1.

Main support of uterus is from - ligament :

a) Cardinal

b) Broad

c) Round

d) Pubocervical

Correct Answer - A
Cardinal
2. Best gas used for creating
pneumoperitonium at laparoscopy is :
a) N2

b) 02

c) CO2

d) N20 Goniometer is used

Correct Answer - C
CO2
CO, is the gas used to create pneumoperitoneum during
laparoscopy.
Other option is - N20 : But it is expensive, less soluble in blood
and supports combustion.
Also know :
Instrument used for creating pneumoperitoneum is veress needle.
Flow Rate of CO, for creating pneumoperitoneum 200 - 2000 ml/min
& pressure between 15 - 25 mm of Hg.
3. Gonococci has affinity for :
a) Columnar epithelium

b) Glandular epithelium

c) Stratified sqamous epithelium

d) Squamous epithelium

Correct Answer - A
Columnar epithelium
4. In a case of Dysgerminoma of ovary one of
the following tumor markers is likely to be
raised :
a) Serum HCG

b) Serum alphafetoprotein

c) Serum lactic dehydrogenase

d) Serum inhibin

Correct Answer - C
Ans. is c i.e. Serum lactic dehydrogenase
however placental alkaline phosphate and lactate
dehydrogenase are commonly produced by dysgerminomas
and may be useful in monitoring the disease."
5. Which of the following ovarian tumor is
most prone to undergo torsion during
pregnancy :
a) Serous cystadenoma

b) Mucinous cystadenoma

c) Dermoid cyst

d) Theca lutein cyst

Correct Answer - C
Ans. is c i.e. Dermoid cyst
"A benign cystic teratoma is the most common neoplasm to undergo
torsion, and it to the M/C benign tumor diagnosed during
pregnancy."
A benign cystic teratoma is synonymous to dermoid cyst.
Remember :
Most common ovarian tumour in pregnancy is serous cystadenoma
but mostly remains undiagnosed.
Incidence of dermoid cyst is increased two fold during pregnancy
and it is the most common neoplasm diagnosed during pregnancy.
Hingorani sign seen : - In ovarian tumor during pregnancy.
Trendelenburg's position can elicit the groove between two separate
swelling. Used to distinguish between ovarian tumour and fibroid.
6. Which of the following has LEAST
pregnancy failure rate :
a) OCP

b) IUCD

c) Diaphragm

d) Condom

Correct Answer - A
OCP
7. Which of the following is true regarding
precocious puberty :
a) Sexual maturity is attained early

b) Mental function is increased

c) No reproductive function

d) Body proportions are enlarged

Correct Answer - A
Ans. is a i.e. Sexual maturity is attained early
Precocious puberty is the appearance of appropriate secondary
sexual characters before the age of 8 years and occurrence of
menstruation before 10 years of chronological age.
Also know : Delayed puberty : is considered delayed when the
secondary sexual characters do not appear by the age of 14, and
menarche is not established by 16 years of age.
8. Cause of unilateral dysmenorrhea :
a) One horn of malformed uterus

b) Endometriosis with unilateral distribution

c) Small fibroid at the utero tubal junction

d) All of the above

Correct Answer - D
All of the above
Causes of unilateral dysmenorrhea :
One horn of malformed uterus
Endometriosis with unilateral distribution
Small fibroid at the utero - tubal junction.
Ovarian dysmenorrhea
Right ovarian vein syndrome
Colonic or caecal spasm.
9. Progesterone of choice in emergency contraception is?
a) Norethisterone

b) Medroxyprogesterone

c) Oxytocin

d) Levonorgestrel

Correct Answer - D
Unprotected intercourse without regard to the time of the month carries an 8% incidence of
pregnancy, an incidence that can be reduced to 2% by the use of emergency
contraceptives within 72 hours of unprotected intercourse.
0.75 mg levonorgestrel are now approved for postcoital contraception and are available
over the counter for women aged >17 years. Levonorgestrel is more effective and is
associated with fewer side effects than the combination estrogen-progestin regimens.
Basically the methods used interfere with the physiological events before implantation, for
e.g. inhibition or delaying of ovulation or interference with postovulatory events necessary
for implantation & longevity of the blastocyst.

Ref: Hall J.E. (2012). Chapter 347. The Female Reproductive System, Infertility, and
Contraception. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J.
Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
10. Which among the following is an absolute
contraindication of Hormone replacement
therapy ?
a) Endometriosis

b) Osteoarthritis

c) Heart disease

d) Breast carcinoma

Correct Answer - D
Absolute contraindications of hormone replacement therapy (HRT):
Undiagnosed vaginal bleeding Estrogen dependent cancer in the
body Severe liver disease Pregnancy Venous thrombosis Well-
differentiated and early endometrial cancer (once treatment for the
malignancy is complete, is no longer an absolute contraindication.)
11. A 40 year old woman presents with
abnormal cervical cytology on PAP smear
suggestive of CIN III (HSIL). The next best
step in management is:
a) Hysterectomy

b) Colposcopy and LEEP

c) Colposcopy and Cryotherapy

d) Conization

Correct Answer - B
According to FIGO classification, cervical intraepithelial neoplasia 3
(CIN 3) belong to stage 0.
Loop electrocautery excision procedure done under colposcopic
visualization is the mode of treatment for CIN II and CIN III lesions.

Ref: Novak's, 14th Edition, Page 582, 583; William's Gynoecology,

1st Edition, Page 635; COGDT, 10th Edition, Pages 841, 837;
Dewhurst's, 6th Edition, Pages 575, 574.
12. Chlamydia trachomatis infection
commonly causes:
March 2004
a) Infertility

b) Post coital bleeding

c) Amenorrhoea

d) Malignancy

Correct Answer - A
Ans. A i.e. Infertility
13. Main difference between anorexia nervosa
and bulimia nervosa lies in:
March 2013
a) Symptomatology

b) Weight

c) Gender

d) Age

Correct Answer - B
Ans. B i.e. Weight
Anorexia nervosa and bulimia
Both anorexia nervosa and bulimia are characterized by an
overvalued drive for thinness and a disturbance in eating behavior.
The main difference between diagnoses is that anorexia nervosa is
a syndrome of self-starvation involving significant weight loss of 15
percent or more of ideal body weight, whereas patients with bulimia
nervosa are, by definition, at normal weight or above.
Bulimia is characterized by a cycle of dieting, binge-eating and
compensatory purging behavior to prevent weight gain.
Purging behavior includes vomiting, diuretic or laxative abuse.
Excessive exercise aimed at weight loss or at preventing weight gain
is common in both anorexia nervosa and in bulimia.
14. Not seen in anorexia nervosa:
September 2009
a) Osteoporosis

b) Refusal to feeds

c) Weight loss

d) Menorrhagia

Correct Answer - D
Ans. D: Menorrhagia
Physical Signs of anorexia nervosa
* Excessive weight loss
* Scanty or absent menstrual periods
* Thinning hair
- Dry skin
* Cold ors wollen hands and feet
Bloated or upset stomach
* Downy hair covering the body Low blood pressure
* Fatigue
* Abnormal heart rhythms
*Osteoporosis
Psychological and Behavioral Signs in anorexia nervosa
* Distorted perception of self (insisting they are overweight when
they are thin)
* Being preoccupied with food Refusing to eat
* Inability to remember things
* Refusing to acknowledge the seriousness of the illness
Obsessive-compulsive behavior
* Depression
15. First polar body is formed after ?
a) Mitosis

b) First meiosis

c) Second meiosis

d) Fertilization

Correct Answer - B
Ans. is 'b' i.e., First meiosis
Oogenesis
Oogenesis refers to the process of formation of ova from the
primitive germ cells. Unlike fetal testis (in which spermatogenesis
beings at puberty), the fetal ovary begins oogenesis by 10 weeks of
gestation. o The sequence of events in oogenesis are :
i) The primitive germ cells undergo mitotic divisions to form oogonia
(diploid Oogonium is unique in that it is the only female cell in which
both 'X' chromosomes are active.
ii) The oogonia proliferate by mitosis to form primary oocytes (diploid
cells).
iii) Primary oocytes formed from the oogonia enter a prolonged
prophase (diplotene stage) of the first meiotic division and remain in
this stage until ovulation occurs after puberty.
iv) Primary oocytes completes the first meiotic division at puberty
just before ovulation to form secondary oocyte (haploid cell) and 1st
polor body.
v) Secondary oocyte immediately begins second meiotic division but
this division stops at metaphase and is completed only if the mature
ovum (ootid) is fertilized with sperm. At that time second polor body
(polocyte) is extruded and the fertilized ovum proceeds to form a
new individual. Fertilization normally occurs in the ampulla of
fallopian tube.
16. Conceptus enters uterine cavity in which
cell stage ?
a) 4 cells

b) 8 cells

c) 16 cells

d) 32 cells

Correct Answer - C
Ans. is 'c' i.e., 16 cells
Fertilization and implantation
Fertilization refers to fusion of male and female gametes (i.e.
spermatozoon and ovum). It takes place in the middle segment
(ampulla) of fallopian tube. Before fertilization, the ovum and sperms
reach the ampulla for fertilization. Fusion of spermatocyte and ovum
leads to formation of zygote. First week of development begins
immediately after fertilization and includes :?
i) Cleavage of zygote : Zygote (fertilized ovum) starts dividing
immediately and large zygote is subdivided into smaller daughter
cells called blastomeres. Blastomeres are still surrounded by zona
pellucida. Cleavage occurs in fallopian tube (uterine tube).
ii) Formation of morula : At about 16 cells stage the blastomeres
tightly align by the process of compaction to form a compact ball of
cells called morula (mulberry). This process of compaction leads to
segregation of cells into two groups (i) inner cells (inner cell mass),
and (ii) outer cells (outer cell mass). Morula enters uterine cavity 4
days after fertilization.
iii) Formation of blastocyst : As the morula enters the uterine
cavity, uterine fluid diffuses through zona pellucida and fills small
intercellular gaps between blastomeres, and morula is converted to
blastocyst. Blastocyst consists of :?
a) Zona pellucida : Outer covering.
b) Embryoblast : A group of centerally located cells of inner cell
mass and later give rise to tissues of embryo proper.
c) Trophoblast : A thin outer layer of cells formed from outer cells
mass and later give rise extraembryonic tissues.
d) Blastocele : Cavity of blastocyst :
The region of blastocyst containing embryoblast is known as
embryonic pole and the opposite pole, the abembryonic pole. The
trophoblasts overlying the embryoblast at embryonic pole is called
polar trophoblast and that occupying the rest of wall called mural
trophoblast. Between 5-6 days after fertilization, blastocyst hatches
from zona pellucida, and this naked blastocyst is ready for
implantation
17. Implantation occurs on which menstrual
cycle day ?
a) 5-7 days

b) 20-22 days

c) 14-18 days

d) 26-28 days

Correct Answer - B
Ans. is 'b' i.e., 20-22 days
Implantation occurs at 6-7 days after fertilization.
Ovulation occurs at 14th day of menstrual cycle and fertilization
occur within 24 hours after ovulation.
Thus, implantation will correspond to 20-22 days of menstrual cycle.
18. Blastocyte comes out on which day after
fertilization ?
a) 4-7 days

b) 10-12 days

c) 12-15 days

d) 15-20 days

Correct Answer - A
Ans. is 'a' i.e., 4-7 days
Free floating unimplanted blastocyst is seen on 4-5 days.
19. DMPA is given once in -
a) 3 months

b) 6 months

c) 9 months

d) 45 days

Correct Answer - A
Ans. is 'a' i.e., 3 months
HORMONAL CONTRACEPTIVES
These are hormonal preparations used for reversible suppression of
fertility.
Types of methods
A. Oral
Combined pill (monophasic pills)
It contains an estrogen and a progestin.
This is the most effective and popular method.
Efficacy is 98-99%
Preparation are -
Ethinyl estradiol 30 pg (•03 mg) + Norgestrel 0.3 mg
Ethinyl estradiol 50 .tg (•05 mg) + Levonorgestrel 0.25 mg
Ethinyl estradiol 30 pig (•03 mg) + Desogestreol 0.15 mg
One tablet (containing estrogen and progesterone) is taken daily for
21 days starting on 51"day of mensturation.
Phased regimens
The estrogen dose is kept constant (or varied slightly between 30-40
mg), while the amount of pregestin is low in first phase and
progressiely higher in the second and third phases.
Preparations are
Biphasic pills
Day 1-10 → Ethinyl estradiol 35 mg + Norethindrone 0.5 mg
Day 11-21 → Ethinyl estradiol 35 mg + Norethindrone 1 mg.
Triphasic pills
Day 1-7 → Ethinyl estradiol 35 mg + Norethindrone 0.5 mg
Day 8-14 →Ethinyl estradiol 35 mg + Norethindrone 0.75 mg
Day 15-21 → Ehinyl estradiol 35 mg + Norethindrone 1 mg
Minipill (progestin only pill)
A low dose progestin pill is taken daily without any gap.
Preparations → Norethindrone (0.35 mg) or Norgestrel 75 mg.
Postcoital (emergency) pills.
a) Levonorgestrel 0.5 mg + ethinyl estradiol 0.1 mg —> within 72
hours of unprotected intercourse and repeated after 12 hours -
Yuzpe method.
b) Levonorgestrel alone 0.75 mg taken twice with 12 hour gap within
72 hours of unprotected intercourse → method of choice for
emergency contraception.
c) Mifepristone 600 mg single dose within 72 hours of unprotected
intercourse.
B. Injectable
They are given i.m. as oily solution
1.Long acting progestin alone
a) Depot medroxy progesterone acetate (DMPA) 150 mg at 3 month
intervals. or
b) Norethindrone (norethisterone) enanthate (NEE) 200 mg at 2
months intervals.
c) The most important undesirable property is complete disruption of
menstural bleeding pattern and total amenorrhoea (more common
with DMPA).
2.Long acting progestin + long acting estrogen - once a month.
20. Patient of juvenile myoclonic epilepsy on
valproate comes to you at 5 months of
pregnancy with level H scan normal what
will you advise?
a) Change the drug

b) Continue the drug in same dose

c) Decrease the dose of drug

d) Increase the dose of drug

Correct Answer - B
Ans. is 'b' i.e., Continue the drug in same dose
Valproic acid has the risk of fetal malformations during the first
trimester of pregnancy.
This patient has normal level II scan at 5 months of pregnancy so
the risk period of valproate is already over and valproate is the drug
of choice in juvenile myoclonic epilepsy.
Thus the drug shoud be continued in the same doses.
21. Gestational Trophoblastic neoplasm does
not include-
a) Choriocarcinoma

b) Placental site trophoblastic tumour

c) Invasive mole

d) Partial mole

Correct Answer - D
Ans. D. Partial Mole
The main types of gestational trophoblastic diseases are:
Hydatidiform mole (complete or partial)
Invasive mole
Choriocarcinoma
Placental-site trophoblastic tumor
Epithelioid trophoblastic tumor
Note: In the given best option best answer can be partial as partial
hydatidiform mole is not completely mentioned in it.
22. Which vaccine is contraindicated in
pregnancy:
a) Chicken pox

b) Rabies

c) Tet toxoid

d) Hepatitis B

Correct Answer - A
Ans. A. Chicken pox
As a rule of thumb the vaccination with live viral or bacterial vaccine
is contraindicated in pregnancy.
The important ones are : –
Measles
Mumps
Poliomyelitis
Rubella
Yellow fever
Varicella
BCG
23. 45 years female with 3 months
menorrhagia. USG showing 2 cm
submucosal fibroid.Treatment options.
a) Ocp for 3 months

b) Progesterone for 3 months

c) Endometrial sampling

d) Hysterectomy

Correct Answer - D
Ans. D. Hysterectomy
YOUNG WOMEN OLDER WOMEN
Contraception desired
Combined OCPs
Contraception Rule out cancer &uterine
Progestogens and other
not desirable pathology
hormones
Mirena
Normal uterus Uterine
Progestogens Effective Fails
(DUB) pathology
Ethamsylate,
Minimal Progestogens
NSAIDs
invasive and others
Estrogen
Continue surgery ?No response
Tranexamic for
for 6–9 Hysterectomy Hysterectomy Surgery
3–4 months
months with with removal of
GnRH 3–4
conservation ovaries after 50
months
of ovaries years
Removal of an intrauterine contraceptive device if medical therapy
fails.
Myomectomy/hysterectomy for uterine fibroids.
Wedge resection/hysterectomy for adenomyosis of the uterus.
Dilatation and curettage with blood transfusion is the primary
treatment of puberty menorrhagia with low Hb%
Multipara, hypertensive woman with menorrhagia should be treated
with MIRENA
Hysterectomy with or without removal of the adnexa according to the
age and the individual needs of the patient.
24. In low ovarian reserve,anti mullerian
hormone level will be:
a) <1

b) 1-4

c) >7

d) >10

Correct Answer - A
Ans. A. <1
AMH and ovarian reserve
AMH of 1.0 has very poor ovarian reserve
The central concept for the measurement of blood levels of AMH to
determine ovarian reserve is this: women with lower AMH levels
have a lower ovarian reserve than women with high AMH levels.
AMH is currently being used by fertility specialists to help predict
women who may respond poorly to fertility medications and in
general, couples who are less likely to be successful with fertility
treatment.
25. Presenting diameter of full flexed head:
a) Suboccipito-bregmatic diameter

b) Suboccipito-frontal diameter

c) Occipito-frontal diameter

d) Occipito-posterior position

Correct Answer - A
Ans. A. Suboccipito-bregmatic diameter
Suboccipito-bregmatic diameter :
The diameter is from suboccipital region to centre of the bregma.
Diameter = 9.5 cm
Fetal head circumference is smallest (32 cm )
Head well flexed
Flexed vertex presentation
Suboccipito-frontal diameter :
Diameter calculated from prominence at mid frontal bone to the
under-surface of the occipital bone where it joins neck
The diameter is 10.5 cm
Vertex is partially deflexed.
Results in occipito-posterior position.
Occipito-frontal diameter :
Diameter extends from the prominent point of mid-frontal bone to the
most prominent point of occipital bone
The diameter = 11.5 cm
Fetal head circumference ~ 34.5 cm
Vertex is deflexed
Associated with Direct occipito- posterior position.
Occipito-posterior position :
It is a vertex presentation in which the occiput is placed posteriorly .
26. What is the dose of ulipristal acetate?
a) 300mg

b) 30mg

c) 300µg

d) 30µg

Correct Answer - B
Ans. B. 30 mg
Ulipristal (Ella) is a progesterone agonist/antagonist marketed for
emergency contraception. It is available by prescription only. Its
mechanism of action varies based on time of administration. When
taken before ovulation, ulipristal delays or inhibits ovulation.
Administration in the early luteal phase may decrease endometrial
thickness and affect implantation of a fertilized egg.
Ulipristal is labeled for use as an emergency contraceptive following
unprotected sexual intercourse or contraceptive failure.
One tablet(30-mg tablet) taken as soon as possible, within 120
hours (five days) of unprotected sexual intercourse or contraceptive
failure.
27. Premature ejaculation is a part of which phase of
sexual disorders?

