All India Institute of Medical Sciences, Rishikesh

Terminal Examination (batch 2018), Sept. 2022- Obstetrics & Gynecology

Question paper version A Time: 3 hours
Instructions: NO Negative marks. Use blue/black ball point pen only to fill in OMR sheet. Avoid scribbling.
1. In a female the Wolfian duct: B) Blood group
A) Forms the round ligament C) Dual marker
B) Forms the ovary D) Fetal echocardiography
C) Regresses and represents Gartner’s duct 10. A 28 year old female has signs and symptoms suggestive of
D) Develops into the fallopian tube nephrolithiasis was adviced to get an IVP (Intravenous
2. A 35 year old P3L3 presents to the Gynaecology OPD with pyelogram). But prior to this IVP, what do you want to
stress urinary incontinence. The commonest cause is: confirm?
A) Estrogen deficiency A) Whether she is sexually active
B) Raised intra-abdominal pressure B) Whether she is pregnant
C) Congenital weakness of sphincter C) Whether she is using contraception
D) Childbirth trauma D) Whether she has a history of children with birth
3. A 26-year-old uncomplicated primigravida presented to you defects
at 28 weeks of gestation. On per abdominal examination, 11. Fetal cardiac activity could be appreciated on transvaginal
her fundal height is 32 weeks. The MOST probable reason sonography at what period of gestation:
for this might be: A) 5 weeks
A) Polyhydramnios B) 6 weeks
B) Wrong dates C) 7 weeks
C) Multiple pregnancy D) 8 weeks
D) Large baby 12. If a 39 weeks’ pregnant woman faints while lying supine on
4. What is the most common cause of hemodilution during your examination table. What will you do immediately?
pregnancy A) Administer oxygen by mask
A) Increase in plasma more than erythrocytes B) Observe the patient
B) Only increase in plasma volume C) Start intravenous fluids
C) Increase in erythrocytes more than plasma D) Turn the patient to her left side
D) Neither erythrocytes nor plasma 13. A 32 year old female known case of type I Diabetes
5. Umbilical cord has: Mellitus comes to you for pre-conceptional counseling.
A) One umbilical artery and One umbilical vein Which one is NOT CORRECT?
B) Two umbilical vein and one umbilical artery A) HbA1C should be < 6.5%
C) Two umbilical artery and one umbilical vein B) Fetus has increased risks of congenital anomalies
D) Two umbilical artery and two umbilical vein C) Folic acid should be started
6. Which of the following is CORRECT: D) Fetus is not at risk of any cardiac malformations
A) Fetal lung maturity may be delayed in maternal 14. If both husband and wife are affected from thalassemia
diabetes minor, what is the probability that the fetus may be affected
B) Umbilical vein contains deoxygenated blood with thalassemia major?
C) Umbilical arteries contain oxygenated blood A) 25% b)50 % c)75% d)100%
D) Placenta allows maternal blood to enter the fetal 15. In India, Universal screening is recommended during
circulation but not vice versa routine antenatal checkup. What are the values of glucose
7. A recently diagnosed women of pulmonary tuberculosis, on tolerance test with 75 grams of glucose?
anti tubercular treatment has got pregnant. Which one of A) FBS/ 1 hour/ 2 hour - 93/180/152
the following is NOT CORRECT: B) FBS/ 1 hour/ 2 hour - 92/180/153
A) Immediately stop anti tubercular treatment C) FBS/ 1 hour/ 2 hour - 90/153/140
B) Vomiting in first trimester can reduce the efficacy D) FBS/ 1 hour/ 2 hour - 95/180/155
of treatment 16. The majority of spontaneous miscarriages are due to
C) Continue anti tubercular as advised, but stop A) Smoking
streptomycin if she is receiving B) Idiopathic (unknown)
D) Liver function tests should be advised to the C) Stress
patient D) Chromosomal anomalies
8. A 20 year old female presented to you with secondary 17. A 34-year-old pregnant lady known case of epilepsy came
amenorrhoea. Her previous cycles were regular. What to you in her first trimester. Her previous child had neural
would be your first step: tube defect. How much folic acid will you advise her?
A) Serum beta-hCG A) 400 mcg/day
B) Serum FSH B) 1 mg/ day
C) Urine pregnancy test C) 4 mg/day
D) Serum prolactin D) 2 mg/day
9. A 12 weeks pregnant lady presented to Gynae OPD for 18. Which of the following nutrients is most likely to be
routine antenatal checkup. At this POG, all of the following deficient during pregnancy?
investigations should be advised EXCEPT A) Calcium
A) NT/ NB scan B) Vitamin B12
C) Folic acid
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 D) Iron D) Submento-bregmatic
19. The ideal time period for NT/ NB scan (Nuchal translucency/ 30. 19-year-old, pregnant woman at 9 months POG was brought
nasal bone) is: to labour room, because she was found to have generalized
A) 12-14 weeks tonic, clonicconvulsion. O/E :Patient was unconscious, pallor
B) 11-14 weeks +, BP 156/100 mmHg, urine dipstick for protein +, Fundal
C) 11-15 weeks height -34 weeks. P/V Cervix - 4 to 5 cms dilated, station –1.
D) 12-15 weeks How do you manage this patient?
20. What is the recommendation of HIV testing during A) General measure, prophylactic antibiotic and immediate
pregnancy: C/section.
A) Advice all women with opt out approach B) General measures, antihypertensive, MgSO4,
B) Advice only to the high risk women resuscitation of the patient, fetal assessment and
C) Advice only to low risk women conservative management.
D) Don’t advice until the patient herself ask for it C) General measures, antihypertensive, MgSO4,
21. All of the following are true about physiological changes resuscitation of the patient,fetal assessment and
during pregnancy EXCEPT: augmentation of labour.
