Adolescent Sexuality Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Adolescent Sexuality. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Adolescent Sexuality Indian Medical PG Question 1: Transmission assessment survey (TAS) is done for which of the following purposes?
- A. To provide reliable estimates of birth rate, death rate and infant mortality rate
- B. For assessing primary immunization coverage
- C. All of the options
- D. To determine when infections have been reduced below target transmission thresholds (Correct Answer)
Adolescent Sexuality Explanation: ***To determine when infections have been reduced below these target thresholds***
- **Transmission assessment surveys (TAS)** are specifically designed to evaluate if the prevalence of a **neglected tropical disease (NTD)**, such as **lymphatic filariasis** or **trachoma**, has fallen below a critical threshold.
- This assessment is crucial for determining whether to **stop mass drug administration (MDA)** campaigns and move towards post-MDA surveillance.
*To provide reliable estimates of birth rate, death rate and infant mortality rate*
- This function is typically associated with **demographic and health surveys (DHS)** or national vital statistics registration systems, not TAS.
- These surveys focus on population-level health indicators and cannot determine infectious disease transmission levels.
*For assessing primary immunization coverage*
- Immunization coverage is assessed through specific **immunization coverage surveys (ICS)** or analysis of routine administrative data.
- TAS is designed for infectious disease transmission, not vaccine uptake.
*All of the options*
- Only the first option accurately describes the specific purpose of a **Transmission Assessment Survey (TAS)**.
- The other options relate to different types of public health surveys with distinct objectives.
Adolescent Sexuality Indian Medical PG Question 2: A male with hyperpigmentation tanner stage 5 presents with hypertension & precocious puberty. The causative defect is:
- A. 17 alpha hydroxylase deficiency
- B. 17 beta hydroxylase deficiency
- C. 11 beta hydroxylase deficiency (Correct Answer)
- D. 21 beta hydroxylase deficiency
Adolescent Sexuality Explanation: ***11 beta hydroxylase deficiency***
- This deficiency leads to an accumulation of **11-deoxycortisol** and **deoxycorticosterone (DOC)**, a potent mineralocorticoid [1].
- **DOC excess** causes **hypertension** and **hypokalemia**, while the shunting of precursors to the androgen pathway results in **precocious puberty** in males and virilization in females, along with **hyperpigmentation** due to increased ACTH [1].
*17 alpha hydroxylase deficiency*
- This deficiency impairs the synthesis of **cortisol** and **sex steroids**, leading to an accumulation of **mineralocorticoid precursors (DOC and corticosterone)**.
- Patients typically present with **hypertension**, **hypokalemia**, and **absent or rudimentary secondary sexual characteristics** (delayed puberty/sexual infantilism) due to the lack of androgens/estrogens, not precocious puberty.
*17 beta hydroxylase deficiency*
- This enzyme is crucial for the final step in sex steroid synthesis (e.g., testosterone from androstenedione).
- A deficiency would lead to **impaired sexual development** and **ambiguous genitalia or undervirilization** in males, along with delayed puberty, completely contradictory to precocious puberty.
*21 beta hydroxylase deficiency*
- This is the **most common cause of congenital adrenal hyperplasia (CAH)**, leading to a profound deficiency in cortisol and aldosterone, and an excess in androgens [1].
- Patients typically present with **salt-wasting crises** (due to aldosterone deficiency) or **virilization** (due to androgen excess), but usually **hypotension** (due to salt wasting) or normal blood pressure, not hypertension alongside precocious puberty in this specific manner [1].
Adolescent Sexuality Indian Medical PG Question 3: A 25-year-old woman presents with vaginal discharge and vulvovaginal irritation. Wet mount shows motile trichomonads. She mentions having a similar infection 2 months ago treated with single-dose metronidazole. What is the most likely explanation for her current infection?
- A. Concurrent bacterial vaginosis
- B. Reinfection from untreated partner (Correct Answer)
- C. Metronidazole resistance
- D. Inadequate initial therapy
Adolescent Sexuality Explanation: ***Reinfection from untreated partner***
- **Trichomoniasis** is a sexually transmitted infection, and treatment of only one partner often leads to **reinfection** from the untreated partner.
