OBG Question # 301:-All are TRUE regarding Feto maternal unit in pregnancy EXCEPT
A:-Progesterone production by the placenta is largely independent of the quantity of precursor available, the utero-placental perfusion and fetal well-being
B:-There is a 17 alpha hydroxylase enzyme block in the fetus and placenta has very little 3 beta hydroxyl steroid dehydrogenase activity
C:-Cholesterol and pregnenolone are obtained mainly from the maternal bloodstream for placental progesterone synthesis
D:-In human syncytiotrophoblast, estradiol increases progesterone production by means of an increase in LDL uptake
Correct Answer:- Option-B
OBG Question # 302:-All are TRUE statements about Corpus luteum of Pregnancy EXCEPT
A:-Progesterone is largely produced by the corpus luteum until about 10 weeks of gestation
B:-Pulsatile luteinizing hormone (LH) and human chorionic gonadotropin (hCG) from the implanting pregnancy stimulate progesterone production by the corpus luteum
C:-In the luteal phase of conception cycles, progesterone concentrations increase from about 1-2 mg/mL on the day of the LH surge to a plateau of approximately 10-35 mg/mL
D:-The transitional luteo-placental shift takes place between the 10tℎ week and 12tℎ week
Correct Answer:- Option-D
OBG Question # 303:-The FALSE statement regarding the glycoprotein hormone Human Chorionic Gonadotropin (HCG) is
A:-A maximal level of about 100,000 IU/L in the maternal circulation is reached at 8-10 weeks of gestation
B:-Long half-life of hCG (48 hours) is due mainly to the greater amino acid content of beta subunit
C:-Hyperglycosylated hCG is the major circulating form of hCG regulating trophoblastic invasion in the first weeks of normal pregnancies
D:-β-hCG can be detected in maternal blood about the eighth day after ovulation or one day after implantation
Correct Answer:- Option-B
OBG Question # 304:-Find out the FALSE statement regarding human parturition
A:-The initiating step in the sequence of events leading to parturition could bean increase in fetal ACTH and cortisol secretion and an increase in placental CRH
B:-There is a definite decline in peripheral blood levels of progesterone prior to parturition and not just a functional withdrawal
C:-An increase in estrogen levels in maternal blood begins at 34-35 weeks
D:-The activity of 15-hydroxyprostaglandin dehydrogenase decreases in the myometrium and the chorion during labor and causes increase in prostaglandins associated with
parturition
Correct Answer:- Option-B
OBG Question # 305:-All the following statements about fetal lung surfactant are TRUE EXCEPT
A:-Phosphatidylcholine (lecithin) and phosphatidylglycerol (PG) are present in only small concentrations until the last 5 weeks of pregnancy
B:-At 20-22 weeks of pregnancy, a less stable and less active lecithin, palmitoyl-myristoyl lecithin, is formed
C:-At about the 30�ℎ
week of gestation, there is a sudden surge of dipalmitoyl lecithin, the major surfactant lecithin
D:-The Sphingomyelin concentration of amniotic fluid changes relatively little throughout pregnancy and prior to 34 weeks, the Lecithin : Sphingomyelin L/S ratio is approximately
1 : 1
Correct Answer:- Option-C
OBG Question # 306:-All the following are TRUE statement about gonadal differentiation EXCEPT
A:-It now appears that both testis and ovary differentiation require dominantly acting genes
B:-SRY activation of SOX 9 may be all that is necessary to activate other genes important to testis development
C:-WNT4 and R-Spondin 1(RSPO1) genes team to promote ovary development via repression of SOX9
D:-Ovarian differentiation is considered the “default” pathway of sexdetermination the automatic result in the absence of a testis-determining factor
Correct Answer:- Option-D
OBG Question # 307:-All are TRUE statements about Complete Androgen Insensitivity EXCEPT
A:-One in three phenotypic sisters of an affected individual may have an XY karyotype but 40% may not have a family history
B:-The normal testes produce normal amounts of AMH and testosterone and absent spermatogenesis, serum LH levels are increased and the serum FSH usually is in the normal
