OBS-GYN Important Questions for NEET PG/FMGE 2025

If you are preparing for the NEET PG/FMGE exam, you cannot forget about one of the most crucial subjects; OBS-GYN. This subject focuses on topics ranging from pregnancy to childbirth and conditions affecting the female reproductive system.

Mastering this subject is essential not only for succeeding in the exams. But, also for future clinical practice.

For helping you conquer the vast syllabus, we have curated a list of important OBS-GYN questions covering high-yield topics. And, these questions come with detailed explanations to deepen your understanding.

Without further ado, let’s dive straight in and explore all the questions to help you prepare effectively.

Q.1 A 28-year-old woman presented to the clinic with continuous urinary leakage through the vagina following a history of prolonged obstructed labour 4 months ago. Which of the following is the most common type of fistula in this scenario?

1. Urethrovaginal fistula
2. Ureterovaginal fistula
3. Vesicovaginal fistula
4. Rectovaginal fistula

Correct Answer: C) Vesicovaginal fistula

Explanation: The most common fistula after obstructed labour is the Vesicovaginal fistula, especially following traumatic labour.

Q.2 A 25 y/o newly married woman wants effective contraception with a minimum failure rate. Which contraceptive method would be the most suitable for her considering both efficacy and ease of use?

1. Implants
2. Oral Pills
3. Condoms
4. Intrauterine Device (IUD)

Answer: A) Implants

Explanation:

Contraceptive Method	Indication	Pearl Index (Failure Rate per 100 Woman-Years)
Oral Contraceptive Pills (OCPs)	Women with irregular menstrual cycles or acne seeking contraception	0.3 - 9
Intrauterine Device (IUD)	Long-term contraception; contraindications to estrogen	0.1 - 0.8 (Copper)0.1 - 0.2 (Hormonal)
Condoms (Male)	Prevention of STIs and contraception	2 - 18
Condoms (Female)	Non-hormonal, barrier method	5 - 21
Contraceptive Implant	Long-term contraception; high efficacy, minimal user interventionConsidered in women with seizures or sickle cell disorder	0.05 - 0.3
Contraceptive Injection (e.g., Depo-Provera)	Long-term, non-daily hormonal contraception; those who cannot use estrogen	0.2 - 6
Vaginal Ring (e.g., NuvaRing)	Monthly regimen with local hormone delivery	0.3 - 9
Sterilization (Female Tubal Ligation)	Permanent contraception	0.5 - 0.1
Sterilization (Vasectomy)	Permanent contraception; more effective than female sterilization	0.1 - 0.15
Natural Family Planning	Natural method, often for religious or personal reasons	2 - 25
Emergency Contraception Pills	Post-coital contraception	1 - 2
Lactational Amenorrhea Method (LAM)	Breastfeeding women, within first 6 months postpartum with exclusive breastfeeding and amenorrhea	0.5 - 2

Q.3 A 28-year-old female G2P1 presents to the clinic at 7 weeks gestation by LMP. She reports using an intrauterine contraceptive device (IUCD) for contraception. On examination, the IUCD strings are not visualized on the speculum exam. Which of the following is the most appropriate next step in management?

1. Combined oral contraceptive pills
2. Pelvic ultrasound
3. Hysterosalpingogram
4. Reassurance and observation

Correct Answer: B) Pelvic ultrasound

Explanation:

The next step in management is to determine the location of the pregnancy to rule out ectopic pregnancy and the location of IUCD. This can be best accomplished with a pelvic ultrasound.

Q.4 A 28-year-old woman presents with a complaint of not having had a menstrual period for the past six months. She reports that her menstrual cycles were previously regular, occurring every 28 days. Her medical history is significant for hypothyroidism, for which she takes levothyroxine. A pregnancy test is negative. Which of the following is the most appropriate initial diagnostic test to evaluate this patient's secondary amenorrhea further?

