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৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived]

পরীক্ষা৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived]তারিখতারিখ অনির্ধারিতসময়20 minutes
মোট প্রশ্ন৪০
সিলেবাস
Exam - 19 Obstetrics and Gynaecology-03 1. Obstetric Operative Procedures Episiotomy, Caesarean section, vacuum and forceps deliveries Version, destructive operations: their indications and complications Steps of operation: Episiotomy, vacuum & forceps delivery 2. Vital Statistics Maternal morbidity & mortality Perinatal morbidity and mortality Neonatal morbidity & mortality 3. Anatomy of the Female Reproductive Organs (a) Basic anatomy of uterus, ovaries, tubes, vagina and vulva (b) Relationship of uterus, ovaries, tubes and vagina to other pelvic organs (c) Developmental anomaly of genital organs Physiology of Reproduction (a) Puberty and its complications, menstruation, ovulation (b) Fertilisation and implantation 4. Bleeding in Early Pregnancy Abortion: Definition, types, causes and management of all types of abortion and its complications Ectopic Pregnancy: Definition, aetiopathology, clinical features, differential diagnosis and abdomen of acute, principles of surgical management Trophoblastic Tumours 5. Bleeding in Early Pregnancy (continued) (i) Hydatidiform mole: Types, clinical features, complications, differential diagnosis, management and follow-up (ii) Choriocarcinoma: Diagnosis and management, follow-up 6. Vaginal Discharge Physiological and pathological, diagnosis and treatment
প্রশ্ন দেখুনঅনুশীলন
ঘনত্ব
উত্তর
উত্তরিতবর্তমানপুনরায় দেখুনঅসম্পূর্ণ

৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived]

৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived] · তারিখ অনির্ধারিত · ৪০ প্রশ্ন

১.
What is the colour doppler finding of placenta in ectopic pregnancy -
  1. ক
    Ring of fire pattern
  2. খ
    Snowstrom appearence
  3. গ
    Peritoneal opacity
  4. ঘ
    Powder burn appearance
সঠিক উত্তর: ক
Ring of fire pattern
উত্তর
সঠিক উত্তর: ক
Ring of fire pattern
ক
ব্যাখ্যা
Explanation :
Color Doppler Sonography:
(TV-CDS)-can identify the placental shape (ring-of-fire pattern) and enhanced blood flow pattern outside the uterine cavity.
২.
Following which is the indirect cause of maternal mortality -
  1. ক
    Haemorrhage
  2. খ
    Infection
  3. গ
    Anaemia
  4. ঘ
    Hypertension in pregnancy
সঠিক উত্তর: গ
Anaemia
উত্তর
সঠিক উত্তর: গ
Anaemia
গ
ব্যাখ্যা
Explanation :
Anaemia is an indirect cause of maternal death. 
About 50% of pregnant women worldwide suffer from anaemia.Anaemia is commonly dietary deficiency. 
৩.
Measurements of cervix -
  1. ক
    5 cm
  2. খ
    2.5 cm
  3. গ
    1.25 cm
  4. ঘ
    1 cm
সঠিক উত্তর: খ
2.5 cm
উত্তর
সঠিক উত্তর: খ
2.5 cm
খ
ব্যাখ্যা
Explanation :
Cervix:
The cervix is the lowermost part of the uterus. It extends from the histological internal os and ends at external os which opens into the vagina after perforating the anterior vaginal wall.
It is almost cylindrical in shape and measures about 2.5 cm in length and diameter.
৪.
Chriocarcinoma is affect which type of ovarian cell -
  1. ক
    Sex cord stroma
  2. খ
    Epithelium
  3. গ
    Germ cell
  4. ঘ
    Polygonal and endocrinal
সঠিক উত্তর: গ
Germ cell
উত্তর
সঠিক উত্তর: গ
Germ cell
গ
ব্যাখ্যা
Explanation :
Choriocarcinoma is a variety of germ cell tumor of ovary.
It affect germ cell of ovary.
৫.
