Last 5 Year PYQs in OBG for INI-CET

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Q1. Who should be screened for cervical cancer are the following groups of individuals:

1. More than 65 years old
2. Less than 21 years, old
3. 21 to 65 year old females
4. Teenagers

Ans. 3) 21 to 65 year old females

Screening for cervical cancer is recommended for females between the ages of 21 and 65 years. This is the age group at higher risk for developing cervical cancer due to the prevalence of human papillomavirus (HPV) infections. Regular screening with a Pap smear or HPV testing can help detect cervical abnormalities and prevent the development of cervical cancer

Q2. Which of the following mechanisms is not involved in the action of oral contraceptives?

1.  Inhibit implantation
2. Cervical mucus thickening
3. Inhibit ovulation
4. Increase GnRH release

Ans. 4) Increase GnRH release
Oral contraceptives, also known as birth control pills, work by primarily inhibiting ovulation (preventing the release of an egg). They also thicken the cervical mucus, making it difficult for sperm to enter the uterus and reach the egg. Additionally, they may alter the endometrial lining, making it less receptive to implantation. However, they do not increase the release of Gonadotropin-releasing hormone (GnRH).

Also read: Last 5 Year PYQs in Forensic Medicine for INI-CET

Q3. What is the appropriate evaluation for a 30-year-old woman who visits an infertility clinic and has a consistent 28-day menstrual cycle?

1. Serum progesterone on 14
2. Serum progesterone day 21
3. Serum LH on day 10
4. Serum LH on day 21

Ans. 2) Serum progesterone day 21

• Serum progesterone day 21. In a woman with a regular 28-day cycle, the evaluation for ovulation can be done by measuring serum progesterone levels on day 21 of the menstrual cycle. Day 21 corresponds to the luteal phase of the menstrual cycle when progesterone levels should be elevated if ovulation has occurred.

Q4. A patient with 12 weeks of amenorrhea presents with vaginal bleeding. On examination, the Cervix is favorable. USG shows a snowstorm appearance. The next best step in the management is?

1. Medical management
2. Follow up with beta-hCG
3. Suction and evacuation
4. Hysterectomy

Ans. 3) Suction and evacuation

• The clinical presentation with vaginal bleeding, a favorable cervix, and the ultrasound findings of a snowstorm appearance are highly suggestive of a complete or partial molar pregnancy.
• The patient comes under Group A where : Cervix is favorable —(a) The preferred method is suction evacuation. A negative pressure is applied up to 200–250 mm Hg. The procedure can be performed under diazepam sedation or general anesthesia.
• The next best step in management is suction and evacuation (also known as dilatation and curettage) to remove the molar tissue.

Also read: Last 5 Year PYQs in Pathology for NEET PG​

Q5. Which of the following structures is not cut in a mediolateral episiotomy?

1. Transverse perineal muscles
2. Obturator muscle
3. Bulbospongiosus
4. Transverse perineal branches of pudendal nerves

Ans. 2) Obturator muscle

Obturator muscle: Mediolateral episiotomy is a surgical incision made during childbirth to enlarge the vaginal opening. The incision typically involves cutting through the skin, subcutaneous tissue, perineal body, transverse perineal muscles, and bulbospongiosus muscle. However, the obturator muscle is not directly involved and is not cut during mediolateral episiotomy.

Q6. Based on the provided clinical image, what would be the most likely diagnosis?

1. Cervical carcinoma
2. Uterine inversion
3. Uterocervical prolapse
4. Fibroid polyp

Ans. 3) Uterocervical prolapse

• Uterocervical prolapse is typically diagnosed through physical examination.
• Symptoms of uterocervical prolapse can range from mild to severe, depending on the extent of the prolapse. It includes feelings of heaviness or pulling in the pelvis tissue protruding from the vagina, urinary problems like incontinence or recurrent urinary tract infections, bowel movement difficulties, and discomfort during sexual intercourse. However, few women with uterocervical prolapse might not experience any symptoms.

Q7. What should be the subsequent course of action for a 26-year-old woman with a history of two vaginal deliveries, complaining of a persistent dull ache in the abdomen, irregular menstrual cycles, and a palpable mass detected during a vaginal examination, which was confirmed by a 5 x 5 cm ovarian cyst on ultrasound?