range
C:-They present with primary amenorrhea, normal breast development, absent or scant pubic and axillary hair, a short vagina and an absent cervix and uterus
D:-Gonadectomy generally is best done before puberty because the overall risk for tumor development is 30%
A:-An females, the classic forms of CAH (with and without salt wasting) are characterized by genital ambiguity and is most commonly due to 21-hydroxylase deficiency
B:-Two-thirds of patients with 11β-hydroxylase deficiency exhibit hypotension and hypokalemia
C:-Females with the non-classical “late-onset” form of 21-hydroxlyased deficiency have normal external genitalia and present later, during early adolescence with precocious
puberty or other signs of hyperandrogenism such as hirsutism
D:-Diagnosis of 21-hydroxylase deficiency is based on a high serum concentration of 17-OH Progesterone
Correct Answer:- Option-B
OBG Question # 309:-The FALSE statement about Puberty in humans is
A:-“diphasic” pattern of gonadotropin secretion from infancy to puberty results primarily from a high sensitivity to low levels of gonadal steroid feedback
B:-central GABA signaling is one of the factors that restrains GnRH neuronal activity during childhood
C:-glutamate signaling may play a role in the resurgence of pulsatile GnRH secretion at the onset of puberty
D:-hypothalamic kisspeptin-GPR54 signaling is a key component of the neurobiologic mechanism that triggers the onset of puberty
A:-AMH production is increased severalfold in anovulatory PCOS
B:-Those with PCOS generally exhibit altered GnRH pulse frequency, increased serum LH concentrations and low-normal FSH levels
C:-Insulin acts synergistically with LH to perpetuate ovarian androgen production and also inhibits hepatic SHBG production
D:-Insulin resistance due to obesity also causes increased leptinsignalling and increased adiponectin levels, there by decreasing fatty acid oxidation and promoting lipotoxicity
Correct Answer:- Option-D
OBG Question # 312:-Identify the FALSE statement about Metformin
A:-Metformin increases insulin sensitivity up to 20% and decreases fasting glucose by about 5%
B:-Metformin decreases weight and BMI by 3-5%
C:-Metformin has no effect on lipolysis and HDL cholesterol
D:-Metformin improves the chronic inflammatory state in women with hyperinsulinemia
A:-about 15-20% of women who develop ovarian cancer have mutations in BRCA1 gene
B:-Prophylacticsalpingo-oophorectomy reduces the risk of ovarian cancer by about 90% and the risk of breast cancer by about 50%
C:-Risk-reducing salpingo-oophorectomy is recommended at age 35 or when childbearing is complete for patients carrying BRCA1 mutations and by age 40 in BRCA2 carriers
D:-The use of combined oral contraceptives is likely to reduce the risk of ovarian cancer, but the effect on breast cancer risk is uncertain
Correct Answer:- Option-A
OBG Question # 314:-All are TRUE about Tamoxifen EXCEPT
A:-Tamoxifen is selective estrogen receptor modulator, having both estrogen receptorantagonist and agonist properties, depending on the tissue
B:-The incidence of endometrial cancer quadrupled with 5 years of tamoxifen treatment
C:-Levonorgestrel intrauterine device (IUD) is not effective to protect the endometrium against hyperplasia and polyps in women using tamoxifen
D:-Tamoxifen is associated with an ultrasonographic image that is characterized by sonolucent changes that are subepithelial in the presence of atrophic epithelium
OBG Question # 315:-Identify the FALSE statement about Endometrial Hyperplasia
A:-Lesions without atypia basically represent only exaggerated forms of persistent proliferative endometrium and are associated with little risk (1-3%) for progression to
adenocarcinoma
B:-Atypical endometrial hyperplasia does not often spontaneously regress and has significant risk (10-30%) of progression to adenocarcinoma if left untreated
C:-There is significant risk (upto 40%) of an unrecognized adenocarcinoma in endometrial hyperplasia with atypia