- The recurrence of symptoms within a short period (2 months) after successful treatment strongly suggests exposure to the pathogen again.
*Concurrent bacterial vaginosis*
- While **bacterial vaginosis** can cause discharge, it is a different infection, and its presence does not explain the recurrence of **trichomonads** found on the wet mount.
- Co-occurrence is possible, but it doesn't account for the re-emergence of the *Trichomonas* organism.
*Metronidazole resistance*
- **Metronidazole resistance** in *Trichomonas vaginalis* is rare, especially after an initial successful treatment with a single dose.
- Resistance is usually suspected if symptoms persist *despite* adequate treatment, rather than recurring after a period of being symptom-free.
*Inadequate initial therapy*
- A single-dose regimen of **metronidazole** is typically an effective and standard treatment for trichomoniasis.
- If the initial treatment was truly inadequate, symptoms would likely have persisted or returned much sooner, rather than appearing 2 months later.
Adolescent Sexuality Indian Medical PG Question 4: The contraceptive which is contraindicated in DVT is?
- A. Barrier method
- B. Non hormonal IUCD
- C. Billing's method
- D. OCP (Correct Answer)
Adolescent Sexuality Explanation: ***OCP***
- **Oral contraceptive pills (OCPs)**, especially those containing estrogen, increase the risk of **venous thromboembolism (VTE)**, including deep vein thrombosis (DVT).
- Estrogen promotes a **hypercoagulable state** by increasing clotting factors and decreasing natural anticoagulants.
*Barrier method*
- **Barrier methods** like condoms or diaphragms are non-hormonal and act physically to prevent sperm from reaching the egg.
- They have **no systemic effects** on coagulation and are safe for individuals with DVT.
*Non hormonal IUCD*
- **Non-hormonal intrauterine contraceptive devices (IUCDs)**, such as copper IUCDs, prevent conception primarily by causing a local inflammatory reaction in the uterus.
- They do not release hormones and therefore **do not affect coagulation** or increase DVT risk.
*Billing's method*
- The **Billing's ovulation method** (cervical mucus method) is a natural family planning technique based on observing changes in cervical mucus.
- It involves no medications or devices and thus has **no impact on DVT risk**.
Adolescent Sexuality Indian Medical PG Question 5: Delayed puberty in a female is characterized by which of the following?
- A. Menarche > 16 year (Correct Answer)
- B. FSH < 20 in 16 year
- C. Menarche occurring more than 1 year after breast budding
- D. No breast budding by age 10
Adolescent Sexuality Explanation: ***Menarche > 16 year***
- Delayed puberty is defined as the **absence of menarche by 16 years of age**, or the absence of any secondary sexual characteristics by age 13.
- This option correctly identifies one of the key diagnostic criteria for delayed puberty in females.
*No breast budding by age 10*
- This is incorrect; the absence of **breast budding by age 13** is the accepted cutoff for delayed puberty.
- Breast development typically begins between ages 8 and 13.
*Menarche occurring more than 1 year after breast budding*
- This is incorrect; menarche typically occurs within **2 to 3 years** of breast development. A delay of merely one year following breast budding is usually within normal limits.
*FSH < 20 in 16 year*
- This statement itself does not definitively characterize delayed puberty and requires more context. A **low Follicle-Stimulating Hormone (FSH)** level in a 16-year-old with delayed puberty would suggest a **hypogonadotropic hypogonadism**, whereas high FSH levels would indicate **hypergonadotropic hypogonadism** (e.g., primary ovarian failure).
- The threshold of FSH < 20 is not a universal or standalone diagnostic criterion for delayed puberty.
Adolescent Sexuality Indian Medical PG Question 6: Which of the following is not a long-acting reversible contraceptive method?
- A. Combined oral contraceptives (Correct Answer)
- B. Implanon
- C. Copper T
- D. Depo-Provera injection
Adolescent Sexuality Explanation: ***Combined oral contraceptives***
- While effective, **combined oral contraceptives** require daily adherence and are not typically classified as long-acting due to their need for frequent, consistent administration.
