UPSC-CMS 2022 - Obstetrics and Gynecology PYQs Practice Questions

Q: During the first stage of labour, the intrauterine pressure is increased up to

40–50 mm of Hg. ***40–50 mm of Hg*** - This pressure range is typical during **uterine contractions** in the first stage of labor, effectively causing cervical effacement and dilation. - These pressures provide sufficient force to facilitate the progression of labor while maintaining adequate **uteroplacental blood flow** between contractions. *100–120 mm of Hg* - This pressure range is generally too high for the first stage of labor and is more commonly seen in the **second stage** or during prolonged, abnormal contractions. - Such elevated pressures could potentially compromise **fetal well-being** due to reduced uteroplacental perfusion. *8–10 mm of Hg* - This pressure range represents the **resting tone** of the uterus between contractions, not the peak pressure during a contraction. - It is too low to cause significant cervical changes or *advance labor*. *2–3 mm of Hg* - This pressure is significantly below the normal resting tone of the uterus and is not associated with any stage of active labor. - Such low pressures would indicate **uterine inactivity** or atony, not active contractions. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which of the following is the most widely used screening test for cervical cancer?

Pap test. ***Pap test*** - The **Pap test** (Papanicolaou test) is the most widely used and effective screening test for cervical cancer globally. - It involves collecting cells from the **cervix** to detect **precancerous** and cancerous changes early. *Endocervical curettage* - **Endocervical curettage** is a diagnostic procedure used to obtain tissue samples from the endocervical canal, typically performed after an abnormal Pap test. - It is a **biopsy procedure**, not a primary screening test for general populations. *Visual inspections with acetic acid* - **Visual inspection with acetic acid (VIA)** is a lower-cost screening method used in resource-limited settings. - It involves applying acetic acid to the cervix and observing for **acetowhite changes**, but its sensitivity and specificity are not as high as the Pap test. *HPV DNA test* - The **HPV DNA test** detects high-risk types of human papillomavirus, which are responsible for most cervical cancers. - While it's increasingly used, especially in conjunction with the Pap test (co-testing) or as primary screening in some settings, the **Pap test** remains the most **widely established** and utilized primary screening method. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Serum level of CA 125 is raised in which of the following conditions?

All of the options. ***All of the options*** - **CA 125** levels can be elevated in various gynecological conditions, both malignant and benign. - While most recognized for its role in **epithelial ovarian cancer**, it is not exclusively specific to this condition. *Epithelial ovarian cancer* - **CA 125** is a commonly used tumor marker for **epithelial ovarian cancer**, playing a role in its diagnosis, monitoring, and recurrence detection. - While elevated in a high percentage of advanced ovarian cancers, it can also be normal in early-stage disease. *Pelvic inflammatory disease* - **Inflammation** of the pelvic organs, such as in **Pelvic Inflammatory Disease (PID)**, can cause an increase in **CA 125** levels. - The elevation is typically due to the irritation of the peritoneal surface or the presence of inflammatory exudates. *Endometriosis* - **Endometriosis**, a condition where endometrial-like tissue grows outside the uterus, is a well-known cause of elevated **CA 125**. - The level of **CA 125** often correlates with the severity and extent of the endometrial implants. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Following vaginal delivery, uterus becomes non-pregnant size by

6 weeks postpartum. ***6 weeks postpartum*** - This period allows for sufficient **myometrial contraction** and involution to return the uterus to its pre-pregnancy size through the process of **autolysis** and fundal descent. - The uterine weight decreases significantly from about 1000g immediately after delivery to approximately 50-70g by 6 weeks. - By the end of the puerperium (6 weeks), complete uterine involution is achieved. *9 weeks postpartum* - By 9 weeks, uterine involution would have been completed much earlier, and the uterus would have attained its **non-pregnant size** several weeks prior. - This timeframe is typically beyond the normal window for the completion of uterine regression. *8 weeks postpartum* - Similar to 9 weeks, by 8 weeks postpartum, the uterus would have already returned to its **non-pregnant state**. - The process of **involution** is usually completed well before this mark. *4 weeks postpartum* - While significant **uterine involution** occurs by 4 weeks, the uterus may still be slightly larger and heavier than its pre-pregnancy size. - Complete return to the **non-pregnant state** typically requires an additional two weeks. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Indications and prerequisites for delivery with the ventouse include which of the following? 1. Delay in the second stage of labour 2. Non-reassuring fetal heart rate 3. Gestation age less than 34 weeks of pregnancy 4. Vertex presentation.