D:-Biopsy is not indicated when the clinical history suggests long-term unopposed estrogen exposure but the endometrial thickness is 5-12 mm
Correct Answer:- Option-D
OBG Question # 316:-STRAW stage-3a is characterized by
A:-menstrual cycles are relatively unchanged, the serum levels of FSH are low, AMH and inhibin B are low
B:-menstrual cycles become shorter, FSH increases, while AMH, AFC and inhibin B declines
C:-periods of amenorrhea lasting greater than or equal to 60 days, FSH level in menopausal range, vasomotor symptoms such as hot flushes
D:-undetectable AMH, Inhibin and occasional antral follicle
A:-Continuous, combined estrogen-progestin regimens of HRT has more risk for endometrial cancer than long-term sequential regimens
B:-Ospemifene is given orally for the treatment of vulvar and vaginal atrophy
C:-Bazedoxifene combined with conjugated estrogens is effective for hot flushes and vaginal atrophy, prevents bone loss and does not stimulate the endometrium or cause breast
tenderness
D:-The use of tibolone in women with a history of breast cancer remains relatively contraindicated
Correct Answer:- Option-A
OBG Question # 318:-All the statements about Emergency Contraception are TRUE EXCEPT
A:-Copper IUD can be used anytime during the preovulatory phase of the menstrual cycle and upto 8 days after ovulation
B:-Ulipristal acetate is slightly more effective than the single 1.5-mg dose of levonorgestrel when used within 120 hours
C:-Mifepristone prevents about 80-85% of expected pregnancies and has the same efficacy and side effects as levonorgestrel method
D:-Treatment with Levonorgestrel acts primarily by preventing or delaying ovulation and by preventing fertilization
Correct Answer:- Option-A
OBG Question # 319:-The FALSE statement about etonogestrel Implant (Nexplanon) is
A:-Inhibits ovulation by preventing LH surge and failure rate is 0.01%
B:-Implants have an immediate contraceptive effect when inserted within the first 7 days of a menstrual cycle
C:-Implants should not be inserted immediate postpartum
D:-It is absolutely contraindicated in women with active thromboembolic disease or known breast cancer
Correct Answer:- Option-C
OBG Question # 320:-All the statements about reproductive ageing are TRUE EXCEPT
A:-Age related Oocyte aneuploidy results primarily from premature separation of sister chromatids during meiosis I or from whole chromosome nondisjunction during meiosis II
B:-Miscarriage riks and the prevalence of aneuploidy oocytes are relatively low and change little until approximately age 35
C:-Live birth rates in donor egg IVF cycles relate to the age of the donor, not the age of the recipient
D:-Aging itself is thought to be a significant factor influencing uterine endometrial response to steroids and receptivity
Correct Answer:- Option-D
OBG- Obstetrics and Gynecology multiple Choice Questions
OBG Question # 321:-Identify the FALSE statement regarding Test for Ovarian Reserve
A:-Total number of antral follicles measuring 2-10 mm in both ovaries is proportional to the number of primordial follicles remaining
B:-Small antral follicles (2-6 mm) are likely the primary source of AMH because they contain larger numbers of granulosa cells and a more developed microvasculature
C:-Recent studies suggest AMH levels decrease with the use of oral contraceptives and GnRH agonists
D:-A single elevated Day -3 FSH concentration (>10 IU/L) has high specificity for predicting poor response to stimulation or failure to achieve pregnancy
Correct Answer:- Option-D
OBG Question # 322:-Find the FALSE statement
A:-The prevalence of uterine anomalies in infertile women and fertile women with normal reproductive outcomes is similar, approximately 2-4%
B:-Submucousmyomas reduce IVF success rates by approximately 70% and intramural myomas by approximately 20-40%
C:-Hysteroscopic polypectomy may improve reproductive performance in infertile women
D:-Conception and term delivery rates after successful hysteroscopiclysis of intrauterine adhesions are > 80%
Correct Answer:-Question Cancelled
