UPSC-CMS 2018 - Obstetrics and Gynecology PYQs Practice Questions

Q: Consider the following hemodynamic changes occurring during pregnancy: 1. Increase in cardiac output 2. Increase in stroke volume 3. Increase in colloid oncotic pressure 4. Increase in pulse rate Which of the statements given above are correct?

1, 2 and 4. ***Correct Answer: 1, 2 and 4*** **Statement 1: Increase in cardiac output** - CORRECT - Cardiac output increases by **30-50% during pregnancy**, peaking at 28-32 weeks - This increase is driven by increased blood volume (40-50% increase), higher metabolic demands, and the need to perfuse the uteroplacental unit **Statement 2: Increase in stroke volume** - CORRECT - Stroke volume increases by **20-30% during pregnancy**, particularly in the first and second trimesters - This contributes significantly to the overall increase in cardiac output alongside increased heart rate **Statement 3: Increase in colloid oncotic pressure** - INCORRECT - Colloid oncotic pressure actually **decreases during pregnancy** from normal values of 25-28 mmHg to approximately 22-24 mmHg - This occurs due to **hemodilution** (plasma volume increases more than red cell mass) and **decreased serum albumin concentration** (dilutional hypoalbuminemia) - The reduced oncotic pressure contributes to the **increased tendency for peripheral edema** in pregnant women **Statement 4: Increase in pulse rate** - CORRECT - Heart rate increases by **10-20 beats per minute** during pregnancy - This tachycardia helps maintain adequate cardiac output to meet the increased circulatory demands of pregnancy *Incorrect Options:* *1, 3 and 4* - Statement 3 is incorrect as colloid oncotic pressure decreases, not increases *2, 3 and 4* - Statement 3 is incorrect as colloid oncotic pressure decreases during pregnancy *1, 2 and 3* - Statement 3 is incorrect; colloid oncotic pressure falls due to hemodilution and hypoalbuminemia [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which of following statements regarding Puerperal sepsis are correct? 1. Multiple per vaginal examinations increase the risk 2. Group A and B beta-haemolytic Streptococcus are among the responsible microorganisms 3. Retained bits of placenta and membrane predispose 4. Vaginal packing can decrease the risk Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - **Multiple per vaginal examinations** introduce exogenous bacteria from the perineum into the sterile uterine cavity, increasing the risk of infection. - **Group A and B beta-haemolytic Streptococcus** are common causative organisms, especially Group A, which can cause severe, rapidly progressive puerperal sepsis. - **Retained products of conception** (placental or membrane fragments) provide a nidus for bacterial growth and interfere with uterine involution, creating a favorable environment for infection. *1, 3 and 4* - This option incorrectly includes "Vaginal packing can decrease the risk" and excludes a correct statement. - While multiple vaginal examinations and retained tissue increase risk, **vaginal packing** can actually increase the risk of infection by creating an anaerobic environment and trapping bacteria. *2, 3 and 4* - This option incorrectly includes "Vaginal packing can decrease the risk" and excludes a correct statement. - The identified microorganisms and role of retained products are correct, but vaginal packing is not a preventive measure for puerperal sepsis. *1, 2 and 4* - This option incorrectly includes "Vaginal packing can decrease the risk" and excludes a correct statement. - While multiple vaginal examinations and specific streptococcal species are correctly identified as risk factors or causes, vaginal packing is not a beneficial intervention. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: In case of Labour complicated with cord prolapse, which of the following statements are correct? 1. Reposition the patient in exaggerated Sims position 2. To replace the cord in the vagina 3. To replace the cord inside the uterus 4. Early amniotomy can prevent cord prolapse Select the correct answer using the code given below:

1 only. ***Correct: 1 only*** **Statement 1 - Reposition the patient in exaggerated Sims position** ✓ - **Correct** - Immediate repositioning (knee-chest, Trendelenburg, or exaggerated Sims position) is crucial to reduce pressure on the prolapsed cord and relieve compression - This helps displace the presenting part away from the cord using gravity **Statement 2 - To replace the cord in the vagina** ✗ - **Incorrect** - Manipulation or replacement of the prolapsed cord is **contraindicated** as it can cause vasospasm and further compromise fetal circulation - The correct approach is to **elevate the presenting part manually** (pushing it up off the cord) while keeping the cord moist and warm, NOT to reposition the cord itself **Statement 3 - To replace the cord inside the uterus** ✗ - **Incorrect** - This is contraindicated as it carries high risk of uterine infection, cord trauma, and vasospasm - Does not reliably prevent recurrence of prolapse **Statement 4 - Early amniotomy can prevent cord prolapse** ✗ - **Incorrect** - Early amniotomy actually **increases** the risk of cord prolapse, especially when the presenting part is not well-engaged - It removes the cushioning effect of forewaters that help keep the cord in place **Correct management of cord prolapse includes:** - Immediate repositioning (Trendelenburg/knee-chest position) - Manual elevation of presenting part to relieve cord compression - Keeping the prolapsed cord moist and warm - Avoiding cord manipulation - Emergency cesarean delivery or instrumental delivery if feasible *Incorrect: 1 and 2 only* - While statement 1 is correct, statement 2 (replacing the cord in vagina) is medically incorrect and contraindicated *Incorrect: 3 and 4 only* - Both statements are incorrect as explained above *Incorrect: 1, 2, 3 and 4* - Only statement 1 is correct; statements 2, 3, and 4 are all incorrect [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which one of the following is NOT a feature of Candida Vaginitis?

