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DNB QUESTION PAPERS

 OBSTETRICS

1. ANATOMY

1) a) Significance of ‘Uterosacral ligament’ in Gynaecology. 5

b) Anatomy of the female perineum and its application in
Obstetrics. 5

2) a) Umbilical cord development and its structure. 4

b) Enumerate various umbilical cord anomalies and their
clinical importance. 6

3) Bilateral ligation of internal iliac arteries in Obstetrics. 5

4) Anatomy of lower uterine segment in pregnancy and its

role in labor. 4

5) Surgical anatomy of pelvic ureter in females. 2

6)Describe the anatomy of fallopian tube. 3

7) a) Describe the lymphatic drainage of female genitalia. 5

b) What is the clinical significance of lymphatic drainage in

management of gynaecological malignancies? 5

8) a) Enumerate the diameters of maternal pelvis in all planes

giving their measurements 4

b) What are the indications of pelvic assessment during

pregnancy and labor? 2

c) Describe pelvic assessment. 4

9) a)Describe the anatomy of pelvic ureter. 3

b)What are the possible sites of ureteric injury during pelvic surgery? 3
c)How can these injuries be prevented? 4

10)a) What are the major blood vessels supplying the pelvis? 4
b)Discuss clinical significance of the collateral circulation of the pelvis with emphasis on
internal iliac artery ligation 4
c)Enumerate the complications of internal iliac artery ligation 2

11)a) Various pelvic retroperitoneal spaces and their boundaries.

b) Importance of such spaces in gynaecology 5+5
12) a) Course of the ureter. 3+2+(2+3)
b) Where can it get injured or damaged during surgery in
c) Diagnosis of injury to the ureter and its management.

13) a. Describe the course of ureter in female pelvis. 3

b. What are the different sites and nature of ureteric injuries in. gynecological surgery? 4
c. What precautions should be undertaken to avoid such injuries. 3

2.NORMAL PHYSIOLOGY

OVARIAN CYCLE

1)a) Different phases of ovarian cycle. 4

b) Process of development and differentiation of ovarian
follicles. 3
c) Causes of ovulation 3

1)a) What are the physiological changes in skin during pregnancy? 4

b) What is supine hypotension syndrome? 2
c) How do you manage a woman with supine hypotension
syndrome? 4

2) Endocrine changes during puberty. 4

3)Describe the changes in serum B hcg levels in normal pregnancy Enumerate the indications
for assessment of B hCG levels in pregnancy and write their clinical significance
4+(2+4)

HYPEREMESIS GRAVIDARUM

1)a) Define hyperemesis gravidarum. 2

b) Its clinical features and complications. 2+2
c) Management of hyperemesis gravidarum. 4

2)a) Enumerate the causes of vomiting during pregnancy. c) How will you manage a
primigravida with hyperemesis b) What are its complications? gravidarum at 9 weeks of
pregnancy? 3+2+5
3)Define hyperemesis gravidarum. What are its clinical features and complications? Discuss its
differential diagnosis. 3+4+3

3. GENERAL

1) Selection of a patient for admission in an intensive care

unit. 5

2)a) Necrotising fasciitis. 5

b) Prophylactic salpingectomy. 5

3)a) Fetal cell free DNA in maternal blood.

 b) Neuroprotector role of antepartum magnesium
sulphate. 5+5

4)a) Risk factors for hospital acquired infections (HAI) and

enumerate its causative organisms.
b) Clinical picture of common HAI in Obstetrics & Gynaecology.
c) Prevention of HAI. (3+2)+3+2

5)a) Principles of Obstetric High Dependency Unit (HDU).

b) How will you set up HDU in your hospital? 5+5

6)a) Maternal & fetal effects of air pollution.

b) Counseling of pregnant women to minimize risks of
air pollution 5+5

7)a)Enumerate key points in setting up an ideal antenatal clinic in your environment.

b) How do you propose to maintain a system to minimize drop out rate? 5+5

8) Write short notes on: a) Complications of blood transfusion b) Stem cell banking 5+5

9)Define Maternal Near-Miss What are the criteria given by WHO for labeling a patient as
Maternal Near Miss? Discuss the steps to reduce maternal morbidity and mortality 2+5+3

10) Low molecular weight heparin and its uses in Obstetrics

11)Enumerate various types of scientific studies and their role in establishing levels of evidence
and recommendations for clinical practice. 10

12) What are the risks of pregnancy at advanced maternal age? How will you screen and
manage such a patient? 3+3+4

13)Enumerate key points in setting adolescent health clinic in your hospital. What are the
reproductive health hazards of adolescent girls? Describe preventive strategies to reduce
reproductive healith hazards in adolescent girls through the clinic. 3+3+4

4.GENETIC COUNSELING

1)a) What is genetic counseling? 2

b) When and to whom we should we offer prenatal genetic
counseling? 4
c) What is pre implantation genetic diagnosis? 4

2)a) What is Preimplantation Genetic Diagnosis (PGD)? 1

b) What is comprehensive chromosomal screening
(CCS)? 1
c) What are the indications, benefits and risk of PGD &
CCS? 3+3+2

3)a)Characteristics of a good screening test. obstetrics and gynaecology? 5+5

 b) Screening protocols for aneuploidies.

4)a) Preconceptional counseling. 3+(3+4)

b) A patient with previous history of neural tube defect in a child comes to ask about chances
of similar defect in her next pregnancy. How will counsel and manage her next pregnancy

5)a) Cell free fetal DNA screening and its indications. (2+2)+(3+3)
b) Invasive tests for prenatal diagnosis and their uses

6)What is genetic counseling? In which patients is it required? What are the procedures that can
be performed to aid diagnosis? 2+3+5

7)Write short notes on a) Pre implantation genetic diagnosis b) Stem cell banking 5+5

8)What is pre-conceptional counseling? . Describe the role of preconceptional counseling in

Obstetrics. How will you counsel a newly married woman with RHD and mitral stenosis 2+4+4

ANC

1)a)What do you understand by antenatal care? b) Investigative facilities for antenatal care that
should be available in a tertiary care centre. c) How will you counsel a low risk pregnant woman
in early antenatal period? 2+4+4

5.PLACENTAL ABNORMALITIES

1)a) Diagnosis and management of morbidly adherent placenta. 5

b) Important issues in the surgical management of placenta
praevia accreta. 5

2)a) What are the hormones produced by placenta?

b) What are the abnormalities of the placenta?
c) What are the placental perfusion disorders? 3+4+3

3)a) What are the various types of morbid adhesions of

placenta?
b) Diagnostic modalities and management options for morbid
adhesions of placenta. 2+(4+4)

4)a) Types of morbidly adherent placenta

b) Risk factors and antepartum diagnosis of placenta
accreta.
c) Anticipated complications & preventive steps in a
woman diagnosed with placenta accreta at 34
weeks of pregnancy. 2+4+4

5)a) What are the risks of placental problems in previous caesarean sections? b) How do you
diagnose morbid adhesions of placenta? c) Discuss the management of a known case of
placenta accrete 2+3+5
6)Define and classify morbidly adherent placenta (MAP). What is the role of Ultrasound and MRI
in diagnosis of MAP? What are the complications of MAP and how will you manage them?
2+4+4

7) What are the predisposing factors for abruptio placentae? How will you diagnose it? What are
its complications? How will you manage a G P2L2 admitted at 38 week with the diagnosis of
abruptio placentae? 2+2+2+4

8)Pathological evaluation of placenta 5

9)Discuss different types of placental abnormalities and their significance 6+4

10)What are the anatomical features of placenta .Enumerate the developmental anomalies of
placenta. Describe the complications of morbidly adherent placenta. 4+3+3

11)Classify placenta praevia.What are the causes of placenta praevia .How will you confirm its
diagnosis.What are the problems in its management. 3+2+2+3

12)a. Enumerate the risk factors for morbidly adherent placenta. Describe the evaluation to
confirm the diagnosis
b. Describe the management of a case of adherent placenta admitted at 32 weeks of
gestation 5+5

6. FETAL CIRCULATION

1)a) Diagrammatic representation of fetal circulation. 5

b) Pregnancy of unknown location (PUL). 5

2) Cardiopulmonary adjustments in a new born child. 3

3)Describe fetal circulation. Briefly discuss the clinical importance of Doppler studies in
Obstetrics. 6+4

7. INTRAPARTUM FETAL ASSESMENT

1)Intra-partum fetal monitoring. 5

2)a) Indications for Electronic Fetal Monitoring (EFM). 3

b) Causes of intrapartum fetal bradycardia and tachycardia. 4
c) How will you manage late deceleration? 3

3)a) Describe the methods of intrapartum fetal monitoring. 4

b) Enumerate the maternal and fetal indications of electronic fetal monitoring during
pregnancy and labor. 3
c) What do you understand by Normal Tracing and Abnormal Tracing' observed during
electronic fetal monitoring. 3

4)a. What are the various methods of antenatal assessment of fetal well being? b. How will you
diagnose and evaluate a "fetus at risk" during antenatal period? c. Describe the management of
fetal heart decelerations during labor 3+4+3
 USG

1)a) Role of ultrasonography in infertility. 5

b) Presence of echogenic bowel in antenatal
ultrasonography. 5

2)a) What are the components of a standard ultrasound

examination in the 1st & 2nd trimester? 4
b) What are the guidelines for nuchal thickness? 4
c) What are the abnormalities in measuring the biparietal
diameter? 2
BIOCHEM MARKERS

1)a) Biochemical markers used for the diagnosis of fetal

anomalies in the first trimester. 5
b) Diagnosis of congenital diaphragmatic hernia during
pregnancy. 5
DOPPLER

1. What is Doppler Flow Velocimetry and what is its importance

in pregnancy?