1. Measure CA 125 levels
2. Follow up after 6 weeks
3. Laparoscopy
4. CT pelvis

Ans. 2) Follow up after 6 weeks

• The correct answer is B. Follow up after 6 weeks.
• In question, the patient is a young woman of reproductive age who presents with an ovarian cyst as detected by an ultrasound scan. In reproductive   functional ovarian cysts is the most common type among all ovarian cysts. These cysts are often harmless, cause no symptoms, and can resolve on their own over time within a period of one to two menstrual cycles, or roughly 4–8 weeks.

Also read: Last 5 Year PYQs in Orthopedics for NEET PG

Q8. Which of the options is not a part of the quadruple screening test?

1. Inhibin B
2. Unconjugated Estriol (E3)
3. AFP
4. hCG

Ans. 1) Inhibin B

• A quadruple screening test or QSt, is a prenatal test which provides information on whether there is a higher chance that a child has certain disorders. The test measure level of four substances in the blood of a pregnant woman, i.e., alpha-fetoprotein (AFP), unconjugated estriol (E3), human chorionic gonadotropin (hCG), and Inhibin A.
• Inhibin B is the correct answer, as it is not included in the quadruple screening test. This test usually measures the level of Inhibin A. This hormone is produced in the placenta of the mother during the pregnancy. A high level of Inhibin is associated with an increased risk of Down syndrome.
• So, to reiterate, the quadruple screening test includes measurements of AFP, E3, hCG, and Inhibin A – but not Inhibin B.

Q9. Which fixative is employed for a pap smear?

1. Formalin
2. Air dried
3. Normal saline
4. 95% ethanol

Ans. 4) 95% ethanol

• The correct answer is 95% ethanol. A fixative is a substance used to preserve specimens for microscopic examination by preventing decay and decomposition.
• 95% ethanol is the standard fixative used in a Pap smear. It preserves cell morphology and prevents cell degradation, making it easier to identify any abnormal cells during microscopic examination.

Q10. In a seminal fluid analysis, what is considered to be the optimal percentage for normal sperm morphology?

1. 10%
2. 4%
3. 6%
4. 8%

Ans. 2) 4%

• Sperm morphology refers to the size and shape of the sperm, which are important factors in its ability to fertilize an egg. Abnormalities in sperm morphology can lead to difficulties with fertility.
• The correct answer is b, 4%. According to the World Health Organization's (WHO) criteria (5th Edition), at least 4% of sperm in a sample should have normal morphology. This means that a man is considered to have a normal sperm morphology if 4% or more of his sperm are of a normal shape and size.
• So, based on the most recent guidelines from the World Health Organization, if 4% or more of the sperm in a sample have normal morphology, it is considered normal. Hence, the correct answer is b, 4%.

Also read: Last 5 Year PYQs in Pediatrics for NEET PG

Q11. Which of the statements below is not accurate regarding lupus nephritis during pregnancy?

1. Immunosuppression can be continued during pregnancy
2. Pregnancy to be planned once the disease has been quiescent for at least 6 months and there is no evidence of renal dysfunction
3. High dose corticosteroids for lupus flare in pregnancy is safe
4. Ecosprin, methotrexate, cyclophosphamide, corticosteroids, and azathioprine are safe in pregnancy

Ans. 4) Ecosprin, methotrexate, cyclophosphamide, corticosteroids, and azathioprine are safe in pregnancy:

• Ecosprin, methotrexate, cyclophosphamide, corticosteroids, and azathioprine are safe in pregnancy. This statement is false.
• Ecosprin (aspirin) is generally considered safe to use in pregnancy, particularly for specific indications such as the prevention of preeclampsia in certain high-risk cases.
• However, medications like methotrexate, cyclophosphamide, and azathioprine are known to have potentially harmful effects on fetal development and are generally avoided during pregnancy due to their teratogenicity (ability to cause birth defects) and other risks.
• Corticosteroids, on the other hand, as mentioned earlier, are considered safe and necessary in managing lupus flares during pregnancy.

Q12. Which of the statements below is not true regarding the management of diabetes during pregnancy?

1. Insulin must be recommended in case of small for gestational age infant
2. In a patient being planned for induction of labor, the night dose of intermediate insulin is given as planned, and the morning dose is withheld
3. In active labor, if RBS <70 mg%, D5 is started at 100-150 ml/hr till the RBS is >100 mg%
4. Capillary blood glucose monitoring levels are kept at fasting: 95 mg%; 1 hr postprandial- 140 mg%; 2 hrs postprandial: 120 mg%

Ans. 1) Insulin must be recommended in cases of small for gestational age

• False. Insulin therapy may be recommended in cases of fetal macrosomia (excessive fetal growth), but it is not routinely recommended in cases of small for gestational age. Small for gestational age infants may not necessitate insulin treatment unless there are other indications, such as poor glycemic control.

