NEET-PG 2012 - Obstetrics and Gynecology PYQs Practice Questions

Q: IUCD lasting for 10 years is a:

CuT - 380A. ***CuT - 380A*** - The **CuT-380A** is a copper-containing intrauterine device (IUD) specifically designed for a highly effective contraceptive duration of **10 years**. - Its mechanism involves the continuous release of copper ions, which create a hostile uterine environment for sperm and ova, preventing fertilization. *Progestase* - **Progestasert** (or Progestasert system) is a progesterone-releasing IUD that has a much **shorter duration of action**, typically around **1 year**. - Its contraceptive effect relies on the local release of progesterone, which thickens cervical mucus and thins the endometrial lining. *CuT - 220 (shorter duration)* - The **CuT-220** is an older generation copper IUD with a **shorter period of efficacy**, typically around **3 to 4 years**. - It contains a smaller surface area of copper compared to the CuT-380A, hence its shorter lifespan. *Nova T (shorter duration)* - **Nova T** is a copper IUD that is effective for a duration of **5 years**, making it a shorter-acting option compared to the CuT-380A. - While also copper-based, its design and total copper content allow for a more limited period of effectiveness. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Calcium requirement above the normal during the first six months of lactation is -

600 mg/day. ***600 mg/day*** - The increased calcium requirement during the first six months of lactation is primarily due to the significant amount of calcium secreted in **breast milk** for infant bone development. - During lactation, approximately **210-300 mg of calcium per day** is lost through breast milk, and considering **absorption efficiency** and maintaining maternal **bone density**, an additional **600 mg/day** above baseline requirements is recommended. - This additional intake helps meet the demands of milk production and prevent maternal bone demineralization during the period of **peak lactation**. *400 mg/day* - While calcium needs are elevated in lactation, an additional **400 mg/day** is insufficient to fully compensate for the calcium loss through breast milk during the initial, high-volume milk production phase. - This amount does not adequately account for both milk calcium content and the need to maintain maternal bone health during the first six months of lactation. *550 mg/day* - This increment is close but is generally considered slightly below the recommended additional intake for optimal maternal health and infant nutrition during **peak lactation**. - Adequate calcium intake is crucial as insufficient levels can lead to a negative calcium balance and increased risk of maternal **osteoporosis**. *75 mg/day* - An additional **75 mg/day** is a negligible increase and is far too low to meet the substantial calcium demands during the first six months of lactation. - This amount would be grossly inadequate considering that lactating mothers lose approximately **210-300 mg of calcium per day** into breast milk alone, not accounting for maternal physiological needs. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Blastocyst makes contact with endometrium on ?

5 - 7 days. ***5-7 days*** - The **blastocyst makes initial contact** (apposition) with the **endometrium** around **day 5-6 after fertilization**. - **Implantation**, which includes adhesion and invasion, typically begins around day 6 and is complete by day 10. - This timeframe allows the blastocyst to travel from the fallopian tube to the uterus and for the uterine lining to be optimally prepared. *< 3 days* - Within the first few days after fertilization, the zygote is still undergoing **cleavage** and development into a **morula**, then a young blastocyst, while traveling down the fallopian tube. - It has not yet reached the uterus or developed sufficiently to interact with the endometrium. *8-11 days* - By 8-11 days, the process of implantation is usually **well underway or completed**, with the blastocyst already invading the endometrial wall. - Initial contact and attachment occur prior to this period. *15-16 days* - This timeframe is well beyond the typical window for initial blastocyst contact and implantation. - By 15-16 days post-fertilization, the embryo would be undergoing **gastrulation** and early organogenesis, assuming successful implantation. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: The thickness of the endometrium at the time of implantation is:

