NEET-PG 2013 Practice Questions

Q: Which of the following anesthetic agents is most notable for its analgesic properties?

Ketamine. ***Ketamine*** - **Ketamine** is unique among general anesthetics for its significant **analgesic properties**, which stem from its action as an **NMDA receptor antagonist**. - Its ability to provide pain relief makes it useful in scenarios where both **anesthesia** and **analgesia** are desired, such as for painful procedures or in trauma settings. *Propofol* - While **propofol** is a widely used intravenous anesthetic, it lacks intrinsic **analgesic properties**. Its primary effects are **sedation** and **hypnosis**. - Pain during propofol injection is common, and other analgesics are usually co-administered for painful procedures. *Thiopentone* - **Thiopentone** is an ultrashort-acting barbiturate primarily used for **induction of anesthesia** due to its rapid onset and profound hypnotic effects. - It has **no analgesic properties** and can even lower the pain threshold, requiring concurrent administration of analgesics.

Q: Intraocular pressure is increased by which anaesthetic?

Ketamine. ***Ketamine*** - **Ketamine** is known to increase **intraocular pressure (IOP)**, making it generally avoided in patients with glaucoma or penetrating eye injuries. - This effect is thought to be due to its dissociative properties, causing **nystagmus**, and stimulating extraocular muscles. *Nitrous Oxide* - **Nitrous oxide** by itself has minimal or no direct effect on **intraocular pressure (IOP)**. - However, in cases of an air-filled globe (e.g., after retinal detachment surgery), it can increase IOP by expanding the gas bubble. *Isoflurane* - **Isoflurane**, like most volatile anesthetics, typically **decreases intraocular pressure (IOP)**. - This reduction is generally due to its effects on reducing aqueous humor production and increasing uveoscleral outflow. *Propofol* - **Propofol** is known for its ability to **decrease intraocular pressure (IOP)**. - This effect is mediated by a reduction in aqueous humor production and an increase in uveoscleral outflow, making it a favorable choice in ophthalmic surgery.

Q: Which of the following anesthetics is known to increase intraocular pressure?

Ketamine. ***Ketamine*** - **Ketamine** is known to increase **intraocular pressure (IOP)**, making it generally avoided in patients with **glaucoma** or those undergoing ocular surgery. - This effect is due to its influence on sympathetic nervous system activity and extraocular muscle tone. *Thiopental* - **Thiopental**, a barbiturate, typically causes a **reduction in intraocular pressure**, which can be beneficial in certain ocular procedures. - Its mechanism involves decreasing cerebral blood flow and metabolic rate, indirectly leading to a decrease in IOP. *Alfentanil* - **Alfentanil**, an opioid, generally has **minimal to no significant effect on intraocular pressure**. - Its primary actions are analgesia and sedation, without direct impact on oculomotor tone or fluid dynamics. *Propofol* - **Propofol** is known to **decrease intraocular pressure**, making it a favorable agent for ophthalmic surgery. - This effect is attributed to a reduction in cerebral blood flow and an inhibition of aqueous humor production.

Q: In the context of obstructed labor, which maternal pelvic parameter is considered the most critical for successful delivery?

Diameter of pelvic inlet. ***Diameter of pelvic inlet*** - The **pelvic inlet** is typically the narrowest and most critical passage for the fetal head to engage and descend into the pelvis during labor. - An inadequate pelvic inlet diameter can lead to **cephalopelvic disproportion**, resulting in **obstructed labor** because the fetal head cannot enter the true pelvis. *Diameter of pelvic outlet* - While important for the final stages of labor, an inadequate **pelvic outlet** usually presents a problem only after the fetal head has successfully navigated the inlet and mid-pelvis. - Obstruction at the outlet is less common as the primary cause of prolonged or arrested first stage labor compared to an unyielding inlet. *Biparietal diameter* - The **biparietal diameter (BPD)** measures the widest transverse diameter of the fetal head, which is crucial but represents a fetal parameter. - While critical for assessing fetal head size in relation to the maternal pelvis, it is a fetal measurement, not a maternal pelvic parameter like the inlet. *Bitemporal diameter* - The **bitemporal diameter** is the shortest transverse diameter of the fetal head and is rarely the presenting issue in **obstructed labor**. - It is typically much smaller than the biparietal diameter and usually presents no obstacle to passage through the pelvis.

Q: For routine diagnostic purposes, endometrial biopsy is usually done at which phase of the menstrual cycle?

