ENT Paper For Final Prof.2013 (A) The Bold Option is KEY:

1. With regard to cochlea, which of the following statement is false: a. It is completely embedded in the temporal bone

b. It is divide into three canals along its length by membranes c. The scala media is filled by perilymph fluid d. The scala vestibuli and scala tympani meet at the apical and of cochlea, called the helicotrema e. The steps is set into the oval window, which conducts sound waves along scala vestibule

2. The following structures drain into the middle meats of nose except: a. Frontal sinus b. Maxillary sinus c. Anterior ethmoid sinus

d. Nasolacrimal duct e. None of the above

3. Sphenoid sinus drains into the:

a. Superior meatus b. Middle Meatus c. Inferior Meatus d. Between the middle and inferior turbinates

e. Sphenoethmoidal recess 4. Which of the following cranial nerves are related to middle ear cavity?

a. Facial and vestibulocochlear

b. Vestibulocochlear and trochlear c. Trochlear and abducent. d. Vestibulocochlear and glossopharyngeal e. Glossopharyngeal and vagus

5. Damage to the littles area or Kiesselbachs plexus results in: a. Nasal bleeding b. Anosmia c. Cacosmia

d. Rhinophyma e. Deviated Nasal Septum

6. Cochlear duct is another name for:

a. Scala vestibule b. Scala tympani c. Scala media d. Semicircular canal

e. Helicotrema

7. Which of the tonsils are located between the palatoglossal and palatophargeal arches: a. Pharyngeal tonsils

b. Lingual tonsils c. Tubal tonsils d. Palatine tonsils

e. Adenoids

8. Superior Meatus is the area: a. Above the superior turbinate

b. Posterior ethmoid cells open into it c. Drains the sphenoid sinus d. Lies between the middle and inferior turbinates

e. Same as Sphenoethmoidal recess 9. Waldeyers Ring that surround the opening into respiratory and digestive system is a r ing of:

a. Blood vessels b. Nerves

c. Lymphatic tissue d. Muscles e. Lymph Nodes

10. What is the most common cause of acute epiglottis in children: a. Hemophilus influenza type B b. Diphtheria

c. Cytomel virus d. Hepatitis B virus

e. None of the above 11. Vestibular schwannoma, commonly originates form:

a. Superior vestibular nerve

b. Inferior vestibular nerve c. Cochlear nerve d. Vagus nerve e. Optic nerve

12. Rhinitis medicamentosa is caused by: a. Viral infection b. Bacterial infection

c. Trauma d. Cold water e. Over medication with local nasal decongestants

13. A peritonsillar abscess suppurative occurs: a. With in the tonsil lar capsule b. With in the tonsil lar tissue c. Outside the tonsillar capsule

d. None of the above e. In the nasopharynx

14. Corynebacterium diphtherias is sensitive to following antibodies:

a. Penicillin and erythromycin b. Sulfonamides c. Tetracyclines d. None of the above

e. Gentamycin

15. The scroll like bony projections form which part of the nasal cavity?

a. Lateral wall b. Medial wall c. Roof d. Floor

e. Anterior and inferior part

16. Plummer Vinson syndrome chartered by: a. Dysphagia microcytic anemia stomatitis, koilonychias

b. Naral obst , head ache c. None of the above d. Oval ulceration and covedidiasion

e. Dysphgiven with gattine ulcerative 17. Achalasia cardia:

a. Caused by viral infection b. Barium swallow and lymps dilated & lengthen esophagus

c. Caused by iron deficiency of vitamin d. All of the above e. No surgical treatment

18. Achalasia cardia:

a. Is due to defect in intermural vagal supply (Auerbachs myenteric plexus) b. Is treated with antibodies c. Is characterized by dial Latin of lover part of esophagus

d. Is a neoplastic cordilim e. Is caused by bacterial infection

19. Tracheostomy is performed in following condition Except : a. Relief of upper airway obstruction

b. Bronchial toilet c. To reduce the dead space d. To improve nasal breathing

e. Assisted ventilation

20. Du tracheotomy: a. Incision is made between cricoid & first tracheal ring

b. Incision in made between thyroid and cricoid cartilage c. A vertical incision is made through third and fourth tracheal rings d. Thyroid earth large is cut vertically e. Incision is made between Thyroid and hyoid bone

21. Secretory otitis media:

a. Has no medical treatment

b. Treated surgically by myringotomy and Grommet insertion c. Is traded by antiviral drug d. Is not diagnosed by Audiological Tests e. None of the above

22. A 45 year old patient presented with 2 months history of right sided upper neck and left Ear hard of hearing. a. Most likely diagnosis is Nasopharyngeal carcinoma b. Nasal Polyp

c. Sinusitis d. Radiological in verlogitive and not helpful e. None of the above

23. A 13 years male permitted with left sided novel bleeding on examination soft palate on left sided is pushed done and

there is lobular pain mass in narophyal. a. Most likely diagnosis is nasopluycal angiofibroma b. It is cause by viral infection c. Cannot treated surgically

d. Commonly occurs in female e. Occurrence mostly in old age grand

24. What is the most common site of Epistaxis in nose: a. Floor of nose b. Lateral wall of nose c. Inferior turbinate

d. Superior part of septum e. Littles area

25. Rhinophyma: a. Is caused by hypertrophy of sebaceous glands of Ext nose b. Is a viral infection c. Is a dermoid cyst

d. Is caused by trauma e. None of the above

26. Furuncle (Boil) nose: a. Is acute infection of hair follicle by staphylococcus a occurs:

b. Is caused by trauma c. Is caused by viral infection d. Antibodies have no role

e. None of the above 27. Otosclerosis:

a. Is best diagnosed by tympariotony b. Occurs always in old age

c. Common symptom is headache d. Caused by bacterial infection e. Mostly treatment is medical

28. All of the following are the clinical features of chronic Rhinitis Except:

a. Nasal obstruction b. Dysphagia c. Headache

d. Swollen turbinates e. Post nasal discharge

29. A 60 years old male prevented with unilateral hearing loss, fascial weabren with numbers of same sided. He also

gives the history of Episodic vertigo: a. Most likely diagnosis is murium dussion b. Patient is suffering from Accusative neesmoae

c. Radiological in oscitation are not helpful d. Surgical treatment is of no value e. Patient is suffering from vasal infection

30. A lady of 30 years old presented with Episoldive vertigo tetanus and having loss during the episodes vertigo is rot ator

associated with nausea and vomiting: a. Mostly likely diagnoses is murium fusion b. Is caused by vestibular neuritis c. Is caused by alcohol ingestion

d. Describe is usually treated with antibodies e. Death in this dessert is caused by respiratory arrest

31. A young lady prevented with episodic vertigo, associated which nausea and vomiting. There is no history of hearing loss during uretero CT scan is normal:

a. Most likely diagnosis is vestibular neuritis b. Patient in suffering from Acoustic newcomer

c. Patient will be treated surgically d. It is a contagious disease e. None of the above

