Q-61. Causes of vulval carcinoma includes
a) HPV
b) HSV
c) Syphilis
d) LGV
e) Chlamydia trachomatis
Answer: All
Explanation:
Causes of vulval intra-epithelial neoplasia (VIN):
HPV
HIV
LGV
HSV
Gonorrhea
Syphlis
Gardnerella vaginalis
Trichomonas
Q-62. Ectopic pregnancy risk is/are increased in
a) IUCD use increase risk
b) Previous ectopic is greatest risk
c) OCP
d) Prior history of tubal surgery
e) Previous genital infections
Answer: a, b, d and e
Explanation:
Ectopic pregnancy:
More than 95 % of extra-uterine pregnancies occur in fallopian tube.
Risk factors for ectopic pregnancy:
Tubal factors:
Salpingitis
Endometriosis
Leiomyomas
Developmental abnormalities of uterus
Previous tubal surgery
Zygote abnormalities:
Ovarian factors:
Fertilization of un-extruded ovum
Trans-migration of ovum into the contra-lateral tube
Exogenous hormones:
Progestin only pills- Due to smooth muscle relaxant effects and subsequent ovum trapping
Diethylstilbestrol
Other factors:
IUD
Previous ectopic pregnancy
Smoking
Increasing maternal age
Q-63. In normal pregnancy gestational age up-to 10 wk can be determined from USG by
a) Gestation sac
b) Yolk sac
c) CRL
d) BPD
e) HC
Answer: a, b and c
Explanation:
Ultrasound examination of fetus:
Gestational sac and yolk sac- 5 weeks
Cardiac activity- 5-6 weeks
Limb buds- 7-8 weeks
Important points:
The first definite Sonographic finding to suggest pregnancy is visualization of the gestational sac.
The first sign of intra-uterine pregnancy is presence of yolk sac within the gestational sac.
Fetal crown to rump length (CRL) can be measured at 5-13 weeks and is the most accurate means to determine gestational age.
Beyond 13 weeks, measurement of fetal bi-parietal diameter is used in conjunction with femur length and abdominal circumference to access gestational age.
Q-64. Biophysical profile scoring includes
a) Fetal muscle tone
b) Fetal breathing movements
c) Pulsatility index
d) Amniotic fluid volume
e) Doppler velocimetry of umbilical artery
Answer: a, b and d
Explanation:
Biophysical profile:
Non stress test
Fetal breathing movement
Fetal movement
Fetal tone
Amniotic fluid volume
Important point:
Each component is worth 2 points, a score of 8 or more is normal, 6 is equi-vocal and 4 or less is abnormal
Q-65. Not sign of fetal distress
a) Early deceleration
b) Late deceleration
c) Absence of acceleration
d) Mild variable deceleration
e) Severe variable deceleration
Answer: a and d
Explanation:
Abnormal Non Stress Test:
Base line oscillation less than 5 bpm
Absent acceleration
Late deceleration- Fetal hypoxemia
Severe variable deceleration- Cord compression
Q-66. Which is/are not feature of preeclampsia?
a) Thrombocytopenia
b) Anuria
c) Jaundice
d) Pain in epigastric region
e) Proteinuria
Answer: b and c
Explanation:
Preeclampsia:
Hypertension
Proteinuria
Edema
In addition of classical findings, women with preeclampsia may complain of
Scotomata
Blurred vision
Pain in epigastrium or right upper quadrant
Symptoms of thrombocytopenia
Q-67. Correct statements about preeclampsia are
a) Proteinuria is always present
b) Thrombocytopenia indicates worsening condition
c) IUGR may occur in severe pre-eclampsia
d) Smoking is an important risk factor
Answer: a, b and c
Explanation:
Risk Factors for Preeclampsia:
Age < 20 years or > 35 years
Nulliparity
Multiple gestations
Hydatidiform mole
DM
Thyroid disease
Chronic hypertension
Renal disease
Collagen vascular disease
Anti-phospholipid syndrome
Family history of preeclampsia
Severe Preeclampsia:
Blood pressure ≥ 160/110 mm Hg
Proteinuria of 5 g or higher in 24 hours urine
Oliguria
Cerebral and visual disturbance
Pulmonary edema and cyanosis
Pain in epigastrium or right upper quadrant
Impaired liver functions
Thrombocytopenia
Fetal growth restriction
Q-68. Risk factors for ca cervix includes
a) Late menarche
b) Genital warts
c) HPV is associated with <20% carcinoma cervix
d) Low socioeconomic condition
e) Smoking
Answer: b, d and e
Explanation:
Risk factors for ca cervix:
Multiple sexual partners
Multiple pregnancies
Low socioeconomic condition/ Poor personal hygiene
Smoking and drug abuse
HPV, HSV, HIV infections
Early menarche
Coitus bore age of 18 years
Q-69. A woman undergoes routine Pap smear examination. Cytology smear shows atypical squamous cell of undetermined significance. Next line of management will be
a) Repeat cervical cytology
b) Cervical biopsy
c) HPV DNA testing
d) LEEP
e) Colposcopy
Answer: a
Explanation:
Pap smear is a screening test only.
Positive tests are indication for further diagnostic procedures, such as Colposcopy, endo-cervical curettage, cervical biopsy or conization, endometrial biopsy or D&C.
Cytology smear shows atypical squamous cell of undetermined significance:
Prior to performing a repeat smear for a patient with minimally abnormal cervical cytology smears, patient should be treated for potential underlying conditions that might contribute to an atypical smear such as antimicrobial for infections or hormones for atrophic vaginitis.
Q-70. Cause (s) of abnormal uterine bleeding is/are
a) Hypothyroidism
b) Asherman’s syndrome
c) Senile endometritis
d) Turner syndrome
e) Cervical polyp
Answer: a, c and e