FMGE 2025 - Obstetrics and Gynecology PYQs Practice Questions

Q: OCPs are not protective for?

Breast Ca. ***Breast Ca (Correct Answer)*** - OCPs are **not protective** against breast cancer - Current or recent use is associated with a **small, reversible increase** in risk, particularly with prolonged use (>5 years) - The risk is attributed to **exogenous estrogen and progesterone** stimulating hormone-sensitive breast tissue proliferation *Endometrial Ca (Incorrect - OCPs ARE protective)* - OCPs offer significant protection against endometrial cancer, reducing risk by about **50%** - This benefit is primarily due to the reliable dose of **progestin**, which induces **endometrial atrophy** and counteracts unopposed estrogen effects *Ovarian Ca (Incorrect - OCPs ARE protective)* - OCPs provide powerful protection against ovarian cancer, with benefit increasing with duration of use and persisting for decades after cessation - Mechanism involves suppression of **gonadotropins** and prevention of **repeated ovulation**, reducing trauma and carcinogenic transformation potential of the ovarian epithelium *Colorectal Ca (Incorrect - OCPs ARE protective)* - OCP use provides a long-lasting protective effect against colorectal cancer - This protective effect is thought to be mediated by **synthetic progestins and estrogens** altering local hormone receptors or bile acid composition [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which sign of pregnancy is demonstrated in the image below?

Hegar Sign. ***Hegar Sign*** - This sign refers to the **softening and compressibility** of the lower uterine segment, which can be appreciated during a bimanual examination, as depicted in the image. - It is a probable sign of pregnancy and typically appears between **6 to 8 weeks of gestation** due to hormonal influences. *Goodell Sign* - This is the **softening of the vaginal portion of the cervix**, which feels like lips rather than the tip of the nose (as it feels in a non-pregnant state). - The image demonstrates palpation of the uterine isthmus between the abdominal and vaginal hands, not just the cervix. *Osiander sign* - This refers to an increased **arterial pulsation** felt through the lateral fornices of the vagina due to increased blood flow through the uterine artery. - The examination shown is a midline palpation to assess the uterus, not the lateral fornices to detect pulsations. *Palmer sign* - This is characterized by **rhythmic uterine contractions** that can be felt on bimanual examination during early pregnancy. - The image illustrates assessing the consistency (softness) of the lower uterus, not feeling for contractions. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: This instrument is contraindicated for?

Obstructed labor. ***Obstructed labor*** - Using forceps in obstructed labor, such as in cases of **cephalopelvic disproportion (CPD)**, is absolutely contraindicated as it can cause severe maternal trauma like **uterine rupture** and significant fetal injury. - The definitive management for true obstructed labor is a **Caesarean section** to safely bypass the mechanical obstruction. *Caesarean section* - Wrigley's forceps are commonly used during a Caesarean section to assist in delivering the fetal head, especially when it is deeply engaged in the pelvis (a "lift-out" forceps application). - Therefore, a Caesarean section is an *indication* for the use of these specific forceps, not a contraindication. *After coming head of breech* - Forceps can be used to deliver the aftercoming head in a breech presentation to control delivery and prevent sudden decompression of the fetal head. **Piper's forceps** are specifically designed for this purpose. - This situation represents a specific indication for an assisted delivery, not a contraindication. *Occipital posterior position* - A persistent occiput posterior position can lead to a prolonged second stage of labor, which is a common indication for operative vaginal delivery. - Depending on the fetal head station, rotational forceps (like **Kielland's**) or outlet forceps (like **Wrigley's**) may be used to either rotate the head or deliver it directly in the posterior position. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: The image depicts which of the following early signs of pregnancy?

