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WorksheetsOBGY
Total questions: 90
Worksheet time: 55mins
Primordial germ cells are derived from which of the following embryological structures?
mesoderm
endoderm
epiblast
hypoblast
Regarding human gametogenesis, consider the following statements: 1. Primordial germ cells are derived from epiblast and migrate from yolk sac to genital ridge 2. Primordial germ cells are bipotential and can form spermatogonia or oogonia 3. SRY gene located on distal end of short arm of Y chromosome determines testicular differentiation 4. Spermatogenesis begins in intrauterine life and continues throughout life 5. Primary oocyte is arrested in diplotene stage of prophase I until puberty 6.Sperms attain maturity in proximal epididymis and motility in distal epididymis 7.Each oogonia gives rise to 1 ova/female pronucleus . How many statements are correct
3 statements are correct
4 statements are correct
5 statements are correct
6 statements are correct
Which of the following is the correct sequence of events during fertilization?
A. Acrosomal reaction → Capacitation → Zona reaction → Cortical reaction → Fusion with oolemma
B. Capacitation → Binding to zona pellucida → Acrosomal reaction → Fusion with oolemma → Cortical reaction
C. Capacitation → Acrosomal reaction → Binding to zona pellucida → Zona reaction → Fusion with oolemma
D. Binding to zona pellucida → Capacitation → Fusion with oolemma → Cortical reaction → Zona reaction
Regarding implantation and early pregnancy, consider the following statements: 1. Implantation usually occurs on day 6 after fertilization, corresponding to day 20 of the menstrual cycle2. Hartmann (placental) sign refers to slight bleeding experienced by some women at the time of implantation 3. Piskacek sign denotes asymmetric enlargement of uterus in early pregnancy due to eccentric implantation 4. Double decidual sac sign is the first ultrasonographic evidence of intrauterine pregnancy 5. Integrins play the most important role in the stage of adhesion during implantation. Which statements are correct
1,2,3,4
1,3,4,5
1,2,3,5
2,3
A 26-year-old woman, G2P1, presents at 18 weeks of gestation for routine antenatal ultrasound. USG reveals two fetuses with a gestational age difference of approximately 6 weeks, each having separate amniotic sacs and placentas. Her menstrual history is regular, and there is no history of assisted reproduction. The obstetrician considers the possibility of superfetation.Which of the following statements regarding this condition is MOST APPROPRIATE?
A. Superfetation is impossible in humans due to early cervical mucus plug formation
B. Superfetation can occur only before implantation of the first embryo
C. Superfetation in humans is possible only till 14–16 weeks of pregnancy
D. The finding is diagnostic of superfecundation
E. Superfetation occurs commonly after ovulation induction
A 30-year-old couple with a history of recurrent pregnancy loss is planned for IVF. Genetic evaluation reveals that both partners are carriers of a balanced chromosomal translocation. To avoid transfer of affected embryos, genetic testing is planned before implantation, and only genetically normal embryos will be transferred into the uterus.Which of the following is the BEST material for performing pre-implantation genetic testing in this patient?
polar body
blastomere
trophoectoderm
amniotic fluid
chorionic villus
A neonate born to a mother with mechanical heart valve on anticoagulation therapy shows nasal hypoplasia, stippled epiphysis, chondrodysplasia, and cataracts.Which drug exposure explains these findings?
Heparin
Warfarin
Aspirin
Clopidrogel
A 24-year-old primigravida presents after delivery of a newborn with bilateral facial weakness, inability to close eyes, absence of facial expressions, and impaired abduction of the eyes. Examination reveals cranial nerve VI and VII palsy along with limb reduction defects.Which of the following drugs is the most likely cause
Phenytoin
Isotretinoin
Tamoxifen
Misoprostol
Which of the following statements regarding human placenta is INCORRECT?
