M.B.B.

S FINAL YEAR – PART II IMPORTANT QUESTIONS

OBSTETRICS AND GYNAECOLOGY
Paper – I: Obstetrics and foetal medicine
Paper – II: Gynaecology
The PDF includes the question papers of Pondicherry University from
November 2014 to May 2019, the model papers taken from both the old and
revised syllabus of PU and The last 2 years of question papers from TN
Dr.MGR Medical University.
OBSTETRICS
ANATOMY OF THE FEMALE REPRODUCTIVE ORGANS:
1. Pelvic diaphragm
2. Tri radiate ligament
3. Supports of uterus
FUNDAMENTALS OF REPRODUCTION AND EMBRYOLOGY:
1. Gastrulation
PHYSIOLOGICAL CHANGES IN PREGNANCY:
1. Cardiovascular physiology changes during pregnancy, labour and
puerperium**
2. Hematological changes in pregnancy*
3. Foetal circulation and changes that occur in the circulatory system at
birth
4. Renal changes in pregnancy
DIAGNOSIS OF PREGNANCY:
1. Clinical tests and laboratory tests to diagnose pregnancy
2. Symptoms, signs and diagnosis of early pregnancy
3. Hegar sign and demonstration
FETAL SKULL AND MATERNAL PELVIS:
1. Sacrotyloid diameter
2. Pawlik’s grip

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ANTENATAL CARE:
1.
a. What are the objectives of antenatal care?
b. List the basic investigations and its frequency of testing required
during pregnancy?
c. Commonly prescribed medications and immunisations during
pregnancy.
d. Note on pregnant woman regarding the diet plan. (2+3+2+3=10)
2. Partogram*****
3. Quickening
4. Objectives of antenatal care
5. Antenatal foetal surveillance
6. NST
7. Bio physical profile****
NORMAL LABOUR:
1. A 25 years old primi gravida with 38 weeks of pregnancy is admitted in
active labour with the first time in cephalic presentation.
a. Enumerate the steps of normal delivery in time pregnancy.
b. List the indication for caesarean section ( 7+3=10)
2. Bishop’s score**
3. Mechanism of labour
4. Enagement
5. Pain management in labour
NORMAL PEURPERIUM:
1. Physiology of lactation
VOMITING IN PREGNANCY:
1. Hyperemesis gravidarum**
HAEMORRHAGE IN EARLY PREGNANCY:
1. 30 years old gravida 3, para 2 with 34 weeks of pregnancy admitted
with bleeding per vaginum.
a. Discuss the D/D
b. Classification and management of accidental haemorrhage and
complications of accidental haemorrhage. ( 3+2+2+3=10)
2. HELLP Syndrome***
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 3. Threatened abortion
4. Placenta succenturiata
5. Medical management of ectopic pregnancy**
6. Causes of second trimester abortion
7. Missed abortion***
8. Causes of first trimester bleeding
MULTIPLE PREGNANCY, HYDRAMINOS AND ABNORMALITIES OF PLACENTA
AND CORD PROLAPSE:
1. G2P1 with 5 months of gestation comes for antenatal check-up, O/E
uterus is 36 weeks size.
a. Enumerate the D/D
b. Mention the complications of multiple gestation
c. How will you manage the twin pregnancy in active labour with first
twin in vertex presentation? (2+4+4=10)
2.
a. Intraspection management of twins
b. List the complications which can occur in during labour and post-
partum in twins
c. Discuss the complications and its management during labour and
delivery. (5+2+3=10)
3. 29 years old G2 P1 L1 with 32 weeks of gestation has been admitted
with breathlessness, palpitations and oedema of legs. O/E she is
anaemic and the uterus is over distended.
a. Discuss the D/D
b. Complications of twin gestation?
c. Write about intra partum management of twin gestation. (3+2+5=10)
4. Mention the causes and complications of multiple gestation.
Management of labour in twin delivery.** (6+4=10)
5. Discordant twins
6. Vanishing twins
7. Causes of oligohydramnios and polyhydramnios.
8. Delivery of second twin
9. Cord prolapse**
10.Complications of multiple pregnancy
11.Multiple pregnancy – define and write about the diagnostic criteria

