Q-111. LH surge is principally due to which of the following hormonal changes
a) Falling FSH levels
b) Sustained/ marked rise in estrogen
c) Rise in progesterone
d) Rise in prostaglandins
Answer: Sustained/ marked rise in estrogen
Explanation:
LH surge is principally due to positive feedback from sustained high level of estrogen. LH surge triggers ovulation.
Q-112. Which of the following intrauterine contraceptive devices does not need to be replaced even after 3-5 years of use?
a) Cu-T 200
b) Cu-T 375
c) Cu-T 380 A
d) Multi-load Cu devices
Answer: Cu-T 380 A
Explanation:
Cu-T 380 A is a T shaped device with a polyethylene frame holding 380 mm2 of exposed surface area of copper.
The IUD frame contains barium sulfate thus making it radio-opaque. It is effective for about 10 years.
Q-113. Which of the following is not a germ cell ovarian tumor?
a) Dysgerminoma
b) Endo-dermal sinus tumor
d) Granules cell tumor
e) Chorio-carcinoma
Answer: Granules cell tumor
Explanation:
Primitive germ cell tumors:
Dysgerminoma
Endo-dermal sinus tumor or Yolk sac tumor
Embryonal carcinomas
Poly-embryoma
Non-gestational chorio-carcinoma
Q-114. A 55 year old lady presents with abdominal distension, bleeding, pelvic pain and respiratory distress. Clinical examination reveals features of ascites and CA-125 levels are elevated. The most likely diagnosis is
a) CA- ovary
b) CA- cervix
c) CA- Lung
d) Lymphoma
Answer: CA- ovary
Explanation:
Carcinoma ovary:
Clinical presentations:
Abdominal distension
Urinary urgency
Pelvic pain
Respiratory distress
Pelvic mass
Ascites
Pleural effusion
Hepato-splenomegaly
Virchow’s node may be enlarged
Tumor marker:
CA-125
Important point:
In women with a pelvic mass and ascites the diagnosis is ovarian cancer unless proven otherwise.
Q-115. Which amongst the following is not seen in normal pregnancy?
a) Increase in systolic blood pressure
b) Increase in heart rate
c) Increase in cardiac output
d) Increase in blood volume
Answer: Increase in systolic blood pressure
Explanation:
Significantly increased parameters in pregnancy:
Heart rate
Cardiac out put
Blood volume
Femoral venous pressure
Important point:
The mean arterial pressure doses not undergo any significant change during a normal pregnancy.
Q-116. Components of active management of third stage of labor include all of the following except
a) Controlled cord traction
b) Early cord clamping
c) Injection methergine (Ergometrine)
d) Injection syntocinon (Oxytocin)
Answer: Early cord clamping
Explanation:
Active management of third stage of labor (WHO):
Administration of uterotonic soon after birth of baby
Delayed cord clamping and cutting
Controlled cord traction for delivery of placenta
Uterine massage
Q-117. A lady G3P1A1 is admitted to the labour room at term. Cervix is 4 cm dilated, membrane is intact and head is palpable 3/5 per abdomen. After 4 hours repeated examination is done and cervix is 5cm dilated station in unchanged and the cervico-graph remains on the right side of alert lens. Which of the following statements about the progress of labor is true?
a) The head was engaged at the time of presentation
b) The cervico-graph progress is satisfactory
c) The cervico-graph status suggests that intervention is likely to be required
d) The cervico-graph on repeat examination would touch the action line
Answer: The cervico-graph status suggests that intervention is likely to be required
Explanation:
Normal labour should progress with a cervical dilation rate of ≥ 1 cm/ hour once the patient has entered the active stage of labour (4 cm dilation).
Q-118. Which of the following statements about vaginal preterm delivery of twins is true?
a) First twin has higher risk of birth asphyxia
b) Second twin has higher risk of hyaline membrane disease
c) First twin has higher risk of mortality
d) Second twin has higher risk of intracranial hemorrhage
Answer: Second twin has higher risk of hyaline membrane disease
Explanation:
The second twin has higher risk of hyaline membrane disease, birth asphyxia and increased peri-natal mortality.
Q-119. The glomerular filtration rate (GFR) in pre-eclampsia
a) Decreases
b) Increases
c) Remains the same
d) None of the above
Answer: Decreases
Explanation:
Renal dysfunction in Preeclampsia and Eclampsia:
The glomerular filtration rate decreases
Renal plasma flow decreases
Decrease urinary calcium excretion
Serum uric acid increases
Serum creatinine increases
Urinary protein increases
Urine sodium concentration increases
Q-120. A 39 year old G4P3 presents to the ante-natal clinic with LMP 8 weeks ago. There is no history of bleeding or pain. VDRL – RPR performed on her visit comes back positive. Confirmatory micro chemical agglutination assay for antibodies to Treponema pallidum (MHA- TP) also returns as positive. The best pharmacotherapy for her condition should include
a) Erythromycin
b) Azithromycin
c) Penicillin
d) Tetracycline
Answer: Penicillin
Explanation:
Treatment of syphlis during pregnancy:
Parenteral penicillin G is the pharmacotherapy of choice for all stage of syphlis during pregnancy.