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Q13. Which of the following investigations is NOT routinely recommended for screening antenatal mothers due to its cost-effectiveness?

1. Echocardiography for cardiac disease
2. Urine analysis for bacteriuria
3. Blood sugar levels for GDM
4. VDRL for syphilis

Ans. 1) Echocardiography for cardiac disease:

• Echocardiography for cardiac disease is not routinely recommended as a cost-effective investigation in the screening of antenatal mothers.
• Echocardiography is usually performed in pregnant women who have specific risk factors or symptoms suggestive of cardiac disease, such as a history of heart disease, significant maternal symptoms, or abnormal findings on physical examination.

Q14. In which of the following conditions would the absence of seminal vesicles and vas deferens be a congenital bilateral occurrence?

1. Cystic fibrosis
2. Klinefelter syndrome
3. Kallmann syndrome
4. Kartagener syndrome

Ans. 1) Cystic fibrosis

• In individuals with cystic fibrosis, the seminal vesicles and vas deferens can be bilaterally absent congenitally.
• Cystic fibrosis is a genetic disorder primarily affecting the lungs, digestive system, and other organs.
• It is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which plays a crucial role in the production of mucus and sweat.
• These mutations can lead to various complications, including reproductive issues in males.

Q15. The Kassowitz rule is related to which of the following?

1. Primary syphilis
2. Congenital syphilis
3. Secondary syphilis
4. Latent syphilis

Ans. 2) Congenital syphilis

• Kassowitz rule ; If a woman with untreated syphilis has a series of pregnancies, the likelihood of infection of the foetus in later pregnancies becomes less.
• Thus, in successive pregnancies, she may have miscarriage at the 5th month, next occasion-stillbirth at the 8th month, next, birth of an infant with congenital syphilis who dies within a few weeks followed by birth of 2 or 3 infants with congenital syphilis who survive, finally, 1 or more healthy children may be born.

Also read: Last 5 Year PYQs in Gynaecology & Obstetrics for NEET PG

Q16. Which hormone is secreted by the human placenta?

1. LH
2. hCG
3. FSH
4. GnRH

Ans. 2) hCG

• hCG is a hormone that is primarily secreted by the placenta during pregnancy.
• It is produced by the synaptic trophoblast cells of the placenta shortly after implantation.
• hCG plays a crucial role in supporting early pregnancy and is responsible for maintaining the corpus luteum, which produces progesterone to support the pregnancy until the placenta is fully formed.
• hCG is also the hormone detected in pregnancy tests to confirm pregnancy.

Q17. In puberty, what is the most common cause of menorrhagia?

1. Endometriosis
2. Anovulation
3. Malignancy
4. Adenomyosis

Ans. 2) Anovulation

• Anovulation is the most common cause of puberty menorrhagia.
• Anovulatory cycles are due to hypothalamic-pituitary-ovarian axis dysfunction
• During puberty, maturation of the hypothalamic-pituitary-ovarian axis causes an increase in GnRH, which induces the secretion of pituitary gonadotropins (LH and FSH). The timing of LH pulses is crucial in establishing normal ovulatory cycles.

Q18. A 30-year-old pregnant female, G2P1, at 28 weeks gestation presents to the emergency department with complaints of fever, mild leukocytosis, and lower abdominal pain. She has a history of uterine fibroids diagnosed during her previous pregnancy. On examination, she has tenderness over the lower abdomen, and the uterus feels enlarged. Fetal heart rate monitoring shows no abnormalities. What is the most likely cause of her symptoms?

1. Red degeneration of fibroid
2. Fibroid torsion
3. Fibroid infection
4. Labor pain

Ans. 1)  Red degeneration of fibroid

• Red degeneration is a complication of leiomyomas or fibroids and is usually associated with pregnancy.
• The patient presents with severe abdominal pain and fever along with moderate leucocytosis and raised ESR. In spite of these features, it is an aseptic condition.
• Pathological examination reveals a beefy red color of the myoma, which is attributed to diffusion of blood pigments from thrombosed vessels.
• Differential diagnosis includes appendicitis, pyelitis, torsion ovary, and accidental hemorrhage.

Also read: Last 5 Year PYQs in Anatomy for NEET PG

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