UPSC-CMS 2018 - Obstetrics and Gynecology PYQs Practice Questions

Q: Manual Vacuum Aspiration (MVA) that has been introduced in primary health centres helps in reducing which of the following indices?

Maternal mortality. ***Maternal mortality*** - **Manual Vacuum Aspiration (MVA)** is a safe and effective method for managing **incomplete abortion** and **early pregnancy loss**, which are significant causes of **maternal mortality**, especially when performed in primary healthcare settings. - By providing timely and accessible care for these complications, MVA helps prevent severe complications like hemorrhage and sepsis that can lead to a mother's death. *Preterm mortality* - Preterm mortality is primarily related to **preterm birth** and its associated complications, such as respiratory distress syndrome and infection. - MVA is a procedure for managing early pregnancy loss or incomplete abortion and does not directly impact the incidence or outcomes of preterm births. *Neonatal mortality* - Neonatal mortality refers to deaths of infants within the first 28 days of life, often due to issues like **birth asphyxia**, **prematurity**, and **neonatal infections**. - MVA addresses complications of pregnancy for the mother and does not directly relate to the common causes of death in newborns. *Infant mortality* - Infant mortality encompasses deaths from birth up to one year of age, including causes such as **sudden infant death syndrome (SIDS)**, congenital anomalies, and infections occurring after the neonatal period. - While improved maternal health can indirectly benefit infant survival, MVA directly tackles maternal health crises rather than primary causes of infant death. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which of following statements regarding Puerperal sepsis are correct? 1. Multiple per vaginal examinations increase the risk 2. Group A and B beta-haemolytic Streptococcus are among the responsible microorganisms 3. Retained bits of placenta and membrane predispose 4. Vaginal packing can decrease the risk Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - **Multiple per vaginal examinations** introduce exogenous bacteria from the perineum into the sterile uterine cavity, increasing the risk of infection. - **Group A and B beta-haemolytic Streptococcus** are common causative organisms, especially Group A, which can cause severe, rapidly progressive puerperal sepsis. - **Retained products of conception** (placental or membrane fragments) provide a nidus for bacterial growth and interfere with uterine involution, creating a favorable environment for infection. *1, 3 and 4* - This option incorrectly includes "Vaginal packing can decrease the risk" and excludes a correct statement. - While multiple vaginal examinations and retained tissue increase risk, **vaginal packing** can actually increase the risk of infection by creating an anaerobic environment and trapping bacteria. *2, 3 and 4* - This option incorrectly includes "Vaginal packing can decrease the risk" and excludes a correct statement. - The identified microorganisms and role of retained products are correct, but vaginal packing is not a preventive measure for puerperal sepsis. *1, 2 and 4* - This option incorrectly includes "Vaginal packing can decrease the risk" and excludes a correct statement. - While multiple vaginal examinations and specific streptococcal species are correctly identified as risk factors or causes, vaginal packing is not a beneficial intervention. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: In case of Labour complicated with cord prolapse, which of the following statements are correct? 1. Reposition the patient in exaggerated Sims position 2. To replace the cord in the vagina 3. To replace the cord inside the uterus 4. Early amniotomy can prevent cord prolapse Select the correct answer using the code given below:

1 only. ***Correct: 1 only*** **Statement 1 - Reposition the patient in exaggerated Sims position** ✓ - **Correct** - Immediate repositioning (knee-chest, Trendelenburg, or exaggerated Sims position) is crucial to reduce pressure on the prolapsed cord and relieve compression - This helps displace the presenting part away from the cord using gravity **Statement 2 - To replace the cord in the vagina** ✗ - **Incorrect** - Manipulation or replacement of the prolapsed cord is **contraindicated** as it can cause vasospasm and further compromise fetal circulation - The correct approach is to **elevate the presenting part manually** (pushing it up off the cord) while keeping the cord moist and warm, NOT to reposition the cord itself **Statement 3 - To replace the cord inside the uterus** ✗ - **Incorrect** - This is contraindicated as it carries high risk of uterine infection, cord trauma, and vasospasm - Does not reliably prevent recurrence of prolapse **Statement 4 - Early amniotomy can prevent cord prolapse** ✗ - **Incorrect** - Early amniotomy actually **increases** the risk of cord prolapse, especially when the presenting part is not well-engaged - It removes the cushioning effect of forewaters that help keep the cord in place **Correct management of cord prolapse includes:** - Immediate repositioning (Trendelenburg/knee-chest position) - Manual elevation of presenting part to relieve cord compression - Keeping the prolapsed cord moist and warm - Avoiding cord manipulation - Emergency cesarean delivery or instrumental delivery if feasible *Incorrect: 1 and 2 only* - While statement 1 is correct, statement 2 (replacing the cord in vagina) is medically incorrect and contraindicated *Incorrect: 3 and 4 only* - Both statements are incorrect as explained above *Incorrect: 1, 2, 3 and 4* - Only statement 1 is correct; statements 2, 3, and 4 are all incorrect [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which one of the following is true regarding normal menstrual physiology?

