JIPMER PG 2020 OBG Questions with explaination
1. 1
st sign of puberty in girls
a. Breast development
b. Axillary, pubic hair
c. Menarche
d. Growth spurt
Ans: a. Breast development
Explanation:
➢ 1
st sign of puberty in girls is -----Thelarche
➢ Hormone responsible for thelarche----Estrogen.
➢ Sequence of puberty changes in girls------ThelarchePubarcheMenarche
➢ Pubic hair appears first than axillary hair.
➢ 1
st sign of puberty in boys is ↑ Testicular sign.
2. According to WHO what is the minimal sperm count
a. 10 million/ml
b. 15 million/ml
c. 20 million/ml
d. 25 million/ml
Ans. b. 15 million/ml
Explanation:
▪ According to WHO(2010) criteria, cut off value for semen analysis are-----
| 1992 guidelines(WHO) | 2010 guidelines(WHO) | |
| Volume | • 2ml | • ≥ 1.5 ml |
| Sperm concentration | 20 million/ml | ≥ 15milliom/ml |
| Sperm motility | 50% progressive or > 25% rapidly progressive | ≥ 32% progressive |
| Morphology( strict criteria) | >15% normal forms | ≥4% normal forms |
| WBC | <1 million/ml | <1 million/ml |
| Immuno-bead test | <10% coated with antibodies | <50% |
a. Tubal block
b. Anovulation
c. Hyperprolactinemia
d. Premature ovarian failure
Ans: d. Premature ovarian failure
Explanation:
▪ Well in this case tubal block hormonal profile has no relation, Anovulation will
not present with this type of hormonal profile. In case of hyperprolactinemia
there would have been history of galactorrhea or serum levels of prolactin
should have been mentioned in the question, which is not there.
▪ In case of anovulation & hyperprolactinemia there is FSH.
▪ So, this is a case of premature ovarian failure.
➢ Premature ovarian failure---
❖ Ovarian failure occurring before the age of 40 years.
❖ There is triad------
• Amenorrhea
• Hypogonadism
• Hypoestrogenism
❖ Cause----- Idiopathic, autoimmune disorders, genetic
causes, radiotherapy, chemotherapy, surgery etc.
❖ Diagnosis---FSH>40mIU/ml
❖ Treatment-- of infertility by doing IVF using donor
oocytes
4. Treatment of stage III b cancer cervix
a. Radical trachelectomy
b. Chemotherapy + Radiotherapy
c. Modified radical hysterectomy
d. TAH with BSO
Ans: b. Chemotherapy + Radiotherapy
Explanation:
❖ Treatment of stage III b cancer Cervix is CONCURRENT CHEMORADIATION.
❖ Cisplatin based chemotherapy+ Brachytherapy+ teletherapy
❖ Stagewise treatment----
| Stage of ca cervix |
| |
| Stage 0 | Fertility preserved------
➢ LEEP(Best) ➢ Laser therapy ➢ Conisation Menopausal-------Hysterectomy/Radiotherapy | |
| Stage IA1 | Fertility preserved ----Conization
No preservation of fertility----total hysterectomy/Radiotherapy(Unfit to surgery) | |
| Stage IA2 | Radical hysterectomy with lymph node dissection Unfit to surgery----Brachytherapy + Chemotherapy | |
| Stage IB & IIA(<4cm) | Radical hysterectomy with pelvic LN dissection Unfit for surgery---RT as for stage IA2 | |
| Stage IB & bulkyIIA(>4cm) | Concurrent Chemoradiation | |
| Stage IIB, IIIA, IIIB | Concurrent chemoradiation | |
| Stage IV A | Concurrent chemoradiation+ palliative Rx | |
| Stage IVB | Palliative Rx with or without Chemoradiation |
5. Not required in the diagnosis of PCOS
a. Hirsuitism
b. Oligomenorrhea
c. Insulin resistance
d. Volume >10mm3
Ans: Insulin Resistance
Explanation:
• For the diagnostic criteria of PCOS there is Rotterdam criteria or ESHRE`s
Criteria.
• According to any of the criteria--- 2/3 features should be present to diagnose
PCOD
❖ Hirsuitism---clinical and or lab findings
❖ Menstrual disturbance—Oligomenorrhea or secondary
amenorrhea, anovulation
❖ USG/TVS—showing Polycystic ovaries(> 12 follicles/ovary, 2-9mm
each follicle or volume of ovary >10ml). Exclusion of other
etiologies
So, nowhere insulin resistance is written in any of the two criteria necessary for the
diagnosis of PCOS.
a. Fibroma
b. Thecoma
c. Mucinous cystadenocarcinoma
d. Granulosa cell tumor
Ans: d. Granulosa cell tumor
Explanation:
▪ Call-exner bodies are seen in Granulosa cell tumor.
7. What is the karyotype of complete Mole
a. 46XX
b. 46YY
c. 69XXX
d. 69XXY
Ans: a. 46XX
Explanation:
H. Mole is of two types---
| Complete Mole | Partial Mole |
| Diploid
90% 46XX 10% 46XY | Triploid
69XXX 69XXY 69YYY |
8. Most common cause of Death in cancer cervix
a. Uremia
b. Sepsis
c. Anemia
d. Fistula
Ans: a. Uremia
Explanation:
➢ Main cause of death in advanced cancer cervix patients is uremia or
renal failure(60% cases) due to cancer spreading to kidneys and shut
down of renal function.