OBG Question # 323:-The FALSE statement regarding Male infertility is
A:-2-5% of men with severe oligospermia and 8% of men with azoospermia may have Y chromosome microdeletions
B:-Hyperprolactinemia and treatment with GnRH analogs or androgens can cause hypogonadotropic hypogonadism in males
C:-Men with idiopathic infertility have significantly lesser CAG trinucleotide repeat lengths in androgen receptor gene
D:-Disorders of estrogen synthesis or action may be associated with infertility in men
Correct Answer:- Option-C
OBG Question # 324:-Risk factors for Ovarian Hyperstimulation Syndrome (OHSS) include all EXCEPT
A:-Can be used to detect numerical chromosomal aneuploidies and monogenic disorders but not structural rearrangements
B:-Chromosomal composition of the oocyte may be inferred from that of the extruded polar bodies
C:-One or two blastomeres may be removed from cleavage stage embryos
D:-Biopsy of the trophectoderm can be performed at the blastocyst stage and has become the most commonly used technique
Correct Answer:- Option-A
OBG Question # 326:-Medical management of endometriosis – Find the FALSE statement
A:-Approximately 85% of women with endometriosis and pelvic pain who are treated with GnRH agonists experience relief of their pain
B:-Dienogest is effective in improving endometriosis-associated pain and may even help overcome progesterone resistance by increasing the number of progesterone receptors
C:-Estrogen-progestin contraceptives is cytoreductive and halts progression of endometriosis in upto 90% of affected women when taken continuously
D:-The levonorgestrel-releasing intrauterine device is of value in women with deep infiltrating rectovaginal endometriosis in reducing pain and dysmenorrhea recurrence following
surgical therapy
Correct Answer:- Option-C
OBG Question # 327:-Find the INCORRECT statement regarding Ectopic pregnancy
A:-the overall risk of recurrence is approximately 10% for women with one previous ectopic pregnancy and at least 25% for women having two or more
B:-estrogen-progestin contraceptives and vasectomy are associated with the lowest absolute incidence of ectopic pregnancy (0.005 ectopic pregnancies/1,000 women years)
C:-if pregnancy does occur with an IUD in situ, the risk for ectopic pregnancy is as high as 80%
D:-approximately one-third of all pregnancies resulting from sterilization failure are ectopic
Correct Answer:- Option-C
OBG Question # 328:-Medical Management of Ectopic pregancy-Find INCORRECT statement
A:-In 85% cases, serum β-hCG concentrations rise somewhat between days 1 and 4 and does not necessarily indicate failed treatment
B:-Medical treatment is not contraindicated for ectopic pregnancies with serum β-hCG concentrations greater than 5,000 IU/L or presence of embryonic heart activity, but the
likelihood of treatment failure and the risk of tubal rupture are increased substantially
C:-Anti D immunoglobulin need be administered only tononsensitized Rh-negative women with ectopic pregnancy undergoing surgical management
D:-Free peritoneal fluid may be observed in almost 40% of women with early unruptured ectopic pregnancies and that the presence or absence of cul-de-sac fluid does not
accurately predict the success or failure of medical treatment
Correct Answer:- Option-C
OBG Question # 329:-Fetoplacental blood volume at term is approximately
A:-125 ml/kg of fetal weight
B:-80 ml/kg of fetal weight
C:-45 ml/kg of fetal weight
D:-240 ml/kg of fetal weight
Correct Answer:- Option-A
OBG- Obstetrics and Gynecology multiple Choice Questions
OBG Question # 330:-Find the INCORRECT statement regarding international guidelines on vaccination in pregnancy
A:-A dose of tetanus-diphtheria-acellular pertussis (Tdap) is ideally given to gravidas between 27 and 36 weeks’ gestation
B:-All women who will be pregnant during influenza season should be offered vaccination, regardless of gestational age
C:-Avoid becoming pregnant for atleast one month after MMR vaccination
D:-HPV vaccination may be administered to high risk pregnant women after the first trimester of pregnancy