32. Following are the complication of cholesteatoma: a. Dysphagia b. Epistaxis c. Deafen

d. Facial nerve palsy e. Logical nerve palsy

33. A 21b years old man attends the ENT clinic with recrement otitis media and a red painful. Swelling behind the Ear consultant informs you that the patient is having mast otitis , which of the following are possible completion of their

condition. a. Lung cancer b. Intra cranial abscess

c. Irritable bond syndrome d. Osteitis e. Laryngeal stenosis

34. Which of the following is the cause of progressive hearing loss : a. Parotitis b. Lung cancer

c. Sudden head Trauma d. Otosclerosis e. Acute otitis media

35. Which of the following may be the cause of Eustachian tube Blockage:

a. Adenoid hypertrophy b. Enlarge tongue c. Acute otitis Ext d. Chronic tonsill itis

e. Hypertrophy of lexical tonsil

36. Which of the following is the indication for the in section of grommet:

a. Laryngeal cancer b. Otitis Externa c. Parotitis d. Glue Eams

e. Adenoid hypertrophy 37. With regard to mexiters disease the following st atements is true:

a. It is charactersed by the triad of deafness, vertigo and tinnitus b. Audiometry will show conductive hearing loss

c. It is treated with antibodies d. It can cause fascial paralysis e. All of the above

38. Following are the causes of dizziness except:

a. Meniere's disease b. Cardiac Arrhythmias

c. Poorly controlled diabetes d. Migraine e. Oral ulceration

39. With regard to labyrinthitis following statements are true Except:

a. It can be a complication of upper respiratory tract infection b. It may cause hearing loss

c. Vestibular suppressants are used in its treatment d. It may be caused by viruses and bacteria e. It is caused by drugs

40. Hearing loss is caused by following drugs except:

a. Streptomycin b. Gentamycin c. Tobramycin

d. Cephradine e. Aspirin

41. With regard to Ram by heart syndrome, the following statements are true except:

a. It may present with fascial palsy, hearing loss and vertigo b. It can be differentiated by bells palsy by the presence of cutaneous vesicles in the Ear canal c. It is caused by viral infection

d. It may be treated by acyclovir and prednisone e. It can lead to brain abscess

42. With regard to benigor paroxysmal postanal vertigo, which statements is false:

a. It may present with severe vertigo while facing a contain direction b. Symptoms may be elicited by the dix Hallpike manicure c. It is caused by the presence of oto leth moving with in semi cellular canals d. It may be treated by epley manoeuvone

e. It is cause by to toxic drugs

43. With regard to Acoustic Neuroma following statements and true Except:

a. It is vestibular nerve schwas all neoplasm b. It may present with hearing loss and vertigo c. It is associated with fascial plasy d. Can be diagnosed by radiological

e. It is a malignant disease

44. Causes of conductive hearing loss includes the following Except:

a. Acoustic neuroma b. Otosclerosion c. Cholesteatoma d. Otitis media with effusion

e. Acute otitis media

EYE PAPER FOR FINAL PROF the Bold Option is KEY

1. Chlamydia trachomatis serotype D causes: a. Trachoma b. Non-specific Keratitis

c. Adult Allergic conjunctivitis d. Ophthalmianeonatorum e. Lymphogranulomavenerum

2. Corynebacteria:

a. Are gram-positivecocci b. Are a normal commensal in Aqueous

c. Cause membranous conjunctivitis d. Cause phylctenular conjunctivitis e. Are widely resistant to antibiotics

3. Features of POAG (Primary Open angle glasscoma) include:- a. Ianglion cell loss b. Photoreceptor loss

c. Fixed dilated pupil d. Normal lamina cribrosa e. Narrowing of pial septa in optic nerve

4. Herpes viruses: a. Are RNA virsus b. Include varicella zoster virus

c. Include pox virus d. Does not Included Epstein Barr virus e. Does not Include cytomegalo virus

5. Vitamin A: a. Is stored primarily in retina b. Is fat-slobule c. Overdose can cause corneal melting

d. Milk is a poor dietary source e. Deficiency cannot be caused by renal disease

6. Aqueous humour: a. Is not formed by ultrafillration b. Is not formed by active secretion c. Is formed by diffusion

d. Differs from plasma by presence of protein e. Has the same content of vitamin C as plasma

7. The following statements about the lens are true:

a. Water content is 70% b. Protein content is 10% c. Has a higher sodium content than aqueous humour

d. Has a low potassium content than A-humour e. Lens fibers develop upto the age of 14 years.

8. Regarding human Eye:-

a. All refractive errors are corrected to 6/6 with a pin hole b. In an uncorrected hypermetropia the image falls behind the retina c. In myopia (uncorrected) the image falls behind the retina

d. Minus lens is used to correct Astigmatism e. Astigmatism is corrected with plus lens in the prescription

9. Regarding the indirect Ophthalmoscope: a. The field of view is largest in hypermetropia b. The field of view is largest in myopia

c. The field of view is several times larger than direct ophthalmoscope d. The image of patients rehina is virtual

e. The image of patients retina is erect

10. The following statement are true:-

a. Direct ophtalmoscopy is more useful than indirect ophthalmoscopy in patients with opacities of ocular media: b. Distant direct ophthalmoscopy is performed at metre c. The imbertfick principle is used to measure IOPs in schiotz tonometer. d. The principal of applanation tonometer is impertfick principal where IOP= F/A where A is 3.06 mm in area.

e. The distant direct ophthalmoscopy does not gives information about Keratoconus

11. The following lid tumors have malignant potential:

a. Basal cell papillomas b. Xanthelasma c. Kerotoacanthoma. d. Capillary haemangioina

e. Neurofibroma

12. In an elderly patient with acute Dacryocystitisyou would: a. Perform probing to confirm obstruction of Nasolaroimal duct

b. Prescribe oral antibioitics c. Advise crigler massage d. Perform immediate DCR

e. Acute ethmoid sinusitis is not a possible D/D

13. Vitamin A deficiency is:

a. Common is young girls b. Causes night blindness c. Ganglion cell less in retina

d. Bitots spots in the retina e. Caused by renal disease

14. Orbital cellulitis: a. Is most frequently caused by sinus infection

b. Is usually not accompanied by fever c. Does not cause motility disturbance d. Genticin is an appropriate antibiotic

e. Frequently causes intracranial infection in children.

15. Sub conjuctivalhaemorrhage is a typical feature of: a. Fungal Keratitis

b. Adenoviral conjunctivitis c. Corneal ulcer d. Ophthalmianeonatorum e. Subarachnoid harmorrhage

16. Allergic conjunctivitis :

a. Is seen more commonly seen in young females

b. Is often bilalteral and symmetrical c. Is associated with keratoconus d. Can be seen only in atopic patients e. Is not associated with Keratoconus

17. The following statements about trachoma are true:-

a. Is seen more commonly is urban than rural populations in developing countries. b. In the acute phase, conjunctivalpapillae are seen

c. In the acuite phase conjuctival follicles are seen d. Vaccinat on is used in prevention e. Surgery is recommended in acute stage

18. The following statement about Keratoeonus are true:-

a. Results in regular myopic astigmatism b. Results in irregular myopic astigmatism

c. Results in irregular hyperopic astigmatism d. Causes corneal perforation. e. Is not corrected with contact lens

19. Cataract is caused by: a. Hypertension b. Basal cell carcinoma

c. Blephritis d. Drysyes e. Smoking

20. The complications of cataract surgery are: a. Proptosis b. Corneal ulcer

c. Endophthamitis d. Ectropion e. Poor Pupil dilatation

21. Before Contemplating cataract surgery:

a. Pupillary reaction should be checked b. Cataract surgery can be performed if theres active corneal ulcer c. Regurgitation test is not advisable d. Relative afferent papillary defect (RAPD) is often seen in a mature cataract.