9. An obese lady is diagnosed with PCOS. What would be the 1st line of management
a. OCP
b. Life style modification
c. Metformin
d. Spironolactone
Ans: b. Life style modification
Explanation:
➢ Many articles, workshops, case controlled studies have proven that in
case of obese females with PCOS have proven that 5-10% of weight
reduction or doing life style modification has improved PCOS symptoms
including reduction in androgen levels, correction of insulin resistance
and hence improving menstrual abnormalities.
➢ So, any medication comes next line of management.
10. Which of the following will not cause fern pattern of cervical mucus
a. High estrogen
b. High progesterone
c. High NaCl
d. Low protein
Ans: b. High Progesterone
Explanation:
➢ Ferning of cervical mucus is caused by estrogen
➢ Estrogen act on cervical glands and leads to profuse secretion of cervical mucus,
if we make smear on slide and visualize under microscope we will see ferning of
cervical mucus. This pattern is caused by presence of NaCl in cervical muscus
➢ Progesterone makes cervical mucus thick & scanty so do not cause ferning
11. Which of the following is not included in 3rd stage of labor
a. Uterine massage
b. Oxytocin I/M
c. Controlled cord traction after signs of placental separation
d. Controlled cord traction before signs of placental separation
Ans: d. Controlled cord traction before signs of placental separation
Explanation:
▪ Controlled cord traction before signs of placental separation can lead to acute
inversion of uterus, so not done.
▪ Now a days placental delivery is done active management of 3rd stage of
labour accord to WHO---
12. Markers antenatally checked are
a. AFP
b. βHCG
c. AMH
d. Inhibin
Ans: c.AMH
Explanation:
➢ In this question they are asking fetal markers for aneuploid in pregnancy that’s
why antenatal word is used.
➢ So, AFP, βHCG, Inhibin are markers for aneuploidy(Down`s syndrome)
➢ Markers for tripple test and quadruple test----
| Triple test markers | Quadruple test markers |
| αFP
βHCG Estriol | αFP
βHCG Estriol Inhibin |
13. Investigation to detect superficial peritoneal Endometriosis
a. USG
b. Laparoscopy
c. CA-125
d. CEA
Ans: b. Laproscopy
Explanation:
➢ Laparoscopy is the gold standard investigation for Endometriosis as it is diagnostic as well as
therapeutic.
14. All of the following decrease sperm motility except
a. Driving for long hours
b. Prolonged abstinence
c. Smoking
d. Long standing
Ans: d. Long Standing
15. Young married female presents with amenorrhea and pain abdomen. All of the following you
will suspect except
a. Ectopic pregnancy
b. Dysmenorrhea
c. Cryptomenorrhea
d. Endometriosis
Ans: b. Dysmenorrhea
Explanation:
➢ Dysmenorrhea is painful menstruation, it wont cause amenorrhea
➢ Whereas D/D for amenorrhea & pain abdomen will be ----
Ectopic pregnancy
▪ Cryptomenorrhea
▪ Endometriosis
16. Which of the following you won`t follow in your practice to reduce the incidence of uterine prolapse
a. HRT
b. Advice proper nutrition from childhood to menopause
c. Advice postpartum exercise
d. Prevention of prolonged 2nd stage of labor
Ans: HRT
Explanation:
▪ Most important cause of Genital prolapsed in our country is home
deliveries conducted by dais.
▪ So, in case of hospitalized deliveries conducted by trained personnel
prolonged 2rd stage of labor can be prevented or managed properly,
post delivery exercises to bulid up tone of perineal muscles can be
explained.(Kegel`s exercise).
▪ Also improving proper nutrition from childhood to menopause can
prevent such cases.
▪ But HRT has no role in reducing incidence of genital prolapsed.
17. Which of the following is not an indication for emergency caesarean section
a. CPD b. Oligohydramnios
c. Fetal distress
d. Cord prolapse
Ans: a. CPD
Explanation:
In case of CPD, we can diagnose at 38 weeks by pelvic assessment and do elective LSCS,
rest all cases emergency LSCS.
18. A 35 year old female presented with painless vaginal bleeding, in the 3rd trimester which of the
following is not done
a. Abdominal examination
b. Per vaginum examination
c. USG
d. I/V fluids
Ans: b. Per vaginum examination
Explanation:
▪ Per vaginum examination is not recommended in case of bleeding occurring in
3
rd trimester which is painless. This is case of placenta previa, so all other things
mentioned in the question can be done except P/V exam
19. Which of the following is not sling operation in case of Genital prolapsed
a. Khanna`s
b. Manchester
c. Purandare
d. Shirodkar
Ans: b. Manchester operation
Explanation:
➢ Khanna`s, Purandare`s, shirodkar operations are abdominal sling operations
done for nulliparous prolapse( where cervix is not amputated) whereas
Manchester operation is done for genital prolapsed in multiparous lady
where amputation of cervix & strengthening is done followed by Pelvic floor
repair.
20. Kleihauer Betke test was positive, baby has hepatoslenomegaly, what is the diagnosis
a. ABO incompatibility
b. Spherocytosis
c. Erythroblastosis fetalis
d. Chronic feto-maternal haemorrhage
Ans: c. Erythroblastosis Fetalis
Explanation:
➢ Kleihauer Betke test is done is based on principle of acid elution. It is used to
measure the amount of fetal hemoglobin transferred from fetus to mother`s
blood stream.
➢ It is usually performed on Rh-negative mothers to determine the required dose of Rho(D)
immune globulin (RhIg) to inhibit formation of Rh antibodies in the mother and
prevent Rh disease in future Rh-positive children
21. Which of the following reinfection to mother does not affect the fetus
a. Chickenpox
b. Coxsachie virus
c. Rubella
Ans: c. Rubella
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