2)a) What are the principles of fetal ductus venous flow

assessment? 3
b) What are the normal and abnormal waveforms? 2
c) What are the indications for its use? 2
d) How does it modify obstetric management? 3

3) Uterine artery Doppler studies in pregnancy. 5

4)Describe the utility of Doppler studies in: a) Multiple gestation b) Infertile women c) Placenta
Praevia 3+4+3

5)Discuss in brief the principles of Doppler velocimetry? Enumerate the vessels studied during
pregnancy and their impact on pregnancy management. 3+5

6)a. What is Doppler blood flow velocimetry? b. Describe the role of fetal umbilical artery
Doppler blood flow evaluation in a case of Fetal Growth Restriction (FGR) . How will you
manage a pregnant woman at 34 week pregnancy with absent diastolic flow? 2+4+4

ANOMALY SCREENING

1)a) Guidelines for Nuchal Translucency measurement in First

Trimester fetal anomaly screening. 5
b) Standard examination of fetal anatomy in an anomaly scan
at second trimester. 5

2)a) What are the fetal anatomical parameters to be evaluated in a

second trimester fetal anomaly detection scan? 3
b) Enumerate neural tube defects of fetus. 3
c) How will you manage subsequent pregnancy with prior history of
Neural tube defect fetus? 4

3) NIPT (Non invasive prenatal testing). 5

4)a) Methods of prenatal screening for aneuploidies in

first trimester of pregnancy. 5
b) Guidelines for measurement of nuchal translucency. 5

RADIOLOGY

1)a) Indications of magnetic resonance imaging in Obstetrics. 5

b) Clinical importance of yolk sac within the gestational sac in
ultrasonography. 5

2)Role of MRI in Obstetrics and Gynaecology. 5+5

3) Sonography in first trimester. 5

4)a. Describe the importance of an 11-14 weeks antenatal scan. b. Enumerate 3 soft markers of
fetal anomalies and their importance Describe antenatal diagnosis and evaluation of fetal
hydrops. 3+3+4

CVS SAMPLING

1)a) Indications of chorionic villous sampling (CVS). 2

b) Compare the advantages and disadvantages of
CVS with amniocentesis. 5
c) Complications of CVS. 3

2)a) What are the indications of chorionic villous sampling? b) When is it performed? c) What
are its complications and how do you manage them? 4+2+4

AMNIOCENTESIS

1)a) What are the genetic indications of amniocentesis? b) When should it be performed? c)
Discuss its complications & their prevention. 4+2+4

8.AFI

1)What is the physiological mechanism of formation of amniotic fluid? Enumerate the etiological
factors of oligohydramnios.How will you manage a primigravida with 34 weeks pregnancy and
AFI-5cms. 3+2+5

2)How is amniotic fluid formed during pregnancy? Enumerate the causes of abnormal quantity
of amniotic fluid. What are the complications of hydradramnios? 3+4+3
 9. HORMONES

1)a) Functions of Follicle Stimulating Hormone (FSH). 3

b) Indications for use of gonadotropins in Gynaecology. 3
c) Commonly used anti-gonadotropins. 4

2)a) What are the normal serum values of FSH, LH, E2,
progesterone and testosterone? 5
b) What is the significance of monitoring them in
Gynaecology? 5

3)Critically evaluate the role of ulipristal acetate for:

a) Treatment of fibroids. 5
b) Emergency contraception. 5

4)a. What are progestogens and how are they classified? 5+5
b. Mention briefly the uses of progestogens in gynecological practice

5) Evidence based use of progesterone in Obstetrics

6) Selective estrogen receptor modulators (SERMs)

7)What is the role of Inhibin A and B in Obstetrics/Gynaecology? 5+5

10.LEAKING PV

1)A primigravida with 8 months of amenorrhoea has history of leaking per vaginum. How will
you confirm the diagnosis? What investigations would you like to do in this case? How would
you manage her? 2+4+4

11.ECTOPIC

1)a) Diagnosis of unruptured tubal ectopic pregnancy. 4

b) Expectant management for unruptured tubal ectopic pregnancy. 3
c) Persistent trophoblastic activity following management of ectopic
pregnancy. 3

2. Define ectopic pregnancy and enumerate the types of ectopic pregnancy. What are the
reasons for increased prevalence of ectopic pregnancy? How will you manage a case of
unruptured ectopic pregnancy in a nulliparous patient? (1+2)+3+4

12.ABNORMAL LABOUR

CPD

1)a) What are the clinical features of obstructed labor in

cephalopelvic disproportion? 3
b) Difficulties in 2nd stage LSCS. 3
 DIFFICULT LABOUR

1) Face to pubis delivery. 5

2)Define 'Obstructed Labor. Enlist its causes. How do you diagnose it? Enumerate the maternal
and fetal complications of obstructed labor 1+3+3+3

3)Discuss occipito-posterior position, its management during labour with special emphasis on
face to pubis delivery 3+4+3

4)A multigravida with 9 month of amenorrhea has a transverse lie. a) What investigations would
you like to do and why? b) How would you manage her? (2+3)+5

5)What are predisposing factors for breech presentation? How will you manage such a case
presenting at 36 weeks? 3+7

6)Define active phase of labor. Enumerate its abnormalities and their management. 2+4+4

SECOND STAGE ARREST

1)a) Define the second stage of labor and second stage arrest. 2
b) Enumerate the causes of second stage arrest. 3
c) Outline the management of a woman in second stage arrest . 5

DTA

1)a)Define deep transverse arrest (DTA) 2

b) Enumerate the maternal and fetal complications of DTA. 4
c) How do you manage a case of deep transverse arrest? 4

SHOULDER DYSTOCIA

1)a)What are the predisposing factors for shoulder dystocia. 3+4+3

b)Describe salient guidelines for managing such a case.
c)What are the maternal and neonatal complications of shoulder dystocia

2)a)What are the factors for prediction of shoulder dystocia? 2+3+5

b)What are the possible maternal and fetal complications of shoulder dystocia.
c)Discuss the management of shoulder dystocia.

13.LABOUR ANALGESIA

1)a) Enumerate the methods of labor analgesia. 3

b) Contraindications for neuraxial analgesia. 2
c) Postdural puncture headache and its management. 2+3

14.LABOUR INDUCTION AND AUGMENTATION

1)a) Advantages of active management of labor (AMOL). 3

 b) Different methods for induction and augmentation of labor. 3
c) Factors which predict successful induction of labor. 4

2)a)What are the indications of induction of labor? 3+3+4

b) Enumerate the Bishop's score and mention its significance
c) What are the methods of induction and highlight the method and uses of oxytocin?

3) Discuss pharmacodynamics of misoprostol. Enumerate the indications for use of misoprostol

in obstetrics. How will you monitor a primigravida who has been induced at full term with vaginal
misoprostol? 2+3+5

4)Describe the physiology of oxytocin in pregnancy. What is the pharmacokinetics and

therapeutic role of oxytocin in labour? 3+(2+5)

5)What are the indications and contraindications of tocolysis? Enumerate the agents available
and write their doses and side effects. 4+6

6)What are the indications of induction of labor? Describe the various methods of pre-induction
cervical ripening. Enumerate complications of induction of labor. 3+4+3

15.CS

1)a) Monitoring during TOLAC (Trial of Labor after Caesarean).

b) Problems during second stage CS. 5+5

2)a) Pros and cons of elective caesarean section on demand.

b) Neonatal morbidity in elective caesarean section.
c) Previous caesarean scar pregnancy. 3+4+3

3)What is TOLAC? What are the determinants of a successful

VBAC? How will you monitor this patient in labour? How will
you diagnose scar rupture? 1+3+3+3

4)Definition, risks, diagnosis and management of Caesarean

scar pregnancy. 2+2+3+3

5)a) What is perimortem caesarean section?

b) Indications and steps of perimortem caesarean
section.
c) What are the components of the counseling of
family? 2+6+2

6)a) Pre requisites of trial of labour after caesarean

section
b) Methods of cervical ripening in a woman with
previous caesarean section.
c) Intrapartum management of a woman with previous
caesarean section. 3+3+4
 VBAC

1)What are the prerequisites of Vaginal Birth After Caesarean(VBAC) How will you counsel a
patient to participate for VBAC? How would you monitor a patient of previous Caesarean
Section during labor 3+3+4

2)What is VBAC (Vaginal Birth After Cesarean)? Discuss factors favourable for VBAC. 4+6

POP

1)a) How is fluid and electrolyte balance maintained in the post

operative period?
b) How would you diagnose and manage post operative fluid
and electrolyte imbalance? 3+(3+4)

16.NEWBORN

1)Write briefly on: a. Admission test at onset of labor, b. Hypoxic ischaemic encephalopathy:
and c. Neonatal jaundice. 3+3+4

2)How will you care for a newborn of a:

a) Diabetic mother
b) Rh-ve mother
c) HIV+ve mother
d) Epileptic mother
e) β-Thalassemia trait +ve mother 2x5

NEONATAL JAUNDICE

1)What are the causes of neonatal jaundice? Discuss in brief kernicterus and role of
phototherapy in its management. 4+(3+3)
2)What is cephalo-haematoma? Describe its etiology and management 3+(3+4)

BIRTH INJURIES

1)a)Classify birth injuries. 4+6

b)How do you anticipate and prevent them

FETAL ANEMIA

1)a) What are the causes of fetal anemia? b) Write the methods used to diagnose fetal anemia.
c) Management plan to treat it. 2+4+4

MAS

1)a) Pathophysiology of Meconium Aspiration

Syndrome(MAS). 4
b) Clinical features of MAS. 3
c) Obstetrician role in prevention of MAS. 3
 HYPERBILIRUBINEMIA

1)a) Define neonatal hyperbilirubinemia. 3

b) Enumerate causes of neonatal hyperbilirubinemia. 3
c) Indications of exchange transfusion in neonatal
hyperbilirubinemia. 4

STILL BIRTHS

1)a) Enumerate the causes of still birth.

b) Mention the various ways by which you will evaluate a still
born infant.
c) How will you counsel the parents? 3+5+2

2)What are the causes of stillbirths? How will you evaluate a patient with a previous history of
stillbirth? 4+6

3)Enumerate the causes of still birth. a. b. Describe the management of pregnancy with fetal
demise documented at 32 weeks of gestation. c. How will you counsel this patient and her
spouse in the postpartum period? 3+4+3

BIRTH ASPHYXIA

1)a) Define birth asphyxia.

b) What is modified biophysical profile score?
c) What is the role of admission test? 3+4+3

2)What is the difference between implied consent and informed consent? What are the potential
areas of litigation in Obstetrics? Discuss the medicolegical aspects of birth asphyxia 3+4+3

3)What is birth asphyxia? What are the preventive steps to avoid birth asphyxia in growth
restricted babies? Enumerate the long term effects on birth asphyxia. 3+4+3

4)a. What is APGAR score? b. Describe the resuscitation of a new born baby with poor APGAR
score c. Define birth asphyxia and enumerate its immediate and long term sequelae. 2+4+4

NEWBORN RESUSCITATION

1)a) Draw an algorithm for steps of neonatal resuscitation. 3

b) List eight maternal conditions warranting the presence of
neonatal resuscitation team at the time of delivery. 4

2)a) Physiology of initiation of air breathing of fetus after

delivery. 3
b) How would you evaluate the condition of newborn? 3
c) Enumerate the basic resuscitation protocols for a newborn
in the delivery room. 4

3)a) How is the condition of a newborn evaluated at birth? 5+5

 b) What is the algorithm of resuscitation protocol in a newborn?

