UPSC-CMS 2020 - Obstetrics and Gynecology PYQs Practice Questions

Q: Which one of the following statements regarding pre-conceptional counseling is NOT correct?

It is needed only in selected complicated pregnancies. ***It is needed only in selected complicated pregnancies*** - Pre-conceptional counseling is important for **all women of reproductive age**, especially those planning a pregnancy, not just for complicated cases. - Its purpose is to **optimize maternal health before conception** to prevent adverse outcomes, regardless of initial perceived risk. *It helps in early detection of risk factors* - Pre-conceptional counseling identifies **maternal and fetal risk factors** such as chronic medical conditions, genetic predisposition, and lifestyle choices before pregnancy. - Early detection allows for ** timely interventions** to mitigate these risks. *It is a part of preventive medicine* - Counseling before pregnancy focuses on **prevention of adverse pregnancy outcomes** by optimizing health and addressing potential issues. - This proactive approach aligns directly with the principles of **preventive healthcare**. *It helps in reducing maternal morbidity and mortality* - By addressing risk factors, optimizing health, and educating women about healthy behaviors, pre-conceptional counseling can significantly **lower the incidence of complications** during pregnancy. - This ultimately contributes to a **reduction in maternal illness and death**. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Consider the following statements regarding Non Stress Test (NST): 1. Reactive NST indicates a healthy fetus 2. NST is an observed association of fetal breathing with fetal movements 3. NST has a low false negative rate ( 50%) 4. Testing should be started at 20 weeks Which of the statement(s) given above is/are correct?

1 and 3. ***1 and 3*** - A **reactive NST** indicates adequate fetal oxygenation and an intact autonomic nervous system, strongly suggesting a **healthy fetus**. - NST has excellent **sensitivity** for detecting fetal well-being, leading to a very **low false-negative rate** (less than 1%), but its relatively high rate of non-reactive results in healthy fetuses contributes to a **high false-positive rate** (over 50%). *1 and 4* - While statement 1 is correct, statement 4 is incorrect because NST testing is typically initiated at **28-32 weeks of gestation**, not 20 weeks, as fetal autonomic nervous system maturation is required. - At 20 weeks, the fetus often lacks the mature neurological responses necessary for a reliable NST. *2 only* - Statement 2 incorrectly describes NST; the NST observes the association of **fetal heart rate accelerations** with **fetal movements**, not fetal breathing. - Fetal breathing movements are typically assessed during a **biophysical profile**, not solely by NST. *3 only* - While statement 3 correctly describes the false negative and positive rates of NST, statement 1 is also correct, as a reactive NST is indeed a strong indicator of a healthy fetus. - This option is incomplete as it misses another correct statement. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which one of the following is a protective factor for endometrial hyperplasia?

Multiparity. ***Multiparity*** - **Multiparity** is a protective factor against endometrial hyperplasia due to **periods of anovulation and progesterone dominance** during pregnancy. - Each pregnancy provides prolonged exposure to high levels of **progesterone**, which counteracts unopposed estrogenic effects on the endometrium and prevents hyperplasia. - Multiple pregnancies reduce the total number of **ovulatory cycles** in a woman's lifetime, thereby decreasing cumulative exposure to unopposed estrogen. *Tamoxifen therapy* - **Tamoxifen**, while an anti-estrogen in breast tissue, acts as a **partial estrogen agonist** on the endometrium, increasing the risk of endometrial hyperplasia and cancer. - It can lead to changes in the endometrial lining, including **polyps** and hyperplasia, due to its estrogenic effects in the uterus. *Diabetes* - **Diabetes**, particularly type 2, is a risk factor for endometrial hyperplasia and cancer, not a protective factor. - It is associated with **increased insulin levels** and insulin-like growth factors, which can promote endometrial cell proliferation. *Delayed menopause* - **Delayed menopause** means a longer lifetime exposure to estrogen during the reproductive years. - Prolonged exposure to **unopposed estrogen** is a significant risk factor for endometrial hyperplasia, as it promotes endometrial proliferation. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: A woman who is not breast feeding her newborn child is advised to use a contraceptive method by:

