Professional Documents
Culture Documents
AMC OBS & GYNAC 2005 To 2009
AMC OBS & GYNAC 2005 To 2009
2005
a) Pudendal nerve
b) Sciatic nerve
c) Common peroneal nerve
Ans: Standard textbooks of gynaecology mention about stretch injury of the sciatic nerve
and its peroneal branch as complications following vaginal hysterectomy.
A woman is challenged with combined oestrogen & progesterone, but does not get
withdrawal bleeding. Which organ is most likely to be affected?
a) Overies
b) Uterus
c) Pituitary
d) Hypothalamus
e) Fallopian tubes
Ans: Uterus.
The most appropriate OCP for a 24-year-old woman taking phenytoin is?
a) Microgynon 30
b) Microgynon 50
c) Diane 35
d) Clomiphene
e) Oestrogen 85 micrograms
Ans: cysts less than 7 cm are given around 6 to 7 weeks of time for follow up, if more
than 7cm go for laparotomy. Functional ovary less likely to be malignant. Kaplan Obs. p.
Ans: Oxytocin is a nonapeptide produced from Post Pituitary along with vasopressin.
Mainly act on myometrium in therapeutic doses which is mediated by intracellular
influx of calcium and synthesis of PG.
3|O&G ps
Oxytocin is responsible for milk ejection reflex but not milk production.
Oxytocin in higher doses shows ADH like action upon kidney leading to decrease urine
output.
In normal therapeutic doses doesn’t effect BP but higer doses cause brief fall in BP (KDT
p.319-320).
A female, 17 weeks pregnant, has acute right iliac fossa pain. Which of the following is
the least likely cause of the pain?
a) Pyelonephritis
b) Red degeneration of a fibroid
c) Ectopic pregnancy
d) Acute appendicitis
e) Torsion of an ovarian cyst
a) Mild hypertension
b) Amenorrhoea after the 3rd injection
c) Fertility problems for 6-12 months after stopping the treatment
d) Menstrual irregularities
e) Weight gain
Ans: Hypertension
http://www.rxlist.com/depo-provera-drug.htm
An 8-week gestation primigravida, presented with slight vaginal bleeding. You will do
an ultrasound examination for all of the following, except?
a) Trans-sphenoidal surgery
b) Phenothiazine
c) Bromocriptine
d) Clomiphene
e) OCP
Ans: The dopamine agonist, bromocriptine mesylate, is often the initial drug of choice. It
lowers the prolactin level in 70-100% of patients. Agents other than bromocriptine have
been used (eg, cabergoline, quinagolide). (Notes Hyper PRL)
In a postmenopausal woman, what is the least likely cause of greenish foul smelling
vaginal discharge? ***
Ans: E.
Ans: C.
The mainstay of treatment for carpal tunnel syndrome (CTS) is rest, wrist immobilization
with a splint, and nonsteroidal anti-inflammatory drugs (NSAIDs).
Corticosteroid injections, oral steroids, and diuretics are other treatment modalities that
have been used.
A volar splint should be placed in neutral position because flexion and extension of the
wrist increases carpal intracanal pressure.
Definitive therapy consists of surgical release of the transverse carpal ligament.
http://emedicine.medscape.com/article/822792-treatment
A woman comes to you 2 years after her menopause asking for something to relieve
her postmenopausal syndromes. You decide to give her combined HRT. You explain to
her that all of the following are the effects of progesterone, except?
Ans: D.
(Deja Review: 216)
There is no effect of estrogen and progesterone on Lipid profile.
6|O&G ps
Which of the following is not true, for a woman having antenatal care?
a) Presence of Anti-Rho means that the baby can have permanent heart block
b) A platelet count of 100,000 is a risk for developing intracranial bleed in the infant
c) The presence of ANA could cause growth retardation of the foetus
d) ?
Ans: A.
Permanent heart block is seen in SLE (emedicine)
a) No renal changes
b) Dilatation of the ureters & calyces
c) Dilatation of the calyces only
d) Dilatation of the ureter only
e) Reduce incidence of infection
Ans: D.
Increased Vasico uterine reflex to cause infection.
(Deja p.230)
Ans: C.
Decelerations are always bad.
