CMS 2021 Paper II \u2013 Part 2 (Q41\u2013Q80)<\/title>\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Playfair+Display:wght@600;700&family=Source+Serif+4:ital,wght@0,300;0,400;0,600;1,400&display=swap\" rel=\"stylesheet\">\n<style>\n#cms21p2b *,#cms21p2b *::before,#cms21p2b *::after{box-sizing:border-box;margin:0;padding:0}\n#cms21p2b{--ter:#C0603A;--ter-light:#e8825f;--ter-pale:#fdf1ec;--teal:#2A7A6F;--teal-light:#3da394;--teal-pale:#eaf4f3;--ink:#1a1a1a;--ink-mid:#444;--ink-soft:#777;--line:#e0d8d4;--bg:#fdfaf8;--white:#ffffff;--correct:#1e6f46;--correct-bg:#eaf7ef;--correct-border:#43a047;--wrong:#b83232;--wrong-bg:#fdf0f0;--wrong-border:#e53935;--radius:10px;font-family:'Source Serif 4',Georgia,serif;font-size:16px;color:var(--ink);background:var(--bg);line-height:1.7;padding:0 0 48px}\n#cms21p2b .cq-sentinel{height:1px}\n#cms21p2b .cq-statusbar{position:fixed;top:0;left:0;right:0;z-index:99999;background:var(--white);border-bottom:2px solid var(--line);border-left:4px 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class=\"cq-statusbar\" id=\"cms21p2b-statusbar\">\n <div class=\"cq-sb-stats\">\n <div class=\"cq-timer-item\" id=\"cms21p2b-timer-item\">\u23f1 <strong id=\"cms21p2b-timer-display\">40:00<\/strong><\/div>\n <div class=\"cq-sb-item\">\u2705 <strong id=\"cms21p2b-sc\">0<\/strong><\/div>\n <div class=\"cq-sb-item\">\u274c <strong id=\"cms21p2b-sw\">0<\/strong><\/div>\n <div class=\"cq-sb-item\">\u23f3 <strong id=\"cms21p2b-sr\">40<\/strong> left<\/div>\n <div class=\"cq-sb-sep\"><\/div>\n <div class=\"cq-sb-item\">Net <strong id=\"cms21p2b-sn\">0<\/strong> \/ <strong id=\"cms21p2b-sm\">160<\/strong><\/div>\n <\/div>\n <div class=\"cq-sb-progress\"><div class=\"cq-sb-fill\" id=\"cms21p2b-fill\"><\/div><\/div>\n <\/div>\n <div class=\"cq-grace\" id=\"cms21p2b-grace\">\n <div class=\"cq-grace-box\">\n <h3>Time's Up!<\/h3><p>Submitting in<\/p>\n <div class=\"cq-grace-count\" id=\"cms21p2b-grace-count\">10<\/div>\n <button class=\"cq-grace-btn\" id=\"cms21p2b-grace-now\">Submit Now<\/button>\n <\/div>\n <\/div>\n <div class=\"cq-header\">\n <h1>Combined Medical Services Examination 2021<br>Paper II \u00b7 Part 2<\/h1>\n <p>Gynaecology & Obstetrics<\/p>\n <div class=\"cq-meta\">\n <span class=\"cq-badge\">Questions 41 \u2013 80<\/span>\n <span class=\"cq-badge\">Options reshuffled<\/span>\n <button class=\"cq-timer-btn\" id=\"cms21p2b-timer-btn\">\u23f1 Start Timed Mode<\/button>\n <\/div>\n <\/div>\n <div class=\"cq-body\">\n <div id=\"cms21p2b-questions\"><\/div>\n <div class=\"cq-submit-wrap\"><button class=\"cq-btn\" id=\"cms21p2b-submit\">Submit Answers<\/button><\/div>\n <div class=\"cq-score\" id=\"cms21p2b-score\">\n <div class=\"cq-score-ring\" id=\"cms21p2b-ring\"><div class=\"cq-ring-inner\"><span class=\"cq-ring-pct\" id=\"cms21p2b-ring-pct\">0%<\/span><span class=\"cq-ring-sub\">score<\/span><\/div><\/div>\n <h2>Your Result<\/h2>\n <div class=\"cq-net-line\" id=\"cms21p2b-net-line\"><\/div>\n <div class=\"cq-verdict\" id=\"cms21p2b-verdict\"><\/div>\n <div class=\"cq-score-bands\">\n <span class=\"cq-band cq-band-c\" id=\"cms21p2b-ct-c\"><\/span>\n <span class=\"cq-band cq-band-w\" id=\"cms21p2b-ct-w\"><\/span>\n <span class=\"cq-band cq-band-s\" id=\"cms21p2b-ct-s\"><\/span>\n <\/div>\n <button class=\"cq-retry-btn\" id=\"cms21p2b-retry\">\u21ba Retry Quiz<\/button>\n <\/div>\n <\/div>\n<\/div>\n<script>\n(function(){\n 'use strict';\n const NS='cms21p2b',TOTAL=40,MAX=160,TIMER_SECS=2400,GRACE_SECS=10;\n const QUESTIONS=[\n {id:41,stem:'Which one of the following statements regarding pre-conceptional counselling is NOT correct?',correct:'It is needed only in selected complicated pregnancies',options:['It is needed only in selected complicated pregnancies','It helps in early detection of risk factors','It helps in reducing maternal morbidity and mortality','It is a part of preventive medicine'],exp:'Pre-conceptional counselling is recommended for ALL women planning pregnancy \u2014 not just complicated cases. It identifies and modifies risk factors (folic acid, rubella immunity, medication review, diabetes control) before conception.'},\n {id:42,stem:'Blood volume increases during pregnancy above nonpregnant level at 30-34 weeks',correct:'by 40-50 per cent',options:['by 10-20 per cent','by 25-30 per cent','by 40-50 per cent','Blood volume does not increase at all'],exp:'Blood volume increases by 40\u201350% above non-pregnant baseline, peaking at 30\u201334 weeks. Plasma volume rises 45\u201350%; red cell mass rises 15\u201325% \u2014 creating physiological dilutional anaemia. This hypervolaemia compensates for delivery blood loss.'},\n {id:43,stem:'Which of the following are contra-indications to external cephalic version in antenatal management of breech presentation?\\n1. Antepartum haemorrhage\\n2. Multiple pregnancy\\n3. Reactive Non Stress Test\\n4. Severe oligohydramnios',correct:'1, 2 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'ECV contraindications: APH (unstable placenta), multiple pregnancy, severe oligohydramnios. A REACTIVE NST is FAVOURABLE for ECV (indicates fetal wellbeing) \u2014 not a contraindication. Statements 1, 2 and 4 correct.'},\n {id:44,stem:'Antepartum haemorrhage is defined as bleeding from genital tract',correct:'After 28 weeks of pregnancy',options:['Before 20 weeks of pregnancy','Before 24 weeks of pregnancy','After 28 weeks of pregnancy','After 34 weeks of pregnancy'],exp:'APH = bleeding from the genital tract after 28 completed weeks and before delivery. Major causes: placenta praevia and abruptio placentae. Bleeding before 28 weeks = threatened miscarriage or preterm labour.'},\n {id:45,stem:'Which one of the following is NOT a risk factor for pre-eclampsia?',correct:'Placenta previa',options:['Primigravida','Obesity','Pre-existing vascular disease','Placenta previa'],exp:'Placenta praevia is a placentation disorder (low implantation) \u2014 NOT a pre-eclampsia risk factor. Pre-eclampsia risk factors: primigravida, obesity, pre-existing vascular\/renal disease, multiple pregnancy, prior pre-eclampsia, thrombophilia.'},\n {id:46,stem:\"What are Spiegelberg's criteria for diagnosis of ovarian pregnancy?\\n1. Tube on the affected side must be intact\\n2. Gestational sac must be in the position of ovary\\n3. Gestational sac is connected to uterus by ovarian ligament\\n4. Ovarian tissue must be detected on the wall on histological examination\",correct:'1, 2, 3 and 4',options:['1, 2 and 3 only','2, 3 and 4 only','1, 2, 3 and 4','1 and 4 only'],exp:\"Spiegelberg's criteria for ovarian pregnancy: all FOUR must be met \u2014 (1) ipsilateral tube intact and separate; (2) sac in ovarian position; (3) sac connected by ovarian ligament; (4) ovarian tissue in sac wall on histology.