Ovulation occurs after 12 hours of LH peak. ***Ovulation occurs after 12 hours of LH peak*** - Ovulation typically occurs approximately **10-12 hours after the luteinizing hormone (LH) peak** and about 34-36 hours after the initial rise in LH. This delay allows for the final maturation of the oocyte. - The **LH surge** is the crucial hormonal signal that triggers the ovulation process in the mature follicle. *Ovulation occurs after 48 hours of LH surge* - This statement is incorrect as **ovulation occurs much sooner** after the LH surge, typically within 34-36 hours from the onset of the surge, and 10-12 hours after its peak. - A 48-hour delay would mean the oocyte would likely be past its optimal viability for fertilization. *Oestradiol levels peak at 48 hours prior to ovulation* - **Estradiol levels peak approximately 24-36 hours before ovulation**, not 48 hours. This peak in estradiol is what triggers the surge in LH. - The timing of the estradiol peak is crucial in initiating the positive feedback loop that leads to the LH surge. *LH surge duration is typically 12-24 hours* - The **LH surge typically lasts for about 48 hours**, not 12-24 hours. A surge of this duration ensures sufficient time for the final maturation of the oocyte and the process of follicular rupture. - The prolonged nature of the LH surge is essential for the completion of meiosis I in the oocyte and the weakening of the follicular wall. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

Manual Vacuum Aspiration (MVA) that has been introduced in primary health centres helps in reducing which of the following indices?

Accepted Answer

Maternal mortality

Answer

Preterm mortality

Answer

Neonatal mortality

Answer

Infant mortality

Question 2

Which of the following are the hypotheses for the onset of Labor?

1. Uterine distension
2. Activation of fetal hypothalamic-pituitary-adrenal axis
3. Increase in prostaglandins
4. Increase in serum calcium levels

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

1 and 3 only

Answer

2, 3 and 4

Answer

1, 2 and 4

Question 3

Which of following statements regarding Puerperal sepsis are correct?

1. Multiple per vaginal examinations increase the risk
2. Group A and B beta-haemolytic Streptococcus are among the responsible microorganisms
3. Retained bits of placenta and membrane predispose
4. Vaginal packing can decrease the risk

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

2, 3 and 4

Answer

1, 2 and 4

Question 4

In case of Labour complicated with cord prolapse, which of the following statements are correct?

1. Reposition the patient in exaggerated Sims position
2. To replace the cord in the vagina
3. To replace the cord inside the uterus
4. Early amniotomy can prevent cord prolapse

Select the correct answer using the code given below:

Accepted Answer

1 only

Answer

1 and 2 only

Answer

3 and 4 only

Answer

1, 2, 3 and 4

Question 5

Which one of the following is true regarding normal menstrual physiology?

Accepted Answer

Ovulation occurs after 12 hours of LH peak

Answer

Ovulation occurs after 48 hours of LH surge

Answer

Oestradiol levels peak at 48 hours prior to ovulation

Answer

LH surge duration is typically 12-24 hours

Question 6

Which one of the following is NOT a feature of Candida Vaginitis?

Accepted Answer

Metronidazole is the treatment of choice

Answer

Yeast-buds and pseudohyphae forms can be seen under the microscope

Answer

Pruritus is out of proportion to discharge

Answer

Discharge is thick and curdy

Question 7

Which of the following is NOT a high risk factor for developing endometrial carcinoma?

Accepted Answer

Multiparity

Answer

Delayed menopause

Answer

Hypertension

Answer

Obesity

Question 8

All of the following are the features of functional ovarian cyst EXCEPT:

Accepted Answer

Usually symptomatic

Answer

Usually < 7 cm in diameter

Answer

Unilocular

Answer

Spontaneous regression occurs

Question 9

Gestational trophoblastic disease is a spectrum comprising which of the following entities?

1. Complete Hydatidiform mole
2. Partial Hydatidiform mole
3. Invasive mole
4. Choriocarcinoma

Select the correct answer using the code given below:

Accepted Answer

1, 2, 3 and 4

Answer

1, 2 and 3 only

Answer

1 and 4 only

Answer

2, 3 and 4 only

Question 10

Which of the following is NOT a component of Fothergill’s operation as a conservative surgery for uterovaginal prolapse?

Accepted Answer

Cervicopexy

Answer

Amputation of cervix

Answer

Plication of Mackenrodt’s ligaments

Answer

Anterior colporrhaphy

UPSC-CMS 2018 — Obstetrics and Gynecology