UPSC-CMS 2013 - Obstetrics and Gynecology PYQs Practice Questions

Q: Pelvic abscess can present with all symptoms except:

bleeding rectum. ***bleeding rectum*** - A **bleeding rectum** is not a typical presentation of a pelvic abscess. It might suggest other conditions like hemorrhoids, colorectal cancer, or inflammatory bowel disease. - Pelvic abscesses are collections of pus in the pelvic cavity, and while they can cause various gastrointestinal symptoms due to local inflammation and pressure, direct rectal bleeding is generally not among them. *pain abdomen* - **Abdominal pain** is a very common symptom of a pelvic abscess, often localized to the lower abdomen. - This pain is caused by inflammation, pressure, and irritation of surrounding organs and tissues. *diarrhea with mucus discharge* - A pelvic abscess can cause irritation to the adjacent **bowel segments**, leading to changes in bowel habits such as diarrhea. - The presence of **mucus discharge** can also be a sign of bowel irritation or inflammation, which can occur secondary to a nearby abscess. *fever* - **Fever** is a classic systemic sign of infection and inflammation, and thus is almost always present in patients with an abscess, including a pelvic abscess. - The body's inflammatory response to the infection typically elevates body temperature. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: During pregnancy, vaccination can be given against all these diseases except :

Mumps. ***Mumps*** - The **mumps vaccine** is a **live attenuated vaccine**, meaning it contains a weakened form of the virus. - Live attenuated vaccines are generally **contraindicated in pregnancy** due to the theoretical risk of transmitting the vaccine virus to the fetus. *Hepatitis A* - The **Hepatitis A vaccine** is an **inactivated (killed) vaccine**. - Inactivated vaccines are generally considered **safe during pregnancy** if there's a significant risk of exposure. *Tetanus* - The **tetanus toxoid vaccine (Tdap)** is recommended during every pregnancy to protect the newborn from **pertussis (whooping cough)** and provide maternal protection against tetanus. - It is an **inactivated vaccine** and is very safe for both mother and fetus. *Hepatitis B* - The **Hepatitis B vaccine** is a **recombinant vaccine**, meaning it's made from a component of the virus. - It is considered **safe in pregnancy** and is recommended for pregnant women at risk of acquiring hepatitis B. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: What is the likely cause of primary amenorrhoea together with retention of urine in an adolescent girl ?

Haematocolpos. ***Haematocolpos*** - **Haematocolpos** is the accumulation of menstrual blood in the vagina due to an **imperforate hymen** or other outflow obstruction, causing primary amenorrhoea. - The retained blood can exert pressure on the urethra and bladder, leading to **urinary retention**. *Testicular Feminizing syndrome* - Also known as **Androgen Insensitivity Syndrome**, individuals have a 46, XY karyotype but appear female externally due to androgen receptor defects. - It causes primary amenorrhoea but typically does not present with urinary retention as the Mullerian ducts regress, meaning there is no uterus and therefore no menstrual blood to accumulate. *Adrenal hyperplasia* - **Congenital adrenal hyperplasia (CAH)** can cause virilization in females, leading to ambiguous genitalia and primary amenorrhoea due to hormonal imbalances. - While it can affect reproductive development, urinary retention due to menstrual blood accumulation is not a typical presentation. *Turner's syndrome* - **Turner's syndrome (45, XO)** is characterized by ovarian dysgenesis and primary amenorrhoea due to the absence of ovarian function. - Individuals often have distinctive features like a short stature and a webbed neck, but urinary retention is not a direct consequence of the syndrome itself. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Histological type of endometrium that is suggestive of ovulation is :

secretory phase. ***secretory phase*** - The **secretory phase** of the endometrium occurs *after* ovulation and is characterized by the effects of **progesterone** produced by the corpus luteum. - Histologically, this phase shows **tortuous glands** with **secretory activity** (containing glycogen and mucus), and a **stroma that becomes edematous**, preparing the uterus for potential implantation. *cystic glandular hyperplasia* - This is a form of **endometrial hyperplasia** characterized by abundant, dilated glands of varying sizes and stroma, typically occurring due to **unopposed estrogen stimulation**. - It does not indicate ovulation; rather, it often results from **anovulation** or other conditions causing persistent estrogen exposure without a subsequent progesterone phase. *adenomatous hyperplasia* - **Adenomatous hyperplasia** (or complex hyperplasia) involves glandular crowding and architectural abnormalities, representing a more advanced form of hyperplasia compared to simple cystic hyperplasia. - It arises from **unopposed estrogen** and is not indicative of normal ovulation; it can be a precursor to endometrial carcinoma, especially if **atypia** is present. *proliferative phase* - The **proliferative phase** occurs *before* ovulation under the influence of **estrogen**, during which the endometrium regrows and thickens. - Histologically, it features relatively **straight, tubular glands** and a compact stroma, and while it precedes ovulation, it does not confirm that ovulation has occurred. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: A pregnant woman in third trimester has normal blood pressure in the arms when standing and sitting but drops to 90/50 when lying down. What is the likely cause?