1. Serum prolactin level
2. Serum FSH and LH levels
3. Pelvic ultrasound
4. Serum estradiol level

Correct Answer: A) Serum prolactin level

Explanation: 

• The most appropriate initial diagnostic test for evaluating secondary amenorrhea in this patient is serum prolactin level. 
• Elevated prolactin can inhibit gonadotropin-releasing hormone (GnRH) secretion, leading to secondary amenorrhea. Since the patient has a history of hypothyroidism, which can also cause elevated prolactin levels, checking serum prolactin is a crucial first step. 
• If prolactin levels are normal, further evaluation with FSH, LH, and estradiol can be considered to assess ovarian function and rule out other endocrine causes. 

Q. 5 A 14-y/o girl presents with complaints of cyclic lower abdominal pain for the past 6 months. She has not yet had her menarche. Abdominal examination reveals a palpable mass extending up to the umbilicus. The genital examination shows the following findings. What is the most likely diagnosis?

1. Transverse Vaginal Septum
2. Imperforate Hymen
3. Polycystic Ovarian Syndrome 
4. Vaginal Agenesis

Correct Answer: B) Imperforate Hymen

Explanation:

Imperforate hymen:

• Cause: This congenital condition involves a hymen that completely obstructs the vaginal opening, leading to the accumulation of menstrual blood behind the hymen.
• Clinical features:
  • Cyclic lower abdominal pain
  • Primary amenorrhea
  • Suprapubic bulge due to Hematocolopos (blood build up in uterus)
  • Urinary symptoms- Frequency/Retention/dysuria
  • Tense Blue bulging membrane at vaginal introitus
• Diagnosis: Clinical examination & USG 
• Treatment: Cruciate incision to release menstrual blood - leads to normal reproductive function

Q.6. A 30-year-old woman with a history of moderate to severe pelvic pain due to endometriosis was prescribed continuous leuprolide three months ago. Despite treatment, she presents again with persistent pelvic pain that interferes with daily activities and quality of life. What is the most appropriate next step in the management?

1. Increase the dose of GnRH agonist
2. Expectant management
3. Laparoscopy
4. Add progestins

Correct Answer: C)  Laparoscopy

Explanation: Laparoscopy is the preferred next step for moderate to severe pain as it allows for direct visualisation and surgical management of endometriosis, including fulguration of lesions, adhesiolysis, and management of endometriomas. This approach aims to provide symptomatic relief.

Q. 7 A 24-year-old sexually active woman presents to the clinic with lower abdominal pain, fever, and unusual vaginal discharge. She is diagnosed with pelvic inflammatory disease. What is the most appropriate initial treatment regimen for this patient?

1. Azithromycin 1 g PO OD + Metronidazole 500 mg PO BD X  14 days
2. Ceftriaxone 500 mg I.M OD + Doxycycline 100 mg PO BD X 14 days + Metronidazole 500 mg PO BD X 14 days
3.  Levofloxacin 500 mg PO OD X 14 days, and Metronidazole 500 mg PO BD X 14 days
4. Amoxicillin-clavulanate 875 mg/125 mg PO BD X 14 days, and Doxycycline 100 mg PO BD X 14 days

Correct Answer: B) Ceftriaxone 500 mg I.M OD + Doxycycline 100 mg PO BD X 14 days + Metronidazole 500 mg PO BD X 14 days

Explanation:

Ceftriaxone, Doxycycline, and Metronidazole cover the spectrum of organisms commonly involved in PID.

• Ceftriaxone covers Neisseria gonorrhoeae, an important pathogen associated with PID. 
• Doxycycline covers Chlamydia trachomatis and other intracellular organisms. 
• Metronidazole targets anaerobes, often found in the pelvis polymicrobial infections.

Q.8 A 25-year-old female presents with complaints of a sudden, profuse, and offensive vaginal discharge. On examination, her vulva is inflamed and her vaginal walls are red and inflamed with small, punctate, hemorrhagic spots. A wet mount microscopy of her vaginal discharge reveals motile, pear-shaped, flagellated organisms. Which of the following statements is true in this scenario? 

