FMGE Past Questions - Obs And Gynae -05

Gestational trophoblastic disease refers to a group of rare tumors that develop in the cells that would normally form the placenta during pregnancy. The question asks about the highest incidence of this disease, and the correct answer is Asia. This is because gestational trophoblastic disease is more common in Asian countries compared to other regions such as Australia, North America, and Western Europe. The incidence of this disease may vary due to various factors including genetic predisposition, lifestyle, and healthcare practices in different regions.

The risk factors associated with macrosomia include maternal obesity, prolonged pregnancy, and previous large infant. Short stature, on the other hand, is not typically considered a risk factor for macrosomia.

A shorter cervical length is associated with an increased risk of preterm delivery. This is because the cervix plays a crucial role in supporting the pregnancy and keeping the fetus inside the uterus until full term. A shorter cervix may indicate cervical insufficiency, which means that the cervix is unable to stay closed and firm during pregnancy, increasing the risk of preterm labor and delivery. Therefore, a cervical length of 2.5 cm is more likely to be associated with an increased risk of preterm delivery compared to longer cervical lengths.

Aspermia is the term used to describe the absence of semen. Semen is the fluid that is released during ejaculation and contains sperm. Therefore, if there is no semen present, it means that there is no fluid being released during ejaculation. This can be caused by various factors such as blockages in the reproductive system or hormonal imbalances.

Nuchal edema is associated with the greatest increased risk for trisomy 21 in the fetus. Nuchal edema refers to the accumulation of fluid at the back of the fetal neck, which can be detected through ultrasound. It is a soft marker for trisomy 21 and is often seen in affected fetuses. Echogenic foci in the heart, hyperechogenic bowel, and choroid plexus cysts are also ultrasound markers for trisomy 21, but they are not associated with as high of a risk as nuchal edema.

The correct answer is the interspinous diameter. The true pelvis is divided into three planes: the inlet, the midplane, and the outlet. The interspinous diameter refers to the distance between the two ischial spines, which is the narrowest part of the midplane. It is an important measurement in obstetrics as it determines the ability of the baby's head to pass through the pelvis during childbirth.

During the period of 10-12 weeks of gestation, the chorion villous biopsy is considered to be the best time for prenatal diagnosis. This is because during this time, there is a sufficient amount of fetal tissue available for sampling, and the risk of complications is relatively low. Additionally, at this stage, the chorionic villi are well-developed and can provide accurate genetic information for prenatal testing.

Dysgerminoma is the most common pure germ cell tumor of the ovary. Germ cell tumors arise from the cells that give rise to eggs in the ovary. Dysgerminoma is a malignant tumor that usually occurs in young women and is characterized by large, uniform cells with clear cytoplasm. It is highly sensitive to radiation and chemotherapy, making it a treatable tumor. Choriocarcinoma is a rare and aggressive tumor, embryonal cell tumor is a type of malignant tumor that contains tissues from all three germ layers, and malignant teratoma is a tumor that contains tissues from multiple germ layers and can be benign or malignant.

Androgen insensitivity syndrome (AIS) is a condition where individuals with male chromosomes (XY) have a reduced ability to respond to male sex hormones (androgens). This results in incomplete development of male sexual characteristics. The karyotype of a patient with AIS is typically 46 XY, meaning they have 46 chromosomes with the presence of both X and Y sex chromosomes. This is because individuals with AIS have a mutation in the androgen receptor gene on the X chromosome, which affects the body's response to androgens. Therefore, the correct answer is 46 XY.

Seizure frequency does not increase in approximately 70% of women with epilepsy during pregnancy.

Misoprostol is a medication that is commonly used in gynecology and obstetrics. It is effective in the induction of labor, prevention of post-partum hemorrhage, and treatment of missed abortion. However, it is not typically used for the treatment of menorrhagia, which refers to abnormally heavy or prolonged menstrual bleeding. Therefore, the correct answer is menorrhagia.

