NEET-PG 2020 - Obstetrics and Gynecology PYQs Practice Questions

Q: What is the obstetric score of a 26-year-old woman who is 36 weeks pregnant, has had one previous delivery of twins, and is certain of her dates?

G2P1L2 (2 live births). ***G2P1L2 (2 live births)*** - **Gravida (G)** refers to the total number of pregnancies, including the current one. This woman is currently pregnant and has had one previous pregnancy, making her G2. - **Parity (P)** refers to the number of pregnancies that reached viability (>20 weeks gestation or >500g), *regardless of the number of fetuses*. She had one previous delivery (twins) that reached viability, so her P is 1. The current pregnancy is not included in parity until after delivery. - **Live births (L)** refers to the number of live children delivered. Her previous pregnancy resulted in twins, meaning 2 live births. *G3P2L2 (3 pregnancies, 2 live births)* - This option incorrectly counts the number of pregnancies (**G**) as 3. She has had one previous pregnancy and is currently pregnant, totaling 2 pregnancies. - It also incorrectly counts the parity (**P**) as 2. Parity refers to the number of deliveries that reached viability, not the number of fetuses. Her previous delivery was a single event, making P1. *G2P2L2 (2 pregnancies, 2 live births)* - While the Gravida (G2) and Live births (L2) are correct, the Parity (**P**) is incorrectly stated as 2. Parity refers to the number of viable pregnancies delivered, and she has only had one previous delivery. - The number of fetuses (twins) does not increase the parity count for a single delivery event. *G3P3L2 (3 pregnancies, 3 live births)* - This option incorrectly states the number of pregnancies (**G**) as 3 and the parity (**P**) as 3. - The woman has only had one previous pregnancy and is currently pregnant, for a total of G2 and P1. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: What will be the Hysterosalpingogram (HSG) finding?

Hydrosalpinx. ***Hydrosalpinx*** - The image, likely a hysterosalpingogram (HSG), shows a **dilated and fluid-filled fallopian tube** with no spillage of contrast into the peritoneal cavity, which is characteristic of hydrosalpinx. - The **contrast media fills the tubal lumen** but is unable to egress, indicating distal tubal obstruction and fluid accumulation. *Cornual block* - A cornual block would present as **obstruction at the uterine ostium** of the fallopian tube, preventing contrast from entering the tubal lumen. - In this image, contrast has clearly entered and dilated the fallopian tube, ruling out a cornual block. *Normal findings* - Normal HSG findings would show **patent fallopian tubes** with free spill of contrast into the peritoneal cavity. - The visible **dilation** and **lack of spill** in the image are distinctly abnormal. *Bicornuate uterus* - A bicornuate uterus is a **congenital uterine anomaly** characterized by two separate uterine horns. - While the uterus appears somewhat irregular, the dominant feature is the dilated fallopian tube, which is not a hallmark of a bicornuate uterus. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: 60-year-old female with a history of intermittent bleeding. What is the diagnosis based on the ultrasound image?

Endometrial polyp. ***Endometrial polyp*** - The ultrasound image shows a well-defined, **echogenic focal lesion within the endometrial cavity**, which is characteristic of an endometrial polyp. - In a 60-year-old female with intermittent bleeding, a polyp is a common cause of **postmenopausal bleeding** and is often identified as an intracavitary mass on ultrasound. - Endometrial polyps appear as **focal, hyperechoic or isoechoic masses** with a smooth contour projecting into the endometrial cavity. *Ca endometrium* - **Endometrial carcinoma** typically appears as diffuse endometrial thickening (>4-5 mm in postmenopausal women), irregular endometrial-myometrial interface, or heterogeneous endometrial echoes, often with evidence of myometrial invasion. - While bleeding is a cardinal symptom of endometrial carcinoma, the distinct **focal, well-circumscribed nature** of the lesion on ultrasound is less typical for carcinoma, which tends to be more diffuse and irregular. *Submucosal fibroid* - A **submucosal fibroid** (leiomyoma) is a benign smooth muscle tumor originating from the myometrium that protrudes into the endometrial cavity. - While it can appear as an intracavitary mass and cause abnormal bleeding, fibroids often have a more **heterogeneous or hypoechoic appearance** with posterior acoustic shadowing, compared to the isoechoic to hyperechoic appearance of a polyp. - The feeding vessel sign (blood flow at the base) is more characteristic of polyps than fibroids. *Endometrial hyperplasia* - **Endometrial hyperplasia** presents as **diffuse, uniform endometrial thickening** rather than a focal intracavitary mass. - It typically shows homogeneous increased echogenicity of the entire endometrium without a discrete, well-defined lesion as seen with a polyp. - While it can cause postmenopausal bleeding, the focal nature of the lesion in this case makes hyperplasia less likely. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: What is the best treatment option for a septate uterus?

