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Medical Obstetrics and Gynecology — MCQ ও উত্তর

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  1. Which layer forms the main component of the placental barrier?

    1. Cytotrophoblast
    2. Syncytiotrophoblast
    3. Amnion
    4. Decidua basalis

    সঠিক উত্তর: Syncytiotrophoblast

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B The syncytiotrophoblast forms the main component of the placental barrier because it is the outer multinucleated layer of the trophoblast that directly interfaces with maternal blood in the intervillous spaces. This layer facilitates nutrient and gas exchange while maintaining a selective barrier to protect the fetus from harmful substances. Unlike the cytotrophoblast, which is a cellular layer beneath, the syncytiotrophoblast has no cell boundaries, allowing efficient transport and secretion of hormones such as hCG. The amnion and decidua basalis are maternal or fetal membranes but do not contribute primarily to the placental barrier function. Understanding this is crucial in surgeries involving the placenta to avoid disrupting this key exchange layer.Reference: Gray's Anatomy, Standring S., 42nd Edition.

  2. At what point in gestation does the placenta become fully functional?

    1. End of first trimester
    2. Second week
    3. At birth
    4. After implantation

    সঠিক উত্তর: End of first trimester

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option A The placenta begins forming soon after implantation, but it becomes fully functional by the end of the first trimester (around 12 weeks gestation). At this point, the placenta effectively takes over the roles of nutrient and gas exchange, hormone production, and waste elimination from the embryo. Prior to this, the embryo relies on the yolk sac and uterine secretions for nourishment. Full placental function is critical for sustaining fetal growth and development throughout pregnancy. This transition marks a key physiological milestone in gestation.Reference: Williams Obstetrics, Cunningham et al., 25th Edition.

  3. What proportion of pregnancies are classified as high-risk?

    1. 5-10%
    2. 20-30%
    3. 50-60%
    4. Over 70%

    সঠিক উত্তর: 20-30%

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B Approximately 20-30% of pregnancies are classified as high-risk due to factors such as maternal age, pre-existing medical conditions, obstetric complications, or multiple gestations. This proportion reflects a balance where significant monitoring and potential interventions are necessary to optimize maternal and fetal outcomes. Identifying high-risk pregnancies allows for appropriate specialized care and timely surgical interventions when complications such as preeclampsia, placenta previa, or fetal distress arise, which improves prognosis. Therefore, this classification is crucial for guiding clinical decision-making and resource allocation in obstetrics.Reference: Williams Obstetrics, Cunningham FG, 25th Edition.

  4. What is the main objective of genetic counseling in pregnancy?

    1. To prevent all genetic disorders
    2. To provide information for informed decision-making
    3. To recommend termination of pregnancy
    4. To select the baby's gender

    সঠিক উত্তর: To provide information for informed decision-making

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B The main objective of genetic counseling in pregnancy is to provide accurate, clear, and comprehensive information to expecting parents about potential genetic risks, inheritance patterns, and available testing options. This empowers them to make informed and autonomous decisions regarding their pregnancy and reproductive options, without imposing judgment or directives. Genetic counseling supports personalized risk assessment and facilitates understanding of complex genetic information, promoting psychological well-being and preparedness. It is not aimed at preventing all disorders, recommending termination, or selecting traits, but rather at enabling informed choice based on individual values and circumstances. Reference: Emery’s Elements of Medical Genetics, Peter D. Turnpenny, 16th Edition.

  5. Which hormone is primarily responsible for maintaining pregnancy?

    1. Estrogen
    2. Progesterone
    3. hCG
    4. Prolactin

    সঠিক উত্তর: Progesterone

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B Progesterone is primarily responsible for maintaining pregnancy by preparing and sustaining the uterine lining (endometrium) for embryo implantation and preventing uterine contractions that could lead to miscarriage. It supports the development of the placenta and modulates the maternal immune response to tolerate the fetus. Unlike estrogen, which mainly promotes uterine growth, progesterone ensures a stable environment for fetal development throughout pregnancy. Although hCG supports early progesterone production by the corpus luteum, progesterone itself is the key hormone for pregnancy maintenance. Reference: Williams Obstetrics, Cunningham, 25th Edition.