A) Pregnancy is a hypercoagulable state D) General measures, BP control, fit control, mother
B) Systemic vascular resistance decreases during stabilization and conservative management.
pregnancy 31. Which statement is CORRECT regarding HIV in pregnancy
C) Blood volume decreases during pregnancy A) Most of the transmission to the baby occurs during post-
D) Cardiac output increases during pregnancy partum
22. In primigravida, usually head engaged by 37 weeks. If head B) Breastfeeding is contraindicated.
fails to engage even at 38 weeks, what could be the possible C) Anti-Retroviral therapy are not important.
cause: D) Elective cesarean section is helpful in decreasing the
A) Deflexed head mother to child transmission
B) Oligohydramnios 32. In pre-eclampsia
C) Anencephaly A) Alpha Methyldopa 2 grams/daily can be given as
D) Intra uterine growth restriction treatment
23. Which is the most roomy plane of the pelvis, in which all B) Severe headache is a sign of aggravating factors
antero-posterior, oblique and transverse diameter are same in C) MgSO4 should be given to all patients with severe pre-
dimension? eclampsia.
A) Pelvic inlet C) Cavity D) All of the above
B) Pelvic outlet D) Mid pelvis 33. A 30 year primigravida comes to the antenatal clinic at 34
24. A 37 weeks pregnant women came to you with decreased weeks of gestation. What clinical features would prompt a
fetal movement. Her NST is not reactive and on USG, there preterm delivery in this lady:
is no fetal breathing movement and gross body movement. A) Diastolic BP > 110 mmHg despite the adequate use of
What is your next line of management? the appropriate antihypertensive agents
A) Repeat the biophysical profile after one week B) Platelets count less than 50,000/cumm
B) Repeat the biophysical profile after 4 hours C) Markedly Elevated liver enzymes
C) Terminate the pregnancy D) All of the above
D) Advice for umbilical artery Doppler 34. Which of the following is true about breech presentation?
25. All of the following are tests for fetal surveillance EXCEPT: A) Delivery should be performed by skilled obstetrician
A) Daily fetal movement count B) Assessment of labour progression should be done at
B) Non stress test closer interval than for cephalic presentation
C) Biophysical profile C) Footling breech is better delivered by caesarean section
D) Level II ultrasonography D) All of the above
26. The relationship of the long axis of the fetus to the maternal 35. A 25-year-old twin pregnancy 1st twin cephalic, 2nd breech
spine is known as: comes to the labour room at 37-week gestation in active
A) Position b)Attitude c)Lie d) Presentation labour. Which of the following is FALSE regarding further
27. The active management of third stage of labour does NOT management in this patient-
include: A) Always to be delivered by cesarean section
A) Controlled cord traction B) Monitored by partograph during labour
B) Uterine massage C) Leave for spontaneous labour
C) Injection oxytocin 10 units intramuscularly D) PPH can occur with 3rd stage
D) Delayed cord clamping 36. The following is TRUE in the management of twin
28. Smallest diameter of fetal head is- pregnancy:
A) Bi-parietal diameter A) Patient should be admitted at 34 weeks to reduce the
B) Bi-temporal diameter incidence of neonatal complications
C) Super-sub parietal diameter B) Active management of third stage of labour prevents
D) Bi-mastoid diameter post-partumhemorrhage
29. Commonest diameter of fetal head for engagement during C) Cesarean section is indicated if the second twin is a
normal labour is- breech
A) Occipito- frontal D) Iron and Calcium is given in doses same as singleton
B) Sub occipito-bregmatic pregnancy
C) Sub occipito-frontal
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 37. A 24-year-old G3P2L2 with previous 2 full term normal mm Hg. On P/V examination-Os fully dilated, cervix-
deliveries with breech presentation in this pregnancy is fully effaced, head 0 station, caput 3+, moulding 3+,good
admitted to the labour room in active phase of labour. uterine contractions, FHR- 100 bpm. What is the most
Which of the following does NOT hold true about further appropriate management in this condition?
management of the patient: A) Vacuum extraction c) Symphysiotomy
A) Lovset’s maneuver is for delivery of the head B) Outlet Forceps delivery d) Cesarean section
B) Mauriceau-Smellie-Veitmaneuver is for delivery 44. A 27-year-old breech pregnancy attends the antenatal
of the head OPD at 36 weeks of gestation. Which of the following
C) Entrapped after coming head can be delivered by may be LEAST associated with breech presentation.
Piper’s forceps A) Polyhydramnios
D) Breech extraction should be preferred B) Oligohydramnios
38. A primigravida at 34 weeks’ gestation develops marked C) Uterine anomaly
pruiritis specially on her palms and soles and mildly D) Low lying placenta
elevated LFT and elevated bile acids. Which of the 45. A 25-year-old Primigravida at 37 weeks POG presents to
following diagnostic possibilities is most consistent with the labour ward with frank rupture of membranes. On
this clinical presentation P/V examination, cervix is 4 cm dilated, 90% effaced
A) Pancreatitis with the presenting part at − 3 station. The presenting part
B) Hyperthyroidism is soft and felt to be fetal buttock. A bedside ultrasound
C) Pruiritis of pregnancy confirms breech presentation with both hips flexed and
D) Intrahepatic cholestasis of pregnancy knees extended. What type of breech presentation is
39. A Primigravida presents with suspected heart disease at described?
antenatal clinic. Which of the following is TRUE A) Frank
regarding this patient? B) Incomplete, single footling
A) Mitral stenosis is the most frequent heart disease C) Complete
during pregnancy D) Double footling
B) Cardiac failure usually presents during early 46. A 20-year-old female at 34 weeks of gestation develops
puerperium a lower urinary tract infection. Which of the following is
C) Diastolic murmur suggests organic heart disease the best choice for treatment?
rather than systolic A) Cephalosporin c) Sulfonamide
D) All of the above B) Tetracycline d) Nitrofurantoin
40. A 28-year-oldPrimigravida with twin pregnancy attends 47. A 33-year-old woman at 10 weeks of gestation presents
the antenatal OPD. Which of the following is TRUE? for her first antenatal examination with hepatitis B
A) Patient needs to get admitted from 24 weeks surface antigen is positive. Liver function tests are
onwards to the ward to facilitate growth of twins normal and her hepatitis B core and surface antibody
B) Double dose of hematinic are commonly given to tests are negative. Which of the following is the best way
prevent anemia due to increased demand to prevent neonatal infection?