7 - 10 mm. ***7 - 10 mm*** - At the time of **implantation** (day 6-10 post-fertilization, around day 20-24 of the menstrual cycle), the endometrium is in the **mid-secretory phase** and measures **7-10 mm** in thickness. - This is the **optimal thickness** for successful embryo implantation, characterized by a receptive endometrium with **decidualization**, **spiral artery development**, and **glycogen-rich glandular secretions**. - Endometrial thickness <7 mm is associated with **poor implantation rates** and reduced pregnancy success. *3 - 4 mm* - An endometrial thickness of 3-4 mm is **too thin** for successful implantation. - This thickness is typically seen in the **early proliferative phase** (immediately after menstruation), not during the implantation window. - Thin endometrium (<7 mm) is associated with **poor receptivity** and lower pregnancy rates in both natural conception and assisted reproduction. *20 - 30 mm* - An endometrial thickness of 20-30 mm is **abnormally thick** and not conducive to normal implantation. - Such thickness may indicate **endometrial hyperplasia**, **polyps**, or other pathological conditions requiring investigation. *30 - 40 mm* - An endometrial thickness of 30-40 mm is **severely abnormal** and would likely prevent successful implantation. - This extreme thickness suggests significant pathology such as **endometrial hyperplasia** or **malignancy** and requires urgent evaluation. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which structure do cytotrophoblasts invade during implantation?

Decidua basalis. ***Decidua basalis*** - The **cytotrophoblasts** invade the maternal **decidua basalis**, which is the portion of the **endometrium** directly underlying the implanted embryo, forming the maternal component of the **placenta**. - This invasion is crucial for establishing the **placenta** and allowing for nutrient and waste exchange between the mother and the fetus. *Decidua parietalis* - The **decidua parietalis** is the portion of the **endometrium** lining the rest of the **uterine cavity**, not directly involved in the immediate implantation site. - It plays a role later in pregnancy, fusing with the **decidua capsularis** as the **embryo** grows. *Decidua capsularis* - The **decidua capsularis** is the portion of the endometrium that overlies the implanted embryo, separating it from the uterine lumen. - It does not undergo invasion by the **cytotrophoblasts** in the same way the **decidua basalis** does. *Decidua vera* - The **decidua vera** is another term for the **decidua parietalis**, referring to the endometrial lining of the uterine cavity that is not involved in the implantation site. - It is not directly invaded by **cytotrophoblasts** during implantation. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

IUCD lasting for 10 years is a:

Accepted Answer

CuT - 380A

Answer

Nova T

Answer

CuT - 220

Answer

Progestasert

Question 2

Calcium requirement above the normal during the first six months of lactation is -

Accepted Answer

600 mg/day

Answer

75 mg/day

Answer

400 mg/day

Answer

550 mg/day

Question 3

Blastocyst makes contact with endometrium on ?

Accepted Answer

5 - 7 days

Answer

< 3 days

Answer

8 - 11 days

Answer

15-16 days

Question 4

The thickness of the endometrium at the time of implantation is:

Accepted Answer

7 - 10 mm

Answer

20 - 30 mm

Answer

30 - 40 mm

Answer

3 - 4 mm

Question 5

Which structure do cytotrophoblasts invade during implantation?

Accepted Answer

Decidua basalis

Answer

Decidua capsularis

Answer

Decidua vera

Answer

Decidua parietalis

Question 6

In which period is maternal mortality highest?

Accepted Answer

Peripartum

Answer

Antepartum

Answer

Postpartum

Answer

No period of maximum risk

Question 7

When should breastfeeding be initiated after a normal delivery?

Accepted Answer

Immediately after delivery

Answer

2 hours after delivery

Answer

4 hours after delivery

Answer

6 hours after delivery

Question 8

Which contraceptive method has the lowest pregnancy failure rate (typical use)?

Accepted Answer

Intrauterine Contraceptive Device (IUCD)

Answer

Diaphragm

Answer

Condom

Answer

Oral Contraceptive Pills (OCP)

Question 9

What is the energy requirement in late pregnancy?

Accepted Answer

2500 calories

Answer

2000 calories

Answer

1400 calories

Answer

3000 calories

Question 10

Rule of Hasse is used to determine :

Accepted Answer

Age of the fetus

Answer

Height of an adult.

Answer

Race of a person.

Answer

Identification of fetal abnormalities.

NEET-PG 2012 — Obstetrics and Gynecology