- Their mechanism involves **exogenous hormones** that suppress ovulation and thicken cervical mucus, but their contraceptive effect relies on continuous daily intake.
*Implanon*
- **Implanon** (etonogestrel implant) is a **subdermal contraceptive implant** that provides effective contraception for up to three years.
- It works by slowly releasing progestin, making it a **long-acting reversible contraceptive (LARC)**.
*Copper T*
- The **Copper T intrauterine device (IUD)** is a non-hormonal LARC that can prevent pregnancy for **up to 10 years**.
- It acts by creating an inflammatory reaction in the uterus that is toxic to sperm and eggs, preventing fertilization.
*Depo-Provera injection*
- The **Depo-Provera injection** (medroxyprogesterone acetate) is a progestin-only contraceptive given every **3 months**.
- While it offers extended protection, it is **not universally classified as a LARC** by major guidelines (WHO, ACOG, CDC), which typically reserve this designation for IUDs and implants that do not require regular clinic visits.
Adolescent Sexuality Indian Medical PG Question 7: A 14-year-old victim of sexual assault with 22 weeks gestation has been brought for Medical Termination of Pregnancy (MTP). Which of the following statements is true?
- A. One doctor is involved
- B. MTP done in 2nd trimester only when mother's life is in danger
- C. MTP can be carried out up to 24 weeks (Correct Answer)
- D. MTP cannot be more than 20 weeks
Adolescent Sexuality Explanation: ***MTP can be carried out up to 24 weeks***
- The **Medical Termination of Pregnancy (Amendment) Act, 2021**, allows termination of pregnancy up to **24 weeks** for certain vulnerable groups, including survivors of sexual assault and minors.
- As a 14-year-old victim of sexual assault, she falls under the category which permits MTP up to 24 weeks.
*One doctor is involved*
- For pregnancies between 12 and 20 weeks, the opinion of **two registered medical practitioners** is required for MTP.
- Beyond 20 weeks up to 24 weeks, as in this case, the opinion of **two registered medical practitioners** is also mandatory.
*MTP done in 2nd trimester only when mother's life is in danger*
- While danger to the mother's life is a valid reason for MTP, the **MTP Act 2021** has expanded the grounds for MTP in the second trimester (beyond 12 weeks) to include other categories like **sexual assault survivors** and **minors**, even if the mother's life is not immediately in danger.
- The primary consideration here is the **vulnerability** of the pregnant person, not solely imminent danger to life.
*MTP cannot be more than 20 weeks*
- This statement is incorrect as per the **Medical Termination of Pregnancy (Amendment) Act, 2021**.
- The Act raised the upper gestation limit from 20 to **24 weeks** for specific categories of women, including victims of sexual assault and minors, aligning with the current case.
Adolescent Sexuality Indian Medical PG Question 8: A sexually active 16-year-old presents for STI screening with recent assault history, multiple partners, inconsistent condom use. Which comprehensive prevention strategy is most appropriate?
- A. HPV vaccination, counseling, PrEP evaluation, and regular screening (Correct Answer)
- B. Condoms and annual screening
- C. Single STI screen and treatment if needed
- D. Abstinence counseling only
Adolescent Sexuality Explanation: ***HPV vaccination, counseling, PrEP evaluation, and regular screening***
- This option offers a **comprehensive approach** addressing multiple risk factors and potential exposures, including **vaccination** for HPV, **counseling** for risk reduction, **PrEP evaluation** for HIV prevention due to multiple partners and inconsistent condom use, and **regular screening** for early detection.
- The patient's history of **sexual assault**, **multiple partners**, and **inconsistent condom use** necessitates a multi-faceted prevention strategy that goes beyond basic screening.
*Condoms and annual screening*
- While **condoms** are essential for preventing STIs, and **annual screening** is important, this strategy is not comprehensive enough given the patient's high-risk profile (multiple partners, inconsistent condom use, sexual assault history).
- It omits important preventive measures like **HPV vaccination** and consideration for **PrEP**, which are crucial for this patient's age and risk factors.
*Single STI screen and treatment if needed*
- A **single STI screen** is insufficient as it only provides a snapshot of current infections and does not incorporate **prevention strategies** for future encounters or address the ongoing risk factors.