4)RDS in newborn - Definition, causes and prophylactic measures (1+2+2)

5)Describe essential steps of neonatal resuscitation.What is Kangaroo care. 6+4

BREAST FEEDING

1)a)Write about the hormonal mechanism involved in lactogenesis

b)What are the contraindications for breast feeding?
c)How will you suppress lactation in these women? 4+3+3

2)What are the benefits of breast feeding to the mother and new born? Discuss galactogenesis
and lactogenesis. Discuss the recent guidelines for breast feeding for HIV positive women in
developing countries 4+3+3

3)Write brief notes on Exclusive breast feeding 3

17.PUERPERIUM

1)a) Define puerperal pyrexia and puerperal sepsis. 2

b) What are the causes of puerperal sepsis? 2
c) Describe the principles of management of puerperal sepsis. 4
d) What are the complications associated with puerperal sepsis? 2

2)What is postpartum collapse? Enumerate its causes. How will you manage a case of amniotic
fluid embolism in a primiparous woman just after delivery? 2+3+5

3)What are the predisposing factors of puerperal sepsis investigate and manage a case of
puerperal sepsis? Discuss in brief its term impact on reproductive health. 3+4+3

4) a. Enumerate the risk factors for post partum sepsis. b. Describe clinical presentation and
management of post partum sepsis. c. What are its complications? 3+4+3

18.PIH

1)a) HELLP syndrome: Its differential diagnosis and

management.
b) Thromboprophylaxis during pregnancy. 5+5

2)a) Enumerate the causes of convulsions during pregnancy.

b) What are the maternal and fetal risks of eclampsia?
c) How will you manage a G1P0 admitted at 32 weeks of
pregnancy with eclampsia? 2+(2+2)+4

3)a) Classify the antihypertensive drugs used during pregnancy.

b) Enumerate the side effects & mechanism of action of each
group.
c) Which anti-hypertensives are contraindicated in pregnancy
and why? 4+4+2

4)a) Diagnostic criteria for severe preeclampsia

b) Management of eclampsia at 34 weeks of gestation 4+6

5)a) Define HELLP syndrome. b) Discuss its pathophysiology, diagnostic criteria and
management 2+(2+2+4)

6)A woman with 7 months of pregnancy has a blood pressure of 140/100mm of Hg. What is her
diagnosis? What investigations would you like to do and how would you manage this patient?
2+(4+4)

7)Enumerate the causes of generalized edema in a primigravida with term pregnancy. Describe
the features of severe pre-eclampsia. How will you prevent eclampsia in pregnant woman with
severe pre-eclampsia? 3+3+4

8) a. Classify the hypertensive disorders of pregnancy. b. Describe the pathophysiology of pre-

eclampsia c. Describe the role of antihypertensive therapy in cases of pregnancy induced
hypertension. Name the hypertensive drugs, dosage and routes of administration with levels of
evidence in managing a case of hypertensive disorder of pregnancy. 3+3+4

19.OBSTETRICAL HAEMORRAGE

APH

1)a) Define APH . 2

b) Describe the differential diignosis of APH. 3
c) Enumerate the complications associated with abruptio placenta. 2
d) How will you prevent and manage these complications? 3

PPH

1)a) Causes of postpartum hemorrhage. 3

b) Outline the management of a case which is unresponsive
to uterotonic agents. 4
c) Enumerate complications of blood transfusion. 3

2)a)Discuss the physiology of third stage of labor. 2+3+5

b)How do you prevent atonic PPH?
c)Describe the various interventions in the management of atonic PPH

3)a. Define post partum hemorrhage (PPH) .How will you anticipate and prevent PPH?
b.Mention briefly the role of balloon tamponade in PPH
c.What are the advantages and disadvantages of uterine artery embolization in massive post
partum hemorrhage? 4+3+3

4)What are the causes of massive obstetric hemorrhage outline emergency obstetric
management in atonic post partum hemorrhage. What are the immediate and late
complications? 3+4+3
5) Write indications for peripartum hysterectomy. What are the consequences of massive blood
loss in Obstetrics? 4+6
20.PRETERM LABOR

1)a) What are the clinical criteria of preterm labor?

b) Prediction and prevention of preterm labor.
c) Role of Atosiban as a tocolytic agent. 3+4+3

2)What are the etiological factors and clinical evidence of preterm labor? What are the steps to
prevent preterm labor? Classify tocolytic agents used in preterm labor 4+3+3
3) a. How would you identify a woman at risk for spontaneous preterm labor? b. Describe the
management of pregnant woman with preterm rupture of membranes at 34 weeks of gestation
5+5
PPROM

1)a) What are the causes of PPROM? 3

b) How will you confirm the diagnosis of PPROM? 3
c) How will you manage a case of PPROM at 33 weeks of
gestation? 4

2) How will you identify women at risk for spontaneous preterm labour? Discuss management of
PPROM (Preterm Premature Rupture of Membranes) 6+4

3)a) Define P.P.R.O.M.

b) What are the risk factors?
c) How will you manage a case of P.P.R.O.M at 28 weeks of
pregnancy? 2+2+6

4)a) Diagnosis of preterm prelabour rupture of

membrane (PPROM)
b) Components of expectant management in PPROM
c) Indications of delivery in PPROM 4+4+2

PROM

1)a) Define premature rupture of membranes (PROM) 2

b) How will you confirm your diagnosis? 2
c)Enumerate risk factors for PROM . 2
d)Outline the management of a pregnant woman with pre-term premature rupture of
membranes at 30 weeks of gestation. 4

21. IUGR

1)a) What is IUGR? 2

b) Enumerate the causes of IUGR. 3
c) Discuss the place of Doppler velocimetry in the diagnosis and management of IUGR. 5

2)What is IUGR pregnancy? Discuss fetal surveillance during antenatal period 3+7
3) a) Problems of SGA fetus. b) Various techniques for evaluation of relative risks to SGA fetus.
c) Evidence based guidelines for management of such a case. 2+4+4

FETAL GROWTH RESTRICTION

1)a) Define fetal growth restriction (FGR). 1

b) Enumerate causes of FGR. 3
c) How will you manage a case of FGR at 32 weeks? 6

2)a) Clinical importance of Doppler studies in fetal growth

restriction. 4
b) What are the perinatal complications in such a case?
Outline their management. 2+4

3)Define Intra Uterine Growth Restriction IUGR.What is the role of Doppler blood flow studies in
the management of IUGR? Describe the perinatal problems of IUGR babies 3+3+4

22. TWIN PREGNANCY

1)Enumerate complications and management of a

monochorionic twin pregnancy. 3+7

2)a) Role of ultrasonography in the management of

monochorionic twin pregnancy. 5
b) Twin reversed arterial perfusion. 5

3)a) Enlist fetal risks in twin gestation. 2

b) How and when will you establish chorionicity of twin
pregnancy? 4
c) How will you diagnose and manage twin to twin
transfusion syndrome? 4

4)a) What is T.T.S.?

b) What are the stages of T.T.S.?
c) Management & prognosis of T.T.S. 2+4+4

5)a) Enumerate the factors that influence the increased

incidence of twinning?
b) How would you determine the chorionicity and
amnionicity?
c) Management of discordant twins. 2+2+6

6)a) Delivery of second twin. b) Embryo reduction. 5+5

7)What do you understand by zygosity and chorionicity of twin pregnancy? How will you
manage a case of mono amniotic, monochorionic twin pregnancy? (3+3)+4
 23.OBESITY

1)a) How will you counsel a young low risk primigravida

regarding dietary intake?
b) How does obesity affect pregnancy?
c) Obstetric management of a pregnant patient with prior
history of bariatric surgery. 5+2+3

2)a) How do you calculate BMI?

b) What are the different ranges of BMI?
c) What is its relevance in Obstetrics & Gynaecology? 1+3+6

24.CVS IN PREGNANCY

1)a) How does the presence of mitral stenosis impact the

pregnant patient?
b) What are the indications for correction during pregnancy
for this condition?
c) How will you manage a patient after mitral valvuloplasty
done in fifth month of pregnancy? 3+2+5

2)a) Describe the specific care of a case of prosthetic mitral valve during the antenatal
period
b Describe the clinical features and diagnostic interventions in a case of heart disease in
pregnancy
c)Describe the risk factors of cardiac decompensation a management of cardiac failure in
a primigravida with Rhd and Mitral stenosis 4+2+4

3)a) Enumerate clinical indicators of heart disease during pregnancy. b) What is NYHA
classification of heart disease and its prognostication? c) Give contraceptive advice for a
woman with mitral stenosis going on discharge after delivery 3+3+4

4)a) Haemodynamic changes in pregnancy b) Effects of mitral stenosis on pregnancy c)

Preventive measures to be taken to avoid complications in pregnant women with mitral stenosis
4+3+3

5)Which anticoagulant, when and why to be woman with prosthetic heart valve? 4+3+3

6)What is peripartum cadiomyopathy? What are its clinical features and prognosis? Describe
the management of congestive heart failure in association with peripartum cadiomyopathy in
term pregnancy 3+4+3

7)A 20 year old G Po with 14 weeks pregnancy is diagnosed to be having RHD with mitral
stenosis. How would you monitor her during pregnancy childbirth and postpartum? 4+3+3

25.RS IN PREGNANCY

1)a) Enumerate the causes of dyspnea in pregnancy. 2

 b) Describe in brief the effects of bronchial asthma on pregnancy and vice versa. 3
c)How will you manage a case of asthma during labor? 5

26.THROMBOEMBOLIC DISORDERS

DVT

1)a) Enumerate high risk factors for thromboembolism during

pregnancy & puerperium.
b) How will you manage a G2P1L1 with history of DVT in the
previous pregnancy? 4+6

2)a) Enumerate risk factor for development of venous

thromboembolism (VTE) in patient undergoing
surgery
b) Options of perioperative thromboprophylaxis. 5+5

3)a)What is the clinical presentation of DVT during pregnancy 2+3+5

b)How is it diagnosed
c)Discuss its management

4)What are the risk factors for venous thrombo-embolism? How will you diagnose deep vein
thrombosis (DVT) during pregnancy. Outline the plan of management of DVT in a primigravida
with 30 weeks of pregnancy. 3+3+4

5)a. Describe the methods of evaluation of a case of suspected antepartum deep vein
thrombosis (DVT) of both lower limbs. b. Describe the management of antepartum DVT c.
Enumerate indications for postpartum thrombo-prophylaxis. 3+4+3
APLA

1)a) What are anti-phospholipid antibodies? 2

b) Clinical and laboratory criteria of diagnosing antiphospholipid
antibody syndrome. 5
c) Pregnancy complications associated with thrombophilias. 3

2)What are the causes of recurrent fetal loss? Define and classify thrombophilia in pregnancy.
Describe the clinical approach to the management of early pregnancy with APLA. 3+3+4

27. RENAL

1)Describe the physiological changes in the renal functions during normal pregnancy b)
Enumerate the causes of acute renal failure (ARF) during pregnancy c) Outline the plan of
management of ARF during pregnancy 3+3+4
AKI

1)a) Causes of Acute Kidney Injury (AKI) during

pregnancy. 3
b) Steps to prevent AKI in patients of obstetric
hemorrhage. 4
 c) Indication of dialysis in AKI during pregnancy. 3

ASYMPTOMATIC BACTERIURIA

1) What are the physiological and anatomical changes in the urinary system during pregnancy?
Define asymptomatic bacteriuria. How does it affect pregnancy? Write the management of
asymptomatic bacteriuria. 3+2+2+3

2)a. Define asymptematic bacteriuria 2+4+4

b. How will you diagnose and manage this condition in pregnancy.
c.What are its clinical associations in Obstetrics

PYELONEPHRITIS

1. Diagnosis, complications and management of a case of acute

pyelonephritis during pregnancy. 3+3+4

2)a) What are the pregnancy induced urinary tract changes? 3

b) What is asymptomatic bacteriuria & its impact on
pregnancy? 4
c) How will you manage acute pyelonephritis in pregnancy? 3

28.LIVER

AFLP

1)a) What is the differential diagnosis of jaundice in pregnancy? 2

b) Write the diagnostic criteria for each of the above. 4
c) How will you manage a case of acute fatty liver of
pregnancy at 34 weeks of pregnancy? 4

2)What are the causes of jaundice in pregnancy? How will you investigate and manage a case
of intrahepatic cholestasis (IHC)? What are the fetal complications of IHC? 3+4+3