22. In ENDOPIATHAL MITIS:

a. Red reflex is often seen in severve cases

b. There is serveve pain in mild endophthalmitis c. Hyphemais often present d. Visual loss is seen e. Herpes simple is a common causative organism in acute endophthalmitis

23. Clinical Features of Keratitis:

a. Is not painful

a. not associated with purulent discharge b. associated with RAPDKeratic precipitates (KPs) c. KPS are seen often d. May lead to corneal perforation

24. In Acute Angle Closure Glaucoma there is:

a. Brisk reacting pupil b. Anterior Chamber is Shallow

c. Pupil is fixed and constricted d. There is no corneal Oedema. e. Keratic precipitates are present

25. Clinical Features of acute uveitis are:

a. No Pain b. Floaters

c. Diffuse redness of conjunctiva d. Keratic Precipitates (KPs) e. No Photophobia

26. Relative Afferent Papillary Defect (RAPD) is seen in: a. a mature cataract b. Vitamin A deficiency

c. Viral Keratitis d. Retinal detachment e. Hypertensive retinopathy

27. Optic neuritis is associated with: a. Headache b. Normal closer vision

c. No Visual Field defects d. Raised intraocular pressures e. Myasthenia graris

28. Macular oedema may be seen in:

a. Diabetic retinopathy b. Viral Keratitis c. Optic neutitis d. Blood dyscrasias

e. Central retinal artery occlusion

29. Causes of Acute anterior uvetitis:

a. Sarcoidosis b. Ankylosing Spondylitis c. Behcets Disease d. Jurenile chronic arthritis

e. Acute angle closure glaucoma

30. In Chemical burns of the Eye:

a. It is essential to take a good detail history first b. Frequent eye wash is advisable c. Cataract is not a complication d. VitA should be prescribed in high dose.

e. Steroids are used in second week on wards

31. In diabetic retinopathy: a. Microaneurysms are located in the outer nuclear layer

b. Microaneurysms are the last clinically detectable signs c. Macular ocdema is the most common cause of visual loss in background diabetic retinopathy d. Hard exutates are located in the outer vasuler layer

e. Vitreous harmmarrhage is a complication of background diabetic retinopathy

32. Hypertensive Retionpathy may cause: a. Venous constriction

b. ArterioConstriction c. Myelinated disc fibers d. Optic neuritis

e. Papilloedema

33. Acute sixth nerve palsy. a. May be caused by Diabetes

b. May be caused by Leukeamia c. Causes vertical diploia d. Causes Divergent squint e. Cannot be treated with prisms

34. Causes of Congenit al cataract are:

a. Toxoplamosis

b. Developmental disorders of lens c. Cytomegalovirus d. Dehydration e. Herpes

35. Cause of Proptosis are:

a. Thyroid ophthalmopathy b. Viral keratitis

c. Acute dacryocystitis d. Lid tumours e. Squint

36. PTOSIS may be associated with:

a. Uveitis b. Optic neuritis

c. Fourth Nerve palsy d. Third Nerve Palsy e. Cataract

37. The Clinical Features of Retinoblastoma are: a. Preseptal cellulitis b. White pupillary reflex (leukokoria) c. Keratitis

d. Optic Neuritis e. Conjunctivitis

38. The following are not notifiable eye diseases:

a. Trachoma b. Diabetic retinopathy c. Ophthalmianeonatorum

d. Vitamin A deficiency e. Adenoviral Conjunctivitis

39. Preventable eye disease leading to blindness are: a. Adenoviral conjunctivitis

b. Cataract c. Central vein occlusion d. Optic neuritis

e. Trachoma 40. Clinical features of CRVO (central retinal vein occlusion) are:

a. Cherry red spot b. VitHaremerrhage

c. RehinalHaemarrhage d. Focal arteriolar constriction e. Cattle trucking

41. In central Retinal artery occlusion, on fundoscopy you see: a. Extensive retinal harrmmarrhages b. Cattle trucking

c. Normal retina d. Macular star e. No Cherry red spot on macula

42. Retinal detachment is caused by:

a. Trauma b. High Hyperopia c. Astigmatism

d. DCR e. Hypertension

43. Sudden visual loss may be due to: a. Keratitis

b. Primary Open angle glaucoma c. Central retinal vein occlusion d. Refractive Error e. Uveitis

44. Clinical Features of proliferative diabetic retinopathy are :

a. New vessels onthe disc (NVD)

b. Tractional retinal detachment c. Neavascular glaucoma d. Macular oedema e. Vitroushaemorrhage

45. Gradual painless loss of vision may be due to: a. Allergic conjunctivitis b. Keratoconus c. Vitamin D deficiency

d. Chalazion e. Retinal detachment

46. The following clinical features in adiabetic patient needs early referral to ophthalmologist:

a. Background diabetic retinopathy with large exudates involving macula. b. Normal fundus c. Early lenticular opacities d. Mild Background diabetic retinopathy.

e. Refractive error

Department of Gynae & Obst Paper A JINNAH MEDICAL COLLEGE PESHAWAR

Final Year MBBS Comprehensive Examination 2014 MCQs

Time Allowed: 1 hr Tot al marks: 40

Note: SECTION- A

1. Which is not true of CVB:

a. Abortion

b. Infection

c. Fetomaternal hemorrhage

d. Fetal malformation

2. Which of the following drugs cause neonatal

jaundice:

a. Vitamin K

b. Syntocinon

c. Aspirin

d. Methyl dopa

e. All of the above

3. Which of the following drugs does not cross the

placenta:

a. Warfarin

b. Insulin

c. Metformin

d. Tetracycline

4. Which of the following is not the feature of

fulminating PIH:

a. Blurring of vision and diplopia

b. Headache

c. Oliguria

d. BP 180/110 mm Hg

5. What is the dose of prophylactic Anti- D globulin after

the delivery:

a. 100 g IM

b. 200 g IM

c. 350 g IM

d. 400 g IM

6. Coagulation failure is seen in all of the following

except:

a. Abruption

b. Retained dead fetus

c. Missed abortion

d. Placenta praevia

7. Traumatic delivery can cause which of the following:

a. Bladder fistula

b. Incontinence of faces

c. Stress incontinence

d. Incompetent os

e. All of the above

8. Which of the following complication do not occur

during pregnancy in a macrosomia fetus:

a. Cephalopelvic disproportion

b. Abnormal presentation

c. Hydramnios

d. Oligohydramnios

9. In which of the following cases might internal podalic

version be indicated.

a. Vertex delivery of first twin and breech

presentation of 2nd

twin.

b. Term transverse lie with cx fully dilated and

membranes intact

c. Impacted shoulder presentation

d. Compound presentation

10. What is the maximum normal time for the 2nd

stage of

labour in primigravida without anesthesia?

a. 20 minutes.

b. 60 minutes.

c. 120 minutes.

d. 240 minutes.

e. No normal maximum.