Correct Answer:- Option-D
OBG Question # 331:-The FALSE statement regarding fetal biometry by USS is
A:-Until 14 weeks’ gestation, the Crown-Rump Length (CRL) is accurate to within 5 to 7 days
B:-The biparietal diameter (BPD) most accurately reflects gestational age, with a variation of 7 to 10 days in the second trimester
C:-If the head shape is flattened-dolichocephaly or rounded brachycephaly, the Head Circumference (HC) is more reliable than the BPD
D:-To measure the AC, a circle is placed outside the fetal skin in a transverse image that contains the stomach, the kidneys and the confluence of the umbilical vein with the portal
sinus
Correct Answer:- Option-D
OBG Question # 332:-All the following are indications for fetal ECHO EXCEPT
B:-in 30 percent of cases, it is transient or physiological
C:-the pelvis is typically considered dilated if it exceeds 4 mm in the second trimester or 7 mm at approximately 32 weeks’ gestation
D:-mild pyelectasis in the second trimester is not considered a soft marker for down syndrome
Correct Answer:- Option-C
OBG Question # 334:-All the statements about Hydramnios (Polyhydramnios) are TRUE EXCEPT
A:-it is diagnosed when AFI exceeds 24 and complicates 1 to 2 percent of singleton pregnancies
B:-underlying causes of hydramnios include fetal anomalies-in approximately 15 percent and diabetes in 15 to 20 percent
C:-the degree of hydramnios correlates with the likelihood of an anomalous infant
D:-idiopathic hydramnios accounts for upto 30 percent of cases of hydramnios
Correct Answer:- Option-D
OBG Question # 335:-Find the FALSE statement regarding teratogens in pregnancy
A:-less than 1 percent of all birth defects are caused by medications
B:-80 percent of birth defects do not have an obvious etiology and of those withan identified cause, nearly 95 percent of cases have chromosomal or genetic origins
C:-mono therapy with Levitracetam is associated with a 8-percent major malformation rate, which is slightly higher than that for the general population
D:-sulfonamides and nitrofurantoin are appropriate for use in pregnancy only if suitable alternatives are lacking
Correct Answer:- Option-C
OBG Question # 336:-All are TRUE regarding cell free fetal DNA EXCEPT
A:-Reliably detected in maternal blood after 9 to 10 weeks’ gestation
B:-The proportion of cell-free DNA that is placental is called the fetal fraction and it composes approximately 50 percent of the total circulating cell-free DNA in maternal plasma
C:-The specificity to detect down syndrome, trisomy 18 and trisomy 13 is over 99 percent
D:-Real-time quantitative polymerase chain reaction (PCR) may be used for Rh genotyping, detection of paternally inherited single-gene disorders or fetal sex determination
Correct Answer:- Option-B
OBG Question # 337:-All are TRUE regarding Prenatal Diagnosis EXCEPT
A:-Biopsy of chorionic villi is typically performed between 10 and 13 weeks’ gestation
B:-Transabdominal amniocentesis is generally done between 11 and 14 weeks
C:-FISH studies are usually completed within 24 to 48 hours
D:-Chromosomal MicroArray can often be performed directly on uncultured amniocytes with a turn around time of only 3 to 5 days
Correct Answer:- Option-B
OBG Question # 338:-All are TRUE regarding Anti D immunoglobulin EXCEPT
A:-300 mcg dose is given for each 15 mL of fetal red cells or 30 mL of fetal whole blood to be neutralized
B:-Anti-D immune globulin may produce a weakly positive-1 : 1 to 1 : 4-indirect coombs titer in the mother
C:-Routine postpartum administration of anti-D immune globulin to at-risk pregnancies within 72 hours of delivery lowers the alloimmunization rate by 50 percent
D:-Antepartum anti-D immune globulin at 28 weeks’ gestation reduces the third-trimester alloimmunization rate from approximately 2 percent to 0.1 percent
Correct Answer:- Option-C
OBG Question # 339:-All are TRUE regarding Non-Stress Test NST EXCEPT
A:-Before 32 weeks, normal accelerations are defined as having an acme that is 10 bpm or more above baseline for 10 seconds or longer
