gyne.obsqs

8/10/2019 Gyne.obsqs

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1) Regarding drug administration:

Choose 2 of the following options.

a) the sublingual route avoids first-pass inactivation in the liverb) suppositories expose the drug to first-pass metabolismc) distribution of nebulised drug in the respiratory tree depends on the par

ticle sized) highly water soluble drugs are administered by the transdermal routee) drugs given by the oral route should have a very high extraction ratio

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2) Regarding protein binding of drugs in the plasma:


a) highly protein bound drugs have a longer biological half-lifeb) protein binding is markedly different in arterial and venous bloodc) free drug concentration is not altered in hypoalbuminaemic statesd) alpha-1 acid glycoprotein principally binds to basic drugse) the greater the protein binding, the lesser the volume of distribution

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3) Alprostadil (PGE1) and Epoprostenol (PGI2):


a) are principally metabolised in the lungsb) dilate ductus arteriosus to increase pulmonary blood flow in neonatesc) inhibit platelet aggregationd) improve oxygenation in ARDS patients when used by the nebulised routee) do not cause apnoea in neonates

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4) The following statements about drug half-life are correct:


a) the half-life of a drug is shorter than its time constantb) drugs given by infusion without a bolus reach a steady state in five half


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-livesc) the extent of drug distribution into the total body water or extracellula

r fluid is unlikely to affect t1/2d) context-sensitive halflife can be used for any druge) about 94% of a drug is cleared from the body in four half-lives

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5) First-order processes:


a) apply to enzyme-mediated reactionsb) are characterised by high rates of reaction when the concentrations of re

acting substances are high, and vice versec) can properly be described in terms of t1/2d) are involved in the elimination of most drugse) change to zero-order kinetic at very high drug doses

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6) Regarding drug clearance by the body:


a) this only refers to elimination by the kidneyb) this refers to the volume of plasma cleared of the drug in unit time

c) it cannot exceed the glomerular filtration rated) it is dependent on its volume of distributione) hepatic clearance is expressed as extraction ratio

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7) 5-HT:


a) is synthesised from tyrosine by enterochromaffin cells of the gastrointestinal tract

b) is also an endogenous neurotransmitter in the brainc) is metabolised by monoamine oxidase to hydroxyindole acetic acidd) is degraded to a great extent by pulmonary endothelial cellse) can cause vasoconstriction and increased gastrointestinal motility


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8) Concerning metabolism of following drugs:


a) lidocaine is metabolised to monoethylglycinexylidide (MEGX) in the liver

b) lithium is almost entirely excreted unchanged by the kidneyc) gentamicin is metabolised in the liver and excreted in the biled) chlorpromazine is degraded via microsomal oxidative metabolism in the liv

ere) levodopa crosses the blood-brain barrier and is then converted to dopamin

e

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9) Regarding arterial blood gas analysis:


a) hydrogen, oxygen and CO2 electrodes measure at 37 degrees Cb) PaO2 read by gas analyser would be higher than patients PaO2 at 37 degrees

Cc) the pH of the blood rises by 0.015 units per 10 degrees C decrease in bod

y temperatured) the alpha-stat approach is to keep uncorrected PaCO2 and pH at normal lev

els

e) PaCO2 of a patient at 30 degrees C will be lower than that at body temperature

) Endometrial Carcinoma with vaginal metastasis is staged as

One answer only.

a) II bb) III ac) III bd) III c

e) IV a

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2) Stress urinary incontenence is characterised by involuntary loss of urine with all of the following EXCEPT

One answer only.

a) Coughingb) Exercisingc) Laughingd) Sleepinge) Sneezing

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3) The following are associated with increased incidence of recurrent pregnancyloss EXCEPT

One answer only.

a) Presence of thyroid antibodiesb) Polycystic ovarian diseasec) Overt diabetes mellitus *d) Partial HLA homozygositye) Balanced translocation in either patient

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4) Management of proximal tubal occlusion is all EXCEPT

One answer only.

a) Transcervical canulationb) Intramural isthmic anastomosisc) Uterotubal implantation *d) Isthmic - Isthmic anastomosis

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5) Which of the following is most reliable in diagnosing ovarian malignancy ?

