Normal pregnancy and antenatal care: Piskacek sign: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Normal pregnancy and antenatal care: Piskacek sign

Sample item

On bimanual examination at 8 weeks, one cornu of the uterus bulges more than the other and the uterus feels asymmetrical. Which sign is this, and what explains it?

APiskacek sign, from implantation near one cornuBHegar sign, from softening of the isthmusCGoodell sign, from softening of the cervixDChadwick sign, from vascular congestion of the vagina

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Piskacek sign, from implantation near one cornu

Piskacek sign is a lateral, asymmetrical enlargement of the uterus when the blastocyst implants near a cornu. The uterus becomes symmetrical again as pregnancy advances. It is a probable sign of early pregnancy.

Option by option

A. Piskacek sign, from implantation near one cornu (correct)
Correct. Implantation near a cornu causes the asymmetrical bulge.
B. Hegar sign, from softening of the isthmus
Hegar sign is softening of the isthmus and does not make the uterus lopsided.
C. Goodell sign, from softening of the cervix
Goodell sign is softening of the cervix, found on speculum or vaginal examination.
D. Chadwick sign, from vascular congestion of the vagina
Chadwick sign is a bluish discolouration of the vagina and cervix from congestion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Piskacek sign, from implantation near one cornu. Piskacek sign is a lateral, asymmetrical enlargement of the uterus when the blastocyst implants near a cornu.

Why is "Hegar sign, from softening of the isthmus" not the answer?

Hegar sign is softening of the isthmus and does not make the uterus lopsided.

Why is "Goodell sign, from softening of the cervix" not the answer?

Goodell sign is softening of the cervix, found on speculum or vaginal examination.

Why is "Chadwick sign, from vascular congestion of the vagina" not the answer?

Chadwick sign is a bluish discolouration of the vagina and cervix from congestion.

What concept does this question test?

It tests Normal pregnancy and antenatal care: Piskacek sign in OBG. The uterus becomes symmetrical again as pregnancy advances. It is a probable sign of early pregnancy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Normal pregnancy and antenatal care: Piskacek sign?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.