Hegar sign. ***Hegar Sign*** - The image demonstrates a bimanual examination where the lower uterine segment (isthmus) is compressed between the internal and external fingers, which is the classic maneuver to elicit **Hegar sign**. - This is a probable sign of pregnancy, characterized by the softening and compressibility of the uterine isthmus, typically detectable between **6 to 8 weeks** of gestation. *Goodell Sign* - **Goodell sign** refers to the significant softening of the **cervix** due to increased vascularity and edema, which feels like the consistency of lips rather than the tip of the nose. - The examination shown in the image is focused on palpating the **uterine isthmus**, which is located superior to the cervix. *Osiander sign* - **Osiander sign** is the detection of an increased **pulsation** in the **lateral vaginal fornices**, which is a result of increased blood flow through the uterine artery. - The image depicts the assessment of tissue consistency and compressibility, not the detection of arterial pulsations. *Palmer sign* - **Palmer sign** is characterized by regular, rhythmic **uterine contractions** that can be palpated during a bimanual examination in early pregnancy. - The maneuver shown is assessing the static compressibility of the uterine isthmus, not its dynamic contractile activity. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which findings are most suggestive of tubal pregnancy?

Adnexal mass with empty uterus and fluid in pelvis. ***Adnexal mass with empty uterus and fluid in pelvis***- The visualization of an **adnexal mass** (corresponding to the tubal gestation) and an **empty uterus** confirms the diagnosis of an ectopic pregnancy.- The presence of **free fluid in the pelvis** (hemoperitoneum) is highly suggestive of a ruptured or leaking tubal pregnancy, representing the most urgent presentation.*Ovarian mass with single layer of endometrium*- An **ovarian mass** suggests pathology involving the ovary itself, such as an ovarian ectopic pregnancy or a cyst, rather than the most common site, the fallopian tube.- The **single layer of endometrium** (thin decidual reaction) may occur in ectopic pregnancy due to insufficient hormonal stimulus but is not sufficient evidence for a tubal location.*Adnexal mass with empty uterus*- While this constellation of findings definitely suggests an **ectopic pregnancy**, it is often indicative of an early and **unruptured** tubal pregnancy.- Lacking **free fluid (blood)** in the pelvis makes this option less suggestive of advanced or complicated tubal pregnancy compared to the correct option.*Trilayer endometrium without adnexal mass*- A **trilayer endometrium** is a typical ultrasound finding during the proliferative phase, or it may be seen in a developing intrauterine pregnancy (IUP).- The absence of an **adnexal mass** essentially excludes the possibility of a tubal ectopic pregnancy. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

OCPs are not protective for?

Accepted Answer

Breast Ca

Answer

Endometrial Ca

Answer

Ovarian Ca

Answer

Colorectal Ca

Question 2

Which sign of pregnancy is demonstrated in the image below?

Accepted Answer

Hegar Sign

Answer

Goodell Sign

Answer

Palmer sign

Answer

Osiander sign

Question 3

This instrument is contraindicated for?

Accepted Answer

Obstructed labor

Answer

After coming head of breech

Answer

Caesarean section

Answer

Occipital posterior position

Question 4

The image depicts which of the following early signs of pregnancy?

Accepted Answer

Hegar sign

Answer

Osiander sign

Answer

Palmer sign

Answer

Goodell sign

Question 5

Which findings are most suggestive of tubal pregnancy?

Accepted Answer

Adnexal mass with empty uterus and fluid in pelvis

Answer

Trilayer endometrium without adnexal mass

Answer

Ovarian mass with single layer of endometrium

Answer

Adnexal mass with empty uterus

Question 6

A female presents with hirsutism, delayed periods, obesity. USG findings are given below. What is the likely diagnosis?

Accepted Answer

PCOD

Answer

Thecal luteal cyst

Answer

POI

Answer

OHSS

Question 7

What is the likely diagnosis for the given image?

Accepted Answer

Genital TB

Answer

Hydrosalpinx

Answer

Normal fallopian tube

Answer

Endometriosis

Question 8

During laparoscopy, multiple small, yellowish-white tubercles are observed scattered over the pelvic peritoneum and adnexal surfaces. What is the most likely diagnosis?

Accepted Answer

Genital TB

Answer

Hydrosalpinx

Answer

Normal fallopian tube

Answer

Endometriosis

Question 9

Which of the following drugs is not given for hypertension in pregnancy?

Accepted Answer

Enalapril

Answer

Nifedipine

Answer

Methyldopa

Answer

Labetalol

Question 10

Which is the primary chemotherapeutic agent used for cervical cancer?

Accepted Answer

Platinum-based therapy

Answer

Immunotherapy

Answer

Hormonal therapy

Answer

Targeted therapy

FMGE 2025 — Obstetrics and Gynecology