPROFILEis? a)NST+FETALTONE b)FETALTONE+AFI c)NST+AFI d)NST+FETALTONE+AFI CorrectAnswer-CAns,C.NST+AFIModifiedBPP=NST&AFIBPPhas5components
187.Iffetusishavinghypoxia,whichofthe BPPparameterwillbeaffectedlast? a)Fetaltone b)Fetalbreathingmovement c)Fetalmovements d)NST CorrectAnswer-AAns.A.FetaltoneFirstactivitytoappear,FetalToneatabout7.5-8.5weeks,isalsopresumablythelastactivitytodisappearwithprogressivelyworseninghypoxia.
188. Testusedtodetectgeneticabnormality inembryo,beforetransferringittothe uterusinIVFis? a)Embryocellbiopsy b)CVS c)ICSI d)Alloftheabove CorrectAnswer-AAns,A.EmbryocellbiopsyPGD,involvesremovingacellfromanIVFembryototestitforaspecificgeneticcondition(cysticfibrosis'forexample)beforetransferringtheembryototheuterus.
189.InIVF,embryosaretransferredbackto uterinecavityatcellsstage? a)2 b)2-4 c)4-8 d)8-16 CorrectAnswer-CAns,C.4-8Typicallyembryosatetransferredatthecleavagestage(Day2or3afteroocyteretrieval).Daythreeembryosatecalledcleavagestageembryosandhaveapproximately4-8cells.
190.Azoospermicpatientcanbeafatherofa child,bywhichofthefollowing? a)IUI b)ZIFT c)ICSI d)Notpossible&counselregardingadoption CorrectAnswer-CAns.C.ICSIPESA=percutaneousepididymalspermaspirationMESA=microscopicepididymalspermaspirationTESA=testicularspermasPirationTESE=testicularspermextraction(testicularbiopsy)
191.Aprimigravidawith36weeksof pregnancyisinlaborwith3cmdilatationandminimaluterinecontraction.Onruptureofmembranes,freshbleedingisnotedwithlatefetaldecelerationupto50beats/min.ThepatientwastakenforLSCSbutfetuscouldnobesaved.Noabruptioorplacentapreviawasseen.Thelikelydiagnosisis? a)Placentaprevia b)Revealedabruptio c)Circumvallateplacenta d)Vasaprevia CorrectAnswer-DAns.D.VasapreviaVasaprevia(l:2500)isarareconditioninwhichfetalbloodvesselsareinfrontofthepresentingpartandcrossthecervix.Theconditionhasahighfetalmortalityrate(50-95%).Thisisattributedtorapidfetalexsanguination,resultingfromthevesselstearingwhenthecervixdilates,membraneruPture.
192.AllarecomponentsofActive ManagementoftheThirdStageofLaborexcept? a)Uterotonicagentwithin1minuteofbirth b)Massageofuterusbeforecontrolcordtraction c)Controlcordtraction d)Noneoftheabove CorrectAnswer-BAns.B.MassageofuterusbeforecontrolcordtractionAdministeranuterotonicdrugatthedeliveryoftheanteriorshoulderorafterwards,withinoneminuteofthebaby'sbirth.BeforeperformingAMTSL,gentlypalpatethewoman'sabdomentoruleoutthepresenceofanotherbaby.Atthispoint,donotmassagetheuterus.PerformcontrolledcordtractionMassagetheuterusimmediately
193.Withwhichofthefollowingevents,the fetomaternalhaemorrhageriskistheleast? a)Amniocentesis b)Cordocentrsis c)Chorionicvillussampling d)Abruption CorrectAnswer-DAns.D.Abruption
194.Infertilityisdefinedas? a)Inabilitytoconceiveafter1yearofregularunprotected intercourse b)Inabilitytoconceiveafter1yearofmarriage c)Inabilitytoconceiveafter2yearsofmarriage d)Inabilitytoconceiveinspiteof2yearsofregularunprotected intercourse CorrectAnswer-AANS.A.Inabilitytoconceiveafter1yearofregularunprotectedintercourseInfertilityisdefinedasaninabilitytoconceiveinspiteof1yearofregularunprotectedintercourse
195.Cordprolapseisleastlikelywith- a)Transverselie b)Footlingbreech c)Oligohydroamnios d)Floatinghead CorrectAnswer-CAns.C.OligohydroamniosCordprolapsehasbeendefinedasthedescentoftheumbilicalcordthroughthecervixalongside(occult)orpastthepresentingpart(overt)inthevaginaoroutsidethevulvainthepresenceofrupturedmembranes
196.IdealtimetodoGlucosechallengetestin pregnancyis? a)12-16weeks b)20-24weeks c)24-28weeks d)30-34weeks CorrectAnswer-CAns.C.24-28weeksO'sullivanBloodSugarScreeningTest(GlucoseChallengeTest)Theidealtimetodothistestis24-28weeksofgestation(asinsulinresistanceinpregnancyismaximumat28weeksofgestation)
197.AfterIUFD,whendoesthemother developDIC- a)48hours b)1-2weeks c)3-4weeks d)6weeks CorrectAnswer-CAns.C.3-4weeksThromboplastinfromthedeadfetuscanenterthematernalsystemandcauseDIC.Thisonlyhappenswhenthedeadfetusisretainedinsidefor3-4weeks.