11. A 20 years old primiparous woman develops

postpartum hemorrhage unresponsive to oxytocin

and intensive massage, misoprostol. Her infant was

8.5 pound, she has bled 750cc. what is most likely

diagnosis?

a. Laceration of cervix

b. Placenta accrete

c. Extensive inversion

d. Rupture uterus

e. Coagulopathy

12. A patient has entered spontaneous premature

labour at 28 weeks gestation. During the vertex

delivery, one should do which of the following.

a. Recommend epidermal anesthesia to control

delivery.

b. Perform an episiotomy.

c. Use prophylactic forceps.

d. Use vacuum extraction

e. Allow spontaneous vaginal birth.

13. The routine use of midline episiotomy during delivery

has been shown to do which of the following.

a. Prevent urinary stress incontinence in the

fourth decade of l ife.

b. Decreases the incidence of fetal cranial

moulding

c. Decreases maternal blood loss.

d. Increases the incidence of third and fourth

degree lacerations.

e. Prevent the development of a rectocele and

uterus prolapse postmenopausal.

14. World wise, which of the following is the most

common problem during pregnancy?

a. Diabetes.

b. Preeclampsia

c. Iron deficiency anemia.

d. Heart disease.

e. Urinary tact infection.

15. Commonest cause of PDA?

a. Drugs.

b. Toxin.

c. Prematurity.

d. Congenital Abnormality.

e. Infection.

16. Which method is most useful in identifying

chromosomal abnormalities:

a. karyotyping.

b. U/S.

c. Bar bodies.

d. Blood test.

17. Source of estrogen and progesterone in last trimester

is:

a. Chorionic villi .

b. Placenta.

c. Ovary.

d. Adenohypophysis

e. Corpus luteum

18. Inhibition of ovulation is function of which hormone?

a. Progesterone.

b. Prolactin.

c. Dopamine.

d. Estrogen.

e. Gonadotrophins.

19. Treatment of diabetes in pregnant lady is?

a. Sulphonal urea.

b. Insulin.

c. Biguanides.

d. Sulfonyl ureas and Biguanides

20. A young girl of 25 years went with her husband on

honey moon after one month of marriage . She

suddenly experienced severe spasmodic pain in her

RT iliac fosse and presented in emergency in state of

shock. Most probable Dx is.

a. Acute appendicitis.

b. Renal colic.

c. Intestinal obstruction.

d. Ectopic pregnancy.

e. Acute cholecystitis

21. Neural tube defects occur due to deficiency of:

a. Iron

b. Folic acid.

c. Vitamin B12

d. Calcium.

22. Sperms life span in female genital tract is.

a. 24 _48 hr

b. 24 _72 hr

c. 24 _ 30 hr

d. 30 _60 hr

23. A pt. came in OPD with enlarged ant axillary lymph

nodes and diagnosed a case of Ca Breast. Which

region is most likely involved?

a. Upper outer Quadrant

b. Lower inner Quadrant

c. Lower outer Quadrant

d. Upper inner Quadrant

24. Which type of anemia will be present in Hook w orm

infection ?

a. Iron deficiency anemia.

b. Folic acid deficiency.

c. Megaloblastic anemia

d. Hemolytic anemia

25. A patient presents with secondary amenorrhoea. One

year back she has history of P.P.H for that she

received five pints of blood what is most probable

caused of her menstrual problem?

a. Pituitary tumor

b. Sheehans Syndrome

c. Addisons disease

d. Adrenal cortex adenoma

e. Psychological problem

26. Which of the following is characteristic of polycystic

ovary disease?

a. Inc L.H

b. Inc FSH

c. Dec L.H

d. Dec F.S.H

e. No change in hormone.

27. Pt presented on 18th

day of menstrual cycle her

normal cycle is such that she ovulates on

day 14 which phase will be in:

a. Follicular

b. Ovulatory

c. Pre menstrual

d. Proliferative

e. Secondary

28. Pt came with primary amenorrhea webbed neck,

short stature Dx of Turner Syndrome her karyotype:

a. 45 xo

b. 46 xy

c. 47 xxy

d. 46 xx

29. Most dangerous side effect of estrogen therapy is:

a. Suppression of lactation

b. Hirsutism

c. Thrombophlebitis

d. Osteoporosis

30. In a pre eclampsia pt which drug is used to lower B.P

before surgery:

a. Hydralazine

b. Amlodipine

c. MgSo4

d. B. Blocker

31. TORCH can lead to all except:

a. Pneumonia

b. Cataract

c. Deafness

d. Cardiac anomalies

e. Blindness

32. DIC is related to all except:

a. Cancer

b. Amniotic fluid embolism.

c. Sepsis.

d. RPOCs

e. MI

33. Which component is low in Cow milk as compared to

mothers milk:

a. Lactose.

b. Fat calcium.

c. Calcium.

d. Protein.

34. To reach the Uterus. Uterine artery crosses the.

a. Ureter.

b. Fallopian tube.

c. Ligament of ovary.

d. Iliac artery.

35. Total gastrectomy results in

a. Iron deficiency Anemia.

b. Microcytic anemia.

c. Pernicious anemia

d. All of above.

36. If after 1 hour of C/sechon pt start bleeding internally

which one is most likely damage.

a. Uterine artery.

b. Internal iliac

c. Ovarian artery.

d. Uterine vein.

e. None of the above

37. Two days before ovulation LH surge rises to:

a. 1_5 fold

b. 4_6 fold

c. 6_10 fold

d. 20_30 fold

e. None of the above

38. Ovaries are attached to broad ligament by:

a. Mesovarium.

b. Mesosalpinx.

c. Suspensory Ligament.

d. Round Ligament.

39. Which is the Karyotype of partial mole?

a. 45xy

b. 47xx

c. 69xxx

d. 46xy

40. A pregnant lady has drunken alcohol which body

organ of baby will be most likely effected?

a. Ovary

b. Brain

c. muscle

d. Heart

Gynae & Obst Paper A KEY

Department of Gynae & Obst Paper B JINNAH MEDICAL COLLEGE PESHAWAR

41. Acute retention of urine in the 1st trimester is due to which of the following:

a. Retroverted gravid uterus

b. Ectopic pregnancy

c. Pregnancy associated with uterine fibroid

d. All of the above

42. A 4- month pregnant woman with a subserous fibroid can cause which of the following

complication?

a. Red degeneration

b. Retention of urine

c. Abnormal presentation of fetus

d. None of the above

43. A 30 year old woman with three previous abortions develops deep venous thrombosis in her

left leg. Which of the following is the probable cause?