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HYPERTENSIVE DISORDERS IN PREGNANCY:
1. A 18 years old primi gravida women at 37 week with B.P 140/90 mm of
Hg. How will you manage this patient and mention its complications.
(7+3=10)
2. A 20 year old primigravida presents to the OPD with one episode of
generalised convulsions at 38 weeks of gestation. How will you evaluate
and manage this case?* (4+6=10)
3. A 28 years old primi gravida admitted with B/P 150/100 mm of Hg.
Discuss
a. Diagnosis of pre-eclampsia
b. Investigations, treatment and complications of pre – eclampsia
c. Pritchard’s regimen (2+5+3=10)
4. Define eclampsia in pregnancy. What is the differential diagnosis?
Discuss the management of eclampsia at 34 weeks of gestation.
(2+3+5=10)
5. Prevention of PIH
6. Pritachard’s regimen
7. Complications of pre-eclampsia*
8. Classify hypertensive disorders in pregnancy and features of severe pre –
eclampsia?
9. Imminent eclampsia
APH:
1. Discus the aetio pathoegenesis, differential diagnosis, management and
complications of placental abruption. ( 2+2+3+3=10)
2. Define APH. What are the predisposing factor of placenta previa? Write
the management of primigravida with placenta previa at 34 weeks.**
(2+2+6=10)
3. Maccafee’s regimen / expectant management of placenta previa*
MEDICAL AND SURGICAL ILLNESSES COMPLICATING PREGNANCY:
12.Causes of anaemia in pregnancy. What are the preventive measures and
treatment of anaemia in pregnancy? Management of anaemic woman in
labour. (2+2+2+4=10)
13.Causes of breathlessness in pregnancy. How will you manage a case of
mitral stenosis in pregnancy?

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 14.30 years old G 2 P 1 L 1 with previous L.S.C.S admitted for safe
confinement of pregnancy.
a. How will you monitor this patient during labour?
b. List the indications for repeat C.S
c. Discuss complications of C.S. during repeat C.S. (3+3+4=10)
15.Cardiovascular changes during pregnancy
16.Iron therapy in anaemia in pregnancy
17.Effect of diabetes on pregnancy
18.Acute renal failure in pregnancy
19.Anti – D Prophylaxis*
20.Parenteral iron therapy
21.Diagnosis and complications of anaemia in pregnancy***
22.Complications of GDM***
23.Asymptomatic bacteuria in pregnancy
24.Monitoring of post – caesarean pregnancy during labour.
25.Diagnosis and management of gestational diabetes
26.Screening for GDM
27.Exchange transfusion
28.Preventive measures taken to prevent Rh isoimmunisation in pregnancy
and labour
29.Prevention of anaemia in pregnancy
GYNAECOLOGICAL DISORDERS IN PREGNANCY:
1. Cervical incompetence
2. Follow up of molar pregnancy
3. Mac Donald’s cercalage
4. Management of molar pregnancy
5. Encirclage
PRE TERM LABOUR, PROM, POST MATURITY AND DATE, IUD:
1. Define PROM. Aetiology, diagnosis, complications and management of
PROM. (1+2+2+2+3=10)
2. Enumerate the causes of pre term labour** and its management*
3. Management of pot – dated pregnancy
4. Diagnosis and management of pre – term labour