B:-Beat-to-beat variability is under the control of the autonomic nervous system
C:-Loss of reactivity is most commonly associated with fetal hypoxia
D:-Abnormal non-stress test is inadequate to preclude any acuteasphyxial event happening in a 7 day interval
Correct Answer:- Option-C
OBG Question # 340:-All are TRUE regarding miscarriage EXCEPT
A:-balanced structural chromosomal rearrangements may originate from either parent and are found in 2 to 4 percent of couples with recurrent pregnancy loss
B:-the incidence of euploid abortion rises dramatically after maternal age exceeds 35 years
C:-a threshold CRL of 5 mm with absent cardiac activity is used to diagnose non-viability or embryonic demise
D:-absence of an embryo in a sac with a mean sac diameter (MSD) 25 mm signifies an embryonic pregnancy
Correct Answer:- Option-C
OBG- Obstetrics and Gynecology multiple Choice Questions
OBG Question # 341:-In three tier system of CTG interpretation, category III abnormal CTG is all EXCEPT
A:-Absent baseline FHR variability and recurrent late deceleration
B:-Absent baseline FHR variability and recurrent variable deceleration
C:-Absent baseline FHR variability and bradycardia
D:-Prolonged deceleration > 2 min but < 10 min
Correct Answer:- Option-D
OBG Question # 342:-Absolute contraindications to neuraxial analgesia in labour include all EXCEPT
A:-Maternal coagulopathy
B:-Thrombocytopenia
C:-Prophylactic low-molecular-weight heparin within 12 hours
D:-Refractory maternal hypertension
Correct Answer:- Option-D
OBG Question # 343:-Proven contraindications for the use of PGE2 for induction of labour include all EXCEPT
A:-suspicion of fetal compromise
B:-bronchial asthma
C:-unexplained vaginal bleeding
D:-cephalopelvic disproportion
Correct Answer:- Option-B
OBG Question # 344:-McRobert’s maneuver for relieving shoulder dystocia acts by all the following EXCEPT
A:-straightening of the sacrum relative to the lumbar vertebrae
B:-rotation of the symphysis pubis toward the maternal head
C:-decrease in the angle of pelvic inclination
D:-increase in overall pelvic dimensions
Correct Answer:- Option-D
OBG Question # 345:-All the following statements are TRUE EXCEPT
A:-Case-control studies are most feasible for examining the association between a relatively common exposure and a relatively rare disease
B:-Strengths of cohort studies include the ability to obtain attributable and relative risks (RRs) because the occurrence of the outcome is being compared in two groups
C:-Phase 3 clinical trials determine the efficacy of treatment for the intended population, compared with other available treatments, assess adverse events and side effects
D:-The negative predictive value (NPV) and positive predictive value (PPV) of a test does not vary with the baseline characteristics of population or prevalence of a disease
Correct Answer:- Option-D
OBG Question # 346:-The following structures may be injured during sacrospinous ligament fixation EXCEPT
A:-Pudendal nerve
B:-Superior gluteal artery
C:-Inferior gluteal artery
D:-Internal pudendal vessels
Correct Answer:- Option-B
OBG Question # 347:-All the following statements about ureteric injury are TRUE EXCEPT
A:-75% of all iatrogenic injuries to the ureter result from gynecologic procedures
B:-Laparoscopic hysterectomies have the least rate of ureteral injuries and vaginal hysterectomies the highest
C:-Ninety-one percent of injuries occur at the level of the pelvicureter and only 2% and 7% occur at the upper and middle ureteral thirds
D:-Careful identification of the ureter before securing the infundibulopelvic ligament and uterine artery is the best protection against ureteric injury during hysterectomy
Correct Answer:- Option-B
OBG Question # 348:-All are TRUE regarding Dermoid cysts of ovary EXCEPT
A:-Malignant transformation occurs in less than 2% of dermoid cysts in women of all ages
B:-Upto 25% of dermoids occur in postmenopausal women
C:-The risk of torsion with dermoid cysts is approximately 50%
D:-They are bilateral in approximately 10% of cases
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