Q-71. Regarding transmission of HIV to infant from infected mother, which statement is /are true
a) Nevirapine prophylaxis is used for prevention of mother-to-child transmission
b) Zidovudine should be given to pregnant woman & infant both
c) Emergency CS decrease chance of transmission
d) Avoid breast feeding
e) Majority of infection occur during labour & perinatal period
Answer: All
Explanation:
HIV infection during pregnancy:
Maternal transmission of HIV occur trans-placentlly before birth, peri-partum by exposure to blood and bodily fluid at delivery or post-partum through breast feeding.
Majority of infection occur during labour & perinatal period.
Emergency CS decreases chance of transmission.
Nevirapine should be initiated in pregnant women with CD4+ counts greater than 250 cells /mm3.
Zidovudine/ HAART (Highly active anti-retro-viral therapy) to mother reduce overall transmission
Q-72. Microscopic features of endo-dermal sinus tumor is/are
a) Schiller-Duval body
b) Intracellular& extracellular hyaline droplets
c) Granulosa granulomas cells with prominent nuclei
d) Spindle shaped cells or myxoid
e) Fibrous sheath
Answer: a, b and d
Explanation:
Microscopic features of endo-dermal sinus tumor of ovary:
Composed of primitive epithelial cells
Schiller-Duval body (Pathognomic finding)
Intracellular& extracellular hyaline droplets
Myxoid elements
Important points:
Previously called yolk sac tumor
Third most common germ cell neoplasm
Bilateral in 100 % of cases
Most rapidly growing neoplasm
Commonly contains cells that produce AFP.
Q-73. False about female pelvis
a) Narrow pelvic plane lies at the level of ischial spines
b) Plane of greatest pelvis dimension corresponds to S1 & S2 vertebrae
c) Angle of inclination is 55 degree
d) Plane of least pelvic dimension form plane of obstetrical outlet
Answer: b
Explanation:
Female pelvis:
Narrow pelvic plane lies at the level of ischial spines
Angle of inclination is 55 degree
Plane of least pelvic dimension form plane of obstetrical outlet
Q-74. Commonest cause of precocious puberty
a) Idiopathic
b) Constitutional
c) Pituitary tumor
d) Benign follicular ovarian cysts
e) Granulosa cell tumor
Answer: a and b
Explanation:
Precocious puberty is divided most easily into gonadotropin-dependent and gonadotropin-independent sexual precocity.
Gonadotropin-dependent precocity is almost always pituitary-mediated and so is also termed central precocious puberty.
Gonadotropin-independent precocity, usually a result of a gonadal or adrenal disorder, is also termed peripheral precocious puberty.
Most cases of precocious puberty are gonadotropin-dependent with no underlying abnormality (Idiopathic).
Idiopathic/ constitutional precocious puberty is the most common situation with female precocity.
Q-75. Factors favoring face presentation
a) Fetal goiter
b) Anencephalic fetuses
c) Multi-parity
d) Uterine malformation
e) Hydrocephalous
Answer: a, b, c and e
Explanation:
Factors favoring face presentation:
Advanced maternal age
Grand multi-parity
Multiple gestations
Pelvic mass
Pelvic contraction
Poly-Hydromnios
Macrosomia
Congenital anomalies- Anencephaly, hydrocephaly and congenital goiter
Prematurity
Cornual implantation of placenta
Placenta previa
Premature rupture of membrane
Q-76. True statement regarding myoma of uterus
a) Mostly asymptomatic
b) Red degeneration occurs
c) Sarcomatous change is common
d) Mifepristone is used for treatment
Answer: a, b and d
Explanation:
A uterine myoma is a benign tumour that grows within the muscle tissue of the uterus.
Mostly asymptomatic
Benign degeneration- Atrophic, hyaline, cystic, calcific, septic, red and Myxomatous degeneration
Metastasizing Leiomyoma or Leiomyosarcoma is rare.
Abnormal uterine bleeding is the most common and most important clinical manifestation.
GnRH agonist may be used for controlling bleeding from Leiomyoma.
Surgery is the mainstay of treatment of Leiomyoma.
Q-77. Correct statement about menstruation
a) Poly-menorrhea means episodes of menstruation at interval of less than 21 days
b) Oligo-menorrhea is scanty regularly spaced bleeding cyclic menstruation
c) Menorrhagia very large amount of regularly spaced bleeding
d) Secondary amenorrhea – on bleeding for > 12 weeks who have previously menstruated
e) Post menopausal bleeding occurs after 1 yr of stoppage of menses
Answer: a, c and e
Explanation:
Q-78. True about MRKH (Mayer-Rokitansky-Kuster-Hauser) syndrome
a) Congenital absence of uterus & vagina
b) Karyotype 46 XO
c) Phenotypically female
d) No ovarian function
e) Associated renal & skeletal disease
Answer: a, c and e
Explanation:
MRKH (Mayer-Rokitansky-Kuster-Hauser) syndrome:
Karyotype 46XX with WNT4 gene mutation
Phenotypically female
Absent uterus and vagina
Ovary and tube present and Functional ovary
Primary amenorrhea
Normal secondary sexual characters
Normal hormone profile
Associated with renal and skeletal abnormalities
Q-79. True statement about effect of drugs on uterine tone
a) Increased by Ketamine
b) Increased by β agonist
c) Decreased by Pethidine
d) Decreased by Nifedipine
e) Unaffected by Halothane
Answer: a and d
Explanation:
Uterine relaxants:
Calcium channel blocker- Nifedipine
Beta agonist- Ritodrine
Disadvantages of Ketamine (Increase uterine tone):
Hypertension
Emergence reactions
Low Apgar score
Abnormalities in neonatal muscle tone
Q-80. True about precocious puberty
a) Secondary sexual character before 8 years in girl & before 9.5 years in boys
b) Increased in testes size-earliest sing of puberty in boy
c) Commonest cause is idiopathic
d) Hypothalamic hamartoma is least of central cause
e) MRI brain is mandatory investigation
Answer: a, b, c and e
Explanation:
Secondary sexual character before 8 years in girl & before 9.5 years in boys
Idiopathic/ constitutional precocious puberty is the most common situation with female precocity.
Increased in testes size-earliest sing of puberty in boy and breast development in girl
Hypothalamic hamartoma is the commonest cause of organic central precocious puberty.
MRI or CT brain is mandatory investigation