Anatomy
1 questionsGland of Cloquet is :
UPSC-CMS 2025 - Anatomy UPSC-CMS Practice Questions and MCQs
Question 171: Gland of Cloquet is :
- A. lymphatic drainage of cervix
- B. lymphatic drainage of uterus
- C. lymphatic drainage of vulva (Correct Answer)
- D. lubricating glands of vagina
Explanation: ***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.
Obstetrics and Gynecology
7 questionsWhich 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 :
Which of the following is the primary surveillance tool in the growth-restricted fetus?
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 :
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 :
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 :
Which one of the following is not a differential diagnosis of chronic inversion of uterus?
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?
UPSC-CMS 2025 - Obstetrics and Gynecology UPSC-CMS Practice Questions and MCQs
Question 171: 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 :
- A. I, III and IV
- B. I, II and IV (Correct Answer)
- C. I, II and III
- D. II, III and IV
Explanation: ***I, II and IV*** - A **low first-trimester maternal beta-hCG level** can be associated with placental dysfunction and poor trophoblastic development, which are common causes of FGR. This is an early predictive marker. - **Abnormal uterine artery Doppler** findings at 20-24 weeks indicate increased placental vascular resistance and impaired placental perfusion, which is a strong and validated predictor of FGR. - **Maternal medical disorders** such as chronic hypertension, pre-existing diabetes, antiphospholipid syndrome, chronic kidney disease, or autoimmune disorders are well-established risk factors for FGR due to impaired placental perfusion or maternal-fetal interface dysfunction. *I, III and IV* - While I and IV are correct, **fetal echogenic bowel (III)** is an ultrasonographic finding that may be associated with FGR but is not a predictive factor for it. Echogenic bowel is primarily a marker for conditions like cystic fibrosis, cytomegalovirus infection, fetal aneuploidy, or bowel ischemia. When FGR occurs with echogenic bowel, it's typically because both are manifestations of an underlying condition (e.g., aneuploidy or infection), rather than echogenic bowel predicting FGR development. - The key distinction: predictive factors help identify pregnancies at risk BEFORE FGR develops, while echogenic bowel is typically detected alongside or after growth restriction has begun. *I, II and III* - While I and II are correct, **fetal echogenic bowel (III)** is not a primary predictive factor for FGR as explained above. - More importantly, **maternal medical disorders (IV)** are crucial independent predictors that must be included, as they represent modifiable or manageable risk factors. *II, III and IV* - While II and IV are correct, **fetal echogenic bowel (III)** is not a direct predictive factor for FGR. - A **low first-trimester maternal beta-hCG level (I)** is an important early biochemical predictor of placental dysfunction and subsequent FGR, and should not be excluded.
Question 172: Which of the following is the primary surveillance tool in the growth-restricted fetus?
- A. Umbilical venous pulsation
- B. Uterine artery Doppler
- C. Umbilical artery Doppler (Correct Answer)
- D. Middle cerebral artery Doppler
Explanation: ***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.
Question 173: 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 :
- A. I and III only
- B. I, II and III (Correct Answer)
- C. I and II only
- D. II and III only
Explanation: ***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.
Question 174: 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 :
- A. II, III and IV
- B. I, II and IV
- C. I, III and IV
- D. I, II and III (Correct Answer)
Explanation: ***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.
Question 175: 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 :
- A. II and IV only
- B. I and III only
- C. I, II and III (Correct Answer)
- D. II, III and IV
Explanation: ***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
Question 176: Which one of the following is not a differential diagnosis of chronic inversion of uterus?
- A. Fungating cervical malignancy
- B. Fibroid polyp
- C. Cervical prolapse
- D. Gartner's cyst (Correct Answer)
Explanation: ***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.
Question 177: 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?
- A. Presence of RBCs in vaginal smear
- B. Vaginal pH < 4.5
- C. Positive 10% potassium hydroxide test (Correct Answer)
- D. Positive NAAT test
Explanation: ***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* - In bacterial vaginosis, the **vaginal pH is typically elevated (> 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.
Pediatrics
1 questionsWhich 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 :
UPSC-CMS 2025 - Pediatrics UPSC-CMS Practice Questions and MCQs
Question 171: 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 :
- A. I, II and III
- B. I, II and IV (Correct Answer)
- C. II, III and IV
- D. I, III and IV
Explanation: ***I, II and IV*** - This correctly identifies the three **most common and clinically significant neonatal complications** of maternal diabetes: **hyperbilirubinemia**, **hypocalcemia**, and **hypoglycemia**. - **Hypoglycemia** is the **most frequent complication** (25-50% of infants), occurring due to fetal hyperinsulinemia that persists after birth when maternal glucose supply is cut off. - **Hypocalcemia** occurs in 20-50% of cases due to impaired parathyroid hormone response, hypomagnesemia, and altered calcium-phosphorus metabolism. - **Hyperbilirubinemia** results from polycythemia (due to chronic intrauterine hypoxia), increased RBC breakdown, and impaired hepatic conjugation. *I, II and III* - While this includes **hyperbilirubinemia**, **hypocalcemia**, and **cardiomyopathy**, it inappropriately excludes **hypoglycemia**, which is the **most common and most critical** neonatal complication requiring immediate monitoring and management. - Omitting hypoglycemia makes this option medically incorrect as a primary answer. *II, III and IV* - This option excludes **hyperbilirubinemia**, which is a very common finding (occurs in up to 25% of infants of diabetic mothers) due to increased erythropoiesis and RBC destruction. - Fetal hyperinsulinemia drives increased oxygen consumption, leading to relative hypoxia and compensatory polycythemia. *I, III and IV* - This option misses **hypocalcemia**, which is one of the **classic metabolic complications** seen in 20-50% of infants of diabetic mothers. - Hypocalcemia typically presents in the first 24-72 hours of life and is exacerbated by concurrent **magnesium deficiency**, which impairs PTH secretion and action. **Note:** All four listed complications (I, II, III, and IV) are recognized complications of maternal diabetes. Hypertrophic cardiomyopathy occurs in 10-20% of cases but is generally less common than the metabolic triad of hypoglycemia, hypocalcemia, and hyperbilirubinemia, which require routine screening in all infants of diabetic mothers.
Pharmacology
1 questionsDaily suppressive therapy for HSV-1 and HSV-2 is :
UPSC-CMS 2025 - Pharmacology UPSC-CMS Practice Questions and MCQs
Question 171: Daily suppressive therapy for HSV-1 and HSV-2 is :
- A. Acyclovir 400 mg thrice daily
- B. Valacyclovir 1 g once daily (Correct Answer)
- C. Acyclovir 400 mg once daily
- D. Valacyclovir 1 g twice daily
Explanation: ***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.