Reproductive Justice — MCQs
False about MTP is -
In the context of Indian regulations, what is the minimum number of Medical Termination of Pregnancy (MTP) cases a doctor must have performed to be eligible to perform an MTP?
A pregnant woman presents with an IUD in place, and the thread is clearly visible. She wishes to continue the pregnancy. What is the most appropriate next step?
In NRHM, the ASHA workers are recruited from the same village. Which part of principles of primary health care is followed here?
Death caused by act done with intent to cause miscarriage is punishable by
Which of the following is NOT a major strategy of RCH-I?
What is the most peripheral level of the healthcare system where the Reproductive and Child Health Programme is implemented?
According to MTP Act, 2 doctors' opinion is required when pregnancy is:
What is the primary health concern addressed by the Rashtriya Bal Swasthya Karyakram (RBSK)?
A woman, who is in the reproductively active age group, presents with a history of greenish and frothy vaginal discharge. On examination, she has multiple punctuate strawberry-like spots. What is the likely diagnosis?
Reproductive Justice Indian Medical PG Practice Questions and MCQs
Question 1: False about MTP is -
- A. Requires opinion of at least two registered medical practitioners when pregnancy exceeds 12 weeks
- B. Consent of husband is must (Correct Answer)
- C. >16 weeks, hysterotomy can be done
- D. Illegal if >20 weeks of pregnancy
Explanation: ***Consent of husband is must*** - The **Medical Termination of Pregnancy (MTP) Act** (amended in 2021) in India explicitly states that **only the consent of the pregnant woman** is required for an abortion. - The husband's consent is **not legally necessary** and cannot be a barrier to accessing MTP services. - **This statement is FALSE**, making it the correct answer to this negation question. *Requires opinion of at least two registered medical practitioners when pregnancy exceeds 12 weeks* - This statement is **TRUE**; for pregnancies between **12 and 20 weeks**, the opinion of **two registered medical practitioners** is required. - For pregnancies between **20 and 24 weeks**, two registered medical practitioners are required for specific vulnerable categories of women. *>16 weeks, hysterotomy can be done* - **Hysterotomy** is a surgical procedure similar to a mini-C-section, used in specific cases for MTP, often in later gestations or when other methods are contraindicated. - While exact gestational limits vary by clinical judgment and local regulations, it is indeed a method considered for **later second-trimester terminations**, including those beyond 16 weeks, under proper medical indication. - **This statement is TRUE**. *Illegal if >20 weeks of pregnancy* - This statement was largely true under the **MTP Act of 1971**, which set the upper limit for MTP at 20 weeks. - However, the **MTP (Amendment) Act of 2021** has expanded this limit, allowing termination up to **24 weeks for specific categories of women** and in cases of substantial fetal abnormalities, there is **no upper gestational limit** for termination. - **This statement is now FALSE** as per the 2021 amendments, though it requires contextual understanding.
Question 2: In the context of Indian regulations, what is the minimum number of Medical Termination of Pregnancy (MTP) cases a doctor must have performed to be eligible to perform an MTP?
- A. 10
- B. 15
- C. 25 (Correct Answer)
- D. 35
Explanation: ***25*** - As per the **MTP Act of India (1971)**, a registered medical practitioner needs to have assisted in or performed a minimum of **25 medical termination of pregnancies** in an approved training center to be certified to perform MTPs independently. - This regulation ensures a certain level of practical experience and competence before a doctor can perform this procedure. *10* - This number is **insufficient** according to Indian MTP regulations for a doctor to be eligible to perform MTPs independently. - The required practical experience is set higher to ensure adequate skill and safety for the procedure. *15* - This number also **falls short** of the minimum requirement stipulated by the Indian MTP Act. - The legislative framework emphasizes a more extensive practical exposure for practitioners. *35* - While performing 35 MTPs would certainly meet the experience requirement, it is **not the minimum specified** by the Indian MTP regulations. - The law requires a lower threshold of practical experience, which is 25 cases.
Question 3: A pregnant woman presents with an IUD in place, and the thread is clearly visible. She wishes to continue the pregnancy. What is the most appropriate next step?
- A. Leave the IUD inside
- B. Remove gently (Correct Answer)
- C. MTP (Medical Termination of Pregnancy)
- D. Cesarean section
Explanation: ***Remove gently*** - When the **IUD thread is visible**, gentle removal is recommended if the woman wishes to **continue the pregnancy**, as this significantly reduces the risk of miscarriage and infection. - Leaving an **IUD in situ** during pregnancy increases risks of **septic miscarriage**, **preterm delivery**, and **chorioamnionitis**. *Leave the IUD inside* - Leaving an **IUD in place** during pregnancy increases the risks of **septic miscarriage**, **chorioamnionitis**, and **preterm labor**. - The presence of the IUD can also lead to **placental complications** and difficulties with fetal development. *MTP (Medical Termination of Pregnancy)* - MTP is an option for unintended pregnancies but is not the most appropriate first step when the patient explicitly **wishes to continue the pregnancy**. - MTP would be considered if the patient chose to terminate, but the question states she wants to continue. *Cesarean section* - **Cesarean section** is a mode of delivery and is not an appropriate initial intervention for an early pregnancy with an **IUD in situ**. - The removal of an IUD from an early pregnancy does not necessitate a cesarean section.