1, 2 and 4. ***1, 2 and 4*** - **Ventouse delivery** is indicated for **delay in the second stage of labor** and **non-reassuring fetal heart rate**, when expeditious delivery is required. - A crucial prerequisite is **vertex presentation**, ensuring proper application of the vacuum cup to the fetal head. *2, 3 and 4* - **Gestation age less than 34 weeks of pregnancy** is a contraindication for ventouse delivery due to the increased risk of **fetal scalp trauma** and **intracranial hemorrhage** in premature infants. - While **non-reassuring fetal heart rate** and **vertex presentation** are valid points, the inclusion of premature gestation makes this option incorrect. *1, 2 and 3* - Again, **gestation age less than 34 weeks of pregnancy** is a contraindication, not an indication or prerequisite, for ventouse delivery. - Although **delay in the second stage** and **non-reassuring fetal heart rate** are correct factors, the inclusion of prematurity renders this option incorrect. *1, 3 and 4* - This option incorrectly lists **gestation age less than 34 weeks of pregnancy** as a prerequisite. - While **delay in the second stage** and **vertex presentation** are appropriate, the prematurity contraindication makes this an unsuitable choice. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

During the first stage of labour, the intrauterine pressure is increased up to

Accepted Answer

40–50 mm of Hg

Answer

100–120 mm of Hg

Answer

8–10 mm of Hg

Answer

2–3 mm of Hg

Question 2

Which of the following is the most widely used screening test for cervical cancer?

Accepted Answer

Pap test

Answer

Visual inspections with acetic acid

Answer

HPV DNA test

Answer

Endocervical curettage

Question 3

Serum level of CA 125 is raised in which of the following conditions?

Accepted Answer

All of the options

Answer

Epithelial ovarian cancer

Answer

Pelvic inflammatory disease

Answer

Endometriosis

Question 4

Following vaginal delivery, uterus becomes non-pregnant size by

Accepted Answer

6 weeks postpartum

Answer

9 weeks postpartum

Answer

8 weeks postpartum

Answer

4 weeks postpartum

Question 5

Indications and prerequisites for delivery with the ventouse include which of the following?

1. Delay in the second stage of labour
2. Non-reassuring fetal heart rate
3. Gestation age less than 34 weeks of pregnancy
4. Vertex presentation.

Accepted Answer

1, 2 and 4

Answer

2, 3 and 4

Answer

1, 2 and 3

Answer

1, 3 and 4

Question 6

Which of the following fetal infections is MOST commonly associated with significant intrauterine growth restriction?

Accepted Answer

Cytomegalovirus infection

Answer

Human papillomavirus infection

Answer

Rubella infection

Answer

Toxoplasmosis

Question 7

Missed abortion is not diagnosed if

Accepted Answer

USG shows fetus with cardiac activity

Answer

uterus is smaller than gestational age

Answer

external os is closed

Answer

vaginal bleed is brownish in colour

Question 8

In which of the following situations might delayed cord clamping be contraindicated?

Accepted Answer

Need for immediate neonatal resuscitation where delayed clamping interferes

Answer

Placental abruption with maternal compromise

Answer

Severe maternal hemorrhage requiring immediate resuscitation

Answer

Cord prolapse requiring immediate delivery

Question 9

Which of the following best defines gestational hypertension?

Accepted Answer

Sustained rise of blood pressure to 140/90 mmHg or more on at least two occasions 4-6 hours apart after 20 weeks of gestation in a previously normotensive woman

Answer

Sustained rise of blood pressure to 140/90 mmHg or more on two occasions 4-6 hours apart with proteinuria after 20 weeks of gestation

Answer

Sustained rise of blood pressure to 140/90 mmHg or more on at least two occasions 4-6 hours apart after 12 weeks of gestation

Answer

Sustained rise of blood pressure to 150/100 mmHg or more on at least two occasions 2 hours apart after 20 weeks of gestation

Question 10

A 27-year-old female is complaining of grayish white discharge with fishy odour. There is no history of itching associated with discharge. Which one of the following is the most likely diagnosis?

Accepted Answer

Bacterial vaginosis

Answer

Trichomoniasis

Answer

Urinary tract infection

Answer

Candidiasis

UPSC-CMS 2022 — Obstetrics and Gynecology