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

পরীক্ষা৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived]তারিখতারিখ অনির্ধারিতসময়20 minutes
মোট প্রশ্ন৩৯
সিলেবাস
Exam - 18 Obstetrics and Gynaecology-02 1. Normal Puerperium (a) Anatomical and physiological changes during puerperium (b) Management of normal puerperium (c) Postpartum family planning (d) IYCF – Breastfeeding & Complementary feeding 2. Hypertensive Disorder in Pregnancy (including pre-eclampsia and eclampsia) 3. Medical Disorders in Obstetrics: (a) Anaemia in pregnancy (b) Urinary problems in obstetrics (c) Diabetes (d) Heart disease (e) Hepatitis 4. Ante-partum Haemorrhage Definitions, classification, clinical features, complications and management 5. Rh Incompatibility 6. Blood Transfusion in Obstetrics 7. Multiple Pregnancy 8. Malposition and Malpresentation Types, causes, diagnosis, complications and management i) Abnormalities of Labour (a) Prolonged labour: Definition, aetiology, diagnosis, complications, management (b) Obstructed labour: Definition, aetiology, diagnosis, complications, management ii) Post-partum Haemorrhage (PPH) Definitions, causes (atonic, traumatic and others), prevention and management, follow-up iii) Abnormal Puerperium Causes, diagnosis and management iv) The Newborn Resuscitation, examination and care of the newborn v) Neonatal Problems Birth asphyxia Jaundice Infection Feeding Other problems of newborn IYCF — Breastfeeding & complementary feeding vi) IUGR & IUB Causes, diagnosis and management
প্রশ্ন দেখুনঅনুশীলন
ঘনত্ব
উত্তর
উত্তরিতবর্তমানপুনরায় দেখুনঅসম্পূর্ণ

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

৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived] · তারিখ অনির্ধারিত · ৩৯ প্রশ্ন

১.
Duration of normal puerperium -
  1. ক
    42 days
  2. খ
    4 weeks
  3. গ
    6 months
  4. ঘ
    12 weeks
সঠিক উত্তর: ক
42 days
উত্তর
সঠিক উত্তর: ক
42 days
ক
ব্যাখ্যা
Explanation :
Puerperium begins as soon as the placenta is expelled and lasts for approximately 6 weeks when the uterus regresses almost to the nonpregnant size.
The period is arbitrarily divided into:
(a) immediate-within 24 hours,
(b) early-up to 7 days and
(c) remote-up to 6 weeks.
Similar changes occur following abortion but takes a shorter period for the involution to complete.
২.
Which factor causes the onset of labour -
  1. ক
    Uterine stretching
  2. খ
    Fetal hypothalopituitary adrenal axis
  3. গ
    Estrogen hormone
  4. ঘ
    Prostaglandin
সঠিক উত্তর: খ
Fetal hypothalopituitary adrenal axis
উত্তর
সঠিক উত্তর: খ
Fetal hypothalopituitary adrenal axis
খ
ব্যাখ্যা
Explanation :
Fetoplacental contribution:
Cascade of events activate fetal hypothalamic-pituitary-adrenal axis prior to onset of labor ➔ increased CRH ➔ increased release of ACTH ➔ fetal adrenals ➔ increased cortisol secretion ➔ accelerated production of estrogen and prostaglandins from the placenta
৩.
What is the cause of breast engorgement in pregnancy -
  1. ক
    Staphylococcus aureus infection
  2. খ
    Exaggerated venous and lymphatic engorgement
  3. গ
    Baby's suckling effect
  4. ঘ
    Milk stasis
সঠিক উত্তর: খ
Exaggerated venous and lymphatic engorgement
উত্তর
সঠিক উত্তর: খ
Exaggerated venous and lymphatic engorgement
খ
ব্যাখ্যা
Explanation :
Breast engorgement is due to exaggerated normal venous and lymphatic engorgement of the breasts which precedes lactation.
This, in turn, prevents escape of milk from the lacteal system.
The primiparous patient and the patient with inelastic breasts are likely to be involved
৪.