A. Human placenta is discoidal, deciduate and hemochorial
B. Weight of placenta at term is approximately 500 grams
C. Thickness of placenta at center normally measures more than 4 cm
D. Placenta and fetus attain equal weight at around 17 weeks of gestation
Which of the following correctly describes the human placental barrier separating maternal and fetal blood?
A. Syncytiotrophoblast → Cytotrophoblast → Decidua → Fetal capillary
B. Cytotrophoblast → Syncytiotrophoblast → Mesoderm → Fetal capillary
C. Syncytiotrophoblast → Cytotrophoblast → Extraembryonic mesoderm → Fetal capillary endothelium
D. Syncytiotrophoblast → Extraembryonic mesoderm → Cytotrophoblast → Fetal capillary
A 24-year-old primigravida presents at 42+ weeks of gestation with absent onset of labor pains. Ultrasound reveals a fetus with absent cranial vault and absent fetal adrenal glands. There is no uterine contraction despite adequate uterine distension.Which of the following best explains the cause of post-term pregnancy in this case?
A. Persistent progesterone secretion by corpus luteum
B. Reduced estrogen production due to absent fetal adrenal DHEA-S
C. Decreased placental aromatase activity
D. Excess relaxin secretion
E. Increased oxytocin receptor expression
A 29-year-old woman at 7 weeks of gestation undergoes routine first-trimester ultrasound. A 5 cm unilocular ovarian cyst is detected. She is asymptomatic, vitals are stable, and fetus is viable.What is the MOST APPROPRIATE management?
A. Immediate surgical removal to prevent torsion
B. Medical management with progesterone supplementation
C. Observation as it is likely corpus luteum cyst
D. Aspiration of cyst under ultrasound guidance
Which of the following hormones is an indicator of placental well-being?
A. Relaxin
B. Inhibin A
C. hCG
D. hPL
A 27-year-old woman presents with 6 weeks of amenorrhea and mild lower abdominal pain. Urine pregnancy test is positive.Transvaginal ultrasonography does not reveal an intrauterine gestational sac. Serial serum β-hCG levels are measured 48 hours apart and are as followsDay 0: 1500 mIU/mL,Day 2: 1750 mIU/mL.Which of the following is the MOST LIKELY diagnosis?
Viable intrauterine pregnancy
Abortion
probable ectopic pregnancy
Molar pregnancy
Biochemical pregnancy
A pregnant woman in labor develops painless vaginal bleeding immediately after rupture of membranes, followed by sudden fetal bradycardia. Blood loss is minimal but fetal distress is severe. What is the most likely diagnosis?
vasa previa
placenta previa
abruptio placenta
uterine rupture
The most common underlying abnormality associated with vasa previa is:
A. Marginal insertion of umbilical cord
B. Velamentous insertion of umbilical cord
C. Battledore placenta
D. Circumvallate placenta
MCQ: Which of the following statements regarding Schultze method of placental separation is INCORRECT?
A. Placental separation starts from the centre
B. A retroplacental clot is usually formed
C. Bleeding occurs only after complete placental separation
D. Maternal surface of placenta is expelled first
E. It is the most common method of placental separation
How many of the following are causes of polyhydramnios?1. Diabetes mellitus 2. Bartter syndrome 3. Patient on indomethacin 4. PPROM 5. Tracheoesophageal fistula
1
2
3
4
A 22-year-old primigravida presents at 20 weeks of gestation. Ultrasound shows severe oligohydramnios with thin membranous strands encircling the fetal forearm. The fetus has constriction rings and distal digital absence. No renal anomaly is noted.What is the most likely diagnosis?
A. Potter syndrome
B. Thanatophoric dysplasia
C. Early amnion–chorion rupture complex
D. Arthrogryposis multiplex congenita
A woman reports her first day of last menstrual period (LMP) as 5th February 2025. Her menstrual cycles are regular.What is her expected date of delivery (EDD)?
