Doubts- Obstetrics and gynecology test

This is a copy of my email to Dr.Sakshi arora, am awaiting reply. Please do comment if you have any queries.

Q.9) what is menomettrorrhagia?

a) heavy bleeding + intermenstural bleeding

b)duration of menstural cycle is increased.

c)polymennorrhea +metrorraghia

d) oligomennorrhea + polymennorhea

Ans) i chose option a) heavy bleeding + intermenstural bleeding. But the answer in the key was c) polymennorhea + metrorrhagia. 

I assumed, polymennorhea meant increased frequency while menorraghia meant increased amount(quantity) of bleeding.

Q11)

All the following are contraindications to TCRE except

a)young women

b)enlarged uterus, fibroid

c)endometrial carcinoma

d)premenopausal women

Though i guessed d) premenopausal women and it came out to be correct, i do not know what TCRE stands for! what is it ma`am?

Q17) All the following test are done to diagnose premature rupture of membranes except

a) nitrazine test

b)fern test

c)alpha feto protein test

d) absent fibronectin

Ans) i knew since we discussed in class that , ph changes so option a and b were ruled out. alpha feto protein i thought was taken from mothers blood to diagnose down`s syndrome etc. so i chose option c. Option d) fibronectin test is done to diagnose PROM, so i did not chose it. But the key had the answer as option d) 

The only logic i am able to assume is that it was mentioned it was absent (absent fibronectin), was that the reason for option d) being the right answer ma`am?

Q22) Most common site of metastasis of choriocarcinoma

a) brain

b)vagina

c)ovary

d)Liver

Ans);- answer in key given as b) vagina.   I only knew of canon ball mets in lungs , and i knew it can metastasize to brain. so i chose option a) but where is it given ma`am? i`ve been trying to search for reference for mets to vagina.

Q25) all the following are criteria for giving methotrexate in unruptured ectopic except

a) HCG< 10,000 Miu/ml

b)absent cardiac activity

c)size of gestational sac is not more than 4.5 cm

d) actinomycin D can be used.

Ans) given in key as c) size of gestational sac not greater than 4.5cm.  I wrote option d) actinomycin d can be used, as i thought whether or not using actinomycin D should not affect the criteria for methotrexate administration (i do not know if it is!)

plus i thought size of gest sac should be < 4.5cm to give methotrexate.

Q39) all are features of macrosomic baby except

a) weight > 4 kg on USG

b)abdominal circumference >95th % for that gestational age on USG

c)cause of shoulder dystocia

d) can be a feature of DOPE

i chose option d) feature of DOPE as i do not know what DOPE was, plus other options are true for a macrosomic baby. 

answer given in key was a) baby wt > 4kg. Now i know we had discussed that wt > 4.5 kg is world wide while Wt> 4kg is macrosomia in india. so I am still in confusion. What is DOPE ma`am? is it an abbreviation?

Q69)

Most common cause of secondary amennorrhea is

a) pregnancy

b) tuberculosis

c) thyrotoxicosis

d) none of the above

I blindly wrote pregnancy as we had discussed in class, but i didn realise the mcq also contained tuberculosis, and that was given as answer in the key. So which one is the answer ma`am? Pregnancy or Tb? i thought pregnancy was more common.

Q98) about polymennorrhea which of the following statement is wrong?

a) OCP`s for 3 cycles help

b) PID is important cause

c) proliferative phase is shortened

d) D&C is curative.

I chose option d) D&C is curative thinking, we are just removing endometrium which may stop the bleeding, but how will it cure polymennorrhea, but the answer given was OCP`s for three cycles help. I thought giving OCP will regularize the cycle wont they ma`am?

Q71) drug of choice for hypertension in pregnancy

a) hydralazine

b) ACE inhibitors

c) Labetalol

d) beta agonist

I blindly chose labetalol since , we discussed in class, plus i knew only for chronic HT they use aldomet which is not there in option. But option in the key was a) hydralazine, which few students have written, they then told me it was given in final punch as hydralazine.