NEET-PG 2024 - OB/GYN PYQs Practice Questions

Q: A 30-year-old woman presents with a history of pelvic pain and infertility. A transvaginal ultrasound is performed, and the image provided shows a tubular, fluid-filled structure with thin walls. There is no evidence of solid components or internal septations. What is the most likely diagnosis?

Hydrosalpinx. ***Hydrosalpinx*** - The ultrasound finding of a **tubular, fluid-filled structure with thin walls** and no solid components or septations is highly characteristic of a **hydrosalpinx**, which is a blocked, fluid-filled fallopian tube. - **Pelvic pain** and **infertility** in a young woman are classic clinical presentations associated with hydrosalpinx, often resulting from previous pelvic inflammatory disease. *Ovarian cyst* - While ovarian cysts are fluid-filled, they typically appear as **rounded or oval structures within or adjacent to the ovary**, not distinctively tubular. - They can cause pain but are not typically associated with a "tubular" morphology on ultrasound. *Ectopic pregnancy* - An ectopic pregnancy would typically present with a **gestational sac** (with or without a fetal pole or yolk sac) outside the uterus, often in the fallopian tube. - While it can be tubular, it usually shows more complex internal echoes representing pregnancy components, and the clinical picture would involve a **positive pregnancy test** and often acute, unilateral pain. *Endometrioma* - An endometrioma is a type of ovarian cyst filled with **endometrial tissue**, often appearing on ultrasound as a **"ground glass" or "chocolate cyst"** with internal echoes due to old blood. - It would not typically present as a thin-walled, anechoic (purely fluid-filled) tubular structure. *Tubo-ovarian abscess* - A tubo-ovarian abscess (TOA) is a **complex inflammatory mass** that typically appears on ultrasound as a **thick-walled, complex structure with internal echoes, septations, or debris**. - TOA patients usually present with **acute symptoms including fever, elevated white blood cell count**, and severe pelvic pain, rather than the chronic presentation described here. - The ultrasound description of thin walls and no solid components makes TOA unlikely. [Practice more OB/GYN PYQs on OnCourse]

Q: What is the typical time between fertilization and implantation?

8 days. ***8 days*** - **Fertilization** typically occurs in the **fallopian tube**, and the resulting **zygote** then undergoes several cell divisions while migrating towards the uterus. - Implantation, the process by which the **blastocyst embeds into the uterine wall**, usually begins around day 6 post-fertilization and is completed by day 8-10. *2 days* - At 2 days post-fertilization, the embryo is typically in the **2-cell to 4-cell stage** and is still located within the fallopian tube, far from the implantation site. - This stage is too early for implantation to occur, as the embryo has not yet reached the **blastocyst stage** or the uterus. *14 days* - By 14 days post-fertilization, implantation would have long been completed, and the initial stages of **trophoblast development** and formation of the **placenta** would be underway. - This time frame represents a more advanced stage of pregnancy, whereas implantation is an early event. *16 days* - Sixteen days post-fertilization is well past the window for initial implantation; at this point, significant embryonic development has occurred, and the woman might even be experiencing early signs of **pregnancy**, such as a missed period. - Implantation is a much earlier process, concluding by day 10 at the latest. [Practice more OB/GYN PYQs on OnCourse]

Q: A pregnant woman with a known case of asthma is experiencing postpartum hemorrhage (PPH). Which drug is contraindicated?

Carboprost. ***Carboprost*** - **Carboprost** is a **prostaglandin F2-alpha analog** that causes strong uterine contractions but also leads to **bronchoconstriction** and increased airway resistance. - Due to its potent bronchoconstrictive effects, **carboprost** is **absolutely contraindicated in patients with asthma** as it can precipitate a severe asthmatic attack. *Methyl ergometrine* - **Methyl ergometrine** is an **ergot alkaloid** that causes sustained uterine contractions and is effective for PPH. - It is contraindicated in patients with **hypertension** or **pre-eclampsia** due to its vasoconstrictive properties, but not typically in asthma. *Misoprostol* - **Misoprostol** is a **prostaglandin E1 analog** used for PPH management, causing uterine contractions. - It is generally safe for use in patients with asthma as it does not have significant bronchoconstrictive side effects. *Oxytocin* - **Oxytocin** is a first-line uterotonic agent for PPH, working by causing rhythmic uterine contractions. - It is generally considered safe in patients with asthma and is not known to exacerbate respiratory conditions. [Practice more OB/GYN PYQs on OnCourse]

Q: In fertility-preserving prolapse surgery, which bony landmark is used for suspension?

