Advanced OBG — Fetal Medicine, Colposcopy and Special Topics MCQs

Obstetrics & Gynaecology · 17 free questions with answers & explanations.

1. First-trimester combined screening for Down syndrome (trisomy 21) includes maternal age, nuchal translucency (NT), free β-hCG, and PAPP-A. In a trisomy 21 pregnancy at 12 weeks, the expected pattern of serum markers is:
2. On colposcopy, aceto-white change is identified at the transformation zone. A thick, dense, white lesion with coarse mosaic vascular pattern and irregular surface contour is seen adjacent to the squamocolumnar junction. The colposcopic feature most predictive of high-grade squamous intraepithelial lesion (HSIL/CIN 2–3) is:
3. Cell-free fetal DNA (cfDNA) / Non-Invasive Prenatal Testing (NIPT) is used for aneuploidy screening. The fraction of cell-free DNA in maternal plasma that is of placental (fetal) origin is called the fetal fraction. Below what fetal fraction is NIPT considered a 'no-call' result requiring repeat testing or invasive confirmation?
4. The ORACLE trial evaluated prophylactic antibiotics in preterm premature rupture of membranes (PPROM). Which antibiotic combination was shown to prolong latency significantly but was also associated with increased risk of necrotising enterocolitis (NEC) in the neonate?
5. A 28-year-old woman at 24 weeks presents with cervical length of 16 mm on transvaginal ultrasound and no symptoms. She has no prior history of preterm birth (nulliparous). The most evidence-based intervention to reduce her risk of spontaneous preterm birth is:
6. A 30-year-old woman at 32 weeks with twin pregnancy (dichorionic-diamniotic twins) is noted on routine ultrasound to have estimated fetal weight discordance: Twin A 1,650 g (on the 15th centile) and Twin B 1,200 g (below the 3rd centile). What percentage discordance threshold is used to define significant twin growth discordance?
7. The SMFM and ACOG recommend antenatal corticosteroids for fetal lung maturity in women at risk of preterm birth. For a woman presenting at 34+2 weeks with threatened preterm labour, which of the following is currently recommended?
8. In a twin-to-twin transfusion syndrome (TTTS) at 20 weeks (Stage II on Quintero staging), the most effective treatment to improve dual survival is:
9. According to Quintero staging of TTTS, Stage III is defined by:
10. A 19-year-old woman presents with cyclic pelvic pain since menarche, no menstrual flow visible per vagina, and a bluish bulge at the introitus. MRI pelvis shows a distended vagina filled with haematocolpos. The diagnosis and the embryological structure whose failure to perforate caused this condition are:
11. The Bishop score is used to assess cervical favourability before induction of labour. A Bishop score is calculated: dilation 2 cm (2 pts), effacement 50% (1 pt), consistency medium (1 pt), position mid/central (1 pt), station -2 (1 pt) = total 6. A Bishop score of 6 in a nulliparous woman predicts:
12. A 38-year-old woman with previously treated Stage III ovarian cancer (platinum-sensitive relapse at 18 months) is being considered for second-line therapy. Genetic testing shows germline BRCA2 mutation. After carboplatin-based chemotherapy achieves response, which maintenance therapy has demonstrated the greatest improvement in progression-free survival in this patient profile?
13. A 30-year-old primigravida at 38 weeks has a prolonged second stage (3 hours without descent despite pushing). Fetal head is at +2 station, OA position, CTG is reassuring. Vacuum delivery is planned. Which of the following is an absolute contraindication to vacuum-assisted delivery?
14. A 26-year-old woman has irregular cycles and elevated serum total testosterone of 4.8 nmol/L. Androgen excess work-up also shows elevated DHEAS and 17-hydroxyprogesterone (17-OHP) at 12 nmol/L (normal <6 nmol/L). The most likely underlying diagnosis causing her hyperandrogenism with elevated 17-OHP is:
15. A 33-year-old woman at 16 weeks gestation has an amniotic fluid AFP of 5.0 MoM with a positive acetylcholinesterase on amniocentesis. What fetal condition does this pattern most suggest?
16. In the Confidential Enquiries into Maternal Deaths (India / CEMACH UK), which is consistently the leading cause of direct maternal mortality in India?
17. A 29-year-old woman with unexplained secondary infertility undergoes diagnostic laparoscopy and hysteroscopy. Hysteroscopy reveals intrauterine adhesions obliterating 50–75% of the uterine cavity. According to American Fertility Society (AFS) classification of intrauterine adhesions, this is: