INI-CET 2022 - Obstetrics and Gynecology PYQs Practice Questions

Q: The following cost-effective investigations are routinely recommended in the screening of antenatal mothers, EXCEPT:

Echocardiography for cardiac disease. ***Echocardiography for cardiac disease*** - **Echocardiography** is not a *routinely recommended* screening investigation for all antenatal mothers due to its cost and the relatively low prevalence of significant congenital heart disease requiring universal screening. - It is typically performed only if there are **specific risk factors** or suspicious findings suggesting cardiac pathology. *Blood sugar levels for GDM* - Screening for **gestational diabetes mellitus (GDM)** with blood sugar levels (e.g., glucose challenge test) is routinely recommended due to the potential maternal and fetal complications if untreated. - GDM is a common condition that can be effectively managed with early diagnosis, making screening a **cost-effective** preventive measure. *VDRL for syphilis* - Screening for **syphilis** using tests like VDRL (Venereal Disease Research Laboratory) is a standard and *routinely recommended* antenatal investigation. - Early detection and treatment of syphilis in pregnant women prevent serious adverse outcomes such as **congenital syphilis**, which can cause severe fetal morbidity and mortality. *Urine analysis for bacteriuria* - **Urine analysis** for **asymptomatic bacteriuria** is routinely recommended during pregnancy because untreated bacteriuria can lead to pyelonephritis, preterm labor, and low birth weight. - It is a simple, **cost-effective** test with significant benefits for maternal and fetal health. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Kassowitz rule is related to:

Congenital syphilis. ***Congenital syphilis*** - The **Kassowitz rule** specifically describes the high rate of perinatal mortality (abortion, stillbirth, or death shortly after birth) in cases of untreated maternal syphilis, especially during early stages of infection. - It highlights that the risk is highest when the mother acquires syphilis shortly before or during pregnancy, leading to severe fetal disease. *Primary syphilis* - This stage is characterized by a **chancre** at the site of infection and is the initial presentation in the infected individual, not directly related to fetal outcomes. - While primary syphilis in the mother can lead to congenital syphilis, the Kassowitz rule itself describes the outcome of congenital infection, not the primary infection in the mother. *Latent syphilis* - **Latent syphilis** refers to a stage where the infection is present but asymptomatic, potentially for years. - While it can be transmitted vertically and lead to congenital syphilis, the Kassowitz rule specifically quantifies the mortality risk of congenital syphilis, not the mother's latent infection itself. *Secondary syphilis* - This stage involves a systemic rash and other widespread symptoms in the infected individual, appearing weeks to months after the chancre. - Though highly infectious and a significant risk for vertical transmission, the rule focuses on the severe consequences *for the fetus* when congenital syphilis occurs, not the symptoms of secondary syphilis in the mother. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which hormone is secreted by the placenta?

hCG. ***hCG*** - **Human Chorionic Gonadotropin (hCG)** is produced by the **syncytiotrophoblast** of the placenta shortly after implantation. - Its primary role is to maintain the **corpus luteum**, ensuring continued production of **progesterone** to support the pregnancy. *GnRH* - **Gonadotropin-releasing hormone (GnRH)** is secreted by the **hypothalamus** in the brain, not the placenta. - It stimulates the pituitary gland to release FSH and LH. *FSH* - **Follicle-stimulating hormone (FSH)** is produced by the **anterior pituitary gland**. - It plays a crucial role in ovarian follicular development in females and spermatogenesis in males. *LH* - **Luteinizing hormone (LH)** is also secreted by the **anterior pituitary gland**. - Its functions include triggering ovulation in females and stimulating testosterone production in males. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

Which of the following is not true about lupus nephritis in pregnancy?

Accepted Answer

Ecosprin, methotrexate, cyclophosphamide, corticosteroids, azathioprine are safe in pregnancy

Answer

Pregnancy to be planned once the disease has been quiescent for at least 6 months and there is no evidence of renal dysfunction

Answer

High dose corticosteroids for lupus flare in pregnancy is safe

Answer

Immunosuppression can be continued during pregnancy

Question 2

Which of the following is false regarding management of diabetes in pregnancy?

Accepted Answer

Elective C-section has no role in reducing incidence of brachial plexus injury

Answer

In active labor, if RBS <70 mg/dL, D5 is started at 100-150 ml/hr till the RBS is >70 mg/dL

Answer

In a patient being planned for induction of labor, night dose of intermediate insulin is given as planned, and the morning dose is withheld

Answer

Capillary blood glucose monitoring levels are kept at fasting- 95 mg/dL; 1 hr postprandial- 140 mg/dL; 2 hrs postprandial- 120 mg/dL

Question 3

The following cost-effective investigations are routinely recommended in the screening of antenatal mothers, EXCEPT:

Accepted Answer

Echocardiography for cardiac disease

Answer

Blood sugar levels for GDM

Answer

VDRL for syphilis

Answer

Urine analysis for bacteriuria

Question 4

Kassowitz rule is related to:

Accepted Answer

Congenital syphilis

Answer

Primary syphilis

Answer

Latent syphilis

Answer

Secondary syphilis

Question 5

Which hormone is secreted by the placenta?

Accepted Answer

hCG

Answer

GnRH

Answer

FSH

Answer

LH

Question 6

A 37-year-old unmarried nulliparous woman, having regular intercourse, is on oral contraceptive pills. Her mother was diagnosed with carcinoma breast at 60 years of age, and her elder sister was diagnosed with carcinoma ovary at 40 years of age. What is the next line of management?

Accepted Answer

Genetic counseling and screening for BRCA

Answer

Prophylactic surgery

Answer

Stop taking oral contraceptive pills

Answer

Routine mammography

Question 7

The given image depicts:

Accepted Answer

Both succenturiate lobe and velamentous insertion

Answer

Normal placenta

Answer

Succenturiate lobe

Answer

Velamentous insertion of the cord

Question 8

All of the following can be used in first-trimester medical termination of pregnancy (MTP), except

Accepted Answer

Extra-amniotic instillation of ethacridine lactate

Answer

Manual vacuum aspiration

Answer

Dilatation and curettage

Answer

Mifepristone + misoprostol

Question 9

A woman with eclampsia is started on magnesium sulfate. What is the first sign of magnesium sulfate toxicity?

Accepted Answer

Loss of knee jerk

Answer

Respiratory depression

Answer

Hypotension

Answer

Reduced muscle tone

Question 10

What is the age group distribution for vulval cancer?

Accepted Answer

Both age groups (35-55 and 65-85 years)

Answer

65-85 years

Answer

35-55 years

Answer

Not age specific

INI-CET 2022 — Obstetrics and Gynecology