- This approach fails to provide **proactive protection** through vaccination or PrEP and does not include ongoing counseling for risk reduction.
*Abstinence counseling only*
- While **abstinence** is the most effective way to prevent STIs, relying solely on **abstinence counseling** is often unrealistic and insufficient for a sexually active individual, especially one with a history of sexual assault and current high-risk behaviors.
- This option completely disregards the need for **medical interventions** like vaccination, PrEP, and regular screening that are vital for this patient's health.
Adolescent Sexuality Indian Medical PG Question 9: What is the preferred method of contraception for a female with a family history of ovarian cancer?
- A. Progestin-only pills (POP)
- B. Copper intrauterine device (Cu IUCD)
- C. Condoms
- D. Combined oral contraceptive pills (OCP) (Correct Answer)
Adolescent Sexuality Explanation: ***Combined oral contraceptive pills (OCP)***
- **OCPs** have been shown to significantly **reduce the risk of ovarian cancer by 30-50%**, with the protective effect increasing with duration of use.
- This protection is attributed to **suppression of ovulation**, reducing repetitive ovulation-related epithelial damage and inflammation that contributes to ovarian cancer development.
- The benefit **persists for years after discontinuation** and is particularly important for individuals with a family history of ovarian cancer, as it addresses a key modifiable risk factor.
- **First-line recommendation** for contraception in women with family history of ovarian cancer.
*Progestin-only pills (POP)*
- While **POPs** are effective contraceptives and generally safe, they do **not offer the same well-established protective effect against ovarian cancer** as combined hormonal contraceptives.
- Their primary mechanism is through thickening cervical mucus and suppressing ovulation, without the estrogen component.
- Evidence for ovarian cancer protection is limited compared to combined OCPs.
*Copper intrauterine device (Cu IUCD)*
- The **Cu IUCD** provides highly effective contraception by creating a local inflammatory response in the uterus that is spermicidal.
- It is a **non-hormonal method** and therefore does not impact the risk of ovarian cancer.
- Excellent contraceptive option for other indications, but not specifically protective against ovarian cancer.
*Condoms*
- **Condoms** primarily prevent pregnancy by blocking sperm from reaching the egg and are effective in preventing sexually transmitted infections.
- They are a **barrier method** and provide no hormonal protection against ovarian cancer.
- Useful for STI prevention but not relevant to ovarian cancer risk reduction.
Adolescent Sexuality Indian Medical PG Question 10: What is the age range of adolescence?
- A. 10-14 years
- B. 6-10 years
- C. 14-20 years
- D. 10-19 years (Correct Answer)
Adolescent Sexuality Explanation: ***10-19 years***
- This is the **universally accepted definition of adolescence** by the **World Health Organization (WHO)**, which is the international standard used globally for medical education and practice.
- This range encompasses all three stages: **early adolescence (10-13 years)**, **middle adolescence (14-16 years)**, and **late adolescence (17-19 years)**.
- It captures the complete spectrum of **pubertal development, physical maturation, cognitive development, and psychosocial changes** characteristic of adolescence.
- Recognized by major pediatric bodies including the **Indian Academy of Pediatrics (IAP)**, **UNICEF**, and **American Academy of Pediatrics (AAP)**.
*14-20 years*
- This range excludes **early adolescence (10-13 years)**, missing the critical onset of puberty and early developmental changes.
- While it extends to 20 years, it omits a significant portion of the adolescent period recognized by WHO.
- Not a standard medical definition used in pediatric practice or competitive examinations.
*10-14 years*
- This represents only **early adolescence**, not the complete age range.
- Misses middle and late adolescence, which are crucial periods for identity formation and psychosocial development.
- Too narrow to be considered the full adolescent period.
*6-10 years*
- This age range corresponds to **middle childhood**, not adolescence.
- Occurs before the onset of puberty and the hormonal changes that define adolescence.
- Children in this stage are in the **concrete operational stage** of cognitive development, distinct from adolescent development.
More Adolescent Sexuality Indian Medical PG questions available in the OnCourse app. Practice MCQs, flashcards, and get detailed explanations.
