Thursday, September 23, 2021

Kerala PSC Assistant Professor in Obstetrics and Gynaecology solved paper 2021

Kerala PSC Assistant Professor in Obstetrics and Gynaecology previous question paper 2021
Question Paper Code: 7/2021/OL
Category Code: 010/2020
Exam: Assistant Professor in Obstetrics and Gynaecology
Date of Test 15-03-2021
Department Medical Education Services
Alphacode A

Question1:-All are TRUE regarding Fetomaternal unit in pregnancy EXCEPT
 A:-Progesterone production by the placenta is largely independent of the quantity of precursor available, the utero-placental perfusion and fetal well-being
B:-There is a 17 alpha hydroxylase enzyme block in the fetus and placenta has very little 3 beta hydroxyl steroid dehydrogenase activity
C:-Cholesterol and pregnenolone are obtained mainly from the maternal bloodstream for placental progesterone synthesis
D:-In human syncytiotrophoblast, estradiol increases progesterone production by means of an increase in LDL uptake
Correct Answer:- Option-B

Question2:-All are TRUE statements about Corpus luteum of Pregnancy EXCEPT
A:-Progesterone is largely produced by the corpus luteum until about 10 weeks of gestation
B:-Pulsatile luteinizing hormone (LH) and human chorionic gonadotropin (hCG) from the implanting pregnancy stimulate progesterone production by the corpus luteum
C:-In the luteal phase of conception cycles, progesterone concentrations increase from about 1-2 mg/mL on the day of the LH surge to a plateau of approximately 10-35 mg/mL
D:-The transitional luteo-placental shift takes place between the  10 week and 12 week
Correct Answer:- Option-D

Question3:-The FALSE statement regarding the glycoprotein hormone Human Chorionic Gonadotropin (HCG) is
A:-A maximal level of about 100,000 IU/L in the maternal circulation is reached at 8-10 weeks of  gestation
B:-Long half-life of hCG (48 hours) is due mainly to the greater amino acid content of beta subunit
C:-Hyperglycosylated hCG is the major circulating form of hCG regulating trophoblastic invasion in the first weeks of normal pregnancies
D:-β-hCG can be detected in maternal blood about the eighth day after ovulation or one day after implantation
Correct Answer:- Option-B

Question4:-Find out the FALSE statement regarding human parturition
A:-The initiating step in the sequence of events leading to parturition could bean increase in fetal ACTH and cortisol secretion and an increase in placental CRH
B:-There is a definite decline in peripheral blood levels of progesterone prior to parturition and not just a functional withdrawal
C:-An increase in estrogen levels in maternal blood begins at 34-35 weeks
D:-The activity of 15-hydroxyprostaglandin dehydrogenase decreases in the myometrium and the chorion during labor and causes increase in prostaglandins associated with parturition
Correct Answer:- Option-B

Question5:-All the following statements about fetal lung surfactant are TRUE EXCEPT
A:-Phosphatidylcholine (lecithin) and phosphatidylglycerol (PG) are present in only small concentrations until the last 5 weeks of pregnancy
B:-At 20-22 weeks of pregnancy, a less stable and less active lecithin, palmitoyl-myristoyl lecithin, is formed
C:-At about the 30 week of gestation, there is a sudden surge of dipalmitoyl lecithin, the major surfactant lecithin
D:-The Sphingomyelin concentration of amniotic fluid changes relatively little throughout pregnancy and prior to 34 weeks, the Lecithin : Sphingomyelin L/S ratio is approximately 1 : 1
Correct Answer:- Option-C

Question6:-All the following are TRUE statement about gonadal differentiation EXCEPT
A:-It now appears that both testis and ovary differentiation require dominantly acting genes
B:-SRY activation of SOX 9 may be all that is necessary to activate other genes important to testis development
C:-WNT4 and R-Spondin 1(RSPO1) genes team to promote ovary development via repression of SOX9
D:-Ovarian differentiation is considered the "default" pathway of sex determination the automatic result in the absence of a testis-determining factor
Correct Answer:- Option-D

Question7:-All are TRUE statements about Complete Androgen Insensitivity EXCEPT
A:-One in three phenotypic sisters of an affected individual may have an XY karyotype but 40% may not have a family history
B:-The normal testes produce normal amounts of AMH and testosterone and absent spermatogenesis, serum LH levels are increased and the serum FSH usually is in the normal range
C:-They present with primary amenorrhea, normal breast development, absent or scant pubic and axillary hair, a short vagina and an absent cervix and uterus
D:-Gonadectomy generally is best done before puberty because the overall risk for tumor development is 30%
Correct Answer:- Option-D