What is the anterior relation of uterine body -
  1. ক
    Antetior layer of pouch of Douglas
  2. খ
    Pelvic cellular tissue
  3. গ
    Posterior wall of uterovasical pouch
  4. ঘ
    Broad ligament
সঠিক উত্তর: গ
Posterior wall of uterovasical pouch
উত্তর
সঠিক উত্তর: গ
Posterior wall of uterovasical pouch
গ
ব্যাখ্যা
Explanation :
Relations of uterine body :
Anteriorly: Above the internal os, the body forms the posterior wall of the uterovesical pouch. Below the internal os, it is separated from the base of the bladder by loose areolar tissue .
Posteriorly: It is covered by peritoneum and forms the anterior wall of the pouch of Douglas containing coils of intestine
Laterally: The double folds of peritoneum of the broad ligament are attached laterally between which the uterine artery ascends up.
৬.
What is the main support of uterus prevent prolapse -
  1. ক
    Pubocervocal ligament
  2. খ
    Uterosacral ligament
  3. গ
    Urogenital diaphragm
  4. ঘ
    Perineal body
সঠিক উত্তর: খ
Uterosacral ligament
উত্তর
সঠিক উত্তর: খ
Uterosacral ligament
খ
ব্যাখ্যা
Explanation :
Uterosacral ligament :
These are the primary proximal suspensory ligaments of the uterovaginal complex.
They hold the cervix posteriorly at the level of the ischial spines.
Uterus is thus maintained anteflexed and the vagina is suspended over the levator plate.
৭.
Sensory supply of the skin of vulva is supplied by which nerve -
  1. ক
    Ilioinguinal nerve
  2. খ
    Genital branch of genitofemoral nerve
  3. গ
    Posterior cutaneous nerve of thigh
  4. ঘ
    Pudendal nerve
সঠিক উত্তর: ঘ
Pudendal nerve
উত্তর
সঠিক উত্তর: ঘ
Pudendal nerve
ঘ
ব্যাখ্যা
Explanation :
Pudendal Nerve
The sensory component supplies the skin of the vulva, external urethral meatus, clitoris, perineum, and lower vagina.
The motor fibers supply all the voluntary muscles of the perineal body, levator ani and sphincter ani externus.
Levator ani, in addition, receives direct supply from S3 and S4 roots.
৮.
Which is not in the classification of gestational trophoblastic disease -
  1. ক
    Invasive mole
  2. খ
    Hydatidiform mole
  3. গ
    Hyperplastic mole
  4. ঘ
    Placental site trophoblastic tumor
সঠিক উত্তর: গ
Hyperplastic mole
উত্তর
সঠিক উত্তর: গ
Hyperplastic mole
গ
ব্যাখ্যা
Explanation :
Classification of GTD :
Hydatidiform mole: • Complete • Partial
 Gestational Trophoblastic Neoplasia (GTN) Invasive mole
Placental site trophoblastic tumor  Choriocarcinoma
৯.
Which type of abortion is related to blighted ovum -
  1. ক
    Threatened abortion
  2. খ
    Inevitable abortion
  3. গ
    Incomplete abortion
  4. ঘ
    Missed abortion
সঠিক উত্তর: ঘ
Missed abortion
উত্তর
সঠিক উত্তর: ঘ
Missed abortion
ঘ
ব্যাখ্যা
Explanation :
Blighted ovum or fetus without cardiac activity is seen in missed abortion.
১০.
Which artery crosses the ureter close to internal os -
  1. ক
    Ovarian artery
  2. খ
    Uterine artery
  3. গ
    Vaginal artety
  4. ঘ
    Internal pudendal artery
সঠিক উত্তর: খ
Uterine artery
উত্তর
সঠিক উত্তর: খ
Uterine artery
খ
ব্যাখ্যা
Explanation :
About 1.5 cm away at the level of internal os, a little nearer on the left side is the crossing of the uterine artery and the ureter.
১১.
