INI-CET 2021 - Obstetrics and Gynecology PYQs Practice Questions

Q: Arrange the following in sequential order with regards to the steps of collection of samples for pap smear testing: Use posterior vaginal wall retractor Take the sample Make smear on a slide Fix the smear

1,2,3,4. ***1,2,3,4*** - The correct sequence for collecting a Pap smear involves first **visualizing the cervix** using a posterior vaginal wall retractor, then **taking the sample** (e.g., using a broom or spatula and brush), followed by **making a smear on a slide** and finally **fixing the smear** to preserve the cells. - This sequential order ensures proper cell collection and preservation for accurate cytological examination. *1,2,4,3* - This option incorrectly places **fixing the smear** before **making the smear on the slide**. Cells must first be spread onto the slide before they can be fixed. - Fixing an un-smeared sample or attempting to smear after fixing would lead to an inadequate or damaged specimen. *3,1,2,4* - This sequence incorrectly starts with **making a smear on a slide** before any sample has been collected or the cervix visualized. - One cannot make a smear without first taking a sample and accessing the cervix via a retractor. *2,1,3,4* - This option incorrectly states that **taking the sample** occurs before **using a posterior vaginal wall retractor**. The retractor is essential for proper visualization and access to the cervix to obtain a quality sample. - Attempting to take a sample without proper visualization would lead to an inadequate or incorrect specimen collection. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which of the following is a part of AMTSL?

Controlled cord traction. ***Controlled cord traction*** - **Controlled cord traction (CCT)** is a key component of Active Management of Third Stage of Labor (AMTSL) performed during placental delivery. - This technique involves applying gentle, sustained traction to the umbilical cord while simultaneously providing counter-traction to the fundus (Brandt-Andrews maneuver) to prevent **uterine inversion**. - CCT is performed after administering a uterotonic and is the primary active maneuver for delivering the placenta. *Uterine massage* - **Uterine massage** is also a component of AMTSL, but it is performed **after placental delivery** to ensure adequate uterine contraction and prevent postpartum hemorrhage. - The three components of AMTSL per WHO recommendations are: (1) Uterotonic administration, (2) Controlled cord traction, (3) Uterine massage after placental delivery. - While technically part of AMTSL, **controlled cord traction** is the more specific answer as it refers to the active maneuver during placental separation and delivery itself. *Early cord clamping* - **Early cord clamping** (within 60 seconds of birth) has been removed from AMTSL recommendations in favor of **delayed cord clamping** (1-3 minutes or when pulsation stops). - Current WHO guidelines recommend delayed cord clamping for all births while still performing AMTSL, as delayed clamping provides neonatal benefits without increasing maternal hemorrhage risk. *Uterotonics after delivery of placenta* - **Uterotonics** (oxytocin 10 IU IM/IV) are administered **within 1 minute of birth** of the baby, which is *before* placental delivery, not after. - This prophylactic administration is the cornerstone of AMTSL and reduces postpartum hemorrhage risk by approximately 60%. - Administering uterotonics *after* placental delivery does not constitute proper AMTSL timing. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which of the following is not a cause of secondary amenorrhea?

Kallman syndrome. ***Kallman syndrome*** - This is a cause of **primary amenorrhea** because it involves congenital **GnRH deficiency**, preventing the onset of puberty and menstruation from the beginning. - Patients typically present with failure of pubertal development and **anosmia** (inability to smell). *Asherman's syndrome* - Characterized by **intrauterine adhesions** or scarring, often following uterine surgeries like D&C. - These adhesions can prevent the proper shedding of the endometrium, leading to **secondary amenorrhea** after previously established menses. *Sheehan's syndrome* - Occurs due to **ischemic necrosis of the pituitary gland** following severe postpartum hemorrhage, typically presenting with failure of lactation, fatigue, and **secondary amenorrhea**. - The pituitary damage leads to **deficiency of multiple pituitary hormones**, including FSH and LH. *Turner's mosaic* - While classic **Turner syndrome (45,XO)** is a common cause of primary amenorrhea and gonadal dysgenesis, **Turner's mosaic** (e.g., 45,XO/46,XX) can sometimes result in variable ovarian function. - In some mosaic cases, individuals may experience **menarche** and then develop premature ovarian failure, leading to **secondary amenorrhea**. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: What is the minimum percentage for normal sperm morphology according to WHO criteria in seminal fluid analysis?