\"},\n {id:47,stem:'Which one of the following statements regarding fetal well being is NOT correct?',correct:'Modified Biophysical profile includes Non-stress test and fetal breathing',options:['Daily fetal movement count is a simple reliable method of fetal well being','Modified Biophysical profile includes Non-stress test and fetal breathing','Mothers perceive 88% of fetal movements','Healthy fetus should have minimum of 10 movements in 12 hours period'],exp:'Modified Biophysical Profile consists of only TWO components: NST and Amniotic Fluid Index. Fetal breathing is part of the full Manning BPP (five components). The statement including fetal breathing in Modified BPP is FALSE.'},\n {id:48,stem:'Which of the following statements are correct with respect to antenatal USG examination?\\n1. It helps in detecting gross fetal anomalies\\n2. It helps in identifying multiple pregnancies\\n3. It helps in identifying viable pregnancy\\n4. Best dating is possible with third trimester ultrasound scan',correct:'1, 2 and 3 only',options:['1 and 2 only','1, 2, 3 and 4','3 and 4 only','1, 2 and 3 only'],exp:'Antenatal USG benefits: detects gross fetal anomalies (1), identifies multiple pregnancies (2), confirms viable pregnancy (3). Statement 4 is FALSE: best dating is in the FIRST TRIMESTER (CRL \u00b13\u20135 days). Third trimester dating is least accurate. Statements 1, 2 and 3 correct.'},\n {id:49,stem:'During pregnancy iron supplementation is needed for',correct:'all pregnant mothers from 16 weeks onwards',options:['all pregnant mothers from 16 weeks onwards','only those pregnant mothers who have Hb < 10 gm%','only those pregnant mothers who are not eating green vegetables','all pregnant mothers since 6 weeks of pregnancy'],exp:\"India's NHP recommends IFA for ALL pregnant women from 14\u201316 weeks onward regardless of Hb or diet. Regimen: 1 IFA tablet daily (100 mg Fe + 500 mcg folic acid) from 16 weeks until 3 months postpartum.\"},\n {id:50,stem:'The clinical feature of physiological edema in pregnancy',correct:'disappears or markedly reduced on rest',options:['is present on both lower limbs and abdomen','is associated with cardiac or renal pathology','is usually of moderate or severe grade','disappears or markedly reduced on rest'],exp:'Physiological oedema: confined to lower limbs (not face\/abdomen), mild grade, no cardiac\/renal pathology, and DISAPPEARS on rest\/lying down. Facial or abdominal oedema warrants investigation for pre-eclampsia.'},\n {id:51,stem:'The normal rate of dilatation of the cervix in a primigravida in the active phase of labor is',correct:'1 cm\/hour',options:['0.25 cm\/hour','0.5 cm\/hour','0.75 cm\/hour','1 cm\/hour'],exp:'Normal cervical dilatation rate in active phase: 1 cm\/hour (primigravida); 1.5\u20132 cm\/hour (multiparous). Active phase begins at 4\u20136 cm. Rates below 0.5 cm\/hour indicate dysfunctional labour.'},\n {id:52,stem:'In the mechanism of normal labour the engaging transverse diameter is',correct:'Suboccipitobregmatic (9.5 cm)',options:['Suboccipitobregmatic (9.5 cm)','Biparietal diameter (9.5 cm)','Bimastoid diameter (7.5 cm)','Suboccipitofrontal diameter (10 cm)'],exp:'In normal vertex delivery with well-flexed head, the engaging AP diameter = Suboccipitobregmatic = 9.5 cm (below occiput to bregma). Good flexion presents the smallest available AP diameter.'},\n {id:53,stem:'Compared to breast milk, colostrum has',correct:'higher protein content',options:['higher fat content','higher carbohydrate content','higher protein content','lower water content'],exp:'Colostrum vs mature breast milk: HIGHER protein (2\u20133\u00d7, rich in sIgA, lactoferrin), LOWER fat, LOWER carbohydrate\/lactose, LOWER water. Provides passive immunity, concentrated nutrition, and laxative effect for meconium passage.'},\n {id:54,stem:'In non lactating mothers, after delivery, ovulation',correct:'may occur as early as 4 weeks',options:['may occur as early as 2 weeks','may occur as early as 4 weeks','may occur as early as 6 weeks','is unusual before 6 weeks'],exp:'Non-lactating mothers: prolactin falls without suckling; ovulation may resume as early as 4 weeks postpartum. Non-breastfeeding women can conceive before their first postpartum period. Early contraception counselling is essential.'},\n {id:55,stem:'Which of the following are the prerequisites of outlet forceps delivery?\\n1. Bladder should be empty\\n2. Membranes should be intact\\n3. Cervix should be fully dilated\\n4. Fetal skull has reached level of pelvic floor',correct:'1, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Outlet forceps prerequisites: empty bladder (1), fully dilated cervix (3), skull at pelvic floor\/vulva (4). Statement 2 is FALSE \u2014 membranes must be RUPTURED (not intact). Statements 1, 3 and 4 correct.'},\n {id:56,stem:'The vaginal pH in childbearing age normally ranges between',correct:'4 - 5.5',options:['2.5 - 3.5','1 - 2','4 - 5.5','7 - 8'],exp:'Normal vaginal pH in reproductive age = 4.0\u20135.5 (acidic), maintained by Lactobacillus producing lactic acid from glycogen. BV raises pH >4.5. Candidiasis occurs at normal pH. pH testing aids differential diagnosis.'},\n {id:57,stem:\"The Gartner's duct cyst is usually located in\",correct:'Anterolateral wall of vagina',options:['Anterolateral wall of vagina','Posterolateral wall of vagina','Posterior wall of vagina','Labia minora'],exp:\"Gartner's duct (vestigial mesonephric duct) runs along the ANTEROLATERAL vaginal wall. Cysts located in anterolateral vaginal wall, typically upper one-third. Distinguished from Bartholin's cysts (posterolateral, lower vagina).\"},\n {id:58,stem:'Endometrial sampling for diagnosis of ovulation is done on which day of menstrual cycle?',correct:'21st to 23rd day',options:['8th - 10th day','12th day','14th day','21st to 23rd day'],exp:'Endometrial sampling for ovulation: days 21\u201323 (7\u20138 days post-ovulation). Shows secretory changes if ovulation occurred. Early sampling shows only proliferative changes. Detects luteal phase defect.'},\n {id:59,stem:'Primary Dysmenorrhoea can be treated by which of the following?