198.Folicacidrequiredinfirsttrimesterof normalpregnancy- a)100microgram b)400-500microgram c)4mg d)5mg CorrectAnswer-BAns,B,400-500microgramSomeNTDsareassociatedwithaspecificmutationinthemethylenetetrahydrofolatereductasegene,theadverseeffectsofwhichcanbelargelyovercomebypericonceptionalfolicacidsupplementation.MorethanhalfofNTDscouldbepreventedwithdailyintakeof400microgramoffolicacidthroughoutthepericonceptionalperiod.Awomanwithapriorpregnancycomplicatedbyaneuraltubedefectcanreducethe23%recurrenceriskbymorethan70%ifshetakes4mgoffolicacidforthemonthbeforeconceptionandforthefirsttrimesterofpregnancy.
199.A30-year-oldis14weekspregnant.She hadtwopainlessdeliveriesat16weeksearlier.Nextlineofmanagementis? a)Cervicalencerclage b)Evaluationfordiabetesmellitusandthyroiddisorders c)Cervicallengthassessment d)Tocolytics CorrectAnswer-CAns,C.CervicallengthassessmentThepatienthadtwopainlessabortionsat16weeksinthepast,somostlyitisacaseofincompetentos.Nextlineofmanagementinthesepatientsisfrequentcervicallengthassessment:clinicallyorbyUSG.Thepatientisevaluatedmorefrequentlyandifthecervixisshort(lessthan2.5cm)thancervicalencerclagehastobedone.Cervicalencerclageisthesurgeryofchoiceforincompetentos,butthesurgeryitselfcanleadtocomplicationssuchasuterinecontractions,abortions,andPROM.Sothesurgeryisonlytobedoneifitisindicated.
200.Uppertwo-thirdanteriorvaginalwall prolapseis? a)Cystocele b)Urethrocele c)Rectocele d)Enterocele CorrectAnswer-AAns.A.Cystocele
201.EarliestsignafterIUFDis? a)Overlappingofskullbones b)Hyperflexionofspine c)Gasingreatvessel d)Overcrowdingofribs CorrectAnswer-CAns.C.GasingreatvesselRobertsign(gasingreatvessels)-12hrsafterdeath.
202.TrueaboutGartnerscystis? a)RetentioncystinremnantsofWolffianduct b)Arisesfrommullerianduct c)Commonlyarisesfromcervix d)Impulseoncoughing CorrectAnswer-AAns,A.RetentioncystinremnantsofWolffianduct
203.Iftheanalspincterisinjured,itiswhich degreeofPerinealTear? a)First b)Second c)Third d)Fourth CorrectAnswer-CAns,C.ThirdPerinealTearsareclassifiedintofourcategoriesFirst-degreetear:lacerationislimitedtothefourchetteandsuperficialperinealskinorvaginalmucosa.Second-degreetear:lacerationextendsbeyondfourchette,perinealskinandvaginalmucosatoperinealmusclesandfascia,butnottheanalsphincter.Third-degreetear:fourchette,perinealskin,vaginalmucosa,muscles,andanalsphincteraretorn
204.Iftherectalmucosaisinjured,itiswhich degreeofPerinealTear? a)First b)Second c)Third d)Fourth CorrectAnswer-DAns,D.FourthRectalmucosaltearisfourthdegreetear.
205.Cryptomenorrheaoccursin? a)Fibroids b)PCOS c)Imperforatehymen d)Alloftheabove CorrectAnswer-CAns,C.ImperforatehymenCongenitalImperforatehymen:ItisduetofailureofdisintegrationofthecentralcellsofMullerianeminencethatprojectintourogenitalsinusTransversevaginalsePtumAtresiaofvagina,cervix.
206.Bestindicatorforovarianreserveis? a)AMH b)LH/FSHratio c)FSH d)Estradiol CorrectAnswer-AAns.A.AMHAMHbloodlevelsarethoughttoreflectthesizeoftheremainingeggsupplyor"ovarianreserve"
207.HPLhasactivitysimilartowhich hormone? a)Oxytocin b)Growthhormone c)Insulin d)Alloftheabove CorrectAnswer-BAns.B.GrowthhormoneHumanplacentalactogen(hPL)wasnamedso,becauseofitspotentlactogenic&growthhormonelikebioactivityaswellasimmunochemicalresemblancetohumangrowthhormone'
208.Whichofthefollowingisnotasoft tissuemarkerofDownsyndromeonUSG? a)IncreaseNT b)Absentnasalbone c)Exomphalos d)Polydactyly CorrectAnswer-DAns.D.Polydactyly
209.Inacaseofrecurrentspontaneous abortionthefollowinginvestigationisunwanted? a)Hysteroscopy b)Testingforantiphospholipidantibodies c)TestingforTORCHinfections d)Thyroidfunctiontests CorrectAnswer-CAns.C.TestingforTORCHinfectionsTestingforTORCHinfectionsisnowthoughttobeunwarranted.
210.Dilatation&evacuationisdoneforall ecxept? a)Inevitableabortion b)Incompleteabortion c)Threatenedabortion d)Noneoftheabove CorrectAnswer-CAns.C.ThreatenedabortionInevitableabortionmeanstheprocessofexpulsionofproductsofconceptionhasbecomeirreversible.Theexpulsionofproductsofconceptionhasnotoccurredbutitisboundtohappenandnothingcanbedonetostopthisprocess.Whentheentireproductsarenotexpelled,partofitisleftinsidetheuterinecavity,itiscalledincompleteabortion.