A. 10th November 2025
B. 12th November 2025
C. 5th November 2025
D. 19th November 2025
26-year-old multigravida presents at 35 weeks of gestation with complaints of easy fatigability and breathlessness on exertion. On examination, she is pale. Laboratory investigations reveal hemoglobin = 6.2 g/dL. Fetal growth is appropriate for gestational age.What is the MOST APPROPRIATE management at this stage?
A. Oral iron therapy
B. Intravenous iron sucrose
C. Packed red blood cell transfusion
D. Await labor and transfuse only if bleeding occurs
28-year-old pregnant woman with iron deficiency anemia has the following details: pre pregnancy Weight: 50 kg,Current Hb: 7 g/dL,Target Hb: 11 g/dL.Using the Ganzoni formula, what is the total iron requirement (approximate)?
A. 740 mg
B. 860 mg
C. 980 mg
D. 1100 mg
Which of the following statements regarding iron requirements in pregnancy are correct?
A. Total iron requirement during pregnancy is approximately 1000 mg
B. Fetus requires iron via passive diffusion
C. Approximate daily iron requirement in pregnancy is 4–6 mg/day
D. Iron requirement is highest in the first trimester
E. Only about 10% of dietary iron is absorbed
Regarding hematological changes in normal pregnancy, consider the following parameters:1. Plasma volume,2. RBC volume, 3. Hemoglobin concentration, 4. Cardiac output, 5. Erythropoietin levels, 6. Total leukocyte count,7. Fibrinogen levels., 8. Plasma albumin concentration. How many of the above parameters increase during pregnancy?
3
4
5
6
Which of the following changes are seen in normal pregnancy?1. Increase in tidal volume, 2. Decrease in residual volume, 3. Increase in minute ventilation, 4. Decrease in PaCO₂,5. Increase in vital capacity
A. 1, 2 and 3 only
B. 1, 2, 3 and 4 only
C. 1, 3, 4 and 5 only
D. All of the above
A 21-year-old primigravida presents at 10 weeks of gestation with a first episode of generalized tonic–clonic seizure. She has no past history of epilepsy, and her antenatal evaluation is otherwise normal. MRI brain is normal. She is anxious about fetal safety and asks for the safest antiepileptic drug to be started in pregnancy.What is the drug of choice in this patient
A. Valproic acid
B. Phenytoin
C. Carbamazepine
D. Levetiracetam
A woman with Graves’ disease becomes pregnant. The drug of choice in the 1st trimester is:
A. Methimazole
B. Carbimazole
C. Propylthiouracil (PTU)
D. Radioactive iodine
30-year-old G2P1 woman at 38 weeks gestation diagnosed with Intrahepatic Cholestasis of Pregnancy (ICP) with severe pruritus. Her recent blood tests show serum bile acid levels >40 μmol/L. What is the next step in management?
A) Start Ursodeoxycholic acid to relieve pruritus
B) Induce labour
C) Start Cholestyramine to reduce bile acid levels
D) Wait for spontaneous onset of labour
Which of the following is not a feature of Acute Fatty Liver of Pregnancy (AFLP)?
A) Hypoglycemia
B) Hypocholesterolemia
C) Fibrinogen <300 mg/dL
D) Prothrombin time <10
Monitoring of magnesium toxicity is done with the following parameters, except
A) Patellar reflex
B) Urine output
C) Respiratory rate
D) Pulse
Therapeutic range of MgSO4 in mEq/L is
A) 8–12
B) 2–4
C) 4–7
D) 10–12
All are the risk factors of preeclampsia except
A) Primigravida
B) Diabetes
C) Autoimmune diseases
D) Singleton pregnancy
Earliest manifestation of end-organ damage in chronic hypertension is?