Metronidazole is the treatment of choice. ***Metronidazole is the treatment of choice*** - **Metronidazole** is the drug of choice for **bacterial vaginosis** and **trichomoniasis**, not candidal vaginitis. - The primary treatment for **Candida vaginitis** involves **azole antifungal agents** (e.g., fluconazole, miconazole, clotrimazole). *Yeast-buds and pseudohyphae forms can be seen under the microscope* - Microscopic examination of vaginal discharge revealing **yeast buds** and **pseudohyphae** is a classic diagnostic finding for **Candida vaginitis**. - This observation directly confirms the presence of **Candida** organisms. *Pruritus is out of proportion to discharge* - In **Candida vaginitis**, **intense pruritus** (itching) is a hallmark symptom, often severe and disproportionate to the amount of vaginal discharge. - This characteristic itching is due to the inflammatory response triggered by the Candida infection. *Discharge is thick and curdy* - The typical vaginal discharge associated with **Candida vaginitis** is often described as **thick, white, and "cottage cheese-like"** or curdy. - This distinct appearance is a key clinical indicator of a yeast infection. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

Consider the following hemodynamic changes occurring during pregnancy:

1. Increase in cardiac output
2. Increase in stroke volume
3. Increase in colloid oncotic pressure
4. Increase in pulse rate
Which of the statements given above are correct?

Accepted Answer

1, 2 and 4

Answer

1, 3 and 4

Answer

2, 3 and 4

Answer

1, 2 and 3

Question 2

Which of the following are the hypotheses for the onset of Labor?

1. Uterine distension
2. Activation of fetal hypothalamic-pituitary-adrenal axis
3. Increase in prostaglandins
4. Increase in serum calcium levels

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

1 and 3 only

Answer

2, 3 and 4

Answer

1, 2 and 4

Question 3

Which of following statements regarding Puerperal sepsis are correct?

1. Multiple per vaginal examinations increase the risk
2. Group A and B beta-haemolytic Streptococcus are among the responsible microorganisms
3. Retained bits of placenta and membrane predispose
4. Vaginal packing can decrease the risk

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

2, 3 and 4

Answer

1, 2 and 4

Question 4

In case of Labour complicated with cord prolapse, which of the following statements are correct?

1. Reposition the patient in exaggerated Sims position
2. To replace the cord in the vagina
3. To replace the cord inside the uterus
4. Early amniotomy can prevent cord prolapse

Select the correct answer using the code given below:

Accepted Answer

1 only

Answer

1 and 2 only

Answer

3 and 4 only

Answer

1, 2, 3 and 4

Question 5

Which one of the following is NOT a feature of Candida Vaginitis?

Accepted Answer

Metronidazole is the treatment of choice

Answer

Yeast-buds and pseudohyphae forms can be seen under the microscope

Answer

Pruritus is out of proportion to discharge

Answer

Discharge is thick and curdy

Question 6

Which of the following is NOT a high risk factor for developing endometrial carcinoma?

Accepted Answer

Multiparity

Answer

Delayed menopause

Answer

Hypertension

Answer

Obesity

Question 7

All of the following are the features of functional ovarian cyst EXCEPT:

Accepted Answer

Usually symptomatic

Answer

Usually < 7 cm in diameter

Answer

Unilocular

Answer

Spontaneous regression occurs

Question 8

Gestational trophoblastic disease is a spectrum comprising which of the following entities?

1. Complete Hydatidiform mole
2. Partial Hydatidiform mole
3. Invasive mole
4. Choriocarcinoma

Select the correct answer using the code given below:

Accepted Answer

1, 2, 3 and 4

Answer

1, 2 and 3 only

Answer

1 and 4 only

Answer

2, 3 and 4 only

Question 9

Which of the following is NOT a component of Fothergill’s operation as a conservative surgery for uterovaginal prolapse?

Accepted Answer

Cervicopexy

Answer

Amputation of cervix

Answer

Plication of Mackenrodt’s ligaments

Answer

Anterior colporrhaphy

Question 10

Which one of the following statements is NOT true regarding general physiological changes after delivery?

Accepted Answer

Cardiac output remains unchanged after delivery

Answer

Blood volume returns to normal by second week

Answer

Pulse may be raised on first day

Answer

Temperature should not be above 99°F

UPSC-CMS 2018 — Obstetrics and Gynecology