Midwifery and Obstetrical Nursing Practice Questions 9/2025: Day 177

Your Reproductive Health Mastery Day

Hey, future top-rankers! Day 177 at logyanlo.in is dedicated to the most repeated Midwifery & Obstetrical Nursing topics in NORCET, RRB, AIIMS, JIPMER, SGPGI & DSSSB 2025: Vaginitis, Pelvic Inflammatory Disease (PID), Syndromic Management, Emergency Contraceptives and Oral Contraceptive Pills (OCP). These five topics appear every single year – master them today and lock your seat in the merit list! Let’s dominate with our Nursing Test Series 2025!

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Why These Topics Matter

Reproductive health = guaranteed questions:

• 10–15% weightage in every nursing officer exam
• Syndromic management & emergency contraception are favourite “scenario” questions
• Vaginitis & PID appear in both theory + image-based sections
• OCP side effects & contraindications are repeated every year
  logyanlo.in gives you the exact high-yield points you need to score 100 % from this unit!

Key Topics in Midwifery Nursing

Vaginitis

Quick Fact

Vaginitis is the most common gynaecological complaint in reproductive-age women.

Complete Coverage

• Definition: Inflammation of vagina – 3 main types asked in exams.
• Types & Classic Features:
  • Candida: Curdy white discharge, intense itching, satellite lesions
  • Bacterial vaginosis: Fishy odour, thin grey-white discharge, clue cells
  • Trichomonas: Frothy yellow-green discharge, strawberry cervix, motile flagellates
• Diagnostics:
  • Whiff test (+ in BV)
  • KOH preparation (hyphae in Candida)
  • Wet mount (motile trichomonads)
• pH: BV >4.5, Candida & Trichomonas <4.5
• Complications: Preterm labour, postpartum endometritis, ↑ HIV transmission.
• Exam Pearl: Clue cells = Bacterial vaginosis (Gardnerella).
• Why It Matters: Most frequently tested vaginal discharge question.

Pelvic Inflammatory Disease (PID)

Quick Fact

PID is ascending infection from vagina/cervix to upper genital tract.

Complete Coverage

• Definition: Spectrum – endometritis, salpingitis, oophoritis, tubo-ovarian abscess.
• Pathophysiology: Chlamydia trachomatis & Neisseria gonorrhoeae (most common).
• Clinical Signs: Lower abdominal tenderness, cervical motion tenderness, adnexal tenderness (CDC criteria).
• Risk Factors: Multiple partners, IUD insertion, douching.
• Diagnostics:
  • Laparoscopy (gold standard)
  • Ultrasound (tubo-ovarian abscess)
  • Positive gonorrhoea/chlamydia test
• Complications: Infertility (15–20%), ectopic pregnancy, chronic pelvic pain (Fitz-Hugh-Curtis syndrome).
• Exam Tip: Cervical motion tenderness = hallmark of PID.
• Why It Matters: Leading cause of infertility in young women.

Syndromic Management (STI)

Quick Fact

Syndromic management is symptom-based treatment without lab confirmation.

Complete Coverage

• Rationale: Fast, cost-effective, ideal where labs unavailable.
• Seven Syndromes (most asked):
  1. Vaginal discharge
  2. Lower abdominal pain (PID)
  3. Genital ulcer (syphilis/herpes)
  4. Urethral discharge
  5. Scrotal swelling
  6. Inguinal bubo
  7. Neonatal conjunctivitis
• Vaginal Discharge Flowchart: Treat for Candida + BV + Trichomonas simultaneously.
• PID Syndrome: Ceftriaxone + Doxycycline + Metronidazole (single visit).
• Exam Favourite: Drug regimen for vaginal discharge syndrome.
• Why It Matters: Repeated every year in community health & midwifery.

Emergency Contraception

Quick Fact

Levonorgestrel 1.5 mg single dose is the most effective emergency contraceptive within 72 hours.

Complete Coverage

• Methods & Time Window:
  • Levonorgestrel 1.5 mg → within 72 hrs (efficacy 95 %)
  • Ulipristal acetate 30 mg → within 120 hrs (best efficacy)
  • Cu-T insertion → within 5 days (99 % effective)
• Mechanism: Delays ovulation, inhibits fertilization/implantation.
• Side Effects: Nausea, irregular bleeding, headache.
• Contraindications: Known pregnancy (doesn’t cause abortion).
• Exam Pearl: Levonorgestrel can be given up to 120 hrs (reduced efficacy).
• Why It Matters: Most common family planning question in 2025.

Oral Contraceptive Pills (OCP)

Quick Fact

Combined OCP failure rate with perfect use = 0.3 %, typical use = 9 %.

Complete Coverage

• Types: Combined (estrogen + progestin), Progestin-only (mini pill).
• Mechanism: Inhibits ovulation, thickens cervical mucus, thins endometrium.
• Absolute Contraindications (WHO Category 4):
  • Breast cancer
  • DVT/PE history
  • Migraine with aura
  • Smoking >35 years + >15 cigarettes/day
  • Severe liver disease
• Benefits: Regulates cycles, reduces ovarian & endometrial cancer.
• Side Effects: Breakthrough bleeding, nausea, breast tenderness, mood changes.
• Missed Pill Rule:
  • 1 pill missed → take as soon as remembered
  • ≥2 pills missed → take 2 pills + use backup for 7 days
• Exam Tip: Migraine with aura = absolute contraindication.
• Why It Matters: Highest weightage family planning method.

Mini FAQ: Midwifery Exam Hacks

Q: Most common cause of vaginal discharge in reproductive age?
A: Bacterial vaginosis (clue cells).

Q: Hallmark clinical sign of PID?
A: Cervical motion tenderness.

Q: Drug regimen for vaginal discharge syndrome?
A: Fluconazole + Secnidazole + Azithromycin (single dose).

Q: Best emergency contraceptive within 120 hrs?
A: Ulipristal acetate 30 mg.

Q: Absolute contraindication for combined OCP?
A: Migraine with aura / History of DVT.

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Conclusion: Your Top Rank Is Locked

Day 177 just handed you the complete reproductive health package! From vaginitis discharge to OCP contraindications – you now own every repeated question. Keep practising daily on our Daily Question Bank and watch your name shine in the final merit list!

Call to Action

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