TNPG 2006 Obstetrics and Gynaecology

OBSTETRIC AND GYNAECOLOGY

169) Inhibin suppresses

a. FSH

b. Mineralocorticoids

c. Insulin

d. Heart Rate

Answer (a) FSH

Reference: Ganong 22^nd Edition Page 433

170) Abortion is defined as expulsion of fetus

a. Before Viability

b. Before 28 weeks

c. Any of the above

d. None of the above

Answer (a) Before Viability

Reference: Dutta Obstetrics 4^th Edition Page 171

Abortion is the termination of pregnancy before the period of viability which is considered to occur at 28^th Week. However for international acceptance, the limit of viability is brought down to either 20^th week or fetus weighing 500 gm. If the expelled fetus weighs less than 500 gm, it is called abortus. The term miscarriage, which is mostly used, is synonymous with abortion

171) Etiology for Transverse Lie

a. Subseptate Uterus

b. Arcuate Uterus

c. Both

d. None

Answer (c) Both

Reference: DUtta obstetrics 4^th Edition Page 423

172) IUGR in USG is diagnosed and assessed by

a. Head to abdomen and Femur to Abdomen Ration

b. Ponderal Index

c. Amniotic Fluid Index

d. All of the above

Answer (d) All of the above

Reference: Dutta obstetrics 4^th Edition Page 498

Note : In the past years, the questions have also asked the Single Best Finding in USG to detect IUGR

173) Most Common Polyp In Uterus is

a. Mucous Polyp

b. Fibroid Polyp

c. Placental Polyp

d. Malignant Polyp

Answer (a) Mucous Polyp

Reference: Dutta Gynaecology 2^nd Edition Page 260

174) SION Test is done

a. During Menstruation

b. On the 10^th Day

c. Post Ovulatory

d. On the 21^st Day

Answer (c)Post Ovulatory

Reference: Dutta Gynecology 2^nd Edition Page 219

Sonosalpingography (visualization of the fallopian tubes with ultrasound) using a variety of media (saline, albuminex, air) has been investigated as a way to document tubal patency or the presence of hydrosalpinges. Apparently the use of special media (such as suspensions of galactose microparticles) is helpful for consistently visualizing tubal passage. A Sion procedure was described (from the Sion Hospital in India) in which the cul de sac behind the uterus (a potential space also called the pouch of Douglas) is filled with about 300 cc of sterile normal saline to better visualize patency of the tubes, tubal motility and peritubal pathology. The available information on the use of these techniques for documenting tubal patency and presence of hydrosalpinges is conflicting, with many pioneers in this field finding the sensitivity of this technique disappointing for the diagnosis of tubal pathology.

The Sion procedure involves instillation of the pouch of Douglas with approximately 300ml of sterile normal saline to elucidate not only the patency of the fallopian tube but visualise the motility, the fimbriae, and peritubal adhesions if present

Dr.Gautam Allahbadia, was awarded the Dr. Kumud Tamaskar Prize for the year 1991 by FOGSI for original research work in infertility - “The Sion Procedure- A new procedure for evaluation of tubal status”. “The Sion Test” was published as ‘Article this month’ in “THE PULSE” official publication of the Bandra Khar Medical association, 15th March, 1992.

175) All of the following are Remnants of Wolfian duct except

a. Gartners Cyst

b. Organ or Giraldes

c. Pedunculated Hydatid of Morgagni

d. Sessile Hydatid of Morgagni

Answer (d) Sessile Hydatid of Morgagni

Reference: Das, Concise Textbook of Surgery, 3^rd Edition Page 1278

176) A 20 year old woman gives a history of sharp pain in the lower abdomen for 2-3 days every month approximately 2 weeks before the menses. The most probable etiology for her pain is:

a. Endometriosis.

b. Dysmenorrhea.

c. Pelvic tuberculosis.

d. Mittelschmerz.

Answer d. Mittelschmerz.