211.WHOnormalHbvalueforanonpregnant adultfemaleis? a)10gm/di b)11gm/dl c)12gm/dl d)13gm/dl CorrectAnswer-CAns.C.12gm/dl
212.Outcomesofoccipitoposteriorposition? a)Deeptransversearrest b)Occipitosacralarrest c)Facetopubisdelivery d)Alloftheabove CorrectAnswer-DAns,D.Alloftheabove
213.RMPcanperformMTPinfirsttrimesterif hehasassistedinMTPs- a)5 b)15 c)25 d)50 CorrectAnswer-CAns,C.25Aregisteredmedicalpractitionershallhaveoneormoreofthefollowingexperienceortrainingingynecologyandobstetricsnamely=Ifhehasassistedaregisteredmedicalpractitionerintheperformanceoftwenty-fivecasesofmedicalterminationofpregnancyofwhichatleastfivehavebeenperformedindependently,
214.Cryingoffetusinuteroiscalledas? a)Vagitusuterinus b)Firstcry c)Uterovaginalis d)Vagitusvagina CorrectAnswer-AAns,A.Vagitusuterinus
215.Trueaboutcephalhematomais: a)Crossesthesuturelines b)Alwayspresentatbirth c)Ventousedeliveryisariskfactor d)Alloftheabove CorrectAnswer-CAns.C.VentousedeliveryisariskfactorTheusualcausesofacephalohematomaareaprolongedsecondstageoflabororinstrumentaldelivery,particularlyventouse.
216.Allarecausesofanovulatory amenorrhoeaexcept? a)PCOD b)Hyperprolactemia c)Gonadaldysgenesis d)Drugs CorrectAnswer-CAns.C.GonadaldysgenesisCausesofanovulatoryamenorrheaPCODHyperprolactinaemiaWeightloss,stress,exerciseDrugsChestwallstimulation
217. Whatisfalseaboutpostmenopausal state? a)LowLH b)Lowestrogen c)HighFSH d)Highandrogen CorrectAnswer-AAns.A.LowLHHormonalchangesinpost-menoPausalstateFSHlevelisincreasedOestrogenlevelisdecreased&mostofitissynthesisedperipherallybyconversionofandrogentooestrogenAndrogenlevelisslightlyincreased
218.Inapostmenopausalfemale,which hormoneincreases? a)FSH b)Estrogen c)GH d)Noneoftheabove CorrectAnswer-AAns,A.FSH
219.Roleoflactobacilliinvaginalsecretions a)TomaintainalkalinepH b)TomaintainacidicpH c)Nutrition d)None CorrectAnswer-BAns.,B.TomaintainacidicpHTheimportanceofDoderlein'sbacillusisthatitspresenceisassociatedwithproductionoflacticacidcontainedinthevaignaandthisacidityinhibitsthegrowthofotherorganisms."Doderlein'sbacillusistheonlyorganismwhichwillgrowatthepHof4-4.5(normalpHofvagina).
220.Hegarsignallaretrueexcept? a)Bimanualpalpationmethod b)Difficultinobese c)Canbedoneat14weeks d)Presentin2/3rdofcases CorrectAnswer-CAns.C.Canbedoneat14weeksHegar'ssign:Presentin2/3rdofcases.Demonstratedbetween6-10weeks,alittleearlierinmultipara.Thissignisbasedonthe2facts(1)upperpartofthebodyofuterusisenlargedbygrowinguterusandlowerpartisemptyandsoftandcervixiscomparativelyfilm.Thereforeonbimannualexamination(2fingersintheanteriorfornixandabdominalfingersbehindtheuterus),abdominalandvaginalfingersseemtoapposebelowthebodyoftheuterus.
221.Hegarsignisseeninhowmanyweeks? a)6-10weeks b)10-14weeks c)14-18weeks d)18-22weeks CorrectAnswer-AAns.A.6-10weeks
222.Palmersignisrelatedto? a)Contractionofuterus b)Duskyhueofantvaginalwall c)Bluishdiscolourationofantvaginalwall d)Increasedpulsationsfeltthroughlateralfornix CorrectAnswer-AAns,A,ContractionofuterusPalmersign:-regularandrhythmiccontractionscanbeelicitedduringbimanualexaminationasearlyas4-8weeks.
223.Newborncanbegivenbreastmilkafter howmuchtimefollowingnormaldelivery? a)Halfhour b)1hours c)2hours d)3hours CorrectAnswer-AAnsA.HalfhourAhealthybabyisputtothebreastimmediatelyoratmost%to1hrfollowingnormaldelivery.Followingcaesareansectionsaperiodof4-6hoursmaybesufficientforthemothertofeedherbaby.
224.4monthamenorrhoeawithincreased FSH,LH&decreasedestrogenina35yrsold? a)Prematuremenopause b)Menopause c)Latemenopause d)Perimenopause CorrectAnswer-AAns,A.PrematuremenopausePrematuremenopauseisdefinedasovarianfailureoccurring2SDinyearsbeforethemeanmenopausalageinapopulation.Itisclinicallydefinedassecondaryamenorrheaforatleast3monthswithraisedFSHlevel,raisedFSH:LHratio&lowE2levelinawomenunder40yrsofage."
225.35yroldwith4monthsamenorrheawith increasedFSH,decreasedestrogen.Whatisthediagnosis? a)Prematureovarianfailure b)PCOD c)Pituitaryfailure d)Hypothalamicfailure CorrectAnswer-AAns.A.PrematureovarianfailureItisacaseofprematuremenoPause(prematureovarianfailure)'
226.Contractionstresstestfalseis? a)Oxytocinnotused b)Invasivemethod c)Detectsfetalwellbeing d)Negativetestisassociatedwithgoodfetaloutcome CorrectAnswer-AAns,A.OxytocinnotusedContractionstresstest(CST)(syn:Oxytocinchallengetest):Itisaninvasivetesttoassesfetalrespiratorywellbeingduringpregnancy.ItdetectsalterationinFHRinresponsetouterinecontractioninducedbyoxytocinindicatinghypoxia.InterpretationsNegativetestindicatedgoodoutcome
227.NST,whatisseenexcept? a)Variability b)Acceleration c)Timeperiod d)Oxytocin CorrectAnswer-DAns,D.OxytocinThenon-stresstest(NST)measuresfetalheartrate,whichismonitoredwithanexternaltransducerforatleast20minutes.Duringfetalmovement,tracingisobservedforheartrateacceleration.Testispositiveiftwoormorefetalheartrateaccelerationsoccursin20minuteperiod.