a. Increased ant thrombin levels

b. Increased factor VIII

c. Idiopathic thrombocytopenia

d. Systematic lupus erythematosus

e. None of the above

44. A woman develops red and degeneration of fibroid at 16 weeks pregnancy. What is the

management:

a. Conservative with sedation

b. Immediate myomectomy

c. Myomectomy and termination of pregnancy

d. Caesarean delivery at term

45. A primigravida with 2 months amenorrhoea has an ovarian cyst 8 x 6 cm in the right fornix.

The treatment is:

a. Immediate laparotomy

b. Conservative management till delivery

c. Ovariotomy in the second trimester

d. Caesarean delivery and ovariotomy

46. Which is the complication of missed abortion:

a. Coagulation failure

b. Uterine rupture

c. Formation of lithopedion

d. None of the above

47. A woman with 8 weeks amenorrhoea develops vaginal bleeding, ultrasound show at empty

uterus. The possible diagnosis is:

a. Delayed period

b. Metropathia haemorrhagia

c. Ectopic pregnancy

d. Persistent corpus luteum

e. All of the above

48. Hydatidiform mole is best diagnosed by:

a. Beta -HCG level

b. Ultrasound

c. Fetoscopy

d. Aminocentesis

49. How long does parenteral iron to show improvement:

a. 1 week

b. 2 weeks

c. 4-8 weeks

d. 12 weeks

50. Maternal death in elcampsia is due to all except:

a. Pulmonary oedema

b. Cardiac failure

c. Cerebral haemorrhage

d. Coagulation failure and bleeding

51. Which of the following complications can occur in pregnancy induced hypertension:

a. Abruption placenta

b. Eclampsia

c. Cerebral haemorrhage

d. Renal failure

e. All of the above

52. When does jaundice appear in the newborn due to Rh incompatibility:

a. 24 hours

b. 45 hours

c. 72 hours

d. Upto 7 days

53. Which of the following drugs improve the prognosis in IUGR pregnancy:

a. Aspirin

b. Heparin

c. Amino acid

d. All of the above

54. A lady with placenta previa delivered a baby. She had excessive bleeding. After resuscitation

most likely complication is

a) Galactorrhoea

b) Diabetes insipidus

c) Loss of menstruation

d) Cushings syndrome

55. A primigravida at 37 weeks starts bleeding per vaginum. Ultrasound reveals a dead fetus with

type IV placenta. How will you manage this case?

a. Syntocinon drip

b. Casesaream delivery

c. External version and await spontaneous delivery

d. Allow spontaneous vaginal delivery

56. Carcinoma in Situ of the cervix in pregnancy is managed by:

a. Vaginal delivery

b. Caesarean section

c. Termination of pregnancy

d. Induction of labour

57. Which is the most specific test to detect Down syndrome:

a. Triple test

b. Ultrasound

c. Chronic villus biopsy

d. Alpha fetoprotein

58. Craniotomy is done in brow presentation by perforating:

a. Frontal bones

b. Orbit

c. Occipital bones

d. Palate

59. External cephalic version is contraindicated in all the following except:

a. Placenta praevia

b. Pregnancy induced hypertension

c. Hydrocephaly

d. Postcasearean pregnancy

60. In a multigravida , vaginal breech delivery requires which of the following:

a. Pudendal block

b. Episiotomy

c. Forceps delivery

d. Syntocinon drip

e. All of the above

61. Multiple pregnancy is least common with :

a. Clomiphene

b. FSH/LH

c. GnRH

d. In vitro fertilization

62. A 35 yr old P3+0 is observed to have CIN grade III on colposcopic biopsy. Best treatment will be

a) Cryosurgery

b) Conization

c) LEEP

d) Hysterectomy

63. Which of the wrong statements is wrong constriction ring:

a. Is left per abdomen

b. Cause retained placenta

c. Causes hour glass contraction of the uterus

d. Prolongs labour

64. Which of the following is least likely to cause uterine rupture?

a. Rudimentary horn

b. Septate uterus

c. Uriculoplasty

d. Previous manual removal of the placenta

65. Which statements is wrong acute inversion is treated is treated with:

a. Immediate resuscitation

b. Manual reposition

c. O Sullivan method

d. Immediate laparotomy and reversion

66. Which is the most common cause of PPH:

a. Atonic uterus

b. Cervical tear

c. Adherent placenta

d. Coagulation failure

67. Which of the following drugs is not effective in controlling PPH:

a. Methergine

b. Synotocinon

c. Misorprostol

d. Drotaverine

68. A primigarvida stars bleeding profusely in the 6th week postpartum. The uterus is 14 weeks

size which of the following is the probable cause:

a. Retained piece of placenta

b. Retained clot

c. Infection

d. Choriocarcinoma

69. Which of the following emergencies does not occur in early puerperium:

a. Cerebral thrombosis

b. Pulmonary embolism

c. Twisting an ovarian cyst

d. Eclampsia

e. Red degeneration in a fibroid

70. The presence of increased levels of which of the following in amniotic fluid is an indicator of

open neural tube defect in the fetus?

a) Phosphatidylesterase

b) Acetylcholinesterase

c) Pseudocholinesterase

d) Butyrylcholinesterase

71. Puerperal fever is caused by:

a. Urinary tract infection

b. Chest infection

c. Genital tract infection

d. All of the above

72. Which drug is contraindicated during lactation:

a. Lithium

b. Earythromycin

c. Warfarin

d. Metformin

73. Toxic shock syndrome is caused by:

a. Use of tampons in the vagina

b. Pelvic cellulities

c. Postpartum haemorrhage

d. None of the above

74. A woman with primary infertility with CA-125 level 90 iu. She has bilateral palpable mass. USG

shows mass in pelvis. Diagnosis may be

a) Ovarian CA

b) TB

c) Endometrioma

d) Borderline ovarian tumor

75. Bishop score comprises all of the following except:

a. Gestational age

b. Cervical effacement

c. Cervical dilation

d. Consistency of the cervix

e. Station of the head

76. Prostaglandin in used in all of the following except:

a. Missed abortion

b. Induction of labour

c. Postpartum haemorrhage

d. Augment the first stage of labour

77. A primigravida develops premature rupture of membranes at 32 weeks. The treatment is:

a. Conservaitive with antibodies and dexamethasone

b. Caesarean section

c. Syntocinon drip

d. None of the above

78. Repeat caesarean section is indicated in which of the following :

a. Breech presentation

b. If previous caesarean section was done for failed trail of labour in borderline CPD

c. Placenta praevia

d. All of the above

79. Fetal distress during late pregnancy occurs in which of the following :

a. Oligohydramnois

b. Multiple pregnancy

c. Hydramnios

d. Breech presentation

80. Aminoinfusion has which of the following effects:

a. Dilutes meconium in amniotic fluid

b. Prevents cord compression

c. Prevents amniotic bands and limb deformities

d. All of the above

81. Which of the following viruses does not cause fetal malformation:

a. Rubella

b. Toxoplasmosis

c. Cytomegalovirus

d. HIV

Gynae & Obst Paper B KEY

ENT Paper SEQs Alon with KEY

Q1:

A 50 years old child prevented with 6 months history of bilateral hearing loss there is occasional

episodes otalgia otoscopy revealed bilateral dull, retraced immobile tympana membranous.

a. What is most likely diagnosis? (1)

b. What audiometrie tests would you requested. (1)

c. Discuss the treatment of child (3)

Area / Topic: EAR

______

Key:

Weightage

a. A single diagnosis is requested which is otitis media with effusion (OME) 1

b. Audiometrie tests required are paratone audiometry and impedance audiometryloss. Impedance audiometry will show bilateral flat came

1

c. Treatment includes antibodies which covers H. Influenza, streptococcus preemie, surgical treatment includes. Bilateral myringotomies with grommet insertion.