Reference Shaw 12th Edition Page 229

177) In adult Female Gonorrhea Affects all Except

a. Vagina

b. Uterus

c. Cervix

d. Urethera

Answer (a) Vagina

Reference: Ananthanarayanan 7^th Edition Page 227

The vaginal mucosa is not usually affected in adults because the stratified epithelium is resistant to infection by the cocci and also because of the acidic pH of the vaginal secretions. However vulvovaginitis occurs in prepubertal girls

178) Fallopian Tube Ideal Site For Sterlisation where occlusion is done is

a. Isthumus

b. Ampulla

c. Fibriae

d. Infundibulum

Answer (a) Isthumus

Reference: Dutta Gynaecology 2^nd Edition Page 440

179) Pap Smear Can identify Ca Cervix in how many percentage of cases

a. 50%

b. 98%

c. 2 %

d. 20 %

Answer (b) 98 %

Reference: Dutta Gynaecology 2^nd Edition Page 108

180) Late Deceleration occurs in

a. Head Compression

b. Cord Compression

c. Chronic Placental Insufficiency

d. None of the above

Answer (d) None of the above

Reference: Dutta obstetrics 4^th Edition Page 654

Cardiotocography
Finding	Condition
Early Deceleration	Head Compression
Late Deceleration	Chronic Placental insufficiency
Variable Deceleration	Cord Compression

181) About the interpretation of intrapartum cardiotocograph

a. Baseline Heart Rate is between 120 to 160 beats per minute

b. Baseline variability is between 5 to 25 beats per minute

c. Deceleration is decreases in Fetal Heart Rate below the base line by 15 bpm or more

d. All are correct

Answer (d) All are correct

Reference: Dutta obstetrics 4^th Edition Page 653

182) Contraindication for LSCS

a. Carcinoma Cervix

b. Placenta Praevia

c. Repair of difficult and High VVF

d. All of the above

Answer (d) All of the above

Reference: Dutta Obstetrics 4^th Edition Page 634

183) Gestational Age in Pregnancy is calculated by

a. Nine months + 7 days

b. Nine lunar months

c. 280 days

d. All The Above

Answer : (d) All of the above

Reference: Dutta Obstetrics 4^th Edition Page 66

184) Progress of Labour is monitored by

a. Cervix Dilatation

b. Descent

c. Maternal Pulse

d. All of the above

Answer (d) All of the above

Reference: Dutta Obstetrics 4^th Edition Page 137

185) Trichomonas Vaginalis is treated with

a. Metronidazole

b. Clotrimazole

c. Both

d. None

Answer (c ) Both

Reference: Dutta Gynaecology 2^nd Edition Page 151

186) Broad Ligmaent that extends from the infundibulum of the Fallopian tube to the lateral pelice wall is called as

a. Infundibulo Pelvic Ligament.

b. Suspenspory ligament of ovary

c. Both

d. None

Answer (c ) Both

Reference: Dutta Gynaecology 2^nd Edition Page 22

187) Example of Anti Androgen is

a. Danazol

b. Flutamide

c. Both

d. None

Answer (b) Flutamide

Reference: KD Tripathi 5^th Edition Page 272

188) Oligospermia means

a. No semen

b. No sperm in semen

c. Dead Sperm

d. Sperm count of less than 20 million

Answer (d ) Sperm count of less than 20 million

Reference: Dutta Gynaecology 2^nd Edition Page 215

TNPG 2006 SURGERY

SURGERY

199) Strawberry haemangioma is

a. Capillary Hemangioma

b. Cavernous Hemangioma

c. Arterial Hemangioma

d. Plexiform Hemangioma

Answer : (a)

Reference: Surgical Short Cases, S.Das, 2^nd Edition Page 12

200) Most Common Neoplasm of Major Salivary Glands is

a. Pleomorphic Adenoma

Answer : (a) Pleomorphic Adenoma

Reference: Surgical Short Cases, S.Das, 2^nd Edition Page 99

Bailey and Love 24^th Edition Page 730

201) MC Parotid Tumour is

a. Pleomorphic Adenoma

Answer : (a) Pleomorphic Adenoma

Reference: Surgical Short Cases, S.Das, 2^nd Edition Page 99

Bailey and Love 24^th Edition Page 730

NOTE – The same question was asked twice in TNPG 2006

202) Parotid Gland is transversed by branches of

a. VII Nerve

b. IX Nerve

c. X Nerve

d. XI Nerve

Answer : ( a) VII Nerve

Reference: Bailey and Love 24^th Edition Page 727

203) All are characteristic features of Gout except

a. Due to problems in Pyrimidine Degradation

b. Heberden’s node

c. Bouchard’s nodes

d. Metatarsophalangeal joint of the first toe is often involved

Answer : ( a) Due to problems in Pyrimidine Degradatio

Reference: Harrison 16^th Edition Pages 2046 and 2308

204) Occult Filariasis means

a. Microfilarie Not Seen In peripheral blood, but seen in tissues

b. Microfilarie Not Seen In tissues but seen in peripheral blood

c. Both

d. None of the above

Answer : ( d)