C) A second twin in transverse lie is always delivered A) Provide immune globulin to the mother
by caesarean section B) Provide hepatitis B vaccine to the mother
D) All twins in breech or cephalic presentation are C) Perform a cesarean delivery at term
delivered by caesarean section D) Provide immune globulin and the hepatitis B
41. Which of the following is TRUE regarding mother to vaccine to the neonate
child transmission in HIV 48. A 28-year-old Primigravida presents to the antenatal
A) The primary means by which an infant can become OPD at 8 weeks’ gestation. She has a history of Type 1
infected with HIV is through use of unsterilized Diabetes Mellitus since the age of 14. She is on insulin
instruments injections and her blood sugars are poorly controlled.
B) The primary means by which an infant can become Which of the following is the most common birth defect
infected with HIV is through vertical transmission associated with uncontrolled pre-gestational diabetes?
C) Mixed feeding has no major effect on transmission A) Anencephaly B)Ventricular septaldefect
if the infant has no oral sores C) Meningomyelocele D)Sacral agenesis
D) All the above 49. A 38-year-old G3P2L2 obese patient at 37 weeks with
42. A 20-year-oldPrimigravida with breech presentation and gestational diabetes mellitus that is well controlled with
estimated fetal weight 4 kg gets admitted in early labour. diet, presents for her routine antenatal visit. Her fetus has
Which of the following is TRUE regarding management an estimated fetal weight of 3.5 kg. Which of the
in this patient following is the best next step in her management?
A) Delivery by cesarean section A) Administration of insulin to prevent
B) First stage of labour is shorter than cephalic macrosomia
presentation B) Cesarean delivery at 39 weeks to prevent
C) Cord prolapse is not a risk shoulder dystocia
D) Forceps can be used for delivery of after coming C) Induction of labor at 38 weeks
head D) Daily fetal movement counts, NST and
43. A 28-year-old multigravida at full term is admitted to the Biophysical profile weekly
labour room. She was in labour for last 14 hours and 50. A 30-year-old primigravida presents at term in active phase
gives history of handling by unskilled birth attendant. of labour. On P/V examination, fetal face and nose is felt.
Presently she is dehydrated, Pulse-106/min, BP- 100/54
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 The most common condition associated with face infection. In which time period does maternal infection with
presentation is rubella virus carry the greatest risk for congenital rubella
A) Hydrancephaly syndrome in the fetus?
B) Placenta previa A) Preconception
C) Prematurity B) First trimester
D) Anencephaly C) Second trimester
51. A 32-year-old G5P1A3 presents for her first antenatal visit. D) Third trimester
A complete obstetrical, gynecological, and medical history 58. A 26-year-old second gravida is admitted to the labour room
and physical examination is done. Which of the following at 33 weeks of gestation with established preterm labour.
would be an indication for elective cerclageplacement? Which of the following condition is associated with preterm
A) Three spontaneous first-trimester abortions labour?
B) Cervical length of 35 mm by ultrasound at 18 weeks A) Uterine anomaly
C) Threesecond-trimester pregnancy losses without B) Asymptomatic bacteriuria
evidence of labor C) Genital tract infection
D) History of loop electrosurgical excision procedure D) All of the above
for cervical dysplasia 59. A 27-year-old primigravida with full term pregnancy came
52. A 26-year-old lady came to the maternity ward at 32 weeks to the labour room in latent phase of labour. On examination,
of gestation with preterm labour. Which of the following the pelvic grip was empty. Head of the fetus was found in the
condition would be absolute contraindications for tocolysis? right flank. Possible diagnosis is:
A) Prelabour rupture of membranes A) Transverse lie c) Breech lie
B) Pre eclampsia B) Cephalic lie d) Oblique lie
C) Chorioamnionitis 60. A 21-year-old multigravida attended the antenatal clinic at
D) Presence of phosphatidylglycerol in amniotic fluid 36 weeks of gestation. Her Hb was 8.5 mg/dl. Iron studies
53. A 30-year-old Primigravida at 32 weeks is being evaluated showed Iron deficiency anemia. Which of the following is
for vaginal bleeding and uterine contractions. Which of the found in the peripheral smear of this patient
following statements regarding the use of betamethasone in A) Microcytic hypochromic
the treatment of preterm labor is true? B) Macrocytichypochromic
A) It enhances the tocolytic effect and decreases the C) Macrocytichyperchromic
risk of preterm delivery D) Microcytic hyperchromic
B) It has been shown to decrease intra-amniotic 61. A 23-year-old primigravida at 37 weeks of gestation. Her Hb
infections is 5.5gm/dl. Which of the following is the most important
C) It promotes fetal lung maturity and decreases the next step in management of this patient
risk of respiratory distress syndrome A) I. V. iron therapy
D) The anti-inflammatory effect of betamethasone B) Blood transfusion
decreases the risk of sepsis in the newborn C) Oral iron therapy
54. On pelvic examination of a patient in labor at 34 weeks, the D) Erythropoietin therapy
patient is noted to be 6 cm dilated, completely effaced with 62. A 24-year-old woman G1P0 at 37 weeks’ gestation was
the fetal nose and mouth palpable. This is an example of noted to have a 2.8 kg weight gain in last one week. She has
which of the following? a blood pressure 140/92 mm Hg and 1+ proteinuria. The
A) Cephalic presentation examination was repeated 6 hours later and the same results
B) Face presentation were obtained. Which of the following is the best diagnosis?
C) Breech presentation A) Normal pregnancy
D) Transverse presentation B) Preeclampsia
55. A patient at 39 weeks’ gestation with ultrasound suggestive C) Eclampsia
of growth restricted fetus, oligohydramnios (AFI 4 cm). D) Pregnancy-induced hypertension
Which of the following is the best next step in the 63. A 20-year-old primigravida attended the antenatal OPD at 10
management of this patient? weeks’ gestation. Her complete blood count shows iron
A) Emergency Cesarean delivery deficiency anemia. In the pregnant population, anemia can
B) Cervical ripening followed by induction of best be defined as which of the following?
labor A) High total iron binding capacity
C) Wait for spontaneous onset of labour B) A genetic defect in ferritin synthesis
D) Perform a Biophysical profile in 2 days C) Low folic acid
56. A 19-year-old Primigravida at 34 weeks’ gestation with D) Hemoglobin less than 11 g/dl
gestational diabetes on insulin. She has been noncompliant
with diet and insulin therapy. Her fundal height measures 38 64. Which is the most common type of anemia in pregnancy?
cm. Which of the following is the most likely explanation for A) Iron deficiency c) Folate deficiency
the discrepancy between the fundal height and the B) Sickle cell disease d) Thalassemia
gestational age? 65. The mother is found to have sickle trait. If the father too has
A) Fetal hydrocephaly trait, what percentage of their children will be born with
B) Uterine fibroids sickle disease?