a) Excitement phase

b) Plateau phase

c) Orgasm phase

d) Refractory phase

Correct Answer - C
Ans. C. Orgasm phase
The male sexual response is described as a sequence of phases
including 4 stages: sexual desire, arousal, orgasm (ejaculation) and
resolution.
The male sexual dysfunction usually occurs in one or more of
the three first stages of the sexual response cycle, including:
Dysfunctions of sexual desire (e.g. hypoactive sexual desire)
Arousal (e.g. erectile dysfunction)
Orgasm/ejaculation (e.g. premature ejaculation, retarded ejaculation
or inability to ejaculate).
Premature ejaculation occurs due to the rapid evolution of the two
first stages of the sexual response cycle and is not necessarily
related to strong sexual arousal or changes in erection.
Premature Ejaculation seems to be a neurobiological problem that is
related to low serotonin levels in those regions of the central nervous
system that regulate ejaculation (brain and spinal cord).
28. 60 year woman comes with 3rd degree
uterine prolapse. What will be the
management?
a) Vaginal hysterectomy with pelvic floor repair

b) Pelvic floor repair

c) Sacrospinous fixation

d) Pessary

Correct Answer - A
Ans. A. Vaginal hysterectomy with pelvic floor repair
Uterine prolapse surgery is performed to remove the uterus and
repair the weak tissue. Uterine prolapse frequently occurs in
postmenopausal women who’ve had one or more vaginal deliveries.
Sagging of the pelvic muscles which leads to uterine prolapse
can occur:
If supportive tissues are damaged during pregnancy and delivery
Due to estrogen loss
As a result of straining repeatedly over the years (chronic cough,
constipation etc.)
Due to gravitational effects
Depending on factors like age of the woman, desire for becoming
pregnant and the overall state of a woman’s health, the treatment
plan is decided.
Here the woman is of old age (non gestational) and have 3rd degree
of prolapse. So best management of choice will be Vaginal
hysterectomy with pelvic floor repair.
 29. Day 20 of menstrual cycle falls under
which phase?
a) Menstrual phase

b) Follicular phase

c) Ovulation phase

d) Luteal phase

Correct Answer - D
Ans. D. Luteal phase
The entire duration of a Menstrual cycle can be divided into
four main phases:
1. Menstrual phase (From day 1 to 5)
2. Follicular phase (From day 1 to 13)
3. Ovulation phase (Day 14)
4. Luteal phase (From day 15 to 28)
30. Chromosome number of partial
hydatidiform mole is-
a) 46 XX

b) 45 XO

c) 46 XXY

d) 69 XXX

Correct Answer - D
Ans. D. 69XX
A partial hydatidiform mole is a triploid pregnancy with 69 instead of
46 chromosomes and another strange complication of the
reproductive process.
Partial hydatidiform mole can be identified by ultrasound showing
placenta tissue, some hygromatous cysts, some fetal oddities, but
no clear fetus structure.
Ultrasound is strictly an indicator. After spontaneous abortion or
dilation and curettage, tissue needs to be examined by pathology
and cytogenetics needs to be determined.
If a triploid karyotype is determined as 69, XXX, 69XXY, or 69 XYY
[6], then a partial mole can be confirmed.
31. Vulvar atrophy and itching are treated by-
a) Estrogen ointment

b) Antihistamines

c) Tamoxifen

d) None

Correct Answer - A
Ans. A. Estrogens ointment
Atrophic vaginitis, the medical term for this condition, occurs as a
result of deterioration of the vaginal tissue.
It’s a common condition in postmenopausal women because as
estrogen levels drop, the tissue that lines the vagina becomes
thinner and more easily damaged.
Women with atrophic vaginitis may also experience vaginal itching,
burning, frequent urination, or vaginal discharge.
Women can treat this condition topically with estrogen creams,
tablets (Vagifem), or an estrogen-releasing ring placed in the vagina
(Estring).
Oral estrogen, available with a doctor’s prescription, will also restore
vaginal tissue.
Vaginal lubricants offer an alternative for women wary of using
estrogen.
Moisturizers such as Replens, Astroglide, and Lubrin can reduce
symptoms and make sexual intercourse more comfortable.
32. PGF2 alpha maximum dose in PPH is-
a) 2000 µg

b) 200 µg

c) 2 mg

d) 20 mg

Correct Answer - C
Ans. C. 2mg
Drug doses for management of PPH:
15-Methyl prostaglandin F2a:
Dose and route:IM: 0.25 mg
Continuing dose:0.25 mg every 15 minutes
Maximum dose:8 doses (Total 2 mg)
Precautions/ contraindications:Asthma
33. Which of the following is false as
physiological change in pregnancy?
a) Increase cardiac output

b) Increase total protein

c) Increase residual volume

d) Increase GFR

Correct Answer - C
Ans. C. Increase residual volume
The respiratory rate is essentially unchanged, but tidal volume and
resting minute ventilation increase significantly as pregnancy
advances.
The functional residual capacity and the residual volume are
decreased as a consequence of the elevated diaphragm.
34. Overt gestational diabetes is defined as
blood glucose more than_?
a) >200 mg/dl

b) >126 mg/dl

c) >100 mg/dl

d) >180 mg/dl

Correct Answer - B
Ans. B. >126 mg/dl
If fasting is 92-125 mg/dl it is diagnosed as GDM and if it is = 126
mg/dl it is designated as overt Diabetes
35. MgSO4 have no role in prevention of-
a) Seizures in severe pre-eclampsia

b) Recurrent seizures in eclampsia

c) RDS in premature baby

d) Bradycardia

Correct Answer - C
Ans. C. RDS in premature baby
Indicated to prevent seizures associated with pre-eclampsia, and for
control of seizures with eclampsia.
Magnesium sulfate (MgSO4) is commonly used as an anticonvulsant
for toxemia and as a tocolytic agent for premature labor during the
last half of pregnancy.
Toxicity of I/V magnesium sulfate includes cardiac arrhythmias,
muscular paralysis, respiratory depression and CNS depression in
mother as well as the neonate.
36. Green frothy vaginal discharge is
produced by –
a) Herpes simplex

b) Candida albicans

c) Trichomonas vaginalis

d) Normal vaginal flora

Correct Answer - C
Ans. C. Trichomonas vaginalis
Trichomoniasis –
It is a sexually transmitted disease
It is almost entirely a disease of child-bearing age
The vaginal discharge is frothy, slightly green in colour and profuse.
There are multiple punctate strawberry spots on the vaginal vault
and portio vaginalis of cervix. Diagnosis : Culture is 98% reliable
37. Which of the following is an absolute
CONTRAINDI​CATION to OCP use:
a) Chronic renal disease

b) DVT

c) Diabetes mellitus

d) History of amenorrhea

Correct Answer - B
Ans. B. DVT
Contraindications to combined oral contraceptives
They are generally accepted to be contraindicated in women with
pre-existing cardiovascular disease, in women who have a familial
tendency to form blood clots/ thrombosis (such as familial factor V
Leiden), women with severe obesity and/or hypercholesterolemia
(high cholesterol level), and in smokers over age 40.
COCP are also contraindicated for women with liver tumors, hepatic
adenoma or severe cirrhosis of the liver, and for those with known or
suspected breast cancer.
38. Which of the following statement is
correct about acute fatty liver of
pregnancy?
a) Occurs in 1 in 1000 pregnancy

b) Mostly seen in last trimester

c) Common if female fetus is present

d) May be associated with decreased uric acid

Correct Answer - B
Ans. B. Mostly seen in last trimester
Acute fatty liver of pregnancy is usually seen in obese woman.
It is more commonly seen in woman carrying a male foetus.
The neonate is at risk of fatty infiltration of liver.
It More commonly occurs in 3rd trimester.
It May be associated with ?uric acid.
39. Female with 41 wk gestation confirmed by
radiological investigation, very sure of her
LMP, no uterine contractions, no
effacement and no dilatation. What should
not be done?
a) Intracervical foley’s

b) PGE1 tab

c) PGE2 gel

d) PGF2alpha

Correct Answer - D
Ans. D. PGF2alpha
PgF2 alpha is a uterine relaxant so it can’t be used in induction of
labour.
40. Double decidua sign is seen during-
a) 1St trimester

b) 2nd early trimester

c) 2nd late trimester

d) 3rd trimester

Correct Answer - A
Ans. A. 1st trimester
The double decidual sac sign (DDSS) is a useful feature on early
pregnancy ultrasound to confirm an early intrauterine pregnancy
(IUP) when the yolk sac or embryo is still not visualized.
The “Double Decidual Sign”, first described by Nyberg and co-
workers consists of two echogenic rings surrounding the hypoechoic
gestational sac.
The inner ring represents the chorion, embryonic disc and decidua
capsularis.
The outer ring represents the decidua parietalis.
41. In Medical termination of pregnancy,
according to FDA, Misoprostol is given
after how many hours of Mifepristone?
a) 24 hours

b) 48 hours

c) 72 hours

d) 96 hours

Correct Answer - B
Ans. is 'b' i.e., 48 hours
FDA approved protocol - (Original protocol)
600 mg of mifepristone (i.e., 3 tablets) given orally on day 1 followed
2 days (48 hours) later by oral misoprostol 400 tig (2 tablets) on day
3.
The treatment should be started no more than 48 days from the start
of the last menstrual period.
But according to the recent protocol
200 mg of mifepristone (it is as effective as 600 mg of mifepristone)
is given orally on Day 1 followed 2 days (48 hours) later by vaginal
misoprostol 800 pg.
This regime provides highest efficacy within 63 days of amenorrhea.
42. First symptom invulval cancer is-
a) Pain

b) Pruritis

c) Ulcer

d) Blood discharge

Correct Answer - B
Ans. B.Pruritis
Women with WN and yulvar cancer commonly present with pruritus
and a visible lesion.
However, pain, bleeding, and ulceration may also be initial
complaints'
 43. Which is increased in premature ovarian
failure :
a) Sr. Inhibin

b) Sr. FSH

c) Sr. Estradiol

d) Both A and B

Correct Answer - B
Answer- B. Sr. FSH
In premature ovarian failure :-
1. FSH level increased (40 mIU/ml or more).
2. Estrogen is decreased (E2 Level 20 pg/ml or less)
3. Inhibin B is decreased.
[Ref Shaw's Gynaecology 10h/e p. 74; Speroffs Clinical
Gynaecologic Endocrinology and Infertility 5th/e p. 463]
44. All of the following are markers of ovarian
reserve except -
a) Inhibin A

b) Estradiol concentration

c) Inhibin B

d) Ovarian volume

Correct Answer - A
Answer- A. Inhibin A
Basal FSH and Estradiol concentration
Clomiphene Citrate Challenge Test
Inhibin B
Antimullerian hormone
Antral follicle count
Ovarian volume
45. Most common site involved in genital TB
-
a) Fallopian tubes

b) Endometrium

c) Ovaries

d) Vulvo - vaginal part

Correct Answer - A
Answer- A. Fallopian tubes
Fallopian Tubes → 90 - 100
46. Which is not a side effect of POP
[Progestin only pill]
a) Ovarian cysts

b) Venous thromboembolism

c) Increased risk of diabetes mellitus

d) Ectopic pregnancy

Correct Answer - B
Answer- B. Venous thromboembolism
Adverse effects of progestin only pill (minipill)
Menstural irregularities
Headache, nausea, dizziners
Bloating or weight gain
Increased risk of INDDM
Ovarian cysts
Breast tenderness
Acne
Ectopic pregnancy
47. Maternal age is not associated with -
a) Preterm labour

b) Post maturity

c) Aneuploidy

d) Hydatidiform mole

Correct Answer - A
Answer- A. Preterm labour
Recent evidence however suggests lowest incidence of preterm
labor between 18 and 35 years of age and higher risk in lower and
higher age groups.
48. What is to be done if 2 OCP is missed on
day 17 - 18 of the cycle -
a) Take 2 pills on the next 2 days

b) Use back up contraceptive

c) Both a and b

d) Continue taking single pill per day

Correct Answer - B
Answer- B. Use back up contraceptive
Missing pills while on OCP - Management :
Missing one pill (late upto 24 hours) -take the missed pill at once and
continue the same regimen.
Missing two pills in the first week (days 1 - 7) - take two pills on each
of the next two days and then continue the schedule. Extra -
precaution (back up) - alternative contraception
Missing two pills in the third week (days 15 - 21) or if more than two
pills are missed at any time - another form of contraception. Start the
next pack without a break.
Missing any of the 7 inactive pills - throw away the missed pills. Start
the new pack as usual.
49. Most common complication of dermoid
cyst is -
a) Cyst Rupture

b) Torsion

c) Malignant degeneration

d) None of the above

Correct Answer - B
Answer- B. Torsion
Torsion is the most common complication occurring in Dermoid cyst.
Because of the fat content of the cyst, it is lighter than other ovarian
tumors and therefore easily torsioned. Almost 15% of dermoid cysts
undergo torsion.
 50. Management of tubal ectopic pregnancy
of 2.5 x 3 cm is -
a) Medical management

b) Salpingectomy

c) According to presence of fetal cardiac activity

d) Observation

Correct Answer - C
Answer- C. According to presence of fetal cardiac activity
Conservative management
Medical management :
1. Hemodynamically stable
2. Serum hCG level < 3000IU/L
3. Tubal diameter < 4 cm without any fetal cardiac activity
4. No intraabdominal haemorrhage
Surgical management :
1. Hemodynamic instability
2. Serum hCG level > 3000 IU/L
3. Tubal diameter > 4 cm
4. Presence of fetal cardiac activity
51. Dose of dexamethasone for fetal lung
maturity is -
a) 6 mg

b) 12 mg

c) 18 mg

d) 24 mg

Correct Answer - A
Answer- A. 6 mg
Betamethasone - 12 mg i.m. 24 hours apart for 2 doses
Dexamethasone - 6 mg i.m. 12 hours apart for 4 doses.
Betamethasone - Steroid of choice.
52. Management of a patient with complete
placenta previa at 38 weeks gestation
without any vaginal bleeding is -
a) Expectant management

b) Macafee and Johnson regimen

c) Elective caesarean section

d) Emergency caesarean section

Correct Answer - C
Answer- C. Elective caesarean section
As this patient is more than 37 weeks gestation, active interference
is mandatory.
But as this patient is not actively bleeding therefore elective
caesarean section can be planned.
53. True about nabothian cyst is all except -�
a) Squamous epithelium occludes the mouth of the glands

b) It is seen in chronic irritation and inflammation

c) It is a pathology of the cervix

d) It is pre - malignant

Correct Answer - D
Answer- D.�It is pre - malignant
Seen in chronic inflammation of cervix.
It is the result of blockage of mouth of the glands of the cervix.
During the process of healing, the squamous epithelium replaces the
columnar epithelium.
The blocked glands become distended with secretion and form small
cysts which can be seen with the naked eye, the so-called nabothian
follicles.
The condition is neither malignant nor pre-malignant.
54. Most common cause of pelvic
inflammatory disease is -
a) Sexually transmitted disease

b) IUCD

c) Pelvic peritonitis

d) Puerperal sepsis

Correct Answer - A
Answer- A. Sexually transmitted disease
Sexually transmitted disease is the most common cause.
Gonococcal and chlamydial infections are the most common cause.
Postabortal or puerperal sepsis.
IUCD
Tuberculosis
Pelvic peritonitis, due to appendicitis and diverticulitis.
55. There is overlapping of skull sutures
which can be reduced with gental
pressure. What is the grade of moulding ?
a) Grade 1

b) Grade 2

c) Grade 3

d) Grade 4

Correct Answer - B
Answer- B. Grade 2
There are three gradings of moulding :
Grade 1 - the bones touching but not overlapping
Grade 2 -overlapping but easily separated
Grade 3 - fixed overlapping.
56. Risk factor for cervical carcinoma is -
a) Smoking

b) Human papilloma virus

c) Low socioeconomic status

d) All of the above

Correct Answer - D
Answer- D. All of the above
HPV infection.
Coitus before 18 years.
Multiple sexual partners.
Delivery of the first baby before the age of 20 years.
Multiparity with poor birth spacing between pregnancies.
Poor personal hygiene.
Poor socioeconomic status.
Smoking.
Immunosupressive disease.
57. 45 yrs female with G5P4A0L4 with LMP
25.8.15, gestational age will be how many
weeks on date 11.5.15?
a) 32 weeks

b) 35 weeks

c) 36 weeks

d) 40 weeks

Correct Answer - C
Answer- C. 36 weeks
if the patient's LMP is 25.8.15 then EDD would be 3.6.16.
On 11.5.15, patient would be 23 days left would for EDD, that is 3
weeks and 2 days. Subtracting this from 40 weeks, the patients
gestational age would be 36 weeks and 5 days.
 58. Which of the following about abdominal
pregnancy is true?
a) Primary abdominal pregnancy is more common

b) If placenta is densely adhered, it should be separated alongwith

the organ it overlies

c) Around 50% of the fetus reach full term and survive

d) If placenta is left behind, infection can occur

Correct Answer - D
Answer- D. If placenta is left behind, infection can occur
Abdominal Pregnancy
A) Primary Abdominal Pregnancy
Criteria to diagnose primary abdominal pregnancy by Studiford :
1. Both the tubes and ovaries are normal without evidence of recent
injury
2. Absence of uteroplacental fistula
3. Presence of a pregnancy related exclusively to the peritoneal
surface and young enough to eliminate the possibility of secondary
implantation following primary nidation in the tube
B) Secondary
Almost always secondary, the primary sites being tube, ovary or
even the uterus - the conceptus escapes out through the rent in the
uterine scar.
59. Oxygen consumption increases in
pregnancy by
a) 10%

b) 20%

c) 30%

d) 40%

Correct Answer - B
Answer- B. 20%
Oxygen consumption increases approximately 20% during
pregnancy, and it is approximately 10% higher in multifetal
gestation.
During labour, oxygen consumption increases 40 - 60%.
60. Stroke volume increases in pregnancy
by
a) 20%

b) 25%

c) 40%

d) 45%

Correct Answer - B
Answer- B. 25%
Hemodynamic changes during pregnancy
Pregnancy near
Non - pregnant Change
term
Cardiac output
4.5 6.26 +40%
(lit/m1)
Stroke volume (ml) 65 75 +27%
Heart rate (per
70 85 + 17%
minute)
Unaffected or mid pregnancy drop of diastolic
Blood pressure
pressure by 5 - 10 mmHg
8 - 10 cm
Venous pressure 20 cm +100%
(femoral)
Colloid oncotic
20 18 - 14%
pressure (mmHg)
Systemic vascular
- 21%
resistance
Pulmonary vascular
- 34%
rests
61. Cardiac output in pregnancy increases
from which week of gestation
a) 5 weeks

b) 15 weeks

c) 25 weeks

d) 35 weeks

Correct Answer - A
Answer- A. 5 weeks
Cardiac output starts to increase from the 5th week of gestation,
reaches its peak 40 - 50% at 30 - 34 weeks.
62. What is the stage of carcinoma cervix
involving body of uterus -
a) Stage I

b) Stage II

c) Stage III

d) Stage IV

Correct Answer - A
Answer- A. Stage I
Cervical Cancer - FIGO Staging
Stage
Carcinoma in situ
0
Stage I Intraepithelial carcinoma confined to the cervix
Stage
Diagnosed only by microscopy
IA
Stage Microinvasiva carcinoma with stromal invasion < 3 mm in
IA1 depth & < 7 mm in wide.
Stage Microinvasiva carcinoma not exceeding 5 mm in depth /7
IA2 mm in width.
Stage
Clinically visible or microscopic lesion > IA2.
IB
Stage
Clinical lesion not exceeding 4cm in diameter.
IB1
Stage
Clinical lesion more then 4 cm in diameter.
IB2
Stage
Extension beyond the cervix but not to the pelvic wall.
II
Stage
Involvement of vagina but not the lower third.
IIA
 Involvement of vagina but not the lower third.
IIA
Stage
Clinically visible lesion more then 4 cm.
IIA1
Stage
Clinically visible lesion more then 4 cm.
IIA2
Stage
Parametrial involvement not reaching the pelcvic side wall.
IIB
63. Therapeutic use of folic acid is
a) Previous pregnancy with child having neural tube defect

b) Megaloblastic anaemia

c) Hemoglobinopathies

d) All of the above

Correct Answer - B
Answer- B. Megaloblastic anaemia
Folic acid is given in all the given conditions. But answer hear is
option b.
This questions is tricky :-
Examiner is asking about therapeutic uses of folic acid (not
preventive)
In megaloblastic anemia, folic is given for treatment —> therapeutic
uses
In pregnancy it is given for prevention of neural tube defect —>
prophylactic use (preventive use)
64. Most common cause of death in cervical
cancer is -
a) Renal failure

b) Infection

c) Haemorrhage

d) Metastasis to vital organs

Correct Answer - A
Answer- A. Renal failure
Renal failure is the most common cause of death in cervical cancer.
Renal failure in cervical cancer occurs due to involvement of ureters
in Stage 1IIB. It can also occur due to direct involvement of kidney
as in stage IV B.
65. During pregnancy increased size of
pituitary is caused by increased size of
cells which secrete ?
a) Growth hormone