In preeclamptic mother, onset of hypertension appear at -
  1. ক
    Early trimester
  2. খ
    After 20 weeks of gestation
  3. গ
    Before conception
  4. ঘ
    After delivery
সঠিক উত্তর: খ
After 20 weeks of gestation
উত্তর
সঠিক উত্তর: খ
After 20 weeks of gestation
খ
ব্যাখ্যা
Explanation :
PE is defined as new onset of hypertension and either proteinuria or other signs of end organ dysfunction after 20 weeks of gestation in a previously normotensive woman.

It is a progressive multisystem disorder.

The pre-eclampsia features may rarely appear even before the 20th week as in case of hydatidiform mole and multiple pregnancy
৫.
Choice of blood product in DIC in obstetrics -
  1. ক
    Whole blood
  2. খ
    Platelet concentrate
  3. গ
    Fresh frozen plasma
  4. ঘ
    RCC
সঠিক উত্তর: গ
Fresh frozen plasma
উত্তর
সঠিক উত্তর: গ
Fresh frozen plasma
গ
ব্যাখ্যা
Explanation :
During DIC coagulation factor  consumption occurs.So FFP is the first choice in DIC in obstetrics. 
৬.
Which drug is used to prevent RDS in infant -
  1. ক
    Dexamethasone after birth
  2. খ
    O2 inhalation
  3. গ
    Hydrocortisone
  4. ঘ
    Betamethasone in preterm PROM
সঠিক উত্তর: ঘ
Betamethasone in preterm PROM
উত্তর
সঠিক উত্তর: ঘ
Betamethasone in preterm PROM
ঘ
ব্যাখ্যা
Explanation :
Dexamethasone and betamethasone both are used for fetal lung maturity in Preterm baby.
৭.
Which viral infection during pregnancy need cesarean section -
  1. ক
    Herpes
  2. খ
    Rubella
  3. গ
    Vericella zoster
  4. ঘ
    CMV
সঠিক উত্তর: ক
Herpes
উত্তর
সঠিক উত্তর: ক
Herpes
ক
ব্যাখ্যা
Explanation :
Primary herpetic lesion is responsible for neonatal meningitis through birth canal.
To prevent this complication,Cesarean section is preferred. 
৮.
Main etiological factor for preeclampsia -
  1. ক
    Abnormal placentation
  2. খ
    Increased circulatory nitric oxide
  3. গ
    Vascular reaction : Vasodilation
  4. ঘ
    Increased Uteroplacental blood flow
সঠিক উত্তর: ক
Abnormal placentation
উত্তর
সঠিক উত্তর: ক
Abnormal placentation
ক
৯.
Following which is the cause of physiological jaundice -
  1. ক
    Increased red cell destruction due to shorter lifespan
  2. খ
    Rh incompatibility
  3. গ
    Sepsis
  4. ঘ
    Galactosemia
সঠিক উত্তর: ক
Increased red cell destruction due to shorter lifespan
উত্তর
সঠিক উত্তর: ক
Increased red cell destruction due to shorter lifespan
ক
ব্যাখ্যা
Explanation :
Causes of physiological jaundice :
1.Increased red cell volume per kg and increased red cell destruction due to shorter lifespan (90 days compared to 120 days in adult) in the neonate.
2. Transient decreased conjugation of bilirubin due to decreased UGPG-GT activity.
3. Increased enterohepatic circulation due to decreased gut motility and high level of intestinal p glucuronidase.
4. Decreased hepatic excretion of bilirubin; and
5. Decreased liver cell uptake of bilirubin due to decreased ligandin (transport protein).
১০.
Which parameter is not included in APGAR scoring -
  1. ক
    Respiratory effort
  2. খ
    Heart rate
  3. গ
    Amniotic fluid volume
  4. ঘ
    Reflex irritability
সঠিক উত্তর: গ
Amniotic fluid volume
উত্তর
সঠিক উত্তর: গ
Amniotic fluid volume
গ
১১.