3) a. What are the causes of jaundice in pregnancy? b. Describe the diagnostic features of
acute fatty liver of pregnancy c. How will you work up and manage a pregnant woman with
jaundice? 3+3+4

IHCP

1. Pathogenesis and management of intra hepatic cholestasis of

pregnancy. 4+6
29.CONNECTIVE TISSUE DISORDER

SLE

1) SLE in pregnancy. 5
2) What are the maternal and perinatal effects of pregnancy with systemic lupus erythematosus
(SLE)? How would you monitor a woman with SLE during pregnancy, child birth and
postpartum? (2+2)+(2+2+2)

30.HEMATOLOGY

ANEMIA

1)a) How will you prevent and treat nutritional anemia during pregnancy? (3+3)
b) What are the initiatives undertaken by the Government in this context? 4

2)A primi is diagnosed with severe anemia (Hb 3 gm/dl) at 36 weeks of gestation.Enumerate
various maternal and fetal complications of severe anemia How will you investigate and manage
her. 2+4+4

3)How will you investigate & manage a case of severe anaemia at 32 weeks of gestation 5+5

4)A multigravida with hemoglobin of 6 gm% had no antenatal care till 30 weeks of pregnancy
How will you investigate and manage this case? 5+5

5)a.How does pregnancy affect iron metabotism 4+4+2

b. How will you diagnose and manage dimorphic anemia in pregnancy
c. Describe screening of thalassemia in pregnancy

6)What are the causes of thrombocytopenia in pregnancy? How will you evaluate such a case?
What is the management of a case of ITP in pregnancy? 5+2+3

7)a. What are micronutrients? 3+4+3

b. Describe the role of four micronutrients in maternal and fetal well being. in pregnancy?
c. What are the indications and modes of parenteral iron therapy

THALASSEMIA

1)a) What are the current recommendations and methods for

screening for thalassemia in pregnancy?
b) Management of pregnant women with thalassemia trait. 5+5

2)What is thalassemia? How will you investigate and manage a pregnancy where both partners
are thalassemic carriers? 3+(3+4)

RH INCOMPATABILITY

1)a) What is feto maternal hemorrhage? How does it affect a

Rh negative woman? 4
b) Enumerate the causes of feto maternal haemorrhage. 2
c) How would you calculate the dose of anti-D required to
prevent Rh iso-immunisation? 4

2)a) Causes, clinical features and complications of

pathological jaundice in a newborn. 2+2+2
 b) How does exchange transfusion help a neonate with Rh
iso-immunization? 4

3)a)Define Rh-isoimmunization.
b)What are the factors that affect the degree of isoimmunization?
c.What is the role of Doppler in a Rh Negative isoimmunized pregnancy.
d)Prevention of Rh-isoimmunization. 1+3+4+2

4)Enumerate the causes of hydrops fetalis. Describe its pathophysiology. How would you
manage a Rh-negative pregnant woman diagnosed with hydrops fetalis at 32 weeks of
pregnancy? 3+3+4

5)What do you understand by Rh incompatibility? Discuss its management during antenatal

period and labour & delivery in a primi Rh negative women. 4+(3+3)

6) Immediate care and follow-up of a baby born to Rh-ve women (3+2)

7) Prevention of Rh isoimmunization 4

DIC

1) a) Physiology of coagulation during pregnancy. 4

b) Mechanism of disseminated intravascular coagulation. 3
c) Blood transfusion and component therapy in DIC. 3

2) a)What are causes of thrombocytopenia in pregnancy.Describe the management of each. 4

b)Describe the diagnostic tests for DIC. 3
c) What are the complications of massive transfusion? 3

SHOCK

1)a)Types and causes of shock in obstetrics. 5

b)outline the management of a women with postpartum shock. 5

2)a) Describe the changes in coagulation system in pregnancy 3

b) Enumerate the causes of obstetric coagulopathy . 3

c) Give the indications for component replacement. 2

d)What are the blood components available for replacement? 2

3)a) Enumerate the causes and describe the management of Septic Shock in obstetrics b) What
are the anti-shock trousers or devices? Describe their use in Obstetrics & Gynaecology?
6+4

4)Define shock in Obstetrics. Enumerate the causes aid phases of endotoxic shock. How will
you manage a case of septic shock in pregnancy? 2+4+4
 31.GDM

1)a) Methods for screening for Gestational Diabetes Mellitus in

pregnancy. 4
b) Complications of hyperglycaemia on pregnancy and fetus. 3+3

2)a) Screening protocols for Gestational Diabetes Mellitus (GDM). 4

b) Role of oral hypoglycemic agents in the management of GDM. 3
c) Management of diabetic ketoacidosis during pregnancy. 3

3)a) Screening tests for Gestational Diabetes Mellitus. 5

b) Principles of medical nutritional therapy in GDM. 5

4)a) Pregnancy is a "Diabetogenic state" — provide a critical appraisal. 2

b) Describe the tests for diagnosing Gestational Diabetes Mellitus. 2

c) modalities to Describe the criteria for optimal glycemic control in pregnancy and the achieve
the same. 3

d )Outline the management of Diabetic Ketoacidosis (DKA) during labour. 3

5)What complications can occur in a newborn of a diabetic mother? How can these be
prevented? Discuss the management of neonatal hypoglycemia 3+3+4

6)Define GDM (Gestational Diabetes Mellitus). Discuss different screening protocols for GDM at
32 weeks of gestation 2+8

7)Describe carbohydrate metabolism in (GDM). How wiltl you screen high and low risk pregnant
women for GDM. Enumerate the steps to achieve optimal glycaemic control in GDM Gestational
Diabetes Mellitus. 3+3+4

8)a. Describe the various methods for screening of Gestational Diabetes Mellitus (GDM). b.
Describe the mechanism of maternal-fetal glucose homoeostasis c.What are the long term
sequelae of GDM? 4+3+3

32.THYROID

1)a) Physiological changes of thyroid gland in pregnancy. 4

b) Functions of fetal thyroid. 3
c) Role of routine screening for thyroid function in pregnancy. 3

2)a) Post-partum thyroiditis: Diagnosis & management. 5

b) Peripartum cardiomyopathy: Diagnosis & management. 5

3)Describe physiological changes of thyroid during pregnancy What are the maternal and fetal
complications of hypothyroidism? Discuss the management of a pregnant woman with overt
hypothyroidism 3+3+4
4) Management of hypothyroidism in pregnancy. 5

5)Post partum thyroid disorders 3

33. NEUROLOGY

EPILEPSY

1)a) A known case of epilepsy wishes to plan for pregnancy How will you counsel her? b). what
are the effects of epilepsy on pregnancy c) Mention the effects of antiepileptic drugs on
pregnancy.d)Outline your proposed plan for managing her during labor. 2+3+3+2

2)Enumerate the causes of convulsions during pregnancy. How does epilepsy affect
pregnancy? Outline the principles of management of epilepsy during pregnancy 3+3+4

34.INFECTIONS IN PREGNANCY

RUBELLA

1)a) Effect of Rubella infection on the foetus and its prevention. 6

b) Safety of vaccination during pregnancy. 4

2)a) What is congenital rubella syndrome? 3

b)Diagnosis of rubella infections in pregnant women and fetus. 3
c)Outline the management of a pregnant women who is exposed
to rubella infection in her 11 wks of gestation. 4

3)a.What is intra-uterine fetal Infection? 2

b. What are the fetal risks of Rubella infection in early pregnancy? 2
c. How will you counsel a woman who reports to you in early pregnancy with history of
exposure to Rubella infection? 6

ZIKA VIRUS

1)a) What is Zika virus?

b) How is it transmitted?
c) How is the infection diagnosed in pregnant women?
d) How is the fetus affected?
e) Should amniocentesis be considered for diagnosis of
congenital Zika virus infection? 1+2+2+3+2

HIV

1)Current recommendations for management of HIV positive

pregnant women. Give details of intrapartum and postpartum
management. 5+(2+3)

2)a)What is Prevention of Parent to Child Transmission programme(PPTCT) 4+3+3

b)Discuss the antenatal management of a seropositive women.
 c)How will you deliver her

3)a. Outline the current strategies of management of HIV sero positive woman during pregnancy
4+6
b. What are the recommendations of NACO for the management during labor delivery, lactation
of neonate in a HIV positive pregnant woman?

4)What is the natural history of human HIV infection? what are the tests for HIV infections in
pregnant women? How will you prevent perinatal transmission of HIV infection in pregnant
women? 3+3+4

5)What are the current recommendations for management of HIV positive pregnant women?
Write the recommendations for management of delivery in such women and their neonates. 4+6

HBSAG

1)a) Why is pregnancy considered high risk for HbsAg positive

women?
b) How will you manage such a woman in labor?
c) Management of her newborn. 2+4+4

MALARIA IN PREGNANCY

1)a) Discuss malarial infestation in pregnancy. b) What are the complications requiring closer
monitoring during pregnancy? c) Discuss treatment of malaria in pregnancy. 3+4+3

CHICKEN POX

1)Discuss the management of pregnancy in a woman who had chicken pox at 26 weeks of
gestation 10
GENITAL ULCER

1)a) What are the different types of genital ulcers?

b) Clinical presentation in relation to specific diagnosis of
genital ulcer.
c) Management of genital wart during pregnancy. 3+4+3

35. RECURRENT PREGNANCY LOSS

1)a) What are the causes of recurrent pregnancy loss? 2

b) How will you evaluate a non pregnant woman having
history of three abortions? 4
c) Outline the plan of management of a pregnant woman
having history of three intrauterine deaths at term. 4

2) Role of progesterone in cases of recurrent pregnancy

loss. 5

3)a)Enumerate the causes of recurrent abortions . 2

 b)Outline the workup of a woman with recurrent abortions . 5
c)What are the indications of cervical encirclage during pregnancy? 3

4) a) Enumerate the causes of second trimester abortions b) How will you investigate a case of
recurrent second trimester abortions and prognosticate the woman about chances of such
abortions in her subsequent pregnancy? 3+(4+3)

5)What do you understand by BOH (Bad Obstetric History)? How will you investigate in interval
phase and during pregnancy? 3+(4+3)

CERVICAL INSUFFICIENCY

1)a) Causes of cervical insufficiency. 3

b) Post operative management following circlage operation. 4
c) Abdominal circlage operation. 3

2)a) Define cervical incompetence. 2

b) What are its causes? 2
c) How will you diagnose and manage a case of cervical
incompetence at 14 weeks of pregnancy? 3+3

36.OBSTETRIC EMERGENCIES

UTERINE INVERSION

1)a) Define acute uterine inversion.

b) Risk factors, diagnosis and outline the plan of
management for acute uterine inversion. 2+(2+2+4)

RUPTURE UTERUS

1)What do you understand by Bandl's ring? Describe the clinical picture and management of
rupture uterus. (3+3)

37.OBS PROCEDURE

EXT.CEPHALIC VERSION

1)a) Indications & contraindication of External Cephalic

Version (ECV). 4
b) Pre-procedure preparation &steps of ECV. 4
c) Post procedure monitoring after ECV. 2

