NEET-PG 2023 - Obstetrics and Gynecology Practice Questions

Q: In your STI clinic, standardized treatment kits are available for different conditions based on clinical presentation and likely pathogens. A 22-year-old female comes to the STI clinic with minimal vaginal discharge. On speculum examination, erosions are seen on the cervix. Which of the following treatment kit should be given to this patient?

Grey. ***Grey*** - A grey kit is indicated for **vaginal discharge** with associated **cervical erosions**, suggesting a treatable bacterial STI like gonorrhea or chlamydia. This kit typically contains antibiotics effective against these pathogens. - The presence of **minimal vaginal discharge** combined with **cervical erosions** points towards cervicitis, for which the grey kit is specifically designed. *Green* - The green kit is typically for the treatment of **vaginal discharge** without specific signs of cervicitis, often targeting common causes like **bacterial vaginosis** or **trichomoniasis**. - It would not specifically address the **cervical erosions** seen in this patient, which are more indicative of cervicitis. *Red* - The red kit is generally used for the treatment of **genital ulcers**, which are typically caused by **herpes simplex virus** or **syphilis**. - While there are erosions, the primary complaint is discharge, and erosions are not typically the sole indicator for a "genital ulcer" kit. *Yellow* - The yellow kit is often designated for **urethral discharge** in males, addressing conditions like **gonorrhea** or **chlamydia** when presenting as urethritis. - This patient is female and presents with **vaginal discharge** and **cervical erosions**, making the yellow kit inappropriate.

Q: A 29-year-old primigravida presents at 36 weeks of gestation with a transverse lie. What is the recommended management?

Schedule cesarean delivery. ***Schedule cesarean delivery*** - A persistent **transverse lie** at 36 weeks makes vaginal delivery impossible and requires definitive management. - **Cesarean delivery** is the definitive and safest option for ensuring maternal and fetal well-being when the transverse lie persists. - While external cephalic version may be attempted first, if unsuccessful, contraindicated, or the lie remains transverse near term, cesarean section is mandatory. - Attempting vaginal delivery with transverse lie risks **cord prolapse**, **uterine rupture**, and **obstructed labor**. *Induce labor* - Inducing labor with a transverse lie is **absolutely contraindicated** due to impossibility of vaginal delivery. - The fetal shoulder or arm would present first, preventing engagement and causing **obstructed labor**. - High risk of **cord prolapse**, **uterine rupture**, and severe maternal-fetal complications. *Perform amniotomy* - **Amniotomy** (artificial rupture of membranes) with a transverse lie is extremely dangerous and contraindicated. - Significantly increases the risk of **cord prolapse** as membranes rupture without an engaged presenting part. - Would necessitate immediate cesarean delivery in emergency conditions, worsening outcomes. *Attempt external cephalic version* - While **external cephalic version (ECV)** can be attempted for transverse lie at 36-37 weeks, it has lower success rates (30-50%) compared to breech presentation. - However, the question asks for "recommended management" which refers to the **definitive management plan** - cesarean delivery remains the final recommendation when transverse lie persists. - ECV may be offered as an option to avoid cesarean, but has risks including **placental abruption**, **fetal distress**, and **failure** requiring cesarean anyway. - At 36 weeks with persistent transverse lie, planning for cesarean delivery is the safest definitive approach.

Q: As per Indian guidelines, what is the recommended age for a woman to begin screening for cervical cancer?

30 years. ***30 years*** - **Indian guidelines** from the **Ministry of Health & Family Welfare (MoHFW)** and the **Indian Council of Medical Research (ICMR)** recommend initiating cervical cancer screening at **age 30 years** or within 3 years of first sexual contact. - The recommended screening methods in India include **VIA (Visual Inspection with Acetic Acid)**, **HPV DNA testing**, or **Pap smear**, performed every 5 years until age 65. - This approach is tailored to the **Indian healthcare setting** and resource availability. *21 years* - This is the recommended screening age according to **US guidelines (ACOG/USPSTF)**, not Indian guidelines. - While appropriate for the US context, Indian guidelines start screening later at age 30, considering **epidemiological data**, **disease prevalence**, and **healthcare infrastructure** specific to India. *25 years* - Some **European countries** and the **UK** recommend starting screening at age 25. - This is **not the recommended age** for cervical cancer screening according to Indian national guidelines. - In India, screening typically begins at age 30 years. *18 years* - Initiating cervical cancer screening at age 18 is **not recommended** by any major international or Indian guidelines. - Screening before age 21 (in US guidelines) or 30 (in Indian guidelines) often leads to **unnecessary procedures and anxiety**, as **HPV infections** and mild dysplasias in adolescents usually resolve spontaneously.

Question 1

In your STI clinic, standardized treatment kits are available for different conditions based on clinical presentation and likely pathogens. A 22-year-old female comes to the STI clinic with minimal vaginal discharge. On speculum examination, erosions are seen on the cervix. Which of the following treatment kit should be given to this patient?

Accepted Answer

Grey

Answer

Green

Answer

Red

Answer

Yellow

Question 2

A 29-year-old primigravida presents at 36 weeks of gestation with a transverse lie. What is the recommended management?

Accepted Answer

Schedule cesarean delivery

Answer

Induce labor

Answer

Perform amniotomy

Answer

Attempt external cephalic version

Question 3

As per Indian guidelines, what is the recommended age for a woman to begin screening for cervical cancer?

Accepted Answer

30 years

Answer

25 years

Answer

21 years

Answer

18 years

NEET-PG 2023 — Obstetrics and Gynecology