UPSC-CMS 2017 - Obstetrics and Gynecology PYQs Practice Questions

Q: An infertile woman presents with yellow or green vaginal discharge, a Bartholin cyst and proctitis. What is the most probable diagnosis?

Gonorrhoea. ***Gonorrhoea*** - This presentation, including **yellow/green vaginal discharge**, a **Bartholin cyst**, and **proctitis**, is highly suggestive of **gonorrhoea**. - *Neisseria gonorrhoeae* can cause inflammation in these specific areas and is a known cause of **infertility** due to pelvic inflammatory disease. *Trichomoniasis* - Characterized by a **frothy, foul-smelling, yellow-green discharge** and often involves **cervical petechiae** (strawberry cervix). - While it causes vaginal discharge, **Bartholin cysts** and **proctitis** are not typical features. *Syphilis* - The primary stage presents as a **painless chancre**, secondary syphilis involves a **rash** and **lymphadenopathy**, and tertiary syphilis has severe organ involvement. - It does not typically present with the specific combination of **Bartholin cyst**, vaginal discharge, and **proctitis**. *Candidiasis* - Causes a **thick, white, "cottage cheese-like" discharge** associated with significant **pruritus** and **vaginal irritation**. - It does not typically lead to **Bartholin cysts** or **proctitis**. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: A 28 year old P1L1 presents with severe pain in her abdomen and is taken for laparotomy. On opening the abdomen pseudomyxoma peritonei is present. What should be the probable reason?

Mucinous cystadenoma of ovary. ***Mucinous cystadenoma of ovary*** - **Pseudomyxoma peritonei** is most frequently caused by the rupture of a low-grade mucinous tumor, often originating from the **appendix** or, less commonly, the **ovary**. - A **mucinous cystadenoma of the ovary**, upon rupture, can release mucinous material into the peritoneal cavity, leading to the characteristic "jelly belly" appearance. *Rupture of dermoid tumor* - Rupture of a **dermoid tumor** (mature cystic teratoma) can cause **chemical peritonitis** due to the release of sebaceous material and hair, but it does not typically lead to pseudomyxoma peritonei. - The contents of a dermoid tumor are usually **fatty** or **keratinous**, not mucinous. *Endometriosis* - **Endometriosis** involves endometrial-like tissue growing outside the uterus, causing pelvic pain and adhesions. - It does not involve the production of a large volume of mucinous material and is therefore not a cause of pseudomyxoma peritonei. *Serous cystadenoma of ovary* - A ruptured **serous cystadenoma** would release serous (watery) fluid, not mucinous material. - While it can cause ascites, it does not produce the characteristic thick, gelatinous material seen in pseudomyxoma peritonei. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: A seven year old girl with precocious puberty is found to be having a 10 cm ovarian cyst on USG. The most likely etiology is

Granulosa cell tumour. ***Granulosa cell tumour*** - This tumor is a common cause of **sexual precocity** in girls because it produces **estrogen**, leading to premature development of secondary sexual characteristics. - Granulosa cell tumors can grow to a significant size, like the **10 cm ovarian cyst** described, and are often malignant or borderline. *Choriocarcinoma* - Ovarian choriocarcinoma is a **highly malignant germ cell tumor** that typically secretes **human chorionic gonadotropin (hCG)**, not estrogen. - While it can cause precocious pseudopuberty by stimulating ovarian steroidogenesis through hCG, it is a very rare primary ovarian tumor. *Benign cystic teratoma* - These are **common germ cell tumors** that contain tissues from all three germ layers; however, they are usually **hormonally inactive** and do not typically cause precocious puberty. - While they can form large cysts, the presence of precocious puberty points away from this diagnosis. *Brenner tumour* - **Brenner tumors** are uncommon epithelial ovarian tumors that are typically **solid and benign**, though malignant forms exist. - They are generally **hormonally inactive** and do not cause precocious puberty; they also typically occur in older women. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

An infertile woman presents with yellow or green vaginal discharge, a Bartholin cyst and proctitis. What is the most probable diagnosis?

Accepted Answer

Gonorrhoea

Answer

Trichomoniasis

Answer

Syphilis

Answer

Candidiasis

Question 2

A 28 year old P1L1 presents with severe pain in her abdomen and is taken for laparotomy. On opening the abdomen pseudomyxoma peritonei is present. What should be the probable reason?

Accepted Answer

Mucinous cystadenoma of ovary

Answer

Rupture of dermoid tumor

Answer

Endometriosis

Answer

Serous cystadenoma of ovary

Question 3

In a 40 year old woman, pap smear shows atypical glandular cells. The next step of management should be:

Accepted Answer

Colposcopy, cervical biopsy, endocervical curettage and endometrial biopsy

Answer

Hysteroscopy and directed endometrial biopsy

Answer

Colposcopic directed cervical biopsy

Answer

Repeat pap smear after three months

Question 4

A 50 year old P4L4 has a simple left ovarian cyst of 10cm. Ca 125 is 30u/ml. Treatment of choice would be:

Accepted Answer

Laparoscopic bilateral oophorectomy (BSO)

Answer

Medical management with oral contraceptives

Answer

Laparoscopic cystectomy

Answer

TAH + BSO (Total abdominal hysterectomy + Bilateral salpingo-oophorectomy)

Question 5

A seven year old girl with precocious puberty is found to be having a 10 cm ovarian cyst on USG. The most likely etiology is

Accepted Answer

Granulosa cell tumour

Answer

Choriocarcinoma

Answer

Benign cystic teratoma

Answer

Brenner tumour

Question 6

A 17 year old girl presents with an ovarian cyst of 5cm. The cyst is echo free, unilocular and CA 125 of 8U/ml. What is most appropriate management?

Accepted Answer

Conservative with follow up ultrasound

Answer

Laparoscopy for cyst removal

Answer

Laparotomy for cyst removal

Answer

Medical treatment

Question 7

Most probable cause of heavy bleeding in a P2L2 during tenth day post partum is:

Accepted Answer

Retained bits of cotyledons and membranes

Answer

Infected episiotomy wound

Answer

Resumption of menstruation

Answer

Subinvolution of placental site

Question 8

Combined contraceptive pills give protection from the following EXCEPT:

Accepted Answer

Cancer of cervix

Answer

Cancer of endometrium

Answer

Cancer of ovary

Answer

Ectopic pregnancy

Question 9

A woman presents with heavy foul smelling discharge with sharply demarcated ulcers without induration on the perineum and the labia majora. Inguinal lymphadenopathy is also present. What is the most probable diagnosis?

Accepted Answer

Chancroid

Answer

Tuberculosis

Answer

Trichomoniasis

Answer

Gonorrhoea

Question 10

A 28 year old woman develops amenorrhoea after having dilatation and curettage. The most likely diagnosis is :

Accepted Answer

Asherman syndrome

Answer

Kallman syndrome

Answer

Turner syndrome

Answer

Anorexia nervosa

UPSC-CMS 2017 — Obstetrics and Gynecology