Magnification obtained by colposcopy is?
On which day LH & FSH should be measured?
What is the best parameter for estimating fetal age by ultrasound in the third trimester?
At which gestational week does the maximum volume of amniotic fluid occur?
Rule of Hasse is used to determine:
Borax causes which of the following effects?
Uterine rupture is most common in -
Which nerve block is given in forceps delivery?
When should semen analysis be done?
NEET-PG 2013 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs
Question 81: Magnification obtained by colposcopy is?
- A. 1-2 times
- B. 5-6 times
- C. 15-25 times
- D. 10-20 times (Correct Answer)
Explanation: ***10-20 times*** - Colposcopes typically provide magnification in the range of **10 to 20 times** to allow for detailed examination of the cervix, vagina, and vulva. - This magnification level is sufficient to identify changes in the **epithelium**, such as those associated with dysplasia or cancer. *1-2 times* - A magnification of 1-2 times is very low and would not be adequate for **detailed visualization** of the cervix and its microscopic changes. - This range is more akin to **naked eye** observation or a simple magnifying glass, insufficient for colposcopic purposes. *5-6 times* - While 5-6 times magnification offers some detail, it is generally **insufficient** for the precise identification of subtle epithelial changes or abnormal vascular patterns characteristic of dysplasia. - Most colposcopes are designed to provide higher magnification to enhance diagnostic accuracy. *15-25 times* - While some advanced colposcopes might offer magnification up to 25 times, the standard and most commonly used range is **10-20 times**. - Magnification significantly beyond 20 times can sometimes lead to a **smaller field of view** and increased difficulty in focusing, making it less practical for routine examination.
Question 82: On which day LH & FSH should be measured?
- A. 1-3rd day (Correct Answer)
- B. 7th day
- C. 14th day
- D. 10th day
Explanation: ***1-3rd day*** - Measuring **LH** (Luteinizing Hormone) and **FSH** (Follicle-Stimulating Hormone) on cycle days 1-3 provides a baseline assessment of **ovarian reserve** and pituitary function. - At this early follicular phase, hormone levels are relatively stable and reflect the intrinsic **gonadal feedback** mechanisms before significant follicular development begins. *7th day* - By day 7, **follicular development** is usually well underway, and FSH levels might be decreasing as a dominant follicle is selected. - Measuring hormones on this day would not provide an accurate baseline assessment, as the levels are already influenced by **follicular growth**. *14th day* - Day 14 is often associated with the **LH surge** that triggers ovulation, making it unsuitable for a baseline assessment of ovarian reserve. - FSH levels would also be significantly different from the early follicular phase due to the ongoing **ovarian cycle events**. *10th day* - On day 10, **estrogen levels** are typically rising, which would already be providing negative feedback to the pituitary, affecting FSH and LH levels. - This timing would not be ideal for assessing baseline hormone levels for **fertility evaluations**.
Question 83: What is the best parameter for estimating fetal age by ultrasound in the third trimester?
- A. Abdominal circumference
- B. Femur length
- C. Intraocular distance
- D. BPD (Correct Answer)
Explanation: ***BPD (Biparietal Diameter)*** - **Biparietal diameter (BPD)** is considered the **best single parameter** among the given options for estimating fetal age in the third trimester, though all parameters become less accurate with advancing gestation. - In the third trimester, BPD accuracy is approximately **±3-4 weeks**, which is why **first trimester dating (CRL) should always be used when available** as it is most accurate (±5-7 days). - BPD is measured at the level of the thalami and cavum septum pellucidum, from outer edge of the proximal skull to the inner edge of the distal skull. - **Note**: Multiple biometric parameters used together improve accuracy more than any single measurement in late pregnancy. *Femur length* - **Femur length (FL)** is highly accurate in the **second trimester** but becomes less reliable in the third trimester due to biological variation. - It can be affected by **skeletal dysplasias** and genetic factors, leading to inaccurate age estimation. - FL is better used for assessing proportionate growth rather than dating in late pregnancy. *Abdominal circumference* - **Abdominal circumference (AC)** is primarily used for assessing **fetal growth and estimating fetal weight**, not for gestational age determination. - It is highly variable and influenced by fetal nutritional status, growth restriction, or macrosomia, making it unreliable for dating. - AC is the **most sensitive parameter for detecting growth abnormalities** (IUGR or LGA). *Intraocular distance* - **Intraocular distance (IOD)** is not a standard biometric parameter for routine gestational age estimation. - It has limited clinical utility and is occasionally used for detecting specific **fetal anomalies** (hypertelorism/hypotelorism) rather than dating. - Standard biometric parameters (BPD, HC, AC, FL) are always preferred for gestational age assessment.