A young woman, pregnant for 14 weeks, uterine size corresponding to 16 weeks, now
presents with bleeding and passing out grape like material through a dilated cervix.
Which of the following is the best follow up?
Ans: A.
Weekly Until 3 consecutive tests become Negative for HCG (Deja Review: Complication
of Pregnancy: Topic H Mole)
A 32-years woman became pregnant. She had 5 pregnancies before, of which she lost
3 spontaneously between 8-10 weeks & 2 were stopped by intervention at 12 weeks.
What is the most likely cause?
a) Cervical incompetence
b) Chromosomal abnormalities
c) Hormonal imbalance
d) Ovarian tumor
e) Valvo vaginitis
Ans: B.
All of the following are true about neural tube defect, except?
Ans: A.
Recurrence risk of giving birth to a second child with a neural tube defect varies with
incidence. Investigators found the risk of having an additional affected birth after an
anencephalic or spina bifida birth to be approximately 10.4% in Belfast but only about
4.12% in London. The risk in the United States is 1-3%.
8|O&G ps
Of all the suspected teratogens, carbamazepine, valproic acid, and folate deficiency
have been most strongly tied to the development of neural tube defects. In humans,
carbamazepine and valproic acid have been definitively identified as teratogens.
Valproic acid is a known folate antagonist and its association with neural tube defects
may be through that action. A woman taking valproic acid during pregnancy has an
estimated risk of 1-2% of having a child with a neural tube defect. Therefore, women
taking antiepileptic drugs during pregnancy are advised to undergo routine prenatal
screening with AFP.
The first step in prenatal screening is measuring the maternal serum AFP at 15-20
weeks' gestation. A patient-specific risk is then calculated based on gestational age and
AFP level. For example, at 20 weeks' gestation, a maternal serum AFP concentration
higher than1000 ng/mL would be indicative of an open neural tube defect. Normal AFP
concentration in the maternal serum is usually lower than500 ng/mL.
Detection of a neural tube defect with fetal ultrasonography in the hands of a skilled
ultrasonographer is usually 98% specific (nuchal translucency at 11 to 13 weeks). False-
positive findings can result from multiple pregnancies or inaccurate fetal dating.
However, closed neural tube defects can sometimes remain undetected, especially in
cases of skin-covered lipomyelomeningoceles and meningoceles, in which the AFP levels
may also be normal. These closed neural tube defects comprise about 10% or more of
total neural tube defects discovered. A skilled ultrasonographer can detect these lesions
with almost 95% sensitivity.
Most common neural tube defects are: Anencephaly and Spina bifida.(emedicine)
A partial list of the fetal anomalies that are associated with elevated AFP levels is as follows:
Anencephaly Gastroschisis
Spina bifida cystica Exstrophy of the cloaca
Encephalocele (leaking) Oligohydramnios
Conjoined twins Sacrococcygeal teratoma
Omphalocele Polycystic kidneys
Turner syndrome Fetal death
9|O&G ps
http://emedicine.medscape.com/article/979902-overview
a) Platelets
b) Uric acid
c) Creatinine
d) SGOT
e) BUN
Ans: Platelets.
Ans: A.
(JM p.961)
a) D & C
b) Progesterone
c) Mefnamic acid
d) OCP
e) Bromocriptine
Ans: Bromocriptine
(JM p.998)
a) Teratoma
b) Ovarian ca
c) Fibroma
d) Granulosa cell tumor
Ans: D.
Fetaus cannot be palpated due to tense and tender uterus.
(Dutta p.248)
a) Hypothalamus
b) Pituitary
c) Ovaries
d) Endometrium
e) Cervical mucous
Ans: Hypothalamus
POP effect the cervical mucus.
Ans: B.
11 | O & G ps
A 26-years old primi, 152 cm tall, with vertex presentation, head at 0 station, cervix
effaced completely and dilated to 4 cm, with intact membranes at 37 weeks. What is
the most approprate management? ***
Ans: E.
A 24-year old woman came with secondary amenorrhoea & was diagnosed to have
Poly Cystic Ovarian Syndrome. WOF is true about her conditions--
Ans: C.