228.Menstrualregulationeffectiveupto? a)14days b)21days c)4weeks d)6weeks CorrectAnswer-AAns,A.14daysMenstrualregulation(lnduction/Aspiration)Aspirationofendometrialcavitywithinl4daysofmissedperiodinawomanwithpreviousnormalcycle.DoneasanOPDprocedure.Helpstodetectfailedabortion,molarpregnancyorectopicPregnancy.Contraindicatedinadvancedpregnancy&inpresenceoflocalpelvicinflammation.
229.pHofvaginainpregnantwomanis usually? a)4.0 b)4.5 c)5 d)>5 CorrectAnswer-AAns.A.4.0Thevaginalacidityisduetolacticacid.ThenormalpHinthehealthywomenofthechildbearingagegroupis4.5
230.VaginalpHbeforepubertyis? a)7 b)6 c)4.5 d)5 CorrectAnswer-AAns.A.7
231.Decidualreactionisduetowhich hormone? a)Progesterone b)Estrogen c)LH d)FSH CorrectAnswer-AAns.A.ProgesteroneIncreasedstructural&secretoryactivityoftheendometriumthatbroughtaboutinresponsetoprogesteronefollowingimplantationisknownasDecidualreaction".
232.Inhibinlevelsarecheckedonwhichday ofmenstrualcycle? a)Day3 b)Day4 c)Day5 d)Day6 CorrectAnswer-AAns.A.Day3Ovarianreservetestisdesignedtoassessboththenumberofimmatureeggsintheovariesandtheirquality,whichgivesanindicationofwoman'spotentialfertility.Itworksbydetectingthelevelsofthreefemalehormones,usingabloodsampletakenondaythreeofmenstrualcycle: 1. Folliclestimulatinghormone(FSH)2. Anti-mullerianhormone(AMH)3. Inhibin-B
233.Besttestforovulation? a)Serumestrogen b)Serumprogesterone c)Both d)None CorrectAnswer-BAns.B.SerumprogesteronePlasmaconcentrationofprogesteronerisesafterovulation&reachespeakof15ng/mlatmidlutealphase&thendeclinesasthecorpusluteumdegenerates".
234.Cardiacoutputincreasesmaximumat whichweek? a)26-28wks b)30-32wks c)32-34wks d)34-36wks CorrectAnswer-CAns.C.32-34wksCardiacoutput:Startstoincreasefrom5thweekofpregnancy,reachesitspeak40-50%atabout30-34weeks.
235.Inpregnancyplasmavolumeincreased maximumatwhatgestationalage? a)10wks b)20wks c)25wks d)30wks CorrectAnswer-DAns,D.30wksPlasmavolumeisincreased.Startingtoincreaseat6weeks&reachingmaxupto50%at30weeks.Totalplasmavolumeincreasestotheextentof1.25litres.
236.5monthpregnantfemale,whichofthe followingistrue? a)50%havesoftsystolicmurmur b)Cardiacoutputisreduced c)Systemicvascularresistanceisincreased d)IncreaseinCVP CorrectAnswer-AAns.A.50%havesoftsystolicmurmurAnatomicalchangesduringpregnancyHeartispushedupwards&outward.Apexbeatisshiftedin4thintercostalsspace.Asystolicmurmurcanbeheardinapicalorpulmonaryarea.Mammarymurmurisacontinuoushissingmurmuraudibleovertricuspidareainleft2nd&3rdiintercostalsspace.ECGshowsleftaxisdeviation.53andrarely54canbeheard.
237.Spinnbarkeitismaximumshownat whichphase? a)Menstrualphase b)Ovulatory c)Postovulatory d)Prefollicular CorrectAnswer-BAns.B.OvulatorySpinnbarkeittest(ThreadtestorFerntest)AsPecimenofcervicalmucuswhenseenunderlowpowermicroscope,showsacharacteristicfernformation.Donetoseetheestrogenicactivityinovulatoryphaseofmenstrualcycle.
238.Rarestpresentationis? a)Cephalic b)Breech c)Shoulder d)Vertex CorrectAnswer-CAns.C.Shoulder
239.Fertileperiodoffemaleismeasuredby? a)LH b)FSH c)Estrogen d)Oxytocin CorrectAnswer-AAns,A.LH"LHsurgefromtheanteriorpituitaryglandoccurs24hourspriortoovulation.Radioimmunoassaysofthemorningsampleofurine&bloodgivesresultsin3hours.NotonlydoestheLHsurgehelpinpredictingovulation,buttheapproximatetimeofovulationcanbegauged&coitusaroundthistimecanimprovethechancesofconception."
240.Externalversionisdoneafter? a)34weeks b)36weeks c)38weeks d)40weeks CorrectAnswer-BAns.B.36weeksThemaneuveriscarriedoutafter36weeksinlabour-deliverycomplex."
