Obstetrics and Gynecology Question Quality Review
Executive Summary
This review covers a candidate sample of 100 validated non-gold questions drawn from a pool of 10,364 items in the Obstetrics and Gynecology subject. The sample was reviewed against 8 benchmark questions and 12 recent PYQs as the quality bar.
The most striking finding in this sample is the severe Bloom's level compression toward the bottom of the taxonomy. The candidate distribution shows 34% at Bloom's Level 1 and 55% at Level 2, leaving only 11% at Levels 3–5 combined. The benchmark set, by contrast, contains items at Levels 3 and 4 that require clinical reasoning, multi-step management decisions, and interpretation of investigation results in context. The gap is operationally significant: the candidate pool as currently constituted cannot support a credible INI-CET or NEET-PG simulation test without heavy supplementation from higher-order items.
Beyond the Bloom's problem, the reviewed set contains a cluster of factually unsafe or wrong-key items, a broken-delivery item with duplicated options, a subject-contamination case, and a large body of low-value recall questions that test isolated facts with no clinical context. Repetition across the generic and risky sub-samples is also observed.
Summary counts (observed in this sample):
| Bucket | Approximate count in sample | Recommended action |
|---|---|---|
| Wrong Key or Factually Unsafe | 4–5 items | Disable or urgent fix |
| Wrong Subject / Wrong Topic Placement | 2 items | Reroute or disable |
| Broken Delivery | 1 item | Disable until fixed |
| Low-Value But Correct | ~45 items | Disable (majority); selective keep |
| Repetitive / Duplicative Coverage | 4–5 item pairs | Disable weaker duplicate |
| Worthwhile Concept, Weak Execution | ~15 items | Fix stem/options/vignette |
What Good Looks Like
The benchmark and PYQ sets establish a clear quality bar. The following features define a high-quality OBG item in this context:
Clinical vignette with decision-forcing context. Benchmark item fc6de48f presents a 32-year-old at 11 weeks with specific MoM values, NT measurement, and a cfDNA result, then asks for the next step. The candidate must integrate screening hierarchy, not just recall a fact. Benchmark item d8ba1ea2 provides a full clinical picture — gestational age, BP, labs, fetal NST — and requires the candidate to synthesize HELLP criteria, gestational age thresholds, and delivery timing simultaneously.
Distractors that represent genuine clinical alternatives. In 3f151a05 (cord presentation), all four options are plausible management choices a clinician might consider; the correct answer requires understanding that membranes are intact and fetal scalp stimulation is reassuring, making expectant management with position change appropriate. A weak item would have three obviously wrong distractors.
Appropriate Bloom's level for the concept tested. PYQ 7974a2cb (Anti-D criteria postpartum) is a Bloom's Level 3 item: the candidate must apply knowledge of DCT and baby Rh status to determine the correct indication. PYQ f8c8a8d6 (5-alpha reductase deficiency) is Level 4: the candidate must analyse a phenotypic profile and karyotype to arrive at a diagnosis. These are the minimum standards for items entering active test templates.
Factual precision in stem and options. Benchmark item 343040c0 asks about the quadruple marker test timing with specific gestational age windows as options. The correct answer is unambiguous and the distractors are plausible but wrong. There is no "all of the above" or vague language.
Exam relevance. Every benchmark item maps to a concept that has appeared in INI-CET, NEET-PG, or AIIMS PG in the last five years. Items on post-term pregnancy definitions in days, pelvic diameters in centimetres, or the colour of vaginal discharge do not meet this bar.
Main Issue Categories
1. Wrong Key or Factually Unsafe
Why this pattern is bad
A wrong key is the most serious quality failure in a question bank. It directly harms candidates who reason correctly and are penalised, and it undermines trust in the platform. Factually unsafe items — where the correct answer is contested, guideline-dependent, or demonstrably incorrect — carry the same operational risk even if the error is subtler.
How it shows up
In this sample, wrong-key and factually unsafe problems appear in three forms: (a) the marked correct answer contradicts standard textbook and guideline consensus; (b) the stem describes a clinical scenario but the key reflects a different scenario than the one described; (c) the question asks about a syndrome but the correct answer is inconsistent with the defining features of that syndrome.
