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

পরীক্ষা৪৮তম বিশেষ বিসিএস [স্বাস্থ্য] ⎯ মেডিকেল অংশ [Archived]তারিখতারিখ অনির্ধারিতসময়20 minutes৩৯ বৈধ · ১ অসম্পূর্ণ
মোট প্রশ্ন৪০
সিলেবাস
Exam - 20 Obstetrics and Gynaecology-04 1. Menstrual Disorders (a) Amenorrhoea: Types, causes and principles of management (b) Menorrhagia: Definition, causes and management (c) Metrorrhagia: Definition, causes and management (d) Dysmenorrhoea: Definition, types, causes and management (e) Abnormal Uterine Bleeding: Definition, PALM-COIN classification, diagnosis, principles of investigation and management Genital Tract Infection (a) Defensive mechanism of genital tract (b) Pelvic inflammatory diseases: acute and chronic (c) Sexually transmitted diseases (d) Genital tuberculosis 2. Urinary Incontinence – Definition, Types (a) Genitourinary fistula: Types, causes, clinical features, principles of management, prevention 3. Other Genital Tract Injuries (a) Perineal tear (b) RVF (Rectovaginal fistula) 4. Genital Prolapse Types, aetiology, supports of uterus, clinical features, diagnosis, differential diagnosis, principles of management, prevention 5. Endometriosis Definition, types, clinical features, principles of management 6. Neoplasia of Reproductive Organs Benign & malignant conditions of vulva & vagina Benign, precancerous & malignant conditions of cervix 7. Vaginal Discharge Physiological and pathological, diagnosis and treatment 8. Menstrual Disorders (a) Amenorrhoea: Types, causes and principles of management (b) Menorrhagia: Definition, causes and management (c) Metrorrhagia: Definition, causes and management (d) Dysmenorrhoea: Definition, types, causes and management (e) Abnormal Uterine Bleeding: Definition, PALM-COIN classification, diagnosis, principles of investigation and management 9. Genital Tract Infection (a) Defensive mechanism of genital tract (b) Pelvic inflammatory diseases: acute and chronic (c) Sexually transmitted diseases (d) Genital tuberculosis 10. Urinary Incontinence – Definition, Types (a) Genitourinary fistula: Types, causes, clinical features, principles of management, prevention 11. Other Genital Tract Injuries (a) Perineal tear (b) RVF (Rectovaginal fistula) 12. Genital Prolapse Types, aetiology, supports of uterus, clinical features, diagnosis, differential diagnosis, principles of management, prevention 13. Endometriosis Definition, types, clinical features, principles of management 14. Neoplasia of Reproductive Organs Benign & malignant conditions of vulva & vagina Benign, precancerous & malignant conditions of cervix
প্রশ্ন দেখুনঅনুশীলন
ঘনত্ব
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উত্তরিতবর্তমানপুনরায় দেখুনঅসম্পূর্ণ

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

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

১.
Which of the following is the most common cause of menorrhagia in women of reproductive age?
  1. ক
    Coagulopathy
  2. খ
    Uterine fibroid
  3. গ
    Hypothyroidism
  4. ঘ
    Endometrial hyperplasia
ব্যাখ্যা
Explanation :
Fibroids (leiomyomas) are the most common benign cause of heavy menstrual bleeding in reproductive-age women.
২.
What is the protective vaginal defence against genital tract infection -
  1. ক
    Undecylanic acid
  2. খ
    Hormone estrogen
  3. গ
    Mucous
  4. ঘ
    Regular menstruation
ব্যাখ্যা
Vaginal Defense Anatomic:
(a) Apposition of the anterior and posterior walls with its transverse rugae;
(b) Stratified epithelium devoid of glands.

Physiologic:
This is maintained by the hormone estrogen
৩.
A fourth-degree perineal tear is most accurately defined as involving:
  1. ক
    Vaginal mucosa and perineal muscles
  2. খ
    Perineal skin only
  3. গ
    Vaginal mucosa and urethra
  4. ঘ
    Anal sphincter and rectal mucosa
৪.
Which gives strongest support to uterus -
  1. ক
    Arcus tendinus
  2. খ
    Broad ligament
  3. গ
    Perineal muscle
  4. ঘ
    Rectovaginal septum
৫.
What is the most common urinary incontinence in female -
  1. ক
    Stress incontinence
  2. খ
    Urge incontinence
  3. গ
    Overflow incontinence
  4. ঘ
    Functional incontinence
ব্যাখ্যা
Explanation :
Stress urinary incontinence is most common in female.Because-