\\n1. Antiprostaglandin\\n2. Cyclic combined estrogen and progesterone preparations\\n3. Pre-sacral neurectomy\\n4. Uterine curettage',correct:'1, 2 and 3',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:\"Primary dysmenorrhoea treatments: NSAIDs\/antiprostaglandins \u2014 first line (1), cyclic combined E+P \u2014 second line (2), pre-sacral neurectomy \u2014 severe refractory cases (3). Uterine curettage is NOT a treatment and risks Asherman's syndrome (4 false).\"},\n {id:60,stem:'Which one of the following is correct regarding obesity and infertility?',correct:'It is associated with hypogonadotropic hypogonadism',options:['It is associated with hypogonadotropic hypogonadism','It is associated with hypergonadotropic hypergonadism','There is no change in HPO axis','It is always associated with endometrial atrophy'],exp:'Obesity causes HYPOgonadotropic HYPOgonadism: excess adipose aromatises androgens to oestrogens \u2192 sustained oestrogen feedback \u2192 suppresses GnRH pulsatility \u2192 oligo-anovulation. Weight loss alone can restore ovulation.'},\n {id:61,stem:'Which one of the following is an abnormal parameter in accordance with WHO Serum Analysis Criteria?',correct:'Viscosity > 4',options:['Volume >= 2 ml','Viscosity > 4','Progressive forward motility of sperms > 50%','Normal morphology of sperms > 14%'],exp:'WHO 2010 normal references: Volume \u22651.5 mL, progressive motility \u226532%, morphology \u22654%. Viscosity scored 1\u20134; viscosity >4 is ABNORMAL (hyperviscosity impairs sperm transport). Volume \u22652 mL, PR >50%, morphology >14% are normal\/above-normal.'},\n {id:62,stem:'Which of the following are causes of GnRH dependent precocious puberty?\\n1. Constitutional\\n2. Tubercular Encephalitis\\n3. McCune-Albright syndrome\\n4. Primary hypothyroidism',correct:'1, 2 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'GnRH-dependent (central) PP: Constitutional (1), CNS lesions including Tubercular encephalitis (2), Primary hypothyroidism\/Van Wyk-Grumbach syndrome (4). McCune-Albright is GnRH-INDEPENDENT (3 incorrect). Statements 1, 2 and 4 correct.'},\n {id:63,stem:'Which one of the following is the most important haematological condition to be ruled out while investigating a case of puberty menorrhagia?',correct:'Coagulation disorder',options:['Anaemia','Coagulation disorder','G-6PD deficiency','Leukemia'],exp:'Most important: COAGULATION DISORDER \u2014 particularly von Willebrand disease (most common inherited bleeding disorder, ~1% prevalence), frequently presenting as menorrhagia at menarche. Iron deficiency anaemia is a consequence, not a cause.'},\n {id:64,stem:'A couple presents with inability to conceive for 3 years. Husband was advised semen analysis. What is the WHO criterion for minimum sperm count per ml in normal semen?',correct:'15 million',options:['10 million','15 million','30 million','40 million'],exp:'WHO 2010 lower reference for sperm concentration = 15 million\/mL (replacing old 20 million\/mL). Total sperm count lower reference = 39 million\/ejaculate. Oligozoospermia: <15 million\/mL.'},\n {id:65,stem:'Which of the following are risk factors for developing pelvic inflammatory disease in females?\\n1. Use of oral contraception pills\\n2. Multiple sexual partners\\n3. Lower socioeconomic status\\n4. Genetic predisposition',correct:'2, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'OCP is PROTECTIVE against PID \u2014 thickens cervical mucus, reduces ascending infection. Statement 1 is incorrect. PID risk factors: multiple sexual partners (2), lower SES (3), genetic predisposition (4). Statements 2, 3 and 4 correct.'},\n {id:66,stem:'A 65-year-old postmenopausal lady presents with abdominal distension and weight loss, diagnosed with ovarian tumour. The most common type would be',correct:'Epithelial tumor',options:['Germ cell tumor','Sex cord tumor','Epithelial tumor','Trophoblastic tumor'],exp:'Epithelial ovarian tumours: 65\u201370% of all ovarian tumours, 90% of malignancies, most common in postmenopausal women (peak 55\u201365 years). Germ cell tumours predominate below 30 years. CA-125 is the key marker.'},\n {id:67,stem:\"Which of the following are the characteristic features of Meigs' syndrome in a female?\\n1. Right sided hydrothorax\\n2. Ascites\\n3. Genital warts\\n4. Fibroma ovary\",correct:'1, 2 and 4',options:['1, 2 and 3','1, 3 and 4','1, 2 and 4','2, 3 and 4'],exp:\"Meigs' syndrome triad: benign ovarian FIBROMA (4) + Ascites (2) + Right-sided hydrothorax (1). Genital warts (HPV) are NOT part of Meigs' syndrome (3 incorrect). All three resolve after tumour removal. Statements 1, 2 and 4 correct.\"},\n {id:68,stem:'A 25-year-old girl presents with abdominal pain, heavy menstrual bleeding with a mass corresponding to 16 weeks gravid uterus. Urine pregnancy test is negative. The most likely diagnosis would be',correct:'Uterine fibroid',options:['Pelvic inflammatory disease','Uterine fibroid','Ovarian tumour','Endometriosis'],exp:'Uterine fibroid: firm non-tender mass corresponding to 16-week uterine size, heavy menstrual bleeding, negative pregnancy test. Most common benign pelvic tumour in reproductive-age women. PID would have fever and tenderness.'},\n {id:69,stem:'A 39-year-old nulliparous female presents with post-coital bleeding for 6 months. The first investigation to be offered will be',correct:'Pap smear',options:['Colposcopy','Dilatation and Curettage','Pap smear','Cone Biopsy of Cervix'],exp:'Post-coital bleeding: red flag for cervical pathology. FIRST investigation = PAP SMEAR (cervical cytology) \u2014 non-invasive, inexpensive screening. If abnormal \u2192 colposcopy. Colposcopy and D&C are not first-line investigations.'},\n {id:70,stem:'Procidentia as a degree of uterovaginal prolapse is characterised by descent of',correct:'uterine cervix body with fundus outside vagina with eversion of entire vagina',options:['uterus into vagina','uterine cervix outside vagina but uterine body inside vagina','uterine cervix below ischial spine','uterine cervix body with fundus outside vagina with eversion of entire vagina'],exp:'Procidentia (complete prolapse): entire uterus below the vulva with complete vaginal eversion \u2014 cervix, body, and fundus all outside the vagina. Surgery: Manchester repair or vaginal hysterectomy with pelvic floor repair.'},\n {id:71,stem:'Which of the following are indications of vaginal examinations during labour?