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[OS 215] OB-GYN E1 > 2013 B > Flashcards

2013 B Flashcards

1
Q

Reproductive Health (RH) addresses

a. Family Planning only
b. The reproductive system, functions and processes at all stages of life
c. Reduction of maternal mortality only
d. Reduction of reproductive tract infection only
e. None of the above

A

B

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2
Q

The need for effective Reproductive Health programs is a growing concern because

a. The rate of decrease in the Maternal Mortality ratio is very slow
b. There is significant increase in the incidence of rape
c. There is higher rate of unsafe abortions
d. All of the above
e. None of the above

A

D

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3
Q

Among the 10 elements of Reproductive Health is/are

a. Violence Against Women (VAW)
b. Male Reproductive Health
c. Adolescent Reproductive Health
d. Sexuality education
e. All of the above

A

E

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4
Q

Reproductive Rights refers to

a. The right to attain the highest standard of sexual and reproductive health
b. The right to access and choose family planning services and other methods of fertility regulation contrary to law
c. The right to access health services to enable women to go safely through pregnancy and childbirth with the best chance of having a healthy infant
d. The right to make decisions concerning reproduction free of discrimination, coercion, and violence
e. All of the above

A

E

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5
Q

The reproductive Health definition posted by the WHO in 1994 is seen within the framework of

a. Primary Health Care
b. Religious Beliefs
c. Rights-based approach to development
d. B and C
e. A and C

A

E

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6
Q

A major obstacle to the implementation of an effective Reproductive Health program is

a. changing the policies of the DOH depending on the Secretary of Health’s beliefs and priorities
b. a sustained economic growth
c. an administrative order on gender equity
d. local health systems development
e. decentralized financial management

A

A

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7
Q

Maternal care and nutrition is an important element of Reproductive health because

a. Many women are needlessly dying due to complications of pregnancy such as anemia and hypertension
b. Pregnancy is an infirmity and should be addressed as an illness
c. Mothers are stupid and ignorant
d. Babies are born out of wedlock
e. DOH programs address Male Reproductive health

A

A

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8
Q

The International Conference on Population and Development held in Cairo called for

a. Extended patent protection for drugs
b. Liberalization of the economy
c. Universal access to RH services including sexual health and family planning
d. Privatization of health facilities
e. Deregulation of the pharmaceutical industry

A

C

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9
Q

Adolescent Reproductive Health programs should

a. Reprimand teens for promiscuous behavior
b. Ensure access of adolescents to appropriate RH services/ information they need
c. Restrict services only to married couples
d. Focus on studies of religious beliefs and philosophies , to ensure morally upright youth
e. Be based only in health centers where the youth should go

A

B

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10
Q

The following statements are true EXCEPT

a. We should deal with the health impact of unsafe abortion as a public health concern
b. Women with unwanted pregnancies should have access to reliable information and counseling
c. In cases of abortion, whether availed of illegally or not, women should have access to quality care for complications of abortion
d. Only married couples of reproductive age [MARCA] should have access to RH services
e. All sexual and Reproductive health services should be confidential

A

D

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11
Q

The equivalent of the female labia majora in males is:

a. Scrotal swelling
b. Urethral fold
c. Urethral grove
d. Glans penis

A

A

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12
Q

The testis is expected to reach the scrotal sac by what month of gestation?

a. 6th
b. 7th
c. 8th
d. 9th

A

B

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13
Q

Features of a patient with Klinefelter syndrome include

a. 45 XO chromosome
b. normal intelligence
c. fertile
d. tall

A

D

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14
Q

Features of a patient with urogenital sinus include:

a. Normal uterus
b. Normal rectum
c. Normal vaginal canal
d. Normal urethra

A

B

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15
Q

Which structure forms the distal vaginal canal?

a. missing option
b. Urogenital sinus
c. Mullerian duct
d. Wolffian duct

A

B

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16
Q

In an apparent newborn female, which feature will alert a clinician to the possibility of intersexuality?

a. Inguinal hernia with incarcerated gonad
b. Enlarged breasts
c. Normal looking vaginal canal
d. Hypospadias

A

A

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17
Q

Which is the most common cause of an empty scrotal sac?

a. Retractile testis
b. Ectopic testis
c. Undescended testis
d. Absent testis

A

C

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18
Q

Which of the following is true?