Example question IDs and explanations
10a2ff50-c63c-46d9-ab26-0824b93d8810— Stein-Leventhal syndrome The marked correct answer is "Seen in post-menopausal women." Stein-Leventhal syndrome (PCOS) is by definition a condition of reproductive-age women. It is not a post-menopausal diagnosis. The other three options — oligomenorrhea/amenorrhea, numerous ovarian cysts, and theca cell hypertrophy — are all true features of PCOS. The key is factually wrong. This item will penalise any candidate who knows the subject.ecf6a359-274b-49de-96cc-ff186df0d04b— Hydatidiform mole genotype The stem describes grape-like cystic structures without an embryo, which is a complete hydatidiform mole. The marked correct answer states "The genotype of the mole is 46XXX and is completely paternal in origin." A complete mole is 46XX (or rarely 46XY), not 46XXX. The 46XXX karyotype is not a recognised genotype for complete mole. This is a factual error in the key. The option about triploid genotype describes a partial mole, which is also incorrect for the scenario described, but the marked answer is itself wrong.06db1a70-1ce4-478e-b4f4-fe753931b1f7— IVF indications The marked correct answer is "Tubal block" as the option that is NOT an indication for IVF. Tubal factor infertility is in fact the primary and classical indication for IVF. The item has the key inverted. Azoospermia, anovulation, and oligospermia are all indications for ART but tubal block is the paradigmatic IVF indication. This is a wrong key.be07addd-b4e1-48c9-a165-01d26c2a904a— Recurrence risk after first-trimester loss The marked correct answer is "Is no different than it was prior to the miscarriage." This is factually contested. The established clinical teaching is that after one first-trimester loss, the recurrence risk is marginally elevated (approximately 20–25% vs. the background 15–20%), though the increase is modest. Stating it is "no different" is an oversimplification that contradicts standard counselling guidance. This item is factually unsafe and should not be used without expert review.816baa84-aef1-484b-9ae4-e80422f64d5b— LUNA procedure The marked correct answer is "Mild to moderate endometriotic lesions." LUNA (laparoscopic uterine nerve ablation) has been studied primarily for dysmenorrhea, not specifically for endometriotic lesion treatment. Multiple RCTs (including the LUNA trial) have shown it does not provide additional benefit over conservative surgery for dysmenorrhea in endometriosis. The framing of the key is misleading and the clinical basis is weak. This item is factually unsafe.
Recommended disposition
10a2ff50: Disable — wrong key, concept is covered by better PCOS items.ecf6a359: Disable — wrong key on genotype; the stem is also poorly constructed.06db1a70: Disable — inverted key; the concept is high-yield but this item is unsalvageable without a full rewrite.be07addd: Disable — factually unsafe; counselling nuance requires expert-reviewed rewrite.816baa84: Disable — factually unsafe; LUNA evidence base does not support the key as written.
2. Wrong Subject or Wrong Topic Placement
Why this pattern is bad
Subject contamination dilutes the OBG pool with content that belongs elsewhere and creates confusion in topic-based study plans. It also inflates apparent coverage of OBG topics while actually testing a different subject's content.
How it shows up
Two patterns are observed: (a) a question placed in OBG that is primarily a Reproductive Biology or Embryology question with no clinical OBG application; (b) a question placed under a specific OBG topic that clearly belongs to a different OBG topic.
Example question IDs and explanations
60affe46-be06-4adc-a3d4-06b0e771b01f— Swyer cell syndrome and infertility (topic: Fertility and Infertility) The question asks why infertility occurs in "Swyer cell syndrome" because "there are no germ cells in this condition." The question conflates Swyer syndrome (46,XY gonadal dysgenesis) with Sertoli cell-only syndrome (Del Castillo syndrome). The stem mentions "Sertoli cells," "blood-testis barrier," and "spermatozoa" — this is male reproductive biology / andrology content, not OBG. The clinical management of Swyer syndrome in a female patient is a legitimate OBG topic, but this question is framed entirely from a male reproductive biology perspective and belongs in Physiology or Andrology, not OBG.1ed23134-f54f-4ed8-b4fa-88f5bddc963b— Gestational age at which ovaries and testes are distinguishable (topic: Reproductive Endocrinology) This is an embryology/developmental biology question. It has no clinical OBG application in the context of PG entrance examinations. It belongs in Anatomy or Physiology. Its placement in Reproductive Endocrinology within OBG is a subject contamination error.be07addd-b4e1-48c9-a165-01d26c2a904a— Recurrence risk after miscarriage (topic: Reproductive Ethics) The topic tag "Reproductive Ethics" is incorrect. This is a clinical question about miscarriage recurrence risk, which belongs under Fertility and Infertility or Prenatal Care. The topic misplacement means it will not appear in the correct study plan context.