3

Q2:

A 15 years old male prevented with recurrent epistaxius and Nasal obstruction on

examination there was a large mass within right nasal cavity and nasopharynx . Radiology of

nasopharynx demonstrated anterior boring of posterior wall of maxillary antrum.

a. What is the likely diagnosis? (1)

b. What investigations are indicated? (2)

c. What is the Treatment? (2)

Area / Topic: Nose

______

Key:

Weightage

a. Nasophyayeal Fibroma 1

b. Plain X-Rays of nose/ Nasopharnyx

CT scan/ MRI

Angiography

2

c. Treatment includes surgery for advommed cases surgery is followed by radio therapy.

2

Q3:

A 38 years old male prevented with serve some throat especially on left side

with fever and left otalgia he was unable to swallow on examination there was

congestion and swelling of Soft palate on left side. Affected consel was hidden

by swelling but there was micpoces on surface.

a. What is most likely diagnosis? (1)

b. What is differential diagnosis? (2)

c. What is Treatment? (2)

Area / Topic: Throat

______

Key:

Weightage

a. Most likely diagnosis is left peritonsillar abscess. 1

b. Differential diagnosis includes acute follicular Transulleiles, Retrophyeal abscess epiglottis.

2

c. It includes medical/ surgical 2

Q 4:

A child of 4 years prevented with fever, difficulty swallowing and breathing difficulty. On

examination there was a greish membrane on tonsils, soft plate and post physical wall, neck nodes

were collaged.

a. What is most likely diagnosis? (1)

b. What is deferential diagnosis? (2)

c. What is the Treatment? (2)

Area / Topic: Throat

______

Key:

Weightage

a. Diphtheria 1

b. D/D includes acute membranous linsellats infections mononucleosis,

agranulocytosis . 2

c. It includes antibodies, Anti depression serum trabeculotomy of needed isolation. 2

Area Topic Nose

Q5:

a. What are the Common causes of Epistaxis. (1)

b. How you will investigate it. (2)

c. What is the Treatment? (2)

Key:

Weightage

a. Common causes 1

b. Common investigation. 2

c. Common points in treatment. 2

Area/Topic: EAR

Q 6:

A 20 year old male prevented with bilateral gradual hard of hearing in both ears. He leans

better in noisy environment and spealin in low voice in low voice on examination both tympanic

membranes are intact.

a. What is most likely diagnosis. (1)

b. What is deferential diagnosis. (2)

c. What is investigation are required. (2)

Key:

Weightage

a. Otoselcrin 1

b. Differential diagnosis includes otatis media with effusion,congental, ossicular fixation, senorineal hearing loss, ossicular discontinuity .

2

c. Investigation include pure tone audiometry and impedance audiometry 2

Area/Topic: Gall Bladder

Q 7:

a. Enumerate common causes of vertigo martis. (2)

b. What is the treatment of memories disseare morton. (3)

Key:

Weightage

a. Only common causes are needed. 2

b. Medial as well as surgical Treatment 3

Area/Topic: Larynx

Q 8:

A child of 3 years age prevented with, fever, differently in swallowing, drooling of salwa and strident.

a. What is most likely diagnosis? (1)

b. What in the treatment. (3)

c. What investigations are needed? (1)

Key:

Weightage

a. Most likely diagnosis is acute epiglotitis. 1

b. Treatment includes:

Medical

Surgical Treatment

3

c. Investigation

Radiological

1

Area/Topic: EAR

Q 9:

a. Enumerate common causes of Ear are. (2)

b. How will you manage acute otitis media. (3)

Key:

Weightage

a. Only common Causes: Like, acute otitis media, Boil, otitis Ext, Otitis Media with efussion scadder trauma, refereed otalagia.

2

b. Like neuralgia, refered pain from temporomandibular joint, oropharynx, laryngeal infections.

Medical Treatment

Surgical Treatment

3

Area/Topic: Larynx

Q 10:

A 7 years old child prevented with the history of snowing replicated upper respiratory

tract infections recently he has developed Hard of hearing in both Ear with occasional otaligia.

a. .What is most likely diagnosis? (1)

b. What investigations are required? (1)

c. What is the Treatments. (3)

Key:

Weightage

a. Most likely diagnosis is enlarged adenoids

b. Investigation required are plain X- Ray of narophynx. CT Scan/ MRI are needed of plain X- ray are not help full. Pure tune audiogram and impedance audiometry for hearing loss.

c. Treatment includes Medical for control of associated infections. Surgical adenoidectomy Myringotomy + Grommet insertion

EYE Paper SEQs Alon with KEY

Area/Topic: Blindness

Q1:

A young boy 10 years old presents to the OPD with a history of night blindness,

and superficial refractile masses, with a silvery colour, and foamy texture on exposed

bulbar conjunctiva, temporally.

a. What is your diagnosis? (1)

b. What other clinical features would your look for? (3)

c. How would you manage this case? (1)

Key:

Weightage

a. Bitots Spots- Vitamin A Deficiency (Acute stage) 1

b. Xerosis (dryness of Conjuctiva, Xerophthalmia (Dry eyes)

Keratomalacia (Corneal Softening) and concurrent infection. Examine

the fundus for other causes of night blindness e.g Retinitis

pigmentosa, congenital night blindness etc.

3

c. High doses of vitamin A and dietary advice should be given.

1

Area/Topic: ____________________

Q2:

A middle aged woman presents to the OPD complaining of bulging of the

eyeballs, right more than left, with, redness of the eyes, swelling of conjunctiva, (chemosis)

and dimness of vision. She has an enlarged thyroid gland on examination, with a rapid

pulse.

a. What is your diagnosis? (1)

b. What other Conditions can cause bulging of eyeballs. (2)

c. How would you manage this case? (2)

Key:

Weightage

a. Thyroid Opthalmopathy (Graves disease) 1

b. Orbital cellulitis, inflammatory eye diseases, arteriovenous

shunts, lacrimal gland tumours, Adult metastatic tumours.

2

c. Refer to endocrinologist for control of thyroid disease, systemic

steroids radiotherapy, surgical decompression, and topical ocular

lubricants.

2

Area/Topic: ____________________

Q3:

A young girl 5 years old of presents to the O.P.D with swelling of the eye. On

examination she is febrile, the swelling is red, hot and tender. Her visual acuity is

normal, pupils are reacting to light and anterior segment is normal.

a. What is your diagnosis? (1)

b. Causes of this condition? (2)

c. How would you manage this case? (2)

Key:

Weightage

a. Preseptal cellulitis of the orbit 1

b. Skin laceration, insect bite, spread of acute dacryocystitis,

haematogenous spread of infection from a remote site like upper

respiratory tract infection, middle ear infection.