a. The primitive germ cells migrate from the yolk sac
b. The development of the seminal vesicles is dependent on dihydrotestosterone
c. Absence of dihydrotestosterone causes regression of the wollfian ducts
d. The functioning kidney originates from the mesonephros

A

A

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19
Q

Early castration will result in;

a. Normal prostate formation
b. Presence of fallopian tubes
c. XX genes
d. Formation of ovaries

A

B

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20
Q

Which of the following statements is true?

a. The start of the development of phenotypic sex is earlier compared to development of gonadal sex
b. The testes normally reach the scrotal sac by the 8th age of gestation
c. The presence of urogential sinus is always abnormal
d. Problem of intersexuality should be suspected in a male with undescended testis

A

D

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21
Q

A condition that results from complete obliteration of the processus vaginalis testis:

a. Hydrocoele of the cord
b. Non-communicating hydrocoele
c. Inguino-scrotal hernia
d. Normal anatomy

A

D

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22
Q

A patient with Meyers-Rokitansky syndrome will have:

a. Normal ovaries
b. 46 XY kayotype
c. infrequent association of skeletal abnormalities
d. normal uterus

A

A

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23
Q

A very tall male with normal sexual development and intelligence was imprisoned for riots he instigated. He would likely to have a genotype of

a. 47XXY
b. 47XYY
c. 45XO
d. 47XXX

A

B

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24
Q

A baby was born with ambiguous genitalia. On physical examination, no gonads were palpated but on ultrasound, uterus was noted to be present. The karyotype was XX with 17 OH-progesterone values within normal values. The most likely problem is:

a. Male pseudohermaphroditism
b. Female pseudohermaphroditism
c. Congenital adrenal hyperplasia
d. True Hermaphroditism

A

B

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25
Q

A baby was born with ambiguous genitalia. On physical examination, no gonads were palpated. On ultrasound, no uterus was appreciated. The karyotype was XY with 17 OH-progesterone within normal values. The most likely problem is:

a. Male pseudohermaphroditism
b. Female pseudohermaphroditism
c. Congenital adrenal hyperplasia
d. True Hermaphroditism

A

A

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26
Q

A patient with androgen insensitivity syndrome will have which of the following features?

a. XX genotype
b. Normal female genitalia
c. Palpable gonads
d. Complete male internal organs

A

C

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27
Q

A 15 Y/O individual was brought up as a male. He was noted recently to have sudden spurt in growth with pimples on his face. His gonads were not palpable but with an enlarged phallus. Ultrasound revealed presence of uterus with a karyotype of XX. The most likely problem of the individual is:

a. Male pseudohermaphroditism
b. Female pseudohermaphroditism
c. Congenital adrenal hyperplasia
d. Testicular dysgenesis

A

C

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28
Q

Which of the following statements is true?

a. The testis will reach the scrotal sac at 9 months AOG
b. The gonadal sex is determined at fertilization
c. The patient with true hermaphroditism will have a karyo typing of XO
d. A male pseudo-hermaphrodite will not have mullerian structures

A

D

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29
Q

Which of the following will not have mullerian structures?

a. Dysgenetic males
b. Pseudo-hermaphrodite males
c. Patients with mixed gonadal dysgenesis
d. Pseudo-hermaphrodite females

A

B

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30
Q

A normal male perineum would have how many openings?

a. 1
b. 2
c. 3
d. 4

A

B

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31
Q

At the level of phenotypic sex development, which statement is true?

a. Undifferentiated structures become ovary or testis
b. Strong feelings of being male of female develops
c. It happens 7 weeks after fertilization
d. The penile shaft is obvious

A

D

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32
Q

The best time to council a patient on the affects of drugs in pregnancy is

a. preconception
b. first prenatal visit
c. first trimester
d. just before labor
e. any of the above

A

A

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33
Q

Reproductive outcomes arising from exposure to pharmacologic agents is/are the following:

a. abortion
b. congenital malformation
c. developmental delays
d. normal fetus
e. all of the above

A

E

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34
Q

Therapy in any woman during the reproductive age must take into consideration

a. timing of exposure during gestation and preconception
b. knowing kinetics of the drug in both non-gravid and gravid state
c. intercurrent disease for which the drug is prescribed
d. established effect of the drug in both mother and fetus
e. all of the above

A

E

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35
Q

What is the mechanisms by which most teratogens act?