Recommended disposition
60affe46: Disable — wrong subject framing; if Swyer syndrome is to be tested in OBG, a new item focused on the female phenotype and management should be written.1ed23134: Disable — embryology trivia with no OBG clinical relevance; belongs in a different subject.be07addd: Reroute to Fertility and Infertility if retained after key review; currently also flagged under Wrong Key.
3. Broken Delivery (Missing Image, Malformed Options, Incomplete Stem)
Why this pattern is bad
A broken delivery item cannot be answered correctly regardless of the candidate's knowledge. Malformed options — particularly duplicated options — make the item unscorable and create a negative candidate experience. Even one such item in a live test damages platform credibility.
How it shows up
In this sample, one item has a clear option duplication error that renders it broken.
Example question IDs and explanations
d2fd34b0-6032-44d6-acf6-8ba4fe725dfb— Non-gonococcal vaginal discharge Options A and B are identical: both read "Trichomonas vaginalis." This means the item has only three distinct answer choices, not four. A candidate who knows the answer is Chlamydia trachomatis can answer correctly, but a candidate who considers Trichomonas as the answer has two identical options to choose from, which is a delivery failure. The item cannot be used in any test template in its current state.
Recommended disposition
d2fd34b0: Disable until the duplicate option is corrected and the item is re-reviewed. The underlying concept (Chlamydia as a cause of non-gonococcal discharge) is clinically relevant and worth fixing, but the item needs a proper fourth distractor (e.g., Gardnerella vaginalis or Neisseria gonorrhoeae) and a more precise stem before reactivation.
4. Low-Value But Correct (Too Simple, Low-Yield, Trivia-Heavy, Weak Exam Relevance)
Why this pattern is bad
Low-value items consume slots in test templates that should be occupied by reasoning-level questions. They inflate the apparent size of the question bank without adding discriminatory power. For INI-CET and NEET-PG preparation, items that can be answered by any first-year MBBS student or that test isolated numerical facts with no clinical application do not prepare candidates for the actual examination. The Bloom's distribution data confirms this is the dominant problem in the candidate sample: 34% at Level 1 and 55% at Level 2, versus the benchmark set which has meaningful representation at Levels 3 and 4.
How it shows up
Three sub-patterns are observed:
Sub-pattern A: Bare-fact recall with no clinical context
These items ask for a single isolated fact — a number, a name, a definition — with no scenario and no reasoning requirement.
13b0ca4a— "What is the first symptom of pregnancy?" Answer: Amenorrhea. This is a first-year MBBS question. It has no discriminatory value for PG entrance. Disable.902d2b09— "Post-term pregnancy is defined as a pregnancy which continues beyond [days]" Answer: 294 days. Pure numerical recall. Duplicated by9539a6c8in the risky sample (see Repetition section). Disable one; the other is marginal.faec4d5b— "Fetal bradycardia is defined as..." Answer: Less than 120 bpm for 15 minutes. Definitional recall. No clinical scenario. Disable.209c15c2— "What is the transverse diameter of the female mid-pelvic plane?" Answer: 10.5 cm. Anatomical trivia. No exam relevance at PG level. Disable.2fe011e4— "At what gestational age does the uterus become palpable abdominally?" Answer: 12 weeks. Basic obstetric fact. Disable.8c45a0f1— "Which is the source of HCG in a pregnant female?" Answer: Syncytiotrophoblast. Bloom's 1 recall. Disable.8143540c— "Which hormone has the greatest production rate near term, approximately 1 gram per day?" Answer: hPL. Numerical trivia. Disable.cd2b5270— "Estimated time for CIN to convert to invasive carcinoma?" Answer: 10 years. Numerical trivia with no clinical application. Disable.ba3a27d5— "Saheli or Centchroman contains which active ingredient?" Answer: Ormeloxifene. Recall of drug name. Marginal; the concept is India-specific and has appeared in PYQs, but the item is Bloom's 1 with no clinical context. Borderline keep/disable.8365712f— "What does Chadwick sign indicate?" Answer: Bluish discoloration of vestibule. Signs-and-symptoms recall. Disable.47cdd380— "What is the preventive dose of anti-D gamma globulin?" Answer: 300 mcg. Numerical recall. The concept of anti-D dosing is important but this item tests only the number, not the indication or timing. Disable; the benchmark set has better anti-D items.7cd14af4— "What is the typical daily dose of ethinyl estradiol in low-dose OCP?" Answer: 20 µg. Pharmacological trivia. Disable.f7f75218— "Emergency contraception first dose within how many hours?" Answer: 72 hours. Basic recall. Disable.29590d12— "Cumulative pregnancy rate at 5 years for LNG-IUD?" Answer: 0.5%. Statistical trivia. Disable.55efc85f— "Which medication is used as a post-coital pill?" Answer: 0.75 mg Levonorgestrel. Recall. Disable.