Question 4: In NRHM, the ASHA workers are recruited from the same village. Which part of principles of primary health care is followed here?
- A. Appropriate technology
- B. Community participation (Correct Answer)
- C. Intersectorial coordination
- D. Equitable distribution
Explanation: **Community participation** - Recruiting ASHA workers from the same village exemplifies **community participation** by empowering local individuals to lead health initiatives and ensures their understanding of local customs and needs. - This approach fosters trust and acceptability within the community, making health services more **accessible and relevant** to the population. *Appropriate technology* - This principle refers to the use of **scientifically sound and acceptable methods** and tools that are affordable and relevant to local conditions. - While ASHAs use appropriate technologies, their recruitment method itself doesn't directly illustrate this principle. *Intersectorial coordination* - This involves collaborative efforts between the health sector and other sectors like education, agriculture, and sanitation, to address the **social determinants of health**. - Recruiting ASHAs addresses human resources within the health sector, not coordination between different sectors. *Equitable distribution* - This principle aims to ensure that health resources and services are **available to all people regardless of their geographic location** or socioeconomic status. - While having ASHAs in rural areas contributes to equity, the specific act of recruiting them *from the same village* primarily highlights community involvement and local ownership, rather than just the distribution of services.
Question 5: Death caused by act done with intent to cause miscarriage is punishable by
- A. 312 IPC
- B. 316 IPC
- C. 314 IPC (Correct Answer)
- D. 309 IPC
Explanation: ***314 IPC*** - **Section 314 of the Indian Penal Code (IPC)** specifically deals with the punishment for an act done with intent to cause miscarriage which results in the death of the woman. - If the act is done without the woman's consent, the punishment can be for life imprisonment or up to ten years, along with a fine. If done with consent, the punishment is up to ten years imprisonment and a fine. *312 IPC* - **Section 312 IPC** deals with causing miscarriage generally, without necessarily resulting in the death of the woman. - The punishment under this section is less severe, up to three years imprisonment and a fine if the woman is not quick with child, and up to seven years and a fine if she is quick with child. *316 IPC* - **Section 316 IPC** addresses causing the death of an unborn child when the intention was to prevent the child from being born alive. - This section applies when the child dies before or during birth but the mother survives, which is not the scenario described in the question where the mother's death is the outcome. *309 IPC* - **Section 309 IPC** pertains to the attempt to commit suicide. - This section is completely unrelated to the act of causing miscarriage or death arising from such an act.
Question 6: Which of the following is NOT a major strategy of RCH-I?
- A. Essential obstetric care
- B. Strengthening referral system
- C. School health programs (Correct Answer)
- D. Emergency obstetric care
Explanation: ***School health programs*** - **School health programs** were **not a major strategic component** of the first phase of the **Reproductive and Child Health (RCH-I)** program. RCH-I focused on more direct maternal and child health interventions. - While important for child health, **school health programs** were typically integrated into broader health initiatives rather than being a core strategy of the RCH-I program. *Essential obstetric care* - **Essential obstetric care** was a **major strategic component** of RCH-I, focusing on providing basic antenatal, natal, and postnatal care to reduce maternal and infant mortality. - This included skilled birth attendance, access to basic birthing facilities, and addressing common maternal health issues. *Emergency obstetric care* - **Emergency obstetric care** was a **critical component** of RCH-I, aimed at managing complications during pregnancy and childbirth that require immediate medical intervention. - This strategy involved strengthening facilities to provide timely interventions like C-sections, blood transfusions, and management of obstetric emergencies. *Strengthening referral system* - **Strengthening the referral system** was a **key strategy** within RCH-I, designed to ensure that women and children with complications could be quickly and efficiently referred from primary health centers to higher-level facilities for specialized care. - This aimed to improve accessibility to advanced medical services and reduce delays in receiving critical treatment.
Question 7: What is the most peripheral level of the healthcare system where the Reproductive and Child Health Programme is implemented?