C) Macrosomia A) 0 b) 25 c) 50 d) 75
D) Breech presentation 66. A 22-year-old Primigravida at 28 weeks’ gestation with
57. A Primigravida at 11 weeks’ gestation has a history of recent hemoglobin of 10. Her mean corpuscular volume (MCV) is
exposure to her 3-year-old nephew who had a rubella viral increased. Mean corpuscular hemoglobin (MCH) and mean
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 corpuscular hemoglobin concentration (MCHC) is normal. 74. Preterm rupture of the membranes is most strictly defined as
Serum iron is 100 mg/dl. Which of the following is the best spontaneous rupture at any time prior to which of the
diagnosis? following?
A) Normocytic, normochromic anemia A) Stage of fetal viability
B) Normal B) Second stage of labor
C) Macrocytic anemia C) 32nd week of gestation
D) Microcytic anemia D) 37th week of gestation
67. The most likely cause of macrocytic anemia is which of the 75. The pathologic retraction ring of Bandl is most commonly
following? associated with which of the following
A) Gastrointestinal (GI) bleeding A) Preterm labour
B) G6PD deficiency B) Fibroiduterus
C) Iron deficiency C) Obstructed labour
D) Folic acid deficiency D) Precipitated labour
68. A 34-year-old G3P2 at 35 weeks’ gestation complains of 76. A 19-year-old primigravida has just delivered. She is pre-
sharp, excruciating pain in the right flank radiating into her eclamptic and her uterus is not well contracted and she has
groin. No fever. Urinary analysis reveals numerous red blood moderate to heavy bleeding. Which of the following is the
cells (RBCs), some WBCs, and no bacteria. Which of the best management option
following options is the most likely diagnosis? A) 20 units of IV oxytocin
A) Appendicitis B) 0.2 mg intramuscular methergin
B) Pyelonephritis C) 10 units of oral oxytocin
C) Round ligament pain D) 250 PGF2 alphaorally
D) Ureteric stones 77. A multigravida has entered spontaneous premature labor at
69. A 23 year old primigravida is seen in the third trimester of 32 weeks gestation. During the delivery, one should NOT do
pregnancy with acute onset of chills and fever, nausea and which of the following?
backache. Her temperature is 102°F. The urinary sediment a) Allow spontaneous vaginal delivery
reveals many bacteria and WBCs. Which of the following is b) Perform an episiotomy
the most likely diagnosis? c) Use prophylactic forceps
A) Acute appendicitis c) Pyelonephritis d) Use vacuum extraction
B) Ruptured uterus d)Abruptio placentae 78. A 24-year-old married female presented with giddiness,
70. In pregnant women with polyhydramnios, what is the most abdominal pain and abnormal vaginal bleeding. What is the
common cause? first investigation you should order?
A) Idiopathic A) USG pelvis
B) Fetal urinary tract anomalies B) Complete blood count
C) Maternal diabetes C) Urine pregnancy test
D) Post-mature pregnancy D) Serum beta-hCG
71. A 34-year-old G4P3L2 at 38 weeks’ gestation known case of 79. A 10 weeks’ pregnant women comes to you with abdominal
diabetes mellitus is in labour. The head delivers but the pain and bleeding per vaginum. On examination, cervical os
shoulder’s do not follow. An efficacious method of delivery was open. What is your provisional diagnosis?
for a shoulder dystocia includes McRobert’s maneuver. A) Incomplete miscarriage
McRobert’s maneuver is described as which of the following B) Complete miscarriage
A) Fundal pressure C) Missed miscarriage
B) Rotation to oblique position after delivery of posterior D) Threatened miscarriage
arm 80. Which of the following is NOT a risk factor for
C) Strong traction on the head developing an ectopic pregnancy?
D) Extreme flexion and abduction of maternal thighs A) Assisted conception i.e. IVF
72. During pregnancy some women may develop gestational B) Previous tubal surgery
diabetes mellitus during the later half of the pregnancy. This C) Pelvic inflammatory disease
is due to which of the following? D) Young maternal age
A) Decreased insulin production
B) Increased food absorption from the GI tract
C) Increased placental lactogen 81. Which of the following methods of treating an ectopic
D) Decreased hepatic secretion of insulin-binding pregnancy does NOT require serial measurements of
globulin serum beta-hCG to ensure resolution?
73. A primigravida is found to be Rh negative (husband is Rh A) Medical management
positive) with a negative antibody screen. Anti-D immune B) Conservative management
globulin should NOT be given for which of the following C) Salpingectomy
situations? D) Salpingostomy
a) After a spontaneous or therapeutic abortion
b) Rh-positive baby with an Rh-negative mother 82. Snow storm appearance on USG would be suggestive of
c) Postpartum to Rh-negative female with Rh- A) Ectopic pregnancy
positive husband B) Partial mole
d) Complete mole C) Complete hydatidiform mole
D) Septic abortion

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 83. Which of the following is NOT TRUE about recurrent A) Placenta previa
miscarriage? B) Chorioamniotis
A) It can be caused by antiphospholipid antibodies C) Appendicitis
B) Defined as two consecutive miscarriages D) Abruptio placentae
C) May be associated with chromosomal 91. A full term primigravida presented with sudden painless
abnormality of either husband or wife excessive bleeding per vaginum. This was her first visit
D) There is a role of heparin and ecosprin in to the hospital. Which one is NOT an appropriate
management management tool for this patient?