Sub-pattern B: Clinically trivial or irrelevant content
c413a8a6— "Most common source of vicarious menstruation?" Answer: Nose. This is an obscure clinical curiosity with essentially zero exam relevance at INI-CET/NEET-PG level. Disable.e91c8e83— "Most common type of cephalic presentation?" Answer: Vertex. This is pre-clinical knowledge. Disable.b5b0d895— "Which contraceptive is supplied free of cost by the government?" Answer: Mala-N. India-specific health programme trivia. Low yield for clinical reasoning. Disable.190f2cb9— "Which of the following complications is seen in pregnancy?" The stem is incoherent — all four options are complications of pregnancy. The marked correct answer is "Hypertension complicating pregnancy" with no clinical basis for preferring it over the others. This item is both low-value and poorly constructed. Disable.d2dc8dc8— "Most appropriate time for breast self-examination?" Answer: One week after menstruation starts. This is a health education question, not a clinical reasoning question. Disable.
Sub-pattern C: "All of the above" as correct answer with no reasoning requirement
Items where the correct answer is "All of the above" and all individual options are obviously true provide no discriminatory value. A candidate who knows any one of the options is true can guess "all of the above" without clinical reasoning.
f0ce8dc5— Cervical incompetence characteristics — Correct answer: "All of the above." The three individual options (cerclage, second trimester abortion, PROM) are all associated with cervical incompetence. No reasoning required. Disable.fe237ff0— Symptoms of retroverted uterus — Correct answer: "All of the above." Disable.a9e3ba37— Medications for primary dysmenorrhea — Correct answer: "All of the above." Disable.cbd223e0— Risk factors for tubal pregnancy — Correct answer: "All of the above." Disable.
Recommended disposition
The majority of items in this bucket should be disabled. The concept bank for OBG at PG level has strong gold-standard coverage for most of these topics. Retaining low-value items dilutes test quality and does not serve candidates preparing for INI-CET or NEET-PG. Selective exceptions are noted in the Fix section below.
5. Repetitive or Duplicative Coverage
Why this pattern is bad
Duplicate or near-duplicate items waste bank capacity, create inconsistency when two versions have slightly different keys or distractors, and reduce the effective diversity of test templates. When one version is clearly weaker, retaining both is a quality liability.
How it shows up
In this sample, exact or near-exact duplicates appear across the generic and risky sub-samples, and within the same sub-sample.