Reference:

Bailey and Love 24^th Edition Page 164

Ä The term Occult Filariasis is commonly used to designate filarial infections in which mf are not found in the periphral blood although they may be seen in other body fluids and tissues. However, it has now been shown that in some cases with occult filariasis, mf may actually be found after more careful blood examination despite their low density. Occult filariasis is believed to result from a hypersensitivity reaction to filarial antigens derived from microfilariae.Only a very small proportion of individuals in a community where filariasis is endemic develop occult forms of the disease.

205) Asymmetrical Septal Hypertrophy with Myocardial disarray is seen in

a. VSD

b. ASD

c. HOCM

d. None of the above

Answer : ( c) HOCM

Reference: Braunwald Chapter 3 - echocardiography

Hypertrophy of the septum with abnormal organization of myocardial cells may be one of the basic abnormalities of HCM, and a key echocardiographic finding is disproportionate hypertrophy of the septum in relation to the posterior wall of the left ventricle, so that the ratio of thickness of the septum to the free wall exceeds 1.3:1.0 and the motion of the hypertrophied septum is reduced. It has also been shown that asymmetrical septal hypertrophy (ASH) is frequently transmitted as an autosomal dominant trait and that there are patients with asymmetrical septal hypertrophy who do not show SAM and therefore do not have obstruction to left ventricular outflow. These patients may be considered to have HCM without obstruction. While the concept of recognizing ASH with or without obstruction to left ventricular outflow by echocardiography is an important one, there are limitations to echocardiographic diagnosis. First, the thickness of the septum may be difficult to measure precisely echocardiographically. Second, it must be appreciated that ASH is not pathognomonic for HCM and related myopathies and can occur in a variety of other disease states, including right ventricular hypertrophy. In addition, some patients with HCM may have concentric rather than asymmetrical hypertrophy, in which the septal and posterior left ventricular walls are equal in thickness.

206) Ranula

a. ExtraVasation Cyst

b. Retention Cyst

c. Exudation Cyst

d. None of the above

Answer : ( b) Retention Cyst

Reference: Surgical Short Cases, S.Das, 2^nd Edition Page 57

207) Prostatic Cancer in T2 Weighted Image presents as

a. Decreased Signal

b. Increased Signal

c. No Change

d. None of the above

Answer : ( a ) Decreased Signal

Reference: Harrison 16^th Edition Page 546

208) Best Method Of Investigation of Gall Stone is

a. X Ray

b. USG

c. CT

d. MRI

Answer : ( b) USG

Reference:

Bailey and Love 24^th Edition Page 1097

209) Cranio Facial Dysjunction is seen in

a. Lefort I Fracture

b. Lefort II Fracture

c. Lefort III Fracture

d. None of the above

Answer : (C ) Lefort III

Reference: Bailey and Love 24^th Edition Page 667

210) All are true regarding Mobius Syndrome except

a. Bilateral Abductor Palsy

b. Bilateral Facial Palsy

c. Both

d. None

Answer : ( d)

Reference: Nelson 15^th Edition Table 266.1 and Chapter 574

Ä The distinctive features of Möbius syndrome are congenital facial paresis and abduction weakness.

o The facial palsy is commonly bilateral, frequently asymmetric, and often incomplete, tending to spare the lower face and platysma. Ectropion, epiphora, and exposure keratopathy may develop.

o The abduction defect may be unilateral or bilateral. It is usually complete, and esotropia is common.

Ä The etiology is unknown. Whether the primary defect is maldevelopment of cranial nerve nuclei, hypoplasia of the muscles, or a combination of central and peripheral factors is unclear. Gestational factors such as trauma, illness, and intake of various drugs, particularly thalidomide, have been implicated. Some familial cases have been reported. Associated developmental defects may include ptosis, palatal and lingual palsy, hearing loss, pectoral and lingual muscle defects, micrognathia, syndactyly, supernumerary digits, or the absence of hands, feet, fingers, or toes. Surgical correction of the esotropia is indicated in selected cases, and any attendant amblyopia should be treated.

Ä In newborns, the first symptom is an inability to suck. Excessive drooling and strabismus (crossed eyes) may occur. Other symptoms may include lack of facial expression; inability to smile; feeding, swallowing, and choking problems; eye sensitivity; motor delays; high or cleft palate; hearing problems; and speech difficulties. Deformities of the tongue, jaw, and limbs, such as club foot and missing or webbed fingers, may also occur.