What is the earliest sign of puberty -
  1. ক
    Thelarche
  2. খ
    Adrenerche
  3. গ
    Menerche
  4. ঘ
    Beginning of growth spurt
সঠিক উত্তর: ঘ
Beginning of growth spurt
উত্তর
সঠিক উত্তর: ঘ
Beginning of growth spurt
ঘ
ব্যাখ্যা
Explanation :
The most common order is beginning of the growth spurt ➔ breast budding ( thelarche) ➔ pubic and axillary hair growth ( adrenarche) ➔ peak growth in height ➔ menstruation (menarche)
১২.
Which drug is the first choice in medical management of ectopic pregnancy -
  1. ক
    Prostaglandin F2 alpha
  2. খ
    Methotrexate
  3. গ
    Hyperosmolar glucose
  4. ঘ
    Potassium chloride
সঠিক উত্তর: খ
Methotrexate
উত্তর
সঠিক উত্তর: খ
Methotrexate
খ
ব্যাখ্যা
Explanation :
Methotrexate (MTX) is a folic acid antagonist. It blocks dihydrofolate reductase and prevents conversion of dihydrofolate to tetrahydrofolate which is the active form of folic acid.
There is block in the synthesis of DNA, RNA and protein.
It is the drug of first choice in medical management of ectopic pregnancy. 
১৩.
Ovary is -
  1. ক
    Intraperitoneal organ
  2. খ
    Attached to the anterior layer of broad ligaments
  3. গ
    Related to ureter
  4. ঘ
    Supplied by artery which is branch of antetior division of internal iliac artery
সঠিক উত্তর: ক
Intraperitoneal organ
উত্তর
সঠিক উত্তর: ক
Intraperitoneal organ
ক
ব্যাখ্যা
Explanation :
(b) Related to posterior layer of broad ligaments 
(c) The ovarian fossa is related superiorly to the external iliac vein, posteriorly to ureter and internal iliac vessels and laterally to the peritoneum separating the obturator vessels and nerves. 
(d) Arterial supply from ovarian artery, a branch of abdominal aorta
১৪.
Gonadotrophin predominant in proliferative phase of menstrual cycle -
  1. ক
    Estrogen
  2. খ
    Progesterone
  3. গ
    FSH
  4. ঘ
    LH
সঠিক উত্তর: গ
FSH
উত্তর
সঠিক উত্তর: গ
FSH
গ
১৫.
Indication of episiotomy except -
  1. ক
    Face to pubis delivery
  2. খ
    Shoulder dystocia
  3. গ
    Cephalic presentations
  4. ঘ
    Ventouse delivery
সঠিক উত্তর: গ
Cephalic presentations
উত্তর
সঠিক উত্তর: গ
Cephalic presentations
গ
ব্যাখ্যা
Explanation :
Indication of episiotomy :
Rigid inelastic perineum 
Anticipating perineal tear - Big baby,Face to pubis delivery, breech delivery,Shoulder dystocia,Persistant occipito posterior position

Operative delivery : Forceps delivery,Ventouse delivery 
১৬.
What is the absolute indication for caesarean section -
  1. ক
    Fetal distress
  2. খ
    Contracted pelvis
  3. গ
    Previous cesarean delivery
  4. ঘ
    Breech presentation
সঠিক উত্তর: খ
Contracted pelvis
উত্তর
সঠিক উত্তর: খ
Contracted pelvis
খ
ব্যাখ্যা
Explanation :
Absolute indication for cesarean section :
Central placenta previa
Contracted pelvis or cephalopelvic disproportion
Pelvic mass causing obstruction( Cervical / broad ligament fibroid)
Advanced carcinoma of cervix
Vaginal obstruction ( Atresia,stenosis)
১৭.
What is the homologus to scrotum -
  1. ক
    Clitoris
  2. খ
    Labia majora
  3. গ
    Labia minora
  4. ঘ
    Bartholin gland
সঠিক উত্তর: খ
Labia majora
উত্তর
সঠিক উত্তর: খ
Labia majora
খ
১৮.
Puberty can be delayed as late as -
  1. ক
    11 years
  2. খ
    13 years
  3. গ
    15 years
  4. ঘ
    16 years
সঠিক উত্তর: ঘ
16 years
উত্তর
সঠিক উত্তর: ঘ
16 years
ঘ
ব্যাখ্যা
Explanation :
Puberty is said to be delayed when the breast tissue and/or pubic hair have not appeared by 13-14 years or menarche appears as late as 16 years. 