Which hormone is responsible for ejection of milk secretion
  1. ক
    Oxytocin
  2. খ
    Estrogen
  3. গ
    Progesterone
  4. ঘ
    Prolactin
সঠিক উত্তর: ক
Oxytocin
উত্তর
সঠিক উত্তর: ক
Oxytocin
ক
১২.
What is the most common congenital heart lesion met in pregnancy -
  1. ক
    ASD
  2. খ
    VSD
  3. গ
    Fallot's tetralogy
  4. ঘ
    Patent ductus arteriosus
সঠিক উত্তর: ক
ASD
উত্তর
সঠিক উত্তর: ক
ASD
ক
ব্যাখ্যা
Explanation :
ASD ( ostium secundum type) is the most common congenital heart lesion during pregnancy whether right shunt occurs.
১৩.
Which is not included in the diagnostic criteria of preeclampsia -
  1. ক
    Hypertension
  2. খ
    Proteinurea
  3. গ
    Thrombocytopenia
  4. ঘ
    Oedema
সঠিক উত্তর: গ
Thrombocytopenia
উত্তর
সঠিক উত্তর: গ
Thrombocytopenia
গ
ব্যাখ্যা
Explanation :
Diagnostic triad of preeclampsia :
1.HYPERTENSION 
2.Proteinurea
3.Oedema
১৪.
Lochia alba is -
  1. ক
    Red colour vaginal discharge after delivery
  2. খ
    Contain plenty of decidual cell
  3. গ
    Duration : 5-9 days
  4. ঘ
    Always pathognomonic
সঠিক উত্তর: খ
Contain plenty of decidual cell
উত্তর
সঠিক উত্তর: খ
Contain plenty of decidual cell
খ
ব্যাখ্যা
Explanation :
Lochia :
Color:
Depending upon the variation of the color of the discharge, it is named as:
(1) lochia rubra (red) 1-4 days,
(2) lochia serosa (5-9 days)-the color is yellowish or pink or pale brownish,
(3) lochia alba (pale white) 10-15 days
Lochia alba contains plenty of decidual cells, leukocytes, mucus, cholesterin crystals, fatty and granular epithelial cells and microorganisms.
১৫.
Which drug is preferable in pregnancy with hyperthyroidism -
  1. ক
    Lithium
  2. খ
    Propylthiouracil
  3. গ
    Methimazole
  4. ঘ
    Amiodarone
সঠিক উত্তর: খ
Propylthiouracil
উত্তর
সঠিক উত্তর: খ
Propylthiouracil
খ
ব্যাখ্যা
Explanation :
The mainstay of treatment is use of antithyroid drugs [propylthiouracil (PTU) or methimazole (MM)].
Both the drugs are effective.
Methimazole is preferably avoided in the first trimester of pregnancy if PTU is available. Methimazole has the risk of embryopathy.
১৬.
True statement about placenta previa -
  1. ক
    Caused by preeclampsia
  2. খ
    Dark coloured bleeding
  3. গ
    Painless,causeless and recurrent bleeding
  4. ঘ
    Uterine size is disproportionately enlarged
সঠিক উত্তর: গ
Painless,causeless and recurrent bleeding
উত্তর
সঠিক উত্তর: গ
Painless,causeless and recurrent bleeding
গ
১৭.
What is the most common organism responsible for urinary tract infection in pregnancy -
  1. ক
    Klebsiella
  2. খ
    E.coli
  3. গ
    Proteus
  4. ঘ
    Pseudomonas
সঠিক উত্তর: খ
E.coli
উত্তর
সঠিক উত্তর: খ
E.coli
খ
ব্যাখ্যা
Explanation :
The organisms responsible are
E.coli (70%), Klebsiella pneumoniae (10%), Enterobacter, Proteus, Pseudomonas and Staphylococcus aureus group.
১৮.
WHO classification of severe anaemia in pregnancy -
  1. ক
    Hb% 10-10.9 gm/dl
  2. খ
    Hb% 11-11.5 gm /dl
  3. গ
    Hb% 7-9.9 gm/dl
  4. ঘ
    Hb% <7 gm/dl
সঠিক উত্তর: ঘ
Hb% <7 gm/dl
উত্তর
সঠিক উত্তর: ঘ
Hb% <7 gm/dl
ঘ
১৯.
