NEET-PG 2015 - Obstetrics and Gynecology PYQs Practice Questions

Q: What is the cause of perihepatic fibrosis in Fitz-Hugh-Curtis syndrome?

Pelvic Inflammatory Disease. ***Pelvic Inflammatory Disease*** - Fitz-Hugh-Curtis syndrome is a complication of **Pelvic Inflammatory Disease (PID)**, where infection spreads from the pelvic organs to the liver capsule [1]. - The inflammation leads to **perihepatic fibrosis** and adhesions, often described as "violin string" adhesions [1]. *Bile Duct Injury* - **Bile duct injury** can cause inflammation and fibrosis of the liver, but it typically affects the intrahepatic or extrahepatic bile ducts directly, rather than the liver capsule. - This condition is often associated with surgical procedures or gallstones, and not directly linked to PID. *Chronic Alcoholism* - **Chronic alcoholism** is a well-known cause of liver fibrosis and cirrhosis, but it specifically damages hepatocytes and leads to diffuse scarring of the liver parenchyma. - It does not primarily cause localized perihepatic fibrosis in the manner seen in Fitz-Hugh-Curtis syndrome. *Viral Hepatitis* - **Viral hepatitis** (e.g., Hepatitis B or C) causes diffuse inflammation and fibrosis throughout the liver, leading to cirrhosis over time. - It does not typically result in the characteristic localized perihepatic adhesions of Fitz-Hugh-Curtis syndrome, which is an ascendant infection. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which drug is contraindicated before delivery of the baby (during first and second stages of labor)?

Ergometrine. ***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. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Commonest cause for puerperal sepsis is :

Streptococci. ***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. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: After taking MMR live vaccine, conception should not occur within ?

4 weeks. ***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. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which serum level is increased in premature ovarian failure?

Serum FSH. ***Serum FSH*** - In **premature ovarian failure**, the ovaries fail to produce sufficient estrogen and inhibin, leading to a loss of negative feedback on the pituitary gland. - This lack of negative feedback results in continuously **elevated levels of FSH** as the pituitary tries to stimulate the non-responsive ovaries. *Serum Inhibin* - **Inhibin** is a hormone produced by ovarian granulosa cells, which normally inhibits FSH secretion. - In premature ovarian failure, due to ovarian dysfunction, **inhibin levels are typically decreased**, not increased. *Serum Estradiol* - **Estradiol** is the primary estrogen produced by the ovaries. - In premature ovarian failure, the ovaries are failing, resulting in **decreased production of estrogen/estradiol**. *Serum Progesterone* - **Progesterone** is primarily produced after ovulation by the corpus luteum. - In premature ovarian failure, ovulation is impaired or absent, leading to **low or undetectable progesterone levels**. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

What is the cause of perihepatic fibrosis in Fitz-Hugh-Curtis syndrome?

Accepted Answer

Pelvic Inflammatory Disease

Answer

Bile Duct Injury

Answer

Chronic Alcoholism

Answer

Viral Hepatitis

Question 2

Which drug is contraindicated before delivery of the baby (during first and second stages of labor)?

Accepted Answer

Ergometrine

Answer

Mifepristone

Answer

Oxytocin

Answer

Misoprostol

Question 3

Commonest cause for puerperal sepsis is :

Accepted Answer

Streptococci

Answer

Gonococci

Answer

Staphylococci

Answer

Anaerobes

Question 4

After taking MMR live vaccine, conception should not occur within ?

Accepted Answer

4 weeks

Answer

8 weeks

Answer

2 weeks

Answer

10 weeks

Question 5

Which serum level is increased in premature ovarian failure?

Accepted Answer

Serum FSH

Answer

Serum Inhibin

Answer

Serum Estradiol

Answer

Serum Progesterone

Question 6

Most common antigen involved in erythroblastosis fetalis is:

Accepted Answer

D antigen in Rh group

Answer

C antigen in Rh group

Answer

E antigen in Rh group

Answer

Duffy antigen

Question 7

A 28-year-old primigravida with 32 weeks of gestation presents with profuse vaginal discharge since yesterday. She was advised USG, which showed a single live intrauterine gestational sac with FL and AC corresponding to the weeks of gestation and AFI as adequate. What is the diagnosis?

Accepted Answer

Normal vaginal discharge

Answer

Candidiasis

Answer

Trichomoniasis

Answer

Preterm Premature Rupture of Membranes (PPROM)

Question 8

Which of the following is NOT a cause of oligohydramnios?

Accepted Answer

Chorioangioma

Answer

Renal agenesis

Answer

Amnion nodosum

Answer

IUGR

Question 9

Contracted pelvis is defined as a condition where the dimensions of the pelvis are reduced, making childbirth difficult. What is the minimum shortening of one or more planes that is considered significant?

Accepted Answer

1.5 cm

Answer

0.5 cm

Answer

1.25 cm

Answer

1 cm

Question 10

Hydrocephalus is best detected antenatally by :

Accepted Answer

Ultrasonography

Answer

X-ray abdomen

Answer

Amniocentesis

Answer

Clinical examination

NEET-PG 2015 — Obstetrics and Gynecology