2)a)What is the role of external cephalic version in modern obstetrics

b)What are its contraindications
c)Discuss its complications 3+3+4
3) What are the causes of fetal malpresentations in term pregnancy? Enumerate the obstetric
complications of fetal malpresentations. Describe the current guidelines and protocol of External
Cephalic Version (ECV). 3+3+4

38. MLC IN OBS

1)a) Areas of medical litigations in obstetrics. 3

b) Measures to reduce medicolegal problems in obstetrics
(including the legal and ethical issues). 7

2)a) What do you understand by written consent? 4

b) Its prerequisites. 3
c) Its medicolegal importance. 3
39.SPM

1)a) Explain the difference between a longitudinal and cross

sectional study using suitable examples. 3
b) How do you calculate sample size of a therapeutic trial? 4
c) How do you evaluate the scientific validity of a research
study? 3

2) a) Define maternal mortality. How it is calculated? 3

b) Enumerate the causes of maternal mortality. 4
c) What are the strategies to reduce maternal mortality? 3

3) a) Enumerate WHO criteria for a screening programme. 4

b) Which gynaecological cancer fulfills most of these criteria? 1
c) Define sensitivity, specificity, positive predictive value,
negative predictive value and confidence interval. 5

4) a) Define maternal mortality. 1

b) List causes of maternal mortality in India. 3
c) Role of maternal death review in reducing maternal mortality. 6

5) a) What is evidence based medicine? 2

b) Enumerate the types of clinical studies. 4
c) What is hierarchy of evidence in medical literature? 4

6) a) Define severe acute maternal morbidity (SAMM) 2

b) Criteria for identifying SAMM. 4
c) Importance of analysis of SAMM. 4

7) a) What is Janani Suraksha Yojana 3

b) What is the role of ASHA (Accredited social health activist) associated with JSY? 4
c) What is "ASHA package" under JSY in relation to the funds available 3

8) a)What is Janani Shishu Suraksha Karyakram (JSSK)? 2

b)What are it components? 3
 c)What are the strategies for its successful outcome? 5

9)What are the aims, vision, goals and components of RCH? State the differences between
RCH I & II ( 2+2+2+2)+2

10) a.Define sex ratio.Enumerate the states in India with a skewed sex ratio. 3
b. PNDT Act and its impact on our society 3
c. Enumerate the therapeutic indications for fetal sex determination 2
d. Describe the methods of antenatal fetal sex determination. 2

11) a. What are the targets in Millennium Development Goals (MDG) regarding women's
health? 4
b. What steps are being taken by the Government to promote hospital deliveries? 6

12) a) What is RCH? 2

b) What are its components? 3
c) What are the strategies for its successful outcome? 5

13) a) What is the maternal mortality rate currently in India? 2

b) Factors responsible for high maternal mortality in India and measures to reduce maternal
mortality rate. (3+5)

14) a.What are Millennium Development Goals (MDG)? 2

b.What is their current status in India? 3
c.Suggest ways to improve them. 5

15)Enumerate benefits provided in JSSK Scheme 10

16)What do you understand by double blind placebo controlled trial and its significance? 7+3

17)a.What are the Maternal and Child Health programme India? 3

b.Describe the Reproductive and Child Health Programme I(RCH its achievement? 4
c.What is the role of 'ASHA in the reproductive health care of rural woman? 3

PERINATAL MORTALITY

1)a) Define perinatal mortality? How is it calculated? 2

b) Enumerate causes of perinatal deaths. 3
c) Outline the recommended evaluation procedures for a woman
with still birth. 5

ANTENATAL DEATHS

1)a) Maternal near miss.

b) Obstetric audit. 5+5

2)a) Maternal near miss (severe acute maternal morbidity). 5

b) Criteria to identify a maternal near miss. 5
 40.TRANSPLANT

1)Uterine transplant: Indications, procedure, ethical

considerations and cause of failure of uterine transplant. 2+3+2+3

2)a) Enumerate the maternal and fetal complications during

pregnancy in a woman who has had a renal transplant.
b) How will you monitor this pregnancy?
c) Outline a delivery plan for this woman. 5+3+2
 GYNAECOLOGY

1.CA-OVARY

1) a)What are tumor markers? 2

b)Enumerate various tumor markers used in gynaecology & write their
clinical significance. 5
c)Define neoadjuvant chemotherapy and its utility in the management
of ovarian malignancy. 3

2)a) Critically evaluate the role of neoadjuvant chemotherapy in

ovarian malignancy. 5

3) a) Preventive measures for epithelial ovarian cancer. 4

b) Place of fertility sparing surgery in ovarian malignancy. 3
c) Types of malignant germ cell ovarian tumors. 3

4) b) Management of ovarian malignancy in a 22-year-old lady. 5

5) a) Tumour markers for gynecological cancers. 5

b) Intraperitoneal chemotherapy for treatment of ovarian
cancer. 5

6) a) What are germ cell tumors of the ovary? 5

b) Outline the management of dysgerminoma. 5

7) a) Define tumour marker. 2

b) Which tumour markers are useful in ovarian cancer? 4
c) Role of tumour markers in management of ovarian
cancer. 4

8) a) Classifications of Germ cell tumours of ovary. 3

b) Describe histopathology of mature cystic teratoma
(Dermoid cyst). 3
c) Management of dermoid cyst. 4

9) a) What is the first line chemotherapy for advanced

ovarian carcinoma? 5
b) Indications and role of neoadjuvant chemotherapy
in ovarian cancer. 5

10) a. Describe the staging laparotomy in ovarian carcinoma 5+5

b. What is the role of chemotherapy in the management of ovarian carcinoma?

11) a. Enumerate the types of ovarian tumors seen in an adolescent girl. 3

b. Describe the clinical characteristics of malignant ovarian tumors 4
c. What are the tumor markers associated with ovarian malignancy? 3
12) a)Hereditary breast and ovarian cancer. 5
b) Risk of Malignancy Index (RMI) for evaluation of ovarian masses 5

13) a.Describe familial ovarian cancer syndrome. 2

b.What are proteomic and genomic approaches to its diagnosis? (3+3)
c.What is the role of prophylactic oophorectomy? 2

14) Classify germ cell ovarian tumours Write in brief about lab & radiological findings and
management of dysgerminoma 4+(3+3)

15) What is the role of conservative surgery in gynaecological malignancy? 2

Write the fertility-preserving surgical procedures and techniques for (a) ovarian and (b)
cervical cancers (4+4)

16)What do you understand by adjuvant chemotherapy? How will manage a case of malignant
epithelial ovarian tumor? 3+7

17)Write briefly on the role of:

a. PET-CT in gynecological malignancy 3
b Chemo-radiation in cervical malignancy 4
c. Serum CA 125 as a tumour marker 3

2.CA-CERVIX

1)) New guidelines for screening of carcinoma cervix. 5

2) a) Surgical anatomy and lymphatic drainage of cervix. 3

b) How can you preserve fertility in cervical cancer patient? 3
c) Basis of chemoradiation and its application in a case of
cancer cervix. 4

3) a) Human Papilloma virus vaccines. 5

b) Treatment options for cervical intra-epithelial neoplasia
(CIN). 5

4) a) Newer methods of screening for premalignant lesions of

cervix? 4
b) Indications of colposcopy and its interpretations. 4
c) Role of LEEP in pre-malignant lesion of cervix. 2

5) HPV vaccine. 5

6) a) Describe the transformation zone of cervix. 3

b) Enumerate indications of colposcopy. 3
c) Management of CIN-3 reported on cervical biopsy. 4

7) a)Enumerate the various methods of screening of CA cervix. 2

b)Critically appraise all methods of screening of CA cervix. 4
 c)What are the recent recommendations for screening of CA cervix. 4

8) a) What is 'Transformation Zone'? 3

b) Describe the new screening guidelines for carcinoma cervix. 3
c) What are the treatment options for CIN Il in a 30 year old woman? 4

9) a.Define Transformation Zone. 3

b.Discuss its evaluation . 3
c.What are the recent guidelines for screening for carcinoma cervix? 4

10) a. Describe the recommended screening procedure for cancer cervix 3

b. Role of HPV vaccine in the prevention of cancer cervix 3
c. Describe the management of high grade squamous intra epithelial lesion of cervix. 4

11. a) Risk factors of cancer cervix 3

b) State FiGO staging of cervical cancer 4
c) Therapeutic options in cervical intraepithelial neoplasia 3

12) HPV vaccine. 5

13)Discuss the blood supply, lymphatic drainage and nerve supply of cervix and its applied
significance. 3+4+3

14)a)What is the lymphatic drainage of cervix and its surgical significance. 4

b)Describe clinical features of carcinoma of cervix(Stage 1B)in 30 yrs old woman 4
c)What are the advantages of surgical management over radiotherapy or vice versa in such
a case? 2

15) a)What are the advantages of liquid based cytology over conventional Pap smear? 3
b)Discuss the role of HPV DNA test in screening of cancer cervix. 4
c)Describe an algorithmic approach to to LSIL in a 35 year old woman. 3

16)Discuss the role of Pap Smear and HPV testing for screening of cancer cervix 5+5

3.CA-ENDOMETRIUM

1) Role of lymphadenectomy in the management of

endometrial carcinoma. 5

2) Current clinical practice guidelines in the management of stage I

adenocarcinoma of body of uterus. 4

3)a) What is endometrial hyperplasia?

b) Classify endometrial hyperplasia, indicating their malignant
potential.
c) Outline the principles of management of atypical
hyperplasia. 1+5+4

4) Role of chemotherapy in cases of endometrial malignancy. 5

5) Treatment options for a 45 years old woman with
abnormal uterine bleeding with simple hyperplasia
without atypia on endometrial biopsy. 7

6.Write briefly about management and prognosis of endometrial hyperplasia. Describe the role
of diagnostic and operative hysteroscopy in the management of uterine pathology 5+5

7)a) What are the causes of post menopausal bleeding per vaginum in a 55
year old woman? 2
b) Give an approach to its diagnosis and management. 4
c) Current clinical practice guidelines in the management of stage I
adenocarcinoma of body of uterus. 4

8)A 50 yr old lady presents with postmenopausal bleeding.How will you clinically evaluate
her?What investigations will you advise for her.Outline the plan of management of endometrial
CA in her. 3+3+4

9)How will you investigate a case of post menopausal bleeding? Give details of FIGO
classification for endometrial carcinoma 5+5

4. SEXUAL ASSAULT

1)Examination of a victim of sexual assault. 5

2)a) What are the basic principles of forensic evidence collection

in a sexual assault survivor? 4
b) How will you counsel a woman subjected to sexual assault? 3
c) Post exposure prophylaxis against STI /RTI in such cases. 3

3) a) What are the basic principle of forensic evidence collection in a victim of sexual assaut? 4
b) Describe counseling of a woman subjected to sexual assault. 3
c)Describe briefly post exposure prophylaxis against HIV . 3

4)a)What is the impact of domestic violence on sexual and reproductive health? 4

b)Briefly outline the principles of providing care to a victim of sexual abuse. 6

5.PUBERTY

PRECOCIOUS PUBERTY

1)Define precocious puberty. What are the causes of precocious

puberty? Outline its management. 1+4+5

2)a)Describe the sequences of changes during puberty. 2

b)Define precocious puberty. 2
c)How will you evaluate and manage a 7 yr old girl with precocious puberty. 6