Infants of diabetic mothers have an increased risk of developing congenital heart defects, with the most common being transposition of the great arteries. In this condition, the positions of the pulmonary artery and aorta are switched, leading to poor oxygenation of the blood. This anomaly requires surgical intervention soon after birth to correct the positioning of the arteries and improve blood flow.

Misoprostol is not helpful in the treatment of ectopic pregnancy because it is a prostaglandin analog that is primarily used for medical abortion and to induce labor. It is not effective in treating ectopic pregnancy, which is a potentially life-threatening condition where the fertilized egg implants outside the uterus. Methotrexate is commonly used to treat ectopic pregnancy by stopping the growth of the embryo, Actinomycin-D is an anticancer drug that can be used in the treatment of gestational trophoblastic disease, and RU 486 (Mifepristone) is another medication used for medical abortion but not specifically indicated for ectopic pregnancy.

Gestational diabetes is not a cause of intrauterine growth retardation. Intrauterine growth retardation refers to the poor growth of a fetus during pregnancy. It can be caused by various factors such as anemia, pregnancy-induced hypertension, and maternal heart disease. However, gestational diabetes, which is a condition characterized by high blood sugar levels during pregnancy, does not directly cause intrauterine growth retardation. Instead, it can lead to other complications such as macrosomia (large birth weight) in the baby.

Amniotic fluid acetyl cholinesterase is the most sensitive biochemical parameter to detect open spina bifida. Acetyl cholinesterase is an enzyme that is produced by the fetus and is present in higher concentrations in the amniotic fluid when there is a neural tube defect such as spina bifida. Therefore, measuring the levels of acetyl cholinesterase in the amniotic fluid can help in the early detection of open spina bifida. Maternal serum alpha fetoprotein and amniotic fluid alpha fetoprotein are also used as markers for neural tube defects, but amniotic fluid acetyl cholinesterase is considered to be the most sensitive. Amniotic fluid glucohexaminase is not a marker for open spina bifida.

Raloxifene is a medication that belongs to a class of drugs called selective estrogen receptor modulators (SERMs). It is primarily used to prevent and treat osteoporosis in postmenopausal women. Unlike other options listed, such as androgens, isoflavones, and tibolone, which have shown some efficacy in reducing hot flushes, raloxifene has not been found to have a significant impact on hot flushes in menopausal women. Therefore, the correct answer is raloxifene.

The diaphragm is the ideal contraceptive for a patient with heart disease because it does not contain any hormones that could potentially worsen the condition. Unlike oral contraceptive pills and Depo-provera, which contain hormones, the diaphragm is a barrier method that does not affect hormone levels in the body. Additionally, the diaphragm does not require any surgical procedures like IUCD, making it a safer option for a patient with heart disease.

In a case of dysgerminoma of the ovary, serum lactic dehydrogenase is likely to be raised. Dysgerminoma is a type of germ cell tumor that commonly occurs in the ovary. Serum lactic dehydrogenase (LDH) is a non-specific marker that can be elevated in various types of malignancies, including dysgerminoma. LDH is an enzyme that is released from cells when there is tissue damage or cell death. Therefore, an increase in LDH levels can indicate the presence of an active tumor and can be used as a marker for monitoring treatment response or disease progression in dysgerminoma.

Cholera vaccination is absolutely contraindicated in pregnancy because the safety of the vaccine has not been established for pregnant women. It is important to avoid any potential risks to the developing fetus, and therefore, pregnant women should not receive the cholera vaccine.

The correct answer is Endometrial tuberculosis. Endometrial tuberculosis is a common cause of secondary amenorrhoea in India. Tuberculosis can affect the reproductive organs, including the endometrium, leading to inflammation and scarring. This can disrupt the normal menstrual cycle and result in amenorrhoea. Premature ovarian failure is another possible cause of secondary amenorrhoea, but it is not as common in India as endometrial tuberculosis. Polycystic ovarian syndrome is a hormonal disorder that can cause irregular periods, but it is not typically associated with secondary amenorrhoea. Sheehan's syndrome is a condition where the pituitary gland is damaged during childbirth, leading to hormonal imbalances and amenorrhoea, but it is not as common as endometrial tuberculosis in India.