Q-51. Physiological changes in pregnancy include which of the following?
a) Increase of blood volume by 100%
b) Decrease in Hb
c) Cardiac output 40 % decrease
d) Peripheral resistance 50 % increase
Answer: b
Explanation:
Blood volume increases by 50% in pregnancy.
The normal lower limit of hemoglobin is 11.0 g/dL. Cardiac output increases by 40%.
Peripheral resistance is decreased by 50%.
Q-52. Screening versus diagnostic tests, which of the following are true?
a) A screening test is performed on women with a ‘high risk’ to confirm or refute the possibility of a disorder.
b) Specificity is the probability that a subject who is negative will not have the condition.
c) Sensitivity is the proportion of subjects with the condition classified as screen positive for the condition.
d) Amniocentesis is an example of a diagnostic test.
Answer: d
Explanation:
Amniocentesis is an example of a diagnostic test for Down’s syndrome and other genetic disorders.
A screening test for Down’s syndrome would be the combined test or triple test.
Q-53. Methods of prenatal testing for congenital abnormalities, which of the following is not true?
a) Nuchal translucency is a screening test for chromosomal abnormalities such as trisomy 21.
b) Structural abnormalities are usually diagnosed at 20 weeks at the ‘anomaly scan’.
c) Chorionic villus sampling (CVS) usually allows an abnormal fetus to be identified at a time when abortion, if requested, could be performed surgically.
d) Amniocentesis is safer than CVS before 12 weeks.
Answer: d
Explanation:
The larger the nuchal translucency, the higher the risk of trisomies and structural, particularly cardiac, abnormalities
CVS can be performed from 11 weeks; surgical termination of pregnancy is not usually performed after 13 weeks. If prenatal diagnosis is requested before 15 weeks, CVS is safer than amniocentesis.
However, an amniocentesis from 15 weeks is safest of all.
Up to 25% of structural abnormalities can actually be identified at 11–14 weeks, but the 20-week scan is still more accurate. However, particularly with the heart, many remain undiagnosed even at 20 weeks.
Q-54. Which one of the following is not risk factor for pre-eclampsia?
a) Multi-parity
b) Advanced maternal age
c) Personal history of disorders characterized by micro-vascular disease
e) Multiple pregnancies
Answer: Multi-parity
Explanation:
Extremes of maternal age are a risk factor, particularly older age.
Nulliparity, chronic hypertension, chronic renal disease, sickle cell, diabetes and autoimmune disease, and multiple pregnancies are all risk factors for the development of pre-eclampsia.
Maternal family history rather than paternal family history is a risk factor for pre-eclampsia.
Q-55. Which two of the following are current indications for screening for gestational diabetes?
a) Previous history of IUGR
b) Persistent glycosuria
c) Increased BMI
d) Oligo-hydramnios
Answer: b and c
Explanation:
Although IUGR may occur as complication of gestational diabetes, it is rare and not an indication for screening. However, a previous fetus > 4.5 kg or poly-Hydromnios in a current pregnancy are indications.
Family history (first-degree relative) of diabetes or personal history of PCOS is risk factors for gestational diabetes.
Q-56. Common causes of ante-partum hemorrhage (APH, bleeding from the genital tract from 24 weeks gestation) include which of the following?
a) Vasa praevia
b) Placenta praevia
c) Uterine rupture
d) Placental abruption
Answer: b and d
Explanation:
Vasa praevia and uterine rupture are both rare causes of APH.
Q-57. Incorrect statements (s) about uterus
a) Length of uterine cervix > length of uterine corpus in nulliparous women
b) Length of uterine cervix > Length of uterine corpus in multiparous women
c) Uterus is 7 cm long in adult nulliparous
d) Uterus is 25 cm long in multiparous
e) Epithelium in corpus is ciliated columnar
Answer: a, b and d
Explanation:
The uterus is a pear shaped and thick wall consisting of serous, muscular and mucous layer.
Surface of mucous layer consists of a single layer of ciliated columnar epithelium.
In nulliparous women, it is approximately 7-8 cm long and 4-5 cm at its widest point.
In nulliparous women, cervix and body of uterus are about in equal in length.
In multiparous women, the cervix is only a little more than a third of the total length of the uterus.
Q-58. Drugs used in emergency contraceptive are
a) Single dose of oral Mifeprestone 10 mg within 5day
b) Mifeprestone 400mg with misoprostol 400μg
c) LNG 1.5 mg tablet within 72 hr
d) Mifeprestone 200 mg with oral misoprostol 400μg
e) Danazol 600 mg 2 dose 12 hr apart within 72 hr
Answer: a, c and e
Explanation:
Drugs used in emergency contraceptive:
Estrogen alone (Within 72 hours):
Ethinyl estradiol for 5 days
Conjugated estrogen for 5 days
Progesterone alone (Within 72 hours):
Levo-norgestrel
Estrogen and Progesterone (Within 72 hours):
Ethinyl estradiol and Levo-norgestrel
Low dose OCP
Cu-T 380 A- Inserted within 7 days from the time of unprotected intercourse.
Mifepristone
Q-59. True statement regarding contraceptive uses
a) IUD can be used as emergency contraceptive
b) Progesterone injection can be used in breast feeding mother
c) Conjugated estrogen is given after unprotected intercourse for 5 day
d) Progesterone only pill is started 21 day postpartum and should be taken every day
Answer: All
Explanation:
Cu-T 380 A- Inserted within 7 days from the time of unprotected intercourse.
Progesterone injection is suitable for the lactating women.
Progesterone only pill is started 21 day postpartum or soon after abortion and should be taken every day.
Q-60. OCP gives protection against
a) Ovary cancer
b) Cervix cancer
c) Endometrial cancer
d) Breast cancer
e) Vaginal cancer
Answer: a and c
Explanation:
Advantages of OCPs (Oral contraceptive pills):
Reduction in risk of:
Ovarian and endometrial cancer
Ectopic pregnancy
PID
Menstrual disorders
Benign breast diseases
Acne
Emerging benefits include protection against bone mineral density los, development of colorectal cancer and progression of rheumatoid arthritis.