Which of the following regarding
uterine descent is not correct?
a) First degree descent implied the cervix descends
below its normal Ievel on straining but does not
protrude from the vulva
b) First degree descent implied the cervix descends
below its normal Ievel on straining and
protrudes from the vulva
c) Second degree descent implies the cervix
reaches upto the vulva on straining
d) Procidentia means whole of the uterus is
prolapsed outside the vulva
Answer
• b
Which of the following are etiologies
of uterovaginal prolapse :
a)
b)
c)
d)
e)
f)
Aging
Estrogen deprivation
Intrinsic collagen abnormalities
Chronic increase in intraabdominal pressure
Acute and chronic trauma of vaginal delivery
All of above
Answer
• f
All of the following are supports of the
uterus except:
a)
b)
c)
d)
e)
Mackenrodt’s ligaments
Uterosacral ligaments
Broad ligament
Pubocervical fascia
Rectovaginal fascia
Answer
• c
Following are the first level of support
in DeLancy system
a)
b)
c)
d)
e)
Cardinal ligament
Pubocervical fascia
Rectovaginal fascia
Pubo-urethral ligaments
Perineal body
Answer
a
Following is not a posterior vaginal
wall defect
a)
b)
c)
d)
Enterocele
Rectocele
Perineal body descent
Perineal tear
Answer
• a
Which of the following is false regarding the
examination of a patient with prolapse?
a) The maximal extent of prolapse is demonstrated with
a standing straining examination when the bladder is
empty
b) Resting tone & voluntary contraction of the anal
sphincters should be assessed during rectovaginal
examination
c) Women with prolapse and urinary incontinence
should have stress testing performed with the
prolapse reduction because this will mimic bladder
and urethral function when the prolapse is treated
d) Screening for presence of UTI or CIN is not needed at
the time of examination
Answer
• d
Which of the following is not an
indication for use of pessary
a) When future childbearing is intended in near
future
b) Refusal for operation by patient
c) As a therapeutic test
d) Prolapse with pregnancy
e) Non healing decubitus ulcer
Answer
• e
All of the following are complications
associated with pessary except
a)
b)
c)
d)
e)
f)
B.vaginitis, ulceration of vaginal wall
Cervicitis
Carcinoma of vaginal wall
Impaction of pessary
Reduction of prolapse
Strangulation of prolapsed tissue
Answer
• e
Following are true for management of
prolapse except
a) Any decision for surgical intervention should take
account of how prolapse is affecting lifestyle
b) Vaginal pessary can be used in elderly patients with
prolapse with associated medical complications which
contradict surgery
c) Vaginal hysterectomy is the only treatment of
prolapse in all women
d) Sling surgeries are indicated in women desiring to
retain reproductive function
e) Assessment of SUI is must during examination of
prolapse so that the same can be corrected during
surgery
Answer
• c
Managenent of 3rd degree prolapse in
a 27yrs P1+0 can be all except
a)
b)
c)
d)
Vaginal hysterectomy
Fothergill’s surgery
Sling surgery
Ring pessary
Answer
• a