Transcervical hysteroscopic resection of the septum. ***Transcervical hysteroscopic resection of the septum*** - This procedure involves using a **hysteroscope** to visualize and resect the **fibrous or muscular septum** that divides the uterine cavity, restoring a normal uterine shape. - It is considered the gold standard due to its **minimally invasive nature**, effectiveness in improving reproductive outcomes, and lower risk of complications compared to abdominal approaches. *Tompkins Metroplasty* - This is an **abdominal surgical procedure** primarily used for the repair of a **bicornuate uterus**, not typically for a septate uterus. - It involves resecting the uterine fundus to create a single uterine cavity, which is more invasive than hysteroscopic septum resection. *Jones metroplasty* - This procedure is also an **abdominal approach** used for the surgical correction of a **bicornuate uterus**, not a septate uterus. - It involves excising the septal portion and approximating the uterine walls. *Strassmann metroplasty* - This is another **abdominal surgical technique** that is primarily indicated for the repair of a **bicornuate or didelphys uterus**, where a large defect needs to be corrected. - It involves reconstructing the uterus through a fundal incision, which is significantly more invasive than hysteroscopic septal resection for a septate uterus. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

What is the obstetric score of a 26-year-old woman who is 36 weeks pregnant, has had one previous delivery of twins, and is certain of her dates?

Accepted Answer

G2P1L2 (2 live births)

Answer

G3P2L2 (3 pregnancies, 2 live births)

Answer

G2P2L2 (2 pregnancies, 2 live births)

Answer

G3P3L2

Question 2

What will be the Hysterosalpingogram (HSG) finding?

Accepted Answer

Hydrosalpinx

Answer

Cornual block

Answer

Normal findings

Answer

Bicornuate uterus

Question 3

A lady on treatment for infertility developed ascites, abdominal pain, and dyspnea. The ultrasound image is shown below. What is the most likely diagnosis?

Accepted Answer

OHSS

Answer

PCOS

Answer

Theca lutein cyst

Answer

Mucinous cystadenomas

Question 4

60-year-old female with a history of intermittent bleeding. What is the diagnosis based on the ultrasound image?

Accepted Answer

Endometrial polyp

Answer

Ca endometrium

Answer

Submucosal fibroid

Answer

Endometrial hyperplasia

Question 5

What is the best treatment option for a septate uterus?

Accepted Answer

Transcervical hysteroscopic resection of the septum

Answer

Tompkins Metroplasty

Answer

Jones metroplasty

Answer

Strassmann metroplasty

Question 6

Which distension medium is used for hysteroscopy with bipolar cautery?

Accepted Answer

NS

Answer

Glycine

Answer

Carbon Dioxide

Answer

Dextran 70

Question 7

A 22-year-old primigravida visits ANC OPD with 20 weeks POG. On examination uterine height reveals a 16-week size. USG shows reduced liquor. What will be the diagnosis?

Accepted Answer

Bilateral renal agenesis

Answer

Bartter’s syndrome

Answer

Liddle syndrome

Answer

Fetal anemia

Question 8

A sexually active female presenting with profuse frothy foul-smelling discharge with intense itching. Strawberry cervix revealed on examination. What will be the diagnosis?

Accepted Answer

Trichomonas vaginalis

Answer

Bacterial vaginosis

Answer

Candidiasis

Answer

None of the options

Question 9

A 36-week pregnant lady with previous twin delivery. What is the Obstetric score?

Accepted Answer

G2P1

Answer

G2P2

Answer

G3P2

Answer

G3P3

Question 10

What is the use of the instrument shown in the image?

Accepted Answer

Laparoscopic sterilization

Answer

Surgical removal of ectopic pregnancy

Answer

Induction of abortion

Answer

Creating pneumoperitoneum for laparoscopic procedures

NEET-PG 2020 — Obstetrics and Gynecology