It occurs due to weakness of pelvic floor muscles or urethral sphincter, leading to leakage during activities that increase intra-abdominal pressure (e.g., coughing, sneezing, laughing, or lifting).
৬.
What is the most common cause of female infertility -
  1. ক
    Ovulatory dysfunction
  2. খ
    Tubal blockage
  3. গ
    Hyperprolactinemia
  4. ঘ
    Endometrial abnormality
ব্যাখ্যা
Explanation :
৭.
What is the most common histological type of cervical cancer?
  1. ক
    Adenocarcinoma
  2. খ
    Squamous cell carcinoma
  3. গ
    Clear cell carcinoma
  4. ঘ
    Small cell carcinoma
ব্যাখ্যা
Explanation:
Squamous cell carcinoma accounts for about 70–80% of cervical cancers, most often arising from the transformation zone.
৮.
Which is not included in the risk factor of PID -
  1. ক
    Sexually active teenagers
  2. খ
    Combined oral pill user
  3. গ
    Low socioeconomic status
  4. ঘ
    Genetic predisposition
ব্যাখ্যা
Explanation :
RISK FACTORS FOR PID
• Sexually active teenagers
• Multiple sexual partners
• Absence of contraceptive pill or barrier method use
• Previous history of acute PID t IUD users (not with LNG-I US)
• Lower socioeconomic status
• Husband/sexual partner with urethritis or STI
• Genetic predisposition
Protective Factors
■ Contraceptive practice
• Barrier methods, especially condom, diaphragm with spermicides 
• Oral steroidal contraceptives have got two preventive aspects.
৯.
In the PALM-COEIN system, which of the following is a structural cause of AUB?
  1. ক
    Adenomyosis
  2. খ
    Ovulatory dysfunction
  3. গ
    Endometrial dysfunction
  4. ঘ
    Iatrogenic
ব্যাখ্যা
Explanation:
The “PALM” part of the classification refers to structural causes, including Polyp, Adenomyosis, Leiomyoma, and Malignancy/hyperplasia.
১০.
Dermoid cysts arise from which of the following germ layers?
  1. ক
    Ectoderm only
  2. খ
    Mesoderm only
  3. গ
    Endoderm only
  4. ঘ
    All three germ layers
ব্যাখ্যা
Explanation:
Dermoid cysts (mature teratomas) are composed of tissues from ectoderm, mesoderm, and endoderm.
১১.
Which of the following is the most characteristic feature of primary syphilis?
  1. ক
    Generalized maculopapular rash
  2. খ
    Painful genital ulcer
  3. গ
    Condyloma acuminata
  4. ঘ
    Non-painful genital ulcer
ব্যাখ্যা
Explanation :
Primary syphilis typically presents with a painless, indurated ulcer (chancre) at the site of infection, often on the genitals.
১২.
Which pathology is mostly responsible for intermenstrual bleeding -
  1. ক
    PCOS
  2. খ
    Adenomyosis
  3. গ
    Pelvic endometriosis
  4. ঘ
    Cervical polyp
ব্যাখ্যা
Explanation :
Most common causes of intermenstrual bleeding:

1. Cervical polyp,erosion,cervicitis


2. Hormonal imbalance


3. Endometrial polyp


4. Contraceptive use (especially OCPs)


5. Endometrial hyperplasia
১৩.
Which test is available in upazila health center to assess cervical pathology -
  1. ক
    VIA
  2. খ
    Paps smear
  3. গ
    Colposcopy
  4. ঘ
    HPV DNA test
ব্যাখ্যা
Explanation :
VIA ( Visual inspection of cervix by acetic acid) test is available in low resource setting where report is available in hours.
১৪.
Which genetic mutation is most commonly associated with hereditary ovarian cancer?
  1. ক
    BRCA1 mutation
  2. খ
    p53 mutation
  3. গ
    KRAS mutation
  4. ঘ
    APC gene mutation
ব্যাখ্যা
Explanation:
BRCA1 (and BRCA2) mutations significantly increase the lifetime risk of ovarian and breast cancer, particularly in hereditary breast-ovarian cancer syndrome
১৫.
Which organism has affinity to cu IUCD -
  1. ক
    Nesseria gonorrhoeae
  2. খ
    Chlamydia trachomatis
  3. গ
    Actinomyces israelii
  4. ঘ
    Mycoplasma hominis
ব্যাখ্যা
Explanation :