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SPECIAL CASES:
1. A 20 year old female presents with 3 months of amenorrhoea and
excessive vomiting and bleeding per vaginum.
a. Discuss the D/D
b. Investigations to be done
c. Management of vesicular mole (3+3+4=10)
2. Couvelaire uterus
3. Trial of labour
ABNORMLAITIES OF PELVIS:
1. Define obstructed labour. Describe the clinical features and
management of a case of obstructed labour. (2+4+4=10)
2. An 18 years old primigravida presented at 39 weeks with free floating
head on abdominal examination.
a. How will you diagnose CPD?
b. Discuss the diagnosis and management of occipito – posterior
presentation. (3+3+4=10)
3. Deep transverse arrest**
MALPOSITION, MALPRESENTATION AND CORD PROLAPSE:
1. A second gravida presents ‘at term’ with breech presentation. Discuss
the management till delivery and complications of the same. (5+3+2=10)
2. A 21 year old third gravida presents at 37 weeks with breech. What is
the aetiology, diagnosis and management of breech? (2+3+5=10)
3. What are the types of breech presentation? How will you diagnose a
case breech? Write briefly about ECV. (2+2+6=10)
4. Impacted breech
5. Shoulder dystocia
6. Assisted breech delivery
7. Complications of breech delivery
ABNORMAL LABOUR:
1. Criteria for forceps delivery
2. Vacuum delivery
3. Indications, complications of instrumental delivery
4. External cephalic version
5. Advantages and disadvantages of ventouse delivery

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 6. Outlet forceps
7. Obstructed labour – definition and causes
COMPLICATIONS OF THIRD STAGE OF LABOR:
1. Definition, types and causes of Post - partum haemorrhage. Discuss the
predisposing factors, clinical features and management of atonic post-
partum haemorrhage. (1+2+2+1+2+2=10)
2. A 30 year old G2P1L1 had spontaneous vaginal delivery and following
the delivery of placenta had excessive vaginal bleeding. On abdominal
examination, the uterus is soft and flabby. What is the diagnosis? How
will you manage the situation and how would it have been prevented?
(1+6+3=10)
3.
a. What are the complications of third stage of labour?
b. Write in detail the management of atonic PPH. (5+5=10)
4. Define Post – partum haemorrhage. Enumerate the causes and
prevention of PPH. Write a note on AMTSL. (2+3+5=10)
5. Management of adherent placenta*
6. Active management of third stage of labour (AMTSL)**
7. Management of atonic PPH
8. Indications and method of manual removal of placenta
9. Complications of third stage of labour
10.Secondary PPH – aetiology and management
11.Prevention of PPH
12.Adherent placenta
INJURIES TO BIRTH CANAL:
1. Complete perineal tear
ABNORMALITIES DURING PUERPERIUM:
1. Puerperal fever**
2. Breast feeding – advantages
3. Complications of puerperium
NEW BORN:
1. APGAR Score*

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DISEASES OF FETUS AND NEW BORN:
1. Macrosomia
2. Neonatal complications in pre term infant*
3. Management of haemolytic disease of new born
4. Respiratory distress syndrome in new born.
5. Cephalhematoma
6. Neonatal jaundice
7. Capud succedanum and cephalhematoma
8. Hyperbilirubinemia in new born
9. Anencephaly*
10.Birth asphyxia – causes and outline the management
11.Meconium aspiration syndrome
PHARMACOLOGY IN OBSTETRICS:
1. Atosiban
2. Folic acid
INDUCTION OF LABOR:
1. Medical methods of labour induction
2. Cervical ripening
OPERATIVE OBSTETRICS:
1. Episiotomy
2. Steps of caesarean section
3. Indications and complications of LSCS*
SAFE MOTHERHOOD, EPIDEMIOLOGY IN OBSTETRICS:
1. Maternal mortality in India****** (10 marks / 6 marks)
2. Dr.Muthulakshmi Reddy scheme
3. Rooming in
4. Causes of perinatal mortality
5. Steps to reduce perinatal transmission of HIV infection
SPECIAL TOPICS IN OBSTETRICS – RADIOLOGY AND DIAGNOSTIC MEDICINE:
1. Amniocentesis
2. Alfa- feto protein
3. First trimester USG****
4. Second trimester USG
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 5. PNR
6. MTP first trimester
7. MTP in second trimester
PSYCHIATRY IN OBSTETRICS:
1. PRE – CONCEPTION counselling