6th postpartum week. ***6th postpartum week*** - For non-breastfeeding women, the **uterus typically involutes** by 6 weeks, and ovulatory cycles can resume as early as 4-6 weeks postpartum. - Due to the rapid return to fertility and the completion of immediate postpartum healing, contraceptive methods are generally recommended around the **6-week postpartum check-up**. *3rd postpartum month* - This is generally considered **too late** for initiating contraception in non-breastfeeding women as fertility can return much earlier. - Waiting until 3 months significantly increases the risk of **unintended pregnancy** because ovulation often occurs before the first postpartum menses. *3rd postpartum week* - While some women may ovulate early, it's generally **too soon** to initiate most contraceptive methods due to ongoing uterine involution and the risk of postpartum complications. - The risk of **thrombosis** is still elevated in the immediate postpartum period, making certain hormonal contraceptives (e.g., estrogen-containing methods) contraindicated. *6th postpartum month* - Similar to the 3rd postpartum month, this is generally **too late** to initiate contraception for non-breastfeeding women. - Prolonged delay significantly increases the likelihood of **unintended conception** during this period. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Indications for removal of IUDs are all EXCEPT:

Cyclical menstrual bleeding. ***Cyclical menstrual bleeding*** - **Normal cyclical menstrual bleeding** is an expected physiological event and not an indication for IUD removal. - While IUDs can alter menstrual patterns (e.g., heavier or lighter bleeding), typical cyclical bleeding that is not excessively heavy, painful, or prolonged usually does not warrant removal. *Pregnancy with IUD* - If a **pregnancy occurs with an IUD in situ**, especially in the first trimester, the IUD should ideally be removed to reduce the risk of spontaneous abortion, preterm labor, or infection. - Removal is especially crucial if the strings are visible and accessible; if not, close monitoring is necessary. *Flaring up of salpingitis* - **Salpingitis (pelvic inflammatory disease - PID)** is a serious infection that can be exacerbated or initiated by the presence of an IUD, particularly during insertion or in individuals with pre-existing infections. - A confirmed or suspected flare-up of salpingitis necessitates IUD removal to control the infection and prevent further complications like infertility or ectopic pregnancy. *Perforation of uterus* - **Uterine perforation** is a serious complication that can occur during IUD insertion and requires immediate removal of the device. - Depending on the extent of perforation, it may lead to pain, hemorrhage, infection, or damage to surrounding organs. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

Which one of the following statements regarding pre-conceptional counseling is NOT correct?

Accepted Answer

It is needed only in selected complicated pregnancies

Answer

It helps in early detection of risk factors

Answer

It is a part of preventive medicine

Answer

It helps in reducing maternal morbidity and mortality

Question 2

Consider the following statements regarding Non Stress Test (NST):

1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks Which of the statement(s) given above is/are correct?

Accepted Answer

1 and 3

Answer

1 and 4

Answer

2 only

Answer

3 only

Question 3

Which one of the following is a protective factor for endometrial hyperplasia?

Accepted Answer

Multiparity

Answer

Tamoxifen therapy

Answer

Diabetes

Answer

Delayed menopause

Question 4

A woman who is not breast feeding her newborn child is advised to use a contraceptive method by:

Accepted Answer

6th postpartum week

Answer

3rd postpartum month

Answer

3rd postpartum week

Answer

6th postpartum month

Question 5

Indications for removal of IUDs are all EXCEPT:

Accepted Answer

Cyclical menstrual bleeding

Answer

Pregnancy with IUD

Answer

Flaring up of salpingitis

Answer

Perforation of uterus

Question 6

Contraindications for insertion of IUDs are all EXCEPT:

Accepted Answer

During cesarean section

Answer

Trophoblastic disease

Answer

Suspected pregnancy

Answer

Severe dysmenorrhea

Question 7

Which one of the following is NOT a contraindication for use of Mini pill?

Accepted Answer

Breast feeding

Answer

Pregnancy

Answer

Thromboembolic disease

Answer

History of breast cancer

Question 8

Which of the following is/are required for a registered medical practitioner to qualify for performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

1. Certified for assisting at least 25 MTP in an authorized centre

2. Diploma or degree in Obstetrics and Gynaecology

3. House surgeon training for 6 months in Obstetrics and Gynaecology

4. Certified training for 6 months in laparoscopic surgeries

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

2 only

Answer

1 only

Answer

1, 2 and 4

Question 9

As per ICMR guidelines, which one of the following statements is true regarding effects of COVID-19 on fetus according to current evidence?

Accepted Answer

COVID-19 virus is not teratogenic

Answer

COVID-19 virus infection is an indication of MTP

Answer

There is increased risk of fetal growth restriction

Answer

There is increased risk of early pregnancy loss

Question 10

As per ICMR guidelines, which one of the following statements is true regarding COVID-19 infection in pregnancy?

Accepted Answer

Pregnant women with heart disease are at higher risk

Answer

COVID-19 pneumonia in pregnancy is more severe with poor recovery

Answer

COVID-19 virus is secreted in breast milk

Answer

Vaginal secretions always test positive for COVID-19 in pregnancy

UPSC-CMS 2020 — Obstetrics and Gynecology