Compression of inferior vena cava. ***Compression of inferior vena cava*** - In the third trimester, the **gravid uterus** can compress the **inferior vena cava (IVC)** when the woman lies supine, reducing **venous return** to the heart. - This decreased preload leads to a drop in **cardiac output** and consequently a fall in **blood pressure** (supine hypotensive syndrome). *Compression of uterine artery* - Compression of the uterine artery would primarily affect **placental blood flow** and fetal well-being, but it is not the direct cause of the mother's systemic hypotension. - **Uterine artery compression** does not significantly impact overall systemic blood pressure in the mother. *Compression of aorta* - While the gravid uterus can compress the **aorta** (aortocaval compression), this typically leads to reduced blood flow to the lower extremities and uterus, not a generalized drop in systemic blood pressure, as collateral circulation usually compensates. - **Aortic compression** can cause a difference in blood pressure between the upper and lower extremities, but the scenario describes a drop in overall systemic pressure when recumbent. *Compression of internal iliac artery* - Compression of the internal iliac artery would mainly affect blood supply to the **pelvic organs** and gluteal region, but it does not account for the significant drop in systemic blood pressure observed in the supine position. - This compression would not cause a generalized reduction in **venous return** to the heart, which is the primary mechanism for supine hypotension. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

Pelvic abscess can present with all symptoms except:

Accepted Answer

bleeding rectum

Answer

pain abdomen

Answer

diarrhea with mucus discharge

Answer

fever

Question 2

During pregnancy, vaccination can be given against all these diseases except :

Accepted Answer

Mumps

Answer

Hepatitis A

Answer

Tetanus

Answer

Hepatitis B

Question 3

What is the likely cause of primary amenorrhoea together with retention of urine in an adolescent girl ?

Accepted Answer

Haematocolpos

Answer

Testicular Feminizing syndrome

Answer

Adrenal hyperplasia

Answer

Turner's syndrome

Question 4

Histological type of endometrium that is suggestive of ovulation is :

Accepted Answer

secretory phase

Answer

cystic glandular hyperplasia

Answer

adenomatous hyperplasia

Answer

proliferative phase

Question 5

A pregnant woman in third trimester has normal blood pressure in the arms when standing and sitting but drops to 90/50 when lying down. What is the likely cause?

Accepted Answer

Compression of inferior vena cava

Answer

Compression of uterine artery

Answer

Compression of aorta

Answer

Compression of internal iliac artery

Question 6

Which of the following is an absolute contraindication to breastfeeding according to WHO guidelines?

Accepted Answer

Active, untreated maternal tuberculosis

Answer

Maternal diarrhoea

Answer

None of the above

Answer

1st 24 hours after Caesarean section

Question 7

Meconium aspiration syndrome can be prevented by taking the following measures except :

Accepted Answer

Delivering the baby by emergency caesarean section

Answer

Amnioinfusion

Answer

Oropharyngeal suctioning

Answer

Suctioning of trachea through laryngoscope

Question 8

A 15-year old unmarried girl comes with history of dysmenorrhea. Age of menarche is 12 years. Per abdominal and per rectum examination reveal nothing abnormal. You will treat the patient with :

Accepted Answer

Reassurance and giving antispasmodics during menses

Answer

Reassurance and giving antispasmodics throughout the month

Answer

Hormones

Answer

Antibiotics

Question 9

A pregnant lady with 37 weeks gestation has been admitted with a history of premature rupture of membranes for 6 hours. She is best treated with:

Accepted Answer

antibiotics followed by labour induction

Answer

steroids followed by labour induction

Answer

expectant management

Answer

steroids and tocolytic agents

Question 10

Use of ventose is preferred over forceps in the delivery of :

Accepted Answer

occipito posterior position

Answer

face presentation

Answer

aftercoming head in breech

Answer

foetal distress

UPSC-CMS 2013 — Obstetrics and Gynecology