4 %. ***4 %*** - According to the **World Health Organization (WHO) 2010 criteria** (maintained in WHO 2021, 6th edition), a minimum of **4% normal forms** is considered the lower reference limit for **sperm morphology**. - This seemingly low percentage reflects the **strict criteria (Tygerberg's strict criteria)** used for assessing sperm shape and structure, which evaluates the head, midpiece, and tail dimensions. - Values ≥4% are considered within normal range for **male fertility potential**. *8 %* - An 8% normal morphology would be considered **above the lower reference limit** according to current WHO guidelines. - While quantitatively better and indicating good sperm quality, it is not the *minimum* threshold required for classification as normal. *6 %* - A **6% normal morphology** is above the 4% minimum threshold set by WHO for normal sperm morphology. - This value is not the designated **lower reference limit** for identifying normal morphology as per the standard recommendations. *10 %* - A 10% normal morphology indicates **very good sperm morphology**, well above the lower reference limit. - However, the question asks for the **minimum percentage** for normal classification, and 10% is not that lower threshold. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

A pregnant woman at 36 weeks gestation is found to have high blood pressure recording and a urine protein of 3+. Concomitant presence of which of the following symptoms would make you suspect imminent eclampsia?

1. Headache
2. Blurred vision
3. Persistent pedal oedema
4. Epigastric pain

Accepted Answer

1 and 2 only

Answer

1,2,3,4

Answer

2 and 4 only

Answer

1,2,3

Question 2

Arrange the following in sequential order with regards to the steps of collection of samples for pap smear testing:
Use posterior vaginal wall retractor
Take the sample
Make smear on a slide
Fix the smear

Accepted Answer

1,2,3,4

Answer

1,2,4,3

Answer

3,1,2,4

Answer

2,1,3,4

Question 3

Which of the following is a part of AMTSL?

Accepted Answer

Controlled cord traction

Answer

Uterine massage

Answer

Early cord clamping

Answer

Uterotonics after delivery of placenta

Question 4

Which of the following is not a cause of secondary amenorrhea?

Accepted Answer

Kallman syndrome

Answer

Asherman's syndrome

Answer

Sheehan's syndrome

Answer

Turner's mosaic

Question 5

What is the minimum percentage for normal sperm morphology according to WHO criteria in seminal fluid analysis?

Accepted Answer

4 %

Answer

8 %

Answer

6 %

Answer

10 %

Question 6

Which of the following instruments are used in the caesarean section?

1. Bard-Parker blade
2. Doyen's retractor
3. Cusco's speculum
4. Allis forceps
5. Shirodkar's uterine clamp
6. Green Armytage forceps

Accepted Answer

1,2,4,6

Answer

1,2,3,6

Answer

1,2,5,6

Answer

1,2,3,5

Question 7

What is the normal cervical length?

Accepted Answer

3 cm

Answer

10 cm

Answer

5 cm

Answer

7 cm

Question 8

Which of the following symptoms are seen in endometriosis?

1. Infertility
2. Dysmenorrhea
3. Vaginal discharge
4. Vaginal bleeding

Accepted Answer

1,2

Answer

2,3

Answer

1,2,4

Answer

3,4

Question 9

A female patient having frothy vaginal discharge was found to have a strawberry cervix. Which of the following is the drug of choice?

Accepted Answer

Metronidazole

Answer

Cefixime

Answer

Tetracycline

Answer

Fluconazole

Question 10

A primigravida in her 10th week of gestation presents with spotting. On examination, the uterus corresponds to 12 weeks. Transvaginal ultrasound was done and it is given below. What is your diagnosis?

Accepted Answer

Hydatidiform mole

Answer

Blighted ovum

Answer

Ectopic pregnancy

Answer

Missed abortion

INI-CET 2021 — Obstetrics and Gynecology