\\n1. To stretch the vagina intermittently\\n2. At the onset of labour\\n3. To monitor progress of labour\\n4. Following rupture of membranes',correct:'2, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'VE during labour indications: at onset (2), to monitor progress every 4 hours (3), following membrane rupture to exclude cord prolapse (4). \"To stretch the vagina intermittently\" (1) is NOT a valid indication. Statements 2, 3 and 4 correct.'},\n {id:72,stem:'Which one of the following statements regarding Rh isoimmunization are correct?\\n1. Liley\\'s chart identifies anemia better than middle cerebral artery doppler\\n2. Indirect Coomb\\'s test is positive in mother\\n3. Baby is at risk of developing anemia\\n4. Direct Coomb\\'s test is positive in baby',correct:'2, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:\"Statement 1 FALSE: MCA Doppler PSV is SUPERIOR to Liley's chart for non-invasive prediction of fetal anaemia. Indirect Coombs positive in MOTHER (2), baby at risk of haemolytic anaemia (3), Direct Coombs positive in BABY (4). Statements 2, 3 and 4 correct.\"},\n {id:73,stem:'As per ICMR guidelines, which of the following are the criteria for SARS-COV-2 exposure for a pregnant female during COVID-19 pandemic?\\n1. Travel to an affected country within previous 14 days\\n2. Close contact with a confirmed case within a distance of 1 metre for more than 15 minutes\\n3. Living in neighbourhood of a confirmed case\\n4. Direct contact with body fluids of a confirmed case',correct:'1, 2 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'ICMR exposure criteria: travel within 14 days (1), close contact within 1 metre for >15 minutes (2), direct contact with body fluids (4). Living in neighbourhood alone is NOT sufficient (3 incorrect). Statements 1, 2 and 4 correct.'},\n {id:74,stem:'Which of the following are the clinical features of septic abortion?\\n1. Persistent tachycardia >= 90 bpm\\n2. Impaired mental status\\n3. Hypothermia',correct:'1, 2 and 3',options:['1 and 2 only','2 and 3 only','1 and 3 only','1, 2 and 3'],exp:'Septic abortion features (SIRS\/sepsis): persistent tachycardia \u226590 bpm (SIRS criterion), impaired mental status (organ dysfunction sign), hypothermia <36\u00b0C (SIRS criterion \u2014 includes both fever AND hypothermia). All three correct.'},\n {id:75,stem:'Consider the following statements:\\nStatement-1: In fetal growth restriction there is always oligohydramnios\\nStatement-2: In fetal growth restriction there is placental insufficiency leading to redistribution of blood flow to fetal brain shunting it from fetal kidney\\nWhich one of the following is correct?',correct:'Statement-2 is true but Statement-1 is false',options:['Both Statement-1 and Statement-2 are true and Statement-2 is the correct explanation for Statement-1','Both Statement-1 and Statement-2 are true and Statement-2 is not the correct explanation for Statement-1','Statement-1 is true but Statement-2 is false','Statement-2 is true but Statement-1 is false'],exp:'Statement 1 FALSE: FGR does NOT always cause oligohydramnios \u2014 many FGR fetuses have normal AFI. Statement 2 TRUE: brain-sparing redistribution (blood shunted from kidneys to brain via placental insufficiency) is correct pathophysiology.'},\n {id:76,stem:'Which of the following are correct regarding failure rate of contraceptive methods?\\n1. Depot medroxyprogesterone acetate 0 to 1 per HWY\\n2. Norplant 0.1 per HWY\\n3. LNG-IUS 0.02 per HWY\\n4. Levonorgestrel 3 per HWY',correct:'1, 2 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Failure rates: DMPA 0\u20130.7\/HWY (1 correct), Norplant ~0.05\u20130.1\/HWY (2 correct), Levonorgestrel pill ~3\/HWY (4 correct). LNG-IUS published rate is 0.1\u20130.2\/HWY \u2014 statement 3 (0.02) understates this. Best examination answer: statements 1, 2 and 4.'},\n {id:77,stem:'Consider the following in respect of Ormeloxifene:\\n1. It is a research product of Central Drug Research Institute, Lucknow\\n2. It is a steroidal compound\\n3. It is a potent antiestrogen with weak estrogenic properties\\n4. It does not inhibit ovulation',correct:'1, 3 and 4',options:['1 and 3 only','1, 3 and 4','2, 3 and 4','1, 2 and 4'],exp:'Ormeloxifene (Centchroman\/Saheli): CDRI, Lucknow product (1 correct), NON-STEROIDAL benzopyran SERM \u2014 statement 2 FALSE, potent antiestrogen with weak oestrogenic properties (3 correct), does not inhibit ovulation (4 correct). Statements 1, 3 and 4 correct.'},\n {id:78,stem:'Steroidal contraceptives available in the basket of contraceptive choice from Ministry of Health & Family Welfare, Government of India are',correct:'Monophasic',options:['Monophasic','Biphasic','Triphasic','Estrogen only pills'],exp:\"India MoHFW provides MONOPHASIC combined OCP in the national family planning basket: Mala-N (Norgestrel + EE) and Mala-D (Norethindrone + EE) \u2014 both monophasic (fixed doses throughout the 21-day pack).\"},\n {id:79,stem:'Which of the following are absolute contraindications of Combined Oral Contraceptive (COCs)?\\n1. Arterial or venous thrombosis history\\n2. Severe hypertension\\n3. Gestational trophoblastic neoplasia\\n4. Diabetes with vascular complications',correct:'1, 2 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'COC absolute contraindications: thrombosis history (1), severe hypertension >160\/100 (2), diabetes with vascular complications (4). GTN is WHO MEC Category 1 for COC after hCG normalisation \u2014 RECOMMENDED post-GTN (3 incorrect). Statements 1, 2 and 4 correct.'},\n {id:80,stem:'After male sterilization, additional contraceptive protection is',correct:'needed for 2 to 3 months',options:['needed for 1 month','needed for 1 to 2 months','needed for 2 to 3 months','not needed'],exp:'After vasectomy, additional contraception needed for 2\u20133 months until azoospermia confirmed on two consecutive semen analyses (~12 weeks). Viable spermatozoa persist in the vas deferens for months after ligation.'