UPSC-CMS 2025 Practice Questions

Q: Gland of Cloquet is :

lymphatic drainage of vulva. ***lymphatic drainage of vulva*** - The **glands of Cloquet** (or the **node of Cloquet**) specifically refer to a deep inguinal lymph node, often considered the most superior and medial node in the femoral triangle. - This node is crucial in the **lymphatic drainage of the vulva**, as it is one of the final nodes before lymph flows into the external iliac nodes. *lymphatic drainage of cervix* - The **cervix** primarily drains to the **internal iliac**, **obturator**, and **presacral lymph nodes**, not the inguinal nodes associated with Cloquet's gland. - Lymphatic pathways for the cervix are more deeply located within the pelvis. *lymphatic drainage of uterus* - The **uterus** largely drains to the **para-aortic** (or lumbar), **internal iliac**, **external iliac lymph nodes**. - The pathways are distinct from the superficial inguinal drainage where Cloquet's gland is found. *lubricating glands of vagina* - The main lubricating glands of the vagina are the **Bartholin's glands** and numerous small **vaginal glands** (Skene's glands are associated with the urethra). - "Glands of Cloquet" refers to a lymph node, not a secretory gland involved in lubrication.

Q: Which of the following is the primary surveillance tool in the growth-restricted fetus?

Umbilical artery Doppler. ***Umbilical artery Doppler*** - The **umbilical artery Doppler** is the primary tool for fetal surveillance in **growth-restricted fetuses** because it directly assesses **placental resistance** and **blood flow** to the fetus. - Abnormal findings, such as **increased resistance** or **absent/reversed end-diastolic flow**, indicate **placental insufficiency** and are key indicators for intervention. *Umbilical venous pulsation* - **Umbilical venous pulsation** can be a sign of **cardiac dysfunction** in the fetus but is considered a **late and severe sign** of fetal compromise, not a primary surveillance tool. - Its presence usually indicates significant **cardiac overload** or **venous congestion**, suggesting advanced stages of fetal distress. *Uterine artery Doppler* - **Uterine artery Doppler** is primarily used for **screening** for preeclampsia and fetal growth restriction in the **second trimester**, not as a primary surveillance tool once growth restriction is established. - It assesses **placental bed development** and **maternal uterine blood flow** but doesn't directly monitor the fetal response to placental insufficiency. *Middle cerebral artery Doppler* - **Middle cerebral artery (MCA) Doppler** is used to assess for **brain-sparing effect** in growth-restricted fetuses, indicating the fetus is shunting blood to the brain due to hypoxia. - While important for evaluating the severity of compromise, it is a **secondary surveillance tool** for brain perfusion, not the primary measure of placental function.

Q: Causes of AUB are subdivided by the acronym PALM-COEIN. What are the characteristics of PALM causes? I. Structural lesions II. Diagnosed by ultrasound III. Confirmed by histopathology Select the correct answer using the code given below :

I, II and III. ***I, II and III*** - The PALM group of AUB causes refers to **structural abnormalities** of the uterus, including polyps (P), adenomyosis (A), leiomyomas (L), and malignancy/hyperplasia (M). - These conditions are typically identified through **imaging techniques** like ultrasound, saline infusion sonography, or hysteroscopy, and often confirmed with **histopathological examination** (e.g., biopsy) to provide a definitive diagnosis or characterize the lesion. *I and III only* - This option is incomplete as **ultrasound (II)** is a primary diagnostic tool for identifying PALM causes. - While structural lesions (I) are involved and histopathology (III) is often confirmatory, imaging remains crucial for initial detection and characterization. *I and II only* - This option is incomplete because **histopathology (III)** is frequently necessary for a definitive diagnosis or to rule out malignancy, especially for conditions like endometrial hyperplasia or malignancy. - While structural lesions (I) are detectable by ultrasound (II), microscopic examination provides crucial details. *II and III only* - This option is incomplete because the PALM causes are fundamentally **structural lesions (I)**. - Imaging and histopathology are methods of diagnosing and confirming these underlying structural changes, not the primary characteristic themselves.

Q: Which of the following are the primary organisms involved in PID ? I. N. gonorrhoeae II. Chlamydia III. Mycoplasma hominis IV. Candida albicans Select the correct answer using the code given below :

I, II and III. ***I, II and III*** - **Neisseria gonorrhoeae** and **Chlamydia trachomatis** are the two most common and well-established primary bacterial causes of PID, responsible for the majority of sexually transmitted cases that ascend from the cervix to the upper genital tract. - **Mycoplasma hominis** is frequently isolated in PID cases and is recognized as a significant pathogen contributing to the polymicrobial nature of PID, particularly in cases not solely due to gonorrhea or chlamydia. - These three organisms together represent the primary causative pathogens in acute PID. *II, III and IV* - This option incorrectly omits **Neisseria gonorrhoeae**, which is one of the two most important primary causes of PID. - **Candida albicans** causes vulvovaginal candidiasis but is **not a primary causative agent of PID**, which involves ascending bacterial infection of the upper reproductive tract (endometrium, fallopian tubes, ovaries, and pelvic peritoneum). *I, II and IV* - While **Neisseria gonorrhoeae** and **Chlamydia trachomatis** are correctly identified as major primary causes, **Candida albicans** is not typically involved in PID pathogenesis. - This option incorrectly excludes **Mycoplasma hominis**, which is a recognized pathogen in PID. *I, III and IV* - This option correctly identifies **Neisseria gonorrhoeae** and **Mycoplasma hominis** but incorrectly includes **Candida albicans**, which is not a PID pathogen. - Critically, this omits **Chlamydia trachomatis**, the single most common cause of PID and a leading cause of tubal factor infertility.

