Obsterics & Gynecology
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Kanal postlari
Correct Answer - A
Ans. A. 21 alpha-hydroxylase
The condition described above represents the Congenital adrenal
hyperplasia.
"More than 90% of CAH cases are caused by 21-hydroxylase
deficiency"
Congenital adrenal hyperplasia:
It is due to an inborn error of adrenal steroid metabolism, commonly
due to 21-hydroxylase (95%) and rarely due to 11-hydroxylase or 3β
hydroxysteroid dehydrogenase deficiency.
Clinical presentation
An ambiguity of sex at birth
Hirsutism and amenorrhea may be the presenting features around
puberty in a milder form.
The karyotype is 46, XX.
Ref. Dutta Gynaecology ed. 6th page no. 440
| 2 | 13 yr old child visit gynaecology OPD
with a complaint of not attaining
menarche with karyotype 46XX. On examination, clitoromegaly is seen. Which enzyme is most likely to be deficient in the above condition? | 938 |
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| 4 | Submentovertical diameter is the longest diameter of fetal skull.
The submentovertical diameter extends from the junction of the floor of the mouth and neck to the highest point on sagittal suture.
Shortest diameters of fetal skull: Bimastoid (7.5 cm) > Bitemporal (8 cm)
Longest diameter
vertical (14 cm) > Supmentovertical | 3 815 |
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| 7 | Correct Answer - D
Unprotected intercourse without regard to the time of the month carries an 8% incidence of
pregnancy, an incidence that can be reduced to 2% by the use of emergency contraceptives within 72 hours of unprotected intercourse. 0.75 mg levonorgestrel are now approved for postcoital contraception and are available over the counter for women aged >17 years. Levonorgestrel is more effective and is associated with fewer side effects than the combination estrogen-progestin regimens Basically the methods used interfere with the physiological events before implantation, for e.g. inhibition or delaying of ovulation or interference with postovulatory events necessary for implantation & longevity of the blastocyst.
Ref: Hall J.E. (2012). Chapter 347. The Female Reproductive System, Infertility, and Contraception. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. | 6 148 |
| 8 | Matn yo'q... | 6 900 |
| 9 | Correct Answer - C
Ans. is i.e. Serum lactic dehydrogenase however placental alkaline phosphate and lactate dehydrogenase are commonly produced by dysgerminomas and may be useful in monitoring the disease. | 5 055 |
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| 13 | Correct Answer - A
Ans. is 'a' i.e., Iron
Required more during lactation as compared to pregnancy: Energy, Vitamin A, thiamin, riboflavin, Vitamin C, niacin, and Vitamin B12. Required more during pregnancy: Iron, protein, and folate. Same requirment in pregnancy and lactation: Fat, calcium, zinc, magnesium, and vitamin B6. | 4 374 |
| 14 | Matn yo'q... | 5 551 |
| 15 | Correct Answer - A
Ans. is None/ a i.e. 3-4 mm
"7he Endometrium is in the secretory phase corresponding to 20 -
21 days of cycle" at the time of implantation. "After ovulation, the endometrium now demonstrates a combined reaction to estrogen and progesterone activity. Most impressive is that total endometrial height is fixed at roughly its preovulatory extent (5-6 mm) despite continued availability of estrogen." Reading the above text it is clear that endometrium is - 5 - 6 mm thick at the time of implantation, which is not given in the option. Still if you have to mark one answer option 'a' i.e. 3 - 4 mm being closest could be right.
Extra Edge
Implantation occurs 7 - 9 days after ovulation.
In human, the blastocyst burrows in the uterine cavity till whole of it lies within the thickness of endometrium. This is called as interstitial implantation.
After implantation of the embryo the uterine endometrium is called the decidua".
Decidua basalis - The part of decidua where the placenta is to be formed.
Decidua Capsularis - The part of the decidua that separates the
embryo from the uterine lumen. | 4 423 |
| 16 | Matn yo'q... | 5 065 |
| 17 | Correct Answer - C
CO2
CO, is the gas used to create pneumoperitoneum during laparoscopy.
Other option is - N20: But it is expensive, less soluble in blood and supports combustion.
Also know:
Instrument used for creating pneumoperitoneum is veress needle. Flow Rate of CO, for creating pneumoperitoneum 200 - 2000 ml/min & pressure between 15 - 25 mm of Hg. | 4 459 |
| 18 | Matn yo'q... | 5 320 |
| 19 | Correct Answer - A Streptococci | 4 606 |
| 20 | Matn yo'q... | 6 047 |