Example question IDs and explanations
902d2b09(generic) and9539a6c8(risky) — Post-term pregnancy definition in days Both items ask the same question with identical options and the same correct answer (294 days). One is tagged as easy/Bloom's 1; the other is also easy/Bloom's 1. Both are low-value. Disable both, or if one must be retained for historical PYQ reasons, keep only the one with a PYQ tag and disable the other.b272b5c7(generic) andb272b5c7(risky) — Most common heart disease in pregnancy The same question ID (b272b5c7) appears in both the generic and risky candidate sub-samples. This is an exact duplicate entry. The item itself is low-value (easy recall). Disable one instance; the item itself is borderline for the Fix bucket if converted to a clinical vignette.8b2d8b66(Endocrinology of Pregnancy, generic) andf805b3b9(Gynecological Disorders, generic) — Hirsutism EXCEPT questions Both items ask about conditions associated with hirsutism in an "EXCEPT" format.8b2d8b66has "Hypothyroidism" as the exception;f805b3b9has "Hyperthyroidism" as the exception. These are near-duplicates testing the same concept (thyroid disease and hirsutism) with inverted keys. Having both in the bank creates confusion. The thyroid-hirsutism relationship is a legitimate exam concept, but two near-identical items with opposite thyroid directions is a quality risk. Disable the weaker one (f805b3b9, which is placed in Gynecological Disorders — a topic mismatch for a question about hirsutism causes) and retain8b2d8b66for potential upgrade.3d43fd06(generic) and56ccca4c(risky) — Burns-Marshall technique3d43fd06asks which is NOT a technique for delivering the aftercoming head in breech, with "Lobst's maneuver" as the correct answer.56ccca4casks what Burns-Marshall technique is used to deliver, with "After-coming head" as the correct answer. These test the same narrow concept (Burns-Marshall and breech delivery of the aftercoming head) from slightly different angles. Both are low-to-medium value. If one is retained, prefer3d43fd06as it requires slightly more discrimination. Disable56ccca4c.bee3135c(generic) and11152113(risky) — AFP in neural tube defects / incorrect gestational agebee3135casks about conditions causing increased AFP, with "Incorrect gestational age dating" as the correct answer — this is a misleading key because NTDs, multiple pregnancy, and abdominal wall defects are the classic causes of elevated AFP; incorrect dating causes a false positive, not a true elevation.11152113asks which marker is increased in amniotic fluid in NTDs, with "Alpha-fetoprotein" as the correct answer. These test overlapping AFP knowledge.bee3135chas a problematic key (see also Wrong Key bucket consideration);11152113is straightforward recall. Disablebee3135c;11152113is marginal but factually correct.
Recommended disposition
9539a6c8: Disable (duplicate of902d2b09; both are low-value but if one must survive, keep the one with a PYQ tag).b272b5c7duplicate entry: Remove duplicate instance; the item itself is a Fix candidate.f805b3b9: Disable (near-duplicate of8b2d8b66; topic mismatch).56ccca4c: Disable (weaker duplicate of3d43fd06).bee3135c: Disable (misleading key; overlaps with11152113).
6. Worthwhile Concept, Weak Execution (Keep the Concept, Fix the Stem/Options/Vignette)
Why this pattern is bad
These items test clinically important and exam-relevant concepts but fail to do so at the appropriate cognitive level. The concept deserves a place in the bank; the current execution does not. Discarding these entirely would create coverage gaps. The fix path is to add clinical context, improve distractor quality, or raise the Bloom's level.
How it shows up
The most common execution failures in this sample are: (a) a bare-fact stem that could be converted to a clinical vignette; (b) distractors that are obviously wrong, making the item too easy; (c) a stem that is clinically relevant but the question asked is the wrong question for the scenario.
Example question IDs and explanations
acbcd8d7— Tocolytic agent causing pulmonary edema This is a good concept (ritodrine/beta-agonist side effects) and the clinical scenario (32-week preterm labour, pulmonary oedema after tocolysis) is appropriate. The distractors are plausible. This item is close to acceptable. The main weakness is that the stem does not specify the clinical context fully (e.g., no mention of whether the patient was on IV fluids, no vital signs). A minor stem enhancement would make this a solid Bloom's 3 item. Fix: add brief clinical detail to the stem.b8534a4e— Antepartum haemorrhage management The concept (examination under anaesthesia / double setup for APH) is high-yield. However, the stem is critically underspecified: "A full-term primipara presents with antepartum hemorrhage" — no bleeding volume, no haemodynamic status, no placental localisation, no gestational age beyond "full-term." The correct answer ("Examination in the operating room