Very early preterm labour can occur at -
  1. ক
    <28 weeks
  2. খ
    28-<32 weeks
  3. গ
    32-<34 weeks
  4. ঘ
    34 - <37 weeks
সঠিক উত্তর: খ
28-<32 weeks
উত্তর
সঠিক উত্তর: খ
28-<32 weeks
খ
ব্যাখ্যা
Explanation :
Classification of preterm labour :
Extremely preterm: <28 weeks.
■ Very early preterm: 28 to <32 weeks.
■ Early preterm: 32 to <34 weeks.
Late preterm: 34 to <37 weeks.
২০.
Milk secretion is actually starts at -
  1. ক
    20 weeks of gestation
  2. খ
    3rd postpartum day
  3. গ
    As soon as delivery
  4. ঘ
    After 7 days of birth
সঠিক উত্তর: খ
3rd postpartum day
উত্তর
সঠিক উত্তর: খ
3rd postpartum day
খ
ব্যাখ্যা
Explanation :
Lactogenesis:
The alveolar cells are the principal sites for production of milk.
Though some secretory activity is evident (colostrum) during pregnancy and accelerated following delivery, milk secretion actually starts on 3rd or 4th postpartum day.
Around this time, the breasts become engorged, tense, tender and feel warm.
২১.
Length of Lower segment of uterus during active labour -
  1. ক
    7.5 -10cm
  2. খ
    7.5 - 10 mm
  3. গ
    17-20 mm
  4. ঘ
    17 -20 cm
সঠিক উত্তর: ক
7.5 -10cm
উত্তর
সঠিক উত্তর: ক
7.5 -10cm
ক
২২.
Which drug is not used in management of PPH -
  1. ক
    Methergine
  2. খ
    Misoprostol
  3. গ
    Tranexamic acid
  4. ঘ
    Norethisterone
সঠিক উত্তর: ঘ
Norethisterone
উত্তর
সঠিক উত্তর: ঘ
Norethisterone
ঘ
ব্যাখ্যা
Explanation :
Commonly used oxytocics in management of PPH :
Oxytocin
Methergine
PGF2 alpha
Misoprostol
Trenexamic acid
২৩.
In ultrasound Buddha position is found in -
  1. ক
    Preeclampsia
  2. খ
    Antepartum haemorrhage
  3. গ
    Hydrops fetalis
  4. ঘ
    Congenital thalassemia
সঠিক উত্তর: গ
Hydrops fetalis
উত্তর
সঠিক উত্তর: গ
Hydrops fetalis
গ
ব্যাখ্যা
Explanation :
USG may reveal in hydrops fetalis -'Buddha' position of the fetus with a halo around the head due to edematous scalp.
২৪.
Which drug have increased tendency of fetal neural tube defect -
  1. ক
    Aspirin
  2. খ
    Cocaine
  3. গ
    Aminoglycosides
  4. ঘ
    Valproate
সঠিক উত্তর: ঘ
Valproate
উত্তর
সঠিক উত্তর: ঘ
Valproate
ঘ
ব্যাখ্যা
Explanation :
Teratogenic effect of sodium valproate :
Increased risk of neural tube defect
ASD
Cleft palate
Polydactyly
Hypospadius
২৫.
What is the most common cause of puerperal pyrexia -
  1. ক
    Breast abscess
  2. খ
    Genital tract infection
  3. গ
    Septic pelvic thrombophlebitis
  4. ঘ
    UTI
সঠিক উত্তর: খ
Genital tract infection
উত্তর
সঠিক উত্তর: খ
Genital tract infection
খ
ব্যাখ্যা
Explanation :
An infection of the genital tract which occurs as a complication of delivery is termed puerperal sepsis.
Puerperal pyrexia is considered to be due to genital tract infection ( Puerperal sepsis) 
Unless proved otherwise.
২৬.
