UPSC-CMS 2021 - Obstetrics and Gynecology PYQs Practice Questions

Q: A 43 year old woman presented with serous discharge from a single duct of the nipple of her right breast which was sent for evaluation. She is unlikely to be suffering from

Fibrocystic disease. ***Fibrocystic disease*** - **Fibrocystic changes** usually present with **lumpy breasts**, pain, and sometimes **multiple** duct nipple discharge, which can be clear or milky. - A **single duct serous discharge** is not a typical presentation, making it less likely given the details. *Intraductal Papilloma* - **Intraductal papilloma** is the **most common cause** of **serous or bloody nipple discharge** from a **single duct**. - This benign tumor grows within the milk ducts and is a frequent finding with the described symptoms. *Carcinoma* - **Ductal carcinoma in situ (DCIS)** or **invasive ductal carcinoma** can present with **unilateral, bloody or serous nipple discharge** from a **single duct**. - The type of discharge and its unilateral, single-duct nature are concerning features that warrant malignancy exclusion. *Duct Ectasia* - **Duct ectasia** can cause nipple discharge which is often **thick, sticky, and multicolored** (green, black, or brown), and may be associated with **nipple inversion**. - While it can be from a single duct, the discharge is typically **not serous** and is more characteristic of a **dilated or inflamed duct**. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Ideal weight gain during pregnancy for a woman with normal BMI should be

11-16 kg. ***11-16 kg*** - For a woman with a **normal Body Mass Index (BMI)** (18.5-24.9), the recommended total weight gain during pregnancy is **11.5 to 16 kg (25 to 35 lbs)**. - This range supports optimal fetal growth and maternal health, reducing risks associated with both inadequate and excessive weight gain. *More than 18 kg* - Gaining more than **18 kg (40 lbs)** during pregnancy, especially for women with a normal BMI, is generally considered **excessive**. - This can increase the risk of complications such as **gestational diabetes**, **hypertension**, **macrosomia**, and **cesarean delivery**. *7 kg* - A total weight gain of only **7 kg (15 lbs)** for a woman with a normal BMI during pregnancy is typically considered **insufficient**. - Inadequate weight gain can lead to a higher risk of delivering a **low birth weight infant** or one who is **small for gestational age**. *18 kg* - A weight gain of **18 kg (approximately 40 lbs)** **exceeds the recommended range** for women with a normal BMI (11.5-16 kg). - This represents the **upper limit** of recommended weight gain for **underweight women** (BMI <18.5), whose target range is 12.5-18 kg (28-40 lbs). - For normal BMI women, 18 kg is considered **excessive** and may increase risks of maternal and fetal complications. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Blood volume increases during pregnancy above nonpregnant level at 30-34 weeks by:

by 40-50 per cent. ***by 40-50 per cent*** - During pregnancy, **blood volume significantly increases**, primarily due to hormonal changes, to support the growing fetus and uteroplacental unit, with the peak increase typically occurring around the third trimester. - This expansion involves both **plasma volume (greater increase)** and **red blood cell mass**, leading to a state of physiologic hemodilution. *Blood volume does not increase at all* - This statement is incorrect as a substantial **increase in blood volume is a hallmark of normal pregnancy physiology** to meet increased metabolic demands. - Failure of blood volume to increase would imply a pathologic state, potentially compromising both maternal and fetal well-being. *by 25-30 per cent* - While a significant increase, **25-30% is generally an underestimation** of the full extent of blood volume expansion that occurs in a healthy pregnancy. - The total increase often reaches higher values, particularly when considering the combined rise in plasma and red blood cells. *by 10-20 per cent* - An increase of **10-20% is considerably less** than what is typically observed during a normal pregnancy. - This level of increase would likely be insufficient to adequately support the physiological demands of the mother and fetus. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which of the following are contra-indications to external cephalic version in antenatal management of breech presentation? 1. Antepartum haemorrhage 2. Multiple pregnancy 3. Reactive Non Stress Test 4. Severe oligohydramnios

1, 2 and 4. ***1, 2 and 4*** * **Antepartum haemorrhage**, **multiple pregnancy**, and **severe oligohydramnios** are all contraindications to external cephalic version (ECV) due to increased risks of fetal distress, placental abruption, and uterine rupture. * These conditions either compromise fetal well-being directly or make the procedure significantly more dangerous for both mother and fetus. *2, 3 and 4* * This option incorrectly includes a **reactive non-stress test** as a contraindication, which actually indicates fetal well-being and is a prerequisite for ECV. * Excluding **antepartum haemorrhage** as a contraindication is also incorrect, as it poses a significant risk. *1, 2, 3 and 4* * This option is incorrect because a **reactive non-stress test** is a sign of fetal health and is a requirement *before* performing an ECV, not a contraindication. * Including it diminishes the specificity of contraindications for this procedure. *1, 2 and 3* * This option erroneously lists a **reactive non-stress test** as a contraindication, when in reality, it's a reassuring finding critical for proceeding with ECV. * It also omits **severe oligohydramnios** which is a significant contraindication due to the inability to safely manipulate the fetus. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Antepartum haemorrhage is defined as bleeding from genital tract occurring:

After 28 weeks of pregnancy. ***After 28 weeks of pregnancy*** - **Antepartum hemorrhage (APH)** is defined as any bleeding from the genital tract occurring from **28 weeks of gestation** until the onset of labour. - This definition helps differentiate it from bleeding in earlier pregnancy, which is typically classified as **threatened abortion**, **miscarriage**, or other early pregnancy complications. *Before 20 weeks of pregnancy* - Bleeding occurring before 20 weeks of pregnancy is generally referred to as **threatened abortion**, **inevitable abortion**, **incomplete abortion**, or **complete abortion**. - These conditions are distinct from antepartum hemorrhage, which pertains to later stages of pregnancy. *Before 24 weeks of pregnancy* - Similar to before 20 weeks, bleeding before 24 weeks would fall under categories related to **early pregnancy loss or complications**, not antepartum hemorrhage. - The viability of the fetus is often still a critical factor in this gestational range, and management differs. *After 34 weeks of pregnancy* - While bleeding after 34 weeks is a form of antepartum hemorrhage, the definition of APH encompasses any bleeding **from 28 weeks onwards**, making "After 28 weeks of pregnancy" the most accurate and comprehensive definition. - Specifying "after 34 weeks" is too narrow and excludes bleeding events that occur between 28 and 34 weeks which are still considered APH. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

A 43 year old woman presented with serous discharge from a single duct of the nipple of her right breast which was sent for evaluation. She is unlikely to be suffering from

Accepted Answer

Fibrocystic disease

Answer

Intraductal Papilloma

Answer

Carcinoma

Answer

Duct Ectasia

Question 2

Ideal weight gain during pregnancy for a woman with normal BMI should be

Accepted Answer

11-16 kg

Answer

More than 18 kg

Answer

7 kg

Answer

18 kg

Question 3

Blood volume increases during pregnancy above nonpregnant level at 30-34 weeks by:

Accepted Answer

by 40-50 per cent

Answer

Blood volume does not increase at all

Answer

by 25-30 per cent

Answer

by 10-20 per cent

Question 4

Which of the following are contra-indications to external cephalic version in antenatal management of breech presentation?

1. Antepartum haemorrhage
2. Multiple pregnancy
3. Reactive Non Stress Test
4. Severe oligohydramnios

Accepted Answer

1, 2 and 4

Answer

2, 3 and 4

Answer

1, 2, 3 and 4

Answer

1, 2 and 3

Question 5

Antepartum haemorrhage is defined as bleeding from genital tract occurring:

Accepted Answer

After 28 weeks of pregnancy

Answer

Before 20 weeks of pregnancy

Answer

Before 24 weeks of pregnancy

Answer

After 34 weeks of pregnancy

Question 6

Which one of the following is NOT a risk factor for pre-eclampsia ?

Accepted Answer

Placenta previa

Answer

Pre-existing vascular disease

Answer

Obesity

Answer

Primigravida

Question 7

What are Spiegelberg's criteria for diagnosis of ovarian pregnancy?

1. Tube on the affected side must be intact
2. Gestational sac must be in the position of ovary
3. Ovary is connected to uterus by utero-ovarian ligament
4. Ovarian tissue must be detected on the wall on histological examination

Accepted Answer

1, 2, 3 and 4

Answer

1, 2 and 3 only

Answer

2, 3 and 4 only

Answer

1 and 4 only

Question 8

Which one of the following statements regarding fetal well being is NOT correct?

Accepted Answer

Modified Biophysical profile includes Non-stress test and fetal breathing

Answer

Mothers perceive 88% of fetal movements

Answer

Daily fetal movement count is a simple reliable method of fetal well being

Answer

Healthy fetus should have minimum of 10 movements in 12 hours period

Question 9

Which of the following statements are correct with respect to antenatal USG examination?

1. It helps in detecting gross fetal anomalies
2. It helps in identifying multiple pregnancies
3. It helps in identifying viable pregnancy
4. Best dating is possible with third trimester ultrasound scan

Accepted Answer

1, 2 and 3 only

Answer

3 and 4 only

Answer

1 and 2 only

Answer

1, 2, 3 and 4

Question 10

During pregnancy iron supplementation is needed for

Accepted Answer

all pregnant mothers from 16 weeks onwards

Answer

all pregnant mothers since 6 weeks of pregnancy

Answer

only those pregnant mothers who have Hb < 10 gm%

Answer

only those pregnant mothers who are not eating green vegetables

UPSC-CMS 2021 — Obstetrics and Gynecology