1. Vaginal pH < 4.5
2. Male sexual partners to be treated at the same time
3. Absence of pruritus
4. Treated by Intravaginal clotrimazole

Correct Answer: B) Male sexual partners to be treated at the same time

Explanation:

The presence of motile, pear-shaped flagellated trichomonas on wet mount microscopy is a characteristic feature of Trichomonas vaginalis. Trichomoniasis is a sexually transmitted infection, so the patient's sexual partner should also be treated.

Q.9 A 32-year-old woman presents with a 6-month history of secondary amenorrhea and pelvic pain. She reports intermittent fever and significant weight loss over the past few months. On physical examination, there is tenderness in the lower abdomen, and an adnexal mass is palpated. Given these findings, what is the most likely diagnosis?

1. Polycystic Ovary Syndrome (PCOS)
2. Endometriosis
3. Genital Tuberculosis
4. Ectopic Pregnancy

Correct Answer: C) Genital Tuberculosis
Explanation:
In this clinical scenario, the patient's history and physical examination findings raise high suspicion of genital tuberculosis (TB).

Q.10 Identify the procedure done to assess infertility, which is given below.

1. Saline-infusion sonography
2. Hysterosalpingography
3. Sonoelastography
4. Contrast-enhanced sonography

Correct Answer: B) Hysterosalpingography

Explanation: 

The above image shows hysterosalpingography with normal uterine filling and bilateral patent tubes.

Hysterosalpingography (HSG):

• Visualising the uterine cavity & fallopian tubes by retrograde injection of radiocontrast dye to identify filling defects & blocks.

Preparation	NSAID 30 minutes before to prevent tubal spasm.Paracervical block in patients with cervical stenosis.
4 phases of radiographic images taken	Pre-contrast preliminary.During contrast filling.Contrast spillage into peritoneum.During deflation and withdrawal.
Contraindications	Acute pelvic infections.Active uterine bleeding.Allergic to iodine.Pregnancy.
Doxycycline can be given	If dilated tubes are identified (indicating previous pelvic infection).As prophylaxis to prevent infections post-HSG.
Complications	Pelvic discomfort.Uterine perforation.Vasovagal reactions.Dye allergy.Intravascular dissemination of the dye.

Q.11 A 32 y/o female presents with irregular vaginal bleeding and post-coital bleeding for the past 3 months. Pelvic examination reveals a 3 cm exophytic lesion on the cervix. Biopsy confirms the diagnosis of squamous cell carcinoma of the cervix. The patient is deeply concerned about preserving her fertility. What is the most appropriate management for this patient?

1. Radical hysterectomy with bilateral salpingo-oophorectomy
2. Chemoradiation 
3. Radical trachelectomy with pelvic lymphadenectomy
4. Conization 

Correct Answer: C) Radical trachelectomy with pelvic lymphadenectomy

Explanation:

Radical trachelectomy is a fertility-sparing surgical procedure and, therefore, balances cancer treatment with the patient's desire for future childbearing. 

Q.12 Which statement regarding Type 1 and Type 2 Endometrial carcinoma is correct?

1. Type 1 is more aggressive and has a poor prognosis than Type 2
2. Type 1 is associated with estrogen excess in young & obese women
3. Type 2 is typically low-grade and non-metastasized compared to Type 1
4. Type 2 is often estrogen-dependent and associated with hyperplasia.

Answer: B) Type 1 is associated with estrogen excess in young & obese women.

Explanation:

• Type 1 Endometrial Carcinoma is associated with estrogen excess, whereas Type 2 is independent of it. 
• In young women, particularly those with obesity, there is an increased production of estrogen due to adipose tissue converting androgens into estrogen.

Q. 13 A 45-year-old woman presents with abdominal distension and discomfort for the past few months. On examination, there is bilateral pelvic tenderness with a palpable pelvic mass. Ultrasound confirms a large cystic lesion 8-10 cm in the right ovary with irregular solid areas. Serum CA-125 levels are elevated. Which of the following epithelial ovarian tumors is most likely to present with the described clinical findings?