}\n ];\n\n const LETTERS=['A','B','C','D'];\n let userAnswers={},answered=0,shuffledOpts={};\n let timerRunning=false,timerRemaining=TIMER_SECS,timerInterval=null,graceInterval=null,quizSubmitted=false;\n\n function shuffle(arr){const a=arr.slice();for(let i=a.length-1;i>0;i--){const j=Math.floor(Math.random()*(i+1));[a[i],a[j]]=[a[j],a[i]];}return a;}\n function fmtTime(s){const m=Math.floor(s\/60),sec=s%60;return(m<10?'0':'')+m+':'+(sec<10?'0':'')+sec;}\n function startTimer(){\n if(timerRunning||quizSubmitted)return;timerRunning=true;\n const btn=document.getElementById(NS+'-timer-btn');\n btn.textContent='\u23f1 '+fmtTime(timerRemaining);btn.classList.add('running');\n document.getElementById(NS+'-timer-item').classList.add('active');\n timerInterval=setInterval(function(){\n timerRemaining--;\n const disp=fmtTime(timerRemaining);\n document.getElementById(NS+'-timer-display').textContent=disp;\n 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Submitting in 10 Submit Now Combined Medical Services Examination 2021Paper II \u00b7 Part 2 Gynaecology & Obstetrics Questions 41 \u2013 80 Options reshuffled \u23f1 Start Timed Mode Submit Answers 0%score Your Result \u21ba Retry Quiz<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[18],"tags":[],"class_list":["post-36606","post","type-post","status-publish","format-standard","hentry","category-cms"],"yoast_head":"\n<title>CMS 2021 P2 Part-2 OBG - atsixty<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/18\/cms-2021-p2-part-2-obg\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CMS 2021 P2 Part-2 OBG - atsixty\" \/>\n<meta property=\"og:description\" content=\"CMS 2021 Paper II \u2013 Part 2 (Q41\u2013Q80) \u23f1 40:00 \u2705 0 \u274c 0 \u23f3 40 left Net 0 \/ 160 Time's Up! 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id=\"cms21p2b-timer-display\">40:00<\/strong><\/div>\n <div class=\"cq-sb-item\">\u2705 <strong id=\"cms21p2b-sc\">0<\/strong><\/div>\n <div class=\"cq-sb-item\">\u274c <strong id=\"cms21p2b-sw\">0<\/strong><\/div>\n <div class=\"cq-sb-item\">\u23f3 <strong id=\"cms21p2b-sr\">40<\/strong> left<\/div>\n <div class=\"cq-sb-sep\"><\/div>\n <div class=\"cq-sb-item\">Net <strong id=\"cms21p2b-sn\">0<\/strong> \/ <strong id=\"cms21p2b-sm\">160<\/strong><\/div>\n <\/div>\n <div class=\"cq-sb-progress\"><div class=\"cq-sb-fill\" id=\"cms21p2b-fill\"><\/div><\/div>\n <\/div>\n <div class=\"cq-grace\" id=\"cms21p2b-grace\">\n <div class=\"cq-grace-box\">\n <h3>Time's Up!<\/h3><p>Submitting in<\/p>\n <div class=\"cq-grace-count\" id=\"cms21p2b-grace-count\">10<\/div>\n <button class=\"cq-grace-btn\" id=\"cms21p2b-grace-now\">Submit Now<\/button>\n <\/div>\n <\/div>\n <div class=\"cq-header\">\n <h1>Combined Medical Services Examination 2021<br>Paper II \u00b7 Part 2<\/h1>\n <p>Gynaecology & Obstetrics<\/p>\n <div class=\"cq-meta\">\n <span class=\"cq-badge\">Questions 41 \u2013 80<\/span>\n <span class=\"cq-badge\">Options reshuffled<\/span>\n <button class=\"cq-timer-btn\" id=\"cms21p2b-timer-btn\">\u23f1 Start Timed Mode<\/button>\n <\/div>\n <\/div>\n <div class=\"cq-body\">\n <div id=\"cms21p2b-questions\"><\/div>\n <div class=\"cq-submit-wrap\"><button class=\"cq-btn\" id=\"cms21p2b-submit\">Submit Answers<\/button><\/div>\n <div class=\"cq-score\" id=\"cms21p2b-score\">\n <div class=\"cq-score-ring\" id=\"cms21p2b-ring\"><div class=\"cq-ring-inner\"><span class=\"cq-ring-pct\" id=\"cms21p2b-ring-pct\">0%<\/span><span class=\"cq-ring-sub\">score<\/span><\/div><\/div>\n <h2>Your Result<\/h2>\n <div class=\"cq-net-line\" id=\"cms21p2b-net-line\"><\/div>\n <div class=\"cq-verdict\" id=\"cms21p2b-verdict\"><\/div>\n <div class=\"cq-score-bands\">\n <span class=\"cq-band cq-band-c\" id=\"cms21p2b-ct-c\"><\/span>\n <span class=\"cq-band cq-band-w\" id=\"cms21p2b-ct-w\"><\/span>\n <span class=\"cq-band cq-band-s\" id=\"cms21p2b-ct-s\"><\/span>\n <\/div>\n <button class=\"cq-retry-btn\" id=\"cms21p2b-retry\">\u21ba Retry Quiz<\/button>\n <\/div>\n <\/div>\n<\/div>\n<script>\n(function(){\n 'use strict';\n const NS='cms21p2b',TOTAL=40,MAX=160,TIMER_SECS=2400,GRACE_SECS=10;\n const QUESTIONS=[\n {id:41,stem:'Which one of the following statements regarding pre-conceptional counselling is NOT correct?',correct:'It is needed only in selected complicated pregnancies',options:['It is needed only in selected complicated pregnancies','It helps in early detection of risk factors','It helps in reducing maternal morbidity and mortality','It is a part of preventive medicine'],exp:'Pre-conceptional counselling is recommended for ALL women planning pregnancy \u2014 not just complicated cases. It identifies and modifies risk factors (folic acid, rubella immunity, medication review, diabetes control) before conception.'},\n {id:42,stem:'Blood volume increases during pregnancy above nonpregnant level at 30-34 weeks',correct:'by 40-50 per cent',options:['by 10-20 per cent','by 25-30 per cent','by 40-50 per cent','Blood volume does not increase at all'],exp:'Blood volume increases by 40\u201350% above non-pregnant baseline, peaking at 30\u201334 weeks. Plasma volume rises 45\u201350%; red cell mass rises 15\u201325% \u2014 creating physiological dilutional anaemia. This hypervolaemia compensates for delivery blood loss.'},\n {id:43,stem:'Which of the following are contra-indications to external cephalic version in antenatal management of breech presentation?\\n1. Antepartum haemorrhage\\n2. Multiple pregnancy\\n3. Reactive Non Stress Test\\n4. Severe oligohydramnios',correct:'1, 2 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'ECV contraindications: APH (unstable placenta), multiple pregnancy, severe oligohydramnios. A REACTIVE NST is FAVOURABLE for ECV (indicates fetal wellbeing) \u2014 not a contraindication. Statements 1, 2 and 4 correct.'},\n {id:44,stem:'Antepartum haemorrhage is defined as bleeding from genital tract',correct:'After 28 weeks of pregnancy',options:['Before 20 weeks of pregnancy','Before 24 weeks of pregnancy','After 28 weeks of pregnancy','After 34 weeks of pregnancy'],exp:'APH = bleeding from the genital tract after 28 completed weeks and before delivery. Major causes: placenta praevia and abruptio placentae. Bleeding before 28 weeks = threatened miscarriage or preterm labour.'},\n {id:45,stem:'Which one of the following is NOT a risk factor for pre-eclampsia?',correct:'Placenta previa',options:['Primigravida','Obesity','Pre-existing vascular disease','Placenta previa'],exp:'Placenta praevia is a placentation disorder (low implantation) \u2014 NOT a pre-eclampsia risk factor. Pre-eclampsia risk factors: primigravida, obesity, pre-existing vascular\/renal disease, multiple pregnancy, prior pre-eclampsia, thrombophilia.'},\n {id:46,stem:\"What are Spiegelberg's criteria for diagnosis of ovarian pregnancy?\\n1. Tube on the affected side must be intact\\n2. Gestational sac must be in the position of ovary\\n3. Gestational sac is connected to uterus by ovarian ligament\\n4. Ovarian tissue must be detected on the wall on histological examination\",correct:'1, 2, 3 and 4',options:['1, 2 and 3 only','2, 3 and 4 only','1, 2, 3 and 4','1 and 4 only'],exp:\"Spiegelberg's criteria for ovarian pregnancy: all FOUR must be met \u2014 (1) ipsilateral tube intact and separate; (2) sac in ovarian position; (3) sac connected by ovarian ligament; (4) ovarian tissue in sac wall on histology.