84. A woman presents with abdominal pain and per-vaginal A) Call for help
bleeding. A transvaginal ultrasound shows a single live B) Send urgent blood investigations and arrange
intrauterine fetus of 8 weeks POG and cervical os is packed red blood cells
closed. What is your diagnosis? C) Assess fetal viability
A) Incomplete abortion D) Observe the patient for spontaneous stoppage
B) Threatened abortion of bleeding
C) Missed abortion 92. A 27-year-old G2P1L1 woman with previous one
D) Septic abortion vaginal delivery. In her level II ultrasound at 20 weeks,
85. During Dilatation & Curettage (D&C) for incomplete she was diagnosed to have low lying placenta reaching
abortion, if there is perforation of uterus and the patient up to internal os. Which of the following is the best next
is bleeding profusely. What will be your next step: step for this patient?
A) You will stop the D&C and Observe the A) Schedule a cesarean at 37 weeks
patient B) Perform a speculum examination at term and
B) You will complete the D&C and observe the then plan accordingly
patient C) Repeat ultrasound at 32 weeks to confirm the
C) Emergency laparotomy location of placenta
D) Vaginal packing D) Order an MRI for uterus and placenta
86. A 38-year-old female conceived after IVF, presented 93. Uterine artery is a branch of:
with abdominal pain and bleeding per vaginum. On A) Posterior division of internal iliac artery
USG, uterine cavity is empty and there is a heteroechoic B) Direct branch of aorta
mass of 3 cm in left adnexa with presence of free fluid C) Anterior division of internal iliac artery
in the pelvis. What is your provisional diagnosis and D) External iliac artery
how will you manage the patient? 94. If a pregnant women has hyperparathyroidism, which of
A) Unruptured ectopic pregnancy, Inj. Methotraxate the following will the infant possibly be at risk of
B) Ruptured ectopic pregnancy, left salpingectomy A) Hyaline membrane disease
should be done B) Coma
C) Unruptured ectopic pregnancy, Left salpingectomy C) Tetany
D) Ruptured ectopic pregnancy, Inj. Methotraxate can D) Hyperglycemia
be given 95. A 30-year-old primigravida wants CDMR (cesarean
87. Management of hyperemesis gravidarum does NOT delivery on maternal request). Which would be the most
include: appropriate incision for her:
A) Intravenous fluids A) Midline vertical incision
B) Antibiotics B) Pfannensteil incision
C) Antiemetics C) Paramedian incision
D) Antaacids D) J shaped incision
88. All of the following are the complications of
hyperemesis gravidarum EXCEPT:
A) Mallory weissoesophageal tears
B) Malnuitrution
C) Congenital malformations
D) Wernicke’s encephalopathy 96. Which of the following is NOT correct:
89. A 32-year-old pregnant woman with 7 weeks of A) Ovarian artery is a direct branch of aorta
amenorrhea presented to you with excessive vomiting B) Uterine veins accompany their respective
and retching, not able to tolerate anything orally. Signs arteries
of dehydration are also present. In this patient USG C) Uterine artery also known as hypogastric artery
should be ordered to confirm or to rule out the D) Ovarian artery does not supply uterus
following possibilities EXCEPT: 97. Anatomical uterine malformation is most commonly
A) Multiple pregnancy associated with:
B) Normal single intrauterine pregnancy A) Recurrent first trimester abortion
C) Molar pregnancy B) Oligohydramnios
D) Threatened abortion C) Recurrent second trimester abortion
90. A 38-year-old woman known case of chronic D) Polyhydramnios
hypertension at 36 weeks of gestation presents to you 98. During stepwise devascularization for the management
with pain abdomen and minimal bleeding per vaginum. of postpartum haemorrhage, which one is
Abdomen is tender on palpation. What is your clinical INCORRECT:
diagnosis? A) Uterine artery ligation
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 B) Internal iliac artery ligation 108. For medical termination of pregnancy, written consent
C) Ovarian artery ligation has to be obtained from?
D) External iliac artery ligation a) The female partner
99. Which of the following ligament provides the maximum b) The male partner
support to uterus to prevent prolapse? c) The female and male partner
A) Broad ligament d) Only verbal consent is needed
B) Utero-ovarian ligament 109. The major cause of the increased risk of morbidity &
C) Cardinal ligament mortality among twin gestation is:
D) Round ligament a) Gestational diabetes
100. During a cesarean section, midline vertical b) Placenta previa
infraumbilical incision made. What are the structures of c) Malpresentation
the anterior abdominal wall would be incised or d) Preterm delivery
separated (in order): 110. Mc Donald cerclage can be performed in all EXCEPT?
A) Skin, Subcutaneous fat, Rectus sheath, Rectus a) Short cervical length
muscle, Peritoneum b) Incompetent cervix
B) Skin, Subcutaneous fat, Rectus muscle, Rectus c) Previous history of three preterm vaginal
sheath, Peritoneum deliveries
C) Skin, Rectus sheath, Rectus muscle, d) Pregnancy with Bleeding PV
Subcutaneous fat, Peritoneum 111. Surgery done for cervical incompetence?
D) Skin, Subcutaneous fat, Peritoneum, Rectus a) Shirodkar procedure
sheath, Rectus muscle b) Fothergill stitch
101. Major congenital malformations occur if insult takes c) Khanna procedure
place at which period of gestation? d) Purandre procedure
A) Pre-organogenesis period (0-2weeks) 112. The only indication of internal podalic version in
B) Embryonic period (2-8 weeks) modern day obstetrics is?
C) Fetal period (>8 weeks) a) Breech
D) Third trimester (28-40 weeks) b) Occipito posterior
102. During pregnancy, uterine muscle mass increased c) Second twin transverse
primarily because of which reason: d) Deep transverse arrest
A) Production of new myocytes 113. A patient in labour is diagnosed with deep transverse
B) Atypical hyperplasia arrest. What would be the best management for her?