b) Prolactin

c) ACTH

d) TSH

Correct Answer - B
Answer- B. Prolactin
Prolactin levels rise gradually throughout pregnancy, preparing the
breast for lactation.
This lactotroph hyperplasia has important implications for the patient
with a prolactinoma who desires pregnancy.
 66. Treatment options for CIN III include all of
the following except -
a) LLETZ

b) Conization

c) Hysterectomy

d) Wertheim's hysterectomy

Correct Answer - D
Answer- D. Wertheim's hysterectomy
Treatment options of (IN III
1. Conservative ablation : coagulation, cryoscrgery, laser ablation
2. Local excision : conization, laser conization, lleT2, LEEP, NETZ
3. Radical excision : Trachelectomy, hystrectomy (with or without
removal of vaginal cuff).
Wertheim's hysterectomy is generally not done in cases of CIN III if
vagina or lymph nodes are not involved.
67. What size of the hegar's dilator if passed
through the internal os can be labeled as
cervical incompetence?
a) 4

b) 6

c) 8

d) 10

Correct Answer - C
Answer- C. 8
Passage without resistance and pain of No. 8 Hegar's dilator is a
screening test for cervical incompetence.
 68. Propulsive stage in labour in multipara
a) 10 minutes

b) 20 minutes

c) 40 minutes

d) 1 hour

Correct Answer - B
Answer- B. 20 minutes
Second stage of labour has two phases :
1. Propulsive phase: from full dilatation of cervix until head touches
pelvic floor.
2. Expulsive phase : Since the time there is irresistible maternal desire
to bear down until the body is delivered.
Mean duration of second stage is 50 minutes for nullipara and 20
minutes in multipara.
69. Funneling in cervicogram is seen in -
a) In labour

b) Cervical incompetence

c) Cervical ectopic

d) During TVS

Correct Answer - B
Answer- B. Cervical incompetence
Cervicogram is done for diagnosis of cervical incompetence. In other
conditions, cervicogram is not done.
70. In cervical incompetence diameter of
internal os of cervix is -
a) 1 cm

b) 1.5 cm

c) 2 cm

d) 2.5 cm

Correct Answer - A
Answer- A. 1 cm
Cervical sonography :
Funelling of the cervix with changes in the form of Y, V, U.
Cervical length < 2.5 cm.
Funnelling of the internal os > 1 cm
Speculum examination : Detection of dilatation of internal os with
herniation of the membranes.
Cervical index = (Funnel length + 1) / (endocervical length).
The "+1" allows an index to be calculated when funelling is absent.
Predictors of preterm birth :
Cervical index > 0.52.
Cervical length < 18 mm
Funnel length > 9 mm.
Funnel width > 6 mm.
71. Occipitoanterior position
a) Anterior fontanalle is posterior

b) Sagittal suture is along the Transverse plane of the maternal

pelvis

c) Coronal suture is along the antero - posterior plane of the

maternal pelvis

d) All of the above

Correct Answer - A
Answer- A. Anterior fontanalle is posterior
In direct occipito anterior position, the sagittal suture of the fetus will
be along the antero - posterior plane of the maternal pelvis and the
coronal suture along the transverse diameter.
72. Method not used for shoulder dystocia
a) McRobert's maneuver

b) Hegar's maneuver

c) Zanavelli maneuver

d) Wood's maneuver

Correct Answer - B
Answer- B. Hegar's maneuver
McRobert's, Zanavelli and Wood's maneuvers' are maneuvers in the
management of shoulder dystocia.
73. Vasa previa is associated with -
a) Marginal placenta

b) Velamentous placenta

c) Battledore

d) Placenta previa

Correct Answer - B
Answer- B. Velamentous placenta
If a leash of blood vessels happen to traverse through the
membranes overlying the internal is, in front of the presenting part,
the condition is called as vasa praevia.
It is associated with velamentous placenta.
The unsupported umbilical vessels in velamentous placenta, lie
below the presenting part and run across the cervical os.
Rupture of membranes involving the overlying vessels leads to
vaginal bleeding.
As it is entirely fetal blood, this may result in fetal exsanguination
and even death.
[Ref Dutta's Obstetrics 8th/e p. 301]
74. Which is not a risk factor for gestational
hypertension
a) Obesity

b) Smoking

c) Primigravida

d) Factor V Leiden mutation

Correct Answer - B
Answer- B. Smoking
Primigravida : Young or elderly (first time exposure to villi)
Family history (hypertension, pre - eclampsia)
Placental ischemia
Obesity
Thrombophilia (antiphospholipid syndrome), protein C and S
deficiency, factor V Leiden mutation)
Molar pregnancy (early onset pre - eclampsia)
75. Most common breech position is
a) Complete breech

b) Frank breech

c) Footling breech

d) Knee presentation

Correct Answer - B
Answer- B. Frank breech
Frank breech (Breech with extended legs) is the most common
breech presentation.
Breech with extended legs (Frank breech) : Thighs are flexed at hip
and legs are extended at knee. It is commonly seen in primigravidae
(70%).
It is the most common type of breech.
76. When fetus is at station +2 & fetal skull
reaches pelvic floor, which of the
following is true
a) Forceps can be applied

b) Best time to give episiotomy

c) Called as crowning

d) May lead to deep transverse arrest

Correct Answer - A
Answer- A. Forceps can be applied
When the fetal skull has reached the level of pelvic floor and station
of head is at + 2 or more, outlet forceps can be applied.
However, crowning is defined as stretching of the vulva' outlet by the
maximum diameter of the fetal head (biparietal diameter) without
any recession. Thus the station is + 5.
Best time to give episiotomy is at the time of crowning of head.
[Ref Dutta's Obstetrics 81h/e p. 651]
77. Contracted pelvis is defined as shortening
of one or more planes by -
a) 0.5 cm

b) 1 cm

c) 1.25 cm

d) 1.5 cm

Correct Answer - A
Answer- A. 0.5 cm
Anatomically, contracted pelvis is defined as shortening of one or
more planes by 0.5 cm.
78. Common misdiagnosis of partial mole is
a) Threatened abortion

b) Choriocarcinoma

c) Complete mole

d) Ectopic pregnancy

Correct Answer - A
Answer- A. Threatened abortion
The clinical picture of partial mole is confused with threatened
abortion or missed abortion due to pain and bleeding alongwith a
fetus (usually dead) in utero.
79. Prolonged second stage of labour may
occur due to
a) Uterine inertia

b) Epidural analgesia

c) Cephalopelvic disproportion

d) All of the above

Correct Answer - D
Answer- D. All of the above
Prolongation of second stage of labour can occur due to any of
the following reasons :
1) Fault in the power
Uterine inertia
Inability to bear down
Epidural analgesia
Constriction ring
2) Fault in the passage
Cephalopelvic disproportion, android pelvis, contracted pelvis
Undue resistance of the pelvic floor or perineum due to spasm or old
scarring
Soft tissue pelvic tumor.
3) Fault in the passenger
Malposition (occipito - posterior)
Malpresentation
Big baby
Congenital malformation of the baby
80. Most common type of conjoint twin is -
a) Thoracopagus

b) Omphalopagus

c) Craniopagus

d) Rachipagus

Correct Answer - A
Answer- A. Thoracopagus
Four types of fusion may occur :
Thorapagus - Most common
Pyopagus (posterior fusion)
Craniopagus (cephalic)
Ischiopagus (caudal)
81. Crowning is
a) Biparietal diameter at the inlet of pelvis

b) Biparietal diameter at the ischial spine

c) Biparietal diameter at the vulval outlet

d) Biparietal diameter just outside the vulval outlet Answer-

Correct Answer - C
Answer- C. Biparietal diameter at the vulval outlet
Crowning : After internal rotation of the head, further descent occurs
until the subocciput lies underneath the pubic arch. At this stage, the
maximum diameter of the head (biparietal diameter) stretches the
vulval outlet without any recession of the head even after the
contraction is over - called "crowning of the head".
82. Uterine height is greater than gestational
age of the patient in a case of all except -
a) Fibroid uterus

b) IUGR

c) Wrong dates

d) Polyhydramnios

Correct Answer - B
Answer- B. IUGR
Uterine height greater than gestational age in case of :
Wrong dates
Polyhydramnios
Pregnancy with fibroid uterus
Multiple pregnancy
83. True about placental site trophoblastic
disease is
a) Highly Malignant behavior

b) Hysterectomy followed by chemoradiation is the treatment of

choice

c) Secretes human placental lactogen

d) Contains syncytiotrophoblasts mainly

Correct Answer - C
Answer- C. Secretes human placental lactogen
Placental Site Trophoblastic Tumour
Arises from the placental bed trophoblasts and invades the
myometrium.
Follows a full - term normal delivery.
Tumor contains mainly cytotrophoblasts with few or no
syncytiotrophoblasts.
Most of these tumors run a benign course, malignancy is rare.
[Ref Shaw's Gynae le/e p. 313; Dutta's Obs 8thie p. 231]
84. Quickening in multiparae is felt at what
weeks of gestation?
a) 14 weeks

b) 16 weeks

c) 18 weeks

d) 20 weeks

Correct Answer - B
Answer- B. 16 weeks
Quickening is feeling of life. It denotes perception of active fetal
movements by the women. It is usually felt about the 18th week,
about 2 weeks earlier in multiparae. Its appearance is an useful
guide to calculate the expected date of delivery with reasonable
accuracy.
85. Pregnancy is contraindicated in which
cardiac disease -
a) Mitral stenosis

b) Primary pulmonary hypertension

c) VSD

d) Mitral regurgitation

Correct Answer - B
Answer- B. Primary pulmonary hypertension
Place of therapeutic termination in case of following heart diseases.
Considering high maternal deaths, absolute indications are :
Primary pulmonary hypertension
Eisenmenger's syndrome
Pulmonary veno - occlusive disease.
86. Malodorous vaginal discharge is due to
a) Bacterial vaginosis

b) Chlamydia trachomatis

c) Trichomonas vaginalis

d) Neisseria gonorrhea

Correct Answer - A
Answer- A. Bacterial vaginosis
Bacterial vaginosis is an alteration of the normal vaginal flora with
consequent overgrowth of pathogenic bacteria.
There is fall in the absolute number of hydrogen peroxide -
producing lactobacilli, leading to a rise in pH and increase in the
absolute number of G. vaginalis, anaerobic gram - negative rods,
Mobiluncus spp. and Mycoplasma hominis.
87. Following delivery, tear involves
perineum, external anal spincter with
intact mucosa, grade of tear is -
a) First degree

b) Second degree

c) Third degree

d) Fourth degree

Correct Answer - C
Answer- C. Third degree
Third degree : Injury to perineum, involving the anal sphincter
complex (both the external and internal).
3a : if half thickness external anal sphincter involved.
3b : if full thickness external anal sphincter involved.
3c : if internal anal sphincter involoved.
88. Amsel criteria is for
a) Bacterial vaginosis

b) Antiphospholipid antibody syndrome

c) Ovarian ectopic pregnancy

d) HELLP Syndrome

Correct Answer - A
Answer- A. Bacterial vaginosis
Amsel criteria : Three out of four of the following should be
present
A white / gray homogenous discharge
A vaginal discharge pH of > 4.5
A positive amine test (drop of 10% potassium hydroxide added to
drop of discharge on a slide produces fishy odour), also known as
Whiff test.
Microscopy demonstrates clue cells.
89. Plane of cleavage during placental
separation runs through
a) Between compact and spongy layer of decidua basalis

b) Between decidua basalis and chorion frondosum

c) Through deep spongy layer of decidua basalis

d) Between layers of chorion frondosum

Correct Answer - C
Answer- C. Through deep spongy layer of decidua basalis
Marked retraction reduces effectively the surface area at the
placental site to about its half. But as the placenta is inelastic, it
cannot keep pace with such an extent of diminution resulting in its
buckling. A shearing force is instituted between the placenta and the
placental site which brings about its ultimate separation.
90. Not a cause of oligohydramnios -
a) IUGR

b) Renal agenesis

c) Amnion nodosum

d) Chorioangioma

Correct Answer - D
Answer- D. Chorioangioma
Fetal,
Chromosomal or structural anamolies
Renal agenesis
Obstructive uropathy
Spontaneous rupture of membrane
Intrauterine infection
Drugs: PG inhibitors, ACE inhibitors
Postmaturity
IUGR
Amnion nodosum
Maternal
Hypertensive disorders
Uteorplacental insufficiency
Dehydration
Idiopathic
 91. Which of the following is true about
ovarian ectopic pregnancy?
a) Studdiford criteria is used for diagnosis

b) There should be no rent on the ovary or tube

c) Absence of evidence of pregnancy at any other site than

ovarian

d) Conservative surgery can be done if diagnosed early

Correct Answer - D
Answer- D. Conservative surgery can be done if diagnosed
early
Ovarian ectopic is a rare entity that is difficult to diagnose clinically. It
usually does not proceed past the first four weeks of pregnancy.
Spiegelberg's criteria is used for diagnosis of ovarian
pregnancy. It includes :
1. Tube on the affected side must be intact.
2. The gestation sac must be in the position of the ovary.
3. The gestation sac is connected to the uterus by the ovarian
ligament.
4. The ovarian tissue must be found on its wall on histological
examination.
92. False about chorionic vinous sampling -
a) Is used for prental genetic diagnosis

b) Is performed only in second trimester of pregnancy

c) Villi collected from chorion frondosum

d) Can cause limb deformities

Correct Answer - B
Answer- B. Is performed only in second trimester of pregnancy
Is used for prenatal genetic diagnosis.
Performed transcervically through 10-12 weeks (first trimester) and
transabdominally from 10 weeks to term. (Advantage over
amniocentesis which is performed in second trimester of pregnancy)
Villi are collected from chorion frondosum.
Can cause oromandibular limb deformities or limb reduction defects
if performed before 10 weeks of gestation.
93. Bacteria responsible for ectopic
pregnancy is
a) Staphylococcus

b) Chlamydia

c) Peptostreptococcus

d) Trichomonas vaginalis

Correct Answer - B
Answer- B. Chlamydia
Salpingitis and PID (Pelvic Inflammatory Disease) is the most
important risk factor for ectopic pregnancy. Chlamydia trachomatis
infection is the most common risk factor for PID and salpingitis.
[Ref Dutta's Obstetrics 8th/e p.. 207]
94. A 28 year old primigravida with 32 weeks
of gestation comes with complain of thin,
frothy, profuse discharge through the
vagina since yesterday. She was advised
USG which showed Single live
intrauterine gestational sac with FL and
AC corresponding to the weeks of
gestation and AFI as adequate.What is the
diagnosis?
a) PPROM

b) Trichomoniasis

c) Normal finding

d) Candidiasis

Correct Answer - B
Answer- B. Trichomoniasis
Patients infected with Trichomonas vaginalis complain of a typical
discharge, which is thin, profuse, frothy, irritating, creamy or slight
green in colour.
Slight green colour of the discharge is often not complained by the
patient but spotted by the physician.
95. Le Fort repair is done for
a) Uterovaginal descent

b) Vault prolapse

c) VVF

d) RVF

Correct Answer - A
Answer- A. Uterovaginal descent
Le Forte's repair
Very elderly menopausal women
Advanced prolapse
Unfit for any major surgical procedure
[Ref Shaw's Gynaecology 16th/e p. 360]
96. Leydig cells of fetus testis secretes
a) hCG

b) LH

c) Testosterone

d) Mullerian inhibiting substance

Correct Answer - C
Answer- C. Testosterone
Leydig cells in fetal testis are the cellular site of testosterone
synthesis.
Fetal testis also secretes mullerian inhibiting substance produced by
sertoli cells which acts locally as a paracrine factor to cause
mullerian duct regression. Mullerian duct regression completes by 9
to 10 weeks' gestation, which is much before testosterone secretion
has commenced.
 97. Risk factors for molar gestation are all of
the following except -
a) Oriental countries

b) Disturbed maternal immune mechanism

c) Higher ratio of maternal/paternal chromosomes

d) Faulty nutrition

Correct Answer - C
Answer- C. Higher ratio of maternal/paternal chromosomes
Risk factors for H. mole :
1. Oriental countries, highest incidence in Philippines.
2. Teenage pregnancies or > 35 years.
3. Faulty nutrition.
4. Disturbed maternal immune mechanism.
5. Higher ratio of paternal/maternal chromosomes (not
maternal/paternal)
Higher the ratio, greater the molar change. Complete moles show
2:0 paternal/maternal ratio whereas partial mole shows 2 : 1 ratio.
98. Embryo gets implanted at what stage of
development?
a) Two cell stage

b) Four cell stage

c) Morula

d) Blastocyst

Correct Answer - D
Answer- D. Blastocyst
After the zygote formation, typical mitotic division of the nucleus
occurs producing two blastomeres.
Two cell stage is reached approximately 30 hours after fertilization.
The blastomeres continue to divide by binary division through 4, 8,
16 cell stage until a cluster of cells is formed and is called morula,
resembling a mulberry.
Morula after spending about 3 days in the uterine tube enters the
uterine cavity through the narrow uterine ostium (1mm) on the 4th
day in the 16 - 64 cell stage.
Implantation occurs on the 6th day which corresponds to the 20th
day of regular menstrual cycle.
Implantation occurs through 4 stages : apposition, adhesion,
penetration and invasion.
99. Poor prognostic factor for hydatidiform
mole is -
a) Prior molar pregnancy

b) Metastasis to lung

c) No prior chemotherapy

d) WHO score > 8

Correct Answer - D
Answer- D. WHO score > 8
High Risk (Poor Prognosis) :
Long duration of disease (> 4 months)
Initial serum hCG level > 40,000 mIU/ml
Brain or liver metastasis
Failure of prior chemotherapy
Following term pregnancy
WHO score > 8
100. Drugs used in endometriosis is
a) Combined oral contraceptives

b) Letrozole

c) Mifepristone

d) All of the above

Correct Answer - D
Answer- D. All of the above
Combined oral contraceptives - Administered intermittently or
continuously, oral contraceptives may alleviate the disease.
Oral progestogens - Exert anti - estrogenic effect and their
continuous administration causes decidualization and endometrial
atrophy.
Danazol - inhibits pituitary gonadotropins
GnRH analogues - Downregulate and suppress pituitary
gonadotropins.
Aromatase inhibitors (letrozole) : Anti - estrogenic action
Anti - progestin (mifepristone)
101. Risk of scar rupture in lower segment of
previous scar present is ?
a) 05 - 1.5 %

b) 15 - 25 %

c) 2.5 - 3.5 %

d) 3.5 - 4.5 %

Correct Answer - A
Ans. A. 05 - 1.5 %
102. Not true in complete hydatidiform mole ?
a) Triploid

b) Absence of fetal parts

c) Diffuse trophoblastic hyperplasia

d) Beta HCG > 50,000

Correct Answer - A
Ans, A. Triploid
Triploidy and diploidy are seen in partial mole. Complete mole has
46 XX karyotype.
103. Components of Mala D are all except ?
a) 0.03 mg Ethinyl estradiol

b) 0.15mg desogestrel

c) 0.15 mg levenogestrel

d) Iron tablets

Correct Answer - B
Ans, B. 0.15mg desogestrel
104. Mechanism of action of IUCD is all
except ?
a) Inhibit ovulation

b) Induce biochemical changes in endometrium

c) Increase tubal motility

d) Inflammatory respone in endometrium

Correct Answer - A
Ans, A. Inhibit ovulation
Act predominantly in the uterine cavity and do not inhibit ovulation.
105. Most common infection in long term
IUCD use -
a) Actinomyosis

b) Mucormycosis

c) Aspergillosis

d) Candidiasis

Correct Answer - A
Ans. A. Actinomyosis
Actinomycosis is an infection common in patients sing inert IUCDs.
106. Absolute contraindication of OC pills are
all except?
a) Suspicious vaginal bleeding

b) Cervical cancer

c) Uterine anamoly

d) Old STD

Correct Answer - D
Ans. D. Old STD
Current STD is an absolute contraindication (not past STDs).
107. Copper IUCD as a contraceptive measure
can be used maximum till what time after
contact ?
a) 2 days