\"},\n {id:47,stem:'Which one of the following statements regarding fetal well being is NOT correct?',correct:'Modified Biophysical profile includes Non-stress test and fetal breathing',options:['Daily fetal movement count is a simple reliable method of fetal well being','Modified Biophysical profile includes Non-stress test and fetal breathing','Mothers perceive 88% of fetal movements','Healthy fetus should have minimum of 10 movements in 12 hours period'],exp:'Modified Biophysical Profile consists of only TWO components: NST and Amniotic Fluid Index. Fetal breathing is part of the full Manning BPP (five components). The statement including fetal breathing in Modified BPP is FALSE.'},\n {id:48,stem:'Which of the following statements are correct with respect to antenatal USG examination?\\n1. It helps in detecting gross fetal anomalies\\n2. It helps in identifying multiple pregnancies\\n3. It helps in identifying viable pregnancy\\n4. Best dating is possible with third trimester ultrasound scan',correct:'1, 2 and 3 only',options:['1 and 2 only','1, 2, 3 and 4','3 and 4 only','1, 2 and 3 only'],exp:'Antenatal USG benefits: detects gross fetal anomalies (1), identifies multiple pregnancies (2), confirms viable pregnancy (3). Statement 4 is FALSE: best dating is in the FIRST TRIMESTER (CRL \u00b13\u20135 days). Third trimester dating is least accurate. Statements 1, 2 and 3 correct.'},\n {id:49,stem:'During pregnancy iron supplementation is needed for',correct:'all pregnant mothers from 16 weeks onwards',options:['all pregnant mothers from 16 weeks onwards','only those pregnant mothers who have Hb < 10 gm%','only those pregnant mothers who are not eating green vegetables','all pregnant mothers since 6 weeks of pregnancy'],exp:\"India's NHP recommends IFA for ALL pregnant women from 14\u201316 weeks onward regardless of Hb or diet. Regimen: 1 IFA tablet daily (100 mg Fe + 500 mcg folic acid) from 16 weeks until 3 months postpartum.\"},\n {id:50,stem:'The clinical feature of physiological edema in pregnancy',correct:'disappears or markedly reduced on rest',options:['is present on both lower limbs and abdomen','is associated with cardiac or renal pathology','is usually of moderate or severe grade','disappears or markedly reduced on rest'],exp:'Physiological oedema: confined to lower limbs (not face\/abdomen), mild grade, no cardiac\/renal pathology, and DISAPPEARS on rest\/lying down. Facial or abdominal oedema warrants investigation for pre-eclampsia.'},\n {id:51,stem:'The normal rate of dilatation of the cervix in a primigravida in the active phase of labor is',correct:'1 cm\/hour',options:['0.25 cm\/hour','0.5 cm\/hour','0.75 cm\/hour','1 cm\/hour'],exp:'Normal cervical dilatation rate in active phase: 1 cm\/hour (primigravida); 1.5\u20132 cm\/hour (multiparous). Active phase begins at 4\u20136 cm. Rates below 0.5 cm\/hour indicate dysfunctional labour.'},\n {id:52,stem:'In the mechanism of normal labour the engaging transverse diameter is',correct:'Suboccipitobregmatic (9.5 cm)',options:['Suboccipitobregmatic (9.5 cm)','Biparietal diameter (9.5 cm)','Bimastoid diameter (7.5 cm)','Suboccipitofrontal diameter (10 cm)'],exp:'In normal vertex delivery with well-flexed head, the engaging AP diameter = Suboccipitobregmatic = 9.5 cm (below occiput to bregma). Good flexion presents the smallest available AP diameter.'},\n {id:53,stem:'Compared to breast milk, colostrum has',correct:'higher protein content',options:['higher fat content','higher carbohydrate content','higher protein content','lower water content'],exp:'Colostrum vs mature breast milk: HIGHER protein (2\u20133\u00d7, rich in sIgA, lactoferrin), LOWER fat, LOWER carbohydrate\/lactose, LOWER water. Provides passive immunity, concentrated nutrition, and laxative effect for meconium passage.'},\n {id:54,stem:'In non lactating mothers, after delivery, ovulation',correct:'may occur as early as 4 weeks',options:['may occur as early as 2 weeks','may occur as early as 4 weeks','may occur as early as 6 weeks','is unusual before 6 weeks'],exp:'Non-lactating mothers: prolactin falls without suckling; ovulation may resume as early as 4 weeks postpartum. Non-breastfeeding women can conceive before their first postpartum period. Early contraception counselling is essential.'},\n {id:55,stem:'Which of the following are the prerequisites of outlet forceps delivery?\\n1. Bladder should be empty\\n2. Membranes should be intact\\n3. Cervix should be fully dilated\\n4. Fetal skull has reached level of pelvic floor',correct:'1, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Outlet forceps prerequisites: empty bladder (1), fully dilated cervix (3), skull at pelvic floor\/vulva (4). Statement 2 is FALSE \u2014 membranes must be RUPTURED (not intact). Statements 1, 3 and 4 correct.'},\n {id:56,stem:'The vaginal pH in childbearing age normally ranges between',correct:'4 - 5.5',options:['2.5 - 3.5','1 - 2','4 - 5.5','7 - 8'],exp:'Normal vaginal pH in reproductive age = 4.0\u20135.5 (acidic), maintained by Lactobacillus producing lactic acid from glycogen. BV raises pH >4.5. Candidiasis occurs at normal pH. pH testing aids differential diagnosis.'},\n {id:57,stem:\"The Gartner's duct cyst is usually located in\",correct:'Anterolateral wall of vagina',options:['Anterolateral wall of vagina','Posterolateral wall of vagina','Posterior wall of vagina','Labia minora'],exp:\"Gartner's duct (vestigial mesonephric duct) runs along the ANTEROLATERAL vaginal wall. Cysts located in anterolateral vaginal wall, typically upper one-third. Distinguished from Bartholin's cysts (posterolateral, lower vagina).\"},\n {id:58,stem:'Endometrial sampling for diagnosis of ovulation is done on which day of menstrual cycle?',correct:'21st to 23rd day',options:['8th - 10th day','12th day','14th day','21st to 23rd day'],exp:'Endometrial sampling for ovulation: days 21\u201323 (7\u20138 days post-ovulation). Shows secretory changes if ovulation occurred. Early sampling shows only proliferative changes. Detects luteal phase defect.'},\n {id:59,stem:'Primary Dysmenorrhoea can be treated by which of the following?