JIPMER PG 2020 OBG Questions

JIPMER PG 2020 OBG Questions with explaination

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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------ThelarchePubarcheMenarche 

➢ 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%

3. 28 year old lady comes to infertility clinic with ↑FSH, serum estradiol , what could be probable diagnosis

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	Treatment
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. 

6. CALL-Exner Bodies are seen in 

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

➢ AMH(Anti-mullerian Hormone) is used to ovarian reserve. AMH is produced by granulose cells of ovary, it tells you about follicle status. AMH <1ng/ml tells poor ovarian reserve. AMH levels are needed for IVF(In-Vitro fertilization cases)

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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