2011 module exam Flashcards
The pelvic diaphragm provides support for the pelvic viscera. It is composed of the levator ani and one more muscle. Which muscle is that?
Coccygeus
What can be injured during multiple deliveries leading to urinary incontinence?
Tendinous arch of the pelvic fascia
Which structure can be found in the deep perineal pouch?
Bulbourethral glands
Which folds form the penile (spongy) urethra?
Urogenital
What defect results from inadequate androgen production?
Hypospadias
What is the origin of the testicular artery?
Abdominal aorta
Which structure provides most of the nourishment for sperm?
- Seminal vesicle
- Prostate gland
• Seminal vesicle
Enlargement of which lobe of the prostate can obstruct the urethra?
Median lobe
Which lymph nodes would be first infiltrated by a testicular tumor?
Lumbar lymph nodes
What provides parasympathetic innervation for the uterus?
Pelvic splanchnic nerves
Which anatomical landmark is used in the staging of metastatic breast cancer?
- Pectoralis minor
- Pectoralis major
- Axillary vein
• Pectoralis minor
What is enlargement of one or both breasts in a female before puberty called?
Macromastia
What condition is characterized by abnormal enlargement of the breast in a male?
Gynecomastia
A 34 year old woman presents with hirsutism, cystic ovaries, and amenorrhea after which she experiences heavy bleeding. The endometrium shows increased proliferation. What is this endometrium called?
- Anovulatory
- Proliferative
- Secretory
• Anovulatory
A woman with a BIRAD 5 lesion on mammogram presented with eczematous changes of her breast. A biopsy was taken; what is expected to show in the biopsy?
Pleomorphic cells in the basal layer of skin
A woman presents to the clinic with a sense of lumpiness and pain in her breast. Biopsy of the breast showed cysts, glandular proliferation, and apocrine metaplasia. What is the most likely diagnosis?
Fibrocystic disease
A woman complains of a fixed mass in her breast. On examination of the biopsy, the ducts were extremely proliferative with atypical nuclei but no evidence of invasion. What is the likely diagnosis?
Carcinoma in situ
<p>An ovarian mass was detected and biopsied. The cells had signet ring morphology. What would this ovarian mass be?</p>
Krukenberg tumor
Which gene is most likely mutated in hereditary serous cystadenoma?
BRCA-1
Which tumor would be composed of cytotrophoblast and surrounding syncytiotrophoblast?
Chriocarcinoma
What is the most common site for developing cervical carcinoma?
Transformation zone
How would a lesion with dysplastic cells occupying two thirds of the cervical epithelium be classified?
High grade squamous intraepithelial lesion
The cervical mucosa shows pleomorphic cells lining glandular spaces. What is the likely lesion?
Adenocarcinoma of the cervix
Which of the following confers a high risk for developing endometrial carcinoma?
- Cousins with endometrial cancer
- PCOS for many years
• PCOS for many years
Which of the following is true regarding leiomyoma?
It is composed of whorls of smooth muscles with spindle cells
After a young female experienced an abortion, the products of conception showed a karyotype of 69 XXY. What is the most likely pathology?
Partial hydatidiform mole
A tumor was found in a pregnant woman on delivery. It was hemorrhagic in appearance. What is it most likely to be?
Chriocarcinoma
Which type of neoplasia is associated with elevated human placental lactogen?
Placental site trophoblastic tumor
A Kuwaiti family has a history of breast cancer. How would they be genetically investigated?
By performing gene-linkage analysis
A family reports history of breast, thyroid and prostate cancer. Which gene should be investigated?
BRCA-2
A woman has a history of breast and colon cancer. Which gene is of concern?
MSH-2
A man was stabbed in his chest, after which he was taken by the ambulance but died on their way to the hospital. What is the cause of his death?
- Hypovolemic shock
- Internal bleeding
- Stab wound to the chest
- Cardiac failure
• Stab wound to the chest
Note: the cause of death is the lesion that could be appreciated and identified; the mechanism of death is usually speculated.
A maid was found lying dead in her house with rope marks on her neck. On examination of the body, a faint discoloration of skin was noticed in the hips, and was more intense in the back. Which of the following is most likely to have taken place?