\\n1. Antiprostaglandin\\n2. Cyclic combined estrogen and progesterone preparations\\n3. Pre-sacral neurectomy\\n4. Uterine curettage',correct:'1, 2 and 3',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:\"Primary dysmenorrhoea treatments: NSAIDs\/antiprostaglandins \u2014 first line (1), cyclic combined E+P \u2014 second line (2), pre-sacral neurectomy \u2014 severe refractory cases (3). Uterine curettage is NOT a treatment and risks Asherman's syndrome (4 false).\"},\n {id:60,stem:'Which one of the following is correct regarding obesity and infertility?',correct:'It is associated with hypogonadotropic hypogonadism',options:['It is associated with hypogonadotropic hypogonadism','It is associated with hypergonadotropic hypergonadism','There is no change in HPO axis','It is always associated with endometrial atrophy'],exp:'Obesity causes HYPOgonadotropic HYPOgonadism: excess adipose aromatises androgens to oestrogens \u2192 sustained oestrogen feedback \u2192 suppresses GnRH pulsatility \u2192 oligo-anovulation. Weight loss alone can restore ovulation.'},\n {id:61,stem:'Which one of the following is an abnormal parameter in accordance with WHO Serum Analysis Criteria?',correct:'Viscosity > 4',options:['Volume >= 2 ml','Viscosity > 4','Progressive forward motility of sperms > 50%','Normal morphology of sperms > 14%'],exp:'WHO 2010 normal references: Volume \u22651.5 mL, progressive motility \u226532%, morphology \u22654%. Viscosity scored 1\u20134; viscosity >4 is ABNORMAL (hyperviscosity impairs sperm transport). Volume \u22652 mL, PR >50%, morphology >14% are normal\/above-normal.'},\n {id:62,stem:'Which of the following are causes of GnRH dependent precocious puberty?\\n1. Constitutional\\n2. Tubercular Encephalitis\\n3. McCune-Albright syndrome\\n4. Primary hypothyroidism',correct:'1, 2 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'GnRH-dependent (central) PP: Constitutional (1), CNS lesions including Tubercular encephalitis (2), Primary hypothyroidism\/Van Wyk-Grumbach syndrome (4). McCune-Albright is GnRH-INDEPENDENT (3 incorrect). Statements 1, 2 and 4 correct.'},\n {id:63,stem:'Which one of the following is the most important haematological condition to be ruled out while investigating a case of puberty menorrhagia?',correct:'Coagulation disorder',options:['Anaemia','Coagulation disorder','G-6PD deficiency','Leukemia'],exp:'Most important: COAGULATION DISORDER \u2014 particularly von Willebrand disease (most common inherited bleeding disorder, ~1% prevalence), frequently presenting as menorrhagia at menarche. Iron deficiency anaemia is a consequence, not a cause.'},\n {id:64,stem:'A couple presents with inability to conceive for 3 years. Husband was advised semen analysis. What is the WHO criterion for minimum sperm count per ml in normal semen?',correct:'15 million',options:['10 million','15 million','30 million','40 million'],exp:'WHO 2010 lower reference for sperm concentration = 15 million\/mL (replacing old 20 million\/mL). Total sperm count lower reference = 39 million\/ejaculate. Oligozoospermia: <15 million\/mL.'},\n {id:65,stem:'Which of the following are risk factors for developing pelvic inflammatory disease in females?\\n1. Use of oral contraception pills\\n2. Multiple sexual partners\\n3. Lower socioeconomic status\\n4. Genetic predisposition',correct:'2, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'OCP is PROTECTIVE against PID \u2014 thickens cervical mucus, reduces ascending infection. Statement 1 is incorrect. PID risk factors: multiple sexual partners (2), lower SES (3), genetic predisposition (4). Statements 2, 3 and 4 correct.'},\n {id:66,stem:'A 65-year-old postmenopausal lady presents with abdominal distension and weight loss, diagnosed with ovarian tumour. The most common type would be',correct:'Epithelial tumor',options:['Germ cell tumor','Sex cord tumor','Epithelial tumor','Trophoblastic tumor'],exp:'Epithelial ovarian tumours: 65\u201370% of all ovarian tumours, 90% of malignancies, most common in postmenopausal women (peak 55\u201365 years). Germ cell tumours predominate below 30 years. CA-125 is the key marker.'},\n {id:67,stem:\"Which of the following are the characteristic features of Meigs' syndrome in a female?\\n1. Right sided hydrothorax\\n2. Ascites\\n3. Genital warts\\n4. Fibroma ovary\",correct:'1, 2 and 4',options:['1, 2 and 3','1, 3 and 4','1, 2 and 4','2, 3 and 4'],exp:\"Meigs' syndrome triad: benign ovarian FIBROMA (4) + Ascites (2) + Right-sided hydrothorax (1). Genital warts (HPV) are NOT part of Meigs' syndrome (3 incorrect). All three resolve after tumour removal. Statements 1, 2 and 4 correct.\"},\n {id:68,stem:'A 25-year-old girl presents with abdominal pain, heavy menstrual bleeding with a mass corresponding to 16 weeks gravid uterus. Urine pregnancy test is negative. The most likely diagnosis would be',correct:'Uterine fibroid',options:['Pelvic inflammatory disease','Uterine fibroid','Ovarian tumour','Endometriosis'],exp:'Uterine fibroid: firm non-tender mass corresponding to 16-week uterine size, heavy menstrual bleeding, negative pregnancy test. Most common benign pelvic tumour in reproductive-age women. PID would have fever and tenderness.'},\n {id:69,stem:'A 39-year-old nulliparous female presents with post-coital bleeding for 6 months. The first investigation to be offered will be',correct:'Pap smear',options:['Colposcopy','Dilatation and Curettage','Pap smear','Cone Biopsy of Cervix'],exp:'Post-coital bleeding: red flag for cervical pathology. FIRST investigation = PAP SMEAR (cervical cytology) \u2014 non-invasive, inexpensive screening. If abnormal \u2192 colposcopy. Colposcopy and D&C are not first-line investigations.'},\n {id:70,stem:'Procidentia as a degree of uterovaginal prolapse is characterised by descent of',correct:'uterine cervix body with fundus outside vagina with eversion of entire vagina',options:['uterus into vagina','uterine cervix outside vagina but uterine body inside vagina','uterine cervix below ischial spine','uterine cervix body with fundus outside vagina with eversion of entire vagina'],exp:'Procidentia (complete prolapse): entire uterus below the vulva with complete vaginal eversion \u2014 cervix, body, and fundus all outside the vagina. Surgery: Manchester repair or vaginal hysterectomy with pelvic floor repair.'},\n {id:71,stem:'Which of the following are indications of vaginal examinations during labour?\\n1. To stretch the vagina intermittently\\n2. At the onset of labour\\n3. To monitor progress of labour\\n4. Following rupture of membranes',correct:'2, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'VE during labour indications: at onset (2), to monitor progress every 4 hours (3), following membrane rupture to exclude cord prolapse (4). \"To stretch the vagina intermittently\" (1) is NOT a valid indication. Statements 2, 3 and 4 correct.'