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Here is a complete answer key for all 60 OB/GYN multiple choice questions visible in the image:
Complete Answer Key - OB/GYN MCQs
| # | Question Summary | Answer |
|---|---|---|
| 1 | Why add progestogen to estrogen in menopausal woman with intact uterus? | To protect the endometrium from hyperplasia/cancer (unopposed estrogen → endometrial carcinoma) |
| 2 | What part of gyn exam must be performed FIRST before bimanual palpation? | Abdominal examination / Inspection of external genitalia |
| 3 | Healthy newborn Apgar score | a. 7-10 at both 1 and 5 minutes |
| 4 | 2nd day postpartum dark red non-foul discharge management | Reassure - this is normal lochia rubra |
| 5 | Organogenesis / maximum teratogen susceptibility window | Weeks 3-8 (days 15-56) of embryonic development |
| 6 | First-line medication for Central (True) Precocious Puberty | GnRH agonist (e.g., leuprolide/triptorelin) |
| 7 | Hormone responsible for submucosal vacuolation in endometrium during luteal phase | Progesterone (from corpus luteum) |
| 8 | When is OGTT performed for GDM screening? | 24-28 weeks of gestation |
| 9 | Definition of "adrenarche" | b. Onset of adrenal androgen secretion (→ pubic/axillary hair). NOT breast development (that is thelarche) |
| 10 | General management of Respiratory Distress | a. Oxygen administration, preferably heated and humidified |
| 11 | Neonatal hypoglycemia is defined as blood glucose | b. < 36-45 mg/dL (usually < 40-47 mg/dL per guidelines) |
| 12 | Normal sequence of female pubertal development | Thelarche → Pubarche → Growth spurt → Menarche |
| 13 | Secondary amenorrhea with FSH >40 mIU/mL on 2 occasions | Premature Ovarian Insufficiency (POI) |
| 14 | Chemical responsible for painful uterine cramps in primary dysmenorrhea | Prostaglandins (PGF2α) |
| 15 | Primary mechanism of Copper IUD | Spermicidal effect of copper ions (NOT hormonal) |
| 16 | Endocrine pattern in hypergonadotropic hypogonadism (delayed puberty) | High FSH, High LH, Low Estradiol |
| 17 | Time frame of the "4th stage of labor" | First 1-2 hours after placental delivery |
| 18 | Primary mechanism of emergency contraceptive pills (morning-after pill) | Inhibition/delay of ovulation (does NOT cause abortion) |
| 19 | How do combined oral contraceptive pills primarily prevent pregnancy? | Suppression of ovulation (inhibition of LH surge) |
| 20 | Truth about kidney function in a neonate | a. Urine pH 5-7; b. Specific gravity 1.001-1.020 |
| 21 | Clinical manifestations of neonatal hypoglycemia | Tremors/jitteriness, poor feeding, apnea, cyanosis, seizures, hypotonia (NOT hypertonia) |
| 22 | Specific treatment of neonatal RDS | Surfactant replacement therapy |
| 23 | Signs after delivery: cord lengthening, gush of blood, globular fundus | Signs of placental separation (normal 3rd stage) |
| 24 | Proven biomechanical benefit of upright/squatting delivery position | Widens pelvic outlet, uses gravity, shorter 2nd stage, fewer perineal tears |
| 25 | Which is NOT a complication of infant of diabetic mother (IDM)? | a. Hyperglycemia - IDMs get HYPOGLYCEMIA, not hyperglycemia |
| 26 | Truth about fetal/neonatal heart murmur | Transient murmurs from incomplete closure of ductus arteriosus or foramen ovale are common and benign |
| 27 | Earliest gestational age pregnancy detectable on ultrasound | ~4-5 weeks from LMP (transvaginal US); fetal cardiac activity ~6 weeks |
| 28 | Neonatal hypothermia definition | Core temperature < 36.5°C (WHO definition) |
| 29 | Correct term for excessively heavy or prolonged regular menstrual periods | Menorrhagia (now called Heavy Menstrual Bleeding, HMB) |
| 30 | What is NOT true about immune system in neonates? | Maternal IgG crosses placenta (passive immunity). IgM does NOT cross. Neonates have limited active immunity. |
| 31 | Fetal station landmark | Ischial spines (station 0 = at level of ischial spines) |
| 32 | Which embryonic layer forms the placenta? | c. Trophoblast (outer layer of blastocyst) |