One answer only.

a) Medical historyb) Plain Xrayc) Physical examinationd) USe) Cytology from ovarian cyst fluid


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6) Which of the following is not associated with an increased risk for ovarian carcinoma ?

One answer only.

a) Radiation exposureb) Nulliparityc) A diet low in fibre and Vit A.d) Familial tendencye) Peutz - Jeghers Syndrome

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7) Approximately 75 - 80% of ovarian tumors originate from

One answer only.

a) Epitheliumb) Stromac) Germ cellsd) Mesoderme) Unclassified tissue

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8) Side effects of Gn RH agonists includes all of the following EXCEPT

One answer only.

a) Hot flashesb) Vaginal drynessc) Bone resorption & osteoporosis

d) Headachee) Decreased high density lipoproteins

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9) The least common side effect caused b GnRH agonists is

One answer only.

a) Decreased libidob) Vasomotor symptomsc) Headached) Vaginal drynesse) Mood changes

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10) Least expensive hormonal regimen for treatment of pelvic pain caused by endometriosis

One answer only.

a) Danazolb) Medroxy progesterone

c) Nafarclind) Buscreline) Leuprolide

1) The standard Cu 250 IUCD is appropriate for a uterus having uterocervical length of

One answer only.

a) 5 - 8 cmb) 6 - 9 cmc) 7 - 10 cmd) 8 - 11 cm

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2) An ideal candidate for the use of IUCD as a contraceptive method should haveall of the following EXCEPT

One answer only.

a) Nulliparousb) One childc) Normal menstrual cycled) Monogamous relationship


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3) The commonest complication of laparoscopic ring tubal ligation is

One answer only.

a) Failure of sterilizationb) Menstrual abnormalityc) Mesosalpingeal bleedingd) Bowel injurye) Wound infection

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4) Which of the following cancidates will be immediately eligible for sterilization

One answer only.

a) Women having uncontrolled diabetesb) Women having Hb < 8 gm %c) Past h/o treated pulmonary koch'sd) Febrile patient

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5) After vasectomy , a backup contraceptive method is required for how many weeks

One answer only.

a) 8 wksb) 10 wksc) 12 wksd) 14 wks

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6) AFP is most often useful for monitoring the response to treatment of which germ cell tumor

One answer only.


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a) Dysgerminimab) Immature teratomac) Endodermal sinus tumord) Choriocarcinoma

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7) Granulosa cell tumor are associated with all EXCEPT

One answer only.

a) Isosexual precoertyb) Endometrial hyperplasia & adenocarcinomac) Present most commonly before the age of 5d) Vaginal bleeding

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8) Combination chemotherapy regimen in Ca ovary

One answer only.

a) Is the treatment of choice for most patients with residual disease following surgery

b) Less toxic than single agent therapyc) Less expensive than single agent therapyd) Produces better results if it is a combination containing cyclophosphamid

e e) None of the above

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9) The following are the pathological features of an ovary , EXCEPT

One answer only.

a) Round shape with irregular internal or external outlineb) Thick septae of > 5mmc) Size more than 10 cmd) Volume < 8ml in postmenopausal woman


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10) The following are the factors associated with CIN EXCEPT

One answer only.

a) Onset of coitus at early stageb) Multiple sexual partnersc) Lower socioeconomic statusd) Nulliparitye) H/o veneral disease

) Intrauterine pregnancy rate after linear salpingostomy is approximately

One answer only.

a) 35%b) 45%c) 60%d) 75%e) 90%

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2) All of the following are necessary for the treatment of ectopic pregnancy with MTX EXCEPT

One answer only.

a) Unrupturedb) No painc) < 4 cm size ly USd) Hemodynamically stablee) Normal blood count & liver enzymes

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3) Which of the following side effects is least common with cisplatin

One answer only.

a) Thrombocytopeniab) Hypomagnesimiac) Cardiac toxicityd) Neuropathy


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e) High frequency hearing loss

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4) Perforation tends to occur earliest when an ectopic pregnancy is located in which portion of fallopian tube ?

