Q.1 Which of the following is the most common type of urinary incontinence in women?
Urge incontinence
Stress incontinence
Overflow incontinence
Mixed incontinence
Explanation - Stress incontinence, caused by urethral sphincter weakness and pelvic floor dysfunction, is the most common form of incontinence in women.
Correct answer is: Stress incontinence
Q.2 What is the primary risk factor for pelvic organ prolapse?
Obesity
Nulliparity
Multiparity
Smoking
Explanation - Multiparity, especially vaginal deliveries, is the leading risk factor due to repetitive trauma to the pelvic floor muscles.
Correct answer is: Multiparity
Q.3 Which muscle is most important for pelvic floor support?
Rectus abdominis
Obturator internus
Levator ani
Piriformis
Explanation - The levator ani, composed of pubococcygeus, puborectalis, and iliococcygeus, is crucial for pelvic organ support.
Correct answer is: Levator ani
Q.4 First-line treatment for stress urinary incontinence includes:
Anticholinergic drugs
Pelvic floor muscle training
Urethral bulking agents
Midurethral sling surgery
Explanation - Kegel exercises and pelvic floor training are recommended as first-line conservative management before surgery.
Correct answer is: Pelvic floor muscle training
Q.5 Which investigation is considered gold standard for diagnosing urinary incontinence?
Cystoscopy
Urodynamic study
Ultrasound pelvis
CT scan
Explanation - Urodynamic testing evaluates bladder function and is the gold standard for differentiating types of incontinence.
Correct answer is: Urodynamic study
Q.6 A woman leaks urine when coughing and sneezing but has no urgency. The most likely diagnosis is:
Overflow incontinence
Urge incontinence
Stress incontinence
Mixed incontinence
Explanation - Stress incontinence presents with leakage during activities that increase intra-abdominal pressure, without urgency.
Correct answer is: Stress incontinence
Q.7 Which surgical procedure is considered the gold standard for stress urinary incontinence?
Burch colposuspension
TVT (tension-free vaginal tape)
TOT (transobturator tape)
Urethral bulking
Explanation - TVT is the most widely accepted surgical procedure for stress incontinence with high long-term success.
Correct answer is: TVT (tension-free vaginal tape)
Q.8 Which nerve primarily innervates the external urethral sphincter?
Hypogastric nerve
Pudendal nerve
Pelvic splanchnic nerve
Obturator nerve
Explanation - The pudendal nerve supplies the external urethral sphincter, allowing voluntary control of urination.
Correct answer is: Pudendal nerve
Q.9 Cystocele is best described as:
Prolapse of the uterus into the vagina
Descent of the bladder into the anterior vaginal wall
Rectal prolapse into the vagina
Small bowel herniation into the vagina
Explanation - A cystocele occurs when the bladder bulges into the anterior vaginal wall due to weakened support.
Correct answer is: Descent of the bladder into the anterior vaginal wall
Q.10 Which of the following is NOT a risk factor for urinary incontinence?
Obesity
Vaginal delivery
Hysterectomy
Hypothyroidism
Explanation - While obesity, parity, and hysterectomy are risk factors, hypothyroidism is not directly associated with incontinence.
Correct answer is: Hypothyroidism
Q.11 Which test is commonly used for simple diagnosis of stress incontinence in clinic?
Cough stress test
Q-tip test
Bonney’s test
Pad test
Explanation - The cough stress test, where leakage is observed during coughing, is a quick clinical diagnostic method.
Correct answer is: Cough stress test
Q.12 The Q-tip test is used to assess:
Bladder capacity
Urethral mobility
Residual urine
Sphincter pressure
Explanation - The Q-tip test assesses urethral hypermobility, where an angle >30° suggests poor support.
Correct answer is: Urethral mobility
Q.13 Which of the following drugs is used to treat urge incontinence?
Oxybutynin
Duloxetine
Estrogen cream
Midodrine
Explanation - Oxybutynin is an anticholinergic that reduces detrusor overactivity in urge incontinence.
Correct answer is: Oxybutynin
Q.14 Vault prolapse occurs after:
Cesarean section
Myomectomy
Hysterectomy
Oophorectomy
Explanation - Vault prolapse is the descent of the vaginal cuff following hysterectomy due to loss of uterine support.
Correct answer is: Hysterectomy
Q.15 Which imaging modality is useful for assessing pelvic floor disorders dynamically?
MRI
CT scan
Ultrasound
X-ray
Explanation - Dynamic pelvic MRI provides detailed visualization of pelvic floor defects and prolapse.
Correct answer is: MRI
Q.16 Which connective tissue disorder increases risk of pelvic organ prolapse?
Marfan syndrome
Down syndrome
Klinefelter syndrome
Turner syndrome
Explanation - Marfan syndrome, with defective connective tissue, predisposes women to pelvic floor weakness and prolapse.
Correct answer is: Marfan syndrome
Q.17 Pelvic floor muscle training is also known as:
Duloxetine therapy
Kegel exercises
Colposuspension
Biofeedback therapy
Explanation - Kegel exercises strengthen pelvic floor muscles and are the cornerstone of conservative management.
Correct answer is: Kegel exercises
Q.18 Which hormone deficiency after menopause contributes to urinary incontinence?
Progesterone
Estrogen
Prolactin
FSH
Explanation - Estrogen deficiency after menopause causes urogenital atrophy, contributing to incontinence.
Correct answer is: Estrogen
Q.19 Which of the following is a complication of untreated pelvic organ prolapse?
Hydronephrosis
Hypertension
Hypothyroidism
Ovarian cysts
Explanation - Severe prolapse can cause ureteric kinking leading to hydronephrosis and renal damage.
Correct answer is: Hydronephrosis
Q.20 Which pessary type is most commonly used for pelvic organ prolapse?
Ring pessary
Gellhorn pessary
Cube pessary
Donut pessary
Explanation - Ring pessaries are the most commonly used, especially in women with mild to moderate prolapse.
Correct answer is: Ring pessary
Q.21 Which surgical approach is used for sacrocolpopexy?
Laparotomy or laparoscopy
Perineal incision
Transvaginal route only
Retroperitoneal approach
Explanation - Sacrocolpopexy is performed abdominally or laparoscopically to suspend the vaginal vault to the sacrum.
Correct answer is: Laparotomy or laparoscopy
Q.22 Which of the following is NOT an indication for urodynamic testing?
Before surgery for incontinence
Failure of initial therapy
Asymptomatic patient
Complex incontinence cases
Explanation - Urodynamics is unnecessary in asymptomatic women and is reserved for complex or surgical cases.
Correct answer is: Asymptomatic patient
Q.23 Which of the following is a symptom of overactive bladder?
Urine leakage on sneezing
Urgency and frequency
Continuous dribbling
Nocturnal enuresis
Explanation - Overactive bladder is characterized by urgency, frequency, and sometimes urge incontinence.
Correct answer is: Urgency and frequency
Q.24 Which connective tissue provides the primary support to the uterus?
Round ligament
Cardinal ligament
Ovarian ligament
Broad ligament
Explanation - The cardinal ligament provides major support to the uterus and cervix within the pelvis.
Correct answer is: Cardinal ligament
Q.25 Which drug is approved for stress urinary incontinence in some countries?
Duloxetine
Oxybutynin
Tolterodine
Mirabegron
Explanation - Duloxetine, a serotonin-norepinephrine reuptake inhibitor, is used in stress incontinence therapy.
Correct answer is: Duloxetine