Ä Most patients have low muscle tone, especially in the upper body. Mental retardation may also occur. As children get older, lack of facial expression and inability to smile become the dominant visible symptoms.

211) Percentage of Cold nodes that are malignant

a. About 20 %

b. About 50 %

c. About 75 %

d. 100 %

Answer : ( a) About 20 %

Reference: Bailey and Love 24^th Edition Page 785

212) Most common form of External abdominal hernia is

a. Inguinal

b. Paraumbilical

c. Incisional

d. Femoral

Answer : (a) Inguinal

Reference: Bailey and Love 24^th Edition Page 1274

213) Enterofaecal Fistula which results in leakage of feces is due to

a. Persistent Omphalo Mesenteric Duct

b. Patent Urachus

c. Both

d. None

Answer : ( a) Persistent Omphalo Mesenteric Duct

Reference: Surgical Short Cases, S.Das, 2^nd Edition Page 235

Omphalomesenteric Duct Remnants.

Ä Remnants of the omphalomesenteric (vitelline) duct may present as abnormalities related to the abdominal wall. In the fetus, the omphalomesenteric duct connects the fetal midgut to the yolk sac. This normally obliterates and disappears completely. However, any or all of the fetal duct may persist and give rise to symptoms.

Ä An umbilical polyp is a small excrescence of omphalomesenteric duct mucosa that is retained in the umbilicus. Such polyps resemble umbilical granulomas except that they do not disappear after silver nitrate cauterization. They may be associated with a persistent vitelline duct or umbilical sinus. Appropriate treatment is excision of the mucosal remnant.

Ä Umbilical sinuses result from the continued presence of the umbilical end of the omphalomesenteric duct. These resemble umbilical polyps, but close inspection reveals the presence of a sinus tract deep to the umbilicus. The morphology of the sinus tract can be readily delineated with a sinogram. Treatment is excision of the sinus.

Ä Persistence of the entire omphalomesenteric duct is heralded by the passage of enteric contents from the umbilicus. This is seen in the early neonatal period and should be treated promptly with laparotomy and excision of the duct to avoid intussusception or volvulus.

Ä Cystic remnants of the omphalomesenteric duct may persist and be asymptomatic for long periods of time. The cysts may be connected to the ileum with a fibrous band that is a remnant of the obliterated omphalomesenteric duct. Patients may present with acute volvulus and intestinal obstruction or with acute abdomen because of cyst infection. The cysts usually remain undiagnosed until operation, at which time they should be excised.

Ä Meckel's diverticulum results when the intestinal end of the omphalomesenteric duct persists. This is a true diverticulum of the intestine with all layers of the intestinal wall represented.

214) Paralytic Ileus is due to all except

a. Peritonitis

b. Hyperkalemia

c. Fracture Spine or Ribs

d. Abdominal Surgery

Answer : ( b) Hyperkalemia

Reference: Bailey and Love 24^th Edition Page 1201

215) Mycotic aneurysm is an aneurysm infected because of :

a. Fungal infection.

b. Blood borne infection (intravascular)

c. Infection introduced from outside (extravascular)

d. Both intravascular & extravascular infection.

Answer (b) Blood borne infection (intravascular)

Reference: Harrison 16th Edition Page 1481 and Oxford Textbook of Medicine Chapter 7.7.7

216) Laryngocele arises as a herniation of laryngeal mucosa through the following membrance:

a. Thyrohyoid.

b. Criciothyroid.

c. Crico-tracheal.

d. Crisosternal.

Answer a Thyrohyoid.

Reference: A Concise textbook of Surgery, 3rd Edition Page 623

217) The treatment of choice for the management of carcinoma of the anal canal is :

a. Abdomino perineal resection.

b. Primary radiotherapy.

c. Combined radio-and chemotheraphy.

d. Neoadjuvant chemotherapy and local excision.

Answer (c) Combined radio-and chemotheraphy.

Reference: Bailey and Love 24th Edition Page 1271

218) Which of the following drugs is not a part of the ‘Triple Therapy’ immunosuppression for post renal transplant patients?

a. Cyclosporine.

b. Azathioprine.

c. FK 506.

d. Prednisolone.

Answer (c) FK 506.