One answer only.

a) Isthmicb) Interstitialc) Ampullaryd) Infundibulare) No difference

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5) The rate of disappearance of hCG is most rapid in which condition

One answer only.

a) Induced abortionb) Spontaneous abortionc) Complete removal of ectopic pregnancy by resectiond) Complete removal of ectopic pregnancy by linear salpingostomye) No difference

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6) Which is the least frequent site of an ectopic pregnancy

One answer only.

a) Fallopian tubeb) Cervix

c) Ovaryd) Abdominal cavitye) Between the leaves of broad ligament

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7) What treatment is recommended for a complete tubal abortion when the fallopian tube appears undamaged, there is no further bleeding, and product of gestationhave been expelled

One answer only.

a) Non operative treatmentb) Evacuation of production of gestation and blood clots from pouch of Dougl

as and peritoneal cavityc) Removal of the abortion and clots and incision in tube for explorationd) Removal of abortion and clots and salpingectomye) Removal of abortion and clots and salpingo oophorectomy

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8) Which is not an indication for chemotherapeutic treatment of postmolar trophoblastic disease

One answer only.

a) Abnormal hCG regression curveb) Presence of metastasisc) Uterine infectiond) Uterine haemorrhagee) Tissue diagnosis of choriocarcinoma

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9) Incidence of all of the following conditions are increased in tamoxifen usersEXCEPT

One answer only.

a) Cervial dysplasiab) Endometrial polypsc) Endometrial hyperplasiad) Uterine fibroidse) Endometrial adenocarcinoma

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10) Women with postmenopausal bleeding need endometrial sampling if endometrialon gynae USG is thicker than


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One answer only.

a) 1mmb) 2mmc) 5mmd) 8mme) 10mm

1) GnRH agonists successfully reduce fibroid & total uterine size in what percentage of patients

One answer only.

a) 30%b) 50%c) 60%d) 70%e) 95%

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2) Menstrual regulation can be performed upto

One answer only.

a) 6 wksb) 12 wksc) 18 wkd) 20 wks

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3) Straussman operation consists of

One answer only.

a) Unification of seperate uterus

b) Sling operation for prolapsec) Tightening of cervical os d) None of the above

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4) Perforation of the uterus while doing endometrial biopsy in non pregnant uterus, needs

One answer only.

a) Laparoscopyb) Observationc) Immediate laparotomyd) Hysterectomy

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5) After fertilization, ova is embedded in the endometrium on which day ?

One answer only.

a) 2nd dayb) 4th dayc) 6th day

d) 10th day

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6) Time taken by the spermatatozoa to reach ampulla of the fallopian tube afterejaculation is

One answer only.

a) 20 minsb) 30 minsc) 60 minsd) 2 hrs

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7) Least common type of ut anomaly in patients with RPL

One answer only.

a) Unicornuateb) Arcuatec) Septated) Bicornuatee) Didelphys


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8) The first trimester spontaneous abortion rate is highest for patients with which type of ut anomaly

One answer only.

a) Unicornuateb) Arcuatec) Septated) Bicornuatee) Didelphys

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9) The gold standard in diagnosing ectopic pregnancy

One answer only.

a) Laparoscopyb) Culdocenterisc) Beta HCGd) USe) Progesterone

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10) What is the most common side effect with MTX therapy for ectopic pregnancy

One answer only.

a) Transient pelvic pain 3 - 7 days after starting treatmentb) Stomatitisc) Bone marrow suppressiond) Gastritis

1) Radiotherapy is indicated in Endometrial Ca in following situation EXCEPT

One answer only.

a) Preop radiotherapy followed by TAH + BSOb) Postop adjuvant radiotherapy after TAH + BSOc) Primary treatment for medically inoperabled) To specifically treat pelvic side wall involvemente) Vaginal recurrence after hysterectomy