Infection is caused by Actinomyces israelii, a grampositive anaerobe.
It may be associated in IUCD users more with noncopper devices.
১৬.
Following which is the cause of primary amenorrhea -
  1. ক
    Pregnancy
  2. খ
    Stress
  3. গ
    Postpill
  4. ঘ
    Turners syndrome
ব্যাখ্যা
Explanation :
Turners syndrome is the most common genetic cause of primary amenorrhea. 
Where common karyotype abnormality is 45,XO abnormality
১৭.
Which amount of blood lost in heavy menstrual bleeding -
  1. ক
    > 5 ml
  2. খ
    > 30 ml
  3. গ
    > 35 ml
  4. ঘ
    > 80 ml
ব্যাখ্যা
Explanation :
Heavy menstrual bleeding (HMB)
Blood loss >80 mL (earlier menorrhagia):
It interferes with woman's physical, emotional, social and psychological quality.
১৮.
Cervical ectopy -
  1. ক
    Premalignant condition
  2. খ
    Collumnar epithelium replaced into transitional epithelium
  3. গ
    Mostly seen in LNG IUS user
  4. ঘ
    Mostly oestrogen dependent
ব্যাখ্যা
Explanation :
Cervical ectopy (also called cervical erosion or ectropion) is a benign condition where the glandular (columnar) epithelium from the endocervical canal extends onto the ectocervix, replacing the normal squamous epithelium.
Mostly depends on hormone estrogen ( Post pill)
১৯.
What is the most common cause of dysmenorrhea of women of reproductive age -
  1. ক
    Leiomyoma
  2. খ
    Endometriosis
  3. গ
    Pelvic inflammatory disease
  4. ঘ
    Ovarian dermoid
ব্যাখ্যা
Explanation :
Causes of dysmenorrhea :
Endometriosis ( Chocolate cyst)
Adenomyosis
PID
Sometimes Fibroid uterus
২০.
WHO(2021) semen analysis report shows total sperm concentration -
  1. ক
    > 39 million/ml
  2. খ
    > 15 million /ml
  3. গ
    > 10 million /ml
  4. ঘ
    > 5 million /ml
২১.
Which organism is most commonly responsible for genital warts?
  1. ক
    Chlamydia trachomatis
  2. খ
    Human papillomavirus (HPV)
  3. গ
    Treponema pallidum
  4. ঘ
    Neisseria gonorrhoeae
ব্যাখ্যা
Explanation :
HPV types 6 and 11 are most commonly associated with genital warts.
২২.
Which of the following is the most common cause of vesicovaginal fistula in Bangladesh -
  1. ক
    Radiation necrosis
  2. খ
    Prolonged obstructed labor
  3. গ
    Neoplasm
  4. ঘ
    Accidental
ব্যাখ্যা
Explanation:
Obstructed labor without timely surgical intervention often causes ischemic necrosis of the vaginal wall and bladder, leading to fistula formation.
২৩.
What is the associated pathology with fibroid uterus -
  1. ক
    PCOS
  2. খ
    Dermoid cyst of ovary
  3. গ
    PID
  4. ঘ
    Endometriosis
অনির্ধারিত
ব্যাখ্যা
The question should have been - What is not associated pathology with fibroid uterus -
Then the answer would be খ) Dermoid cyst of ovary.
Since the question was incorrect in the live exam, the question has been canceled.
----------------------

Explanation :
Diseases Commonly Associated with Fibroid Uterus:

1. Endometriosis
2. Adenomyosis
3. Polycystic Ovary Syndrome (PCOS)
4. Endometrial hyperplasia
5. Infertility
6.PID
২৪.
Which of the following is the gold standard for diagnosing genital tuberculosis?
  1. ক
    Mantoux test
  2. খ
    Endometrial biopsy
  3. গ
    Chest X-ray
  4. ঘ
    ESR level
ব্যাখ্যা
Explanation:
Histopathological confirmation of granulomas with or without caseation in endometrial tissue is the gold standard.
২৫.
What is the true diagnostic value of PCOS -
  1. ক
    Rise FSH: LH ratio
  2. খ
    Raised serum estradiol
  3. গ
    Raised serum progesterone
  4. ঘ
    Raised SHBG
ব্যাখ্যা
Explanation :
Diagnostic values of PCOS :
↑ LH (Luteinizing hormone): Often elevated

Normal or ↓ FSH (Follicle-stimulating hormone): LH:FSH ratio > 2:1 (in many cases)