Which drug is the first choice in GDM -
  1. ক
    Metformin
  2. খ
    Linagliptin
  3. গ
    Sulphonylurea
  4. ঘ
    Insulin
সঠিক উত্তর: ঘ
Insulin
উত্তর
সঠিক উত্তর: ঘ
Insulin
ঘ
ব্যাখ্যা
Explanation :
Insulin is the drug of first choice in GDM mother ( Basal + bolus)
২৭.
What is the dose of Oxytocin in active management of the third stage of labour -
  1. ক
    10 IU in drip
  2. খ
    5 IU in drip
  3. গ
    20 IU in drip
  4. ঘ
    10 IU in IM
সঠিক উত্তর: ঘ
10 IU in IM
উত্তর
সঠিক উত্তর: ঘ
10 IU in IM
ঘ
ব্যাখ্যা
Explanation :
In active management of third stage of labour 10 IU intramuscular oxytocin is used within 1 mins after delivery.
২৮.
What is the main aggravating factor for subinvolution of uterus -
  1. ক
    Maternal anaemia
  2. খ
    Prolapse of the uterus
  3. গ
    Retained product of conception
  4. ঘ
    Cesarean section
সঠিক উত্তর: গ
Retained product of conception
উত্তর
সঠিক উত্তর: গ
Retained product of conception
গ
ব্যাখ্যা
Explanation :
Subinvolution :
Predisposing factors are-
(1) Grand multiparity;
(2) Overdistension of uterus as in twins and hydramnios;
(3) Maternal ill-health;
(4) Cesarean section;
(5) Prolapse of the uterus;
(6) Retroversion after the uterus becomes pelvic organ;
(7) Uterine fibroid.
Aggravating factors are:
(1) Retained products of conception;
(2) Uterine sepsis (endometritis).
২৯.
Drug causing suppression of milk secretion -
  1. ক
    Sulpiride
  2. খ
    Domperidone
  3. গ
    Pyridoxine
  4. ঘ
    Intranasal oxytocin
সঠিক উত্তর: গ
Pyridoxine
উত্তর
সঠিক উত্তর: গ
Pyridoxine
গ
ব্যাখ্যা
Explanation :
INADEQUATE MILK PRODUCTION (Lactation failure):
It may be due to infrequent suckling or due to endogenous suppression of prolactin ( ergot preparation, pyridoxine, diuretics or retained placental bits).
Medical method :Bromocriptine inhibits prolactin secretion.
৩০.
What is the drug of first choice in hypertensive emergency in pregnancy -
  1. ক
    I/V labetalol
  2. খ
    Alpha methyl dopa
  3. গ
    Nifedipine
  4. ঘ
    Nitroglycerin
সঠিক উত্তর: ক
I/V labetalol
উত্তর
সঠিক উত্তর: ক
I/V labetalol
ক
ব্যাখ্যা
Explanation :
IV labetalol ( Both alpha and beta blocker)  is the drug of first choice in hypertensive emergency in pregnancy. 
৩১.
Which factor have more risk for placenta previa -
  1. ক
    IVF treatment
  2. খ
    Multiparity
  3. গ
    Maternal age >35 years
  4. ঘ
    Smoking
সঠিক উত্তর: গ
Maternal age >35 years
উত্তর
সঠিক উত্তর: গ
Maternal age >35 years
গ
৩২.
How much anti D is administered in Rh -ve mother after normal delivery -
  1. ক
    50 mcgm
  2. খ
    100 mcgm
  3. গ
    200 mcgm
  4. ঘ
    300 mcgm
সঠিক উত্তর: ঘ
300 mcgm
উত্তর
সঠিক উত্তর: ঘ
300 mcgm
ঘ
ব্যাখ্যা
Explanation :
Anti-D-gammaglobulin is administered intramuscularly to the mother 300 µg following delivery.
All Rh-negative unsensitized women should receive 50 µg of Rh-immunoglobulin IM within 72 hours of induced or spontaneous abortion, ectopic or molar pregnancy or CVS in the first trimester.
Pregnancies beyond 12 weeks should have full dose 300 mg
৩৩.