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2) Invasive molar tissue is most commonly found in

One answer only.

a) Myometriumb) Vaginal wallc) Ovaryd) Livere) Lungs

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3) Which method of terminating a molar gestation is never indicated

One answer only.

a) Suction curettageb) Prostaglandicc) Hypertonicsalined) Hysterotomye) Hyterectomy

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4) The following are the risk factors for H mole EXCEPT

One answer only.

a) Maternal age > 40 yrsb) Prior h/o H mole

c) Prior h/o term pregnancyd) Maternal age < 20 yrse) Prior h/o spontaneous abortion

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5) Treatment of choice for 30 years old para 1 with stress incontinence is

One answer only.

a) Pelvic floor exerciseb) Bladder trainingc) Mechanical incontinence deviced) Kelly's repaire) Sling operation

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6) Treatment of choice for a 55 yrs old multipara with 3rd degree prolapse uterus with cystocele with rectocele with stress incontinence

One answer only.

a) Vaginal hysterectomy with pelvic floor repair

b) Kelly's repairc) a) + b)d) a) + colposuspension

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7) Best treatment for severe stress incontinence without prolapse is

One answer only.

a) Pelvic floor exerciseb) Kelly's repairc) Burch colposuspensiond) MMK operatione) Urethral collagen implant

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8) Diagnosis of genuine stress incontinence is made by which of the following before taking the patient for surgery

One answer only.

a) Historyb) Subjective demonstration of stress incontinencec) Objective demonstration of stress incontinence


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d) Urodynamic studies

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9) The commonest cause of stress incontinence is

One answer only.

a) Constipationb) Raised intra abdominal pressurec) Congenital weakness of sphincterd) Childbirth traumae) Estrogen deficiency

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10) The amount of progesterone released per day by the progesterone releasing IUCD ( Progestarest ) is

One answer only.

a) 60 mugmb) 65 mugmc) 70 mugmd) 75 mugm

1) A 25 years old woman with rheumatic mitral stenosis reports at 12 weeks gesta

tion. As per her management plan, she requires balloon valvuloplasty. The best time to carry it out will be

One answer only.

a) Immediatelyb) 16 weeksc) 28 weeksd) 32 weeks

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2) The correct sequence of appearance of embryonic structures as detected by sonography is

One answer only.


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a) Chorionic sac - yolk sac - embryo - heart beatb) Chorionic sac - embryo - yolk sac - heart beatc) Amnionic sac - yolk sac - embryo - heart beatd) Gestational sac - embryo - yolk sac - heart beat

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3) All are true about cardiovascular changes during pregnancy except

One answer only.

a) There is a rise in intravascular volumeb) Cardio - thoracic ratio increasesc) CVP increases during third trimesterd) MAP stays unaltered

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4) A 25 years old woman is found to have high MSAFP at 16 weeks of gestation. All are likely diagnosis except

One answer only.

a) Down's syndromeb) IUDc) Multifetal gestation

d) Congenital nephrosis

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5) Banana sign is a sonographic feature of

One answer only.

a) Anencephalyb) CMV encephalitisc) Spina bifidad) Congenital absence of corpus callossum


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6) The diameter that can be clinically measured is

One answer only.

a) External conjugateb) True conjugatec) Obstetric conjugated) Direct conjugate

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7) The smallest fetal skull diameter in the coronal plane is

One answer only.

a) Bitemporal diameterb) Bimastoid diameter

c) Biparietal diameterd) Occipitofrontal diameter

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8) The kind of pelvis is determined by assessing

One answer only.

a) Interischial diameterb) Anteroposterior diameter of inletc) Posterior sagittal diameterd) Transverse diameter of inlet

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9) All are true about chorionic villous sampling except

One answer only.

a) It is one of the earliest methods of prenatal diagnosisb) It is associated with neural tube defects if performed before 9 weeksc) It gives quick cytogenetic results as compared to amniocentesisd) It cannot diagnose structural anomalies