১৯.
Features of ovulation -
  1. ক
    Mid cycle abdominal pain
  2. খ
    Acne
  3. গ
    Nausea vomiting
  4. ঘ
    Pervaginal bleeding
সঠিক উত্তর: ক
Mid cycle abdominal pain
উত্তর
সঠিক উত্তর: ক
Mid cycle abdominal pain
ক
২০.
What is the site of development of ovum -
  1. ক
    Paramesonephric duct
  2. খ
    Mesonephric duct
  3. গ
    Genital ridge
  4. ঘ
    Urogenital fold
সঠিক উত্তর: গ
Genital ridge
উত্তর
সঠিক উত্তর: গ
Genital ridge
গ
ব্যাখ্যা
Explanation :
The ovary is developed on either side from the genital or gonadal ridge.
This ridge is formed in a four-week embryo between the dorsal mesentery (medially} and the mesonephric ridge (laterally) by the multiplication of the coelomic epithelium along with condensation of the underlying mesenchyme
২১.
What is the karyotype of partial molar pregnancy -
  1. ক
    69,XXX
  2. খ
    96,XXY
  3. গ
    46,XX
  4. ঘ
    47,XXY
সঠিক উত্তর: ক
69,XXX
উত্তর
সঠিক উত্তর: ক
69,XXX
ক
ব্যাখ্যা
Explanation :
Partial mole :
The karyotype is triploid either 69,XXY or 69,XYY with one maternal but usually two paternal haploid chromosomes.
Microscopic examination of the dilated chorionic villi shows predominant hyperplasia of the syncytiotrophoblast and presence of fetal blood vessels with fetal red blood cells
২২.
Fertilizable lifespan of sperm -
  1. ক
    12 hours
  2. খ
    24 hours
  3. গ
    36 hours
  4. ঘ
    48 hours
সঠিক উত্তর: ঘ
48 hours
উত্তর
সঠিক উত্তর: ঘ
48 hours
ঘ
ব্যাখ্যা
Explanation :
Fertilizable lifespan :
Oocyte : 12-24 hours
Sperm : 48-72 hours
২৩.
What is the commonest cause of precocious puberty -
  1. ক
    Constitutional
  2. খ
    Primary hypothyroidism
  3. গ
    Granulosa cell tumor
  4. ঘ
    CNS lesion
সঠিক উত্তর: ক
Constitutional
উত্তর
সঠিক উত্তর: ক
Constitutional
ক
২৪.
Which is not included in the cause of stillbirths -
  1. ক
    Birth asphyxia
  2. খ
    Maternal placental abruption
  3. গ
    Fetal congenital malformation
  4. ঘ
    Physiological jaundice
সঠিক উত্তর: ঘ
Physiological jaundice
উত্তর
সঠিক উত্তর: ঘ
Physiological jaundice
ঘ
ব্যাখ্যা
Explanation :
Causes of stillbirth -
Birth asphyxia and trauma
Pregnancy complications ( Placental abruption,hypertension, DM)
Fetal congenital malformation 
Infection
২৫.
What is not the derivative of Mullerian duct -
  1. ক
    Cervix
  2. খ
    Vagina ( Mucous membrane)
  3. গ
    Uterus
  4. ঘ
    Fallopian tube
সঠিক উত্তর: খ
Vagina ( Mucous membrane)
উত্তর
সঠিক উত্তর: খ
Vagina ( Mucous membrane)
খ
২৬.
What is the lining epithelium of ovary -
  1. ক
    Simple collumnar epithelium
  2. খ
    Single layer of cubical cell
  3. গ
    Stratified squamous epithelium
  4. ঘ
    Transitional epithelium
সঠিক উত্তর: খ
Single layer of cubical cell
উত্তর
সঠিক উত্তর: খ
Single layer of cubical cell
খ
ব্যাখ্যা
Explanation :
The ovary is covered by a single layer of cubical cell known as germinal epithelium. 
২৭.