3) a)Define puberty.
 b)What are the causes of precocious puberty?
c)Discuss the evaluation and management of a 7 yr old girl with precocious puberty.
1+3+(3+3)

4) Endocrine changes during puberty. 4

DELAYED PUBERTY

1)a) What are the causes of delayed puberty?

b) Give an algorhythmic clinical approach to an adolescent
girl with delayed puberty. 5+5

2)a) Differential diagnosis of delayed pubertal development. b) How will you investigate delayed
pubertal development in a 16 year old girl? 5+5

PUBERTY MENORRHAGIA

1)a) Enumerate the causes of puberty menorrhagia. 2

b)Discuss the differential diagnosis of puberty menorrhagia 3
c)Describe the management of puberty menorrhagia 5

6.PELVIC PAIN AND DYSMENORRHEA

CHRONIC PELVIC PAIN

1)a) Define chronic pelvic pain. 5

b) What are the possible contributory factors for chronic pelvic pain 5

2)a) What are the possible contributory factors for chronic

pelvic pain? 3
b) How will you investigate and manage chronic pelvic pain
in a 27 year old lady with secondary infertility? 5

3)a) Define chronic pelvic pain. 1

b) Enumerate the causes of chronic pelvic pain. 3
c)Discuss the management of chronic pelvic pain. 6

4) a) Causes of acute pelvic pain in women. 4

b) How would you manage a 21 years old lady with acute pelvic pain? 6

DYSMENORRHEA

1)a) Describe the various types of dysmenorrhoea. 3+3+4

b) Enumerate the causes of dysmenorrhoea
c) Discuss the various treatment options for primary dysmenorrhoea

2) a) Describe the various types of dysmenarrhoea. 3+3+4

b) Enumerate the causes of dysmenorrhoea
c) Discuss the various treatment options for primary dysmenorrhoea
 7.FIBROIDS

1) a) Write the clinical features of cervical fibroids. 2

b) How will you manage a big anterior wall cervical fibroids in a 45 year old woman? 3
c) Discuss the preoperatve evaluation a 3
d) Enumerate its intra-operative complications 2

2)a.Decsribe the types of cervical fibroid.

b.What are the complications anticipated during surgery for cervical fibroid and how will you
prevent them. 4+(3+3)

3. a) Outline strategies to minimize blood łoss intra- operatively during myomectomy. 4

b) Enumerate factors which favour a myomectomy procedure in reproductive age group. 3
c) Discuss present status of uterine artery embolisation in fibroid uterus. 3

4) a)Enumerate the causes of menometrorrhagia in a 45 yr old multipara. 3

b)How will you investigate her? 4
c)Outline the management of submucous fibroid polyp? 3

5) a)What is the physiology for controlling menstrual blood loss at endometrial level? 3
b)How will you evaluate a case of heavy menstrual bleeding? 4
c) What are the non-surgical management options available in a case of fibroid uterus? 3

8.AUB AND DUB

AUB

1)a) What is FIGO classification of system (PALM-COEIN) for

causes of abnormal uterine bleeding (AUB) in non-gravid
women of reproductive age? 6
b) Management of AUB-A in a case of heavy menstrual
bleeding) in a 38 years old woman. 4

2) PALM-COEIN classification of abnormal uterine

Bleeding. 3

3)a)Classification of abnormal uterine bleeding

b) Outline the workup plan for a 30 year old woman. having abnormal uterine bleeding
c) How will you manage endometrial hyperplasia in such a woman? 3+4+3

4)Discuss recent classification for abnormal uterine bleeding. (AUB). Briefly outline
management of fibromyoma. 6+4

DUB

1. a. Describe the endocrinal regulation of endometrium in the control of normal blood loss at
menstruation. 3
 b. Describe the various histopathological features in endometrium in a case of dysfunctional
uterine bleeding (DUB). 4
c. Give the rationale behind the use of various pharmacotherapeutic agents in the
management of DUB.
3
9. MENOPAUSE

1)a) Pathophysiology of osteoporosis in post menopausal women.

b) Prevention, diagnosis and management of post menopausal
osteoporosis.
3+(2+2+3)
2)a) What are the current recommendations for
menopausal hormone therapy?
b) What are the advantage & disadvantages of
menopausal hormone therapy?
,4+6
3) a) Briefly discuss the endocrinal basis of various changes during menopause. 3
b) What are the common problems in a postmenopausal woman? 3
c) What is the present status of hormonal therapy in menopausal women? 4

4. Role of gynaecologist in prevention of osteoporosis in post menopausal woman. What drugs

can be used for its treatment? 7+3

5.a)What are the factors affecting bone health in post menopausal women 3+4+3
b)Discuss preventive strategies for post menopausal osteoporosis.
c)How do you diagnose post menopausal osteoporosis?

6.a)What are the biochemical markers of bone turnover? 4

b)How is bone mineral density evaluated? 3
c)What are the therapeutic options for osteoporosis? 3

7)a) What are the symptoms of menopause?

b) Treatment of vasomotor symptom of menopause.
c) Prevention of post menopausal osteoporosis. 3+4+3

8)a) What are the endocrinological changes at menopause? 3

b) Explain possible mechanism of hot flushes. 3
c) What are the current recommendations for hormonal replacement therapy? 4

9)a) What are the endocrinological changes at menopause? 3+3+4

b) Explain possible mechanism of hot flushes.
c) What are the current recommendations for hormonal replacement therapy?

10)Define Menopause? What are the menopausal symptoms? What is the place of HRT in
current scenario? 2+4+4

11)a. Define menopause. What is peri-menopausal transition? 3+4+3

b.What is menopausal syndrome? Describe the management of hot flashes in menopause
c.Describe the role of local estrogen therapy in a menopausal woman
 10.GENERAL GYN

1. a) Atrophic vaginitis (5+5)

b) Current indications of HRT and the controversies

2. a) Parameters a gynecologist should utilize during assessment of a 60 year old woman who
comes for a health check-up. Give reasons for your choice. (3+3)
b) What advice will you give the lady even if all parameters are normal? 4

3.a)A young girl of 17 years of age has obesity and oligomenorrhoea. 2

b)What is your provisional diagnosis? 3
c)What are the investigations to be done and advice regarding the management? 5

11.PCOD

1)a) What are inositols? 3

b) Physiological role and clinical utility of inositols in PCOD. (3+4)

2)a) Criteria for diagnosis of Polycystic Ovarian

Syndrome (PCOS). 2
b) Investigations and treatment of a 14 year old girl
with hirsutism. 8

3. a) What is the pathophysiology of polycyst syndrome (PCOS)? 4

b) What are its health consequences? 3
c) What are the recent trends in its management? 3

HIRSUITISM

1)Write the causes, investigations and management of a young girl with hirsutism 3+4+3

2. a. Define masculinization and virilization. 2

b. Describe the evaluation of a case of hirsutism. 4
c. Critically evaluate the various treatment modalities for hirsutism. 4

12.STD

1)a) What is syndromic approach for various complaints for Reproductive Tract Infections (RTI)
including Sexually Transmitted Infection (STI)? 2
b)Draw algorithm of syndromic treatment of urethral discharge. 4
c)Which pre-packed (STV/RTI) Kits are available for syndromic management? 4

2)a)What are the types of sexually transmitted genital ulcers? 3+4+3

b)Describe their clinical presentations.
c)How will you confirm the diagnosis?

CANDIDIASIS

1)a)What are the predisposing factors for vulvovaginalcandidiasis? 2

b)How do you diagnose it? 2
 c)Workup plan for a woman having recurrent candidiasis. 3
d)Treatment of recurrent vulvovaginal candidiasis. 3

2)a)What is the constitution of vaginal discharge in a young women. 3

b)What is the protective mechanism against ascending infection in female genital tract . 3
c)Outline management of vulvovaginal candidiasis. 4

HPV

1)a)Describe the Human Papilloma Virus (HPV) infection and its mechanism of carcinogenesis.
b) What is the natural history of HPV infections?
c) How do you diagnose it?
d) Write your comments on HPV-vaccination. 3+2+2+3

TB

1)a) Clinical features of genital tuberculosis in young women of

reproductive age group. 3
b) Recent advances in laboratory diagnosis of genital
tuberculosis. 4
c) Indications for surgery in women having genital
tuberculosis. 3

2.a) Critically evaluate the various Nuclear Amplification Assays (NAA)in the diagnosis of
endometrial tb. 3+3+4
b) Define MDR-tuberculosis and XDR-tuberculosis. What are the difficulties in the
management of such cases?
c) What are the treatment options and their success rates for a case of genital tuberculoses
with infertility?
PYOMETRA

1)a)Define pyometra. b) Enlist its causes. c) Outline the management plan for pyometra. 2+3+5

2)Pyometra Diagnosis and management 5

13.UTERINE LEIOMYOMA

1)a) Enumerate the options of medical treatment for

uterine leiomyoma. 5
b) Role of progesterone receptor modulations in
treatment of uterine leiomyoma. 5

14.CONGENITAL ANOMALIES

1)a) How will you classify Mullerian duct anomalies? 2+3+2+3

b) Show the different anomalies diagrammatically
c) Enumerate various gynecological and obstetrical problems caused by these anomalies.
d) Outline the plan of management of a septate uterus.

2)a) Classify Mullerian abnormalities. 3+(4+3)

 b) Problems of reproduction in women with Mullerian abnormalities and their management

3)a)Classify Mullerian anomalies and enumerate their significance in Obstetrics and

Gynaecology. (3+2)
b)How will you diagnose and manage a case of intrauterine septum? (2+3)

4)a)Classify Mullerian duct anomalies. 2

b)What are their clinical features? 4
c)Outline the management of haematocolpos with transverse vaginal septum in an
adolescent girl. 4

GENITOURINARY FISTULA

a) Enumerate causes of genitourinary fistula. 2

b) Outline the principles of management of a post
hysterectomy fistula. 6

VVF

1)a) Enumerate the causes of vesicovaginal fistulae.

b) Basic principles of its management.
c) Enumerate the treatment options of radiational fistulae. 3+4+3

2)a) What are the gynecological causes of VVF? 2+4+4

b) Describe the principles of management of VVF
c) Describe the pre operative and post operative care of a woman undergoing VVF repair.

3)Describe the preoperative evaluation in vesico-vaginal fistula. What are surgical principles of
the management of post hysterectomy vesico vaginal fistula? Outline its post operative
management. 3+4+3

15.ENDOMETRIOSIS AND ADENOMYOSIS

ENDOMETRIOSIS

1)a) What is the pathophysiology of infertility in cases of

endometriosis?
b) Critically evaluate the advantages and disadvantages of
various modes of therapy in young women having
endometriosis. 4+6

2)a) Define endometriosis.

b) Aetiopathogenesis and diagnostic modalities of
endometriosis.
c) Non-surgical management of endometriosis. 1+(2+3)+4

3)a) Indications of surgical intervention in endometriosis.

b) Role of GnRH agonists in endometriosis. 5+5
4) Define endometriosis. Discuss the etiology, clinical features and medical management of
endometriosis. 1+(3+3+3)

5)a) How does endometriosis lead to infertility? 3+3+4

b) Mention the determinants of treatment options for pelvic endometriosis

c) Discuss the different treatment options and their rationale

6)a)Describe the role of endometriosis in the etiology of infertility 3+3+4.

b) What are the conservative surgical procedures in the management of a case of
endometriosis presenting with infertility?
c)Enumerate the indications and types of medical therapy in the treatment of endometriosis.