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10) Quadruple test for screening of Down's syndrome assesses the levels of

One answer only.

a) hCG, estrogen, progesterone and AFPb) hCG, estrogen, inhibin A and AFPc) hCG, progesterone, inhibin A and AFPd) hCG, AFP, CA-125 and unconjugated estriol

) Amniotic fluid is maximum at

One answer only.

a) 32 - 36 weeksb) 36 - 38 weeksc) 38 - 40 weeksd) At 40 weeks

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2) Golden liquor is characteristic of

One answer only.

a) IUDb) Rh - incompatibilityc) Concealed haemorrhaged) Post maturity

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3) Icterus gravidarum can cause all except

One answer only.

a) Pruritisb) Hepatorenal syndromec) Jaundiced) Rise in serum transaminases


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4) Phenytoin intake during pregnancy is peculiarly associated with

One answer only.

a) Distal phalangeal hypoplasiab) Neural tube defectsc) Cleft lipd) Aplasia cutis

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5) In a pregnant woman with syphilis and pencillin hypersensitivity, the following drug may be given

One answer only.

a) Septranb) Ceftriaxonec) Doxycyclined) Minocycline

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6) All are true about incarcerated retroflexed gravid uterus except

One answer only.

a) Urinary retentionb) Constipationc) Anterior sacculationd) Paradoxical incontinence

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7) Therapy of choice for red degeneration of fibroid during pregnancy

One answer only.

a) GnRH analoguesb) Antibiotics


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c) Analgesicsd) Rubifacients

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8) A 26 year old woman with term gestation delivers normally and is found to have sudden breathlessness on second post partum day. Chest skiagram shows increased cardiac silhoutte. Homan's sign is negative. What is the most likely diagnosis

One answer only.

a) Pulmonary embolismb) Acute respiratory failurec) Peripartum cardiomyopathyd) DIC

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9) Transplacental transfer of HIV can take place in the following % of cases

One answer only.

a) 30%b) 40%c) 50%d) 60%

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10) The following STD is an indication of cesarean section

One answer only.

a) HSV 2b) HSV 1

c) HPVd) Condyloma acuminata

1) Pseudocyesis is associated with all except

One answer only.

a) Morning sicknessb) Bloated abdomenc) Positive urinary hCG


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d) Pica

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2) All are correct matches regarding their maximum values during normal pregnancy except

One answer only.

a) Se hCG - 10 weeksb) Se hPL - 35 weeksc) Se estriol - 35 weeksd) Se progesterone - term

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3) Hypothroidism is associated with all except

One answer only.

a) Infertilityb) Hypomenorrheac) Down's syndrome in the fetusd) Abortions

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4) Drug of choice in a pregnant woman with thyrotoxicosis is

One answer only.

a) Propylthiouracilb) Methimazole

c) Lugol's iodined) Carbimazole

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5) Gestational diabetes is not associated with

One answer only.

a) Macrosomiab) Neural tube defectsc) Altered GTTd) Hydramnios

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6) A 30 year old multigravida happens to have a +ve Pap's smear at 28 weeks of gestation. The next step in her management would be

One answer only.

a) Repeat Pap's smearb) Colposcopyc) Punch biopsy

d) Four quadrant biopsy

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7) A 25 years old primigravida reports at 6 weeks gestation with h/o seizure disorder. She has been on phenytoin for the last 6 months. The appropriate management in this case would be

One answer only.

a) Continue phenytoin and adjust the levels as per serum levelsb) Stop phenytoin and start barbituratesc) Terminate pregnancy as phenytoin has had its teratogenic effectd) Stop phenytoin and terminate pregnancy if sonography detects malformation

s.