LH is elevated LH:FSH=3:1
Andrstenedione and DHEA elevated
(Dutta p.422)
In a twin pregnancy, after delivery of the first twin, you do all of the following, except?
a) Vaginal examination
b) External version if the second twin is breech
c) Oxytocin infusion if contractions don’t start
d) Check foetal heart rate
e) Check lie of the second twin
Ans: B
(LJ p.175)
Regarding uterine rupture after previous Lower segment Ceasarian Section WOF is
most likely indication?
a) Incidense is increased by 5%
b) Increase with prostaglandin induction
c) Increase with oxytocin augmentation
Ans: C.
LSCS chances of rapture is less than 0.5%.
12 | O & G ps
Ans: breast.
Prostate ca never goes to brain parenchyma but involve skull.
(JM p.243)
Ans:
A 26 yrs old young lady with 10 weeks of amenorrhoea. WOF test will affect her
management after the diagnosis of her pregnancy?
a) Varicella Antibody
b) HIV
c) Glucose Challenge test
Ans: B
(Déjà p.369)
(Déjà p.267) vericella.
2006
AOF are used in BISHOP Score , Except-
a.Cervical length
b.Cervical dilatation
c.Position relation to ischial spine
d.Moulding of the head
e.Cervical effacement
Ans: D.
Remember the mnemonic C P E D S
Ans: B
Ans: d. ABO incompatibility decreases the risk of autoimmunization. Kaplan Obs p.70
http://www.nlm.nih.gov/medlineplus/ency/article/007062.htm
14 | O & G ps
An 18 yr old girl comes to you for your advice regarding Contraceptives as she is going to
start her sexual relationship.WOF you will prescribe:
a. OCP
b.IUCD
c.Condom
d. Low dose progesterone
A 45 yr old lady complains of irregular menstrual bleeding. She has been treated for CIN-II
previously and a Pap smear done 6 months ago was fond normal.WOF is the most
appropriate investigation for her?
a. Colposcopy
b. USG to detect endometrial thickness
c. Cone biopsy
d. Endometrial curettage
e. Repeat Papsmear
A 29 yr old lady comes to you with obesity, irregular cycles and hirsutism. What will help
you to Dx her condition-
A 32 yr old primi in her 33 weeks of gestation informs you that her baby’s movement
suddenly become decrease for the last 28 hrs. Before that her pregnancy was going
normal without any problem.WOF would be your management to combat the concern:
a.USG [October’03]
b. Do Cardiotopography(CTG)
c.Fetal Scalp pH
d.Immediate delivery of the baby
Ans: B.
15 | O & G ps
A 38 yr old primi of 39 weeks pregnancy admitted in Labour Unit with the onset of regular
uterine contraction, her cervix is 8 cm dilated, fully effaced, station +1, initially fetal heart
rate was 155 but after a while on the progress of labour fetal heart beats suddenly falls
from 155 to 80 per minute; otherwise normal in respect of mother’s general condition.
What would be your next step of Mx: ***
a.Fetal scalp pH
b.Cardiotopography
c.Vaginal examination to exclude any cord prolapse
d.Emergency delivery by C/S
e.Percutaneous umbilical sampling
Ans: D
a.OCP
b.Levonogestrol within 72 hrs,and second dose 12 hrs after the first one.
Ans: B. JM 964
Failure rates: JM 960.
A lady recently married comes to you with vaginal infection(cystitis).This is 3rd episode.
Most appropriate Ix- ****
a. Vaginal swab
b. Husband’s urethral swab
c. Colposcopy
Ans: ……………………..
A female comes to you for infertility. Her LH increased, FSH increased, Oestradiol –
decreased. Rx:
a.Clomiphen citrate
b.Give her Oestrogen daily
c.IVF
A young obese 24 yr old female with hirsutism, oligomenorrhoea and irregular periods,
was found to have endometrial hyperplasia(benign)on curettage.AOF are appropriate
treatments, Except-
Ans: E.
A baby with Down’s syndrome is born to a couple who definitely refuse to take the child
home after failure to convince them.The most appropriate course of action:
Arrange temporary foster care
a. Immediately C/S
b. Vaginal examination
Ans: …………………………………
17 | O & G ps
2007
A woman came at 17 weeks of pg with lab reports showing that there is a 1:50 chance of
getting a Down's syn baby. She does not want a Down baby. She is asking for your
management. What do you do?
