NEET-PG 2015 — Obstetrics and Gynecology
67 Previous Year Questions with Answers & Explanations
Which of the following statements about fallopian tubes is incorrect?
Which drug is contraindicated before delivery of the baby (during first and second stages of labor)?
Length of the fetus is 40 cm. What would be the age of gestation?
After taking MMR live vaccine, conception should not occur within ?
Commonest cause for puerperal sepsis is :
Where is the newborn care corner located?
IgM appears in fetus at what gestational age -
Which of the following conditions is most commonly associated with malodorous vaginal discharge?
Which of the following precancerous conditions, if treated, has the highest likelihood of not leading to cancer?
In which part of the fallopian tube is ectopic pregnancy most likely to survive longer?
NEET-PG 2015 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 1: Which of the following statements about fallopian tubes is incorrect?
- A. Lined by cuboidal epithelium (Correct Answer)
- B. Tubal ostium is the point where the tubal canal meets the peritoneal cavity
- C. Müllerian ducts develop in females into the Fallopian tubes
- D. Isthmus is the narrower part of the tube that links to the uterus
Explanation: ***Lined by cuboidal epithelium*** - The Fallopian tubes are lined by a **ciliated columnar epithelium**, not cuboidal epithelium, which aids in ovum transport. - This ciliated epithelium is critical for moving the ovum towards the uterus and for sperm transport. *Tubal ostium is the point where the tubal canal meets the peritoneal cavity* - The **tubal ostium** specifically refers to the opening of the **infundibulum** of the Fallopian tube into the **peritoneal cavity**, where it receives the ovum after ovulation. - This opening is surrounded by **fimbriae**, which are finger-like projections that help capture the ovum. *Müllerian ducts develop in females into the Fallopian tubes* - In females, the **Müllerian ducts (paramesonephric ducts)** differentiate to form the **Fallopian tubes**, uterus, cervix, and the upper two-thirds of the vagina. - This development is crucial for the formation of the female reproductive tract in the absence of Anti-Müllerian Hormone (AMH). *Isthmus is the narrower part of the tube that links to the uterus* - The **isthmus** is indeed the **narrower, muscular segment** of the Fallopian tube that connects directly to the **uterus**. - This region is characterized by its thick muscular wall and smaller lumen.
Question 2: Which drug is contraindicated before delivery of the baby (during first and second stages of labor)?
- A. Mifepristone
- B. Oxytocin
- C. Misoprostol
- D. Ergometrine (Correct Answer)
Explanation: ***Ergometrine*** - **Ergometrine** is a potent uterotonic agent that causes **tetanic (sustained) uterine contractions**. - It is **absolutely contraindicated before delivery of the baby** (during first and second stages of labor) because: - Sustained contractions lead to **fetal hypoxia** and **fetal distress** by reducing placental blood flow - Risk of **uterine rupture** due to excessive uterine tone - **Obstructed labor** and **cervical lacerations** from forcing delivery against sustained contraction - Ergometrine is **only used after delivery of the baby** in the third stage for active management and prevention of postpartum hemorrhage. *Mifepristone* - **Mifepristone** is an antiprogesterone used for medical abortion in early pregnancy or cervical ripening before labor induction. - It is not relevant during active labor as it acts by blocking progesterone receptors, not by causing immediate uterine contractions. *Oxytocin* - **Oxytocin** is the drug of choice for induction and augmentation of labor. - It causes **rhythmic, intermittent contractions** that allow for adequate placental perfusion between contractions. - Safe to use during first and second stages when properly monitored. *Misoprostol* - **Misoprostol** is a prostaglandin E1 analog used for cervical ripening and labor induction. - Can be used before and during labor for induction, though requires careful monitoring. - Unlike ergometrine, it does not cause sustained tetanic contractions when used in appropriate doses.
Question 3: Length of the fetus is 40 cm. What would be the age of gestation?
- A. 4 months
- B. 6 months
- C. 8 months (Correct Answer)
- D. 7 months
Explanation: ***8 months*** - At **8 months** of gestation (approximately **32 weeks**), the average crown-heel length of a fetus is about **40-43 cm**. - Foetal growth charts and developmental milestones indicate a close correlation between this length and the corresponding gestational age. *4 months* - At **4 months** of gestation (approximately **16 weeks**), the fetus is much smaller, typically around **12-15 cm** in crown-heel length. - Significant organ development is underway, but growth in length is not as rapid as in later trimesters. *6 months* - At **6 months** of gestation (approximately **24 weeks**), the fetus measures around **28-30 cm** in crown-heel length. - This stage is marked by significant weight gain and further development of organs, but it is still short of 40 cm. *7 months* - At **7 months** of gestation (approximately **28 weeks**), the fetus's crown-heel length is typically around **35-38 cm**. - While closer to 40 cm, it usually falls slightly short, with the average 40 cm length being more characteristic of 8 months.
Question 4: After taking MMR live vaccine, conception should not occur within ?
