MCQs on Obstetrics and Gynaecology - 2

1:-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 sexdetermination the automatic result in the absence of a testis-determining factor

Correct Answer:- Option-D

2:-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

3:-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

4:-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

5:-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

6:-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

7:-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

8:-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

9:-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

10:-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

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