What is the most common cause of jaundice in pregnancy -
  1. ক
    Intrahepatic cholestasis
  2. খ
    Viral hepatitis
  3. গ
    Gall stone
  4. ঘ
    Haemolytic disease
সঠিক উত্তর: খ
Viral hepatitis
উত্তর
সঠিক উত্তর: খ
Viral hepatitis
খ
ব্যাখ্যা
Explanation :
Viral hepatitis is the most common cause of jaundice in pregnancy, Whereas hepatitis B is most specific concern.
৩৪.
What is the most common anaemia in pregnancy -
  1. ক
    Thalassemia
  2. খ
    Anaemia of chronic disease
  3. গ
    Iron deficiency anaemia
  4. ঘ
    Folic acid deficiency
সঠিক উত্তর: গ
Iron deficiency anaemia
উত্তর
সঠিক উত্তর: গ
Iron deficiency anaemia
গ
ব্যাখ্যা
Explanation :
Iron deficiency anaemia is 95% prevalent during pregnancy. 
৩৫.
What is the most common malpresentation in labour -
  1. ক
    Brow
  2. খ
    Face
  3. গ
    Breech
  4. ঘ
    Shoulder
সঠিক উত্তর: গ
Breech
উত্তর
সঠিক উত্তর: গ
Breech
গ
ব্যাখ্যা
Explanation :
Most common malpresentation: Breech

Most common position abnormality (malposition):
Occiput posterior
৩৬.
Timing of insertion of postpartum IUCD -
  1. ক
    48 hours after delivery
  2. খ
    7 days of postpartum
  3. গ
    4-6 weeks after postpartum
  4. ঘ
    Before placental separation
সঠিক উত্তর: গ
4-6 weeks after postpartum
উত্তর
সঠিক উত্তর: গ
4-6 weeks after postpartum
গ
ব্যাখ্যা
Explanation :
PPIUCD can be inserted:
(a) postplacental (within 10 minutes of placental delivery),
(b) within 48 hours postpartum,
(c) during cesarean section (intracesarean) or even,
(d) 4-6 weeks after postpartum. Perforation rates are less.
Expulsion rate is slightly high (5-10%).
৩৭.
What is not included in the cause of obstructed labour -
  1. ক
    Uterine inertia
  2. খ
    Cephalopelvic disproprotion
  3. গ
    Big baby
  4. ঘ
    Transverse lie
সঠিক উত্তর: ক
Uterine inertia
উত্তর
সঠিক উত্তর: ক
Uterine inertia
ক
ব্যাখ্যা
Explanation :
Causes of obstructed labour:

Fault in the passage:
(1) Bony: Cephalopelvic disproportion and contracted pelvis are the common causes. Secondary contracted pelvis may be encountered in multiparous women.
(2) Soft tissue obstructions: This includes cervical dystocia due to prolapse or previous operative scarring, cervical or broad ligament fibroid, impacted ovarian tumor or the nongravid horn of a bicornuate uterus below the presenting part.
♦ Fault in the passenger:
(1) Transverse lie;
(2) Brow presentation;
(3) Congenital malformations of the fetus-hydrocephalus ( commonest), fetal ascites, double monsters;
(4) Big baby, occipitoposterior position;
(5) Compound presentation;
(6) Locked twins.
৩৮.
What is the commonest cause of antepartum haemorrhage -
  1. ক
    Placenta succenturiate
  2. খ
    Local trauma
  3. গ
    Abruptio placenta
  4. ঘ
    Varicose vein
সঠিক উত্তর: গ
Abruptio placenta
উত্তর
সঠিক উত্তর: গ
Abruptio placenta
গ
৩৯.
Timing of initiation of ovulation in lactating mother after delivery -
  1. ক
    6 weeks
  2. খ
    10 weeks
  3. গ
    6 months
  4. ঘ
    4 weeks
সঠিক উত্তর: খ
10 weeks
উত্তর
সঠিক উত্তর: খ
10 weeks
খ
ব্যাখ্যা
Explanation :
In nonlactating mothers, ovulation may occur asearly as 4 weeks and in lactating mothers about 10 weeks after delivery.