1. Mucinous cystadenocarcinoma
2. Serous cystadenocarcinoma
3. Endometrioid carcinoma
4. Brenner tumor

Answer: B. Serous cystadenocarcinoma

Explanation:
Serous cystadenocarcinoma is the most common epithelial ovarian carcinoma, typically presenting with bilateral ovarian involvement, elevated CA-125 levels, and a mix of cystic and solid components on imaging. 

Q.14 A 68-year-old woman presents with a 3 cm ulcerated lesion on the left labia majora. Biopsy confirms invasive squamous cell carcinoma. Physical examination reveals two palpable, mobile lymph nodes in the left groin, each measuring approximately 1 cm in diameter. What is the most likely FIGO stage of her vulvar cancer?

1. Stage IA
2. Stage IB
3. Stage IIIA 
4. Stage IVA

Correct Answer: C) Stage IIIA 

Explanation:

The patient in this scenario has a T2 tumor (>2 cm in size) with the involvement of two inguinal lymph nodes (N2a). According to the FIGO staging for invasive vulvar cancer, this clinical presentation corresponds to Stage IIIA.

Q15. All of the following criteria are used for diagnosing PCOS except?

1. Hyperandrogenism  
2. Oligomenorrhea  
3. Elevated estrogen levels  
4. Presence of ovarian cysts  

Correct Answer: C) Elevated estrogen levels  

Explanation:

Elevated estrogen levels can occur in some cases of PCOS due to disturbances in hormone regulation, it is not a primary diagnostic criterion for PCOS. 

Q.16 A 30 Y/o woman presents with difficulty sitting and walking due to the pain. On physical examination, a tender, fluctuant mass is palpated in the right inferior labia majora. Which of the following is the most appropriate initial management for this patient's condition?

1. Oral antibiotics alone
2. Aspiration of the cyst with a syringe and needle
3. Immediate referral for surgical excision of the gland
4. Incision and drainage followed by placement of a Word catheter

Correct Answer: D) Incision and drainage placement of a Word catheter

Explanation:

Based on the above scenario, the patient likely suffers from a Bartholin gland cyst.

Bartholin Gland:

• Bartholin glands are a part of the vulva.
• The ducts of the gland open into the vaginal vestibule and secrete mucus that lubricates the vulva.

Bartholin gland cyst:

• It occurs due to obstruction of the gland’s duct.
• In some cases, the contents of cyst may get infected and lead to abscess formation. The most common organisms involved are anaerobic Bacteroides and peptostreptococcus and aerobic E coli, S aureus.
• Symptoms:

• Most of the cysts are small and remain asymptomatic except for minor discomfort during sexual intercourse.
• Larger or infected cysts may cause severe pain during sitting, walking and intercourse.
• On Physical examination:
• Cysts are unilateral, fluctuant or tense and infected become tender with surrounding erythema.
• Treatment:
  • Small, asymptomatic cysts require no treatment.
  • Large or symptomatic cysts and abscesses are treated with Incision & drainage followed by placement of a Word catheter or marsupialization.

Q.17 A 28-year-old pregnant woman at 33 weeks gestation presents for a routine prenatal visit. She reports decreased fetal movements over the past two days. She has a history of gestational diabetes, and her pregnancy has been otherwise uneventful. The doctor decides to perform antepartum fetal surveillance. Which of the following is the most appropriate initial test to assess the fetal well-being in this scenario?

1. Amniotic fluid index
2. Biophysical profile
3. Contraction Stress test
4. Non Stress test

Correct Answer: D) Non Stress test

Explanation:

• The NST is a non-invasive, quick, and reliable method to assess fetal heart rate response to fetal movements, which is crucial given the reported decrease in fetal movements.
• During an NST, the mother is placed in a comfortable position, and external monitors are attached to her abdomen to record the fetal heart rate and any fetal movements for 20-30 minutes.
• A reactive NST (presence of accelerations in fetal heart rate with movements) indicates good fetal health, while a non-reactive NST (lack of sufficient accelerations) may necessitate further testing or intervention.

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