},\n {id:72,stem:'Which one of the following statements regarding Rh isoimmunization are correct?\\n1. Liley\\'s chart identifies anemia better than middle cerebral artery doppler\\n2. Indirect Coomb\\'s test is positive in mother\\n3. Baby is at risk of developing anemia\\n4. Direct Coomb\\'s test is positive in baby',correct:'2, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:\"Statement 1 FALSE: MCA Doppler PSV is SUPERIOR to Liley's chart for non-invasive prediction of fetal anaemia. Indirect Coombs positive in MOTHER (2), baby at risk of haemolytic anaemia (3), Direct Coombs positive in BABY (4). Statements 2, 3 and 4 correct.\"},\n {id:73,stem:'As per ICMR guidelines, which of the following are the criteria for SARS-COV-2 exposure for a pregnant female during COVID-19 pandemic?\\n1. Travel to an affected country within previous 14 days\\n2. Close contact with a confirmed case within a distance of 1 metre for more than 15 minutes\\n3. Living in neighbourhood of a confirmed case\\n4. Direct contact with body fluids of a confirmed case',correct:'1, 2 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'ICMR exposure criteria: travel within 14 days (1), close contact within 1 metre for >15 minutes (2), direct contact with body fluids (4). Living in neighbourhood alone is NOT sufficient (3 incorrect). Statements 1, 2 and 4 correct.'},\n {id:74,stem:'Which of the following are the clinical features of septic abortion?\\n1. Persistent tachycardia >= 90 bpm\\n2. Impaired mental status\\n3. Hypothermia',correct:'1, 2 and 3',options:['1 and 2 only','2 and 3 only','1 and 3 only','1, 2 and 3'],exp:'Septic abortion features (SIRS\/sepsis): persistent tachycardia \u226590 bpm (SIRS criterion), impaired mental status (organ dysfunction sign), hypothermia <36\u00b0C (SIRS criterion \u2014 includes both fever AND hypothermia). All three correct.'},\n {id:75,stem:'Consider the following statements:\\nStatement-1: In fetal growth restriction there is always oligohydramnios\\nStatement-2: In fetal growth restriction there is placental insufficiency leading to redistribution of blood flow to fetal brain shunting it from fetal kidney\\nWhich one of the following is correct?',correct:'Statement-2 is true but Statement-1 is false',options:['Both Statement-1 and Statement-2 are true and Statement-2 is the correct explanation for Statement-1','Both Statement-1 and Statement-2 are true and Statement-2 is not the correct explanation for Statement-1','Statement-1 is true but Statement-2 is false','Statement-2 is true but Statement-1 is false'],exp:'Statement 1 FALSE: FGR does NOT always cause oligohydramnios \u2014 many FGR fetuses have normal AFI. Statement 2 TRUE: brain-sparing redistribution (blood shunted from kidneys to brain via placental insufficiency) is correct pathophysiology.'},\n {id:76,stem:'Which of the following are correct regarding failure rate of contraceptive methods?\\n1. Depot medroxyprogesterone acetate 0 to 1 per HWY\\n2. Norplant 0.1 per HWY\\n3. LNG-IUS 0.02 per HWY\\n4. Levonorgestrel 3 per HWY',correct:'1, 2 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Failure rates: DMPA 0\u20130.7\/HWY (1 correct), Norplant ~0.05\u20130.1\/HWY (2 correct), Levonorgestrel pill ~3\/HWY (4 correct). LNG-IUS published rate is 0.1\u20130.2\/HWY \u2014 statement 3 (0.02) understates this. Best examination answer: statements 1, 2 and 4.'},\n {id:77,stem:'Consider the following in respect of Ormeloxifene:\\n1. It is a research product of Central Drug Research Institute, Lucknow\\n2. It is a steroidal compound\\n3. It is a potent antiestrogen with weak estrogenic properties\\n4. It does not inhibit ovulation',correct:'1, 3 and 4',options:['1 and 3 only','1, 3 and 4','2, 3 and 4','1, 2 and 4'],exp:'Ormeloxifene (Centchroman\/Saheli): CDRI, Lucknow product (1 correct), NON-STEROIDAL benzopyran SERM \u2014 statement 2 FALSE, potent antiestrogen with weak oestrogenic properties (3 correct), does not inhibit ovulation (4 correct). Statements 1, 3 and 4 correct.'},\n {id:78,stem:'Steroidal contraceptives available in the basket of contraceptive choice from Ministry of Health & Family Welfare, Government of India are',correct:'Monophasic',options:['Monophasic','Biphasic','Triphasic','Estrogen only pills'],exp:\"India MoHFW provides MONOPHASIC combined OCP in the national family planning basket: Mala-N (Norgestrel + EE) and Mala-D (Norethindrone + EE) \u2014 both monophasic (fixed doses throughout the 21-day pack).\"},\n {id:79,stem:'Which of the following are absolute contraindications of Combined Oral Contraceptive (COCs)?\\n1. Arterial or venous thrombosis history\\n2. Severe hypertension\\n3. Gestational trophoblastic neoplasia\\n4. Diabetes with vascular complications',correct:'1, 2 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'COC absolute contraindications: thrombosis history (1), severe hypertension >160\/100 (2), diabetes with vascular complications (4). GTN is WHO MEC Category 1 for COC after hCG normalisation \u2014 RECOMMENDED post-GTN (3 incorrect). Statements 1, 2 and 4 correct.'},\n {id:80,stem:'After male sterilization, additional contraceptive protection is',correct:'needed for 2 to 3 months',options:['needed for 1 month','needed for 1 to 2 months','needed for 2 to 3 months','not needed'],exp:'After vasectomy, additional contraception needed for 2\u20133 months until azoospermia confirmed on two consecutive semen analyses (~12 weeks). 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Submitting in 10 Submit Now Combined Medical Services Examination 2021Paper II \u00b7 Part 2 Gynaecology & Obstetrics Questions 41 \u2013 80 Options reshuffled \u23f1 Start Timed Mode Submit Answers 0%score Your Result \u21ba Retry Quiz<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[18],"tags":[],"class_list":["post-36606","post","type-post","status-publish","format-standard","hentry","category-cms"],"yoast_head":"\n<title>CMS 2021 P2 Part-2 OBG - atsixty<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/18\/cms-2021-p2-part-2-obg\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CMS 2021 P2 Part-2 OBG - atsixty\" \/>\n<meta property=\"og:description\" content=\"CMS 2021 Paper II \u2013 Part 2 (Q41\u2013Q80) \u23f1 40:00 \u2705 0 \u274c 0 \u23f3 40 left Net 0 \/ 160 Time's Up! 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