a. alteration in tissue growth
b. cell death
c. errors in cellular differentiation
d. unknown
e. all of the above

A

E

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36
Q

Which of the following periods is most crucial to structural malformations?

a. Prefertilization
b. Zygote
c. Embryonic
d. Fetal

A

C

37
Q

These maternal values determine the maternal and fetal therapeutic/toxic responses to drugs EXCEPT

a. increased serum albumin concentration
b. increased cardiac output and plasma volume
c. increased glomerular filtration rate
d. reduced intestinal motility
e. none of the above

A

E

38
Q

Which of the following statements regarding US FDA classification is NOT correct:

a. A – controlled studies showed no fetal risk
b. B – human studies done with possible risk to human fetus and possible animal risk
c. C – human studies have not been performed; animal studies may or may not show risk; potential benefits may justify potential risk
d. X – contraindicated in pregnancy
e. none of the above

A

E

39
Q

Drug/s which is/are safe to give to the above patient

a. Amoxicillin
b. Cefuroxime
c. Tetracycline
d. a and b only
e. all of the above

A

D

40
Q

Which of the following statements is TRUE

a. We can prescribe mefenamic acid for the patient’s body pains and weakness
b. Paracetamol is not necessary and she can just increase her oral fluid intake
c. The patient should be prescribed an antibiotic as she has upper respiratory tract infection which is probably bacterial
d. B and C only
e. all of the above

A

E

41
Q

The baseline risk for occurrence of congenital malformations in the general population is

a. 1%
b. 3%
c. 5 %
d. 7 %
e. 10 %

A

B

42
Q

A 30 year old G3P2 in her 32nd week AOG consulted at the OB Admitting Section for profuse vaginal bleeding which she noticed upon waking up. She had no prenatal checkups. Vital signs were within normal with no note of uterine contractions. Fetal heart tones were noted at the left lower quadrant at 140/min. What is the most probable diagnosis?

a. Abruptio Placenta
b. Vasa Placenta
c. Placenta Previa
d. Placenta Accreta

A

C

43
Q

What examination should be requested in the above patient to verify the diagnosis?

a. Pelvic ultrasound
b. CT scan
c. MRI
d. Abdominal xray

A

A

44
Q

What will be the cause of concealed hemorrhage in Abruptio Placenta?

a. The fetal head is presenting and floating
b. The placenta and membranes are completely separated
c. Blood gains access to the amniotic cavity after breaking through the membranes
d. Fetal presentation is double footing

A

C

45
Q

What is the reason why there is also an increase in the possibility of bleeding even after doing an elective CS in a G1 patient with placenta previa totalis at 37 weeks AOG?

a. bleeding from the implantation site at the lower uterine segment
b. increase in the probability of uterine atony in Placenta previa
c. associated coagulopathy in placenta previa
d. previous history of premature labor

A

A

46
Q

A 25 yr old G1P1 patient consulted at the OBAS because of profuse vaginal bleeding. She delivered at home 3 days ago attended by a traditional birth attendant. Internal examination showed an open cervix with the corpus enlarged to 16 weeks AOG. What is the most probable diagnosis?

a. uterine atony
b. retained placental fragments
c. uterine rupture
d. vulvar hematoma

A

B

47
Q

The ovarian artery is a direct branch of what main vessel?

a. internal iliac artery
b. external iliac artery
c. aorta
d. uterine artery

A

C

48
Q

There is loss of endothelial activity with activation of the intrinsic pathway in consumptive coagulopathy. What is the associated condition that activates this pathway?

a. abruptio placenta
b. retained dead fetus
c. septic abortion
d. amniotic fluid embolism

A

C

49
Q

what is the most common cause of uterine inversion

a. presence of concomitant placenta accrete
b. vigorous fundal pressure on the third stage of labor
c. over-traction of the umbilical cord
d. presence of a relaxed and atonic uterus

A

C

50
Q

A 35 year –old undergoing CS for abruption placenta has a haemoglobin of 85 g/dL and there is slight oozing of blood from the uterine incision. Her platelet count is 150,000 cells/m3. How will you replace the blood loss for this patient?

a. give fresh whole blood (FWB) and crystalloids
b. give packed RBC and frozen plasma
c. give crystalloids and RBC
d. give packed RBC, fresh frozen plasma and platelet concentrate