Just before menstruation. ***Just before menstruation*** - An endometrial biopsy is typically performed in the **late secretory phase (just before menstruation)**. This timing is crucial for evaluating the endometrial response to progesterone and for detecting abnormalities that may be evident during this phase. - This timing allows for the assessment of the **full development of the secretory glands** and stroma, which can reveal issues like **inadequate luteal phase** or **endometrial hyperplasia** more clearly. *10-12 days after menstruation* - This time point corresponds to the mid-proliferative phase, where the endometrium is still growing under **estrogen influence**. - While suitable for evaluating proliferative changes, it might **miss subtle secretory phase abnormalities** or early signs of hyperplasia that are more evident later. *Just after menstruation* - This period is the early proliferative phase, where the endometrium is **thin and regenerating**. - Biopsying at this time might yield insufficient tissue for comprehensive evaluation and would be too early to assess **hormonal responses** that occur later in the cycle. *At the time of ovulation* - Ovulation marks the transition from the proliferative to the secretory phase, influenced by a surge in **luteinizing hormone (LH)**. - An endometrial biopsy at this phase would primarily show a proliferative endometrium and would not provide adequate information about the **key features of the secretory phase**, which are important for diagnostic purposes related to fertility or abnormal bleeding.

Q: Oligomenorrhoea means ?

Cycle longer than 35 days. ***Cycle longer than 35 days*** - **Oligomenorrhea** is defined by menstrual cycles that are **infrequently occurring**, specifically lasting longer than 35 days. - This condition is distinct from **amenorrhea**, which is the complete absence of menstruation. *Cycle < 20 days* - A menstrual cycle lasting less than 20 days is considered **polymenorrhea**, indicating abnormally frequent menstruation. - This is the opposite of oligomenorrhea, which refers to infrequent menstruation. *Cycle more than 45 days* - While a cycle longer than 45 days would technically fall under **oligomenorrhea**, the general definition begins at an interval longer than **35 days**. - Cycles significantly longer than 45 days might also point to **amenorrhea**, depending on the exact duration and pattern. *Cycle more than 28 days* - A cycle lasting more than 28 days is within the **normal range** for many individuals, as the average cycle length is 21-35 days. - Therefore, this duration alone does **not define oligomenorrhea**.

Q: Magnification obtained by colposcopy is?

10-20 times. ***10-20 times*** - Colposcopes typically provide magnification in the range of **10 to 20 times** to allow for detailed examination of the cervix, vagina, and vulva. - This magnification level is sufficient to identify changes in the **epithelium**, such as those associated with dysplasia or cancer. *1-2 times* - A magnification of 1-2 times is very low and would not be adequate for **detailed visualization** of the cervix and its microscopic changes. - This range is more akin to **naked eye** observation or a simple magnifying glass, insufficient for colposcopic purposes. *5-6 times* - While 5-6 times magnification offers some detail, it is generally **insufficient** for the precise identification of subtle epithelial changes or abnormal vascular patterns characteristic of dysplasia. - Most colposcopes are designed to provide higher magnification to enhance diagnostic accuracy. *15-25 times* - While some advanced colposcopes might offer magnification up to 25 times, the standard and most commonly used range is **10-20 times**. - Magnification significantly beyond 20 times can sometimes lead to a **smaller field of view** and increased difficulty in focusing, making it less practical for routine examination.

Q: On which day LH & FSH should be measured?

1-3rd day. ***1-3rd day*** - Measuring **LH** (Luteinizing Hormone) and **FSH** (Follicle-Stimulating Hormone) on cycle days 1-3 provides a baseline assessment of **ovarian reserve** and pituitary function. - At this early follicular phase, hormone levels are relatively stable and reflect the intrinsic **gonadal feedback** mechanisms before significant follicular development begins. *7th day* - By day 7, **follicular development** is usually well underway, and FSH levels might be decreasing as a dominant follicle is selected. - Measuring hormones on this day would not provide an accurate baseline assessment, as the levels are already influenced by **follicular growth**. *14th day* - Day 14 is often associated with the **LH surge** that triggers ovulation, making it unsuitable for a baseline assessment of ovarian reserve. - FSH levels would also be significantly different from the early follicular phase due to the ongoing **ovarian cycle events**. *10th day* - On day 10, **estrogen levels** are typically rising, which would already be providing negative feedback to the pituitary, affecting FSH and LH levels. - This timing would not be ideal for assessing baseline hormone levels for **fertility evaluations**.

Q: What is the best parameter for estimating fetal age by ultrasound in the third trimester?