241.Leastcommonpresentationoftwins? a)Bothvertex b)Bothbreech c)Bothtransverse d)Firstvertexand2ndtransverse CorrectAnswer-CAns.C.BothtransverseLie-Presentationintwinpregnancy:Themostcommonlieinthefetusesislongitudinal(90%).Thecombinationofpresentationoffetusesare:Bothvertex(50%)Firstbreechsecondvertex(10%)Firstvertexandsecondtransverse(rare)Firstyertexandsecondbreech(30o/o)Bothbreech(10%)Bothtransverse(rarest).
242.
Presentingpartintransverselie? a)Shoulder b)Face c)Vertex d)Brow CorrectAnswer-AAns.A.Shoulder'Whenthelongaxisofthefetusliesperpendicularothematernalspineorcentraliseduterineaxis,itiscalledtransverselie.Butmorecommonly,fetalaxisliesobliquetothematernalspine&isthencalledobliquelie.Ineitheroftheconditionsshoulderusuallypresentsoverthecervicalopeningduringlabour&botharecollectivelycalledshoulderpresentations."
243.Severelyanaemicpregnantpatientin cardiacfailure.Choiceoftransfusion? a)Platelets b)Packedcells c)Wholeblood d)Exchangetransfusion CorrectAnswer-BAns.B.Packedcells
244.Hydropsfetalisisdueto? a)Rhmismatch b)Hyperproteinemia c)Placentalhypoplasia d)Alloftheabove CorrectAnswer-AAns.A.Rhmismatch
245.Caputsuccedaneumindicatesthatfetus wasalivetill? a)Immediatelyafterbirth b)Till2-3daysafterbirth c)2-3weeksafterbirth d)2-3monthsafterbirth CorrectAnswer-AAns.A.ImmediatelyafterbirthCaPutsuccedaneumFormationofswellingduetostagnationoffluidinthelayersofscalpbeneaththegirdleofcontact.Boggydiffuseswelling,notlimitedtomidline.Disappearsspontaneouslywithin24hours.Usuallyoccursafterruptureofmembranes.
246.Caputsuccedeumissaidtooccurin baby? a)Within24hrs b)2-3days c)2-3weeks d)2-3months CorrectAnswer-AAns.A.Within24hrs
247.Foruterineprolapseinpregnancy,Ring pessarycanbeinsertedupto? a)12weeks b)14weeks c)16weeks d)18weeks CorrectAnswer-DAns.D.18weeksPessarytreatmentforProlaPseItdoesnotcuretheprolapse,onlygivessymptomaticreliefbystretchingthehiatusgenitalis,thuspreventingtheuterine&vaginaldescent.IndicationsofPessarYEarlYPregnancy-uPto18weeksPuerPeriumPatientsabsolutelyunfitforsurgeryPatientsunwillingforoperationWhilewaitingforsurgeryAdditionalbenefitslikeimprovementofurinarysymptoms
248.Notamethodfordeliveryofafter-coming headofbreech? a)Forcepsmethod b)BurnsandMarshallmethod c)Malarflexionandshouldertraction d)Halfhandmethod CorrectAnswer-DAns.D.HalfhandmethodMethodsofdeliveryofaftercomingheadareBurns-MarshallmethodForcePsdeliveryMalarflexionandshouldertraction(modifiedMauriceau-Smellie-Veittechnique)
249.Investigationofchoiceinpost menopausalbleeding? a)PAPsmear b)Laproscopy c)Fractionalcurettage d)Ultrasound CorrectAnswer-CAns.,C.Fractionalcurettage
250.PreferredIUDformenorrhagea? a)NOVAT b)CuIUD c)Mirena d)Gynefix CorrectAnswer-CAns.C.Mirena
251.Preferredtreatmentformenorrhageain reproductiveagegroup? a)NOVAT b)CuIUD c)OCPs d)Hysterectomy CorrectAnswer-CAns.C.OCPs
252.Drugnotusedcommonlyfor menorrhagea? a)Methergin b)Clomiphene c)GnRH d)NSAIDS CorrectAnswer-AAns.A.Methergin
253.Drugcausingabruptionplacenta? a)Methadone b)Cocaine c)Amphetamine d)Fluoxetine CorrectAnswer-BAns.B.Cocaine
254.
ClassicalCsectionindicatedin? a)CACervix b)Centralplacentapraevia c)Failedinduction d)Fetaldistress CorrectAnswer-AAns.A.CACervix
255.DefinitiveindicationofLSCS? a)Mentoant b)Contractedpelvis c)Occipitoposterior d)Vertex CorrectAnswer-BAns,B.Contractedpelvis
256.Afterdeliveryuptowhichweekisknown aspuerperium? a)2weeks b)4weeks c)6weeks d)8weeks CorrectAnswer-CAns.C.6weeksImmediatepuerperium:24hEarlypuerperium:upto1weekRemotepuerperium:upto6weeks
257.Whichofthesestepsisfollowedfirstfor themanagementofshoulderdystociaafterMcRobertsmaneuver? a)Sharpflexionofhipjointstowardsabdomen b)Suprapubicpressure c)90degreerotationofposteriorshoulder d)Emergencyc-section CorrectAnswer-BAns.B.SuprapubicpressureApplyingagentlesuprapubicpressureisthefirststepinmanagementofshoulderdystociaafterMcRobertsmaneuver.Mnemonic"HELPERR"asaguidefortreatingshoulderdystocia:"H"standsforhelp"E"standsforevaluateforepisiotomy."L"standsforlegs(pullyourlegstowardyourstomachMcRobertsmaneuver)"P"standsforsuprapubicpressure"E"standsforentermaneuvers(internalrotationofbaby'sshoulders)"R"standsforremovetheposteriorarmfromthebirthcanal."R"standsforrollthepatient.