- A. 4 weeks (Correct Answer)
- B. 8 weeks
- C. 2 weeks
- D. 10 weeks
Explanation: ***4 weeks*** - The **MMR (measles, mumps, and rubella) vaccine** is a **live attenuated vaccine**, meaning it contains weakened forms of the viruses. - To minimize any theoretical risk of congenital rubella syndrome, women are advised to **avoid conception for at least 4 weeks** (or one month) after receiving the MMR vaccine. *2 weeks* - This period is generally considered too short for ensuring the complete clearance of the attenuated live virus from the woman's system before conception. - The standard recommendation for live attenuated vaccines like MMR is typically longer due to potential, though rare, viral transmission risks to the fetus. *8 weeks* - While a longer waiting period like 8 weeks would certainly be safe, it is **not the minimum recommended duration** by public health guidelines. - Waiting 4 weeks (one month) is sufficient and a more practical guideline for most women planning conception. *10 weeks* - This duration is significantly longer than the standard recommendation and is not necessary to ensure safety after an MMR vaccination. - The 4-week guideline balances safety with practicality for reproductive planning.
Question 5: Commonest cause for puerperal sepsis is :
- A. Gonococci
- B. Staphylococci
- C. Streptococci (Correct Answer)
- D. Anaerobes
Explanation: ***Streptococci*** - **Streptococci**, particularly **Group A Streptococcus (GAS/Streptococcus pyogenes)** and **Group B Streptococcus (GBS)**, are the **most common causative organisms** of puerperal sepsis in modern obstetric practice. - **Group A Streptococcus** causes severe, rapidly progressive puerperal sepsis with high morbidity and is the **leading bacterial cause** historically and currently. - **Group B Streptococcus** commonly colonizes the genital tract and frequently causes postpartum endometritis and sepsis. - These organisms can invade through the **placental site** and **cervical/vaginal lacerations** during delivery. *Anaerobes* - **Anaerobic bacteria** (e.g., *Bacteroides fragilis*, anaerobic streptococci) are important pathogens but typically cause **polymicrobial infections** rather than being the single most common cause. - They thrive in devitalized tissue and are often isolated **in combination with aerobic organisms**. - While significant in complicated cases, they are **not the most common single cause** in contemporary practice. *Staphylococci* - **Staphylococcus aureus** typically causes **wound infections** (cesarean section sites), **mastitis**, and occasionally toxic shock syndrome. - They are less commonly the primary cause of intrauterine puerperal sepsis compared to streptococci. *Gonococci* - **Neisseria gonorrhoeae** causes **pelvic inflammatory disease (PID)** and can lead to postpartum endometritis in untreated cases. - It is **not a common cause** of puerperal sepsis as most pregnant women are screened and treated during antenatal care. - More associated with **sexually transmitted infections** than typical postpartum infections.
Question 6: Where is the newborn care corner located?
- A. NICU
- B. OPD
- C. Labour room (Correct Answer)
- D. Wards side room
Explanation: ***Labour room*** - A **newborn care corner** is an essential facility located in the **labour room** to provide immediate care, resuscitation, and stabilization for newborns right after birth. - This setup ensures that critical interventions like **drying**, **warming**, **suctioning**, and initiation of **ventilation** can be performed promptly, improving neonatal outcomes. *NICU* - The **NICU (Neonatal Intensive Care Unit)** is for sick or premature newborns requiring intensive medical care, not the initial care at birth for all newborns. - While newborns from the labour room may be transferred to the NICU if they require specialized care, the initial care corner is distinct. *OPD* - **OPD (Outpatient Department)** is for patients seeking consultation without admission, and is not equipped or intended for immediate newborn care. - Newborns are brought to OPD for follow-up visits or routine check-ups much later, not immediately after birth. *Wards side room* - A **ward side room** is part of a general hospital ward, usually for inpatient care, and is not specifically designed or staffed for the initial, immediate care of a newborn at the moment of delivery. - While mothers and newborns may be transferred to a ward side room after stabilization, it's not where delivery and immediate postnatal care occur.
Question 7: IgM appears in fetus at what gestational age -
- A. 10 weeks
- B. 20 weeks (Correct Answer)
- C. 30 weeks
- D. at birth
Explanation: ***20 weeks*** - The fetal immune system begins to develop around **20 weeks of gestation**, at which point the fetus starts producing its own **IgM antibodies**. - **IgM** is the first antibody isotype produced by the developing fetal **B lymphocytes** and is important for early immune responses. *10 weeks* - While some components of the immune system may start to differentiate earlier, **IgM production** at a functional level is not yet established at **10 weeks of gestation**. - At this early stage, the fetal immune system is still primarily in its **developmental phase**, with major organogenesis occurring. *30 weeks* - By **30 weeks**, the fetus has already been producing IgM for several weeks, and the immune system is more mature, capable of a more robust **antibody response**. - While **IgG** levels are significantly increasing due to maternal transfer at this stage, **IgM production** began earlier. *at birth* - At birth, a neonate has circulating **IgM antibodies**, which are indicative of prior fetal immune activation and are measurable in umbilical cord blood. - However, the initial production of **fetal IgM** occurs much earlier in gestation, not at the time of birth.