  6. What is a typical early symptom of pregnancy?

    1. Morning sickness
    2. Leg swelling
    3. Back pain
    4. Shortness of breath

    সঠিক উত্তর: Morning sickness

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option A A typical early symptom of pregnancy is morning sickness, characterized by nausea and vomiting, usually beginning around the 6th week of gestation. This symptom results from hormonal changes, especially increased levels of human chorionic gonadotropin (hCG) and estrogen. Morning sickness helps clinicians identify early pregnancy before more definitive signs such as fetal heart tones or ultrasound confirmation. Other symptoms like leg swelling, back pain, or shortness of breath usually occur later in pregnancy due to physiological changes in blood volume, posture, or respiratory demand. Hence, morning sickness is a common, reliable early clinical feature.Reference: Williams Obstetrics, Cunningham et al., 25th Edition.

  7. Which sexually transmitted infection should be screened for during preconception counseling?

    1. Syphilis
    2. HIV
    3. Chlamydia
    4. Gonorrhea

    সঠিক উত্তর: HIV

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B HIV screening in preconception counseling is crucial because early identification and treatment reduce the risk of mother-to-child transmission during pregnancy, labor, and breastfeeding. Initiating antiretroviral therapy before conception improves maternal health and significantly decreases perinatal HIV transmission. Universal HIV screening is recommended for all women planning pregnancy to ensure timely intervention and optimize outcomes. This proactive approach is part of standard prenatal care to protect both mother and child. Reference: Williams Obstetrics, Cunningham, 25th Edition.

  8. What is the primary function of protein during pregnancy?

    1. Energy storage
    2. Fetal tissue growth
    3. Hormone production
    4. Calcium absorption

    সঠিক উত্তর: Fetal tissue growth

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B Protein is essential during pregnancy primarily for fetal tissue growth. It provides the necessary amino acids required for the development of fetal organs, muscles, and overall cellular structure. Adequate protein intake supports the rapid cell division and differentiation happening in the fetus. Additionally, protein contributes to the growth of maternal tissues such as the uterus and placenta. Unlike energy storage or calcium absorption, the key role of protein is to build and repair tissues, making it critical for healthy fetal development. Reference: Maternal & Child Health Nursing, Adele Pillitteri, 7th Edition.

  9. How is hyperemesis gravidarum best described?

    1. Mild morning sickness
    2. Severe vomiting with dehydration
    3. Constipation in pregnancy
    4. Heartburn after meals

    সঠিক উত্তর: Severe vomiting with dehydration

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B Hyperemesis gravidarum is best described as severe and persistent vomiting during pregnancy that leads to significant dehydration, electrolyte imbalances, and weight loss. Unlike mild morning sickness, it requires medical intervention due to risks of maternal and fetal complications. The condition often necessitates hospitalization for intravenous fluid replacement and antiemetic therapy. Recognition and timely treatment are crucial to prevent adverse outcomes. Reference: Williams Obstetrics, Cunningham et al., 26th Edition.

  10. Which maternal position is optimal for normal labor progression?

    1. Supine with legs extended
    2. Upright and mobile positions
    3. Left lateral only
    4. Prone position

    সঠিক উত্তর: Upright and mobile positions

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B The upright and mobile positions during labor optimize uterine contractions and improve fetal alignment with the birth canal, facilitating effective descent. These positions enhance pelvic diameter, increase gravity-assisted fetal movement, and reduce maternal discomfort. Additionally, mobility promotes better maternal cardiovascular and respiratory functioning, which supports improved oxygen delivery to the fetus. Clinical evidence shows that such positions are associated with a shorter duration of labor and decreased need for instrumental delivery or cesarean section. Reference: Williams Obstetrics, Cunningham et al., 25th Edition.

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