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 GYNAECOLOGY
CONGENITAL MALFORMATIONS OF FEMALE GENITAL TRACT:
1. Crypto menorrhoea
PUBERTY – NORMAL AND ABNORMAL:
1. FSH
2. Test for ovulation
3. Corpus luteum
4. Hyperprolactinemia
MENOPAUSE:
1. A woman of 52 years old presents with Post menopausal bleeding for 10
days.
a. Enumerate the causes
b. What are the signs and symptoms of CA cervix?
c. How will you stage CA cervix? (3+3+4=10)**
2. Causes of post – menopausal bleeding*
3. Post – menopausal general complaints**
PELVIC INFECTION:
1. 30 years old P1L1 presents with white discharge per vaginum, pain
lower abdomen on and off with dyspareunia.
a. D/D
b. Treatment of acute PID (5+5=10)
2. Trichomoniasis***
3. Garderella vaginalis
4. Pelvic inflammatory disease (PID)
5. Diagnosis and treatment of vaginal candidiasis / vulvo – vaginal
candidiasis
6. Vulvovaginal moniliasis**
7. Tubo – ovarian masses
8. Vulvo – vaginal candidiasis
9. Bacterial vaginosis**
INFECTIONS OF PELVIC ORGANS:
1. Hematocolpos
2. Bartholin’s cyst

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DYSMENORRHOEA AND OTHER DISORDERS OF MENSTRUAL CYCLE:
1. A 15 year old girl who attained menarche 3 months back presents with
menorrhagia. Enumerate the causes and discuss the diagnosis in this
patient. (5+5=10)
2. The incidence, clinical features, diagnosis and management of fibroid
uterus. (1+2+2+5=10)
3. Broad ligament fibroid.
4. Cervical fibroid
5. D/D for menorrhagia
AUB:
1. A 40 year old nulliparous woman complains of metrorrhagia. There is a
supra pubic mass of 14 weeks per abdomen.
a. Enumerate the D/D
b. What are the types of endometrium that can be seen in anovulatory
DUB
c. If investigations reveal, endometriosis in the woman, how will you
manage? (3+2+5=10)
2. 43 years old woman with mass abdomen and menorrhagia for 1 year
duration.
a. How will you evaluate this patient?
b. Discuss the management options in patient. (5+5=10)
3. A 32 year old woman admitted in the hospital with complains of mass
abdomen =.
a. Discuss the D/D
b. Mention the various management options for fibroid uterus.
(4+6=10)
4. What are the causes of abnormal uterine bleeding? How will you classify
dysfunctional uterine bleeding (DUB) and manage a 36 year old
multiparous woman with DUB? (3+7=10) **
5. A 40 years old P3 presented with profuse bleeding Per vaginum for 6
months.
a. D/D
b. Conservative management of DUB. (3+7=10)