followed by amniotomy") implies placenta praevia has been excluded or that this is a double-setup scenario, but the stem does not establish this. The item is clinically ambiguous as written. Fix: add placental localisation status, haemodynamic stability, and specify that placenta praevia has been excluded on ultrasound, or reframe as a double-setup scenario explicitly.de11931f— Eclampsia with palpitations The concept (magnesium toxicity causing cardiac arrhythmia, or magnesium as treatment for arrhythmia in eclampsia) is clinically relevant. However, the stem is incomplete: "an ECG was performed" but the ECG findings are not described. The correct answer (magnesium sulfate) is defensible if the arrhythmia is assumed to be magnesium-responsive, but without the ECG result, the item is ambiguous — DC shock or adenosine could be correct depending on the rhythm. Fix: add the ECG finding (e.g., prolonged QT, or specify the arrhythmia type) to make the reasoning path explicit.c463f855— Secondary amenorrhea with no withdrawal bleed after E+P This is a well-constructed clinical reasoning item (Bloom's 3). The scenario correctly points to a uterine cause (Asherman's syndrome). The distractors are appropriate. The main weakness is the absence of a clinical vignette — no age context beyond "25-year-old," no history of prior uterine instrumentation, no other symptoms. Adding a brief history (e.g., prior D&C after abortion) would make this a Bloom's 4 item and significantly increase its discriminatory value. Fix: add a brief relevant history to the stem.40b393a8— Antiphospholipid syndrome The concept is high-yield (APS presenting with recurrent abortions, DVT, thrombocytopenia, MI). The correct answer (Primary APS) is appropriate. However, the distinction between primary and catastrophic APS is the key teaching point, and the stem does not provide enough temporal information to distinguish them (catastrophic APS requires ≥3 organ systems within 1 week). The item is currently answerable by exclusion rather than by applying diagnostic criteria. Fix: add temporal framing and specify organ involvement to make the primary vs. catastrophic distinction explicit.80429b1b— Endometrial cancer risk factors The concept is high-yield and the correct answer (diabetes mellitus) is appropriate. The distractors (multiparity, OCP use, smoking) are all genuinely protective or neutral, making this a reasonable item. The weakness is that the clinical vignette is perfunctory — the diagnosis is given in the stem, so the item is purely about risk factor recall rather than clinical reasoning. Fix: remove the diagnosis from the stem and present the risk factor profile as part of a history, asking the candidate to identify the most likely predisposing factor.930333f2— Placenta praevia management at 28 weeks The concept (expectant management of asymptomatic placenta praevia with planned caesarean at 36–37 weeks) is correct and exam-relevant. The item is factually sound. The weakness is the absence of clinical detail — no bleeding history, no haemodynamic status, no prior caesarean history. The item reads as a management guideline question rather than a clinical scenario. Fix: add a brief clinical vignette with haemodynamic stability confirmed and no active bleeding, to contextualise the management choice.b272b5c7— Most common heart disease in pregnancy The concept (mitral stenosis as the most common rheumatic heart disease in pregnancy in India) is high-yield. The item is factually correct. The weakness is that it is bare-fact recall. Fix: convert to a clinical vignette — e.g., a pregnant woman with exertional dyspnoea, mid-diastolic murmur, and a history of rheumatic fever — and ask for the most likely diagnosis or the most dangerous haemodynamic period.adc7497f— Best diagnostic method for ovulation The concept is relevant (ultrasound as the gold standard for confirming ovulation). The item is factually correct. The weakness is the bare-fact format and the absence of clinical context. Fix: present a clinical scenario of a woman being investigated for anovulatory infertility and ask which investigation would most reliably confirm ovulation.127d657b— Progestogen with greatest haemostatic effect for DUB The concept (norethisterone for DUB) is exam-relevant. The item is factually correct. The distractors are plausible. The weakness is the absence of a clinical scenario. Fix: add a brief vignette of a woman with heavy menstrual bleeding and ask for the most appropriate progestogen.
Recommended disposition
All items in this bucket: Fix — the concept justifies retention, but the execution requires stem enhancement, distractor improvement, or vignette addition before deployment in active test templates. Priority fixes are acbcd8d7, de11931f, c463f855, and 40b393a8, as these are closest to acceptable and require the least rewriting effort.
Prioritization
The following table ranks action items by urgency and impact.