2

c. Oral or intravenous antibiotics (e.g flucoxacillin benzyl

penicillin)

2

Area/Topic: ____________________

Q 4:

You are in a busy OPD and a mother brings her 4 months old child complaining of

watering since birth. The rest of ocular examination is normal

a. What is your diagnosis? (1)

b. What other conditions cause watering in a child this age? (1)

c. How would you manage this case? (3)

Key:

Weightage

a. Congenital Nasolacrilmal duct obstruction or delayed canalization of NLD. 1

b. Punctual atresia, fistulae, between sac and skin 1

c. Advise Crigeer massage, probing of the NLD should be delayed upto the age of 12

month as spontaneous canalization occurs in upto 95% of cases.

3

Area/Topic: ____________________

Q5:

A middle aged woman of poor socioeconomic background presents with

purulent discharge from left eye, for the past seven months from left eye,

which has not responded to intensive antibiotic therapy. On examination

regurgitation occurs on applying pressure to the lacrimalsac. Her vision is

6/6.

a. What is your diagnosis?

b. What other investigations would you perform.

c. What is the treatment?

d. If this is an acute episode would you advise surgery?

Key:

Weightage

a. Chronic Dacryocystitis. 1

b. Slit lamp examination, probing and irrigation, contrast

dacryoscystocraphy and lacrimal scintillogrpahy

2

c. Surgical intervention Dacryochystorhinostomy (DCR)

1

d. No, treat conservatively at first.

1

Area/Topic: ____________________

Q 6:

A 70 year old man, farmer by occupation, presents to your busy OPD with a small

shiny nodule, firm consistency with dilated blood vessels on the surface, the

lymph nodes (subman dibular and cervical) are normal. The lesion is not painful

but is increasing in size and beginning to bleed sometimes.

a. What is your diagnosis? (1)

b. What other condition come to mind? (2)

c. How would you manage this case? (2)

Key:

Weightage

a. Basal cell carcinoma 1

b. Squamous cell, carcinoma, sebaceous gland carcinoma

keratoacanthoma, Melanoma, Actinic keratosis, seborrhoeic,

keratosis, pyogenicgranulom.

2

c.

a) Surgical excision with biobsy

b) Radiotherapy

c) Cryotherapy

d) Laser microsurgery

2

Area/Topic: ____________________

Q 7:

A patient presents to you with a raised IOP RE 28 and LE 35 mm Hg, open angle

on gonioscopy. He is diagnosed as Primary Open Angle Glaucoma (POAG)

a. What changes do you expect the see in the optic disc? (4)

b. What other parameters of the disc must you also observe? (1)

Key:

Weightage

a) There is concentric enlargement o the disc and increase in cup disc

ratio to 0.5 with progression. There is inferotemporal expansion of

the cup, followed by superior expansion of the cup so that it

becomes vertically oval . In advanced stages there is total disc

cupping and optic never head appears white, deeply excavated and

slit like pores in lamina cribrosa are seen.

4

b) Colour Pallor? Neovascularization?

Contour swelling? Myopic disc?

1

Area/Topic: ____________________

Q 8:

A young girl 16 year old presents to you with redness and watering of the right

eye. She is photophobic and her visual acuity is reduced in the right eye to 6/36. On

Fluorescent staining there is a branching pattern on cornea

a. What is your diagnosis. (1)

b. What is your differential diagnosis? (2)

c. How would you treat this patient? (2)

Key:

Weightage

a. Viral Keratitis 1

b. Healing corneal, obrasion, herpes zoster keratitis, contract lens wear,

acanthamoeba Keratitis and toxic keratopathies secondary to topical

medications.

2

c. Antiviral topical and systemic medications cycloplegics and

painkillers.

2

Area/Topic: ____________________

Q 9:

A newborn child is brought to you in the OPD with severve mucopurulent discharge

a. What is your diagnosis? (1)

b. How would you treat this condition? (3)

c. Is it a notifiable disease? (1)

Key:

Weightage

a) Ophtalmia neonatorum 1

b) With topical tetracycline and oral erythromycin to the child. Both

parents should be examined for evidence of genital disease and treated

3

c) Yes 1

Area/Topic: ____________________

Q 10:

A patient 30 years old male presents to your OPD with watering and redness of

both eye. His visual acuity is 6/6 RE LE. On Eversion of upper eye lids you see diffuse

inflammation and more than five follicles on upper tarsus.

a. What is your diagnosis? (1)

b. How would you treat his condition? (2)

c. Would you advise surgery? (2)

Key:

Weightage

a. Trachoma 1

b. With antibiotics, and advise good hygiene especially face

washing and better waste disposal.

2

c. No. Surgery is recommended for complications. 2

Gynae & Obst Paper B SEQs Along with KEY

Area/Topic: Ectopic Pregnancy

Q1:

A young patient 30 yrs of age reports to Emergency word C/O severe pain lower abdomen. And P/V

spotting for 2 days. Her L.M.P is 6weeks back. How will you proceed?

Key:

Weightage

a. History. Risk factors for ectopic like Previous surgery on fallopian tube, Appendectomy, IUCD use P/O prenis obstetric history

(0.5)

b. Examination B.P(hypotension, Tachycardia). Tenderness,Guardiy ofs Exclude various gynecologcauses, pelvic examination emphasis on suspicious of ectopic pregnancy

(1)

c. Investigation Apart from baseline specific investigation like S.PHCE. Pelvic scan (0.5)

d. Making a differential dx _________ (1)

e. Stabilizing the patient (0.5)

f. Deciding whether to go for lapratomy or laparoscopy dependiy on PT condition (1)

g. Counseling the patient explain future prospects of (0.5)

Area/Topic: Contraception

Q2: A young lady P2 wants contraception. She is interested in non hormonal mode of Contraception, tell her about.

a. Non hormonal methods of contraception (2)

b. Side effects of IUCD ( Non hormonal ) (2)

c. Names of permanent sterilization (1)

Key:

Weightage

a. Natural Methods _ Rhythm or Calendar method Basal body temperature, coitus Interrupts, Copper Containing devices. Male and female condoms, cervical caps. Vegan diaphcam

2

b. Expulsion ectopic pregnancy, meroolgir infection Displacement upward into patient cavity.

2

c. Male sterilization _ Vasectomy female sterilization bilateral tubal ligation 1

Area/Topic: Fibroid Uterus

Q3: A 25 years old nulliparous presented with Complaints of metrorrhagia. On examtion there is 20weeks mass in lower abdomen arising from the pelvis.

a. What is the most probable diagnosis. (2)

b. What is the medical treatment. (2)

c. What is the surgical treatment . (1)

Key:

Weightage

a. Fibroid uterus 2

b. NSAID (Mefenenic acid,) Tranexamic acid, GnRH analogues. 2

c. Myomectomy. 1

Area/Topic: Menopause

Q 4: A 50 yrs old lady presented with the complaint of hot Flushes, irritability, loss of sleep and

depression, She has not had meustrual flow for the last 1year.

a. What is most probosle diagnosis. (1)

b. What are treatment options, (2)

c. What are side effects of Hormone . (2)

Key:

Weightage

a. Non pharmacoloziced Yoga, Acupuncture, evening primrose oil, Soya, Phytoestrogen,