Question 8: Which of the following conditions is most commonly associated with malodorous vaginal discharge?
- A. Bacterial vaginosis (Correct Answer)
- B. Chlamydia trachomatis
- C. Trichomonas vaginalis
- D. Neisseria gonorrhoeae
Explanation: ***Bacterial vaginosis*** - This condition is characterized by a "fishy" or **malodorous vaginal discharge**, particularly noticeable after intercourse due to the release of amines. - It results from an imbalance in the vaginal flora, with an overgrowth of anaerobic bacteria and a decrease in protective lactobacilli. *Chlamydia trachomatis* - Often presents with **asymptomatic cervicitis** or mild watery discharge; **malodorous discharge** is not a common or prominent symptom. - While it can cause pelvic pain or dysuria, it's not typically associated with the characteristic smell of bacterial vaginosis. *Trichomonas vaginalis* - Can cause a **frothy, yellow-green discharge** that may be malodorous, but the "fishy" odor is more classically associated with bacterial vaginosis. - Other common symptoms include intense itching, burning, and dyspareunia. *Neisseria gonorrhoeae* - Causes cervicitis, which can lead to a **purulent or mucopurulent vaginal discharge**, but it does not typically produce the distinctive malodor seen in bacterial vaginosis. - Infection can also manifest as dysuria, pelvic pain, or be asymptomatic.
Question 9: Which of the following precancerous conditions, if treated, has the highest likelihood of not leading to cancer?
- A. Cervical intraepithelial Neoplasia (Correct Answer)
- B. Ductal carcinoma in situ of breast
- C. Lobular carcinoma in situ of breast
- D. Vaginal intraepithelial neoplasia
Explanation: ***Cervical intraepithelial neoplasia (CIN)*** - CIN has a high success rate with treatment (e.g., **cryotherapy**, **LEEP**), often completely eradicating the dysplastic cells and preventing progression to **invasive cervical cancer**. - The effectiveness of screening via **Pap smears** allows for early detection and intervention, significantly reducing cancer risk. *Ductal carcinoma in situ (DCIS) of breast* - While treatable, DCIS carries a higher risk of recurrence and progression to **invasive breast cancer** in the same or contralateral breast compared to CIN. - Treatment often involves **lumpectomy** with or without radiation, and sometimes **total mastectomy**, reflecting its more serious potential. *Lobular carcinoma in situ (LCIS) of breast* - LCIS is largely considered a **risk indicator** for future invasive cancer in either breast, rather than a direct precursor that inevitably progresses. - Management often involves **close surveillance** or **chemoprevention**, as surgical excision does not prevent cancer development in other areas of the breast. *Vaginal intraepithelial neoplasia (VAIN)* - While treatable, VAIN is less common and often coexists with or follows **cervical or vulvar neoplasia**, indicating a broader field defect due to **HPV**. - Recurrence rates post-treatment can be significant, and patients often require long-term follow-up due to the continued risk of progression.
Question 10: In which part of the fallopian tube is ectopic pregnancy most likely to survive longer?
- A. Isthmus
- B. Ampulla
- C. Cornua
- D. Interstitial (Correct Answer)
Explanation: ***Interstitial*** - An **interstitial (intramural) pregnancy** occurs in the portion of the fallopian tube that passes through the muscular wall of the uterus, known as the **cornua**. This position allows for a larger and more distensible space, potentially accommodating the pregnancy for a longer duration before rupture. - The surrounding **myometrial tissue** can provide a temporary blood supply and structural support, leading to later presentation (often up to 12-16 weeks) and often more significant hemorrhage upon rupture due to the rich vascularization of the uterine wall. - Interstitial pregnancies account for approximately 2-4% of all ectopic pregnancies but have a higher mortality rate due to massive hemorrhage when rupture occurs. *Isthmus* - The **isthmus** is the narrowest part of the fallopian tube, making it less accommodating for an ectopic pregnancy. - Pregnancies here tend to rupture earlier (typically by 6-8 weeks) due to limited space and thinner muscular walls. - Accounts for approximately 12% of tubal ectopic pregnancies. *Ampulla* - The **ampulla** is the most common site for ectopic pregnancies (approximately 70-80%), but pregnancies here typically rupture earlier than interstitial ones (usually by 8-12 weeks). - While wider than the isthmus, it lacks the substantial myometrial support of the interstitial portion. - The ampullary wall is thin and distensible but cannot sustain pregnancy as long as the interstitial portion. *Cornua* - While the interstitial part of the tube is located within the uterine wall (cornua), \"cornua\" itself refers to the upper angles of the uterus where the fallopian tubes enter. - The term **\"cornual pregnancy\"** is sometimes used interchangeably with **\"interstitial pregnancy,\"** though some authorities distinguish between them based on precise location. - Without the specific context of \"interstitial,\" this option is less precise in identifying the segment of the fallopian tube associated with prolonged survival.