BPD. ***BPD (Biparietal Diameter)*** - **Biparietal diameter (BPD)** is considered the **best single parameter** among the given options for estimating fetal age in the third trimester, though all parameters become less accurate with advancing gestation. - In the third trimester, BPD accuracy is approximately **±3-4 weeks**, which is why **first trimester dating (CRL) should always be used when available** as it is most accurate (±5-7 days). - BPD is measured at the level of the thalami and cavum septum pellucidum, from outer edge of the proximal skull to the inner edge of the distal skull. - **Note**: Multiple biometric parameters used together improve accuracy more than any single measurement in late pregnancy. *Femur length* - **Femur length (FL)** is highly accurate in the **second trimester** but becomes less reliable in the third trimester due to biological variation. - It can be affected by **skeletal dysplasias** and genetic factors, leading to inaccurate age estimation. - FL is better used for assessing proportionate growth rather than dating in late pregnancy. *Abdominal circumference* - **Abdominal circumference (AC)** is primarily used for assessing **fetal growth and estimating fetal weight**, not for gestational age determination. - It is highly variable and influenced by fetal nutritional status, growth restriction, or macrosomia, making it unreliable for dating. - AC is the **most sensitive parameter for detecting growth abnormalities** (IUGR or LGA). *Intraocular distance* - **Intraocular distance (IOD)** is not a standard biometric parameter for routine gestational age estimation. - It has limited clinical utility and is occasionally used for detecting specific **fetal anomalies** (hypertelorism/hypotelorism) rather than dating. - Standard biometric parameters (BPD, HC, AC, FL) are always preferred for gestational age assessment.

Q: Commonest variety of compound presentation is?

Head with hand. ***Head with hand*** - This is the **most frequent type** of compound presentation, where a fetal extremity (typically a hand) prolapses alongside the fetal head into the maternal pelvis. - It occurs due to factors that prevent the fetal head from snugly filling the pelvis, such as **cephalopelvic disproportion** or a **high fetal station**. *Head with foot* - While possible, the presentation of the **head with a foot** is less common than with a hand. - A foot alongside the head often suggests a more complex presentation or potential issues with fetal lie or attitude. *Head with both foot* - The simultaneous presentation of the **head with both feet** is exceedingly rare. - This scenario would indicate a profound degree of space for fetal extremities to descend alongside the head, possibly in cases of extreme prematurity or pelvic relaxation. *Head, hand & foot* - The combined presentation of the **head, a hand, and a foot** is extremely uncommon. - Such a complex presentation would suggest significant fetal mobility in a large pelvic space, making it a very rare occurrence in clinical practice.

Question 1

Which of the following anesthetic agents is most notable for its analgesic properties?

Accepted Answer

Ketamine

Answer

Thiopentone

Answer

Propofol

Answer

None of the options

Question 2

Intraocular pressure is increased by which anaesthetic?

Accepted Answer

Ketamine

Answer

Nitrous Oxide

Answer

Isoflurane

Answer

Propofol

Question 3

Which of the following anesthetics is known to increase intraocular pressure?

Accepted Answer

Ketamine

Answer

Thiopental

Answer

Alfentanil

Answer

Propofol

Question 4

In the context of obstructed labor, which maternal pelvic parameter is considered the most critical for successful delivery?

Accepted Answer

Diameter of pelvic inlet

Answer

Biparietal diameter

Answer

Bitemporal diameter

Answer

Diameter of pelvic outlet

Question 5

For routine diagnostic purposes, endometrial biopsy is usually done at which phase of the menstrual cycle?

Accepted Answer

Just before menstruation

Answer

10-12 days after menstruation

Answer

Just after menstruation

Answer

At the time of ovulation

Question 6

Oligomenorrhoea means ?

Accepted Answer

Cycle longer than 35 days

Answer

Cycle < 20 days

Answer

Cycle more than 45 days

Answer

Cycle more than 28 days

Question 7

Magnification obtained by colposcopy is?

Accepted Answer

10-20 times

Answer

1-2 times

Answer

5-6 times

Answer

15-25 times

Question 8

On which day LH & FSH should be measured?

Accepted Answer

1-3rd day

Answer

7th day

Answer

14th day

Answer

10th day

Question 9

What is the best parameter for estimating fetal age by ultrasound in the third trimester?

Accepted Answer

BPD

Answer

Abdominal circumference

Answer

Femur length

Answer

Intraocular distance

Question 10

Commonest variety of compound presentation is?

Accepted Answer

Head with hand

Answer

Head with both feet

Answer

Head, hand & feet

Answer

Head with feet

NEET-PG 2013

Anesthesiology

Obstetrics and Gynecology