A

C

51
Q

A 26 year old primigravid is delivered by outlet forceps extraction manifested with bleeding right after delivery despite a well contracted uterus. What will be the most probable diagnosis?

a. retained placental fragments
b. cervical laceration
c. vaginal hematoma
d. uterine atony

A

B

52
Q

Estrogen

a. increases basal insulin levels and the insulin response to glucose
b. increases levels of HDL and triglycerides and decreases the levels of LDL and total cholesterol
c. decreases SHBG, increases HDL and LDL

A

B

53
Q

The following are actions of progestins except:

a. inhibit the systhesis of estrogen receptors
b. stimulate the synthesis of progesterone receptors
c. increase intracellular synthesis of estradiol dehydrogenase
d. increase the conversion of estradiol to estrone

A

NA

54
Q

True of the two-cell system theory except:

a. the pertinent target cells in the male are the leydig and sertoli cells of the testis, while the thecal and granulose cells of the ovary mediate gonadotropin function in the female
b. in the female, the thecal cells synthesize the androgen testosterone, which is then converted to estradiol in the granulose cells
c. FSH stimulation increases the production of ABP which is important for maintaining the high testicular concentrations of testosterone necessary for spermatogenesis
d. FSH stimulation increases aromatase activity thus increasing the conversion of testosterone to estrogen

A

NA

55
Q

The following statements is/are true of the combination oral contraceptive pills exept:

a. thrombosis is one of the most serious side effects of the pill and is related to progesterone and is dose related
b. new progestins like desogestrel, gestodene have reduced androgenicity manifested by the decreased sex hormone binding globulin and decreased free testosterone
c. the progestational agent in the pill primarily suppresses FSH secretion and thus prevents ovulation while the estrogenic agent suppresses LH secretion and thus prevents the emergence of a dominant follicle
d. the use of oral contraception protects against endometrial and ovarian cancer

A

A

56
Q

Androgen

a. increases basal insulin levels and the insulin response to glucose
b. increases levels of HDL and triglycerides and decreases the levels of LDL and total cholesterol
c. decreases SHBG, increases HDL and LDL

A

C

57
Q

Competitive inhibitor of progesterone receptor

a. finasteride
b. clomiphene
c. cyproterone acetate
d. RU 486

A

D

58
Q

Reductase inhibitor which slows down the growth of prostate tissue

a. finasteride
b. clomiphene
c. cyproterone acetate
d. RU 486

A

A

59
Q

Which of the following estrogens is used in oral contraceptives?

a. estrone
b. ethinyl estradiol
c. estriol
d. equilin

A

B

60
Q

What is the progestin with the least androgenic effect?

a. norethindrone
b. norgestrel
c. levonogestrel
d. norgestimate

A

D

61
Q

Average life span of the ovum

a. 12-24 hrs
b. 24-36 hrs
c. 36-48 hrs
d. 49-72 hrs

A

A

62
Q

After ovulation the oocyte remains fertilizable for a maximum of how many hours?

a. up to 12 hours or less
b. up to 24 hours
c. more than 48 hours
d. as much as 72 hours

A

B

63
Q

The probability that a single oocyte would result in a livebirth

a. fecundity
b. fecundability
c. fertility
d. NOTA

A

A

64
Q

Regarding mechanism of action which of the following is not true of progestin only contraceptive pills?

a. inhibit ovulation reliably
b. alter cervical mucus
c. alter endometrial lining

A

A

65
Q

What is the contraceptive usage of Depo-Provera

a. 50 mg every 3 months
b. 100 mg every 3 months
c. 150 mg every 3 months
d. 200 mg every 3 months

A

C

66
Q

Of the following, which is not effective for post-coital contraception?

a. ethinyl estradiol
b. copper IUD
c. levonorgestrel
d. norplant

A

D

67
Q

What is the mechanism of oral contraceptives?

a. Prevent ovulation
b. Suppress gonadotropin-releasing factors
c. Impair sperm transport
d. All of the above

A

D

68
Q

Which of the following is not an absolute contraindication to using an intrauterine device?

a. Active or recent salpingitis
b. Pregnancy
c. Undiagnosed uterine bleeding
d. Uterine leiomyomata