258.Peripartumcardiomyopathyoccursat- a)Within7days b)Within6weeks c)Within24months d)Within5months CorrectAnswer-DAns.D.Within5monthsPPCMisastructuralheartmusclediseasethatoccursinwomeneitherattheendofpregnancyoruptofivemonthsaftergivingbirth.Pearson'sdiagnosticcriteriaforperipartumcardiomyopathy:Developmentofcardiacfailureinthelastmonthofpregnancyorwithin5monthsafterdeliveryAbsenceofanidentifiablecauseforthecardiacfailureAbsenceofrecognizableheartdiseasepriortothelastmonthofpregnancy,andLeftventricularsystolicdysfunctiondemonstratedbyclassicechocardiographiccriteria,suchasdepressedejectionfractionorfractionalshorteningalongwithadilatedleftventricle.
259.Nervemostlycompressedinpregnancy puerperium: a)Radialnerve b)Mediannerve c)Femoralnerve d)Facialnerve CorrectAnswer-CAnsC.FemoralnerveThemostcommonpostpartumnerveinjuryisfootdropduetoinjurytotheperonealnerveandinjurytothelateralfemoralcutaneousnerve.Obstetriciansmayconsiderfrequentpositionchangesinlabor,avoidanceofprolongedhipflexion,andshorteningthepushingtimebyallowingforpassivedescentofthefetusbeforepushingbeginsasmeansofavoidinglateralfemoralcutaneousnerveinjury.
260.Inpregnancywhichofthefollowinglevel isalteredmostly: a)TotalT3 b)FreeT3 c)FreeT4 d)TSH CorrectAnswer-AAnsA.TotalT3TotalT3levelsarealteredthroughoutpregnancy.Hormonesduringpregnancy: Increased Decreased Unchanged GrowthHormone Luteinizinghormone ADHFollicle-stimulating Free hormone T3,FreeT4 Di-Hydro Prolactin EpiAndroSterone TotalT3,TotalT4 Aldosterone Testosterone,Androstenodione andcortisolInsulin(duetoinsulinresistance) Estrogen Progesterone TotalT3andtotalT4increaseduetostimulationofthyroidtissuebyhCGduringtheearlyperiodofgestation.ButthereisnochangeinfreeT3andT4duetoincreaseinTBG.ThisleadstotransientfallinTSHduringanearlyweeksofgestation.
ThelevelofTSHreachesnormallevelduringsecondandthirdtrimester.
261.WhatismeantbySuperfecundation? a)Fertilizationoftwoormoreovainoneintercourse b)Fertilizationoftwoormoreovaindifferentintercoursesinsame menstrualcycle c)Fertilizationofovaandthenit'sdivision d)Fertilizationofsecondovumfirstbeingimplanted CorrectAnswer-BAns.B.FertilizationoftwoormoreovaindifferentintercoursesinsamemenstrualcycleSuperfecundationisthefertilizationoftwoormoreovafromthesamecyclebyspermfromseparateactsofsexualintercourse,whichcanleadtotwinbabiesfromtwoseparatebiologicalfathers.Thetermsuperfecundationisderivedfromfecund,meaningtheabilitytoproduceoffspring.
262.Acutefattylivercommonlyseenin pregnancyat- a)3rdtrimester b)1sttrimester c)Immediatepostpartum d)Intrapartum CorrectAnswer-AAns.A.3rdtrimesterAcutefattyliverofpregnancy(AFLP)isarare,potentiallyfatalcomplicationthatoccursinthethirdtrimesterorearlypostpartumperiod.Acutefattyliverofpregnancyismorecommonlyassociatedwith:MalefetusFirstpregnancyMaternalobesityItisduetodefectinthelong-chain-3-hydroxyacyl-CoA-dehydrogenasepathway.Itisuncommoninsubsequentpregnancies.
263.Fetalheartstartscontractingat- a)10-12days b)10-12weeks c)3-5weeks d)3-5month CorrectAnswer-CAns.C3-5weeksThefetalheartstartscontractingatapproximately23daysofgestation.
264.Whichofthefollowingiscorrect regardingplacenta? a)Placentalarteryprovidesnutrientsthroughumbilicalcordto baby b)PlacentahasWharton'sjelly c)Placentahas2veinsand1artery d)Estrogenissecretedbyplacenta CorrectAnswer-BAns.B.PlacentahasWharton'sjellyTheumbilicalcordisastructurethatprovidesvascularflowbetweenthefetusandtheplacenta.Itcontainstwoarteriesandonevein,whicharesurroundedandsupportedbygelatinoustissueknownasWharton'sjelly.
265.
Anesthesiaofchoiceforcesareansectioninseverepre-eclampsia: a)Spinal b)GA c)Epidural d)Spinal+epidural CorrectAnswer-CAns.C.EpiduralContinuousEpiduralAnesthesiaisthefirstchoiceforpatientswithpreeclampsiaduringlabour,Vaginaldeliveryandcesareansection.Preeclampsiapatientshaveariskofsevereairwayedema,whichmakesintubationdifficultContinuousEpiduralAnesthesiacanimproveuteroplacentalperfusionandalsodecreasecatecholaminesecretions.
