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.42Hard
A 28-year-old female reports irregular menstrual cycles with excessive bleeding. Laboratory tests show elevated FSH and normal prolactin levels. What could be the likely diagnosis?
Answer: B
Elevated FSH with irregular cycles indicates diminished ovarian reserve characteristic of POI. PCOS typically shows normal or low FSH with hyperandrogenism.
Q.43Medium
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.44Easy
What is the correct chronological order of events during the menstrual cycle?
Answer: A
The menstrual cycle begins with menstruation (days 1-5), followed by proliferative phase (days 5-14), ovulation (day 14), and secretory/luteal phase (days 15-28).
Q.45Medium
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.
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Q.46Hard
A couple has been trying to conceive for 2 years without success. The male partner has normal semen analysis. What is the next appropriate investigation for the female partner?
Answer: A
HSG is the first-line radiological investigation for assessing tubal patency and uterine cavity in suspected secondary infertility after normal male factor evaluation.
Q.47Easy
Which hormone is essential for maintaining the corpus luteum during the first 8 weeks of pregnancy?
Answer: B
hCG produced by trophoblastic cells maintains the corpus luteum until week 8-10, after which placental progesterone takes over luteal function.
Q.48Medium
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.
Q.49Medium
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.50Hard
During in vitro fertilization (IVF), what is the purpose of using GnRH agonists in the downregulation phase?
Answer: B
GnRH agonists cause initial stimulation followed by desensitization, suppressing endogenous LH and FSH to prevent premature ovulation during controlled ovarian hyperstimulation.
Q.51Medium
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.52Easy
What is the recommended interval for cervical cancer screening using Pap smear in women aged 21-65 years with normal previous results?
Answer: B
As per WHO and Indian guidelines, women with normal Pap smear results should be screened every 3 years. Annual screening is reserved for high-risk cases.
Q.53Hard
A 26-year-old male presents with complaints of erectile dysfunction and reduced sperm count. Testosterone level is 2.5 ng/mL (normal: 3-10 ng/mL). What could be the underlying cause?
Answer: B
Low testosterone with erectile dysfunction requires assessment of LH and FSH. If LH/FSH are low, it indicates secondary hypogonadism (pituitary/hypothalamic origin).
Q.54Medium
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.55Medium
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.56Medium
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.57Hard
During oogenesis, at which stage does the first meiotic division complete?
Answer: B
Oocytes arrest in prophase I during fetal development and remain in this arrested state (dictyotene). First meiotic division completes just before ovulation, producing secondary oocyte and polar body.
Q.58Medium
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.59Easy
Which hormone is primarily responsible for maintaining the corpus luteum during early pregnancy?
Answer: A
hCG is secreted by the trophoblast cells of the blastocyst and maintains the corpus luteum, preventing its degeneration and ensuring continued progesterone production during early pregnancy.
Q.60Medium
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.