C) Hyperplasia and hypertrophy a) Ventouse application
D) Anaplasia b) Cesarean section
103. The Contraceptive pills that can be safely administered c) Forceps rotation and ventouse application
in a lactating female is? d) Outlet forceps application
a) Combined OC pills 114. A primigravida in labour is fully dilated, fully effaced,
b) Biphasic pill vertex at +5 station. The junior resident detects fetal
c) Progesterone Only pill distress up to 90 beats per minute. The patient is
d) Triphasic pill exhausted and unable to bear down. What would be the
104. An absolute contraindications for combined oral most appropriate course of action?
contraceptive pill is? a) Wrigley forceps application
a) After treatment for choriocarcinoma b) Piper forceps application
b) Cervical cancer c) Cesarean section
c) History of ectopic pregnancy d) Keilland forceps application
d) Heavy menstrual Bleeding
105. Which of the following is not an absolute 115. Level of anaesthesia for Caesarean Section is up to?
contraindication to Intrauterine Contraceptive Device a) T4 b)T6 c)T8 d) T10
insertion? 116. A primigravida at term was rushed in to the casualty.
a) History of Ectopic Pregnancy The relatives gave the history she had been having labor
b) Undiagnosed abnormal bleeding from genital tract pains for the last two days at home and suddenly
c) Carcinoma cervix collapsed half an hour ago. She was extremely pale.
d) Choriocarcinoma Pulse was week and feeble and at 140 beats per minute.
106. Combine oral contraceptive pill supplied free of cost by BP was 70/50 mm of Hg. P/A examination revealed loss
the Government of India is? of uterine contour and maternal abdomen was full of
a) Yasmin fetal parts. There was bleeding PV. What is the most
b) YAZ likely diagnosis?
c) Mala D a) Abruption
d) Mala N b) Ruptured uterus
107. Most common cause of first trimester abortion is? c) Eclampsia
a) Chromosomal abnormalities d) Cephalo-pelvic disproportion
b) Rh isommunization 117. A 22-year-old girl with history of one missed period,
c) Cervical incompetence came to the hospital with complaint of acute pain lower
d) Hormonal imbalance abdomen and fainting attack. Urine pregnancy test was
found to be positive. She was extremely pale. Pulse was
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 week and feeble and at 146 beats per minute. BP was 128. A patient at term came to the labor room. PV finding
80/50 mm of Hg. She was carrying an USG report was os closed, cervix 3 cm long, firm, posterior, vertex
showing a 5 cm right adnexal mass and free fluid in the at -3 station. What was her Bishops Score?
abdomen. What is the most likely diagnosis? a) 1 b)2 c)3 d)4
a) Torsion right ovary 129. Risk & complications of induction of labour include all
b) Ruptured right tubal ectopic of the following EXCEPT:
c) Peritonitis a) Failed induction
d) Appendicitis b) Atonic PPH
118. Hydrops fetalis is associated with all of the following c) Uterine hyper stimulation leading to fetal hypoxia
condition EXCEPT? d) Prostaglandin may cause hypothermia due to its
a) Rh isoimmunisation direct effect on thermoregulatory centers in the
b) Beta- thalassemia brain
c) Alpha- thalassemia 130. In Abruptio placenta: Which is true?
d) Parvo virus infection a) Has minimum effect on the fetus
119. Common causes of post neo-natal mortality in India are b) Causes painless bleeding
all EXCEPT? c) Can be a cause of postpartum hemorrhage
a) Malnutrition d) All should deliver by caesarean section
b) Tetanus 131. The risk for development of fetal macrosomia is
c) Diarrhea increased in all of the followingconditions EXCEPT
d) Acute respiratory infections A) Diabetes with pregnancy
120. Incidence of maternal mortality is highest amongst B) Post term pregnancy
which cardiac disease? C) Prior macrosomic infant
a) Marfan’s syndrome D) Primigravida
b) Eissenmenger syndrome 132. All of the following are methods of induction of labour
c) Mitral Stenosis EXCEPT-
d) VSD A) Dinoprostone gel
121. Most common immunoglobulin secreted in breast milk? B) Misoprostol
a) Ig G b)Ig A c)Ig M d)Ig E C) Oxytocin
122. Milk let down is under the effect of the following D) Progestrone
hormone? 133. A 28-year-old multigravida at 32 weeks’
a) Estrogen gestationpresented with BP of 164/100 mmHg. Which of
b) Progesterone the following is the first line drug for management of this
c) Prolactin patient
d) Oxytocin A) Labetalol
123. Most common psychiatric complication in the post- B) Nifedepine
partum period is ? C) Alpha- methyldopa
a) Post-partum depression D) Hydralazine
b) Post-partum psychosis 134. Commonest cause of retained non separated placenta is
c) Post-partum blues A) Adherent placenta
d) Psychiatric symptoms are not common in the post- B) Atonicity
partum period C) Endometritis
124. The most common bacteria isolated from cases of D) Incarcerated placenta
puerperal infection is:
a) E.coli. 135. Estimated risk of scar rupture is maximum with which
b) Streptococcus of the following condition
c) Staphylococcus A) Previous classical cesarean section
d) Clostridium perfringens B) Previous lower segment rupture
125. After parturition, endometrium regenerates from which C) Previous upper segment rupture
part of the decidua D) Previous 2 transverse caesarean section
a) Basal zone 136. A 26-year-old second gravida is admitted to the labour
b) Compact zone room at 33 weeks of gestation with established preterm
c) Spongy zone labour. Which of the following is associated with preterm
d) Parietal layer labour
126. Symptoms and signs of puerperal endometritis include A) Uterine anomaly
all the following EXCEPT: B) Symptomatic bacteriuria
a) Malodorous vaginal discharge. C) Genital tract infection
b) Lower abdominal pain D) All of the above
c) Fever 137. Fetal hyperinsulinemia leads to
d) Involuted uterus A) Fetal macrosomia causing difficult vaginal delivery
127. Assessment of progress of labor is best done by ? B) Inhibition of pulmonary surfactant formation
a) Per abdominal examination C) Decreased serum potassium
b) Per vaginal examination D) Neonatal hyperglycemia
c) CTG 138. What is the most appropriate treatment option for
d) Partogram recurrent pregnancy loss with antiphospholipid syndrome
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 A) Tab warfarin B) Shoulder presentation
B) Heparin with low dose ecosprin C) Cervical cancer
C) Progesterone D) Previous classical C-section.