266.Whichofthefollowingisnotahigh-risk pregnancy? a)Previoushistoryofmanualremovalofplacenta b)Anemia c)Diabetes d)Obesity CorrectAnswer-AAns.A.PrevioushistoryofmanualremovalofplacentaHighRiskPregnancyisseenin:Cardiovascularandrenalfactors:ModeratetoseverepreeclampsiaChronichypertensionSevereheartfailure(classII-IV,NYHAclassification)ModeratetosevererenaldisordersMetabolicdisorders:ObesityInsulin-dependentdiabetesPreviousendocrineablationObstetrichistory:FetalexchangetransfusionbecauseofRhincompatibilityStillbirthLateabortion(16?20wk)Post-termpregnancy(>42wk)Pretermnewborn(<37wkand<2500g)Intrauterinegrowthrestriction(weight<10thpercentileforestimatedgestationalage)PolyhydramniosMultifetalpregnancy
PreviousbrachialplexusinjuryAbnormalfetalpositionOtherdisorders:AbnormalcervicalcytologicfindingsSicklecelldiseaseSevereanemiaThrombophiliaAutoimmunedisordersAnatomicabnormalities:UterinemalformationInsufficient(incompetent)cervixExposuretoteratogens:GroupBstreptococcalinfectionsSmoking>10cigarettes/day(associatedwithprematureruptureofmembranes)Currentpregnancycomplications:Pretermlaborat<37WksPretermprematureruptureofmembranesModeratetoseverepreeclampsiaPolyhydramnios(hydramnios)oroligohydramniosPost-term(>42wk)UterinerupturePlacentapreviaAbruptioplacentaeChorioamnionitisProlapsedcordFetalbradycardiafor>30minFetaltachycardiafor>30minFetalweight<2.5kgFetalweight>4kgFetalacidosispH7
267.Whichofthefollowingisnotusedin preeclampsia? a)Methyldopa b)Atenolol c)Labetalol d)Hydralazine CorrectAnswer-BAns.B.AtenololChoiceofanti-hypertensivesinpregnancyPIH/pre-eclampsia/severepre-eclampsia:LabetalolAcuteHypertension/Hypertensioncrisis:IVlabetalol>Nifedipine>HydralazineChronicHypertensioninpregnancy:Labetalol>Methyldopa.
268.Postmenopausalwomen1stlineofdrug forosteoporosisis- a)OCP b)Bisphosphonates c)Raloxifene d)Strontium CorrectAnswer-BAns.is.B.BisphosphonatesFirstlineofmanagementofosteoporosis?Bisphosphonatesfemales.Alendronate,etidronate,pamidronate,andIbandronatearebisphosphonateswhichinhibitboneresorption,andareveryeffectiveforbothosteoporosispreventionandtreatment.Uses:FirstlinedrugsfortreatingpostmenopausalosteoporosisPaget'sdiseaseOsteolyticbonemetastasis.Raloxifene:Itisaselectiveestrogenreceptormodulatorwhichisalsousefulinmanagementofosteoporosisbutitisahormonalpreparation.
269.A36-weekoldpregnantladywith previoustwindelivery.WhatistheOvarianscore? a)G2P1 b)G2P2 c)G3P2 d)G3P3 CorrectAnswer-AANS.A.G2P1Gravidaincludesallconfirmedpregnancies.Eachpregnancyisonlycountedonetime,evenifthepregnancywasmultiplegestations,suchastwinsortripletsParityreflectsthetotalnumberofbirthsafter20weeks,notthetotalnumberofinfantsborn.Ref.OBSDutta8thedPageno.107
270.DCDAtwins,38wks,firsttwinbreech motherhasBP140/96,1+proteinuriawhat'sthemanagement a)ImmediateLSCS b)Inductionat40weeks c)Immediateinductionanddelivery d)Inductionifsignsofpreeclampsia CorrectAnswer-AANS.A.ImmediateLSCSCASEDISCUSSION:ThepatienthasmildpreeclampsiawithBP140/96,soTOPis37weeks.Thispatientis38weekssoimmediateterminationofpregnancyisrequired.ThefirsttwinisbreechsothemodeofdeliveryisLSCShencetheanswerisA.INDICATIONSOFCESAREANSECTION:Theindicationsarebroadlydividedinto:ObstetricPlacentapreviaPreeclampsiaPreviouscesareansectionCordprolapseofthefirstbabyAbnormaluterinecontractionsContractedpelvis.Fortwins:Boththefetusesoreventhefirstfetuswithnoncephalic(breechor
transverse)presentationTwinswithcomplications:IUGR,conjoinedtwinsMonoamniotictwinsMonochorionictwinswithTTTSThecollisionofboththeheadsatbrimpreventingengagementofeitherhead.Ref.OBSDutta8thedPageno.244
271.A32-year-oldwomancomplainsof amenorrheasincethedeliveryofababy15monthspreviously,despitethefactthatshedidnotbreastfeedherbaby.Thedeliverywascomplicatedbyexcessivehemorrhagethatrequiredatransfusionof2.5litersofblood.Shehasalsobeenfatiguedandhasgainedanadditional4.5Kgsincethebabywasborn.Laboratorydatashowthefollowing:SerumLH<1IU/L(normal,4-24IU/L)Serumestradiol5pg/mL(normal,20-100pg/mL)SerumTSH0.1mU/L(normal,0.5-5mU/L)SerumGH3ng/mL(normal,<5ng/mL)SerumACTH28pg/mL(normal,10-50pg/mL)Serumprolactin2ng/mL(normal,Injectionof500gofTRHfailedtoproducetheexpectedriseinbothserumTSHandprolactin.Whichofthefollowingdiagnosesmostlikelyexplainsthefindingsinthispatient? a)Hashimoto'sthyroiditis b)Isolatedgonadotropindeficiency
b)Isolatedgonadotropindeficiency c)Primaryamenorrhea d)Sheehan'ssyndrome CorrectAnswer-DAns.D.Sheehan'ssyndromeSheehan'ssyndromeItishypopituitarismduetoischemicdamagetothepituitaryresultingfromexcessivehemorrhageduringparturition.Thepituitaryisenlargedduringpregnancy;itismoremetabolicallyactive,andmoresusceptibletohypoxemia.Furthermore,thebloodvesselsinthepituitarymaybemoresusceptibletovasospasmbecauseofthehighestrogen.Inabout30%ofwomenwhohemorrhageexcessivelyduringparturition,somedegreeofhypopituitarismeventuallybecomesmanifest.Thesymptomsdependonhowmuchofthepituitaryisdamagedandwhatcelltypesaredestroyed.Thepatientdescribedaboveexhibitedpersistentamenorrheaafterthedeliveryofherinfant.Thisisduetothedestructionofpituitarygonadotrophsanddiminishedsecretionofgonadotropins(LH).TherealsoappearstohavebeensignificantdestructionoflactotrophssinceTRHinjectionfailedtoinduceanincreaseinprolactin.Hadthewomenattemptedtobreastfeedherinfant,afailuretolactatemostlylikelywouldhaveoccurred.Thiscaseisalsocharacterizedbysecondaryhypothyroidism.ThelowTSHandfailuretorespondtoTRHinjectionareconfirmatory.CorticotrophsappeartohavebeensparedsinceplasmaACTHisnormal.Itisnotclearwhethersomatotrophsweredamaged.FurthertestingwouldbeneededtoseeifGHreserveisdiminished.