A

A

69
Q

A 19 year old G3P0 (0030) drug addict high school drop-out desires a temporary form of contraception. In terms of preventing pregnancy in this patient, the best choice of the following would be:

a. Rhythm method
b. Condoms
c. Injectable DMPA
d. IUD

A

NA

70
Q

A cause of primary amenorrhea

a. Polycystic ovary syndrome
b. Premature ovarian failure
c. Kallmann syndrome
d. Functional hypothalamic amenorrhea

A

C

71
Q

A cause of secondary amenorrhea

a. Prepubertal hypothyroidism
b. Androgen resistance
c. Phenothiazine derivatives
d. 17,20 desmolase deficiency

A

C

72
Q

Which of the following is a cause of amenorrhea and manifest with presence of the uterus but with absent breast development?

a. Agonadism
b. Turner syndrome
c. 17 alpha hydroxylase deficiency with 46 XY karyotype
d. Testicular feminization

A

B

73
Q

Which of the following is a cause of amenorrhea and manifest with the absence of both uterine and breast development?

a. 46, X abnormal X
b. Uterovaginal agenesis
c. Congenital anatomic defect in CNS
d. Agonadism

A

D

74
Q

What causes endometrial bleeding during menses?

a. Progesterone withdrawal from an estrogen-primed endometrium
b. Estrogen withdrawal from a progesterone-primed endometrium
c. High progesterone content
d. High estrogen content

A

A

75
Q

What is menorrhagia?

a. Uterine bleeding at regular intervals of 7 days
c. Uterine bleeding more than 35 days apart
d. Uterine bleeding at irregular but frequent intervals

A

B

76
Q

Which is a cause of anovulatory bleeding?

a. Coagulopathies
b. Intrauterine device
c. Adenomyosis
d. Gonadal steroids

A

D

77
Q

Which is the most effective in the control of acute uterine bleeding?

a. Paracetamol
b. Estrogens
c. Androgens
d. NSAIDS

A

NA

78
Q

Which is true of primary dysmenorrhea?

a. Dyspareunia is seen.
b. Fixed retroverted uterus with posterior tenderness is seen.
c. Pain is correlated with increased duration and flow of menses.
d. Laparoscopy is the best diagnostic modality.

A

C

79
Q

Which is a symptom of Premenstrual Syndrome?

a. Bipedal edema
b. Psychosis
c. Joint pains
d. Lethargy

A

D

80
Q

Preterm labor is defined as:

a. Regular uterine contractions 5-8 minutes apart
b. Cervical effacement
c. Progressive cervical dilatation
d. All of the above

A

D

81
Q

Which of the following risk factors has the strongest association with preterm birth?

a. Gestational diabetes
b. History of preeclampsia
c. History of preterm birth
d. Smoking

A

D

82
Q

Which of the following vaginal infections is significantly associated with preterm birth?

a. Candidiasis
b. Bacterial vaginosis
c. Trichomoniasis
d. Herpes simplex infections

A

B

83
Q

What is the mechanism by which betamethasone reduces respiratory distress syndrome?

a. Acts synergistically with bete-adrenergic agents to prolong latency period
b. Increased prostaglandin production
c. Increased interleukin-1 production
d. Increased production of surfactant

A

D

84
Q

Which is the most common cause of indicated preterm birth?

a. Abruptio placentae
b. Placenta previa
c. Preeclampsia
d. Gestational diabetes

A

C

85
Q

Which of the following tocolytics is associated with premature closure of fetal ductus arteriosus?

a. Ritodrine
b. Nifedipine
c. Magnesium sulfate
d. Indomethacin

A

D

86
Q

Postterm pregnancy is defined as pregnancy which extends beyond how many weeks?

a. 37 weeks
b. 40 weeks
c. 42 weeks
d. 44 weeks

A

C

87
Q

What is the most important reason for increased fetal morbidity and mortality in postterm pregnancy?

a. Placental insufficiency
b. Meconium-stained amniotic fluid
c. Oligohydramnios and cord compression
d. Decreased fetal urination

A

A

88
Q

What is the appropriate management of a woman who has reached 42 weeks with a Bishop’s score of 5 and estimated fetal weight of 3850 grams?

a. Expectant management or induction
b. Start fetal well-being studies
c. Amniocentesis to determine fetal lung maturation
d. Elective cesarean section

A

A

89
Q

For dichorionic diamnionic membranes to occur in monozygotic twins, when should division occur with reference to fertilization?

a. 72 to 180 hours
c. 180 to 240 hours

A

A

[OS 215] OB-GYN E1 (5 decks)

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