Question 84: At which gestational week does the maximum volume of amniotic fluid occur?
- A. 32 weeks
- B. 34 weeks
- C. 36 weeks (Correct Answer)
- D. 40 weeks
Explanation: ***36 weeks*** - The volume of **amniotic fluid** gradually increases during pregnancy, reaching its **peak** around **36 weeks** of gestation. - After 36 weeks, the volume of amniotic fluid typically begins to **decrease** as the pregnancy approaches term. *32 weeks* - At 32 weeks, the amniotic fluid volume is still **increasing** and has not yet reached its maximum level. - The fetus is actively growing and contributing to fluid production, but the peak is still several weeks away. *34 weeks* - Although significant, the amniotic fluid volume at 34 weeks has not yet reached its **maximum**. - The volume will continue to rise for another two weeks before plateauing and then declining. *40 weeks* - By 40 weeks, a normal-term pregnancy, the volume of amniotic fluid has typically **decreased** from its peak at 36 weeks. - A declining amniotic fluid volume (oligohydramnios) can be a concern at term if it's too low.
Question 85: Rule of Hasse is used to determine:
- A. Fetal age estimation (Correct Answer)
- B. Adult height measurement
- C. Determination of ethnicity
- D. General forensic identification
Explanation: ***Fetal age estimation*** - **Rule of Hasse** is specifically used for estimating the **fetal age** in forensic cases involving remains of an unborn fetus. - It relates the crown-heel length of the fetus in centimeters to its age in lunar months (first 5 lunar months) or halves of lunar months (second 5 lunar months). *Adult height measurement* - Adult height is typically measured directly or estimated using long bone lengths, an entirely different set of methods from Hasse's Rule. - This rule is specific to the **developing fetus** and not applicable to adults. *Determination of ethnicity* - Ethnicity determination involves analyzing skeletal features, particularly of the skull and pelvis, and is not related to fetal length or age estimation. - Hasse's Rule provides an age estimate based on size, not ancestral origin. *General forensic identification* - While forensic identification is a broad field, Hasse's Rule is a very specific tool for **fetal age assessment**, not general adult identification. - General forensic identification involves techniques like DNA analysis, fingerprinting, and skeletal remains analysis for adults.
Question 86: Borax causes which of the following effects?
- A. Induces uterine contractions (labor-inducing)
- B. Irritates genitourinary tract (side effect)
- C. Traditionally used to stimulate menstrual flow
- D. Causes gastrointestinal irritation (side effect) (Correct Answer)
Explanation: ***Causes gastrointestinal irritation (side effect)*** - Borax, specifically its component **boric acid**, is rapidly absorbed through the **gastrointestinal tract** and can cause symptoms like nausea, vomiting, and diarrhea even in small amounts. - This **gastrointestinal irritation** is a common sign of acute borax toxicity. *Induces uterine contractions (labor-inducing)* - While certain substances can induce uterine contractions, **borax is not known** or traditionally used for this purpose. - It is **not an oxytocic agent** and does not act on uterine smooth muscle in a way that would induce labor. *Irritates genitourinary tract (side effect)* - Although borax can be toxic, its primary route of significant irritation and toxicity is not typically the **genitourinary tract** in the way implied for adverse effects. - While it can be absorbed through mucous membranes, the genitourinary tract is not its primary target for **direct irritant effects** in systemic exposure. *Traditionally used to stimulate menstrual flow* - There is **no reliable scientific or traditional medical evidence** to support the use of borax to stimulate menstrual flow. - Substances used for this purpose, known as **emmenagogues**, are typically herbal or pharmaceutical preparations, and borax is **not among them**.