What is the cause of early pregnancy bleeding related to pregnant state -
  1. ক
    Cervical erosion
  2. খ
    Ruptured vericose vein
  3. গ
    Implantation bleeding
  4. ঘ
    Polyp
সঠিক উত্তর: গ
Implantation bleeding
উত্তর
সঠিক উত্তর: গ
Implantation bleeding
গ
ব্যাখ্যা
Explanation :
Causes of early pregnancy bleeding related to pregnant state :
Abortion (95%)
Ectopic pregnancy 
Hydatidiform mole
Implantation bleeding
২৮.
What is the dangerous variety of tubal ectopic pregnancy -
  1. ক
    Interstitial
  2. খ
    Infundibular
  3. গ
    Isthmic
  4. ঘ
    Ampullary
সঠিক উত্তর: গ
Isthmic
উত্তর
সঠিক উত্তর: গ
Isthmic
গ
ব্যাখ্যা
Explanation :
Isthmic variety ruptures more early without a feature of positive pregnancy test.
So it may cause sudden rupture and shock.
২৯.
Ovary produce following hormone except -
  1. ক
    Estrogen
  2. খ
    Androgen
  3. গ
    LH
  4. ঘ
    Inhibin
সঠিক উত্তর: গ
LH
উত্তর
সঠিক উত্তর: গ
LH
গ
ব্যাখ্যা
Explanation :
■ OVARIAN STEROIDOGENESIS
The principal hormones secreted from the ovaries are
(a) Estrogens;
(b) Progesterone;
(c) Androgens; and
(d) Inhibin.
৩০.
The mean age of menerche -
  1. ক
    9 years
  2. খ
    11 years
  3. গ
    13 years
  4. ঘ
    15 years
সঠিক উত্তর: গ
13 years
উত্তর
সঠিক উত্তর: গ
13 years
গ
ব্যাখ্যা
Explanation :
The first menstruation (menarche) occurs between 11 and 15 years with a mean of 13 years.
৩১.
What is not clinical diagnostic feature of Persistant gestational trophoblastic neoplasia -
  1. ক
    Persistant follicular cyst of ovary
  2. খ
    Continued vaginal bleeding
  3. গ
    Persistantly soft and enlarged uterus
  4. ঘ
    Slow decline of beta HCG level
সঠিক উত্তর: ক
Persistant follicular cyst of ovary
উত্তর
সঠিক উত্তর: ক
Persistant follicular cyst of ovary
ক
ব্যাখ্যা
Explanation :
The clinical diagnostic features of persistent gestational trophoblastic neoplasia :

♦ Continued vaginal bleeding.
♦ Persistent theca lutein cysts.
♦ Persistently soft and enlarged uterus.
♦ Slow decline in P-hCG levels.
♦ Local or systemic metastases should always be excluded (X-ray chest, CT, MRI of brain and liver).
Asymptomatic patients, with a normal chest X-ray, are unlikely to have brain or other visceral metastasis.
৩২.
What is the most common cause of recurrent miscarriages -
  1. ক
    Unicornuate uterus
  2. খ
    Uterine large fibroid
  3. গ
    Infection
  4. ঘ
    Cervical incompetence
সঠিক উত্তর: ঘ
Cervical incompetence
উত্তর
সঠিক উত্তর: ঘ
Cervical incompetence
ঘ
ব্যাখ্যা
Explanation :
Recurrent miscarriage is defined as the sequence of two or more spontaneous abortions as documented by either sonography or on histopathology, before 20 weeks (ASRM-2013)
Most common cause in second trimester is cervical incompetence. 
৩৩.
Which ligament of uterus is developementally corresponds to Gubernaculum testis -
  1. ক
    Round ligament
  2. খ
    Mackenrodt's ligament
  3. গ
    Broad ligament
  4. ঘ
    Cardinal ligament
সঠিক উত্তর: ক
Round ligament
উত্তর
সঠিক উত্তর: ক
Round ligament
ক
ব্যাখ্যা
Explanation :
Round ligament :
It corresponds developmentally to the gubernaculum testis and is morphologically continuous with the ovarian ligament.
৩৪.