Ref.WilliamObs.ed.24thpageno.798,1163DuttaGynaecology6thed.Pageno.465
272.A7weekspregnantladyhas1accidental exposuretox-ray.Whichofthefollowingshouldbedone? a)Continuepregnancy b)Terminatepregnancy c)Chromosomeanalysis d)Preinvasivediagnostictesting CorrectAnswer-AAns.A.ContinuepregnancyExposuretoX-rayhasaverylowrangeofradsoingivencasescenarioPregnancywillbecontinued.Exposure>15radduringthesecondandthirdtrimesteror>5radinthefirsttrimesterneedspatientcounseling.Electiveterminationofpregnancymaybeconsidered.Ref.OBSDutta8theditionPageno.740William'sObs24theditionPageno.931Tableno46-5
273.InModernobstetrics,forsensitizedRh- negativemotherwhatshouldbedonetoevaluatetheconditionofthemother? a)MCAdopplerpeaksystolicvolume b)Fetalblood c)Amniocentesis d)Biophysicalprofile CorrectAnswer-AAns.A.MCAdopplerpeaksystolicvolumeDopplerultrasound:SerialDopplerstudyofthemiddlecerebralartery(MCA)-peaksystolicvelocity(PSV)isthemainstaytoassessfetalanemia.Avalue>1.5multiplesofthemedian(MOMs)forthecorrespondinggestationalage,predictsmoderatetoseverefetalanemia.Thisvalue(between24weeksand35weeksofgestation),isanindicationforcordocentesisandfetaltransfusionMostcentershavereplacedserialamniocentesiswithserialMCADopplerstudies.Ref.OBstetricsDuttaed.8thpg.391
274.Apatientdeliveredathomewitha completeperinealtearcametothehospitalafter2weeks.Whatmanagementwillyouprefer? a)Immediaterepair b)Repair3weekspost-delivery c)Repair6weekspost-delivery d)Repair3monthspost-delivery CorrectAnswer-DAns.D.Repair3monthspost-deliveryTherecenttearsshouldberepairedimmediatelyfollowingthedeliveryoftheplacenta.Thisreducesthechanceofinfectionandminimizesbloodloss.Incasesofdelaybeyond24hours,therepairistobewithheld.Antibioticsshouldbestartedtopreventinfection.Thecompletetearshouldberepairedafter3monthsifdelayedbeyond24hours.Incaseofanydoubttothegrade3rd-degreetear,itisadvisabletoclassifytoahigherdegreeratherthanalowerdegree.Ref.ObsDutta24theditionPageno.490
275.Allareusedforpostcoitalcontraception except- a)CuT b)Ru486 c)Highdoseestrogen d)Danazol CorrectAnswer-DAns.D.DanazolEMERGENCYCONTRACEPTIVES: Drug Dose PREGNANCYRATE Levonorgestrel 0.75mgstatand 0?1 after12hours Ethinylestradiol50?g+ 2tabstatand2after 0?2 norgestrel0.25mg 12hours Ethinylestradiol 2.5mgBd?5days 0?0.6 Mifepristone 100mgsingledose 0?0.6 CopperIuds(Goldstandard) Insertionwithin5 0?0.1 days (RU486Mifepristone) 30mgPO 0?1 (ulipristalacetate) Ref:DUTTAGYNAECOLOGYED.6THPAGENO.492
276.33yroldfemalewithheavymenstrual bleedingfor6monthscomestothegynaecologyOPD.Onexamination,noabnormalitywasseen.USGalsoappearednormal.Thepatientwastriedtobemanagedonnon-hormonaltreatmentbutitfailed.Whatwillbethenextmanagementstep? a)Hormonaltherapy b)Endometrialsampling c)Hysterectomy d)Hysterectomy CorrectAnswer-BAns.B.EndometrialsamplingBeforestartingHormonaltherapyendometrialsamplingisdoneasifhormonaltherapyprecedessamplingthesamplingresultswillbealtered.AsalreadymentionedinquestiontheUSGandclinicalexaminationshownoabnormalityhencethediagnosiscan'tbemadeonthatsofordiagnosisweneedtodoendometrialsamplingandseethehormonalpattern.Thenwecanproceedwithhormonaltherapy.Ref.DuttaGynaecologyed.6thpageno.120