↑ Androgens (e.g., testosterone, DHEAS): Causes hirsutism, acne

↑ AMH (Anti-Müllerian hormone): Reflects increased follicle number

↑ Insulin / Insulin resistance: Common metabolic feature

↑ Estrogen (estrone): Due to peripheral conversion in adipose tissue

↓ SHBG (Sex hormone-binding globulin): Leads to more free androgens
২৬.
Which tumor marker is most commonly elevated in epithelial ovarian carcinoma?
  1. ক
    Alpha-fetoprotein (AFP)
  2. খ
    Beta HCG
  3. গ
    CA-125
  4. ঘ
    LDH
ব্যাখ্যা
Explanation:
CA-125 is the most commonly elevated tumor marker in epithelial ovarian carcinoma, particularly serous type.
It is useful for diagnosis, prognosis, and monitoring.
২৭.
Most common variety of ovarian tumor-
  1. ক
    Epithelial tumor
  2. খ
    Germ cell tumor of ovary
  3. গ
    Sex cord stromal tumor
  4. ঘ
    Unclassified tumor
ব্যাখ্যা
Explanation :
Incidence of ovarian tumor :
Epithelial ovarian tumor 60-70%
Germ cell tumor 20-25%
Sex cord stromal tumor 6-10%
২৮.
What is the most commonly affected organ in female genital tuberculosis?
  1. ক
    Ovary
  2. খ
    Fallopian tube
  3. গ
    Endometrium
  4. ঘ
    Cervix
ব্যাখ্যা
Explanation :
The fallopian tubes (100%)are most commonly involved in female genital tuberculosis, typically showing bilateral involvement and causing tubal block or damage.
২৯.
Increased vaginal discharge during mid-cycle, which is clear and stretchable. What is the most likely cause?
  1. ক
    Bacterial vaginosis
  2. খ
    Trichomoniasis
  3. গ
    Cervicitis
  4. ঘ
    Physiological ovulatory discharge
ব্যাখ্যা
Character of Mid-Cycle (Ovulatory) Vaginal Discharge:
Color: Clear or transparent
Consistency: Thin, stretchy, and slippery (egg-white like)
Amount: Increased
Odor: Odorless or mild
pH: Alkaline (~7.0 to 8.0)
Ferning pattern: Positive on drying (due to estrogen effect)
৩০.
What is the most common indication for total abdominal hysterectomy?
  1. ক
    Endometrial cancer
  2. খ
    Adenomyosis
  3. গ
    Uterine fibroid
  4. ঘ
    Vesicovaginal fistula
ব্যাখ্যা
Explanation :
Indications of Hysterectomy :

1. Uterine fibroids (leiomyoma)( Most common)

2. Abnormal uterine bleeding

3. Endometriosis

4. Adenomyosis

5. Chronic pelvic pain
৩১.
Premalignant lesion of vulva -
  1. ক
    VaIN
  2. খ
    Vulvar hyperplasia
  3. গ
    Lichen sclerosus
  4. ঘ
    Xeroderma pigmentosum
৩২.
Commonest site of endometriosis -
  1. ক
    Cervix
  2. খ
    Myometrium
  3. গ
    Ovary
  4. ঘ
    Pouch of Douglas
৩৩.
Chancroid is caused by -
  1. ক
    Treponema pallidum
  2. খ
    Chlamydia trachomatis
  3. গ
    Haemophilus ducreyi
  4. ঘ
    Haemophilus vaginalis
৩৪.
Organism causing moniliasis -
  1. ক
    Trichomonas vaginalis
  2. খ
    Candida albicans
  3. গ
    Gardenella vaginalis
  4. ঘ
    Chlamydia trachomatis
৩৫.
What is the most common functional cyst of ovary-
  1. ক
    Theca leutin cyst
  2. খ
    Corpus luteum cyst
  3. গ
    Follicular cyst
  4. ঘ
    Granulosa lutein cyst
ব্যাখ্যা
Explanation :
Follicular Cysts Follicular cysts are the most common functional cysts .
They are usually multiple and small as seen in cases of cystic glandular hyperplasia of the endometrium or in association of fibroid.

Hyperestrinism is implicated
৩৬.
Which of the following is the most appropriate initial investigation in suspected PID?
  1. ক
    MRI of pelvis
  2. খ
    High vaginal and endocervical swabs
  3. গ
    Complete blood count
  4. ঘ
    C-reactive protein
ব্যাখ্যা
Explanation :
Endocervical and vaginal swabs for gonorrhea and chlamydia are first-line investigations in suspected PID
৩৭.
Which of the following is the most important risk factor for pelvic organ prolapse?
  1. ক
    Vaginal childbirth
  2. খ
    Genetic default
  3. গ
    Menopause
  4. ঘ
    After hysterectomy
ব্যাখ্যা
Explanation :
Explanation:
Vaginal delivery, especially with prolonged labor or instrumental delivery, weakens pelvic support structures and is the leading risk factor.
৩৮.
Target age group for HPV vaccination -
  1. ক
    25-35 years
  2. খ
    45-55 years
  3. গ
    15-25 years
  4. ঘ
    9-14 years
ব্যাখ্যা
Explanation :
Target HPV vaccine group in Bangladesh holded by government is 9-15 years.
৩৯.
HIV affects which type of immune cell predominantly -
  1. ক
    CD8 T lymphocyte
  2. খ
    CD4 T lymphocyte
  3. গ
    NK cell
  4. ঘ
    Mononuclear phagocytic system
ব্যাখ্যা
Explanation :
Target of HIV in immunity :
Mostly CD4 T lymphocyte 
Others - 
Macrophage and other antigen presenting cell
৪০.
Example of germ cell tumor of ovary -
  1. ক
    Serous cyst adenoma
  2. খ
    Granulosa cell tumor
  3. গ
    Tumor of thecoma fibroma group
  4. ঘ
    Dysgerminoma