| 33 | Screening for adolescent with severe menorrhagia at menarche | Coagulation studies (screen for von Willebrand disease and other bleeding disorders) |
| 34 | Marked compressibility of lower uterine segment (isthmus) at 7 weeks | Hegar's sign - probable sign of pregnancy |
| 35 | Main contraceptive mechanism of progestin in COCPs | Inhibition of LH surge → suppresses ovulation |
| 36 | When to screen for GBS by vagino-rectal culture | 35-37 weeks of gestation (updated ACOG: 36-37 wks) |
| 37 | Healthy newborn Apgar | 7-10 at both 1 and 5 minutes |
| 38 | Contraceptive strictly contraindicated in migraines with visual aura | Combined oral contraceptive pills (estrogen-containing) - WHO MEC category 4 (absolute contraindication) due to stroke risk |
| 39 | Moderately depressed newborn Apgar score | b. 3-6 (needs resuscitation/stimulation + O₂) |
| 40 | "Radiation" as a mechanism of heat loss means | Loss of heat via electromagnetic waves to cooler surrounding environment without direct contact |
| 41 | Bishop score for: 2 cm dilated, 60% effaced, soft, mid position, -1 station | Score ~8 → Favorable cervix → proceed with induction |
| 42 | When to give Anti-D immunoglobulin to Rh-negative unsensitized woman | 28 weeks antenatally + within 72 hours of any sensitizing event |
| 43 | Return of ovulation in a non-lactating postpartum woman | ~6-8 weeks postpartum |
| 44 | True positive (certain/diagnostic) sign of pregnancy | Fetal heart tones auscultated / Fetus visualized on ultrasound / Fetal movement felt by examiner |
| 45 | "Secondary hypothermia" in neonate | Normal term infant dropped into environment → temperature drops 1-2°C shortly after birth |
| 46 | First Leopold maneuver reveals soft, asymmetric mass in fundus | Breech presentation (head is down; soft buttocks in fundus) |
| 47 | LOT position at +1 station in 2nd stage → next cardinal movement | Internal rotation (to OA position) |
| 48 | Maternal IgG in infant provides | Passive immunity (NOT active) lasting ~3-6 months |
| 49 | Ideal fetal attitude for uncomplicated vertex delivery | Complete flexion (chin on chest, presenting suboccipitobregmatic diameter ~9.5 cm) |
| 50 | Suture separating two parietal bones / triangular fontanelle | Sagittal suture separates parietals; Posterior fontanelle is triangular |
| 51 | Mechanism of anovulatory dysfunctional uterine bleeding (AUB-O) | Unopposed estrogen (no ovulation → no corpus luteum → no progesterone → irregular endometrial shedding) |
| 52 | Formal definition of natural menopause | b. 12 consecutive months of amenorrhea without other pathological cause |
| 53 | "Conduction" as mechanism of heat loss | Heat loss by direct physical contact (e.g., skin touching cold surface) |
| 54 | Severely depressed newborn by Apgar score | c. 1-3 → intensive resuscitation required |
| 55 | Structural cause of AUB under FIGO PALM-COEIN classification | PALM = structural: Polyp, Adenomyosis, Leiomyoma, Malignancy; COEIN = non-structural |
| 56 | Cellular mechanism initiating endometrial breakdown during menstruation | Progesterone withdrawal → spiral artery vasospasm → ischemia → prostaglandin release → shedding |
| 57 | What is NOT a risk factor for Neonatal Respiratory Distress? | Stress/anxiety (maternal psychological stress is not a direct fetal RDS risk factor) |
| 58 | Risk factors for neonatal sepsis | Premature rupture of membranes (PROM), prematurity (less immunologic ability) |
| 59 | Definition of perinatal period | From 28th completed week of gestation to 7th day after birth (WHO); neonatal period = birth to 28 days |
| 60 | Cervical dilation for transition from latent to active phase of labor | 6 cm (per ACOG 2014 updated guidelines) |
Key themes tested: Obstetric stages of labor, neonatal assessment (Apgar), female puberty sequence, menstrual cycle hormones, contraception mechanisms, pregnancy signs, GDM screening, neonatal thermoregulation, and classification systems (PALM-COEIN, WHO perinatal definitions).
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