Sexual Dysfunction Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Sexual Dysfunction. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Sexual Dysfunction Indian Medical PG Question 1: A teenage girl presented with irregular cycles and increased facial hair. Her ovaries showed increased volume. Which of the following are used in the first line treatment?
1. Laparoscopic ovarian drilling
2. Anti-androgens
3. Lifestyle modifications
4. Combined oral contraceptive pills
- A. 2,3,4 (Correct Answer)
- B. 1,2,3
- C. 1,2,4
- D. 1,3,4
Sexual Dysfunction Explanation: ***2,3,4 (Correct Answer)***
- **Lifestyle modifications (3)** are the foundational first-line intervention for all PCOS patients, particularly those who are overweight or obese, as they improve insulin sensitivity, reduce androgen levels, and improve both metabolic and reproductive outcomes.
- **Combined oral contraceptive pills/COCs (4)** are the first-line pharmacological treatment for menstrual irregularity and hyperandrogenism in PCOS when fertility is not desired. They regulate cycles, suppress ovarian androgen production, and reduce hirsutism and acne.
- **Anti-androgens (2)** such as spironolactone are used in first-line management of moderate-to-severe hirsutism and acne in PCOS, typically in combination with COCs. They block androgen receptors or inhibit androgen synthesis, providing additional benefit for hyperandrogenic symptoms like the increased facial hair in this patient.
*1,2,3*
- **Laparoscopic ovarian drilling (1)** is a second-line surgical treatment reserved for anovulatory infertility in PCOS patients who fail to respond to ovulation induction with clomiphene citrate. It is NOT a first-line treatment for menstrual irregularity and hirsutism.
- While lifestyle modifications (3) and anti-androgens (2) are appropriate first-line components, the inclusion of ovarian drilling makes this combination incorrect as a first-line approach.
*1,2,4*
- **Laparoscopic ovarian drilling (1)** is an invasive procedure indicated only as second-line therapy for specific cases of anovulatory infertility, not for initial management of irregular cycles and hirsutism.
- Although anti-androgens (2) and COCs (4) are appropriate first-line pharmacological treatments, the inclusion of ovarian drilling excludes this from being a correct first-line treatment combination.
*1,3,4*
- This combination includes two appropriate first-line treatments: **lifestyle modifications (3)** and **combined oral contraceptive pills (4)**.
- However, **laparoscopic ovarian drilling (1)** is a second-line or third-line surgical intervention for very specific indications (anovulatory infertility resistant to medical management), making this combination incorrect as a first-line approach for this clinical presentation.
Sexual Dysfunction Indian Medical PG Question 2: Which of the following can be considered as grounds of divorce under matrimonial law?
- A. Sterility
- B. Frigidity
- C. Impotence developing after the marriage (Correct Answer)
- D. Temporary Mental illness
Sexual Dysfunction Explanation: ***Impotence developing after the marriage***
- **Impotence** (inability to consummate the marriage) can constitute a ground for **nullity** if it existed **at the time of marriage** and was not disclosed.
- However, **impotence developing after marriage** may be considered under certain legal frameworks as inability to fulfill marital obligations, though its status varies by jurisdiction.
- In the context of medical jurisprudence, **sexual incapacity** affecting the continuation of marriage is recognized as a potential ground in matrimonial disputes.
- This is the **most appropriate answer** among the given options as it relates to inability to fulfill a fundamental aspect of marriage.
*Sterility*
- **Sterility** (inability to conceive children) is generally **not considered a ground for divorce** under most matrimonial laws.
- It does not prevent consummation of marriage or fulfillment of other marital duties.
- While it may cause personal distress, legal systems distinguish between inability to conceive and inability to engage in sexual relations.
*Frigidity*
- **Frigidity** (lack of sexual desire or responsiveness) is typically **not a sufficient ground for divorce** on its own.
- If the spouse is physically capable of consummating the marriage, lack of desire alone does not constitute legal grounds.
- It may overlap with other marital issues but has weaker legal standing compared to actual physical incapacity.
*Temporary Mental illness*
- **Temporary mental illness** is generally **not a ground for divorce** because it implies a recoverable condition.
- For mental disorder to constitute grounds for divorce under Indian matrimonial law (Hindu Marriage Act Section 13), it must be:
- **Incurable** or of such nature that cohabitation becomes unreasonable
- **Continuous or intermittent** mental disorder of sufficient severity
- A **temporary** condition that can be cured does not meet these criteria.