Ischial spine. ***Ischial spine*** - The **ischial spine** serves as a crucial anatomical landmark for **suspension in fertility-preserving prolapse surgery**, particularly for procedures like sacrospinous ligament fixation. - Fixation to the ischial spine helps in supporting the vaginal apex or uterus, maintaining the natural vaginal axis and reducing the risk of recurrence. *Sacral promontory* - The **sacral promontory** is used in sacrocolpopexy or sacrohysteropexy, which traditionally involves mesh fixation and may not be ideal for **fertility preservation** due to potential future pregnancy complications or mesh-related issues. - While it provides strong support, its use might reduce vaginal elasticity and increase risk for future deliveries. *Pubic symphysis* - The **pubic symphysis** is primarily involved in procedures for **stress urinary incontinence** (e.g., tension-free vaginal tape) and is not a primary point for suspending the uterus or vaginal apex in prolapse surgery. - Using it for prolapse repair could alter the normal anatomical relationship and lead to dyspareunia or chronic pain. *Ischial tuberosity* - The **ischial tuberosity** is a bony prominence that provides attachment for various ligaments and muscles of the pelvis and perineum but is **too inferior and lateral** to be effectively used for uterine or vaginal vault suspension. - Its location makes it unsuitable for achieving appropriate apical support in prolapse surgery. [Practice more OB/GYN PYQs on OnCourse]

Question 1

A 30-year-old woman presents with a history of pelvic pain and infertility. A transvaginal ultrasound is performed, and the image provided shows a tubular, fluid-filled structure with thin walls. There is no evidence of solid components or internal septations. What is the most likely diagnosis?

Accepted Answer

Hydrosalpinx

Answer

Ovarian cyst

Answer

Ectopic pregnancy

Answer

Endometrioma

Answer

Tubo-ovarian abscess

Question 2

A 25-year-old pregnant woman, at 18 weeks of gestation, undergoes a routine ultrasound scan. The ultrasound images provided show below. Based on the imaging findings, what is the most likely diagnosis?

Accepted Answer

Spina bifida

Answer

Anencephaly

Answer

Encephalocele

Answer

Holoprosencephaly

Answer

Iniencephaly

Question 3

What is the typical time between fertilization and implantation?

Accepted Answer

8 days

Answer

2 days

Answer

14 days

Answer

16 days

Question 4

A pregnant woman with a known case of asthma is experiencing postpartum hemorrhage (PPH). Which drug is contraindicated?

Accepted Answer

Carboprost

Answer

Methyl ergometrine

Answer

Misoprostol

Answer

Oxytocin

Question 5

In fertility-preserving prolapse surgery, which bony landmark is used for suspension?

Accepted Answer

Ischial spine

Answer

Sacral promontory

Answer

Pubic symphysis

Answer

Ischial tuberosity

Question 6

A 45-year-old woman presents with a history of cervical erosion and spotting for the past 2 months. What is the next best step?

Accepted Answer

LBC + HPV

Answer

Pap smear + HSV

Answer

Pap smear + HBV

Answer

LBC + HSV

Question 7

A GSP4 woman comes for routine sonography for the first time. She has four daughters and expresses a desire for a boy this time, asking for sex determination. To abide by ethical guidelines, what should you do?

Accepted Answer

Check routine ANC and sex for developmental abnormalities and do not reveal gender to the patient

Answer

Check routine ANC and sex for developmental abnormalities and do reveal gender to the patient

Answer

Do reveal gender if a girl

Answer

Check only routine ANC, do not check sex

Question 8

A young woman presents with prolapse, and a mesh is being placed. Where is this mesh typically fixed to?

Accepted Answer

Sacral promontory

Answer

Ischial spine

Answer

Ischial tuberosity

Answer

Pubic symphysis

Question 9

Which of the following is a tumor marker associated with ovarian solid-cystic masses?

Accepted Answer

AFP

Answer

CEA

Answer

HCG

Answer

HER2/neu

Question 10

A 32-year-old woman presents with a new 2 cm black nodular mass near her episiotomy scar. She reports that the mass is painful and tends to increase in size during menstruation. What is the most likely diagnosis?

Accepted Answer

Endometriosis

Answer

Melanoma

Answer

Foreign body granuloma

Answer

Inclusion cyst

NEET-PG 2024 — OB/GYN