- The body was hanged for half an hour then laid down on the floor
- The body was hanged for eight hours then laid down on the floor
- The body was hanged for three hours then laid down on the floor
• The body was hanged for three hours then laid down on the floor
A woman with history of vaginal bleeding was diagnosed with endometrial carcinoma. Which imaging modality would be ordered to assist the staging of endometrial carcinoma?
- MRI of the pelvis
- CT of the pelvis
• MRI of the pelvis
Which of the following describes the effect of progesterone on breathing during pregnancy?
Increases the tidal volume
Which of the following metabolic changes takes place during the second half of pregnancy?
Increased postprandial amino acid levels
Which of the following facilitates oxygen diffusion through the placenta from the mother to the fetus despite a gradient of 30 mmHg?
Fetal hemoglobin shifts oxygen dissociation curve to the left
Movement of CO2 from the fetus to the mother through the placenta increases PaCO2 on the maternal side and decreases it on the fetal side facilitating diffusion of oxygen; what is this effect called?
- Bohr effect
- Double bohr effect
• Double bohr effect
What is the mechanism of action of northindrone?
Thickens the cervical mucus
Which drug can be used to induce abortion before 20 weeks of pregnancy?
Mifepristone
Which of the following is a contraindication for the usage of oral contraceptives?
Cerebrovascular disease
Which drug is a partial estrogen agonist that is used to induce ovulation?
Clomiphene
What is the mechanism of action of clomiphene?
It antagonizes the effect of negative feedback of estrogen on the pituitary and hypothalamus
Which of the following is true regarding hormone replacement therapy?
- It is most effective if used early enough
- It induces bone deposition by osteoblasts
• It is most effective if used early enough
A pregnant woman was on phenytoin to control her epileptic seizures. However, she developed seizures during pregnancy. What would explain that?
The total concentration of phenytoin has deceased during pregnancy
Which of the following are identified as a definite cause of recurrent miscarriages?
Anti-phospholipid antibodies
How do anti-sperm antibodies result in infertility?
Prevent cervical mucus penetration by sperm
A concerned mother brought her daughter to the physician. The daughter had signs of breast development, axillary and pubic hair growth, as well as acne. The physician diagnosed her with precocious puberty. What would the age of the daughter probably be?
- 7
- 10
- 13
- 14
•7
A 14 year old girl was brought to the clinic with history of primary amenorrhea although she does report experiencing pain at the same time every month. On examination, the obstetrician diagnosed her with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. How is this condition managed?
- Creation of breast
- Administration of medroxy progesterone acetate
- Hormone replacement therapy
- Creation of neovagina
• Creation of neovagina
Note: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome (also referred to as Mayer-Rokitansky syndrome or Rokitansky-Küster-Hauser syndrome) consists of vaginal aplasia with other müllerian (ie, paramesonephric) duct abnormalities. [1] Type I MRKH syndrome is characterized by variable underdevelopment of the vagina and uterus. Type II MRKH also incorporates extragenital/extramüllerian malformations, including vertebral, cardiac, urologic (upper tract), and otologic anomalies. [2] Surgical correction of the vaginal anomaly permits normal sexual function and, possibly, reproduction with assisted techniques.
What is the normal range of menstrual cycle length?
- 21 to 35 days
- 28 to 38 days
• 21 to 35 days
A woman has her periods with normal amount every 45 days. What is this menstrual bleeding pattern called?
Oligomenorrhea
A 45 year old woman with 3 children presents with vaginal bleeding. A pipelle was used to get an endometrial biopsy that showed complex hyperplasia with atypia. How would this patient be managed?
- Endometrial ablation
- Hysterectomy
• Hysterectomy
Which of the following is true regarding lactogenesis?
Lactose, proteins and water are transported via exocytosis
Which of the following is one benefit of lactation for the mother?
Prolongs lactational anovulation
What is the source of nutrients for the embryo before four weeks of gestation?
Trophoblast
Which of the following is true regarding implantation?
Reduced endometrial receptivity is the main cause of most cases of failure of implantation
Which of the following represents hormone levels during menopause?
