Which of the following contraceptive methods has the highest Pearl Index (failure rate) in typical use?
Answer: B
Condoms have a Pearl Index of 12-15 in typical use, making them less reliable than IUDs (0.8), pills (9), or sterilization (0.1-0.15).
Q.22Medium
What is the primary mechanism of action of levonorgestrel as an emergency contraceptive?
Answer: B
Levonorgestrel primarily works by inhibiting or delaying ovulation, especially effective within 72 hours before ovulation. It does not act as an abortifacient.
Q.23Medium
Which stage of spermatogenesis is most sensitive to radiation damage?
Answer: A
Spermatogonial stem cells are most radiosensitive. Damage here affects all subsequent stages. Recovery takes 74 days (duration of spermatogenesis).
Q.24Medium
Which of the following STIs can be VERTICAL transmitted (from mother to child)?
Answer: B
Syphilis (causes congenital syphilis), HIV, Hepatitis B, and HSV can be vertically transmitted. Chlamydia and gonorrhea cause neonatal infections but are acquired during delivery.
Q.25Medium
What is the primary advantage of Copper-T (Cu-IUD) over hormonal IUDs in terms of side effects?
Answer: A
Cu-IUDs work non-hormonally, avoiding systemic hormonal side effects. They are effective for 10 years, longer than some hormonal variants.
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Q.26Medium
A 32-year-old woman presents with amenorrhea and galactorrhea. Pregnancy test is negative. Which investigation would be MOST diagnostic?
Answer: A
Galactorrhea with amenorrhea strongly suggests hyperprolactinemia. Serum prolactin >200 ng/mL indicates pituitary adenoma, while TSH should also be checked for secondary hyperprolactinemia.
Q.27Medium
Which of the following is a characteristic feature of Polycystic Ovary Syndrome (PCOS)?
Answer: A
PCOS typically presents with elevated LH:FSH ratio (>2:1 or 3:1), hyperandrogenism, insulin resistance, and anovulation, not regular cycles.
Q.28Medium
What is the most common chromosomal abnormality in spontaneous miscarriages?
Answer: C
Trisomy 16 is the most common chromosomal abnormality in first-trimester miscarriages (accounts for ~15% of chromosomal losses) but is incompatible with life beyond early pregnancy.
Q.29Medium
A woman using combined oral contraceptive pills reports breakthrough bleeding. Which factor is MOST likely responsible?
Answer: B
Breakthrough bleeding typically results from insufficient progestin to stabilize endometrium. Management includes switching to a pill with higher progestin content.
Q.30Medium
Which sexually transmitted infection is characterized by painless genital ulcers with indurated edges and a clean base?
Answer: B
Primary syphilis presents with painless, indurated ulcers (chancre) with a clean base and raised borders. HSV causes painful vesicles; LGV causes small painless pustules.
Q.31Medium
What is the mechanism of action of misoprostol when used for medical abortion in the first trimester?
Answer: B
Misoprostol, a prostaglandin analog, causes sustained uterine contractions that expel pregnancy tissues. It is typically used after mifepristone (progesterone antagonist) in medical abortion protocols.
Q.32Medium
A couple seeks fertility treatment after 3 years of unprotected intercourse without conception. Which investigation should be done first in the female partner?
Answer: C
Initial infertility workup in females includes confirmation of ovulation (through basal body temperature, progesterone levels) and basic hormone assessment before invasive procedures.
Q.33Medium
During embryonic development, the notochord is primarily derived from which germ layer?
Answer: D
The notochord develops from cells of the primitive node (primitive pit) during gastrulation and serves as the primary organizer for embryonic development.
Q.34Medium
A 32-year-old woman presents with secondary infertility and dysmenorrhea. Imaging shows thickened endometrial tissue outside the uterus. What is the most likely diagnosis?
Answer: B
Endometriosis is characterized by ectopic endometrial tissue outside the uterus, causing dysmenorrhea, pelvic pain, and infertility due to inflammation and mechanical obstruction.
Q.35Medium
Which of the following conditions is associated with increased risk of gestational diabetes mellitus?
Answer: C
Maternal obesity, advanced age (>35 years), family history of diabetes, and previous gestational diabetes are significant risk factors for GDM.
Q.36Medium
A pregnant woman presents with vaginal bleeding in the first trimester and a positive pregnancy test. Pelvic ultrasound shows an empty uterus. What is the most likely diagnosis?
Answer: C
An empty uterus with positive hCG indicates an ectopic pregnancy (implantation outside the uterus), which may present with vaginal bleeding, abdominal pain, and hemodynamic instability.
Q.37Medium
Which of the following is the mechanism of action of levonorgestrel as an emergency contraceptive?
Answer: B
Levonorgestrel prevents or delays ovulation when given within 72 hours of unprotected intercourse and may also alter cervical mucus to impede sperm transport.
Q.38Medium
A 24-year-old woman with irregular cycles is diagnosed with polycystic ovary syndrome. Which hormonal finding is most characteristic?
Answer: B
PCOS is characterized by elevated LH levels relative to FSH (typically LH:FSH ratio >3:1), along with hyperandrogenism and insulin resistance.
Q.39Medium
Which statement about human milk lactation is correct?
Answer: D
Oxytocin triggers the milk ejection reflex (letdown reflex), while prolactin stimulates milk production. Both hormones are essential for successful lactation.
Q.40Medium
Which of the following pathogens is the leading cause of congenital infections in the TORCH group?
Answer: C
CMV is the most common congenital infection, affecting 0.5-1% of live births and causing microcephaly, hearing loss, and developmental delays if acquired in utero.