Q: What are the characteristics of dermoid cyst? I. Germ cell ovarian tumour II. Bilateral in 15-20 % cases III. Torsion is common IV. Rupture is common Select the correct answer using the code given below :

I, II and III. ***I, II and III*** - **Dermoid cysts (mature cystic teratomas) are germ cell ovarian tumors** arising from totipotent germ cells, containing mature tissues from all three germ layers (ectoderm, mesoderm, endoderm) - They are **bilateral in 15-20% of cases**, which is a significant percentage for benign ovarian masses - **Torsion is the most common complication** (10-15% of cases) due to their buoyancy, irregular shape, and mobility - **Rupture is relatively uncommon** (spontaneous rupture in only 1-4% of cases), making statement IV incorrect *II and IV only* - While bilaterality (15-20%) is correct, rupture is NOT a common characteristic - This option incorrectly includes statement IV (rupture common) and misses the fundamental classification as a germ cell tumor *I and III only* - Correctly identifies germ cell origin and torsion risk - However, this excludes the significant bilaterality rate (15-20%), which is an important clinical characteristic - Incomplete answer *II, III and IV* - Correctly identifies bilaterality and torsion - Incorrectly states rupture is common (actually occurs in only 1-4% of cases) - Critically fails to mention the germ cell tumor classification, which is fundamental to understanding dermoid cysts

Q: Which one of the following is not a differential diagnosis of chronic inversion of uterus?

Gartner's cyst. ***Gartner's cyst*** - A **Gartner's cyst** is a benign vaginal cyst resulting from remnants of the **Wolffian duct**. - It is typically a **small, asymptomatic lesion** along the lateral vaginal wall and would not be mistaken for a uterine inversion, which involves the uterus turning inside out. - This is **not a differential diagnosis** of chronic uterine inversion. *Fungating cervical malignancy* - An **exophytic (fungating) cervical malignancy** can present as a mass protruding through the cervix. - On examination, it can be confused with an inverted uterus, as both can present with **vaginal bleeding** and a **fleshy mass** visible at or beyond the cervix. - This is a **recognized differential diagnosis** of chronic uterine inversion. *Fibroid polyp* - A **pedunculated submucous fibroid** (fibroid polyp) that prolapses through the cervix is a **classic differential diagnosis** of chronic uterine inversion. - Its appearance as a firm, smooth, fleshy mass protruding through the cervix can closely mimic an inverted uterine fundus. - Differentiation requires careful examination - the attachment site and presence of a pedicle help identify a fibroid polyp. *Cervical prolapse* - **Cervical prolapse** (procidentia) involves the descent of the entire uterus with the cervix leading. - While both conditions involve protrusion beyond the vaginal opening, they are **clinically distinct** - in prolapse, the cervix is visible with its external os, and the uterus remains anatomically normal (not inverted). - However, in exam contexts, **cervical prolapse is sometimes listed as a differential** as both present with a mass at the introitus, though experienced clinicians can readily distinguish them on examination.

Q: A 28 -year-old P_2 ~L_2 presents to Gynaecology OPD with complaints of malodorous vaginal discharge. On examination, the discharge was found to be grayish-white in colour and adherent to vaginal walls. Which one of the following is a bedside diagnostic criterion for the causative organism?

Positive 10% potassium hydroxide test. ***Positive 10% potassium hydroxide test*** - A **positive whiff test** (amine test) with 10% KOH, producing a **fishy odor**, is a characteristic bedside diagnostic criterion for **bacterial vaginosis**. - This test detects the presence of **amines** produced by anaerobic bacteria in the vaginal discharge. *Presence of RBCs in vaginal smear* - The presence of **red blood cells (RBCs)** in a vaginal smear is not a specific diagnostic criterion for bacterial vaginosis. - RBCs may indicate **inflammation**, trauma, or other infections, but not specifically bacterial overgrowth. *Vaginal pH 4.5)** due to the reduction of **lactobacilli** and overgrowth of anaerobic bacteria. - A pH less than 4.5 would suggest a normal vaginal flora or possibly a fungal infection, not bacterial vaginosis. *Positive NAAT test* - **Nucleic acid amplification tests (NAATs)** are used to detect specific pathogens like **Chlamydia** or **Gonorrhea**, not typically bacterial vaginosis. - While NAATs are highly sensitive and specific, they are not a **bedside diagnostic criterion** for bacterial vaginosis.