A) Hepatic impairment
B) Renal impairment
C) Visual impairment
D) Pulmonary impairment
All are the signs of severe preeclampsia except,
A) Thrombocytopenia
B) Impaired liver function
C) Pulmonary edema
D) Thromboembolism
A 28-year-old primigravida woman at 32 weeks’ gestation is admitted to the labour ward with complaints of severe headache, visual disturbances, and upper abdominal pain. On examination her blood pressure is 170/110 mmHg, and urine dipstick shows proteinuria (+++). She is diagnosed with severe preeclampsia and is started on magnesium sulfate regimen. Six hours into the infusion, the nursing staff notes that the patient is becoming increasingly drowsy, with slurred speech and a respiratory rate of 8 breaths per minute. Deep tendon reflexes are absent, and the pulse oximeter shows oxygen saturation dropping to 88% on room air. What is the drug of choice?
A) Sodium bicarbonate
B) Calcium gluconate
C) Calcium bicarbonate
D) Sodium gluconate
Which of the following tests is most sensitive for the detection of iron depletion in pregnancy?
A) Serum iron
B) Serum ferritin
C) Serum transferrin
D) Serum iron binding capacity
Dose of folic acid per day for treating megaloblastic anemia in pregnancy:
A) 400 micrograms
B) 4 mg
C) 1 mg
D) 2 mg
Which of the following iron preparations cannot be used intramuscularly?
A) Iron dextran
B) Iron sorbitol
C) Ferric carboxy maltose
D) None of the above
Which of the following features indicates the presence of heart disease in pregnancy and which is not seen in normal pregnancy?
A) Exertional dyspnea
B) Distended neck veins
C) Systemic hypotension
D) Pedal edema
Which of the following statements regarding cardiovascular physiological changes in pregnancy are correct?1. Cardiac output begins to increase by 5 weeks of gestation and reaches maximum at 28–32 weeks. 2. Peripheral vascular resistance decreases due to progesterone-mediated smooth muscle relaxation and relaxin 3. Diastolic blood pressure shows maximum fall in the second trimester. 4. Femoral venous pressure increases due to compression of inferior vena cava by the gravid uterus, leading to peripheral pooling of blood. 5. Pulmonary capillary wedge pressure and left ventricular ejection fraction increase during pregnancy
A. Only 1, 2 and 3 are correct
B. Only 1, 2, 3 and 4 are correct
C. Only 2, 3 and 5 are correct
D. All of the above are correct
Regarding diabetes in pregnancy, which of the following statements are correct?
1. Human placental lactogen (HPL) is the most important hormone responsible for insulin resistance in pregnancy.
2. Significant insulin resistance develops mainly after 24–28 weeks of gestation.
3. Maternal insulin freely crosses the placenta and regulates fetal glucose levels
4. Gestational diabetes mellitus usually resolves within 6 weeks after delivery.
5. Congenital malformations are commonly seen in gestational diabetes mellitus diagnosed after 28 weeks.
Regarding pre-gestational diabetes mellitus in pregnancy, which of the following statements are correct?
1. HbA1c is a useful investigation to predict the risk of gross congenital anomalies in the fetus
2. The most common system involved in congenital malformations due to pre-gestational diabetes is the central nervous system.
3. Caudal regression syndrome is a characteristic congenital anomaly associated with pre-gestational diabetes
4. Karyotyping is routinely recommended to detect congenital anomalies in diabetic pregnancy.
5. Strict glycemic control with HbA1c < 6.5% eliminates the need for fetal anomaly scans.
Regarding management of gestational diabetes mellitus (GDM), which of the following statements are correct?
1. Medical Nutrition Therapy (MNT) is the initial management when 2-hour post-prandial glucose values are between 140–199 mg/dL.
2. Target metabolic goals in GDM include fasting blood sugar < 95 mg/dL and 2-hour post-prandial glucose < 120 mg/dL.
3. Metformin is recommended only after 20 weeks of gestation and is not used in pre-gestational diabetes
4. Glyburide is preferred over insulin because it reduces the risk of neonatal hypoglycemia.
5. If 2-hour post-prandial glucose is ≥ 200 mg/dL at any time, insulin should be started immediately
Regarding shoulder dystocia, which of the following statements are correct?