D) Inj. HCG 149. Following instrument is used for hemostasis of uterine
139. A 24-year-oldprimigravida at 20 weeks’ gestational age scar in a cesarean section?
has microcytic hypochromic anemia with Hb of 9 gm/dl A) Green Armytage forceps
and normal iron stores. What is the most likely diagnosis B) Babcock
A) Folate deficiency C) Ovum forceps
B) Vit B12 deficiency D) Bowel clamp
C) Thalassemia 150. Fetal assessment include the following EXCEPT:
D) Iron deficiency a) Fetal biophysical profile
140. Which of the following is true regarding abruption b) Fetal blood sugar sample
placentae c) Fetal Doppler velocimetry
A) Postpartum hemorrhage occurs only when there is d) Fetal Cardiotocography
hyperfibrinogenemia 151. Excessive increased level of β-HCG is expected in:
B) Maternal anemia is a major cause of abrution a) Ectopic pregnancy
C) Fetus is not usually affected b) Pregnancy of diabetic mothers
D) It is associated with antecedent hypertension c) Fetus with down syndrome
141. A patient who just delivered her third child had severe d) Incomplete abortion
bleeding post-delivery, while still on the delivery table. 152. The following are unique complication of
What should be the first line of management? monochorionic pregnancies EXCEPT?
A) Uterine packing a) Twin to twin embolism syndrome
B) Insert misoprostol per-rectally b) Twin reversed arterial perfusion sequence
C) Administer carboprost intramuscularly c) Discordant for anomaly
D) Shout for help d) Selective fetal growth restriction
142. Regarding Intra uterine contraceptive device (IUCD), 153. In placenta Previa: Which is true?
which statement is TRUE a) It is commoner in primigravida
A) Reduces pelvic inflammatory disease b) May cause abnormal lie
B) Inhibits ovulation c) Causes recurrent painful bleeding
C) Increases incidence of endometrial cancer d) Digital examination is mandatory
D) If pregnancy occurs, there is increased risk of ectopic 154. For intrauterine fetal transfusion in Rh isoimmunized
pregnancy pregnancies with severe fetal anemia, blood used is of
143. The mechanism of action of OCPs include all the which blood group?
following, EXCEPT: a) positive c) AB positive
A) Enhances ovarian androgen production b) negative d) AB positive
B) Alter the cervical mucous. 155. The best uterine scar a patient can have for Caesarian
C) Alter the endometrium. section is
D) Ovulation suppression. a) Transverse upper segment
144. What is true of the device “Essure”? b) Longitudinal upper segment
A) It is a method of male sterilization c) Transverse lower segment
B) It is a laparoscopic method of female sterilization d) Classical Cesarean section
C) It is a hysteroscopic method of female sterilization 156. All are true of Zika virus infection in Pregnancy
D) It is a type of a instrument used to decrease blood loss in EXCEPT?
atonic uterus a) It is a neurotropic virus
145. What is the appropriate time for an Triple Screen ? b) It is caused by the bite of culex mosquito
A) 11-14 week c) Infection in first trimester may lead to fetal microcephaly
B) 11- 13+6 week d) There is no treatment available at the moment
C) 16-18 week 157. A pregnant woman presents with a central placenta
D) 18-20 week previa and fetus is malformed. Which of the following will
146. Which of the following neonatal complication is NOT be the best management?
related to forceps delivery? a) Caesarean section
A) Fractured skull b) Oxytocin drip
B) Skin laceration c) Rupture of membranes
C) Cephalohematoma d) Induce with PG E2
D) Chignon 158. The commonest site of ectopic pregnancy is:
147. Pre-requisite for outlet forceps delivery include all of a) Peritoneal cavity c) Ovary
the following EXCEPT: b) Mesosalpinx d) Ampulla of the fallopian tube
A) Cervix fully dilated and fully effaced 159. The most common cause of ectopic pregnancy is:
B) Ruptured membranes a) History of pelvic inflammatory disease
C) Fetal head at 0 station b) Congenital anomalies of the tube
D) Empty bladder. c) Endometriosis
148. The following are absolute indication for cesarean d) Tubal surgery
section EXCEPT: 160. Treatment of choice for hydatidiform mole?
A) Face presentation a) Suction and Evacuation
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 b) Hysterectomy b) Malabsorption syndrome
c) Hysterotomy c) Non-compliant patient
d) Cesarean Section d) Allergy to iron sucrose
161. Most common structural anomaly in fetuses of diabetic 174. A 32 year primigravida comes to the antenatal clinic at 33
mothers is ? weeks of gestation. What clinical features would prompt a
a) Central Nervous System c) Renal preterm delivery in this lady :
b) Cardiac d) Skeletal a) Diastolic BP > 110 mmHg despite the adequate use of
162. The following risk is not increased in a pregnancy with the appropriate antihypertensive agents.
diabetes? b) Platelets count less than 50,000/cu. mm
a) Fetal structural malformation c) Markedly Elevated liver enzymes.
b) Aneuploidy d) All of the above
c) Polyhydramnios 175. Consent of how many doctors is needed for MTP till 12
d) Macrosomia weeks of pregnancy
163. Most specific malformation in a fetus of a mother with a) Three b)Two c)One d)Four
diabetes? 176. What is the legal limit of medical termination of pregnancy
a) Ventricular Septal Defect in India?
b) Transposition of Great Vessel a) 18 weeks period of gestation
c) Caudal Regression Syndrome b) 22 weeks period of gestation
d) Skeletal Dysplasia c) 20 weeks period of gestation
164. First trimester screening for Aneuploidy includes d) 24 weeks period of gestation
testing for 177. Induction of labour can be allowed in which obstetrical
a) Unconjugated Estriol and PAPP -A condition?
b) Inhibin A and PAPP-A a) Central Placenta Previa
c) β HCG and PAPP-A b) Twin pregnancy with first twin breech
d) MSAFP and PAPP-A c) Previous one full term lower segment cesarean
165. Which of the following is not an ultrasound marker for d) Contracted pelvis
Down syndrome ? 178. A 30-year-old unbookedprimigravida with twin gestation
a) Presence of nasal bone at 25 weeks presents to labor room with irregular uterine
b) Increased nuchal translucency contractions and very light vaginal bleeding. Which of the
c) Echogenic bowel following is the most appropriate first step in the evaluation
d) Choroid plexus cyst of vaginal bleeding in this patient?