7)Discuss etiology of endometriosis and role of laparoscopy in its diagnosis 5+5

ADENOMYOSIS

1)a)What is adenomyosis? 2
b)Describe the clinical features of adenomyosis. 3
c)How will you manage a 38yr old symptomatic women with adenomyosis? 5

16.PROLAPSE UTERUS

1.Describe the etiology,classification and symptoms of prolapsed uterus.Describe the

management of vault prolapsed in a 60 yr old lady (2+2+2)+4

2)a) What is the quantification system of pelvic organ prolapse (POP-Q)? 5+3+2
b) Compare it with conventional staging system.
c) Analyze critically its universal usage.

3)a)Describe the surgical anatomy of pelvic organ support system . 4+3+3

b)What are the etiological factors of pelvic organ prolapse in a 30 years old woman.
c)Describe basic principles of surgical correction of enterocele

4)Describe the supports of uterus and discuss posterior compartment defects 6+4

5)a)What is POP-Q classification of pelvic organ prolapse? 4+3+3

b)Describe basic concept of site specific repair for genital prolapse.
c)Outline briefly preventive strategies for vault prolapse .

6) a)What is preoperative preparation for major gynecological surgery in uterovaginal prolapse?

b)How will you counsel a woman before the surgical procedure for uterovaginal prolapse?
c)How will you manage bladder injury during cystocele repair? 3+4+3

VAULT PROLAPSE

1)a) What are the techniques followed during hysterectomy to

prevent vault prolapse?
b) Surgical procedures in a case of post-hysterectomy vault
prolapse. 4+6
2)a) Outline the principles of preoperative evaluation to prevent
post hysterectomy vaginal vault prolapse. 3
b) Measures taken during surgery to prevent it. 3
c) Surgical options available to treat vault prolapse. 4

3)a) Steps to prevent vault prolapse after hysterectomy.

b) Discuss the treatment options available for post
hysterectomy vault prolapse. 4+6

17.GTN

1)a) What are the histological categories of gestational

trophoblastic Neoplasia (GTN)? 2
b) Work-up for a case of GTN. 4
c) Therapeutic option in low risk GTN. 4

2)a) Follow up of a patient with hydatidiform mole after

evacuation. 4
b) Indications & choice of chemotherapy for
Gestational Trophoblastic neoplastic (GTN). 6

3)a)Write the recent classification of Gestational trophoblastic neoplasm. 4+3+3

b) Discuss the investigations to be done in these patients.
c) How will you follow up a case of molar pregnancy?

4)a. Classify gestational trophoblastic tumors

b. Describe the clinical features and treatment of hydatidiform mole.
c. Mention the importance of follow up of these cases. 3+4+3

5)a) Classification of Gestational Trophoblastic Neoplasia (GTN)

b) Staging of GTN and Modified WHO Prognostic Scoring System. 3+(3+4)

6)a)What are the clinical features of Gestational Trophoblastic Neoplasia (GTN)? 3+3+4
b) What is the WHO-Risk Scoring in GTN.
c)Describe single and multiagent chemotherapy in GTN and its follow up

18. CONTRACEPTION

1)a) Contraceptive prescription for a seropositive woman. 3

b) Risks of vasectomy. 4
c) Essure. 3

2)a) Advantages of third generation intrauterine devices (IUDs). 4

b) Combined oral contraceptives and neoplasia. 3
c) Contraceptive prescription for a woman with diabetic
mellitus. 3

3)a) What are the recent developments in male contraception? 4

 b) RISUG or reversible inhibition of sperms under guidance. 2
c) Non-scalpel vasectomy: Technqiue. 4

4)a) What are the adolescent health programmes in India and

their current status?
b) Need and methods of adolescent contraception. 5+5

5)a) What are long acting reversible contraceptive methods

(LARC)?
b) As per WHO medical eligibility criteria, what are the
absolute contraindications of hormonal contraceptives?
c) Principles of tubal re-anastamosis. 3+3+4

6)a) Medical eligibility criteria for contraceptions.

b) Non-oral hormonal contraception. 4+6

7)a) Define ‘Emergency Contraception’.

b) Describe the options available for emergency
contraception. 2+8

8)a)Government of India initiative on post placental IUCD PP-IUCD insertion. 4

b) Frameless intrauterine Devices 3
c) Association of pelvic inflammatory disease PID and intrauterine contraceptive devices.3

9)a )List the WHO eligibility criteria for combined pills.

Progestin only pills and intrauterine devices with following special situations in women: (i)
Known case of hypertension (ii) Previous history of GDM (iii) Known case of epilepsy (iv) Patient
of valvular RHD
Write notes on a) Female condoms (b) Temporary male contraception (other than condom)
6+(2+2)

10)a) What are the various methods of emergency contraception?

b) Mention their mode of action?
c) Enumerate their side effects and failure rates.
d) Write your opinion on over-the-counter (OTC) availability of emergency contraceptives

11)a)What are the various types of IUCDs prevalent in India? 4+3+3

b) What are the contraindications for its use as per medical eligibility criteria (MEC)?
c) What are the non-contraceptive uses and benefits of hormone releasing IUCDs.

12)a)What are the medical eligibility criteria of WHO for intrauterine contraceptive devices
(IUCD)?
b)Write the mechanism of action, advantages and disadvantages of progesterone containing
IUCD 4+(2+2+2)

13. Define emergency contraception. Describe the various methods available. Discuss their
mode of action and failure rates 2+4+4

14)a. Define pearl index 2+4+4

 b. Describe the "WHO Medica Eligibility Criteria' for the use of contraceptives and its clinical
utility
c. Critically evaluate the different methods of emergency contraception

15)a)Various non oral hormonal contraceptive methods b) Non contraceptive uses of LNG-IUS
6+4

16)a) Contraindications of use of intrauterine devices 4+3+3

b) What is the prognosis of pregnancy with retained intrauterine device?
c) How will you evaluate a case of lUD user where thread is not visible?

17) Classify types of oral contraceptive pills available. What are their non-contraceptive
benefits? 6+4

18)Post partum contraception 10

19) What are different methods of female sterilization? Discuss the process of consent for
tubectomy . 6+4

20)Write short notes on a) Combined injectable contraceptives b) Postpartum IUCD 5+5

21)What are the routes of administration of hormonal contraception? Describe the vaginal
contraceptive ring - its applications, advantages and disadvantages Enumerate non
contraceptive benefits of hormonal contraception 3+4+3

22)Describe female condom, how to use it and its advantages 3+4+3

FEMALE STERILIZATION

1) Enumerate complications of female sterilization. 2

2)a) Different methods of female sterilization. 3

b) Enumerate the risks of tubal sterilization. 3
c) Reasons for failure of tubal sterilization. 4

3)a) What are the advantages of laparoscopic sterilization?

b) Long term risks of tubal ligations.
c) Health benefits of tubal sterilization. 3+4+3

NON HORMONAL CONTRACEPTION

1)a) Non-oral hormonal contraception.

b) Enumerate non-contraceptive benefits of combined oral
contraceptive pills.
c) Advantages and disadvantages of newer progestins. 4+3+3

MTP ACT
1)a) Amendments to original MTP Act. 5
b) PCPNDT Act for the obstetrician. 5

2)a)What are the methods used for first trimester MTP? b) Write the advantages and
disadvantages of medical methods of abortion c) Complications of manual vacuum aspiration
(MVA) 2+(3+3)+2

3)What is Medical Termination of Pregnancy (MTP) Act, 1971? What are the indications for
termination of pregnancy under this Act? What are the various methods of termination of
pregnancy in first trimester? 4+2+4

19. HYSTEROSCOPY

1)a) Role of hysteroscopy in gynaecological conditions.

b) Complications of hysteroscopy.
c) Preventive steps one should take to avoid complications
of hysteroscopy. 4+2+4

2)a) What is office hysteroscopy?

b) What are its indications, prerequisites and precautions?
c) Management of endometrial polyps on hysteroscopy. 1+5+4

3)a) Indications& role of hysteroscopy in infertile women

b) Advantages & disadvantages of different distending
media used in hysteroscopy. 4+6

4)Enumerate indications and complications of hysteroscopy. How will you manage

complications of hysteroscopy 3+ 3+4
20. LAPAROSCOPY

1)a) Role of laparoscopy in Gynaecology. 3

b) Evaluate the energy sources used for homeostasis in endoscopic surgery. 4
c) Advantages of robotic surgery. 3

2) Robotic surgery in Gynaecology. 5

3)a) What are entry related injuries in laparoscopy?

b) Vascular anatomy of anterior abdominal wall in relation to
sites of port insertion. 5+5

4)a) Basic principles of Robotic assisted surgery.

b) Advantages and limitations of robotic surgery
versus other surgical approaches in gynaecology. 4+6

5) a) What are the indications of operative laparoscopy? 3+4+3

b) What are the complications of operative laparoscopy?
c) How can they be anticipated and prevented?

6)a) What is the preoperative preparation for laparoscopic surgery? 2+(3+3)+2

 b)What are the indications and complications of laparoscopic surgery in Gynaecology?
c)How can these complications be prevented?

7) a) Indications and complications of laparoscopic surgery. 5+5

b) How is robotic surgery different from laparoscopic surgery and its role in gynecology?

21.GYN SURGERY

1)a) Steps to prevent ureteric injury during gynaecological surgery. 4

b) Diagnosis & management of iatrogenic ureteric injury. 4

2)a) Indications of uterine artery embolization. 4

b) Procedure and post procedure care of a patient
after uterine artery embolization. 6

3 a) What are the principles underlying the use of electrosurgical energy in operative
procedures
b) Critically evaluate the use of monopolar versus bipolar diathermy.
c) Describe the indications, methodology and complications of ovarian driling in cases of
polycystic ovarian syndrome 3+3+4

4)a)What is selective pelvic lymphadenectomy& its indications in relation to the

gynaecological malignancy? 5
b)Describe the basis of concurrent chemoradiation and its application in gynaecological
cancers. 5

5) Uterine artery embolization. 5

6)What is non descent vaginal hysterectomy? What are its indications and prerequisites?
Enumerate its immediate and late post operative complications. Describe its advantages and
disadvantages in comparison to laparoscopic hysterectomy 2+3+2+3

7. What is uterine artery embolisation? Enumerate its indications in contemporary obstetrics and
gynecological practice. Describe its techniques, advantages and disadvantages in brief 3+3+4

HYSTERECTOMY

1)Evaluate TLH (total laparoscopic hysterectomy) vs NDVH

(non-descent vaginal hysterectomy). 5

2)a) Indications of peripartum hysterectomy.

b) What are the complications associated with peripartum
hysterectomy?
c) Outline its postoperative management. 2+4+4

3)Classify & describe briefly the types of hysterectomy Which are the cases where ureteric
damage is more likely and how can it be prevented? 4+3+3
4)A 45 year old woman had abdominal hysterectomy for cervical
fibroid. She had anuria in the post operative period:
a) What are the possible causes of her anuria?
b) Outline the principles of management.
c) What complications can occur in her? 3+5+2

