Q-41. Which of the following are true symptoms of pregnancy?
a) Amenorrhea
b) Bleeding
c) Urinary frequency
d) Nausea and vomiting
e) Breast tenderness
Answer: a, c, d and e
Q-42. Increased nuchal translucency in 13th week fetal ultrasound characteristic of:
a) Turner syndrome
b) Down’s syndrome
c) Hydrocephalus
d) Klinefelter’s syndrome
Answer: Down’s syndrome
Explanation:
Screening for nuchal translucency provides the parents with an individualized, specific risk of their having a child with Down syndrome, trisomy 13, or trisomy 18.
This test, performed between 11 and 14 weeks of pregnancy, involves the use of ultra-sonography to measure the clear space in the folds of tissue behind a developing baby’s neck.
Increased nuchal translucency refers to a measurement greater than 3 mm.
This finding indicates that the risks of some genetic disorders and birth defects, including Down syndrome, are increased.
Down’s syndrome is the most common cause of increased nuchal translucency in fetal ultrasound.
Q-43. All are advantage of Hysteroscopic over open Myomectomy except
a) Less Pain
b) Early Ambulation
c) Less Blood loss
d) Recurrence
Answer: Recurrence
Explanation:
For women who are candidates for Hysteroscopic Myomectomy, this procedure is preferred over an abdominal approach, particularly laparotomy, for the following reasons:
Outpatient procedure
Minimal recovery time
Decreased peri-operative morbidity
Minimal or no scarring of myometrium
Reduced the risk of postoperative adhesion formation
Reduced postoperative pain
Blood loss
Q-44. Which of the following maneuvers is not used for the management of shoulder dystocia?
a) McRoberts maneuver
b) Supra-pubic pressure
c) Woods corkscrew maneuver
d) Mauriceau–Smellie–Veit maneuver
Answer: Mauriceau–Smellie–Veit maneuver
Explanation:
Shoulder dystocia:
It is a type of obstructed labour in which the anterior shoulder of the fetus fails to deliver after the emergence of the head.
Mauriceau–Smellie–Veit maneuver is used in the management of after coming head in case of breech delivery.
Q-45. Estrogen administration in a menopausal woman increases the:
a) Gonadotropin secretion
b) LDL cholesterol
c) Bone mass
d) Muscle mass
Answer: Bone mass
Explanation:
Q-46. Which among the following is most commonly associated with carcinoma cervix?
a) HPV 35
b) HPV 33
c) HPV 18
d) HPV 16
Answer: HPV 16
Explanation:
Human papillomavirus (HPV) is the most common viral infection of the reproductive tract.
Oncogenic or high-risk HPV types, including types 16 and 18, can cause intraepithelial neoplasia of the ano-genital region, including cervical, vulvar, vaginal, penile, and anal cancers as well as some oropharyngeal cancers.
Non-oncogenic, or low-risk HPV types, such as HPV 6 or 11, can cause (1) benign or low-grade abnormalities of cervical cells, (2) ano-genital warts, and (3) a disease of the respiratory tract called recurrent respiratory papillomatosis (RRP).
Two HPV types (16 and 18) cause 70% of cervical cancers and precancerous cervical lesions
HPV 16 is most commonly associated with carcinoma cervix.
Q-47. Not a criteria for diagnosis of superimposed preeclampsia in a pregnant lady with pre existing hypertension:
a) Increase in systolic BP by 30mm Hg and diastolic BP by 15mm Hg
b) Platelets less than 75000
c) New onset proteinuria
d) Nevo-vascular changes in retinal vessels
Answer: Nevo-vascular changes in retinal vessels
Explanation:
Preeclampsia is defined by the new onset of elevated blood pressure and proteinuria after 20 weeks of gestation.
Hypertension is defined as blood pressure equal to or greater than 140/90 mm Hg or an increase in mean arterial pressure of 20 mm Hg. The use of an increase in blood pressure of 30/15 mm Hg over first-trimester values is controversial.
Superimposed pre-eclampsia (on chronic hypertension)
New onset proteinuria in a woman with hypertension but no proteinuria before 20 weeks gestation
A sudden increase in proteinuria or blood pressure, or platelet count less than 100,000 in women with hypertension and proteinuria before 20 weeks gestation
Q-48. Which drug is not given in pregnancy induced hypertension?
a) Alpha methyl dopa
b) Enalapril
c) Nifedipine
d) Labetalol
Answer: Enalapril
Explanation:
Commonly used antihypertensive medications in pregnancy:
Severe hypertension
Hydralazine
Labetalol
Short-acting Nifedipine
Mild to moderate hypertension
Methyldopa
Labetalol
Hydralazine
Long-acting Nifedipine
Congenital malformations have been reported with the use of ACE inhibitors during the first trimester of pregnancy, while fetal and neonatal toxicity, death, and congenital anomalies have been reported with the use of ACE inhibitors during the second and third trimesters of pregnancy.
If the patient becomes pregnant, Enalapril should be discontinued as soon as possible. Enalapril is considered contraindicated during pregnancy.
Q-49. Which of the following are true regarding estimation/ calculation of gestational age?
a) A woman’s ‘gestation’ is 2 more weeks than the time period since conception.
b) If a cycle is >28 days, the EDD will be later and needs to be adjusted.
c) If the cycle is <28 days the number of days by which the cycle is less than 28 should be deducted from the EDD.
d) Measurement of crown–rump length between 7 and 14 weeks: if there is >1 week difference between LMP and scan, EDD estimated by LMP is used.
Answer: a, b and c
Explanation:
Nagle’s rule to calculate EDD where the cycle is not exactly 28 days—the number of days by which the cycle is longer or shorter than 28 days is added to the date calculated by LMP.
Currently, in the UK, NICE recommends re-dating of all women (except IVF pregnancies) on the basis of the CRL at the nuchal scan (i.e. <14 weeks). From 14 weeks, the head circumference is best used. Ultrasound measurements to calculate gestational age are of little use beyond 20 weeks.
Q-50. Diagnostic criteria for HELLP syndrome are A/E:
a) Hemolysis
b) Elevated liver enzyme
c) Low platelets < 25000 d) Retro-peritoneal hemorrhages Answer: Retro-peritoneal hemorrhages Explanation: The HELLP syndrome is a serious complication in pregnancy characterized by hemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10-20% of cases with severe preeclampsia. Diagnostic criteria for HELLP syndrome Hemolysis Elevated Liver Enzymes and Thrombocytopenia