1. Turtle sign is seen due to recession of the fetal head back into the perineum after its delivery.
2. McRoberts manoeuvre is the first and most effective manoeuvre
3. Wood’s corkscrew manoeuvre involves rotation of both fetal shoulders, whereas Rubin’s manoeuvre involves only one shoulder.
4. Fundal pressure is an essential part of management to aid delivery of the impacted shoulder.
Increased in PIH
SFLT 1
S Endogolin
VEGF
NO
Prostacyclin I2
Most important factor responsible for stage of adhesion in implantation is
(a)
Which part of decidua forms the maternal side of placenta
(a)
First site of hematopoeisis and source of alpha feto protein
(a)
Outermost foetal membrane
(a)
Hormone factory of placenta is
(a)
Hormone factory of placenta is
(a)
Teratogenic exposure to which drug causes fetal hydantoin syndrome
(a)
Teratogenic exposure to which drug leads to microtia/anotia,CNS defects and cleft lip,palate
(a)
Most common congenital cause of SNHL
(a)
Layer of fibronoid degeneration between blastocyst and decidua basalis that limits the penetration of blastocyst
(a)
Morning sickness in pregnancy is due to which hormone
(a)
Most common cause of anemia in pregnancy
(a)
Most sensitive RBC index for iron deficiency anemia
(a)
Most commonly used parenteral iron preparation
(a)
Most common cardiac malformation in case of child of pre gestational diabetic mother
(a)
A 48-year-old woman with a history of ER-positive breast cancer presents for a routine follow-up. She completed chemotherapy 2 years ago and is currently on oral hormonal therapy. She now complains of occasional spotting per vaginum over the past month. Pelvic examination is unremarkable.Which of the following malignancies is she most at risk of developing as a side effect of her ongoing treatment?
A) Endometrium Ca
B) Ovary Ca
C) Cervix Ca
D) Vagina Ca
A 52-year-old woman, nulliparous, diabetic, and obese presents with postmenopausal bleeding. What is the most likely diagnosis?
A) Carcinoma in situ of cervix
B) Carcinoma endometrium
C) Dysfunctional uterine bleeding (DUB)
D) None of the above
The most malignant endometrial carcinoma is:
A) Adenocarcinoma
B) Adenoacanthoma
C) Mixed adenosquamous carcinoma
D) Clear cell carcinoma
Carcinoma endometrium with Para-aortic lymph node status is classified as stage:
A) I
B) II
C) III
D) IV
Which of the following lymph nodes is not typically involved in the regional lymphatic drainage of endometrial carcinoma?
A) Para-aortic
B) External iliac
C) Inferior mesenteric
D) Inguinal
Concerning invasive cervical carcinoma, all are correct except:
A) Radical hysterectomy is not indicated for stage Ia disease, if the excision margins are free of the disease
B) MRI imaging is safe for staging even during pregnancy
C) Radical trachelectomy and pelvic lymphadenectomy can be done for stage IIa disease
D) Pregnancy rate is about 35% within 1 year following radical trachelectomy
HPV triage strategy includes all except:
A) Conventional pap smear
B) Liquid based cytology
C) Hybrid capture 2 for HPV DNA
D) Colposcopy
Point B in the treatment of carcinoma cervix receives the dose of:
A) 7000 cGy
B) 6000 cGy
C) 2000 cGy
D) 10,000 cGy
Cervical cone biopsy, when performed in a case of carcinoma cervix, can cause all of the following complications, except:
A) Bleeding
B) Cervical stenosis
C) Infection
D) Spread of malignancy
Which of the following statements is false regarding carcinoma of the cervix involving the parametrium but without pelvic wall involvement?
A) Staging should be done after cystoscopy.
B) It is classified as Stage IIB.
