UPSC-CMS 2010 - Obstetrics and Gynecology PYQs Practice Questions

Q: In pregnancy, there is a physiological increase of the

cardiac output. ***cardiac output*** - **Cardiac output** increases significantly in pregnancy, by approximately 30-50%, to meet the increased metabolic demands of the growing fetus and maternal tissues. - This increase is primarily due to increases in both **heart rate** and **stroke volume**. *blood viscosity* - **Blood viscosity** actually decreases in pregnancy due to a greater increase in **plasma volume** compared to the increase in red blood cell mass, leading to hemodilution. - This reduction in viscosity can contribute to a lower peripheral vascular resistance. *peripheral resistance of the blood vessels* - **Peripheral resistance** typically decreases in pregnancy due to the vasodilatory effects of hormones like **progesterone** and the establishment of the low-resistance uteroplacental circulation. - This vasodilation helps accommodate the increased blood volume and cardiac output without a significant rise in blood pressure. *blood pressure in the third trimester* - **Blood pressure** usually decreases or remains stable in the first and second trimesters, with a slight rise towards pre-pregnancy levels in the third trimester. - A significant increase in blood pressure, especially in the third trimester, is *not* physiological and can indicate complications like **gestational hypertension** or **preeclampsia**. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Match List-I (Signs of pregnancy) with List-II (Anatomical sites) and select the correct answer using the code given below the Lists:

A→3 B→4 C→2 D→1. ***A→3 B→4 C→2 D→1*** This question has inherent issues as the anatomical sites in List-II do not perfectly correspond to the signs in List-I. Based on the image provided and available options: - **A (Jacquemier's sign) → 3**: Jacquemier's sign refers to the **bluish-purple discoloration of the vagina and cervix** due to increased vascularity. While primarily a vaginal/cervical sign, if the list groups this under broader "uterine/pelvic" changes, this may be the intended match, though medically it is most specific to the vagina (which would be option 4). - **B (Chloasma gravidarum) → 4**: Chloasma gravidarum is the **hyperpigmentation of facial skin** (mask of pregnancy). This does NOT occur on the vagina. This matching appears incorrect unless List-II's option 4 refers to something other than "vagina" in the original source. - **C (Striae gravidarum) → 2**: Striae gravidarum are **stretch marks that typically appear on the abdomen** (also breasts, thighs). This match is **correct**. - **D (Montgomery's tubercles) → 1**: Montgomery's tubercles are **enlarged sebaceous glands on the areola of the breast**. This match is **correct**. *Other options are incorrect as they mismatch the anatomical sites for these well-established signs of pregnancy. The correct answer reflects the intended matching from the original UPSC-CMS 2010 examination, though some matches may not align perfectly with anatomical specificity.* [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: If a patient of polycystic ovary syndrome on metformin conceives, how soon should the metformin be stopped?

Immediately following the diagnosis of pregnancy. ***Immediately following the diagnosis of pregnancy*** - Based on **current evidence**, metformin can be safely **discontinued once pregnancy is confirmed** in PCOS patients. - The primary role of metformin in PCOS is to improve **ovulation and achieve conception**—once pregnancy occurs, this goal is accomplished. - Recent large randomized trials (including **PregMet** and **MiTy studies**) have shown **no significant benefit** in continuing metformin during pregnancy for reducing miscarriage or gestational diabetes. - Current practice favors **individualized decisions**, but routine continuation is not standard. *After the 1st trimester* - This was **older practice** based on theoretical benefits of reducing early pregnancy loss. - However, systematic reviews and meta-analyses have **not confirmed** these benefits in well-designed trials. - While some clinicians may continue metformin through the first trimester in selected cases, this is not the standard recommendation for all PCOS pregnancies. *After the 2nd trimester* - Continuing metformin this long is **not evidence-based** for routine PCOS management. - While metformin may be continued throughout pregnancy for **gestational diabetes** management (separate indication), this is not specifically for PCOS. - Most guidelines do not support routine continuation beyond pregnancy confirmation for PCOS alone. *Before the onset of labour* - This timing has **no physiological basis** for PCOS-related metformin use. - If metformin is being used for gestational diabetes (different indication), timing of discontinuation would be individualized, but this is not the standard answer for PCOS patients. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: A pregnant woman presents at 28 weeks of gestation with haemoglobin level of 7 gm%; and peripheral smear reveals it to be of microcytic hypochromic type. What would be the correct option of therapy?