Question8:-The FALSE statement regarding Congenital Adrenal Hyperplasia is
A:-An females, the classic forms of CAH (with and without salt wasting) are characterized by genital ambiguity and is most commonly due to 21-hydroxylase deficiency
B:-Two-thirds of patients with 11β-hydroxylase deficiency exhibit hypotension and hypokalemia
C:-Females with the non-classical "late-onset" form of 21-hydroxlyased deficiency have normal external genitalia and present later, during early adolescence with precocious puberty or other signs of hyperandrogenism such as hirsutism
D:-Diagnosis of 21-hydroxylase deficiency is based on a high serum concentration of 17-OH Progesterone
Correct Answer:- Option-B

Question9:-The FALSE statement about Puberty in humans is
A:-"diphasic" pattern of gonadotropin secretion from infancy to puberty results primarily from a high sensitivity to low levels of gonadal steroid feedback
B:-central GABA signaling is one of the factors that restrains GnRH neuronal activity during childhood
C:-glutamate signaling may play a role in the resurgence of pulsatile GnRH secretion at the onset of puberty
D:-hypothalamic kisspeptin-GPR54 signaling is a key component of the neurobiologic mechanism that triggers the onset of puberty
Correct Answer:- Option-A
Question10:-All are TRUE regarding premature ovarian Insufficiency (POI) EXCEPT
A:-In all patients under age 30 with a diagnosis of POI, a karyotype should be obtained
B:-Women with POI should be offered testing for FMR1 premutations
C:-Women with POI should be screened for antiadrenal antibodies and for antithyroid antibodies
D:-Likelihood of achieving pregnancy after diagnosis of POI is about 60-80% and donor eggs are rarely required for IVF
Correct Answer:- Option-D

Question11:-The FALSE statement regarding PolyCystic Ovarian Syndrome (PCOS) is
A:-AMH production is increased severalfold in anovulatory PCOS
B:-Those with PCOS generally exhibit altered GnRH pulse frequency, increased serum LH concentrations and low-normal FSH levels
C:-Insulin acts synergistically with LH to perpetuate ovarian androgen production and also inhibits hepatic SHBG production
D:-Insulin resistance due to obesity also causes increased leptinsignalling and increased adiponectin levels, there by decreasing fatty acid oxidation and promoting lipotoxicity
Correct Answer:- Option-D

Question12:-Identify the FALSE statement about Metformin
A:-Metformin increases insulin sensitivity up to 20% and decreases fasting glucose by about 5%
B:-Metformin decreases weight and BMI by 3-5%
C:-Metformin has no effect on lipolysis and HDL cholesterol
D:-Metformin improves the chronic inflammatory state in women with hyperinsulinemia
Correct Answer:- Option-C

Question13:-All statements regarding Familial cancers are TRUE EXCEPT
A:-about 15-20% of women who develop ovarian cancer have mutations in BRCA1 gene
B:-Prophylacticsalpingo-oophorectomy reduces the risk of ovarian cancer by about 90% and the risk of breast cancer by about 50%
C:-Risk-reducing salpingo-oophorectomy is recommended at age 35 or when childbearing is complete for patients carrying BRCA1 mutations and by age 40 in BRCA2 carriers
D:-The use of combined oral contraceptives is likely to reduce the risk of ovarian cancer, but the effect on breast cancer risk is uncertain
Correct Answer:- Option-A

Question14:-All are TRUE about Tamoxifen EXCEPT
A:-Tamoxifen is selective estrogen receptor modulator, having both estrogen receptorantagonist and agonist properties, depending on the tissue
B:-The incidence of endometrial cancer quadrupled with 5 years of tamoxifen treatment
C:-Levonorgestrel intrauterine device (IUD) is not effective to protect the endometrium against hyperplasia and polyps in women using tamoxifen
D:-Tamoxifen is associated with an ultrasonographic image that is characterized by sonolucent changes that are subepithelial in the presence of atrophic epithelium
Correct Answer:- Option-C

Question15:-Identify the FALSE statement about Endometrial Hyperplasia
A:-Lesions without atypia basically represent only exaggerated forms of persistent proliferative endometrium and are associated with little risk (1-3%) for progression to adenocarcinoma
B:-Atypical endometrial hyperplasia does not often spontaneously regress and has significant risk (10-30%) of progression to adenocarcinoma if left untreated
C:-There is significant risk (upto 40%) of an unrecognized adenocarcinoma in endometrial hyperplasia with atypia
D:-Biopsy is not indicated when the clinical history suggests long-term unopposed estrogen exposure but the endometrial thickness is 5-12 mm
Correct Answer:- Option-D

Question16:-STRAW stage-3a is characterized by
A:-menstrual cycles are relatively unchanged, the serum levels of FSH are low, AMH and inhibin B are low
B:-menstrual cycles become shorter, FSH increases, while AMH, AFC and inhibin B declines
C:-periods of amenorrhea lasting greater than or equal to 60 days, FSH level in menopausal range, vasomotor symptoms such as hot flushes
D:-undetectable AMH, Inhibin and occasional antral follicle
Correct Answer:- Option-B