| Priority | Action | Items | Rationale |
|---|---|---|---|
| P1 — Immediate | Disable wrong-key / factually unsafe items | 10a2ff50, ecf6a359, 06db1a70, be07addd, 816baa84 |
Active harm to candidates; cannot be used in any template |
| P1 — Immediate | Disable broken delivery item | d2fd34b0 |
Unscorable; duplicate options |
| P2 — This sprint | Disable subject contamination items | 60affe46, 1ed23134 |
Inflates OBG pool with non-OBG content |
| P2 — This sprint | Disable exact duplicates | 9539a6c8, duplicate instance of b272b5c7, 56ccca4c, bee3135c |
Bank hygiene; inconsistency risk |
| P3 — Next sprint | Disable bulk low-value Bloom's 1 recall items | 13b0ca4a, 902d2b09, faec4d5b, 209c15c2, 2fe011e4, 8c45a0f1, 8143540c, cd2b5270, 8365712f, 47cdd380, 7cd14af4, f7f75218, 29590d12, 55efc85f, c413a8a6, e91c8e83, b5b0d895, 190f2cb9, d2dc8dc8, f0ce8dc5, fe237ff0, a9e3ba37, cbd223e0 |
Bloom's 1–2 trivia; no discriminatory value for PG entrance |
| P4 — Ongoing | Fix worthwhile-concept items | acbcd8d7, de11931f, c463f855, 40b393a8, b8534a4e, 80429b1b, 930333f2, b272b5c7, adc7497f, 127d657b |
Concept is exam-relevant; execution needs upgrade to Bloom's 3–4 |
| P5 — Structural | Commission new Bloom's 3–4 items | — | Only 11% of candidate sample is at Bloom's 3–5; benchmark requires ~40–50% at these levels for credible INI-CET simulation |
Example Keep / Fix / Disable Calls
The following table provides concrete disposition decisions for representative items from the reviewed sample.
| Question ID | Topic | Current State | Decision | Reason |
|---|---|---|---|---|
acbcd8d7 |
Labor and Delivery | Bloom's 3, clinical scenario, correct key | Fix | Good concept (ritodrine pulmonary oedema); stem needs minor clinical detail enhancement |
c463f855 |
Menstrual Disorders | Bloom's 3, correct key, good reasoning | Fix | Add prior uterine instrumentation history to stem; elevates to Bloom's 4 |
40b393a8 |
Gynecological Disorders | Bloom's 3, correct key | Fix | Add temporal framing to distinguish primary from catastrophic APS |
de11931f |
Labor and Delivery | Bloom's 3, incomplete stem | Fix | Add ECG finding to make reasoning path unambiguous |
821e4cc5 |
Labor and Delivery | Bloom's 4, clinical vignette, correct key | Keep | Well-constructed scenario; inevitable abortion diagnosis requires clinical reasoning |
a3f13d46 |
Labor and Delivery | Bloom's 4, EXCEPT format, correct key | Keep | Cerclage contraindications are high-yield; distractors are plausible |
930333f2 |
Maternal-Fetal Medicine | Bloom's 4, correct key | Fix | Add clinical context (haemodynamic stability, no active bleeding) to stem |
80429b1b |
Gynecologic Oncology | Bloom's 3, correct key | Fix | Remove diagnosis from stem; reframe as risk factor identification from history |
10a2ff50 |
Reproductive Endocrinology | Wrong key (PCOS is not post-menopausal) | Disable | Factually incorrect key; will penalise correct reasoners |
ecf6a359 |
Gynecologic Oncology | Wrong key (46XXX is not a recognised complete mole genotype) | Disable | Factual error in key; stem also poorly constructed |
06db1a70 |
Fertility and Infertility | Inverted key (tubal block IS an IVF indication) | Disable | Wrong key; concept is high-yield but item is unsalvageable as written |
816baa84 |
Gynecological Disorders | Factually unsafe (LUNA evidence base does not support key) | Disable | Clinical basis for key is not supported by current evidence |
d2fd34b0 |
Gynecological Disorders | Duplicate options (two identical Trichomonas options) | Disable | Broken delivery; unscorable in current state |
60affe46 |
Fertility and Infertility | Wrong subject (male reproductive biology framing) | Disable | OBG subject contamination; replace with female-focused Swyer syndrome item |
13b0ca4a |
Prenatal Care | Bloom's 1, "first symptom of pregnancy" | Disable | Pre-clinical recall; no discriminatory value for PG entrance |
190f2cb9 |
Maternal-Fetal Medicine | Incoherent stem; all options are complications of pregnancy | Disable | Item is logically broken; no correct answer can be defended |
9539a6c8 |
Labor and Delivery | Exact duplicate of 902d2b09 |
Disable | Duplicate; both are low-value but this instance has no PYQ tag |
c413a8a6 |
Menstrual Disorders | Vicarious menstruation trivia | Disable | Zero exam relevance at INI-CET/NEET-PG level |
b272b5c7 |
Maternal-Fetal Medicine | Correct key, low Bloom's, duplicate entry | Fix (after removing duplicate) | Convert to clinical vignette; concept is high-yield for India |
be07addd |
Reproductive Ethics | Factually unsafe key; wrong topic tag | Disable | Unsafe counselling advice; topic misplaced |