b) 3 days

c) 4 days

d) 5 days

Correct Answer - D
Ans. D. 5 days
IntroductionofCopperlUDwithinamaximumperiodof5dayscan
preventconceptionfollowingaccidentalunprotectedexposure.
108. Clomiphene citrate is used for ?
a) Anovulation

b) Endometriosis

c) Puberty menorrhagia

d) Hormone replacement therapy

Correct Answer - A
Ans A. Anovulation
109. First line treatment of infertility in PCOS
is ?
a) Clomiphene

b) FSH

c) GnRH

d) Assisted reproductive techniques

Correct Answer - A
Ans. A. Clomiphene
Clomiphene citrate is the first line of treatment of infertility in a PCOS
woman.
110. Drug commonly used in treatment of
endometriosis is?
a) LH

b) GnRH

c) MPA

d) FSH

Correct Answer - B
Ans. B. GnRH
111. Investigation of choice in endometriosis
?
a) Laproscopy

b) Hysteoscopy

c) CT scan

d) MRI

Correct Answer - A
Ans. A. Laproscopy
Laproscopy is considered as gold standard investigation for
diagnosis of endometriosis.
It is diagnostic as well as therapeutic,
112. Carcinoma endometrium with
involvement of the vaginal wall is
included in which stage ?
a) IIIA

b) IIIB

c) IIIC

d) IVA

Correct Answer - B
Ans. B. IIIB
113. Meigs syndrome is associated with
which tumor ?
a) Fibroma

b) Cystadenoma

c) Dysgerminoma

d) Teratoma

Correct Answer - A
Ans. A. Fibroma
Meigs syndrome combination offibroma with ascites andhydrothorax,
usuaily rightsided.
Seen in 1- 5% patients.
114. Sentinel lymph node biopsy is used to
map the lymph node status of which
cancers?
a) Breast

b) Melanoma

c) Vulva

d) All the above

Correct Answer - D
Ans, D. All the above
Lymphatic mapping and sentinel lymph node biopsy
Technique use to know the local lymph node status in cancers of
breast, vulva and melanoma
115. Most common type of fibroid is ?
a) Intramural

b) Subserosal

c) Cervical

d) Submucosal

Correct Answer - A
Ans. A. Intramural
116. Most common cancer in pregnancy ?
a) Melanoma

b) Breast carcinoma

c) Gastric carcinoma

d) Thyroid carcinoma

Correct Answer - B
Ans. B. Breast carcinoma
Breast carcinoma is the most common cancer in pregnancy
constituting 46% (1:3000 to 10,000) of the cases followed by
hematological malignancies constituting 18 - 25%o of the cases,
117. Most common cause of vulval carcinoma
is ?
a) HPV infection

b) EBV infection

c) Herpes genitalis infection

d) Syphilis infection

Correct Answer - A
Ans. A. HPV infection
HPV infection is a common risk factor for the development of
invasive vulval carcinoma.
118. Following the criteria for conservative
surgery in patients with ovarian
carcinoma except ?
a) FIGO stage II disease

b) Young patient with no or few children

c) Well differentiated serous tumor

d) No infiltration of capsule, lymphatics or mesoovarium

Correct Answer - A
Ans. A. FIGO stage II disease
Requirements for conservative surgery in patients with
ovarianCancer are:
FIGO stage IA disease
Well differentiated serous, mucinous, endometroid or clear cell
tumor
Young patient with no or few children
No other pelvic pathology precluding pregnancy
119. Most common ovarian cyst to undergo
torsion is ?
a) Dysgerminoma

b) Benign cystic teratoma

c) Ovarian fibroma

d) Brenner's tumor

Correct Answer - B
Ans, B. Benign cystic teratoma
Benign cystic teratoma is the most common ovarian neoplasm to
undergo torsion.
120. Most common malignant ovarian tumor
is ?
a) Serous cystadenocarcinoma

b) Mucinous cysadenocarcinoma

c) Malignant teratoma

d) Sarcoma

Correct Answer - A
Ans, A. Serous cystadenocarcinoma
121. Which of the following is the most
common malignant germ cell tumor of
ovary?
a) Yolk sac tumor

b) Dysgerminoma

c) Polyembryoma

d) Choriocarcinoma

Correct Answer - B
Ans, B. Dysgerminoma
122. Most common germ cell tumor of ovary
is ?
a) Dysgerminoma

b) Serous cystadenoma

c) Yolk sac tumor

d) Dermoid cyst

Correct Answer - D
Ans. D. Dermoid cyst
123. Call Exner bodies seen in ?
a) Granulosa cell tumors

b) Serous cystadenomas

c) Dysgerminoma

d) Krukenberg tumor

Correct Answer - A
Ans. A. Granulosa cell tumors
The formation of Call - Exner bodies is a distinct feature of granulosa
cells and can be readilyrecognized in certain types of granulosa cell
tumours.
124. Inhibin is a tumor marker for ?
a) Granulosa cell tumor

b) Dysgerminoma

c) Serous cystadenoma

d) Krukenberg tumor

Correct Answer - A
Ans. A. Granulosa cell tumor
125. Management of Stage IIA carcinoma
cervix in third trimester of pregnancy is ?
a) Radical hysterectomy, pelvic lymphadenetomy after classic
caesarian delivery

b) Periodic cytology and evaluation

c) Cone biopsy

d) Chemotherapy and brachytherapy

Correct Answer - A
Ans. A. Radical hysterectomy, pelvic lymphadenetomy after
classic caesarian delivery
126. Treatment of IBI ca cervix ?
a) Wertheim's hysterectomy

b) Radiotherapy

c) Chemotherapy

d) Chemoradiotherapy

Correct Answer - A
Ans. A. Wertheim's hysterectomy
127. What is the next step in investigating a
45 yrs old female with post coital
bleeding and visible cervical mass on
speculum examination ?
a) Dilatation and curettage

b) Conisation

c) Colposcopy

d) Hysteroscopy

Correct Answer - C
Ans. C. Colposcopy
128. Most common mode of spread for genital
tuberculosis is?
a) Hematogenous

b) Lymphatic

c) Direct

d) Ascending

Correct Answer - A
Ans. A. Hematogenous
From any of the primary sites, the pelvic organs involved by
hematogenous spread in about 90% of the cases.
129. Estimation of fetal hemoglobin is done
by ?
a) Gerhard test

b) Kleihauser-Betke Acid Elution Test

c) Grinders test

d) Simpsons test

Correct Answer - B
Ans. B. Kleihauser-Betke Acid Elution Test
Modified Keihauser-Betke Acid Elution test: it k used to note the
number fetal red cells per 0 low power fields.
If there are 80 fetal erythrocyte in 50 low power fields in maternal
peripheralblood films, it presents the transplacental hemorrhage of 4
ml of fetal blood.
130. Most common breech presentation in
primigravida is ?
a) Flexed breech

b) Frank breech

c) Footling presentation

d) Incomplete

Correct Answer - B
Ans, B. Frank breech
Breech with extended legs/Frank breech
131. Transverse lie is caused by all except ?
a) Multiparity

b) Prematurity

c) Anencephaly

d) Placenta previa

Correct Answer - C
Ans, C. Anencephaly
Etiology transverse lie:
Multiparity
Twins
Contracted pelvis
Pelvic tumors
Intrauterine death
Prematurity
Hydramnios
Placentaprevia
Congenital malformation of uterus - arcuate, subseptate
132. 20 year old female with primary
amenorrhoea with normal presentation
of everything except no axillary or pubic
hair. What is the diagnosis?
a) Testicular feminization syndrome

b) Kallman syndrome

c) Turners syndrome

d) Klienfelters syndrome

Correct Answer - A
Ans, A. Testicular feminization syndrome
Phenotypically normal females with absence of axillary and
pubic hair with primary amenorrhoea have two differential
diagnosis:
Testicular feminizing syndrome and
Mullerian agenesis.
133. In PID due to neiserriea gonorrhea, tubal
damage is?
a) Peritubal

b) Endotubal

c) Extratubal

d) Juxtatubal

Correct Answer - B
Ans. B. Endotubal
Gonococcal infection involves the mucosa and mainly remains an
endoluminal pathology while the other bacterial PID tend to involve
deeper tissues and can also involve extratubal tissues. So the most
probable answer is endotubal.
134. Condition where there is ingrowth of the
endometrium, both glandular and
stromal component in myometrium is ?
a) Adenomyosis

b) Courvelaire uterus

c) Placenta accreta

d) Uterine fibroid

Correct Answer - A
Ans, A. Adenomyosis
Adenomyosis is a condition where there is ingrowth of the
endometrium, both the glandular and stromal components, directly
into the myometrium.
135. Couvelaire uterus is seen in ?
a) Placenta previa

b) Abruptio placentae

c) Plencenta accrete

d) Velamentous placenta

Correct Answer - B
Ans. B. Abruptio placentae
Couvelaire uterus
Also called uteroplacental apoplexy.
It is seen in association with severe forms of "concealed abruptio
placen "
136. Swiss cheese pattern is seen in ?
a) Metropathica hemorrhagica

b) Serous cystadenoma

c) Mucinous cystadenoma

d) Dermoid

Correct Answer - A
Ans. A. Metropathica hemorrhagica
Microscopicappearance of endometrium shows: Glandular
hyperplasiawith cystic dilation of few glands of variable sizes givingit
a swiss cheese appearance.
137. Upper age limit to diagnose a patient as
having primary amenorrhoea is ?
a) 13 years

b) 14 years

c) 15 years

d) 16 years

Correct Answer - D
Ans. D. 16 years
A young girl who has not yet menstruated by her 16 years of age
has pimary amenonhoea rather than delayed metarche.
Delayed puberty is defined as failure of development of signs of
sexual development by the age of 14 years in boy.
In girls delayed puberty is defined as failure of breast budding by I 3
years or absence of menarche by I 5 year or lack of secondary
sexual characters by l7 years.
138. Lileys zone 3 at 35 weeks gestation
management is?
a) Follow up

b) Intrauterine infusion

c) Preterm termination of pregnancy

d) Cordocentesis

Correct Answer - C
Ans, C. Preterm termination of pregnancy
A chart that uses the spectrographic measurement of amniotic fluid
bilirubin levels plotted against gestational age to estimate the
severity of fetal hemolysis resultingfrom Rh isoimmunizntion.
139. How much time after reduced movement
fetal heart stops?
a) 1 hr

b) 2 hrs

c) 6 hrs

d) 12 hrs

Correct Answer - D
Ans, D, 12 hrs
On an averagefetalheart stops after 12 - 48 hours of diseased fetal
movements in intrauterinefetal death.
140. Red cell volume is increased by what
percentage in pregnancy?
a) 10 - 20%

b) 20 - 30%

c) 30 - 40%

d) 40 - 50%

Correct Answer - B
Ans. B. 20 - 30%
141. Following are the causes of
oligohydramnios except?
a) IUGR

b) Postmaturity

c) Maternal dehydration

d) Labetolol

Correct Answer - D
Ans, D. Labetolol
142. Not a risk for ectopic pregnancy ?
a) Use of condom

b) OCP

c) PID

d) Previous ectopic pregnancy

Correct Answer - A
Ans. A. Use of condom
143. Risk factors for the ectopic pregnancy
are ?
a) IUCD

b) History of infertility

c) Tubal endometriosis

d) All the above

Correct Answer - D
Ans, D, All the above
144. 34 weeks pregnancy with low lying
placenta previa, floating head, Hb - 11
gm%. What should be the further line of
management?
a) Expectant management

b) Induction of labour

c) Caesarian section

d) Blood transfusion

Correct Answer - A
Ans. A. Expectant management
145. Which of the following is an absolute
indication for caesarian section?
a) Central placenta previa

b) Breech presentation

c) Bad obstetric history

d) Previous caesarian delivery

Correct Answer - A
Ans, A. Central placenta previa
Absolute indications for caesarian section-
Central placenta previa
Contracted pelvis or cephalopelvic disproportion (absolute)
Pelvic mass causing obstruction (cervical or broad ligament fibroid)
146. What is used to aid identification of
areas of dysplasia in colposcopy?
a) 3 - 5% acetic acid

b) Acetocarmine red

c) 1 % formic acid

d) 1 % alcohol

Correct Answer - A
Ans. A. 3 - 5% acetic acid
Colposcopy is the mainstay in the diagnosis of cervical dysplasia
and precancerous lesions.
147. Following are the ultrasound doppler
parameters used in the diagnosis of
intrauterine growth restriction except?
a) Abdominal circumference

b) Doppler velocimetry

c) Increased diastolic velocity in middle cerebral artery

d) Ponderal index

Correct Answer - A
Ans, A. Abdominal circumference
148. Most common cause of early abortion -
a) Genetic

b) Maternal

c) Immunologic

d) Anatomic abnormalities

Correct Answer - A
Ans. A. Genetic
149. Following are the indicatons of
hysterosalpingography except
a) Fallopian tube patency in infertility

b) Study uterine anamoly

c) Detect uterine synechiae

d) Detect endometriosis

Correct Answer - D
Ans, D. Detect endometriosis
Indications of HysterosaIpingography
To study the patency offallopian tubes in infertility and postoperative
tuboplasty
To assess the feasibility of tuboplasty by studying the extent of tubal
pathologist.
To study the uterine anomaly such as septate and cornuate uterus
To detect uterine synechiae
To detect uterine polyp
To study the incompetence of internal OS
150. Sarcoma botryoides all are true except ?
a) Also called embryonalrhabdomyosarcoma

b) Commonly arises from vagina

c) It presents with blood stained watery vaginal discharge

d) It can be treated with VAC regime

Correct Answer - B
Ans B. Commonly arises from vagina
Sarcoma botyroides ( Embrvonalrhabdomyosarcoma)
Special type of mixed mesodermal tumour commonly arising from
cervix, rarely from vagina &uterus.
151. Monzygotic twin with one healthy baby
born at term and one dead mummified
fetusis suggestive of ?
a) Fetus acardiacus

b) Fetus papyraceous

c) Hydatidiform mole

d) Vanishing twin

Correct Answer - B
Ans. B. Fetus papyraceous
Fetus Paoyraceous or compressus-
Is a state which occurs in case of twins when one of the fetuses dies
early.
The dead fetus is flattened mummifed and compressed between the
membranes of livingfetus and uterine waII.
It may occur in both varieties of twins but is more common in
monozygotic twins and is discovered at delivery or earlier by
sonography.
152. Mediolateral episiotomy is preferred
because ?
a) Reduces damage to anal sphincter and anal canal

b) Less blood loss

c) Easy to suture

d) Easy technique

Correct Answer - A
Ans, A. Reduces damage to anal sphincter and anal canal
Mediolateral episiotomy reduces the risk of damage to anal
sphincter and anal canal thought it may slightly increase the
bleeding.
153.
Which is not a part of basic essential
obstetric care?
a) Blood transfusion

b) Parenteral antibiotics

c) Parenteral oxytocic drugs

d) Parenteral sedatives for eclampsia

Correct Answer - A
Ans. A. Blood transfusion
Basic essential obstetric care services at the health center level
should include at least the following:
Parenteral antibiotics
Parenteral oxytocic drugs
Parenteral sedativesfor eclampsia
Manual removal of placenta
Manual removal of retained products
154. Vasa previa is seen in which type of
placenta ?
a) Central

b) Vilamentous

c) Peripheral

d) None of the above

Correct Answer - B
Ans. B. Vilamentous
Vasa previa
If a leash of blood vessels happen to traverse through the
membranes overlying the internal os, in front of presenting part, the
condition is called vasa previa.
These are the unsupported umbilical vessels in vilamentous
placenta.
155. Duration of second stage of labor
depends upon -
a) Size of fetus

b) Mother's build

c) Parity

d) Lie of fetus

Correct Answer - C
Ans, C, Parity
The duration of the normal second stage is usually very much
shorter than the normalfirst stage of labour.
As with the first stage the duration of the second stage
willmainlydepends on whether it is the first labour or the woman
haspreviously given birth to a viable infant i. e. it depends on the
parity status ofthe mother,
156. Simultaneous administration of estrogen
and progesterone in hormone
replacement therapy increases risk of ?
a) Ovarian cancer

b) Breast cancer

c) Cervical cancer

d) Both a and b

Correct Answer - D
Ans D. Both a and b
Risk due to both estrogen and progesterone in HRT:-
Breast cancer
Ovarian cancer
Risk due to only estrogen in HRT:-
Endometrial carcinoma
157. LEEP stands for ?
a) Loop electrosurgical excision procedure

b) Loop electromagnetic excision procedure

c) Loop electrodiagnostic excision procedure

d) Loop electrochemical excision procedure

Correct Answer - A
Ans, A, Loop electrosurgical excision procedure
LEEP
Stands for Loop Electrosurgical diagnostic procedure.
It is also known as large loop excision of the transformation zone
(LLETZ).
158. Definitive treatment for a case of severe
pre eclampsia is -
a) MgS0,

b) Delivery of baby

c) Antihypertensive drugs

d) Rest

Correct Answer - B
Ans, B. Delivery of baby
For all types of PIH, irrespective of severity, definitive management
is termination of pregnancy"
159. Another name for mancehster operation
for uterine prolapse is ?
a) Fothergill

b) Mercy

c) McDonald

d) Purandare

Correct Answer - A
Ans, A, Fothergill
Manchester operation also called Fothergill's operation.
160. What is the risk of recurrence of
anencephaly in subsequent pregnancy?
a) 1%

b) 2%

c) 3%

d) 4%

Correct Answer - B
Ans, B. 2%
The risk of recurrence of anencephaly in subsequent pregnancy is
2%.
161. Following is true about tamoxifene
except ?
a) It is a selective estrogen receptor modulator

b) It is a competitive inhibitor of estrogen at receptor site

c) It decreases risk of venous thromboembolism

d) It can be used for induction of ovulation

Correct Answer - C
Ans, C, It decreases risk of venous thromboembolism
162. Following is true regarding the
management of intrauterine fetal death
except ?
a) In 50% of cases spontaneous expulsion occurs in 2 weeks

b) Fibrinogen levels should be checked weekly

c) Delivery by medical induction is preferred if spontaneous

expulsion does not occur

d) Caesarian section has limited place in management of

intrauterine fetal death

Correct Answer - A
Ans, A, In 50% of cases spontaneous expulsion occurs in 2
weeks
163. Sequence of lochia ?
a) Rubra - Serosa - Alba

b) Serosa - Alba - Rubra

c) Alba - Rubra - Serosa

d) Alba - Serosa - Rubra

Correct Answer - A
Ans, A, Rubra - Serosa - Alba
Lochia
It is the vaginal discharge for the first fortnight during peurperium.
The discharge originates from the uterine body, cervix and vagina.
164. Amenorrhoea following
hyperprolactinoma is caused by ?
a) Inhibition of GnRH pulse secretion

b) Inhibition of adrenal steoridogenesis

c) It causes hypergonadotropic hypogonadism

d) It leads to formation of ovarian cysts

Correct Answer - A
Ans, A. Inhibition of GnRH pulse secretion
Prolactin inhibits GnRH pulse secretion and suppresses
ganadotropin levels.
Hyperprolactinemiacauses amenorrhea, anovulation and
Hypogonadism.
165. Old complete perineal tear is repaired at
?
a) Immediately

b) 3 - 6 months

c) 6 - 9 months

d) 9 - 12 months

Correct Answer - B
Ans, B. 3 - 6 months
The definitive surgery for complete perineal tear k repair of the anal
sphincter complex (sphinaeroptasty) with restoration of the perineal
body (perineoraphy).
For the fresh injuries the best time of repair is within 24 hours afire
injury,
For old perineal tears this should preferable be done 3 - 6 months
following injury.
166. Which of the following has maximum
diabetogenic potency in pregnancy ?
a) Estrogen

b) Progesterone

c) Cortisol

d) Prolactin

Correct Answer - C
Ans, C, Cortisol
167. Role of ergometrine to stop post partum
hemorrhage is due to ?
a) Increased uterine muscle tone

b) Vasoconstriction

c) Increased platelet aggregation

d) Increased coagulation

Correct Answer - A
Ans. A. Increased uterine muscle tone
Ergometrine acts directly on myometrium and excites uterine
contractions, which closes blood vessels in between thus helps in
controlling PPH.
Vasoconstrictive action of ergometrine does not control bleeding but
may cause rise in B.P. gangrene of toe, PreciPitate bronchospasm.
Option (c) & (d), are not the action of ergometrine.
168. Continence & incontinence of urine is
seen in ?
a) VVF