FSH is high, Estradiol is low, inhibin is low, AMH is low
Which of the following women is more likely to have an early menopause?
A woman who smokes 2 packets of cigarettes per day for 10 years
A 35 year old woman presents with amenorrhea for the last 14 months accompanied with hot flushes and dry vagina. What is she most likely to have?
Primary ovarian failure
Which phase of sexual response cycle is characterized by increased muscle tension, increased heart rate and breathing, increased blood flow to the genitals, as well as skin flushes?
Excitement
A pregnant woman gave birth to a baby with cleft palate. She recalls using amoxicillin five times daily for seven days during the 20th week of gestation; she is convinced that the congenital abnormality in her baby is because of that drug. What would confer strong evidence against that?
It is not related to the drug because the palate closes in the first trimester
During which phase of myometrial activity are progesterone, prostacyclin, nitric oxide and relaxin active?
Active inhibition
A pregnant woman is brought to the maternity hospital in preterm labor at 32 weeks of gestation. What can be administered to decrease the myometrial contractions?
Beta 2 agonists
A woman’s last menstrual period was on 10/1/2015. What is the expected date of delivery?
- 10-10-2016
- 17-10-2016
- 13-10-2016
- 7-10-2016
• 17-10-2016
A pregnant woman was examined; the fetal head was in the right flank and his buttocks were in the left flank. What is this lie called?
- Horizontal lie
- Longitudinal lie
- Transverse lie
• Transverse lie
Note: the pic wasn’t provided.
A pregnant woman was examined, the fetal head was in the suprapubic region, and the fetal back was palpated in the left flank. Where would the fetal heart be auscultated?
- In the left lower quadrant
- In the left upper quadrant
- Just above the maternal umbilicus
- Just below the maternal umbilicus
• In the left lower quadrant
Note: the position of the fetus described in the scenario is called left occipitoanterior (LOA).
A woman who is pregnant for the fifth time had two previous miscarriages and two preterm deliveries. The two babies survived. Which of the following truly represents her parity code?
- G5 P0 + 2 + 2 + 2
- G5 P2 + 2 + 2 + 2
• G5 P0 + 2 + 2 + 2
Note: G (gravida): number of pregnancies regardless the outcome including the current one. P (para); 1st number: term deliveries; 2nd number: preterm deliveries; 3rd number: number of miscarriages, 4th number: number of living births.
When does implantation take place?
One week after fertilization
Which of the following events takes place just before implantation?
Hatching of the zona pellucida
A pregnant woman presents with severe hypertension, proteinuria and seizures. What is she having?
Eclampsia
A pregnant woman came to the obstetric clinic where an ultrasound was performed. It revealed a big baby and a large amount of amniotic fluid. What could the mother have?
Gestational diabetes
A 39 year old woman presented with hirsutism, chronic amenorrhea and obesity. What is the likely diagnosis?
Polycystic ovarian syndrome
A tall female presents with normal breast development, amenorrhea and no pubic or axillary hair. What is the likely diagnosis?
Androgen insensitivity syndrome
A young man presents to the clinic with grouped superficial painful ulcers on his penis and lymphadenopathy. What is the likely diagnosis?
Herpes genitalis
A 31 year old man presented with a soft tender yellow penile lesion that has a necrotic base. What is the likely condition?
Chancroid
A woman in active labor is having an obstructed labor. Her pelvis was found to have converging walls, straight sacrum, prominent ischial spines and a narrow subpubic arch. What type of pelvis is this?
- Platypoid
- Gynecoid
- Android
- Anthropoid
- Mixed
• Android
EBM: A study was performed to assess the association between ovarian cancer and smoking. The cases were picked from the oncology clinic in a hospital while the controls were picked from the cardiology clinic in the same hospital. What could have gone wrong during the selection procedure?
The smokers will be overrepresented among the controls
EBM: Why is cox multivariate regression used in analysis of the association of an exposure with an outcome?
It eliminates the effect of potential confounders
EBM: Which measure of association can be retrieved from a case-control study?
Odds ratio
EBM: What measure of disease occurrence can be retrieved from a cohort study?
Cumulative incidence