166. WHO recommended dose of oral misoprostol for a) Vaginal examination to determine cervical dilatation
prevention of post-partumhemorrhage is_____ µgm? b) Urine culture to check for urinary tract infection
a) 100 b)200 c)400 d)600 c) Ultrasound to check placental location
167. Which type of hepatitis viral infection is particularly d) Lab test to evaluate for disseminated intravascular
associated with high maternal mortality during pregnancy? coagulopathy
a) Hepatitis E virus 179. After caesarean section, the blood soaked linen is disposed
b) Hepatitis C virus in the following color coded bucket?
c) Hepatitis D virus a) Blue b)Red c)Yellow d)Black
d) Hepatitis B virus 180. Which is an indication of intrauterine blood transfusion in a
168. Which of the following drug is not given for urinary Rh iso-immunized pregnancy?
tract infection during pregnancy a) MCA PSV <1MOM
a) Tetracycline c) Fosfomycin b) MCA PSV 1-1.29 MOM
b) Nitrofurantoin` d) Cephalosporin c) MCA PSV 1.29-1.5 MOM
169. Specific antidote for magnesium sulphate toxicity is ? d) MCA PSV > 1.5MOM
a) Naloxone 181. Name the National health program that entitles all
b) Nalorphine pregnant women with free transport for delivery, treatment,
c) Calcium gluconate drug, diagnostics and diet
d) Calcium sulphate a) JSSK (Janani Shishu Suraksha Karyakram)
170. Partogram should be plotted after the following cervical b) PMSMA (Pradhan MantriSurakshitMatritvaAbhiyan)
dilatation has been reached? c) JSY (Janani Suraksha Yojna)
a) 1cm b)3cm c)2cm d)4cm d) RKSK (Rashtriya Kishore SwasthyaKaryakram)
171. The following is true about cephalhaematoma 182. Fetus is said to have growth restriction if the estimated fetal
a) Always present at birth weight on USG is less than
b) It is limited by the suture line a) 5th percentile for that POG
c) Always lies over a suture line b) 10th percentile for that POG
d) There is impulse on crying c) 15th percentile for that POG
172. Most common uterine anomaly associated with recurrent d) 20th percentile for that POG
pregnancy loss is____________uterus 183. The main form of hemoglobin in the normal fetus is which
a) Bicornuate c) Arcuate of the following?
b) Septate d) Unicornuate a) Gower 1
173. All are the indications of parenteral iron therapy b) Hemoglobin A (HbA)
EXCEPT: c) Bart’s hemoglobin
a) Intolerance to oral iron d) Hemoglobin F (HbF)
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184. Couvelaire uterus is found in which clinical obstetric a) 3% b)6% c)9% d)12%
condition? 196. Lovsetmanoeuvre is performed in which clinical condition?
a) Placenta Previa a) Delivery of extended arms in breech presentation
b) Abruption b) Delivery of nuchal arm in breech presentation
c) Vasa previa c) Delivery of after coming head of breech
d) Atonic uterus d) Delivery in brow presentation
185. Which of the following is not a drug for the management 197. Velamentous insertion of the cord is associated with an
of hyperemesis gravidarum? increased risk for
a) Pyridoxine a) Premature rupture of membranes
b) Thalidomide b) Fetal bleeding before onset of labour
c) Doxylamine c) Torsion of the umbilical cord
d) Ondensetron d) Fetal malformation
186. Drug of choice of Hepatitis B in pregnancy if the HBV 198. A patient who delivered 12 hours ago, requests you for a
DNA load is high? post-partum ligation. After how much time of vaginal
a) Tenofovir c) Interferon delivery can post-partum sterilization be performed?
b) Ritonavir d) Lamivudine a) 12 hours c)48 hours
187. Which of the following condition is NOT associated with b) 24 hours d) 7 days
symmetrical fetal growth restriction? 199. Which one of the following is rapid method of testing for
a) Fetal infections trisomy 21 in an amniotic fluid sample?
b) Major congenital malformation a) Karyotype
c) Diabetes b) QFPCR
d) Fetal Aneuploidy c) Whole genome analysis
188. An antenatal patient presented with polyhydramnios, which d) None of the above
of the following drug might be useful? 200. Which one the following investigation will not routinely be
a) Progesterone c) Indomethacin prescribed to a pregnant lady who comes for her first
b) beta- blocker d) Furosemide antenatal visit to the OPD?
189. Most common uterine anomaly in general population is a) Blood group c) HbsAg
a) Arcuate uterus b) Hemoglobin d) TPH
b) Bicornuate uterus
c) Unicornuate uterus
d) Septate uterus
190. Cervical sign which might be used for diagnosis of
pregnancy is:
a) Jacuemier’s sign
b) Hegar’s sign
c) Osiander’s sign
d) Goodell’s sign
191. Which is not an invasive test for screening for aneuploidy
a) Amniocentesis
b) Chorionic Villous Sampling
c) Cordocentesis
d) Cell free fetal DNA
192. A primigravida at 8 weeks POG came to the ANC OPD for
checkup. Her Blood group was found to be B Neg. What
should be the next step in her management.
a) Get ICT titre
b) Husband Blood Group
c) Husband DNA Analysis
d) Advise MTP
193. What dose of anti D injection is to be administered to a Rh
negative ICT negative mother following Amniocentesis?
a) 300 microgram
b) 50 microgram
c) 120 microgram
d) 150 microgram
194. A patient with B negative blood group, husband blood
group AB+, ICT positive came at 28 weeks to ANC OPD
carrying an USG report showing fetal hydrops. What is the
best line of management
a) Do an MTP
b) Delivery the baby
c) Transfuse O negative blood to mother
d) Intrauterine blood transfusion
195. What is the incidence of breech at term?
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