Question 87: Uterine rupture is most common in -
- A. Posterior lower segment
- B. Upper uterine segment
- C. Lateral uterine wall
- D. Anterior lower segment (Correct Answer)
Explanation: ***Anterior lower segment*** - The **anterior lower segment** is the most common site for **uterine rupture** due to prior **cesarean sections** or other uterine surgeries which are often performed anteriorly. - This area is thinner and more prone to stretching and tearing during labor, especially in cases of repeated surgical scars. *Posterior lower segment* - While rupture can occur in the **posterior lower segment**, it is less common than the anterior location. - This area is usually less stressed by previous surgical incisions compared to the anterior wall. *Upper uterine segment* - Rupture in the **upper uterine segment** typically involves an **unscarred uterus** and is a rare event, often associated with a **grand multiparous patient** or **oxytocin hyperstimulation**. - This type of rupture is usually spontaneous and more catastrophic due to the rich vascularity of the upper segment. *Lateral uterine wall* - Rupture of the **lateral uterine wall** is uncommon and usually associated with **trauma** or **manual extraction of the placenta**, rather than prior surgical scars. - It is not the most frequent site for spontaneous or scar-related uterine rupture.
Question 88: Which nerve block is given in forceps delivery?
- A. Posterior femoral
- B. Genitofemoral
- C. Ilioinguinal
- D. Pudendal (Correct Answer)
Explanation: ***Pudendal*** - A **pudendal block** anesthetizes the **perineum, vulva, and lower vagina**, providing pain relief for instrumental deliveries like **forceps delivery** and for episiotomy. - It involves injecting a local anesthetic near the **pudendal nerve** as it passes posterior to the **ischial spine**. *Posterior femoral* - The **posterior femoral cutaneous nerve** primarily innervates the skin of the posterior thigh and part of the perineum but does not provide sufficient deep analgesia for a forceps delivery. - Blocking this nerve alone would not adequately cover the extensive area affected during instrumental delivery. *Genitofemoral* - The **genitofemoral nerve** primarily innervates the skin of the upper medial thigh and parts of the genitalia but is not the primary nerve for pain relief during vaginal delivery procedures. - Its blockade would not provide the comprehensive analgesia needed for a forceps delivery. *Ilio inguinal* - The **ilioinguinal nerve** innervates the skin of the groin, mons pubis, and labia majora but does not provide sufficient anesthesia for the deeper structures involved in a forceps delivery. - An ilioinguinal nerve block is more commonly used for pain control in procedures involving the groin or hernia repair, not for instrumental vaginal delivery.
Question 89: When should semen analysis be done?
- A. After 30-60 mins irrespective of liquefaction
- B. As early as possible
- C. After liquefaction with thorough mixing (Correct Answer)
- D. After 15-30 mins irrespective of liquefaction
Explanation: ***After liquefaction with thorough mixing*** - Semen analysis should be performed **after complete liquefaction** (typically within 20-30 minutes, maximum 60 minutes) followed by **thorough mixing**. - According to **WHO guidelines (2010, 2021)**, the sample must first liquefy completely at room temperature, then be mixed well before microscopic examination. - This ensures accurate assessment of **sperm concentration, motility, and morphology** without artifacts from viscous semen. - The standard practice is to examine within **60 minutes of collection** but only after liquefaction is complete. *After 30-60 mins irrespective of liquefaction* - The phrase "irrespective of liquefaction" is **incorrect** as analysis before complete liquefaction leads to inaccurate results. - Performing analysis on a non-liquefied sample can cause **underestimation of sperm motility** and difficulty in proper microscopic assessment. - Liquefaction status must be assessed before proceeding with analysis. *As early as possible* - Analyzing too early before **liquefaction** (which typically takes 20-30 minutes) will yield inaccurate results. - A viscous, non-liquefied sample impairs proper **sperm movement assessment** and mixing. *After 15-30 mins irrespective of liquefaction* - While 30 minutes may be sufficient for many samples to liquefy, the phrase "irrespective of liquefaction" makes this incorrect. - Some samples may require up to **60 minutes** to liquefy completely, and analysis should not proceed until liquefaction is confirmed.