FMGE 2021 — OB/GYN

Q: A 27-year-old woman presented with a malodorous discharge in the vagina which started a week earlier. On examination, Whiff's test is positive and the gram stain shows the presence of clue cells. This infection is commonly treated with which of the following?

Metronidazole. ***Metronidazole*** - This patient's symptoms (malodorous vaginal discharge, positive **Whiff test**, and presence of **clue cells** on Gram stain) are classic findings for **bacterial vaginosis (BV)**. - **Metronidazole** is the first-line and most effective antibiotic for treating bacterial vaginosis, as it targets the anaerobic bacteria overgrowing in the vagina. *Azithromycin* - **Azithromycin** is primarily used to treat infections like **chlamydia**, gonorrhea, or some respiratory tract infections. - It is **not effective** against the anaerobic bacteria responsible for bacterial vaginosis. *Nystatin pessary* - **Nystatin** is an **antifungal medication** specifically used to treat **vulvovaginal candidiasis (yeast infection)**. - The patient's presentation (malodorous discharge, positive Whiff test, clue cells) does not align with a yeast infection, making nystatin ineffective. *Tetracycline* - **Tetracycline** is a broad-spectrum antibiotic, but it is **not the preferred treatment** for bacterial vaginosis. - Its use is often associated with a higher risk of side effects and is typically reserved for other bacterial infections like **chlamydia**, acne, or Rocky Mountain spotted fever. [Practice more OB/GYN PYQs on OnCourse]

Q: Which is correct about ABO and Rh incompatibility leading to Erythroblastosis fetalis?

Cytotoxic. ***Cytotoxic*** - **Erythroblastosis fetalis** involves maternal antibodies (IgG) crossing the placenta and binding to fetal red blood cell antigens, leading to **complement-mediated lysis** of fetal red blood cells. - This is a classic example of a **Type II hypersensitivity reaction**, characterized by antibody-mediated cell destruction. *Cell mediated hypersensitivity* - This refers to **Type IV hypersensitivity reactions**, which involve T lymphocytes and macrophages, not antibodies. - Examples include **contact dermatitis** and **tuberculosis skin tests**. *Immune complex* - This describes **Type III hypersensitivity reactions**, where antigen-antibody complexes form and deposit in tissues, leading to inflammation. - Conditions like **serum sickness** and **lupus nephritis** are examples of immune complex diseases. *Antigen-antibody reaction* - While present, this option is too broad; all hypersensitivity reactions involve some form of antigen-antibody (or antigen-T cell) interaction. - It does not specifically describe the **mechanisms of tissue damage** or the **type of hypersensitivity** involved in erythroblastosis fetalis. [Practice more OB/GYN PYQs on OnCourse]

2 Previous Year Questions with Answers & Explanations

Questions

All Subjects Community Medicine (1)Internal Medicine (2)OB/GYN (2)Patient Safety (1)Pediatrics (1)Pharmacology (1)Psychiatry (3)Surgery (1)

A 27-year-old woman presented with a malodorous discharge in the vagina which started a week earlier. On examination, Whiff's test is positive and the gram stain shows the presence of clue cells. This infection is commonly treated with which of the following?

Which is correct about ABO and Rh incompatibility leading to Erythroblastosis fetalis?

FMGE 2021 - OB/GYN FMGE Practice Questions and MCQs

Question 1: A 27-year-old woman presented with a malodorous discharge in the vagina which started a week earlier. On examination, Whiff's test is positive and the gram stain shows the presence of clue cells. This infection is commonly treated with which of the following?

A. Metronidazole (Correct Answer)
B. Azithromycin
C. Nystatin pessary
D. Tetracycline

Explanation: ***Metronidazole*** - This patient's symptoms (malodorous vaginal discharge, positive **Whiff test**, and presence of **clue cells** on Gram stain) are classic findings for **bacterial vaginosis (BV)**. - **Metronidazole** is the first-line and most effective antibiotic for treating bacterial vaginosis, as it targets the anaerobic bacteria overgrowing in the vagina. *Azithromycin* - **Azithromycin** is primarily used to treat infections like **chlamydia**, gonorrhea, or some respiratory tract infections. - It is **not effective** against the anaerobic bacteria responsible for bacterial vaginosis. *Nystatin pessary* - **Nystatin** is an **antifungal medication** specifically used to treat **vulvovaginal candidiasis (yeast infection)**. - The patient's presentation (malodorous discharge, positive Whiff test, clue cells) does not align with a yeast infection, making nystatin ineffective. *Tetracycline* - **Tetracycline** is a broad-spectrum antibiotic, but it is **not the preferred treatment** for bacterial vaginosis. - Its use is often associated with a higher risk of side effects and is typically reserved for other bacterial infections like **chlamydia**, acne, or Rocky Mountain spotted fever.

Question 2: Which is correct about ABO and Rh incompatibility leading to Erythroblastosis fetalis?

A. Cell mediated hypersensitivity
B. Immune complex
C. Antigen-antibody reaction
D. Cytotoxic (Correct Answer)

Explanation: ***Cytotoxic*** - **Erythroblastosis fetalis** involves maternal antibodies (IgG) crossing the placenta and binding to fetal red blood cell antigens, leading to **complement-mediated lysis** of fetal red blood cells. - This is a classic example of a **Type II hypersensitivity reaction**, characterized by antibody-mediated cell destruction. *Cell mediated hypersensitivity* - This refers to **Type IV hypersensitivity reactions**, which involve T lymphocytes and macrophages, not antibodies. - Examples include **contact dermatitis** and **tuberculosis skin tests**. *Immune complex* - This describes **Type III hypersensitivity reactions**, where antigen-antibody complexes form and deposit in tissues, leading to inflammation. - Conditions like **serum sickness** and **lupus nephritis** are examples of immune complex diseases. *Antigen-antibody reaction* - While present, this option is too broad; all hypersensitivity reactions involve some form of antigen-antibody (or antigen-T cell) interaction. - It does not specifically describe the **mechanisms of tissue damage** or the **type of hypersensitivity** involved in erythroblastosis fetalis.