Question17:-The FALSE statement regarding Menopausal Hormone Therapy (MHT/HRT) is
A:-Continuous, combined estrogen-progestin regimens of HRT has more risk for endometrial cancer than long-term sequential regimens
B:-Ospemifene is given orally for the treatment of vulvar and vaginal atrophy
C:-Bazedoxifene combined with conjugated estrogens is effective for hot flushes and vaginal atrophy, prevents bone loss and does not stimulate the endometrium or cause breast tenderness
D:-The use of tibolone in women with a history of breast cancer remains relatively contraindicated
Correct Answer:- Option-A

Question18:-All the statements about Emergency Contraception are TRUE EXCEPT
A:-Copper IUD can be used anytime during the preovulatory phase of the menstrual cycle and upto 8 days after ovulation
B:-Ulipristal acetate is slightly more effective than the single 1.5-mg dose of levonorgestrel when used within 120 hours
C:-Mifepristone prevents about 80-85% of expected pregnancies and has the same efficacy and side effects as levonorgestrel method
D:-Treatment with Levonorgestrel acts primarily by preventing or delaying ovulation and by preventing fertilization
Correct Answer:- Option-A

Question19:-The FALSE statement about etonogestrel Implant (Nexplanon) is
A:-Inhibits ovulation by preventing LH surge and failure rate is 0.01%
B:-Implants have an immediate contraceptive effect when inserted within the first 7 days of a menstrual cycle
C:-Implants should not be inserted immediate postpartum
D:-It is absolutely contraindicated in women with active thromboembolic disease or known breast cancer
Correct Answer:- Option-C

Question20:-All the statements about reproductive ageing are TRUE EXCEPT
A:-Age related Oocyte aneuploidy results primarily from premature separation of sister chromatids during meiosis I or from whole chromosome nondisjunction during meiosis II
B:-Miscarriage riks and the prevalence of aneuploidy oocytes are relatively low and change little until approximately age 35
C:-Live birth rates in donor egg IVF cycles relate to the age of the donor, not the age of the recipient
D:-Aging itself is thought to be a significant factor influencing uterine endometrial response to steroids and receptivity
Correct Answer:- Option-D

Question21:-Identify the FALSE statement regarding Test for Ovarian Reserve
A:-Total number of antral follicles measuring 2-10 mm in both ovaries is proportional to the number of primordial follicles remaining
B:-Small antral follicles (2-6 mm) are likely the primary source of AMH because they contain larger numbers of granulosa cells and a more developed microvasculature
C:-Recent studies suggest AMH levels decrease with the use of oral contraceptives and GnRH agonists
D:-A single elevated Day -3 FSH concentration (>10 IU/L) has high specificity for predicting poor response to stimulation or failure to achieve pregnancy
Correct Answer:- Option-D
Question22:-Find the FALSE statement
A:-The prevalence of uterine anomalies in infertile women and fertile women with normal reproductive outcomes is similar, approximately 2-4%
B:-Submucousmyomas reduce IVF success rates by approximately 70% and intramural myomas by approximately 20-40%
C:-Hysteroscopic polypectomy may improve reproductive performance in infertile women
D:-Conception and term delivery rates after successful hysteroscopiclysis of intrauterine adhesions are > 80%
Correct Answer:-Question Cancelled

Question23:-The FALSE statement regarding Male infertility is
A:-2-5% of men with severe oligospermia and 8% of men with azoospermia may have Y chromosome microdeletions
B:-Hyperprolactinemia and treatment with GnRH analogs or androgens can cause hypogonadotropic hypogonadism in males
C:-Men with idiopathic infertility have significantly lesser CAG trinucleotide repeat lengths in androgen receptor gene
D:-Disorders of estrogen synthesis or action may be associated with infertility in men
Correct Answer:- Option-C

Question24:-Risk factors for Ovarian Hyperstimulation Syndrome (OHSS) include all EXCEPT
A:-Young age
B:-Higher BMI
C:-Higher AMH and AFC
D:-Higher serum Oestradiol
Correct Answer:- Option-B

Question25:-Preimplantation Genetic Testing (PGT) - Find the FALSE statement
A:-Can be used to detect numerical chromosomal aneuploidies and monogenic disorders but not structural rearrangements
B:-Chromosomal composition of the oocyte may be inferred from that of the extruded polar bodies
C:-One or two blastomeres may be removed from cleavage stage embryos
D:-Biopsy of the trophectoderm can be performed at the blastocyst stage and has become the most commonly used technique
Correct Answer:- Option-A


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