Timing of giving episiotomy -
  1. ক
    Just prior to crowning
  2. খ
    After head delivery
  3. গ
    Peraistant descent
  4. ঘ
    During second stage of labour
সঠিক উত্তর: ক
Just prior to crowning
উত্তর
সঠিক উত্তর: ক
Just prior to crowning
ক
ব্যাখ্যা
Explanation :
Episiotomy is given in bulged thinned perineum during contraction just prior to crowning ( When 3-4 cm head visible).
৩৫.
Fallopian tube -
  1. ক
    Length 4 cm
  2. খ
    Have only pelvic opening
  3. গ
    Infundibulum is largest and widest
  4. ঘ
    No submucosa
সঠিক উত্তর: ঘ
No submucosa
উত্তর
সঠিক উত্তর: ঘ
No submucosa
ঘ
ব্যাখ্যা
Explanation :
■ FALLOPIAN TUBE (SYN: UTERINETUBE)
The uterine tubes are paired structures, measuring about 10 cm (4") 
Each tube has got two openings, one communicating with the lateral angle of the uterine cavity, called uterine opening and measures 1 mm in diameter, the other is on the lateral end of the tube, called pelvic opening or abdominal ostium
Ampulla-tortuous part and measures about 5 cm (2") in length which ends in wide.
৩৬.
What is the target MMR rate in SDG -
  1. ক
    50/ lakh live birth
  2. খ
    70/ lakh live birth
  3. গ
    100/ lakh live birth
  4. ঘ
    140 / lakh live birth
সঠিক উত্তর: খ
70/ lakh live birth
উত্তর
সঠিক উত্তর: খ
70/ lakh live birth
খ
ব্যাখ্যা
Explanation :
SDG Target for MMR
Target (SDG 3.1): Reduce the global MMR to less than 70 per 100,000 live births by 2030
৩৭.
Lymphatics of the ovary drain at -
  1. ক
    Pre-aortic group
  2. খ
    External iliac group
  3. গ
    Obturator group
  4. ঘ
    Superficial inguinal lymph node
সঠিক উত্তর: ক
Pre-aortic group
উত্তর
সঠিক উত্তর: ক
Pre-aortic group
ক
ব্যাখ্যা
Explanation :
Lymphatics of the ovary and fallopian tube drains at pre-aortic group of lymph node.
৩৮.
What is the pH of vaginal epithelium in reproductive period -
  1. ক
    < 4
  2. খ
    4-5
  3. গ
    6-7
  4. ঘ
    > 7
সঠিক উত্তর: খ
4-5
উত্তর
সঠিক উত্তর: খ
4-5
খ
ব্যাখ্যা
Explanation :
Vaginal epithelium in reproductive period :
Multilayered, thick
E:++Gly:+
pH: 4-5 (acidic)
DB: appear,
secretion abundant
৩৯.
Parasite related to miscarriages -
  1. ক
    Plasmodium
  2. খ
    Leishmania
  3. গ
    Echinococcus
  4. ঘ
    Schistosoma
সঠিক উত্তর: ক
Plasmodium
উত্তর
সঠিক উত্তর: ক
Plasmodium
ক
ব্যাখ্যা
Explanation :
Infections could be related to abortion -
(i) Viral: Rubella, cytomegalovirus, variola, vaccinia or HIV.
(ii) Parasitic: Toxoplasma, malaria.
(iii) Bacterial: Ureaplasma, Chlamydia, Brucella.
Spirochetes hardly cause abortion before 20th week because of effective thickness of placental barrier.
৪০.
What is the prerequisites of forceps delivery -
  1. ক
    Head should not engaged
  2. খ
    Bladder must be full
  3. গ
    The membrane must be intact
  4. ঘ
    The cervix must be full dilated
সঠিক উত্তর: ঘ
The cervix must be full dilated
উত্তর
সঠিক উত্তর: ঘ
The cervix must be full dilated
ঘ
ব্যাখ্যা
Explanation :
Prerequisite for forceps delivery :
Fetal head must be engaged
The cervix must be full dilated
The membrane must be ruptured
Caput and moulding must not present
Bladder must be emptied