b) Vesicoperitoneal

c) Ureterovaginal

d) Uretrovaginal

Correct Answer - C
Ans. C. Ureterovaginal
Continence and incontinence of urine is seen in ureterovaginal
fistula.
169. Type of suture used in complete perineal
tear is -
a) Catgut

b) Silk

c) Vicryl

d) Vicryl and catgut

Correct Answer - D
Ans. D. Vicryl and catgut
Rectum is dissected to clear of scar tissue & freshening of cut
edges.
Cut edges ofrectum and anus are sutured with vicryl.
Deep muscle of perenial body and levatorani are identified and
sutured with No l-catgut.
Superficial muscle is sutured with vicrylcatgut sutures.
170. Uterine rupture is most common in -
a) Ant lower segment

b) Classical C.S

c) Placenta previa

d) Normal labour

Correct Answer - B
Ans. B. Classical C.S
171. Chances of uterine rupture are least in -
a) LSCS

b) Classic

c) Inverted

d) Low vertical

Correct Answer - A
Ans. A. LSCS
172. Age of metropathic hemorrhagica is ?
a) 20-25

b) 50-55

c) 60-65

d) 40-45

Correct Answer - D
Ans, D. 40-45
Metropathiahemorrhagica
Specializedform of DUB.
Mostly seen in premenopausal women.
Maximum age incidence: Between ages 40-45 years.
Patient complains of prolonged amenorrhea (of 6-8 weeks) followed
by excessive painless bleeding (anovular bleeding).
173. Management of ecclampsia in 34 weeks
of pregnancy is -
a) Continue of convulsion and wait for 37 wk to complete

b) Wait for spontaneous labours

c) BP contineu

d) Anti hypertensive, anticonvulsant and termination of pregnancy

Correct Answer - D
Ans. D. Anti hypertensive, anticonvulsant and termination of
pregnancy
174. Hematuria in previous LSCS patient
indicates -
a) Urinary tract infection

b) Placenta previa

c) Rupture uterus

d) None

Correct Answer - C
Ans. C. Rupture uterus
175. Battle door insertion of placenta ?
a) Cord attached to the margin of placenta

b) Placenta attached to the margin

c) Cord attached to the membranes

d) Placenta attached to the centre

Correct Answer - C
Ans. C. Cord attached to the membranes
Change in fetal heart rate (tachycardia/loss of beat to beat
variability/decelerations) is earliest sign of impending scar
dehiscence, followed by maternal tachycardia.
176. All are true about constriction ring
except ?
a) Also called schroeder's ring

b) Can be caused by injudicious oxytocin use

c) Ring can be palpated per abdomen

d) Inhalation of amyl nitrate relaxes the ring

Correct Answer - C
Ans, C. Ring can be palpated per abdomen
177. 21yr college girl with mild endometriosis
treatment-
a) Cyclical OC pill

b) Continuous Oc pill

c) Progesterone only pill

d) Danazole

Correct Answer - A
Ans, A. Cyclical OC pill
178. Not seen in endometriosis ?
a) Vaginal discharge

b) Dysparenuria

c) Infertility

d) Chronic pelvic pain

Correct Answer - A
Ans. A. Vaginal discharge
Clinical features of Endometriosis
Pain
Infertility
Dysmenonhea
Dyspareunia(deep)
179. Metrorrhagia is produced by the
following except?
a) Polyp

b) CA endometrium

c) IUD

d) Intramural fibroid

Correct Answer - D
Ans, D. Intramural fibroid
180. Bonney's test is used determine ?
a) Uterine prolapsed

b) Stress urinary incontinence

c) Vesicovaginal fistula

d) Uteric fistula

Correct Answer - B
Ans. B. Stress urinary incontinence
181. Red degeneration of fibroid is seen in ?
a) Early pregnancy

b) Mid pregnancy

c) Puperium

d) Nulliparous women

Correct Answer - B
Ans. B. Mid pregnancy
182. Radical hysterectomy in stage lb ca
cervix better than radiotherapy all are
true except ?
a) Chance of survival more

b) Chance of recurrence less

c) Ovary function can be preserved

d) Less complicated

Correct Answer - A
Ans, A. Chance of survival more
183. Bilateral ovarian carcinoma + capsule +
ascitis+ paraaortic LN. Which stage ?
a) 1C

b) 2C

c) 3C

d) 4C

Correct Answer - A
Ans. A. 1C
184. Radiation to point A in cervix is ?
a) 8000 rad

b) 6000 rad

c) 10000 rad

d) 4000 rad

Correct Answer - A
Ans. A. 8000 rad
185. Most common presentation of cervical
cancer is -
a) Deep pelvic pain

b) Rectal pain

c) Bleeding per vaginum

d) Weight loss

Correct Answer - C
Ans, C. Bleeding per vaginum
186. Treatment of simple hyperplasia of
endometrium is ?
a) Progesterone

b) Estrogen

c) Hysterectomy

d) Cryosurgery

Correct Answer - A
Ans, A. Progesterone
187. Most common presenting feature of
complete mole is ?
a) Vomiting

b) Amenorrhoea

c) Amenorrhoea

d) Bleeding per vaginum

Correct Answer - D
Ans, D. Bleeding per vaginum
Clinical features of complete mole
Vaginal bleeding is the most common symptom causing patient to
seek treatment for complete mole pregnancy.
Abnormal uterine bleeding usually during the first trimester is the
most common presenting symptom occurring in more than 90% of
patients with molar pregnancies.
188. Androgenic XX chromosome is ?
a) Partial mole

b) Complete mole

c) Turner's syndrome

d) Stein leventhal syndrome

Correct Answer - B
Ans, B. Complete mole
Characteristics of complete Mole
Complete H. mole shows no evidence of fetal tissue at all.
Complete hydatiform moles exhibit characteristic swelling and
trophoblastic hyperplasia.
Most common karyotype is 46XX.
The molar chromosomes are entirely of paternal origin, although
mitochondrial DNA is of maternal origin.
The complete mole arises from an ovum that has been fertilized by a
haploid sperm, which then duplicates its own chromosomes called
Anilrogenesis.
The ovum nucleus may be either absent or inactivated.
189. High chance of rupture in tubal
pregnancy are seen in which ?
a) Ampulla

b) Isthmus

c) Interstitial

d) Fimbrial

Correct Answer - B
Ans. B. Isthmus
M.C.siteoftubal rupture = Isthmus
190. Most common site of ectopic pregnancy
is -
a) Tubal

b) Abdominal

c) Ovarian

d) Uterine

Correct Answer - A
Ans, A. Tubal
Most common site of ectopic pregnancy is fallopian tube.
In tubal pregnancy M.C. site is ampula followed by Isthmus.
191. % of ectopic pregnancy seen in fallopian
tube is?
a) 75%

b) 90%

c) 80%

d) 67%

Correct Answer - B
Ans, B. 90%
M.C. site of ectopic pregnancy = Fallopian tube (97%).
192. Drugs used in ectopic pregnancy ?
a) PGE2

b) PGI

c) PGF2

d) None

Correct Answer - C
Ans. C. PGF2
193. Most common congenital uterine
anomaly is ?
a) Bicornuate uterus

b) Septate uterus

c) Unicornuate uterus

d) Arcuate uterus

Correct Answer - B
Ans. B. Septate uterus
194. When is copper T inserted ?
a) 3 days after periods are over

b) Within 10 days of start of menstrual cycle

c) PID just before menstruation

d) Just after menstruation

Correct Answer - B
Ans, B. Within 10 days of start of menstrual cycle
ldeal time for insertion of Cu-T is within 10 days of the start of the
menstrual cycle
It has the advantage that cervical canal is dilated, uterus is relaxed
and chances ofpregnancy are remore.
Post Partum insertion within 48 hours of delivery or 6 weeks after
delivery.
Post-MTP insertion immediately following D & E (in early pregnancy)
195. Most common cause of annular cervix is
?
a) Obstructive labor

b) Prepitate labor

c) Primary cervical dystocia

d) Iatrogenic

Correct Answer - C
Ans, C. Primary cervical dystocia
Annular cervix is detachment of the cervix following prolonged
labour in primary cervical dystocia.
196. Intrauterine adhesions best seen by?
a) USG

b) CT

c) Hysteroscopy

d) MRI

Correct Answer - C
Ans. C. Hysteroscopy
Hysteroscopy is the endoscopic technique of visualizing the interior
of uterus directly,
It is both diagnostic and therapeutic.
197. Insulin resistance in pregnancy is due to
?
a) Estrogen

b) Progesterone

c) HPL

d) GH

Correct Answer - A:C

Ans. C>A. HPL>Estrogen
During Pregnancy insulin levels are increased because of increased
insulin secretion as well as increase in insulin resistance due to a
number of contra insulin factors but the most important hormone
causing insulin resistance is Human placental lactogen.
198. Gestational diabetes mellitus ?
a) Is first recognized during pregnancy

b) Previous history of IUGR

c) There is no recurrance of GDM in future pregnancy

d) No risk of overt diabetes

Correct Answer - A
Ans. A. Is first recognized during pregnancy
Gestational diabetes mellitus is defined as carbohydrate intolerance
of variable severity with onset or first recognition during Pregnancy.
Pregnancy is a form of stress that can cause latent diabetes to
manifest just as do surgical operations or acute infections.
In most of the cases the carbohydrate intolerance reverts by the end
of puerperium but this manifestation may be the first indication of
diabetes yet to come.
More than half the women with gestational diabetes will develop
frank diabetes within the next 20 years.
However in some of these carbohydrate intolerance may persist
beyond the puerperium and these are in reality cases of pre-
gestational diabetes which have become overt during pregnancy.
199. True about gestational diabetes is ?
a) These are increased chances of congenital malformation

b) Only 2% of women present with overt diabetes

c) There is chance of macrosomia

d) Usually diagnosed in early pregnancy

Correct Answer - C
Ans. C. There is chance of macrosomia
200. Most common presenting symptom of
TB endometritis is -
a) Abdominal pain

b) Infertility

c) Amenorrhoea

d) Vaginal discharge

Correct Answer - B
Ans, B. Infertility
Most common symptom of Genital TB is:-
Infertility (35-60%) is either due to blockage offallopian tube or due
to loss oftubal function even iftubes are patent.
201. PID after insertion of IUD is seen in how
many weeks?
a) 3

b) 5

c) 7

d) 14

Correct Answer - A
Ans, A. 3
The risk of developing PID is 2-10 times greater among the IIJD
users.
The risk is more in the first 3 weeks.
Infection with chlamydia and actinomycosis most common.
202. Acute PID, most common route of spread
?
a) Descending

b) Ascending infection

c) Lymphatics

d) Hematogenous

Correct Answer - B
Ans, B, Ascending infection
M/c route of spread of PID is:-
Ascending infection along with sperms.
All PIDs are sexually transmitted except TB.
203. Best way to look at endometrial activity
is by -
a) HSG

b) Biopsy

c) USG

d) Colposcopy

Correct Answer - B
Ans, B. Biopsy
Endometrial sampling or curettage or biopsy is the best method to
assess endometrial activity.
204. Block given in forceps delivery ?
a) Pudendal

b) Ilio inguinal

c) Genitofemoral

d) Posterior femoral

Correct Answer - A
Ans, A. Pudendal
For forceps oPerationpudendal block is given supplemented by
perineal and labial infiltration.
205. Cause of big baby ?
a) Hyperglycemia

b) Hyperinsulinemia

c) Multiparity

d) Post maturity

Correct Answer - A:B:C:D

Ans, All of the above A, B, C, D
206. Decubitus ulcer is ?
a) Due to trauma

b) Due to venous congestion

c) Due to friction created by thighs

d) Due to

Correct Answer - B
Ans, B. Due to venous congestion
Decubitus ulcer is a trophic ulcer always found at the dependent part
of the prolapsed mass (in prolapsed uterus).
It is due to decreased circulation due to narrowing of uterine vessels
by stretching efect with additionalkeratinizations, cracks.
207. Patient with history of vaginal prolapse
with ulcer on it. Diagnosis ?
a) Carcinoma

b) Pressure erosion

c) Syphilis

d) Decubitus ulcer

Correct Answer - D
Ans, D. Decubitus ulcer
208. SERMs are ?
a) Agonist on estrogen receptor

b) Antagonist on estrogen receptor

c) Some are agonist some antagonist on estrogen receptor

d) Used due to reduced chances of hot flushes, thromboembolism

Correct Answer - C
Ans, C, Some are agonist some antagonist on estrogen
receptor
SERM’s are selective estrogen receptor modulators called SERMs
blocks the effects of estrogen in the breast tissue.
They block the effect of estrogen by acting on estrogen recePtors.
209. Female with hirsutism with
ammenorrhoea and obesity. Diagnosis ?
a) PCOD

b) Ovarian tumor

c) Androgen insensitivity syndrome

d) Turner syndrome

Correct Answer - A
Ans, A. PCOD
The clinical and laboratory features of the patient described in the
question match with those of PCOS as depicted in the table.
So the most appropriate answer is PCOD.
210. HAIRAN syndrome is seen in ?
a) PCOD

b) Endometeriosis

c) CA ovary

d) Adrenal tumours

Correct Answer - A
Ans, A. PCOD
PCOD is also known as HAIRAN SyNDROME
211. Regarding PCOD all are true except ?
a) High FSH/LH

b) High DHEA

c) Raised LH

d) T Estrogen

Correct Answer - A
Ans, A. High FSH/LH
PCOD is also known as HAIRAN SyNDROME
212. Which hormone increases in PCOD ?
a) LH

b) FSH

c) Estrogen

d) TSH

Correct Answer - A
Ans, A, LH
Stein leventhal syndrome is also called ‘Polycystic Ovarian
Syndrome'
213. Stein Levinthal syndrome what hormone
is raised?
a) LH

b) FSH

c) GnRH

d) Progesterone

Correct Answer - A
Ans, A. LH
214. What should not be done during delivery
of Rh negative?
a) IV Fluids

b) External version

c) Manual removal of placenta should be done gently

d) Ergometire to be withheld at delivery of ant. shoulder

Correct Answer - A
Ans, A. IV Fluids
215. History of yellow green watery discharge
and pruritus?
a) Trichomonas vaginalis

b) Candida

c) Bacterial vaginosis

d) Clamydia tracomatis

Correct Answer - B
Ans. B. Candida
During Rh PregnancfstePs should be taken to prevent feto
maternal bleeding; -
Precautions during caesariansection to prevent blood spilling into
peritoneal cavity
Prophylactic ergometine with delivery of ant shoulder to be withheld.
Amniocentesis should be done after sonographic. Localization of
placenta to prevent placental injury.
Forcible attempt for external version should not be done.
Manual removal of placenta should be done gently.
To refrainfrom abdominal palpation in abruption placenta.
216. Most common genital infection in
pregnancy is ?
a) Candida

b) Gonorrhea

c) Trachoma

d) Cytomegalo virus

Correct Answer - A
Ans, A. Candida
Seventy per cent show typical discharge, which is profuse, thin,
creamy or slightly green in colour,irritating and frothy.
The vaginal walls are tender, angry looking and the discharge
causes pruritus and inflammation of the vulva.
217. Decreased fetal heart sound is due to
which drug -
a) Oxytocin

b) Sodium bicarbonate

c) IV fluids

d) Iron

Correct Answer - A
Ans, A, Oxytocin
Vaginitis due to candida is more common than trichomonas and is
more prevalent in Diabetic pregnancy.
Treatment is miconazole vaginal cream for 7 days.
218. Dose of mifepristone in MTP is ?
a) 10mg

b) 20 mg

c) 100mg

d) 200mg

Correct Answer - A
Ans, A. 10mg
Decreased fetal heart rate or fetal distress is due to fetal hypoxia.
219. A young sexually active female has
intensive pruritus and watery discharge,
smear shows ?
a) Trichomonas vaginalis

b) Candida vaginitis

c) Gardenlla vaginalis

d) HIV

Correct Answer - D
Ans, D. HIV
220. Treatment for trichomonas vaginalis is ?
a) Metronidazole

b) Azithromycin

c) Ciprofloxacin

d) None

Correct Answer - A
Ans. A. Metronidazole
The drug of choice for Trichomonasvaginits is Metronidazole.
221. Which organism causes puerperal sepsis
?
a) CMV

b) Toxoplasma gondii

c) Group A beta hemolytic streptococci

d) Group B beta hemolytic streptococci

Correct Answer - C
Ans, C. Group A beta hemolytic streptococci
Most common cause of puerperal sepsis is Group A streptococcus.
Other organisms that are implicated are: Striptococcus group B, C
and G, staphylococcus aureus, E. coli, Enterobacterspeciesand
chlamydia trachomatis.
222. The prostaglandin most commonly used
at term for induction of labor is ?
a) PGI2

b) PGE1

c) PGE2

d) PGF2a

Correct Answer - C
Ans. C. PGE2
PGE2 is most commonly used at term for induction of labor.
223. HCG levels at which Expectant
management of Ectopic pregnancy can
be done :
a) 10000 IU/L

b) 1000 IU/L

c) 2500 IU/L

d) 5000 IU/L

Correct Answer - B
Ans. B. 1000 IU/L
Initial HCG levels < 1000 IU/l & subsequent levels are falling.
224. MC cause of Primary Amenorrhea is ?
a) Constitutional/idiopathic

b) RMKH syndrome

c) Ovarian dysgenesis

d) None of the above

Correct Answer - C
Ans, C. Ovarian dysgenesis
MC cause of primary amenorrhea is ovarian dysgenesis/Turner
syndrome.
225. An infertile woman has bilateral tubal
block at cornua diagnosed on
hysterosalpingography. Next treatment
of choice is ?
a) IVF

b) Laparoscopy and hysteroscopy

c) Tuboplasty

d) Hydrotubation

Correct Answer - B
Ans. B. Laparoscopy and hysteroscopy
Laparoscopy (with chromopertubation with methylene blue
dye):
Best investigation for tubal patency, as tubal patency can be
confirmed under vision, and besides, any pathology can
simultaneously be corrected with operative laparoscoPy.
226. Fetal karyotyping can be done by all,
EXCEPT?
a) Cordocentesis

b) Amniocentesis

c) CVS

d) Fetal skin biopsy

Correct Answer - D
Ans. D. Fetal skin biopsy
Percutaneous umbilical blood sampling (PUBS) is also known as
cordocentesisis performed after 16 weeks' gestation' under USG
guidance a needle is inserted into umbilical vein. This technique
apart from karyotyping is also useful for evaluating fetal metabolism
and hematologic abnormalities.
227. 55 year old lady complaints of mass in
the vagina, which is reducible &
increases on defecation. The diagnosis
is?
a) Rectal prolapse

b) Uterine prolapse

c) Cervical fibroid

d) Vaginal cancer

Correct Answer - B
Ans. B. Uterine prolapse
Prolapse is defined as the displacement of an organ from its normal
anatomical position.
Genital prolapse occurs due to weakness of the suPPorts.
228. Moschowit's surgery is done for -
a) Cervical cancer

b) Fundal fibroids

c) Uterine prolapse

d) Enterocele prevention

Correct Answer - D
Ans. D. Enterocele prevention
Enteroceleformatiol can be prevented by Moschowit's or Halban's
surgeries, in both the POD is obliterated.
229. Which of the following is used in
quantifying hirsutism?
a) Bishop score

b) Rotterdam criteria

c) Ferriman-Gallwey score

d) All of the above

Correct Answer - C
Ans. C. Ferriman-Gallwey score
The Ferriman-Gallwey score is a method of evaluating and
quantifying hirsutism in women. The method was originally published
in l96l by D. Ferriman and J.D. Gallwey in the Journal of Clinical
Endocrinology.
230. MC heart disease in pregnancy is ?
a) MS

b) AS

c) MR

d) WPW syndrome

Correct Answer - A
Ans. A. MS
Mitral stenosis is the MC valvular heart disease in pregnancy.
231. Rate of cervical dilatation in primigravida
is ?
a) 0.8 cm/hour

b) 1.2 cm/hour

c) 1.5 cm/hour

d) 2 cm/hour

Correct Answer - A
Ans. A. 0.8 cm/hour
The normal rate of cervical dilatation in active phase is 1.2 cm/hour
in primigravidae and 1.5 cm/hour in multiparae.
232. Complications of pre eclampsia are all
except ?
a) Post datism

b) DIC

c) Blindness

d) None of the above

Correct Answer - A
Ans. A. Post datism
233. What is monitored in a patient of pre
eclamsia ?
a) Uric acid

b) Platelet count

c) LFT

d) All of the above

Correct Answer - D
Ans. D. All of the above
 234. Not an absolute contraindication for
methylergometrine use is ?
a) Eclampsia

b) Heart disease

c) Rh incompatibility

d) After delivery of first baby in twin pregnancy

Correct Answer - C
Ans. C. Rh incompatibility
Methylergometrine (Methergin) can be used in the prevention
and treatment of PPH. Absolute contraindications to the use of
Methergin are:
1. Chronic hypertension/preeclampsia/eclampsia
2. Heart disease inpregnancy
3. Afterthe deliveryofthefirstbabyofthe twins.
235. A lady with 35 weeks of pregnancy is
admitted in view of first episode of
painless bout of bleeding yesterday. On
examination Hb 10g%, BP 120/70 mmHg,
uterus relaxed, and cephalic floating.
FHS regular. Next line of management is
?
a) Cesarean section

b) Induction of labor

c) Wait and watch

d) Blood transfusion

Correct Answer - C
Ans. C. Wait and watch
This is a case of placenta previa (painless bleeding, relaxed uterus,
and floating head all point to placenta previa).
In this case, all the criteria for conservative management are fulfilled
and therefore the answer is wait and watch for fetal lung maturity.
236. G3P2L2 with previous 2 LSCS with
anterior placenta previa has got a very
high risk of which complication?
a) Placenta acreta

b) Vasa previa

c) Abruption

d) None of the above

Correct Answer - A
Ans. A. Placenta acreta
The term placenta accreta is used to describe any placental
implantation in which there is abnormally firm adherence to the
uterine wall.
The incidence of placenta accreta, increta, and percreta has
increased, most likely because of the increasedcesarean delivery
rate.
237. B-Lynch suture is applied on ?
a) Cervix

b) Uterus

c) Fallopian tubes

d) Ovaries

Correct Answer - B
Ans. B. Uterus
Described first by Christopher, B-Lynch is a compression suture
placed on uterus in the management of atonic PPH when the
medical methods fail.
238. A 28-year-old primigravida with 33 weeks
of pregnancy suddenly complains of
headache, oliguria, and blurred vision.
Her BP is 180/110 and urine albumin is
+3. The line of further management is ?
a) Wait and watch

b) LSCS

c) Induction of labor

d) Anticonvulsant + antihypertensive therapy

Correct Answer - D
Ans. D. Anticonvulsant + antihypertensive therapy
The patie nt is a case of severe preeclampsia, with impending
eclampsia.
Magnesium sulfate is the drug of choice for eclampsia and also for
impendingeclampsia.
239. Which of the following statements
concerning abdominal pregnancy is
correct?
a) Gastrointestinal symptoms are quite often very severe

b) Fetal survival is approximately 80%

c) Aggressive attempts should be made to remove the placenta at

the time of initial surgery

d) Placenta can be left in situ at the time of surgery

Correct Answer - D
Ans. D. Placenta can be left in situ at the time of surgery
Although leaving the placenta in the abdomen following surgical
delivery predisposes to riskesof postoperative infections, the risk is
much less severe than the hemorrhage associated with attempts of
removal of placenta at the time of primary surgery.
240. Complete vesicular mole is associated
Theca leutin csyts in what percentage of
cases ?
a) <5

b) 5-15

c) 20-40

d) 60-70

Correct Answer - C
Ans. C. 20-40
Theca-lutein cysts: In many cases of hydatidiform mole, the ovaries
contain multiple theca-lutein cysts.
241. Patient with 3 months amenorrhoea, c/o
hyperemesis and vaginal bleeding since
one month. O/E=uterus 16 weeks with
absent fetal heart sound. The diagnosis
is ?
a) Vesicular mole

b) Ectopic pregnancy

c) IUFD

d) Abruptio placentae

Correct Answer - A
Ans. A. Vesicular mole
Vesicular mole is an abnormal condition of placenta where there is
hydropic degeneration and proliferative changes in the young
chorionic villi. It is a benign condition with malignant potential.
Uterine bleeding is almost universal and may vary from spotting to
profuse hemorrhage.
It is the MC presenting feature.
The discharge has' white currant in red currant juice' appearance.
242. Patient with choriocarcinoma & jaundice,
treatment of choice is ?
a) Methotreaxate

b) Actinomycin D

c) Suction evacuation

d) Combination of all

Correct Answer - B
Ans. B. Actinomycin D
243. EMACO regime is for ?
a) Ca cervix

b) Ca endometrium

c) Ca ovary

d) Chorio carcinoma

Correct Answer - D
Ans. D. Chorio carcinoma
244. Stage lb cervical cancer is diagnosed in
a young woman. Assuming that the
cancer is confirmed to the cervix and
that intraoperative biopsies are negative,
which of the following structure would
not be removed during the radical
hysterectomy?
a) Uterosacral and uterovesical ligaments

b) Pelvic nodes

c) The entire parametrium on both sides of the cervix

d) Both ovaries

Correct Answer - D
Ans. D. Both ovaries
Preservation of the ovaries is generally acceptable, particularly in
younger women.
245. In vaginal hysterectomy, the first clamp
includes:
a) Uterine artery

b) Fallopian tube & round ligament

c) Uterosacral ligament

d) None of the above

Correct Answer - C
Ans. C. Uterosacral ligament
Vaginal hysterectomy with pelvic floor repair is done for
vaginouterine prolapse in peri/post menopausal women.
First clamp includes uteroscaral&Macenrodt's ligament.
Second clamp includes uterine artery.
Third clamp includes cornual structures.
246. Therapeutic conization is indicated in?
a) Microinvasive carcinoma cervix stage lal

b) CIN III

c) Unsatisfactory colposcopy with cervical dysplasia

d) Cervical metaplasia

Correct Answer - A
Ans. A. Microinvasive carcinoma cervix stage lal
In stage 1A1, there is no lymph node involvement.
Therapeutic conization is the surgery of choice for stage 1A1 in
young patients who are desirous of future childbearing
247. Cervical cancer III B treatment is ?
a) Wertheim's operation

b) Radiotherapy

c) Chemotherapy

d) Chemoradiation

Correct Answer - D
Ans. D. Chemoradiation
Cisplatin is given before RT as a radiosensltizer, hence the preferred
terminology is CTRT (concurrent chemo and radiotherapy also
known as chemoradiation).
248. Wertheim's hysterectomy is done for ?
a) 1A1 cervical cancer

b) IB cervical cancer

c) Germ cell ovarian cancer

d) All of the above

Correct Answer - B
Ans. B. IB cervical cancer
Stages of Ca cervix that are operable (radical/Wertheim's
hysterectomy) are 1A2, IB, and IIA.
249. Radio isotope used in Ca cervix
Brachytherapy ?
a) Cobalt

b) Iridium

c) Cesium

d) All of the above

Correct Answer - D
Ans. D. All of the above
 250. Ca vulva spreads to all except ?
a) Urethra

b) Deep inguinal nodes

c) Superficial inguinal nodes

d) Paraaortic nodes

Correct Answer - D
Ans. D. Paraaortic nodes
Modes of spread of ca. vulva
1. Direct: Urethra, Vagina, Rectum, pelvic bones
2. Lymphatic: MC route of spread.
3. Lymphatics oflabia to superficial, then deep inguinal nodes & then
pelvic nodes
4. Hematogenous route rare & may occur in advanced cases
251. Which ovarian tumour can present with
menorrhagia ?
a) Demoid cyst

b) Epithelial ovarian cancer

c) Granulosa cell tumour

d) Yolk sac tumour

Correct Answer - C
Ans. C. Granulosa cell tumour
Granulosa cell tumours (or granulosa-theca cell tumours) are
tumours that arise fromgranulosa cells. These tumoursare part of the
sex cordgonadal stromal tumour or non-epithelial group of tumours.
252. All are risk factors for ectopic pregnancy
except ?
a) Past history

b) Tubal ligation failure

c) IVF

d) LNG IUCD

Correct Answer - D
Ans. D. LNG IUCD
IUCD: The modern copper IIJD does not increase the rkk of ectopic
pregnancy. However, there is a relative increase in tubal pregnancy
(7 times more) should pregnancy occur with IUCD in situ.
Studies have demonstrated that up to l% of pregnancies achieved
through IVF or GIFT can result in a heterotopic gestation.
253. A 21-year-old female presents to
emergency ward with 2 months of
amenorrhea with pain in abdomen and
shock. BP 90/60 mmHg and Hb 6 gm%.
Urine pregnancy test is found positive.
Next immediate line of treatment is ?
a) Laparotomy

b) IV fluids & cross match

c) Medical management

d) Laparoscopy

Correct Answer - B
Ans. B. IV fluids & cross match
This is a case of ruptured ectopic pregnancy. Positive Urine
Pregnancy Test indicates that the amenorrhea is due to pregnancy.
Pain and shock in early pregnancy are mostly always due to
ruptured ectopic.
254. DOC for medical management of ectopic
pegnancy ?
a) Actinomycin D

b) Intramuscular Methotrexate

c) Intramuscular Methotrexate

d) PGf2 alpha

Correct Answer - B
Ans. B. Intramuscular Methotrexate
255. What is not used in PCOS ?
a) OC pills

b) Cyclical progesterones

c) Myoinositol

d) Danazol

Correct Answer - D
Ans. D. Danazol
Insulin sensitizers are also used to tackle insulin resisitance.
Danazol has no role in PCOS.
256. Pearl necklace appearance is
characteristic of ?
a) Ectopic pregnancy

b) PCOS

c) Endometriosis

d) PID

Correct Answer - B
Ans. B. PCOS
USG features of polycystic ovarian syndrome (PCOS)
Greater than 12 follicles measuring between 2 mm and 9 mm in
diameter located peripherally, resulting in a pearl necklace
appearance.
Increased echogenicity of ovarianstroma and /or ovarian volume
greater than 10 ml.
257. Violin string adhesion [violent string
sign] is seen in ?
a) PCOS

b) Endometriosis

c) Fitz - high -curtis syndrome

d) Ruptured ectopic pregnancy

Correct Answer - C
Ans. C. Fitz - high -curtis syndrome
Laparoscopy is performed, the liver capsule will appear inflamed,
with classic violin string adhesions in the perietal peritoneum
beneath the diaphragm.
Five percent to 10% of women with acute PID develop symptoms of
perihepatic inflammation, the Fitz-High-Curtis syndrome.
258. Dysgerminoma spreads mainly via ?
a) Hematogenous route

b) Lymphatic route

c) Direct spread

d) Does not spread

Correct Answer - B
Ans. B. Lymphatic route
Dysgerminomas are the most common malignant germ cell tumors,
accounting for about 30% to 40% of all ovarian cancers of germ cell
origin.
In the 25% of patients who present with metastatic disease, the
tumor most commonly spreads via the lymphatics.
259. Triad of symptoms of endometriosis are
all except ?
a) Infertility

b) Dysmenorrhea

c) Dyspareunia

d) Cyclical hematuria

Correct Answer - D
Ans. D. Cyclical hematuria
Endometriosis is defined as the presence of normal functional
endometrial mucosa (glands and stroma) abnormally implanted in
locations other than the uterine cavity. It was first described by Von
Rokitansky About one third of women with endometriosis remain
asymptomatic.
260. Complication of Benign Ovarian Cysts is
?
a) Torsion

b) Intracystic hemorrhage

c) Pseudomyxoma perotonei

d) All of the above

Correct Answer - D
Ans. D. All of the above
261. Level 1 support of uterus & vagina is ?
a) levator ani

b) Perineal body

c) Uterosacral ligaments

d) All of the above

Correct Answer - C
Ans. C. Uterosacral ligaments
Delancey’s three levels of pelvic (uterus, vagina) support=
Level 1: The uterosacral-cardinal ligament complex provides
attachment of the uterus and vaginal vault to the sacrum. Uterine
prolapse occurs when this ligament complex breaks or is attenuated.
262. MC presenting symptom of fibroid is ?
a) Menorrhagia

b) Infertility

c) Lump

d) Compression

Correct Answer - A
Ans. A. Menorrhagia
263. Medical management of fibroids is with
all except -
a) Progesterone

b) Mifepristone

c) Ulipristal acetate

d) Misoprostol

Correct Answer - D
Ans. D. Misoprostol
264. Endometriosis is ?
a) Endometrium within the myometrium

b) Functional endometrium outside the uterus

c) Myometrium within the endometrium

d) Rare squamous variety of CA endometrium

Correct Answer - B
Ans. B. Functional endometrium outside the uterus
Endometriosis
Definition: Presence of functional endometrium at places other than
uterus (ectopic endometrial tissue)
 265. Samson's theory for Development of
Endometriosis is ?
a) Celomic metaplasia

b) Hematogenous spread

c) Lymphatic spread

d) Retrograde menstruation

Correct Answer - D
Ans. D. Retrograde menstruation
Theories for Development of Endometriosis
1. Samson's theory of retrograde menstruation: the most accEpted
theory
2. Ivanoff and Meyer: Celomic metaplasia
3. HematogenoussPread
4. Lymphatic spread (Halban's theory)
5. Direct implantation.
266. Examination of a 26 years old obese
infertile female reveals. Fixed retroverted
uterus & Nodularity of the uterosacral
ligaments. The most likely diagnosis is ?
a) PCOS

b) Endometriosis

c) Adenomyosis

d) TB

Correct Answer - B
Ans. B. Endometriosis
Pelvic examination of endometriosis: May be normal or may
reveal the following:
Fixed retroverted uterus
Pelvic tenderness
Nodules in the POD
Nodularity of the uterosaoal ligaments
Unilateral or bilateral adnexal mass
Speculum examination may reveal bluish nodules in posterior fornix.
267. Investigation of choice for endometriosis
?
a) USG

b) CA 125

c) MRI

d) Laparoscopy

Correct Answer - D
Ans. D. Laparoscopy
Laparoscopy is the Investigation ofChoice.
268. Powder burnt lesion seen in ?
a) PID

b) PCOS

c) Endometriosis

d) All of the above

Correct Answer - C
Ans. C. Endometriosis
Laparoscopy findings in endometriosis are:
Chocolate cysts
Blueberrylesion
Red/flame lesion
Powder burn sPots
Red/purple raspberry lesion
Subovarian adhesions
Matchstick burnt sPots
White lesion.
 269. Treatment of choice in patient with
infertility & endometriosis ?
a) IUI

b) Surgery

c) Danozol

d) Ovulation induction

Correct Answer - B
Ans. B. Surgery
Surgical Management
1. Patients with infertility: laparoscopic ovarian cystectomy,
adhesiolysis, and electrocoagulation of endometriotic implants.
2. If the family is complete and the patient has severe pain or
menstrual complaints: hysterectomy with bilateral
salpingooophorectomy. Generally combined approach is adopted
where laparoscopic surgery is followed by GnRHa.
270. Surgery of choice in 42 year old P3L3
with diffuse endometriosis is ?
a) Ovarian cystectomy & adhesiolysis

b) Hysterectomy

c) Hysterectomy with BSO with resection of endometrial implants

d) Ovarian cystectomy & adhesiolysis & resection of implants

Correct Answer - C
Ans. C. Hysterectomy with BSO with resection of endometrial
implants
If the family k complete and the patient has severe pain or menstrual
complaints: Hystetectomy with bilateralsalpingo- oophorectomy with
resection of all endometriotic implants.
271. The most common Mullerian anomaly is?
a) Mullerian agenesis (RMKH)

b) Unicornuate uterus

c) Bicornuate uterus

d) Septate uterus

Correct Answer - D
Ans. D. Septate uterus
Septate uterus is the MC Mullerian anomaly.
272. SEAM used in DUB is ?
a) Clomiphene

b) Raloxifene

c) Ormiloxifene

d) Mifepristone

Correct Answer - C
Ans., C. Ormiloxifene
Ormeloxifene is a third generation benzopyran SERM which blocks
the cytosol receptors by its competitive binding and selectively acts
on estrogen recePtors as agonist and antagonist in different
reproductive tissues.
273. Choice of adjuvant treatment for
endometrial carcinoma stage IA, grade I
is?
a) Radiotherapy

b) Chemotherapy

c) Chemotherapy plus radiotherapy

d) No treatment

Correct Answer - D
Ans. D. No treatment
Management of Ca endometrium
A) Stage l=1:
Surgery (total abdominal hysterectomy with bilateral salpingo-
oophorectomy with lymph node sampling), followed by radiotherapy.
Only patients with stage 1A, grades 1 and 2 do not require
postoperative radiotherapy.
B) Stage 2:
Modified radical hysterectomy, bilateral salpingo-oophorectomy with
lymph node dissection, followed by radiotherapy.
C) Stages 3 and 4:
Debulking surgery followed by radiotherapy.
274. A 46-year-old P3L3 complains of
menorrhagia since 3 months. Next line of
management is ?
a) D & C

b) Progesterone x 6 months

c) OC pills x 6 months

d) Hysterectomy

Correct Answer - A
Ans. A. D & C
In Patients with menorrhagia in perimenopausal age group (40+),
always make the diagnosis first before proceeding with any
treatment.
It is necessary to rule out endometrial hyperplasia and cancer in this
age group. Hence, histopathological examination of endometrium is
required, and therefore D 6C should be done first.
275. Simple hyperplasia with atypia will
progress to ca endometrium in % of
cases ?
a) 1-2

b) 3-4

c) 8-9

d) 20

Correct Answer - C
Ans. C. 8-9
276. Grade 1 Ca endometrium, there is
presence of % non sqoumaous growth ?
a) <5

b) 6-25

c) 25-50

d) >50

Correct Answer - A
Ans. A. <5
FIGO Grading of Endometrial Carcinoma
Histopathologic degree of differentiation:
Gl: < 5% nonsquamous or nonmorular growth pattern.
277. Definitive treatment of adenomyosis is ?
a) OC pills

b) NSAIDS

c) Endometrial ablation

d) Hysterectomy

Correct Answer - D
Ans, D. Hysterectomy
Hysterectomy
The only way to completely cure this condition is to have a
hysterectomy.
278. MC cause for hysterectomy is ?
a) Prolapse

b) Fibroids

c) Ca endometrium

d) Acute PID

Correct Answer - B
Ans. B. Fibroids
A hysterectomy is an operation to remove the uterus.
A woman may have a hysterectomy for different reasons,
including:
Uterine fibroids that cause pain, bleeding, or other problems.
279. Prolonged surgery time of vaginal
hysterectomy would lead to damage to
which nerve ?
a) Obturator

b) Pudendal

c) Peroneal

d) Sural

Correct Answer - C
Ans. C. Peroneal
Most commonly injured lower extremity nerve in patients undergoing
surgery in lithotomy position is the common paroneal nerve(LA-S2).
280.
Which of the following is not a part of PID -
a) Endometritis

b) Cervicitis

c) Tuboovarian abcess

d) Peritonitis

Correct Answer - B
Ans. B. Cervicitis
PID is a spectrum of infection & inflammation of upper genital tract
organs involving uterus, fallopian tubes, ovaries, pelvic
peritoneum&parametrium.
Cervicitis is not included.
281. Triad for clinical diagnosis PID includes
all except ?
a) Fever

b) Lower abdominal pain

c) Cervical motion tenderness

d) Bilateral adnexal tenderness

Correct Answer - A
Ans. A. Fever
Diagrosis ofPID is often difficult.
The "gold standard" for diagnosis relies on the laparoscopic
appearance ofFallopian tube inflammation but cost and limited
availability of the technique often preclude its use.
In theabsence of laparoscopy, the triad of lower abdominal pain,
cervical motion tenderness, and bilateral adnexal tenderness has
been advocated as the minimal criterion for clinical diagnosis of PID.
282. Acute salpingitis is most commonly
caused by ?
a) N. gonorrhoeae