Q: Daily suppressive therapy for HSV-1 and HSV-2 is :

Valacyclovir 1 g once daily. ***Valacyclovir 1 g once daily*** - **Valacyclovir 1 g once daily** is an effective and commonly prescribed regimen for daily suppressive therapy of HSV-1 and HSV-2 due to its good bioavailability and convenient once-daily dosing. - This dosage is particularly effective in reducing the frequency of outbreaks and the risk of transmission. *Acyclovir 400 mg thrice daily* - While **acyclovir** is an effective antiviral for HSV, the standard dose for suppressive therapy is typically **400 mg twice daily** (not thrice daily) to maintain adequate antiviral levels. - A thrice-daily regimen might be used for acute outbreaks but is generally not preferred for long-term daily suppression due to adherence challenges. *Acyclovir 400 mg once daily* - **Acyclovir 400 mg once daily** is generally considered insufficient for effective daily suppressive therapy for HSV infections. - This low frequency of dosing would likely not maintain adequate antiviral concentrations to consistently prevent outbreaks. *Valacyclovir 1 g twice daily* - **Valacyclovir 1 g twice daily** is often used for the treatment of acute HSV outbreaks (e.g., genital herpes episodes) or for severe cases of suppression, but it is not the standard daily suppressive dose. - For routine daily suppressive therapy, a 1g once-daily dose is usually sufficient and preferred for convenience and patient adherence.

Question 1

Gland of Cloquet is :

Accepted Answer

lymphatic drainage of vulva

Answer

lymphatic drainage of cervix

Answer

lymphatic drainage of uterus

Answer

lubricating glands of vagina

Question 2

Which of the following are the predictive factors for Fetal Growth Restriction (FGR)?
I. Low level of maternal 1^st trimester Beta hCG
II. Abnormal uterine artery Doppler at 20-24 weeks of pregnancy
III. Fetal echogenic bowel on ultrasound
IV. Maternal medical disorder

Select the correct answer using the code given below :

Accepted Answer

I, II and IV

Answer

I, III and IV

Answer

I, II and III

Answer

II, III and IV

Question 3

Which of the following is the primary surveillance tool in the growth-restricted fetus?

Accepted Answer

Umbilical artery Doppler

Answer

Umbilical venous pulsation

Answer

Uterine artery Doppler

Answer

Middle cerebral artery Doppler

Question 4

Causes of AUB are subdivided by the acronym PALM-COEIN. What are the characteristics of PALM causes?
I. Structural lesions
II. Diagnosed by ultrasound
III. Confirmed by histopathology

Select the correct answer using the code given below :

Accepted Answer

I, II and III

Answer

I and III only

Answer

I and II only

Answer

II and III only

Question 5

Which of the following are the primary organisms involved in PID ?
I. N. gonorrhoeae
II. Chlamydia
III. Mycoplasma hominis
IV. Candida albicans

Select the correct answer using the code given below :

Accepted Answer

I, II and III

Answer

II, III and IV

Answer

I, II and IV

Answer

I, III and IV

Question 6

What are the characteristics of dermoid cyst?
I. Germ cell ovarian tumour
II. Bilateral in 15-20 % cases
III. Torsion is common
IV. Rupture is common

Select the correct answer using the code given below :

Accepted Answer

I, II and III

Answer

II and IV only

Answer

I and III only

Answer

II, III and IV

Question 7

Which one of the following is not a differential diagnosis of chronic inversion of uterus?

Accepted Answer

Gartner's cyst

Answer

Fungating cervical malignancy

Answer

Fibroid polyp

Answer

Cervical prolapse

Question 8

A 28 -year-old P_2 ~L_2 presents to Gynaecology OPD with complaints of malodorous vaginal discharge. On examination, the discharge was found to be grayish-white in colour and adherent to vaginal walls. Which one of the following is a bedside diagnostic criterion for the causative organism?

Accepted Answer

Positive 10% potassium hydroxide test

Answer

Presence of RBCs in vaginal smear

Answer

Vaginal pH < 4.5

Answer

Positive NAAT test

Question 9

Which of the following are neonatal complications of maternal diabetes during pregnancy?
I. Hyperbilirubinemia
II. Hypocalcemia
III. Cardiomyopathy
IV. Hypoglycemia

Select the correct answer using the code given below :

Accepted Answer

I, II and IV

Answer

I, II and III

Answer

II, III and IV

Answer

I, III and IV

Question 10

Daily suppressive therapy for HSV-1 and HSV-2 is :

Accepted Answer

Valacyclovir 1 g once daily

Answer

Acyclovir 400 mg thrice daily

Answer

Acyclovir 400 mg once daily

Answer

Valacyclovir 1 g twice daily

UPSC-CMS 2025

Anatomy

Obstetrics and Gynecology

Pediatrics

Pharmacology