1

b. Endometrial Cancer Breast cancer. 2

c. Deep venous Thrombosis Myocardial infarction 2

Area/Topic: Uterouaginal proplape

Q5: A 60 years old lady presents to complaints of something coming and of vagina.

a. What is deferential Diagnosis. (2)

b. What is non-surgical method of treat. (1)

c. What is surgical method of treatment, of 111o UV prolapsed? (2)

Key:

Weightage

a. Polyp cystocele, Rectocele, uterovagiul prolaps, Vaginal wall cyst,viginal tumous. 2

b. Ring passery. 1

c. Vaginal hysterectomy. 2

Area/Topic: Outlet Forceps

Q 6:

A pregnant patient is fully dilated for the last 2hours on P/V examination. The baby head is Lying

at +3 stations. Light meconium is also noticed. Obstetrician decides to expedite the delivery.

a. What is the instrument of choice (1)

b. What are the prerequisite (2)

c. What are complication (2)

Key:

Weightage

a. Outlet Forceps. 1

b. Outlet Forceps. 2

c. Vaginal tean. Corvical tear uterine capture. Sphincter injury bladder inury, PP+1. 2

Area/Topic: PPH

Q 7:

a. What is postpartum huge. (2)

b. What are the causes. (2)

c. What is medical treatment of atonic uterus. (1)

Key:

Weightage

a. Pri.PPH is bleeding more the 500ml coming from genital treat cither first 24hrs of delivery,

2

b. Atonic uterus relaind placenta, vaginal team, comical team. Uterus rupture.

2

c. Oxytocus. Misoprosten, prostaglandem ______F2X.Tranenanec acid. 1

Area/Topic: C. Section

Q 8: A 30years old lady has had 2 cesarean sections. Now she is 36wks pregnant.

a. What will be has mode of delivery (1)

b. Name three indication for elective C/S. (2)

c. Name Two complication of C/S (2)

Key:

Weightage

a. Elecruie C/S 1

b.

I. Contracted pelvic.

II. Pelvic term ones.

2

c. Breech presentation, P injury to bladder. Wound sepsis 2

Area/Topic: Placenta Precia

Q 9:

A woman attends the labour room in emergency. She is 36wks pregnancy. U/S show placenta

covering the O.S. She is bleeding heavily.

a. What is your next step? (2)

b. What is type III and type IV placenta preria. (2)

c. Can a patient to type I placenta previa deliver vaginally. (1)

Key:

Weightage

a. Prepare patient for emergency C/S.

2

b. Type III when placenta is partially covering the os. Type IV Placenta completely covering the internal os.

2

c. Yes 1

Area/Topic: Twins

Q 10:

Gu P3 patient presents to L.room. She is 20wks pregnant but her fundal height is 24wks.

a. Whist is differential diagnosis of large for data feudal height. (2)

b. How will you deliver a patient of twin pregnancy when both features are cephalic. (1)

c. What complications can occur when delivery twin fetuses. (2)

Key:

Weightage

a. To multiple pregnancy, polyhydranios wrong dates, pelvic tumors. Uterus fibroids. Full bladder. Fetal tumors.

2

b. Vaginal delivery 1

c. Abnormal lie to 2nd twin. Retained 2nd twin, postpantum hge. Is Chances of instrumental/operation delivery.

2

Gynae & Obst Paper B SEQs Along with KEY

Q1:

a. Define that stage of labour and mention its normal duration?

b. What is acute management of third stage?

Key:

Weightage

d. Stage that lasts from delivery basy till delivery of placenta. If physiological managed duration its on hour. But if actually managed

the duration lasts for 30 minute.

2

e. Acute management involves

Only synomrtrine at delivery of anterior shoulder Early cord clamping.

Delivery of placenta by controlled cord traction.

3

Q2:

Comment on booking vioit ultra sound it helpsin.

Key:

Weightage

d. Conferring ubtrauterine pregnancy excludes ectopic pregnancy. 1

e. Dating pregnancy and planning. 1

f. If multiple pregnancy determines chorinicity. 1

g. Offering screening test for Dows syndrome by measuring translucency. 1

h. Diagnosing major defect like anencephaly 1

Q3:

Enumerate the benefits of breast feeding.

Key:

Weightage

d. Encourage bonding behvear mother and baby. 1

e. Contains lectoferin lact bacilli and inhibits Ecoli and reduces risj of gastro. 1

f. It transmit humeral and cellular immunity to baby protecting babys gut. 1

g. It helps in decreasing risk of atopic disease in baby like eczema. 1

h. It is available on demand, warm and sterile. 1

Q 4:

a. Enumerate emergency management of Eclampsia.

Key:

Weightage

a. Put the patient in lateral position, pass air way, do suction + give oxygen. 1

b. Maritain intravenous line. If in fits start give loading dose of magnesium sulphate. 1

c. Check pulse, BP , respiration rate, urine output ausuttale lungs , pulse oximetry. 1

d. Give if hydrolazine or labeteol to control blood pressure. 1

e. Send investigation that is complete blood count, coagulation profile, liver function tests, urea and electrolytes, 24 hour urine proteins.

Q5:

Define types of miscarreages ?

Key:

Weightage

d. Threatened Miscarreage. 1

e. Missed Miscarreage. 1

f. Incomplete Miscarreage. 1

g. Complete Miscarreage. 1

h. Recurrent Miscarreage. 1

Q 6:

Explain management of Missed Miscarriage.

Key:

Weightage

a. Expectant Management:- arraiting spontaneous Loss.

1

b. Medical Management:-

Miffepristone followed by

Misoprotol or misopostal alone. Other prostaglanotion like F2 Alpha

2

c. Surgical Evacuation:- after cervical pruning with prostaglandins. 2

Q 7:

a. What are types of Breach?

b. Define external Cephalic version.

Key:

Weightage

c.

Flexed Breach.

Extended Breach

Footing Breach.

3

d. It is manipulation of fetus through maternal abdomen to change noncephalic fetus to cephalic Prevention.

2

Area/Topic:

Q 8:

A 35 years old para 4, postnatal 7 days sfter delivery by TBA presented with high grade fever,

rigors and chills and foul smelling vaginal discharge. Her B.P is 90/50 temperature 101o F , pulse

120/min.

a. What is your diagnosis?

b. What are the causes of this condition?

c. What are the risk to mother?

d. How you will mange her?

Key:

Weightage

d. Puerpureal Pyrexia. 0.5

e. Retained placenta, Endometritis, UTI. 1

f. DIC, shock , PID. 0.5

g. Remove placenta , give systemic antibiotics in high dose, check for

complications and prevent and treat any complicatiomn.

3

Area/Topic:

Q 9:

Primigravida admitted in labour room is fully dilated since two hours. She is exhausted

and cannot bear down. On examination vertex is at +2 station with clear liquor. Senior was

consisted who advised to go for vacuum delivery?

a. What are the Pre-requisite for vacuum.

b. What complication can occur with vacuum.

Key:

Weightage

c. See pre-requisites of instrumental delivery. 2

d. Maternal risks. Trauma (chignon, cephahermatoma, intra hemorrhage, infection, Neonatal jaundice)

3

Q 10:

Key:

Weightage

d.

e.