A. terminate
B. do amniocentasis
C. do usg to exclude Down's
D. reassure
Ans: C.
A. 8 wk clinical ex
B. 8 wk USG
C. 18 wk Clinical ex
D. 18 wk USG?
E. Late trimester uterine height
A woman came G2P1 with prevoius delivery of a 4200 gm baby at 42 wks with shoulder
dystocia. What do you do this time? ***
A. Induce at 38 wks
B. Induce prematurely
C. do x-ray pelvimetry at term
D. CS
Ans: A.
Déjà 386
Ans: ……………………………
All i know is the root value for Erb's palsy given was wrong.
An 18 yo girl came to you for contraceptive advice. she has decided to commence on
sexual activity but has not yet chosen her partner. What advice do you give her?
A. CoC
B. IUCD
C. CoC + Condom
D. barrier methods
Ans: C
A mother of two child comes to you for contraceptive advice. You prescribe microgynon
30. She again comes and tells you that she experiences bleeding twice a month. One with
2 days duration and another for 5 days. What will be your next step?
A pregnant lady presents at 26 weeks with hydrops fetalis. Which investigation will help
you in the management:
a.coomb’s test
b.IgM and Ig G for parvovirus
Ans: A.
a.danasol
b progesterone
c.ocp
Ans: C.
(JM Breast Pain)
a.Menopause in 40 years
b.BMI <20 C.?
A 17 year old girl presented with amenorrhea. Her height and physical appearance are
normal for her age. What will be the cause
a. mullerian agenesis
b.ovarian agenesis
c.ovarian dysgenesis
c.pituitary failure
d.hypothalamic dysfunction
Ans: A.
(Long question and choices) the time interval between onset of growth spurt and
menarche
CTG for 30 min given heart rate 145, baseline variability 5bpm, no acceleration, no
decelerations,
a.normal
b.abnormality due to fetal sleep
c.abnormal and requires immediate cs.
d. abnormal and scalp ph.
e.some abnormality present and requires close observation.
Ans: …………………………..
A long question about when to start folic acid and how long to take it to prevent neural
tube defect.
Ans: ……………………………..
What is the most important adverse effect of GA over epidural anaesthesia in normal
labour?
a.maternal hypotention
b.thiopentone has direct respiratory depressant action on foetus
c.increase bleeding
Ans: …………………………………
20 | O & G ps
2009
16w pregnant primi, C/o, vomiting, Tenderness and guarding over RIF, no fever No
bleeding, Increased when straining
a. A Apendicitis
b. Salphingitis
c. PID
Ans: …………………….
36w Pregnant mother, with 2 children given birth at 39w previously. She wants to deliver
bcos herusbund is going for interstate the next day. Her cx 2cm long, not dlated. What is
your advice?
Ans: ………………………
Woman with bloody nipple discharge, what is the most probable diagnosis?
a. Duct papiloma
b. Abcess
c. Breast CA
A lady 6 months post purtum presented with depressed mood and tearfulness. She said
that, she is having a feeling to through her baby in to the wall and fear that she will do so.
For that reason she always asks her husband to be around and never leave her and baby
alone. What is the condition?
a. Delusions
b. Obsession
c.
21 | O & G ps
Ans: Obsession
A 16 years girl presented with an endometrioma of ovary, size 7cm. what is the
management?
a. Prolactinoma
Ans: Prolactinoma
A girl of 16 years of age comes to you with her boy friend who is only 15 years of age. She
was asking for OCPs. What should be you action?
a. Refuse to give
b. Counsel and give OCPs
c. Telephone her mother
A 85 years old lady presented with vaginal prolapse, 3rd degree. What is the
management?
a. Pessary
b. Surgery
Ans: ………………………….
A lady 2 days post purtum asked you that she does not want to feed her baby. What is the
first step to stop breast milk?
Ans: Tight fitting bra and stop stimulating nipple (JM Post Purtum Complication)
22 | O & G ps
Sonia is a 24 year old secretary , One week after delivery of a healthy baby, she
presented to you as a GP with 4 cm Breast Abscess, what is your management
Ans: B
Inappropriate antibiotics continue to be prescribed for breast infection. Optimal
management of breast abscesses consists of repeated aspiration or mini incision and
drainage combined with appropriate antibiotic therapy.