Sexual Dysfunction Indian Medical PG Question 3: F00 in ICD denotes
- A. mood disorders
- B. organic disorders (Correct Answer)
- C. substance use
- D. psychosis
Sexual Dysfunction Explanation: ***Organic disorders - CORRECT***
- **F00-F09** in the **International Classification of Diseases (ICD-10)** Chapter V (Mental and behavioural disorders) specifically denotes **organic, including symptomatic, mental disorders**
- These disorders are characterized by brain disease, brain injury, or other insult leading to **cerebral dysfunction**
- **F00** specifically refers to **Dementia in Alzheimer's disease**
*Mood disorders - Incorrect*
- Mood disorders are classified under codes **F30-F39** in ICD-10
- This category includes conditions like bipolar affective disorder, depressive episodes, and recurrent depressive disorders
*Substance use - Incorrect*
- Mental and behavioral disorders due to psychoactive substance use are classified under codes **F10-F19** in ICD-10
- This section covers disorders resulting from the use of alcohol, opioids, cannabis, sedatives, hypnotics, and other substances
*Psychosis - Incorrect*
- Specific psychotic disorders like schizophrenia are classified under codes **F20-F29** in ICD-10
- Psychosis can be a symptom of various mental disorders, including some organic conditions
Sexual Dysfunction Indian Medical PG Question 4: A patient has dyspareunia, and dysmenorrhea with adnexal tenderness. What is the first step of investigation?
- A. Colposcopy
- B. Diagnostic laparoscopy
- C. Transvaginal USG (Correct Answer)
- D. Transabdominal pelvic ultrasound
Sexual Dysfunction Explanation: ***Transvaginal USG***
- This is the **first-line investigation** for evaluating pelvic pain, dyspareunia, dysmenorrhea, and adnexal tenderness due to its ability to provide **high-resolution images** of the uterus, ovaries, and surrounding structures to identify potential pathology like **endometriomas** or other adnexal masses.
- It allows for detailed assessment of **ovarian cysts**, fibroids, and other pelvic abnormalities, which can explain the patient's symptoms.
*Colposcopy*
- This procedure is primarily used to closely examine the **cervix, vagina, and vulva** for abnormal cells, often following an abnormal Pap test.
- It is not the initial step for investigating generalized pelvic pain, dyspareunia, or adnexal tenderness.
*Diagnostic laparoscopy*
- While a **diagnostic laparoscopy** can provide a definitive diagnosis for conditions like **endometriosis**, it is an **invasive surgical procedure** and typically reserved for cases where non-invasive imaging, such as transvaginal ultrasound, has not yielded a clear diagnosis or when conservative management has failed.
- It is not considered the first-step investigation due to its **invasive nature** and associated risks.
*Transabdominal pelvic ultrasound*
- A **transabdominal pelvic ultrasound** provides a broader view of the pelvic organs but often has **lower resolution** and is less accurate for detailed assessment of the uterus, ovaries, and adnexa compared to transvaginal ultrasound, especially in obese patients.
- It is often used if a transvaginal ultrasound is not feasible or for assessing larger pelvic masses, but the **transvaginal approach** is superior for detailed evaluation of the female reproductive organs.
Sexual Dysfunction Indian Medical PG Question 5: Match the following drugs in Column A with their contraindications in Column B.
| Column A | Column B |
| :-- | :-- |
| 1. Morphine | 1. QT prolongation |
| 2. Amiodarone | 2. Thromboembolism |
| 3. Vigabatrin | 3. Pregnancy |
| 4. Estrogen preparations | 4. Head injury |
- A. A-1, B-3, C-2, D-4
- B. A-4, B-1, C-3, D-2 (Correct Answer)
- C. A-3, B-2, C-4, D-1
- D. A-2, B-4, C-1, D-3
Sexual Dysfunction Explanation: ***A-4, B-1, C-3, D-2***
- **Morphine** is contraindicated in **head injury** as it can increase intracranial pressure and mask neurological symptoms.
- **Amiodarone** is contraindicated in patients with **QT prolongation** due to its risk of inducing more severe arrhythmias like Torsades de Pointes.
- **Vigabatrin** is contraindicated during **pregnancy** due to its potential for teratogenicity and adverse effects on fetal development.
- **Estrogen preparations** are contraindicated in patients with a history of **thromboembolism** due to their increased risk of blood clot formation.
*A-1, B-3, C-2, D-4*
- This option incorrectly matches **Morphine** with QT prolongation and **Estrogen preparations** with head injury, which are not their primary contraindications.
- It also incorrectly links **Vigabatrin** with thromboembolism and **Amiodarone** with pregnancy.
*A-3, B-2, C-4, D-1*
- This choice incorrectly associates **Morphine** with pregnancy and **Vigabatrin** with head injury, which are not the most critical or direct contraindications.
- It also misaligns **Amiodarone** with thromboembolism and **Estrogen preparations** with QT prolongation.
*A-2, B-4, C-1, D-3*
- This option incorrectly matches **Morphine** with thromboembolism and **Amiodarone** with head injury, which are not their most significant contraindications.
- It also incorrectly links **Vigabatrin** with QT prolongation and **Estrogen preparations** with pregnancy.
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