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 6. A 30 year old primi para presents with fibroid 10 cms. Discuss
a. Treatment options available
b. Pre – op investigations
c. Complications of myomectomy
7. Puberty menorrhagia**
8. Complications of fibroid*
9. Metropathia menorrhagia
10.Conservative management of fibroid uterus
DISPLACEMENT OF UTERUS:
1. A 65 year old post menopausal woman presents with mass descending
through vaginum. Discuss the D/D, investigations and management for
this case. (3+4+3=10)*
2. Write elaborately on supports of uterus. Discuss in detail about the
aetiology and management of UV prolapse. (4+2+4=10)
3. Mention the aetiology and degrees of UVP. How will you manage a case
of III degree genital prolapse in a 45 year old lady? (3+2+5=10)**
4. Nulliparous prolapse
5. Degrees of UV prolapse and causes.
6. Classification of pelvic organ prolapse*
7. Vault prolapse**
8. Conservative management of UVP
9. Classification of retrovaginal prolapse
INFERTILITY:
1. Define primary infertility. Enumerate the causes and management of
anovulatory infertility. (1+3+6=10)
2. How will you evaluate an infertile couple married for 10 years and how
will you manage anovulation? (7+3=10)*
3. What are the causes of male infertility? How will you evaluate a case of
male infertility? (5+5=10)
4. A 26 years old woman is married for four years and is anxious to
conceive. How will you evaluate this patient and counsel them? (8+2=10)
5. Test for tubal patency** / tubal factors in infertility*
6. Semen analysis*
7. Post – coital test
8. Causes of infertility
9. Intra uterine insemination
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 10.Management of anovulation
BENIGN LESIONS OF CERVIX:
1. Define dysplasia, various types of dysplasia. Screening techniques for
carcinoma cervix and management of LSIL and HSIL. (1+2+5+2=10)
2. Pap smear********
3. Management of CIN II
4. Screening methods for CA cervix
BENIGN LESIONS OF UTERUS:
1. Simple endometrial hyperplasia
2. Endometrial hyperplasia
BENIGN LESIONS OF OVARY:
1. Dermoid cyst of ovary
2. Complications of ovarian cysts
3. Torsion of ovarian cysts
ENDOMETRIOSIS AND ADENOMYOSIS:
1. What are the clinical features of endometriosis? How will you manage a
case of endometriosis? (4+6=10)
2. Chocolate cyst of ovary**
3. Adenomyosis – clinical features and management
GENITAL MALIGNANCIES:
1. What are the signs and symptoms of cancer cervix? How will you
manage a 33 years old parous woman with stage I a CA cervix? (4+6=10)
2. Staging laparotomy in ovarian tumours**
3. Tumour markers in gynaecology
4. EMA – CO regime
5. Staging and management of CA cervix
6. Brenner tumour
7. Choriocarcinoma
8. Chemotherapy for persistent trophoblastic disease
9. Staging of endometrial carcinoma
10.Stages of carcinoma ovary.
11.Symptoms and signs of CA cervix*
12.Dysgerminoma*

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 13.Diagnosis and treatment of vesicular mole.
URINARY PROBLEMS IN GYNAECOLOGY:
1. Ureteric injuries
2. Urethrocele
3. Stress urinary incontinence
GENITAL FISTULAE:
1. Recto vaginal fistula
INTERSEXUALITY:
1. Hirsutism
AMENORRHOEA:
1. Medical management of PCOS in unmarried woman
2. Follicular study
3. Causes secondary amenorrhoea*****
4. Turner’s syndrome
5. Principles of management of secondary amenorrhoea.
6. Asherman’s syndrome
7. Androgen insensitivity syndrome or testicular feminizing syndrome
CONTRACEPTION:
1. PPIUCD
2. Non – contraceptive benefits of OCP*
3. Minipills
4. Injectable contraceptives**
5. Complications of OCP
6. Emergency contraceptive****
7. Tubal – sterilization techniques
8. Contraindications of IUD*
9. Barrier methods of contraception
10.Management of missing copper T
11.LNG – IUCD
12.Contraindications of OCP
13.Minilap sterilisation

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SPECIAL TOPICS:
1. Novasure
2. Dermoid cyst***
3. Centchroman
4. Mittelschmerz
5. Hot flushes
6. Uterine artery embolization
7. HSG
8. Dyspareunia
9. Causes of leucorrhoea
10.Medical methods of abortion
11.HRT **
OPERATIVE GYNAECOLOGY:
1. Female sterilization
2. Complications of abdominal cystectomy
3. No scalpel vasectomy
4. Steps of abdominal hysterectomy
5. Fractional curettage
6. Indications and complications of vaginal hysterectomy
7. Staging laparotomy for various genital malignancies
ENDOSCOPY:
1. Hysteroscopy*
2. Colposcopy*
3. Abdominal cervicopexy
OTHERS:
1. Preventive measures for perinatal mortality

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