Reference: Tripathi 5th Edition Page 790 and Sabistons 15th Edition Chapter 20

TNPG 2005 ANAESTHESIA

ANAESTHESIA

1) Pulse oximeter used to measure

a. Oxygen saturation

b. Oxygen content

c. partial pressure of Oxygen

d. all of the above

Answer a) Oxygen Saturation

Reference: Ajay Yadav 47

2) Analgesia of choice in a pregnant women in CVS disease complicating pregnancy is

a. Spinal Anaesthesia

b. Epidural Anaesthesia

c. General Anaesthesia

d. Local Anaesthesia

Answer B) Epudiral Anaesthesia

Reference: Dutta 4^th Edition Page 296

3) An anesthetist orders a new attendant to bring the oxygen cylinder. He will ask the attendant to identify the correct cylinder by following color code:

a. Black cylinder with white shoulders.

b. Black cylinder with gray shoulders.

c. White cylinder with black shoulders.

d. Grey cylinder with white shoulders.

Answer A).Black cylinder with white shoulders.

Reference Understanding Anaesthesia Equipments - 4th Edition Dorsch and Dorsch Page 13

4) A 25 years old male is undergoing incision and drainage of abscess under general anesthesia with spontaneous respiration. The most efficient anaesthetic circuit is:

a. Mapleson A.

b. Mapleson B.

c. Mapleson C.

d. Mapleson D.

Answer A). Mapleson A.

Reference Understanding Anaesthesia Equipments - 4th Edition Dorsch and Dorsch . Page 209

5) A 38 year old man is posted for extraction of last molar tooth under general anaesthesia as a day care case. He wishes to resume his work after 6 hours. which one of the following induction agents is preferred:

a. Thiopentone sodium

b. Ketamine.

c. Diazepam.

d. Propofol

Answer D). Propofol

Reference Clinical Anaesthesia 3rd Edition - Morgan Page 173

6) At the end of a balanced anaesthesia technique with non-depolarizing muscle relaxant, a patient recovered spontaneously from the effect of muscle relaxant without any reversal. Which is the most probable relaxant the patient had received?

a. Pancuronium.

b. Gallamine.

c. Atracurium.

d. Vecuronium.

Answer C).Atracurium.

Reference Clinical Anaesthesia 3rd Edition - Morgan Page 191

TNPG 2005 ENT

ENT

1) The most common diagnosis in a young boy with history of profuse nasal bleeding is

a. Juvenile Naso pharyngeal angiofibroma

b. Nasal polyp

c. Deviated nasal septum

d. Cirrhosis

Answer : a) Juvenile Nasopharyngeal angiofibroma

Reference: Dhingra 3^rd Edition Page 299

2) Left sided vocal cord palsy is commonly due to

a. Left hilar bronchial carcinoma

b. Mitral Stenosis

c. Thyroid Malignancy

d. Thyroid Surgey

Answer : a) Left hilar bronchial carcinoma

Reference: Dhingra 3^rd Edition Page 360

3) Why vocal cord pale

a. Vocal cord is muscle, lack of blood vessels network

b. Absence of mucosa, no blood vessels

c. absence of sub mucosa, no blood vessels

d. absence of mucosa with blood vessels

Answer : c) absence of sub mucosa, no blood vessels

Reference: Gray 38^th Edition Chapter on larynx

4) Presbyacusis is

a. Age associated vision loss

b. Age associated hearing loss

c. Both

d. None

Answer : b) Age associated hearing loss

Reference: Dhingra 3^rd Edition Page 47

5) Acoustic dip in audiogram in noise induced hearing loss is at

a. 4 KHz

b. 3 KHz

c. 2 KHz

d. 1 KHz

Answer : a) 4 KHz

Reference: Dhingra 3^rd Edition Page 46

6) False positive fistula test

a. Perilymph fistula

b. Malignant sceloris

c. Congenital syphilis

d. Cholesteatoma

Answer : c) Congenital Syphilis

Reference: Dhingra 3^rd Edition Page 53

7) Reaction time for tymphanic reflex is

a. 20 to 30 ms

b. 30 to 40 ms

c. 40 to 160 ms

d. 600 to 800 ms

Answer : c) 40 to 160 ms

Reference: ganong 22^nd Edition Page 179

8) Columella effect is seen in

a. Tympanoplasty

b. Septoplasty

c. Tracheostomy

d. None of the above

Answer : a) Tympanoplasty

Reference: Dhingra 3^rd Edition Page 40