#Kathmandu University
BIRAT MEDICAL COLLEGE
Budhiganga-02, Tankisinuwari, Morang
Level: Final MBBS (Batch: 2021)
Semester: 8th
Time: 2 hrs. 30 mins.
Date: March 19, 2026
Examination: End-Semester
Subject: Obst. & Gynae.
Marks: 50
#INSTRUCTION TO THE CANDIDATE
Answer each section in a separate answer book.
Write brief, relevant and legible answers.
Illustrate your answer with well labeled diagrams where required.
All questions are compulsory.
#SECTION 'B'
Short Answer Questions [6Q × 5 = 30 marks]
Briefly mention about management of labor of heart disease in pregnancy. [5]
Define shoulder dystocia. Write the algorithm for its management. [1+4=5]
Define IUGR. What are the causes of IUGR? Differentiate between symmetrical and asymmetrical IUGR. [1+2+2=5]
Write down two indication for HRT. Discuss the different HRT regimens and write down four contraindications of HRT. [1+4=5]
Enumerate the indications of operative vaginal delivery. Differentiate between forceps and Ventouse. [2+3=5]
Define PPROM. Outline the management of PPROM at 34 weeks of gestation. [1+4=5]
#SECTION 'C'
Problem Based Questions / Modified Essay Questions [2Q × 10 = 20 marks]
#Problem I
45 yrs. old lady presented in OPD with complain of foul-smelling discharge for 6 months. O/E Pt was thin built ill looking. P/S examination showed fibrosed vaginal wall with dirty looking growth on the cervix which started to bleed in insertion of speculum.
a. Enlist the points you would like to ask on history. [2]
b. What is your diagnosis? [1]
c. What are the different methods for the screening of this patient? [2]
d. Write down the FIGO Staging of CA Cervix. [3]
e. What are risk factors for CA Cervix? [2]
#Problem II
A 26-year-old primigravida at 38 weeks of gestation presents to the labor ward with regular uterine contractions. On abdominal examination the fetal head is felt in the fundus and the buttocks are present in the lower uterine segment.
a. What is breech presentation? List the types of breech presentation. [3]
b. Mention four causes/risk factors associated with breech presentation. [2]
c. List the mechanism of labor in breech delivery. [3]
d. Mention two complications of breech delivery for the fetus. [2]