b) Chlamydia trachomatis

c) Mycoplasma

d) Staphylococcus

Correct Answer - B
Ans, B. Chlamydia trachomatis
Option B is now a days slightly more commoner than option a) &
hence the best option to mark
If polymicrobial/mixed infection, is in the option, then that is the
answer.
283. Tumor marker for germ cell malignancy
are all except?
a) LDH

b) Alkaline phosphatase

c) AFP

d) CA-125

Correct Answer - D
Ans. D. CA-125
284. Acute pelvic pain could be due to ?
a) Ectopic pregnancy

b) PID

c) Corpus luteum hematoma

d) All of the above

Correct Answer - D
Ans. D. All of the above
285. Nugent score includes all except -
a) Lactobacillus

b) Gardnerella

c) Mobiluncus

d) Gonococcus

Correct Answer - D
Ans. D. Gonococcus
Nugent's criteria for diagnosis ofbacterial vaginosis
Many use Nugent's criteria to quantify or grade bacteria via Gram
stain of vaginal samples.
In brief, Nugent's criteria evaluated 3 types of bacteria via Gram
stain: Lactobacillus, Bacteroides/ Gardnerella, and Mobiluncus.
286. Clue cells are seen in?
a) Bacterial vaginosis

b) Candidiasis

c) Chlamydiasis

d) Trichomoniasis

Correct Answer - A
Ans. A. Bacterial vaginosis
Bacterial vaginosis/vaginitis (BV) is a common vaginal infection.
Clue cells (vaginal epithelial cells covered with coccobacilli and the
cells appear as stippled or granular). CIue cells are diagnostic ofBV.
287. HSG findings suggestive of genital koch
?
a) Beaded tubes

b) Honeycomb uterus

c) Golf club tube

d) All of the above

Correct Answer - D
Ans. D. All of the above
In active tuberculosis, HSG is contraindicated.
288. A pregnant lady presents with genital
warts. The best management for her is ?
a) Imiquimod

b) Trichloroacetic acid

c) Podophyllin

d) Cryotherapy

Correct Answer - D
Ans,. D. Cryotherapy
For reasons unknown genital warts increase in size and number
during pregnancy.
Treatment options during pregnancy include cryotherapy and
trichloroacetic acid (TCA).
Out of the two, cryosurgery is more effective than TCA and hence is
prefnred.
289. 28 year old female complaints of foul
smelling yellowish urethral discharge
since 4 days. History of burning
micturation. History of sexual contact
with multiple partners 2 days before the
onset of symptoms. Most likely
diagnosis is ?
a) Syphilis

b) Chancroid

c) Gonococcal urethritis

d) Non-infective urethritis

Correct Answer - C
Ans. C. Gonococcal urethritis
History of foul smelling mucopurulent discharge , & short incubation
period with high risk exposure clinches the diagnosis
290. Twin-peak sign is seen in ?
a) All Monozygotic twins

b) Monochorionic twins

c) Dichorionic twins

d) Siamese twins

Correct Answer - C
Ans. C. Dichorionic twins
291. In ca Cervix treatment, point A receives ?
a) 3000 cGy

b) 5000 cGy

c) 7000 cGy

d) 10,000 cGy

Correct Answer - C
Ans. C. 7000 cGy
Point A and Point B are in relation to radiotherapy for Ca Cervix.
292. Ashermans syndrome is characterized
by ?
a) Amenorrhea

b) Menorrhagia

c) Polymenorrhea

d) All of the above

Correct Answer - A
Ans. A. Amenorrhea
Intra-uterine adhesions
Asherman syndrome was identified in 1948 as uterine synechiae.
These intra-uterine adhesions (IUA) are often associated with
amenorrhea or infertility.
293. GARDASIL vaccine is for -
a) HPV 16,18

b) HSV

c) HPV 6,11,16,18

d) Hepatitis B

Correct Answer - C
Ans. C. HPV 6,11,16,18
294. LNG content of Mirena is -
a) 20 gms

b) 20 mg

c) 52 gms

d) 52 mgs

Correct Answer - D
Ans. D. 52 mgs
Mirena/LNG IUD/LNG 2O/levonova/LNG IUS
Mirenacontainsatotalof52mglevonorgestrel(LNG).LNGisreleasedintotheuterinecavit
at a rate of approximtely20pg/day.
295. Which of the following decreases the risk
of Pelvic Inflammatory Disease ?
a) Cu T

b) Spermicidal agents

c) O.C. pills

d) Today vaginal sponge

Correct Answer - C
Ans. C. O.C. pills
Several studies have shown that regular O.C. pill users are
protected from PIDs to the extent of 50%.
296. Patient with 45 XO , what HRT to be
given ?
a) Growth hormone + E+P

b) Estrogene

c) No HRT Needed

d) HRT only after 45 years

Correct Answer - A
Ans. A. Growth hormone + E+P
Growth hormone (GH) therapy has become the standard of care for
girls with turner syndrome and should be considered as soon as
decreased linear growth velocity is apparent.
Initial hormone replacement involves low dose
estrogenmonotherapy.
Progestagenreplacement is generally added 1-2 yearsafter starting
estrogen or upon breakthrough bleeding.
297. Tamoxifen decreases the risk of which
cancer?
a) Breast

b) Endometrium

c) Ovary

d) All of the above

Correct Answer - A
Ans. A. Breast
Tamoxifen has been used for more than 30 years to treat patients
with breast cancer.
Tamoxifenworks against breast cancer, in part, by interfering with
the activity of estrogen, a female hormone that promotes the growth
of breast cancer cells.
In October 1998, the U.S. Food and Drug Administration (FDA)
approved the use of tamoxifen to reduce the incidence of breast
cancer in women at increased risk of the disease.
298. Raloxifene decreases the risk of which
cancer?
a) Breast

b) Cervix

c) Ovary

d) All of the above

Correct Answer - A
Ans. A. Breast
After an average of 81 months, raloxifene reduces risk of invasive
breast cancer by about 38 percent compared to tamoxifenreducing
breast cancer by about 50 percent.
299. Least failure rate ?
a) CuT

b) MIRENA

c) DMPA

d) O.C. PILLS

Correct Answer - B
Ans. B. MIRENA
300. Nuva ring contains ?
a) EE+ etonogestrel

b) LNG + EE

c) LNG

d) EE+ drosperinone

Correct Answer - A
Ans. A. EE+ etonogestrel
Contraceptive rings
Nuva Ring: It is a soft vaginal ring that releases 15 microgram EE
and 120 microgram ENG, etonogestrel,the active metabolite of
desogestrel, per day as a controlled delivery system.
301. Which drug used for endometriosis can
cause increase in hepatic enzyme &
adverse lipid profile -
a) 0. C. pills

b) GnRh analogues

c) Both of the above

d) None of the above

Correct Answer - A
Ans. A. 0. C. pills
O. C. pills (progesterone component) are a/w increase in LDL &
decrease in HDL cholesterol but estrogens have opposite effect.
Cholestasis &cholestatic jaundice are occasional side effects of O.
C. pills.
302. Norgestimate in OC pills has the
following advantage ?
a) Reduces venous thrombosis

b) Is cheaper than standard OC pills

c) Reduces acne and hirsutism

d) Useful in heart disease

Correct Answer - C
Ans. C. Reduces acne and hirsutism
Three newer progestogens, namely desogestrel, gestodene, and
norgestimatecan decrease the ameanilhirsutism as compared to
olderprogesterones, which actually can cause oily skin and acne.
303. Which of the following is not an ideal
candidate for IUCD insertion ?
a) Previous LSCS

b) Lactating mother

c) Acute PID

d) All of the above

Correct Answer - C
Ans. C. Acute PID
304. Betamethasone given to preterm patient
for all except ?
a) Fetal lung maturity

b) Decrease intraventricular hemorrhage

c) Prevents periventricular leukomalacia

d) Prevent PPH

Correct Answer - D
Ans. D. Prevent PPH
Steroids (dexamethasone or betamethasone) are given to enhance
fetal lung maturity and they also decrease the incidence
intraventricular hemorrhage.
 305. A 32-year-old female with mild
hypertension. Two days after normal
delivery, she develop seizures,
headache. No proteinuria was there. On
imaging she was found to have
parasagittal infarction and hematoma
3x2cm.The most probable cause is?
a) Eclampsia

b) Superior sagittal sinus thrombosis

c) Pituitary apoplexy

d) Subarachnoid hemorrhage

Correct Answer - B
Ans. B. Superior sagittal sinus thrombosis
The various etiologies for dural sinus thrombosis are:
1. Thrombophilia (factor V Leiden mutation, prothrombin gene
mutation20210, deficiencies of antithrombin, protein C and protein S,
APLA syndrome, hyperhomorysteinemia)
2. Pregnancy
3. Postpartumstate
306. Penicillamine use in pregnancy is
associated with this fetal complication ?
a) Conradi syndrome

b) Renal anomalies

c) Thymus hypolplasia

d) Cutis laxa

Correct Answer - D
Ans. D. Cutis laxa
Pencillamine interferes with synthesis of collagen & elastin & can
cause :elastosisperforansserpiginosa and localized cutis laxa.
307. DOC for malaria in pregnancy ?
a) Chloroquin

b) Quinine

c) Primaquin

d) Artesunate

Correct Answer - A
Ans, A. Chloroquin
Drugs for treatment of malaria in pregnancy-
Malaria can be life threatening during pregnancy.
Chloroquin is 1st choice of drug.
If resistant to chloroquin, quinine should be given under supervision.
Primaquin (for radical cure) should be withheld until the pregnancy is
over.
Artesunate is the 1st choice in case of complicated malaria.
308. Prophylactic methergin given for ?
a) Induction of labour

b) Induction of abortion

c) To stop excess bleeding from uterus

d) All of the above

Correct Answer - C
Ans, C. To stop excess bleeding from uterus
Methergin (methyl-ergo-novine) is a semisynthetic ergot derivative
derived from lysergic acid.
Indications
Prophylactic:- Active management of 3rd stage of labour to prevent
excess bleeding following delivery.
Therapeutic:- To stop atonic uterine bleeding.
309. 6 year old son of pregnant women is
suffering from chicken pox. Which of the
following is given to pregnant women ?
a) Acyclovir

b) Acyclovir + immunoglobulin

c) Only immunoglobulin

d) Vaccination

Correct Answer - B
Ans. B. Acyclovir + immunoglobulin
Varicella during pregnancy
The risk of congenital malformations is nearly absent when maternal
infection occurs after 20 weeks.
VariceIa vaccine is not recommended in pregnancy.
Varicella zoster immunoglobulin (VZIG) should be given to exposed
non-immune as it reduces the mortality.
Oral acyclovir is safe in pregnancy & reduces the duration of illness
when given with in 24 hrs of rash but it cannot prevent congenital
infection.
310. Maximum chance of transmission during
delivery?
a) HSV

b) CMV

c) VZV

d) Rubella

Correct Answer - A
Ans. A. HSV
"Transplacental infection by HSV is not usual.
The fetus becomes affected by virus shed from the cervix or lower
genital tractduring vaginal delivery."
311. Drug of choice for pneumocystis carinii
in pregnancy?
a) SMZ/TMP

b) Primaquine

c) Dapsone

d) Pentamidine

Correct Answer - A
Ans, A. SMZ/TMP
312. A pregnant woman in first trimester has
four fold rise in IgG against
toxoplasmosis. it indicates ?
a) Protective antibodies

b) Acute infection

c) Chronic infection

d) None of the above

Correct Answer - B
Ans, B. Acute infection
Acute infection is detected by detecting IgM specific antibody high
titre of IgG antibody & detection of sero-conversion for IgG from
negative to positive
 313. HRT is given in ?
a) Symptomatic postmenopausal women

b) Following hysterectomy

c) Gonadal dysgenesis

d) All of the above

Correct Answer - D
Ans, D. All of the above
Indications of HRT
1. Symptomatic women suffering from oestrogen deficiency.
2. High risk cases of menopausal complications such as cardiovascular
disease, osteoporosis, stroke, Alzheimer disease & colonic cancer
(prophylactic).
3. Premature menopause, spontaneous or following surgery
(prophylactic).
4. Gonadal dysgenesis in adolescents. (therapeutic)
 314. Methergin is given for prophylaxis of ?
a) Anaemia

b) Cardiac disease

c) Renal disease

d) Lung disease

Correct Answer - A
Ans, A. Anaemia
Methergin (methyl-ergo-novine) is a semisynthetic ergot derivative
derived from lysergic acid.
Indications
1. Prophylactic : Active management of3rd stage oflabour to prevent
excess bleeding following delivery (note-bleeding causes anemia).
2. Therapeutic: To stop atonic uterine bleeding.
 315. All of the following occurs because of
prostaglandin use except?
a) Excess water retention

b) Flushes

c) Increased motility of bowel

d) Nausea

Correct Answer - A
Ans, A. Excess water retention
Disadvantages & side effects of prostaglandins
1. Cost
2. Nausea, vomiting, diarrhea, pyrexia, bronchospasm, tachycardia &
chills
3. Cervical lacerations (PGF-2alpha)
4. Tachysystole (hyperstimulation) of uterus
5. Riskofuterine rupture in case ofuterine scar.
316. Definite use for PGE2 is all except ?
a) Contraception

b) Induces labour

c) Therapeutic abortion

d) Keeps patency of PDA

Correct Answer - A
Ans. A. Contraception
317. Which of following most commonly
clinically used?
a) Diagonal conjugate

b) Ant post diameter of inlet

c) Transverse diameter of outlet

d) Oblique diameter of pelvis

Correct Answer - A
Ans, A. Diagonal conjugate
Most commonly used clinical conjugate is Diagonal conjugate.
318. Least diameter of inlet of gynecoid pelvis
is?
a) Transverse

b) Oblique

c) Diagonal conjugate

d) Obstetric conjugate

Correct Answer - D
Ans, D. Obstetric conjugate
319. Tdap vaccine is give in between which
weeks of pregnancy?
a) 10-16 weeks

b) 17-22 weeks

c) 22-26 weeks

d) 27-36 weeks

Correct Answer - D
Ans, D. 27-36 weeks
Women should get adult tetanus, diphtheria and acellular pertussis
vaccine (Tdap) during each pregnancy. Ideally, the vaccineshould
be given between 27 and 36 weekes ofpregnancy".
320. If 300 microgram anti D is given to
mother , amount of blood it will
neutralise ?
a) 30m1

b) 40m1

c) 50m1

d) 60m1

Correct Answer - A
Ans, A. 30m1
321. Maximum success after reversal of tubal
ligation?
a) Cauterization

b) Pomeroy's technique

c) Clip method

d) Fimbriectomy

Correct Answer - C
Ans, C. Clip method
The Falope sialistic ring destroys 2-3 cm fallopian tube. The Hulka&
Filshie clips destroya smaller segment (3-4mm)' thus preserving the
potential of successful reversal of surgery. The failure rate varies
between .2 and 15%"
322. Failure rate of Pomeroy's method of
tubal ligation is ?
a) 0.2%

b) 0.4%

c) 0.6%

d) 0.8%

Correct Answer - B
Ans, B. 0.4%
The failure rate is 0.4% and it k mainly due to spontaneous
canalization".
323. Least failure rate is of ?
a) OC pills

b) IUDs

c) Condom

d) DMPA

Correct Answer - A
Ans. A. OC pills
Oral contraceptive pills have least chances of pregnancy as they
have minimum failure rate (evaluated by pearl index).
324. Cholestasis of pregnancy false is ?
a) Bilirubin level >2mg%

b) Most common cause of jaundice in pregnancy

c) Oestrogen is involved

d) Manifestations usually appear in last trimester

Correct Answer - B
Ans. B. Most common cause of jaundice in pregnancy
325. I-pill is used when ?
a) Accidental sexual exposure

b) OCP forgotten

c) Of choice in young

d) All of the above

Correct Answer - A
Ans. A. Accidental sexual exposure
I-pill
l-pill is an emergency contraceptive Pill containing levonorgestrel.
Asingledoseof I pillprovidesasafeandeasywaytopreventanunintended
pregnancy,afterunprotected sex orcontraceptivefailure.
It should be take i-pill as soon as possible, preferably within 12
hours and no later than 72 hours ofunprotected intercourse.
Single dose tablet to be taken orally after a meal.
326. Emergency contraceptive should must
be started with in how much time after
unprotected intercourse?
a) 24 hrs

b) 48 hrs

c) 72 hrs

d) 96 hrs

Correct Answer - C
Ans, C. 72 hrs
Morning aftn pill : ethinyl-estrediol 2.5 mg, premarin 15 mg, the drug
is taken orally twice daily for 5 days.
Beginning soonafter e4tosure but not latcr than 72 hrs."
327. 35 year old with history of repeated D&C.
She now has secondary amenorrhea.
What is your diagnosis?
a) Hypothyroidism

b) Kallman syndrome

c) Sheehan's syndrome

d) Asherman's syndrome

Correct Answer - D
Ans, D. Asherman's syndrome
328. Asherman's syndrome false is ?
a) Associated with menstrual irregularities

b) Progesterone challenge test is positive

c) Synechiae formation in uterus

d) May be secondary to TB

Correct Answer - B
Ans, B. Progesterone challenge test is positive
329. Most common site of endometriosis -
a) Ovary

b) FT

c) Colon

d) LSCS Scar

Correct Answer - A
Ans, A. Ovary
 330. Gold standard diagnostic technique for
diagnosis of endometriosis?
a) Laproscopy

b) Ca 125 level

c) Ultrasound

d) MRI

Correct Answer - A
Ans, A. Laproscopy
Investigations for endometrioses
Laproscopyisconsideredasgold standard.
Usedasboth diagnostic aswellastherapeutic technique.
1. CA-f 25 is raised > 35 u/ml
2. Ultrasound
3. CT&MRI
4. Color DoPPler
5. CYstoscoPY
331. TB uterus all is true except?
a) Mostly secondary

b) Increase incidence of ectopic pregnancy

c) Involvement of endosalpinx

d) Most common is ascending infection

Correct Answer - D
Ans, D. Most common is ascending infection
332. Fallopian tube tuberculosis ?
a) Most common type of genital TB

b) Size of the tubes is unchanged

c) Is asymptomatic

d) Primary focus of infection is always in fallopian tubes

Correct Answer - A:C

Ans, A>C. Is asymptomatic > Most common type of genital TB
Most common type of genital TB > Is asymPtomatic
333. Initial drug for ovarian cancer ?
a) Cisplatin

b) Doxorubicin

c) Ifosfamide

d) Methotrexate

Correct Answer - A
Ans, A, Cisplatin
334. Diagnosis of adenomyosis is made by ?
a) Histopathology

b) Ultrasound

c) MRI

d) Laproscopy

Correct Answer - D
Ans, D. Laproscopy
335. Endometrial carcinoma involving cervix,
stage is?
a) 1

b) 2

c) 3

d) 4

Correct Answer - B
Ans, B. 2
336. Hydronephrosis is seen in which stage
of Ca cervix?
a) 2a

b) 2b

c) 3a

d) 3b

Correct Answer - D
Ans, D. 3b
337. Bartholin's cyst treatment of choice -
a) Excision

b) Antibiotics

c) Marsupialisation

d) Drainage

Correct Answer - C
Ans. C. Marsupialisation
338. Definitive management of Adenomyosis
is?
a) GNRH analogue

b) Danazole

c) LH

d) Hysterectomy

Correct Answer - D
Ans, D. Hysterectomy
Hysterectomy is the treatment of choice.
Local resection can be tried in younger women in whom it is
localized.
Medical treatment oPtions are NSAIDS & hormonal therapy, though
not much effective
GnRH, danazole, Mirena IUCD for menorrhagea & pain.
339. Most common degeneration of fibroids ?
a) Calcareous

b) Hyaline

c) Red

d) Cystic

Correct Answer - B
Ans B. Hyaline
Most common degeneration overall _ hyaline
340. Which of the following cannot be treated
by laparoscopy-
a) Ectopic pregnancy