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8) All are true about respiratory system changes during pregnancy except

One answer only.

a) Tidal volume increasesb) Total lung capacity increasesc) Residual volume decreasesd) Hyperventilation


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9) All are neonatal complications of diabetes in pregnancy except

One answer only.

a) Hypocalcemiab) Hypomagnesemiac) Hyperbilirubinemiad) hyponatremia

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10) Most common cause of death in a pregnant diabetic is

One answer only.

a) Renal failure due to chronic pyelonephritisb) Renal failure due to diabetic nephropathyc) Diabetic keto - acidosisd) Hyperosmolar coma

1) The least common vertex presentation is

One answer only.

a) LOAb) ROAc) LOPd) ROP

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2) Embryonic heart action must be seen sonographically when CRL is atleast

One answer only.

a) 2 mmb) 3 mmc) 4 mm


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d) 5 mm

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3) Nuchal thickness is a useful sonographic feature for screening of

One answer only.

a) Anencephalyb) Spina bifidac) Down's syndromed) Klinefelter's syndrome

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4) Colostrum can be expressed in a primigravida at

One answer only.

a) 6 weeksb) 12 weeksc) 16 weeksd) 20 weeks

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5) All are true about 2nd meiotic division of ovum except

One answer only.

a) It occurs on 14th day of 28 day menstrual cycleb) It follows fertilisationc) It leads to the release of 2nd polar bodyd) It is a must for further development of embryo

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6) Cytotrophoblast releases all hormones except

One answer only.


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a) hCGb) Inhibinc) Activind) GnRH

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7) An embryo acquires human form at

One answer only.

a) 6 weeksb) 8 weeksc) 12 weeksd) 16 weeks

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8) Placenta is formed by

One answer only.

a) Decidua basalis and chorion frondosumb) Decidua basalis and chorion laevec) Decidua capsularis and chorion frondosumd) Decidua vera and chorion frondosum

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9) All are true about human placenta except

One answer only.

a) Seperation line is through decidua spongiosum

b) 80% of placenta is of fetal originc) Placenta to fetal weight ratio at term is 1: 6d) Hofbauer cells constitute the endrocrinal bulk of placenta

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10) All are signs of placenta ageing except

One answer only.

a) Decreased Langhan's cellsb) Decreased syncytial thicknessc) Negative Nitabuch membraned) Rohr's striae

1) Which is not the true diameter of pelvic inlet :

One answer only.

a) AP diameterb) Oblique diameterc) Anatomical conjugated) Transverse diameter

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2) The following are true for narrow pelvic plane except :

One answer only.

a) Beginning of backward curve of pelvic axisb) Origin of levator anic) Level of 'O' stationd) Plane of internal rotation

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3) Vaginal examination can estimate all except

One answer only.

a) Obstetric conjugateb) Inter - ischial diameter

c) Transverse diameter of inletd) Subpubic angle

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4) The angle of internal rotation in direct occipito - anterior position is

One answer only.

a) 45 degrees forwardb) 135 degreesc) 0 degreesd) 45 degrees backwards

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5) The sequence of delivery of head in a normal labor is

One answer only.

a) Chin - face - brow - vertex - occiputb) Occiput - vertex - brow - face - chinc) Face - brow - vertex - occiput - chind) Vertex - brow - face - chin - occiput

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6) All are methods of intrapartum surveillance of fetus except

One answer only.

a) Fetal scalp stimulation

b) Fetal scalp blood samplingc) Fetal cord blood samplingd) Fetal electrocardiography

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7) All are true about restitution in normal labor except

One answer only.

a) It occurs after expulsion of fetal headb) It brings bisacromial diameter in the same oblique diameter of inlet as thatof engagementc) It relieves the fetal neck torsiond) It is a passive fetal movement


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8) All are signs of placental seperation except

One answer only.

a) Harder uterusb) Subpubic bulgec) True cord lengtheningd) Sudden gush of blood

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9) Brim - index of pelvis has a normal range of

One answer only.

a) 65 - 100b) 75 - 100c) 85 - 100d) 95 - 100

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10) The antero - posterior diameter of engagement of fetal skull is smallest inwhich attitude of head

One answer only.

a) Complete extensionb) Partial extensionc) Marked deflexiond) Incomplete flexion

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