LAP MYOMECTOMY

1)a) Critically evaluate the role of laparoscopic myomectomy.

b) What factors may contribute to a weak scar?
c) How will you manage pregnancy in a woman after
laparascopic myomectomy? 3+3+4

22.INFERTILITY

1)a) What is ovarian reserve? 2

b) Its role in infertility. 3
c) Outline the management of an infertile woman who is a poor
responder. 5

2)a) Genital tuberculosis and infertility.

b) Unexplained infertility. 5+5

3. Management of :
a) Endometrioma in a young infertile woman.
b) Premature ovarian failure. 5+5

4)a) Time lapse imaging of embryo in the IVF lab.

b) Complications of ART. 5+5

5) Sperm retrieval techniques 5

6)a) Assessment of tubal factors in infertility.

b) Role of clipping in hydrosalpinx before IVF.
c) Tubal recanalization in modern era. 3+3+4

7)a) Role of surgery for the tubal factors of infertility. 5

b) Management of unexplained infertility. 5

8)a) Controlled ovarian stimulation and monitoring of follicular

growth. 5
b) Prevention of ovarian hyperstimulation syndrome (OHSS). 5

9)a) Assessment of embryo quality in Assisted Reproductive

Technology (ART). 5
b) Situations to suggest surrogacy. 5

10) Role of hysteroscopy in the management of infertility. 5

11)a) Evaluation of male partner with oligospermia.
b) Intrauterine Insemination. 6+4

12)a) Indications of in-vitro fertilization (IVF).

b) Protocols for controlled ovarian hyperstimulation.
c) Factors affecting outcome of IVF. 3+4+3

13)a)Mention the causes of ovulatory dysfunction in a woman presenting with infertility 2

b)How will you induce ovulation in an infertile woman with ovulatatory dysfunction? 5
c)What are the complications associated with ovulation induction?how will you prevent
these? 3

14)a) What are the tubal etiological factors responsibe for female infertility? 3
b) How will you evaluate an infertile woman for tubal patency? 3
c)What are the surgical options for blocked fallopian tubes? 4

15. A 30-year-old lady presents with history of two miscarriages and inability to conceive.
Discuss the possible causes and their evaluation. How would you manage tubal block? (3+3)+4

16. What is ART (Artificial Reproductive Technique)? Which techniques are included in ART?
What are the national guidelines for ART. Give your comments on pre-implantation genetic
diagnosis (PGD) 1+3+3+3

17.a) What are the tubal etiological factors responsibe for female infertility? 3+3+4
b) How will you evaluate an infertile woman for tubal patency?
c) What are the surgical options for blocked fallopian tubes?

18)a)What do you understand by 'ovarian reserve?

b) How do you test it in a patient of infertility?
c) Outline the management plan in a woman with low ovarian reserve. 3+3+4

19) a) Role of cryofreezing in assisted reproductive technologies. b) Role of various fertility

preservation options available for cancer patients in females. 5+5

20)a) Causes of premature ovarian failure (POF). 3+3+4

b) How will you evaluate a case of POF?
c) Therapeutic options and management of a case of POF with infertility

21) Sperm retrieval techniques in assisted reproduction 5

22)What are the clinical indicators of normal ovulatory function.Enumerate the tests of ovulation.
Discuss the basic principles of controlled ovarian hyperstimulation 4+3+3

23) What are the causes of male infertility? Describe the normal semen parameters. How will
you manage an infertile couple with oligospermia in male partner? 3+3+4

24)How will you evaluate a semen sample? What are the treatment options available for male
factor infertility? 5+5
25. What are the indications of intrauterine insemination? Write briefly about different methods
of semen preparation 4+6

26. What is ovarian reserve? How can we test for ovarian reserve? What is the significance of
anti Mullerian hormone (AMH)? 3+3+4

27. How does mild endometriosis contribute to subfertility? How can you improve chances of
pregnancy in these cases? 5+5

28. a. Draw labeled diagram(s) of Graffian follicle

b. Describe the tests of ovarian reserve with critical interpretation of the results of each test
c. Enumerate the treatment options for a woman with poor ovarian reserve with other factors of
infertility work up being normal. 3+4+3

29. a. Enumerate the minimal criteria as laid down by the WHO, of a normal semen analysis.
b. Draw the structure of a mature spermatozoon.
c. Enumerate causes of azoospermia. 4+3+3

OVARIAN FAILURE

1)a) Various methods to assess ovarian reserve. 4

b) Enumerate the causes of chromosomally competent
ovarian failure. 2
c) How will you manage a 22 year old woman with premature
ovarian failure? 4

23. AMENORRHOEA
PRIMARY

1)a) Essential requirements for the onset and continuation of

normal menstruation. 3
b) Causes of cryptomenorrhoea. 3
c) Evaluation of a 17 year old girl presenting with primary
amenorrhoea. 4

2)a)Define primary amenorrhea What are its causes? 4+6

b. How will you manage an 18 years old young girl with primary amenorrhea?

3)Define primary amenorrhoea. Enumerate its causes. How will you work-up and manage such
a case? 2+2+3+3

4) Clinical presentation and management of a 14 year

old girl with imperforate hymen. 3+3

SECONDARY

1)a) Define secondary amenorrhoea.

b) Enlist its causes.
c) Plan of management of a case of secondary amenorrhoea
using a flow chart. 2+3+5
2)Define secondary amenorrhea? Enlist its causes. How will you evaluate a 28-year-old lady
with history of secondary amenorrhea since last delivery 5 years ago? 1+3+6

3)a) Define secondary amenorrhea. b) Enlist its causes c) What is galactorrhea amenorrhea
syndrome? d) Outline the principles of management of galactorrhea amenorrhea in a 24 year
old woman 1+2+3+4

4)Define secondary amenorrhoea Enumerate its causes. How will you work up a case of
secondary amenorrhoea 2+3+5
24.VAGINAL DISCHARGE

1)a) Distinguish between physiological and pathological

vaginal discharge.
b) How will you evaluate vaginal discharge to accurately
make a diagnosis in a woman of reproductive age group?
c) Therapy for various vaginal discharges. (2+2)+3+3

BACTERIAL VAGINOSIS

1)a) What is Bacterial Vaginosis (BV)? 2

b) What is the differential diagnosis & diagnostic criteria of BV? 6
c) Treatment of BV. 2
2)a) Enumerate the normal flora of vagina. 3+2+2+3

b)Describe the causes of vaginal discharge in reproductive years.

c)How will you diagnose and treat bacterial vaginosis?
d)W hat is the clinical significance of bacterial vaginosis in pregnancy?

3. a. Describe syndromic approach to management of bacterial vaginosis

b. What is the treatment of vaginal discharge as per this approach?
c. Describe the pathogenesis, diagnostic criteria and pathological condition. 2+3+5

4. Describe normal vaginal ecosystem. What are the consequences of its abnormalities? How
will you diagnose and manage a case of bacterial vaginosis? 3+2+(3+2)

25. ADNEXAL MASS

1)a) What are the causes of adnexal mass in an 18 year old

unmarried girl?
b) How will you investigate her?
c) Outline the principles of management of germ cell tumour. 3+3+4

2)a) Evaluation of adnexal mass in reproductive age

group
b) Management of a 30 years old woman with torsion
of right ovary. 5+5
3) A 12 year old girl presents with a unilateral adnexal mass. a) Discuss its differential
diagnosis? b) Outline the investigation plan. c) How will you manage a germ cell tumor in this
girl? 3+3+4

4)What is the differential diagnosis of an adnexal mass in a young woman. Describe the
indications and follow up of fertility sparing surgery in a young woman with malignant ovarian
tumor 4+3+3
26.MASS ABDOMEN

1)a) What are the causes of lower abdominal lump in a 13 year old adolescent
girl?
b) Clinical and investigative approach in this girl to arrive at a diagnosis.
c) How will you manage ovarian dermoid cyst in this young girl? 2+4+4

27. PID

1)a) Enumerate the etiological factors of acute pelvic inflammatory disease

(PID) in a young woman of reproductive age?
b) What are its symptoms, signs and management?
c) Its long term consequences & their prevention. 2+4+4

2)a) Write the CDC criteria for diagnosing PID.

b) What are the indications of hospitalization in PID?
c) How will you manage the hospitalized PID patient? 3+2+5

3)a) What are the microbial etiologies of acute salpingitis?

b) Diagnosis and laparoscopic grading of acute salpingitis.
c) Justify that delayed care is a risk factor for impaired
fertility. 3+4+3

4)a) What are the CDC guidelines for diagnosis of acute PID? 3
b) Describe the tubal pathology in 'Genital Tuberculosis . 4

5)a)Discuss the pathophysiology of acute pelvic inflammatory disease (PID)

b) How will you manage such a case in a nulligravida women

c) Propose a practical health awareness campaign to prevent and reduce the incidence of PiD
in india 3+4+3

6)What do you understand by pelvic inflammatory disease? How will you investigate and
manage it? 4+(3+3)

7) What are the etiological factors of acute pelvic inflammatory diseases.What are its clinical
features and differential diagnosis.Describe its treatment and sequelae 3+4+3

28. VULVA

1)a) Enumerate causes of vulval ulcers.

 b) How will you clinically evaluate a case and how will you proceed to
confirm your diagnosis?
c) Outline its management. 2+(3+2)+3

2)a) Lymphatic drainage of vulva

b) Staging of carcinoma vulva
c) Indications of radiotherapy in carcinoma vulva 4+4+2

3)a. Describe the lymphatic drainage of the vulva. 5+5

b. Discuss the clinical features, staging and management of carcinoma vulva

29 .STRESS URINARY INCONTINENCE

1)a) What are the risk factors and causes of stress urinary incontinence (SUI)
in mid life?
b) How will you confirm SUI?
c) Current treatment of SUI. 2+4+4
2)a)Describe the mechanism of urinary Continence 5+3+2

b)List various parameters assessed on urodynamic study with their normal values.

c)Write the complications of sling surgery for stress urinary incontinence.

3)What is stress incontinence?Discuss its etiology and evaluation.Outline the management of

stress incontinence. 2+(2+2)+4

4)a. How will you diagnose and investigate a woman with stress urinary incontinence?
b. Describe the medical and surgical treatment in stress urinary incontinence. 5+5

5)a) Physiology of urinary continence. b) How will you evaluate incontinence in a 55 year old
parous 4+3+3 woman? How will you treat stress incontinence in such a woman? 4+3+3

6) What is the physiological mechanism of urinary continence? How will you investigate urge
incontinence in a 55 year old parous woman? What are the non-pharmacological and
pharmacological approaches to treat urge incontinence? 3+4+3

30.OVERACTIVE BLADDER

1)a) Pharmacotherapy in overactive bladder.

b) Bio-feedback therapy in pelvic floor dysfunction.
c) Role of physiotherapy in post-natal women. 3+4+3

2)Describe physiology of micturition. What is the etiopathogenesis of overactive bladder? How

do you diagnose and manage it? 3+2+5

31.POST COITAL BLEEDING

1)a) Enumerate the causes of post coital bleeding.

 b) How will you investigate and manage a 45 year old woman
having post coital bleeding? 2+4+4