C) Radiotherapy should be given
D) Hysterectomy can be useful.
21-year-old woman with a history of migraine with aura seeks contraception. She is advised to avoid high-dose estrogen formulations. Which of the following combined oral contraceptive pills contains the lowest dose of estrogen and would be the most appropriate choice in her case?
A) Mala N
B) Triquilar
C) Femilon
D) Novelon
Oral contraceptive pills decrease the incidence of all of the following conditions except:
A) Salpingitis
B) Hepatic adenoma
C) Ovary CA
D) Fibroadenosis
OCP gives protection against following cancer
A) Breast
B) Liver
C) Cervix
D) Ovarian
The use of combined OCPs is associated with an increased incidence of:
A) Bacterial vaginosis
B) Chlamydial endocervicitis
C) Vaginal warts
D) Genital herpes
Hypokalemic paralysis is a side effect of:
A) Gossypol
B) DMPA
C) Testosterone enanthate
D) Cyproterone acetate
In a woman on a subdermal progesterone implant, the menstrual abnormality seen is :
menorrhagia
metrorhhagia
ammenorhea
polymenorrhea
A 32-year-old multiparous woman visits the family planning clinic seeking a long-term, reversible contraceptive method. She expresses a preference for an intrauterine contraceptive device (IUCD) and specifically asks for one that protects for up to 10 years. Which of the following IUCDs would be most appropriate for her?
CuT380A
CuT200
Nova T
Multiload
A 32-year-old woman G3P2 presents to the family planning clinic requesting long-term contraception. She is morbidly obese with a BMI of 40. She has a history of menorrhagia, and her last delivery was 6 weeks ago. She is currently exclusively breastfeeding and is diabetic. She also mentions that she smokes a pack of cigarettes per day for the last six years. Which of the following is an absolute contraindication to IUCD insertion in this patient?
A) Undiagnosed vaginal bleeding
B) Diabetes
C) Smoking
D) Obesity
A 24-year-old woman presents to the outpatient clinic requesting emergency contraception after unprotected sexual intercourse 36 hours ago. She has regular menstrual cycles and no significant medical history. She is not currently using any form of contraception and does not desire pregnancy at this time. Which of the following is the emergency contraceptive of choice for her?
A) OCP
B) Danazol
C) Levonorgestrel
D) Mifepristone
Sterilization procedure with maximum chances of reversal is:
A) Pomeroy’s tubal ligation
B) Irving’s technique
C) Laparoscopic tubal ligation with silastic bands
D) Laparoscopic tubal ligation with clips
Ferning of cervical mucus depends on:
estrogen
progesterone
LH
FSH
What is the first-line investigation for evaluating male factor infertility?
post coital test
semen analysis
serum testosterone
DHEAS
Drugs used for ovulation induction are all except:
danazol
clomiphene citrate
Gonadotropins
letrozole
A patient treated for infertility with clomiphene citrate presents with sudden onset of abdominal pain and distension with ascites, the probable cause is
A) Uterine rupture
B) Ectopic pregnancy rupture
C) Multifetal pregnancy
D) Hyperstimulation syndrome
Fallopian tube dysmotility is seen:
Noonan Syndrome
Turner Syndrome
Kartagener syndrome
Marfan Syndrome
Causes of Premature ovarian insufficiency
radiation
infection
oophorectomy
hormonal treatment
Tests for ovarian reserve
AMH
LH
FSH
estradiol
Post coital test detects
fallopian tube block
cervical factor abnormality
sperm count
sperm abnormality
Which of the following statements regarding levonorgestrel releasing intra uterine contraceptive devices are correct
there is increased incidence of menorrhagia
this system can be used as a hormone replacement therapy
this method is useful for treatment of endometrial Hyperplasia
irregular uterine bleeding can be a problem initially
Methods of permanent sterilization
electrocoagulation
vasectomy
clipping
medroxy progesterone