Injectable iron therapy. ***Injectable iron therapy*** - With a hemoglobin of **7 gm%** at **28 weeks of gestation**, the patient has **severe anemia** that requires a rapid increase in hemoglobin. - **Injectable iron therapy** provides a swift and effective way to replenish iron stores and improve hemoglobin levels, especially when oral iron absorption is insufficient or time is critical. *Blood transfusion* - While blood transfusions rapidly increase hemoglobin, they are generally reserved for **acute hemodynamic instability**, severe symptomatic anemia, or when immediate delivery is anticipated. - This patient, though severely anemic, does not present with criteria for **immediate transfusion**. *Oral iron and folic acid therapy* - **Oral iron therapy** is the standard treatment for moderate anemia, but for a hemoglobin of **7 gm%**, it may be too slow to raise hemoglobin levels quickly enough. - While folic acid is important in pregnancy, it doesn't directly address the **iron deficiency** indicated by microcytic hypochromic anemia. *Oral iron therapy* - **Oral iron therapy** is usually the first-line treatment for **iron deficiency anemia**. - However, at **7 gm% hemoglobin** in the **third trimester**, oral iron may not increase hemoglobin levels fast enough, and compliance or absorption issues could further delay recovery. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

In pregnancy, there is a physiological increase of the

Accepted Answer

cardiac output

Answer

blood viscosity

Answer

peripheral resistance of the blood vessels

Answer

blood pressure in the third trimester

Question 2

Match List-I (Signs of pregnancy) with List-II (Anatomical sites) and select the correct answer using the code given below the Lists:

Accepted Answer

A→3  B→4  C→2  D→1

Answer

A→3  B→5  C→2  D→1

Answer

A→3  B→1  C→4  D→2

Answer

A→2  B→4  C→1  D→3

Question 3

If a patient of polycystic ovary syndrome on metformin conceives, how soon should the metformin be stopped?

Accepted Answer

Immediately following the diagnosis of pregnancy

Answer

After the 1st trimester

Answer

After the 2nd trimester

Answer

Before the onset of labour

Question 4

With reference to the transmission of HIV from mother to child, which one of the following statements is not correct?

Accepted Answer

Single dose of 200 mg nevirapine at the onset of labour eliminates the risk of HIV transmission to the newborn

Answer

The rate of transmission of HIV from mother to child is between 15-48%

Answer

HIV is transmitted through breast milk

Answer

In majority of cases, transmission of virus occurs during intrapartum period

Question 5

A pregnant woman presents at 28 weeks of gestation with haemoglobin level of 7 gm%; and peripheral smear reveals it to be of microcytic hypochromic type. What would be the correct option of therapy?

Accepted Answer

Injectable iron therapy

Answer

Blood transfusion

Answer

Oral iron and folic acid therapy

Answer

Oral iron therapy

Question 6

Serum AFP (alpha fetoprotein) levels are increased at 16 weeks of pregnancy in all the following conditions, except

Accepted Answer

Down's syndrome

Answer

gastroschisis

Answer

multiple pregnancies

Answer

neural tube defects

Question 7

The fetal well-being can be assessed by all of the following, except

Accepted Answer

Kleihauer-Betke test

Answer

non-stress test

Answer

ultrasound

Answer

contraction stress test

Question 8

Match List-I with List-II and select the correct answer using the code given below the Lists:

Accepted Answer

A→3  B→4  C→1  D→2

Answer

A→1  B→4  C→3  D→2

Answer

A→2  B→4  C→1  D→3

Answer

A→4  B→1  C→3  D→2

Question 9

Which one of the following is diagnosed by Spiegelberg criteria?

Accepted Answer

Ovarian pregnancy

Answer

Molar pregnancy

Answer

Twin pregnancy

Answer

Uterine pregnancy

Question 10

Which of the following is the most appropriate management in a ruptured tubal pregnancy?

Accepted Answer

Quick resuscitation followed by laparotomy and excision of the offending tube

Answer

Autotransfusion of the fresh blood harvested from the peritoneal cavity

Answer

Blood transfusion immediately after the clamps have been placed to control the bleeding

Answer

Excision of the offending tube and the ipsilateral ovary (salpingo-oophorectomy)

UPSC-CMS 2010 — Obstetrics and Gynecology