b) Sterilization

c) Non descent of uterus

d) Genital prolapsed

Correct Answer - C
Ans, C. Non descent of uterus
341. Which is least injured in gynaecological
procedures?
a) Ureter at pelvic brim

b) Renal pelvis

c) Urinary bladder

d) Ureter at infundibulopelvic ligament

Correct Answer - B
Ans. B. Renal pelvis
Urinary bladder & pelvic ureter are vulnerable to injury during
gynecologicalsurgery.
342. Definitive treatment for preeclampsia?
a) Delivery of baby

b) Antihypertensive drugs

c) Rest

d) Diet

Correct Answer - A
Ans, A. Delivery of baby
343. Best to diagnose unruptured ectopic
pregnancy ?
a) Scopy

b) UPT

c) USG

d) Culdocentesis

Correct Answer - A
Ans, A. Scopy
344. Most of ectopic pregnancies are at
ampulla as?
a) It is the narrowest part

b) Tubal movements are least here

c) Salpingitis produces least crypts here

d) Plicae are most numerous here

Correct Answer - D
Ans, D. Plicae are most numerous here
345. Prolapsed of uterus in nulliparous
women, treatment is?
a) Sling used involving rectus sheath

b) Anterior colporrhaphy

c) Posterior colporrhaphy

d) Manchester operation

Correct Answer - A
Ans., A. Sling used involving rectus sheath
346. Exclusively Fetal blood loss occurs in ?
a) Vasa previa

b) Placenta praevia

c) Polyhydramnios

d) Oligohydramnios

Correct Answer - A
Ans. A. Vasa previa
347. Placenta previa, false is ?
a) Most common cause of APH

b) Painful vaginal bleeding

c) Usg is the investigation of choice

d) Increased maternal age is a risk factor

Correct Answer - A
Ans. A. Most common cause of APH
348. 45 yr old female patient underwent
hysterectomy, on 7th post op day
complaints about continuous dribbling
of urine and fever. Micturition was not
voluntary, what diagnosis?
a) Vesico vaginal fistula

b) Uretero vaginal fistula

c) Vesico uterine fistula

d) Urethra vaginal fistula

Correct Answer - C
Ans, C. Vesico uterine fistula
Fetal complications of vacuum delivery
SuPerficial scalloP abrasions
Sub-aPoneurotic haemorrhage
Retinal haemorrhage
349. Vacuum delivery produces?
a) Chingon

b) Cephalhematoma

c) Both

d) None

Correct Answer - C
Ans, C. Both
350. HT indicated in menopausal women
a) Hot flash

b) Ca breast

c) Endometriosis

d) Uterine bleeding

Correct Answer - A
Ans. A. Hot flash
Hormone Therapy (HT) is one of the government-approved
treatments for relief of menopausal symptoms.
These symptoms, caused by lower levels of estrogen at
menopause, include :
Hot flashes,
Sleep disturbances, and
Vaginal dryness.
HT is also approved for the prevention of osteoporosis.
351. In Uterine prolapse how to know if ring is
in place?
a) If not expelled after increased abdominal pressure

b) If Bleeding does not occur

c) If patient feels discomfort

d) None

Correct Answer - A
Ans. A.If not expelled after increased abdominal pressure
A vaginal pessary is a removable device placed into the vagina.
It is designed to support areas of pelvic organ prolapse.
A variety of pessaries are available, including the ring pessaries
If not expelled after increased abdominal pressure ring pessary is
supposed to be placed in place
352. Drug that is used for fetal lung maturity
is:
a) Dexamethasone

b) Folic acid

c) Beclomethasone

d) None

Correct Answer - A
Ans. A. Dexamethasone
Betamethasone and dexamethasone are corticosteroids, also called
glucocorticoids, that are given before birth (antenatally) to speed up
a preterm fetuses lung development.
Either is used when a mother is in preterm labor and birth may occur
in 24 to 48 hours.
353. Best time to do quadruple test
a) 8-12 weeks

b) 11-15 weeks

c) 15-20 weeks

d) 18-22 weeks

Correct Answer - C
Ans. C.15-20 weeks
The quad screen is done in the second trimester, usually between
15 and 20 weeks of pregnancy.
Ideally, the test should be performed in conjunction with first-
trimester screening tests.
354. Which One of the following is not a
cause of secondary Postpartum
Haemorrhage?
a) Placenta previa

b) Retained bits of placenta

c) Endometritis

d) Polyp

Correct Answer - A
Ans. A.Placenta previa
Causes of secondary Postpartum Haemorrhage are:
Retained bits of placenta
Postpartum infection
Infection of Cervical and Vaginal Tears
Puerperal Inversion of Uterus
Uterine Polyp or Fibroid:
Undiagnosed carcinoma of cervix
Chorion-epithelioma
355. RDA of iodine in lactation in microgram-
a) 150

b) 220

c) 100

d) 250

Correct Answer - D
Ans. D. 250
To accommodate increased iodine needs during pregnancy and
lactation, the iodine RDA is 220 mcg/day for pregnant women and
250 mcg/day for lactating women
356. Paget's is associated with which other
cancer:
a) Vulva

b) Vagina

c) Cervix

d) Uterus

Correct Answer - A
Ans. A. Vulva
Extramammary Paget's disease (EMPD), also extramammary Paget
disease, is a rare, slow-growing, usually noninvasive intraepithelial
(in the skin) adenocarcinoma outside the mammary gland and
includes Paget's disease of the vulva and the extremely rare Paget's
disease of the penis.
357. Fimbriectomy procedure is known as-
a) Uchida method

b) Irving method

c) Madlener technique

d) Kroener method

Correct Answer - D
Ans. D. Kroener method
Uchida technique—A saline solution is injected subserosal in the
mid portion of the tube to create a bleb.
Irving method — The tube is ligated on either side and mid portion of
the tube (between the ties) is excised.
Madlener technique -It is the easiest method. The loop of the tube is
crushed with an artery forceps.
Kroener method of fimbriectomy is not a common procedure
358. Establishment of fetoplacental
circulation seen at-
a) 11 to 13 days

b) 20 to 22 days

c) 7 days

d) 25 to 26 days

Correct Answer - B
Ans. B.20 to 22 days
Important Events Following Fertilization
0’ hour Fertilization (day-15 from LMP)
30 hours 2 cell stage (blastomeres)
40–50 hours 4 cell stage
72 hours 12 cell stage
96 hours 16 cell stage. Morula enters the uterine cavity
5th day Blastocyst
4–5th day Zona pellucida disappears
5–6th day Blastocyst attachment to endometrial surface
6–7th day Differentiation of cyto and syncytiotrophoblast layers
10th day Synthesis of hCG by syncytiotrophoblast
9–10th day Lacunar network forms
10–11th day Trophoblasts invade endometrial sinusoids
establishing uteroplacental circulation
Interstitial implantation completed with entire
decidual coverage
13th day Primary villi
16th day Secondary villi
16th day Secondary villi
21st day Tertiary villi
21st–22nd Fetal heart. Fetoplacental circulation
day
359. Dilatation & curettage (D&C) is
contraindicated in-
a) Pelvic inflammatory disease (PID)

b) Endometriosis

c) Ectopic pregnancy

d) None

Correct Answer - A
Ans. A. Pelvic inflammatory disease (PID)
Predisposing risk factors for PID are:
Sexual contact
History of STI
Procedures involving the upper female genital tract including:
Dilatation & curettage (D&C)
Recent intrauterine device (IUD) insertion
Therapeutic abortion (T/A)
360. Anteversion of uterus is maintained by?
a) Cardinal ligament

b) Uterosacral ligament

c) Pubocervical ligament

d) Round ligament

Correct Answer - D
Ans. D. Round ligament
In most women, the uterus is anteverted and anteflexed. The
function of the round ligament is maintenance of the anteversion of
the uterus(a position where the fundus of the uterus is turned
forward at the junction of cervix and vagina) during pregnancy.
Normally, the cardinal ligament is what supports the uterine angle
(angle of anteversion).
361. What is the effect of Progesterone only
pills?
a) Completely suppresses ovulation

b) Thin lining of uterus

c) Thick cervical mucus

d) All of the above

Correct Answer - D
Answer: D. All of the above
Progestogen-only pills / Progestin-only Pills (POP) / Morning
after pills -
Contraceptive pills
Contain only synthetic progestins & doesn't contain estrogen.
Mechanism:
Mucus thickening in the neck of the womb:
Penetration of sperm to reach egg and womb becomes difficult.
Prevents ovulation:
The lining of the uterus becomes thin
Fertilized egg implantation is prevented
Advantages:
Doesn’t interfere with breastfeeding
Also helps in premenstrual symptoms and painful periods
362. Long-standing pelvic inflammation may
lead to which of the following
conditions?
a) Pyometra

b) Uterine polyposis

c) Pseudopregnancy

d) Cystic endometrial hyperplasia

Correct Answer - A
Ans. A.Pyometra
Pyometra is collection of pus due to obstruction of flow in the uterine
cavity.
It may be due to Long-standing PID or secondary to cervical
stenosis.
363. Meiosis occurs in
a) Adult ovary

b) Prepubertal testis

c) At birth in ovary

d) All

Correct Answer - A
Ans. is. A. Adult ovary
Meiosis 1 is completed at puberty hence answer is adult ovary
Total number of oocytes at 20 weeks of intrauterine life is about 6–7
million. At birth, the total number of primordial follicles is estimated to
be about 2 million. The primary oocytes do not finish the first meiotic
division until puberty is reached.
Spermatogenesis occurs at puberty so it cannot happen in
prepubertal testis .
364. Prolactin secreted maximum at-
a) 24 hrs after delivery

b) REM

c) 2 hrs running

d) 24 hour after Ovulation

Correct Answer - A
Ans. A.24 hrs after delivery
Prolactin is maximum 24 hrs after delivery.
Prolactin secretion also increases during strenuous exercise and
sleep(NREM).
24 hrs after ovulation estrogen has a negative feedback effect on
prolactin which decreases the level of prolactin.
365. A sexually active female with the profuse
frothy foul-smelling discharge with
intense itching. Strawberry cervix
revealed on examination. What will be
the diagnosis?
a) Trichomonas vaginalis

b) Bacterial vaginosis

c) Candidiasis

d) None

Correct Answer - A
Answer: a. Trichomonas vaginalis
Trichomonas vaginitis:
Clinical Features:
There is sudden profuse and offensive vaginal discharge often
dating from the last menstruation.
Irritation and itching of varying degrees within and around the
introitus are common.
There is the presence of urinary symptoms such as dysuria and
frequency of micturition.
There may be history of previous similar attacks
On Examination:
There is thin, greenish-yellow and frothy offensive discharge per
vaginum.
The vulva is inflamed with evidences of pruritus.
Vaginal examination may be painful. The vaginal walls become red
and inflamed with multiple punctate hemorrhagic spots. Similar spots
are also found over the mucosa of the portio vaginalis part of the
cervix on speculum examination giving the appearance of
‘strawberry’
Ref: Dutta Gynaecology 6th edition Page no.163-164
366. 18-year-old girl presents with 6 months
of amenorrhea with h/o low-grade fever,
weight loss, pain abdomen, generalized
weaknesses. On PR examination,
palpable left-sided pelvic mass felt...
Diagnosis is
a) Fibroid with degeneration

b) TB pelvis with Tubo ovarian mass

c) Ectopic pregnancy

d) Granulosa cell tumour

Correct Answer - B
Ans.B.TB pelvis with Tubo ovarian mass
The tubercles burst to pour the caseous material inside the lumen
producing tubercular pyosalpinx, which may adhere to the ovaries
and the surrounding structures.
Often the infection spreads outwards producing peri salpingitis with
exudation, causing dense adhesions with the surrounding structures
tubercular tubo-ovarian mass.
Clinical diagnostic features:
Weakness, low-grade fever, anorexia, anemia or night sweats may
be present.
Infertility: It may be primary or secondary
Chronic pelvic pain
Vaginal discharge— postcoital bleeding or a blood-stained
discharge.
Constitutional symptoms such as loss of weight, malaise, anorexia,
pyrexia, and anemia are present in the acute phase of the disease.
Menstrual abnormality: In about 50 percent, the menstrual function is
normal.
Presence of pelvic mass with nodules in the pouch of Douglas
palpable
Ref. Gynaecology Dutta ed. 6th Page no. 139-142
367. A pregnant female had Meconium
stained liquor and underwent emergency
LSCS. A few days later her condition
deteriorated. USG showed edematous
bowels. What's the cause?
a) Meconium peritonitis

b) Paralytic ileus

c) Adhesive intestinal obstruction

d) Intra-abdominal abscess

Correct Answer - B
Ans.B. Paralytic ileus
POSTOPERATIVE COMPLICATIONS OF LSCS:
Intestinal obstruction: The obstruction may be mechanical due to
adhesions or bands, or paralytic ileus following peritonitis.
Paralytic ileus is an adynamic obstruction in which there is a failure
of transmission of peristaltic waves
Clinical features :
The resultant stasis leads to the following:
Accumulation of fluid and gas in the bowel
With associated distension: marked and tympanitic
Vomiting (effortless)
Absence of bowel sounds
Absolute constipation
Dutta obstetrics ed. 8th Page no. 678
Bailey & Love's Short Practice of Surgery - 27th Edition (Page
no 1297)
 368. Best treatment option for septate uterus-
a) Tompkins Metroplasty

b) Jones metroplasty

c) Strassmann metroplasty

d) Transcervical hysteroscopic resection of the septum

Correct Answer - D
Ans. D. Transcervical hysteroscopic resection of the septum
Hysteroscopic metroplasty is more commonly done.
Resection of the septum can be done either by a resectoscope
or by laser.
Advantages are:
1. High success rate (80–89%),
2. Short hospital stay
3. Reduced postoperative morbidity (infection or adhesions)
4. Subsequent chance of vaginal delivery is high compared to
abdominal metroplasty where the cesarean section is mandatory.
Other methods:
Abdominal metroplasty could be done either by excising the septum
(Strassman, Jones, and Jones) or by incising the septum
(Tompkins).
Ref. Dutta Gynaecology ed. 6th page no. 47
369. Distension media used for hysteroscopy
with bipolar cautery?
a) Glycine

b) NS

c) Co2

d) Dextran 70

Correct Answer - B
Ans. B. NS
The distending media commonly used in hysteroscopy is normal
saline
—The uterine cavity is distended with a media to separate the
uterine walls and to have a panoramic view. The media used could
be either a gas or a liquid.
Carbon dioxide (CO 2 )—is commonly used for diagnostic purposes.
It is soluble in blood and is safe.
Hysteroflator provides a gas flow rate of a maximum of 100 mL per
minute and a maximum pressure of 100 mm Hg.
Liquid media is used for operative procedures.
Normal saline can be used is suitable for bipolar cautery but not
suitable for monopolar electrosurgery. Constant flow is to be
maintained to flush the operative area.
Ref. Dutta Gynaecology ed. 6th page no. 620, 624
370. Most common site for Fertilization is-
a) Ampulla

b) Isthmus

c) Intramural

d) Fimbriae

Correct Answer - A
Ans. A. Ampulla
Fertilization is the process of fusion of the spermatozoon with the
mature ovum.
It begins with sperm egg collision and ends with the production of a
mononucleated single cell called the zygote.
Its objectives are:
To initiate the embryonic development of the egg and
To restore the chromosome number of the species.
Almost always, fertilization occurs in the ampullary part of the uterine
tube.
Reference: Dutta Obstetrics ed. 8th Page no 23
371. A 22-year-old primigravida visits ANC
OPD with 20 weeks POG. On examination
uterine height reveals a 16-week
size.USG shows reduced liquor. What
will be the diagnosis?
a) Renal agenesis

b) Fetal anemia

c) Barter’s syndrome

d) Liddle syndrome

Correct Answer - A
Ans. A. Renal agenesis
The question states reduced liquor that means oligohydramnios is
seen.
Oligohydramnios is defined as an amniotic fluid index of 5 cm or
less.
It is almost always present when there is either obstruction of the
fetal urinary tract or renal agenesis.
Williams Obstetrics ed 24th page 237
372. Which of the following is not an
estrogen-dependent pubertal change?
a) Hair growth

b) Menstruation

c) Vaginal Cornification

d) Cervical mucus

Correct Answer - B
Ans. B. Menstruation
Pubarche or development of axillary and pubic hair is due to
testosterone (in both the sexes).
Puberty in females :
Involves the beginning of menstrual cycles (menarche), breast
development (thelarche), and an increase in adrenal androgen
secretion (adrenarche).
Estradiol induces the development of secondary sex characteristics,
including the breasts and reproductive tract, and increased fat in the
hips.
Estrogens also regulate the growth spurt at puberty, vaginal
cornification, and cervical mucus production, induce closure of the
epiphyses, have a positive effect in maintaining bone formation, and
can antagonize the degrading actions of parathyroid hormone on
bone.
Reference: Rhoades and Tanner's Medical Physiology, 2nd edition
(Page no: 680)
373. A mother brought her 16-year-old
daughter to Gynaecology OPD with a
complaint of not attending menarche.
She gives H/O cyclic abdominal pain. On
further examination midline, abdominal
swelling seen. Per rectal examination
reveals a bulging mass in the vagina.
Which of the following can be most
commonly seen?
a) Imperforate hymen

b) Transvaginal septum

c) Vaginal agenesis

d) MRKH

Correct Answer - A
Ans. A. Imperforate hymen
According to the clinical case, patients suffer from primary
amenorrhea and cryptomenorrhea(cyclic abdominal pain).
The girl is aged about 14–16 years.
The chief complaints are periodic lower abdominal pain, which may
be continuous, primary amenorrhea and urinary symptoms, such as
frequency, dysuria or even retention of urine.
In fact, in significant cases, the presenting feature may be the
retention of urine. The cause of retention is due to the elongation of
the urethra.
An abdominal examination reveals a suprapubic swelling, which may
be uterine or full bladder. Prior catheterization reveals the true state.
Vulval inspection reveals a tense bulging membrane of bluish
coloration
Ref. Dutta Gynaecology ed. 6th page no. 42
374. 13 yr old child visit gynaecology OPD
with a complaint of not attaining
menarche with karyotype 46XX. On
examination, clitoromegaly is seen.
Which enzyme is most likely to be
deficient in the above condition?
a) 21 alpha-hydroxylase

b) 11 beta-hydroxylase

c) 17 alpha-hydroxylase

d) 3 beta-hydroxysteroid dehydrogenase

Correct Answer - A
Ans. A. 21 alpha-hydroxylase
The condition described above represents the Congenital adrenal
hyperplasia.
"More than 90% of CAH cases are caused by 21-hydroxylase
deficiency"
Congenital adrenal hyperplasia:
It is due to an inborn error of adrenal steroid metabolism, commonly
due to 21-hydroxylase (95%) and rarely due to 11-hydroxylase or 3β
hydroxysteroid dehydrogenase deficiency.
Clinical presentation
An ambiguity of sex at birth
Hirsutism and amenorrhea may be the presenting features around
puberty in a milder form.
The karyotype is 46, XX.
Ref. Dutta Gynaecology ed. 6th page no. 440
375. In early pregnancy clinical signs of
feeling the cer​vix and the body of bulky
uterus separated be​cause of softened
isthmus at 6 - 8 weeks of gestation :
a) Goodell's sign

b) Chadwick's sign

c) Piskacek's sign

d) Hegar's sign

Correct Answer - D
Correct Ans: D. Hegar's sign
At 6 to 8 weeks menstrual age, the firm cervix contrasts with the now
softer fundus and the compressible interposed softened isthmus
—Hegar sign
376. Misoprostol used in the induction of
labour is an analogue of which of the
following type of prostaglandin?
a) PG E1

b) PG E2

c) PG I2

d) PG F2alpha

Correct Answer - A
Correct Ans: A. PG E1
Misoprostol is a methyl ester of PGE1.
Indications of Misoprostol:
It is used for cervical ripening.
Transvaginally it is used for induction of labour.
Uses of Prostaglandins in Obstetrics:
Induction of abortion
Termination of molar pregnancy
Induction of labour
Cervical ripening prior to induction of labour
Acceleration of labour
Management of atonic postpartum hemorrhage
Medical management of tubal ectopic pregnancy