- A. Anganwadi Center
- B. Sub-center (Correct Answer)
- C. District Level
- D. Block Level
Explanation: ***Sub-center*** - The **Sub-center** is the most peripheral and first contact point between the primary healthcare system and the community. - It is where basic Reproductive and Child Health (RCH) services, including **antenatal care**, **immunization**, and **family planning**, are delivered directly to the population. *Anganwadi Center* - **Anganwadi Centers** primarily focus on providing nutritional support, preschool education, and some health-related awareness. - While they support RCH efforts (e.g., distributing supplements), they are not the main implementing level for comprehensive RCH services but rather a community-level support structure. *District Level* - The **District Level** (e.g., District Hospitals) serves as a referral center and provides specialized RCH services, monitoring, and program management. - It is a higher tier that supervises and supports RCH programs, but the direct implementation at the community level happens below this. *Block Level* - The **Block Level** (e.g., Community Health Centers) provides comprehensive primary healthcare services and acts as a referral point for Primary Health Centers. - While it plays a significant role in RCH service delivery and supervision, the services are actually implemented to the community at the Sub-center level, which is administratively below the block.
Question 8: According to MTP Act, 2 doctors' opinion is required when pregnancy is:
- A. 10 weeks
- B. 6 weeks
- C. > 12 weeks
- D. > 20 weeks (Correct Answer)
Explanation: ***> 20 weeks*** - According to the **MTP (Amendment) Act 2021**, two registered medical practitioners' opinions are required for terminating a pregnancy when its duration is **between 20 to 24 weeks** (for specific categories of women). - For pregnancies **beyond 24 weeks**, termination is only permitted in cases of substantial fetal abnormalities diagnosed by a Medical Board. - This is the **current legal requirement** under Indian law. *10 weeks* - For pregnancies **up to 20 weeks**, only **one registered medical practitioner's** opinion is required for termination. - At 10 weeks, the pregnancy is well within this limit, so only one doctor's opinion is needed. *6 weeks* - Similar to 10 weeks, a pregnancy at 6 weeks falls within the **20-week limit**. - Only **one registered medical practitioner's** opinion is required, not two. *> 12 weeks* - Under the **old MTP Act 1971**, two doctors' opinions were required for pregnancies beyond 12 weeks. - However, under the **current MTP (Amendment) Act 2021**, pregnancies between 12-20 weeks require only **one doctor's opinion**. - This option represents outdated legal requirements and is **incorrect** under current law.
Question 9: What is the primary health concern addressed by the Rashtriya Bal Swasthya Karyakram (RBSK)?
- A. Adult chronic diseases
- B. Elderly health
- C. Non-communicable diseases in the youth
- D. Comprehensive healthcare for children from birth to 18 years (Correct Answer)
Explanation: **Comprehensive healthcare for children from birth to 18 years** - The **Rashtriya Bal Swasthya Karyakram (RBSK)** is a national program explicitly designed to provide comprehensive health screening and early intervention for 0-18 year-olds - Its focus is on detecting and managing the **4 D's**: Defects at birth, Deficiencies, Diseases, and Developmental delays - The program provides regular health check-ups, early detection of health conditions, referral for treatment, and promotes healthy development across this critical age group *Adult chronic diseases* - While public health initiatives address adult chronic diseases, they are not the primary focus of the **RBSK** program, which targets a younger demographic - Programs like the **National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS)** are more aligned with adult chronic disease management *Elderly health* - **RBSK** is specifically focused on the health of children and adolescents, not the elderly population - **National Programme for Healthcare of the Elderly (NPHCE)** is a dedicated initiative for elderly health *Non-communicable diseases in the youth* - While **RBSK** does address some non-communicable diseases (NCDs) through early detection and management, its scope is much broader, encompassing all 4 D's - RBSK aims for **holistic child health** rather than exclusively targeting NCDs in youth, which is a subset of its overall mandate
Question 10: A woman, who is in the reproductively active age group, presents with a history of greenish and frothy vaginal discharge. On examination, she has multiple punctuate strawberry-like spots. What is the likely diagnosis?
- A. Chlamydia infection
- B. Gonococcal vaginitis
- C. Candidiasis
- D. Trichomoniasis (Correct Answer)
Explanation: ***Trichomoniasis*** - The classic presentation of **greenish, frothy vaginal discharge** coupled with **strawberry cervix (multiple punctate spots)** is highly characteristic of trichomoniasis, caused by the parasite *Trichomonas vaginalis*. - This infection often causes **vaginal itching, irritation**, and dyspareunia. *Chlamydia infection* - Chlamydia often presents with **mucopurulent cervical discharge** and can be **asymptomatic**, but typically does not cause frothy, green discharge or strawberry cervix. - It is more commonly associated with symptoms like **dysuria** or **post-coital bleeding** when symptomatic. *Gonococcal vaginitis* - Gonorrhea typically causes **purulent discharge** that may be yellowish or greenish, but it is not typically frothy. - It is also associated with **dysuria** and pelvic pain, but the strawberry cervix is not a common finding. *Candidiasis* - Candidiasis (yeast infection) typically presents with a **thick, white, curd-like vaginal discharge**, often described as cottage cheese-like. - It is associated with **intense vulvovaginal itching and burning**, but not a frothy discharge or strawberry cervix.
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