2014 module exam Flashcards
A woman with breast cancer subsequently developed metastases to her vertebral column. What is the most direct route for spread to the vertebral column?
a) tributaries of cephalic vein
b) tributaries of lateral thoracic vein
c) tributaries of thoracoacromial vein
d) lymphatic vessels draining to axilla
e) tributaries of posterior intercostal vein
e) tributaries of posterior intercostal vein
What is thelarche?
a) Development of breast tissue
b) Development of pubic hair
a) Development of breast tissue
A patient suffering from tuberculosis of the epididymis presented with ulcer in the posterior wall of the scrotum. what group of lymph nodes are involved initially in this case?
a) external iliac
b) internal iliac
c) superficial inguinal
d) deep inguinal
c) superficial inguinal
Which of the following event is first detected in male puberty?
a) Presence of sperms in the urine
b) Nocturnal sperm emissions
c) Appearance of pubic hair
d) Appearance of axillary hair
e) Increase in testicular size
e) Increase in testicular size
What is the correct sequence of sexual response cycle in males?
a) Excitement-plateau-resolution-organism
b) excitement-plateau-orgasm-resolution
c) erection-plateau-resolution-orgasm
d) erection-plateau-ejaculation-refractory
e) erection-plateau-ejaculation-resolution
b) excitement-plateau-orgasm-resolution
Which of the following is the segment of chromosome Y that is involved in sexual differentiation?
a) ZFY
b) RP.84
c) SRY
d) Pseudochromosome / pseudoautosome
e) Centromere
c) SRY
Which of the following is related to the lateral aspect of the ovaries?
a) Iliolumbar artery
b) Superior gluteal artery
c) Inferior gluteal artery
d) Superior vesical artery
e) Inferior vesical artery
f) Obturator artery
f) Obturator artery
A 28-year-old female presents with severe pain in right lower quadrant for the past 3 hours. She did an ultrasound one week ago because of menstrual irregularities, and they found a cystic mass in the ovary. Recent ultrasound showed no cyst with only fluid behind the uterus. What is the cause of the severe pain?
a) ischaemia
b) inflammation
c) torsion
d) degeneration
e) rupture
e) rupture
Oogenesis arrest at which phase from birth until puberty?
a) Prophase 1
b) Metaphase 1
c) Anaphase 1
d) Telophase 1
e) Prophase 2
f) Metaphase 2
g) Anaphase 2
h) Telophase 2
a) Prophase 1
Oogenesis arrest at which phase until fertilization?
a) Prophase 1
b) Metaphase 1
c) Anaphase 1
d) Telophase 1
e) Prophase 2
f) Metaphase 2
g) Anaphase 2
h) Telophase 2
f) Metaphase 2
Formation of 2nd polar body is at which phase?
a) Prophase 1
b) Metaphase 1
c) Anaphase 1
d) Telophase 1
e) Prophase 2
f) Metaphase 2
g) Anaphase 2
h) Telophase 2
h) Telophase 2
A 35-year-old woman was noticed to have an absent kidney on one side. Which of the following is she likely to have?
a) unicornuate uterus
b) absent ovary on unilateral side
c) imperforate hymen
d) uterus bicollis
b) absent ovary on unilateral side
BRCA2 mutation is associated with predisposition to male breast cancer. What is the percentage of the risk? (what is the risk of developing male breast cancer if a person has BRCA2 mutation?)
1) <1%
2) 5-10%
3) 10-15%
4) 15-25%
2) 5-10%
What causes cortisol binding globulin (CBG) to increase during pregnancy?
a) Estrogen
b) HCG
c) HPL
a) Estrogen
Blood pressure decreases in the first two trimesters. This decrease is due to decrease in?
a) total peripheral resistance
b) heart rate
c) stroke volume
a) total peripheral resistance
candida infection in mouth of baby
a) galactorrhea
b) galactocele
c) mastitis
d) breast abscess
e) nipple pain
f) cracked nipple
g) bloody discharge
h) breast engorgement
c) mastitis
improper latching of baby
a) galactorrhea
b) galactocele
c) mastitis
d) breast abscess
e) nipple pain
f) cracked nipple
g) bloody discharge
h) breast engorgement
f) cracked nipple
inadequate feeding
a) galactorrhea
b) galactocele
c) mastitis
d) breast abscess
e) nipple pain
f) cracked nipple
g) bloody discharge
h) breast engorgement
h) breast engorgement
During embryonic development, the Mullerian system opens into the dorsal aspect of the cloaca. What congenital anomaly will develop?
a) rectovaginal fistula
b) rectovesical fistula
a) rectovaginal fistula
what passes superficial to the ureter from lateral to medial
a) Epididymis
b) Vas deferens
c) Efferent ductules
d) Seminal vesicle
e) Prostate
f) Ejaculatory duct
g) Penis
b) Vas deferens
supplied by branches of internal pudendal artery
a) Epididymis
b) Vas deferens
c) Efferent ductules
d) Seminal vesicle
e) Prostate
f) Ejaculatory duct
g) Penis
g) Penis
a 48-year-old woman didn’t get her menstrual cycle for 10 months. How would you classify her?
a) Late menopause
b) Menopause
c) Early menopause
d) Secondary amenorrhea
e) Primary amenorrhea
d) Secondary amenorrhea
What is a contraindication for combined oral contraceptives?
a) Uterine fibroids
b) Cerebrovascular disease
c) Endometrial cancer
b) Cerebrovascular disease
Which drug is a progesterone receptor blocker that is used to induce abortion?
Mifepristone
Which drug is biotransformed into a metabolite that inhibits FSH?
a) Ethinyl estradiol
b) Mestranol
b) Mestranol
Where does sperm storage and maturation take place?
a) Vas deferens
b) Epididymis
b) Epididymis
What is responsible for myometrial activation during labor?
a) Estrogen
b) Nitric oxide
c) Prostacyclin (PGI2)
d) Progesterone
e) Relaxin
a) Estrogen
Who is more likely to develop menopause earlier (premature menopause)?
a) A lady who smokes 20 packs of cigarettes per day for 10 years
b) A 30-year-old who had unilateral oophorectomy because of ovarian torsion
c) A 49-year-old with simple hysterectomy
a) A lady who smokes 20 packs of cigarettes per day for 10 years
What is the expected date of delivery (EDD) for a pregnant lady who had her last menstrual period (LMP) at 1/1/2018?
8/10/2018
Where does metabolism of oxytocin occur during pregnancy?
a) Placenta
b) Maternal liver
c) Maternal kidney
d) Fetal liver
e) Fetal kidney
a) Placenta
Fetal head is felt in the right lumbar region and his buttocks in the left lumbar region
a) Transverse lie
b) Oblique lie
c) Horizontal lie
d) Cephalic presentation
e) Breach presentation
f) Symphysis fundal height appropriate for 38 weeks of gestation
g) Symphysis fundal height appropriate for 36 weeks of gestation
a) Transverse lie
Fundus of uterus can be felt at the xiphisternum (xiphoid process)
a) Transverse lie
b) Oblique lie
c) Horizontal lie
d) Cephalic presentation
e) Breach presentation
f) Symphysis fundal height appropriate for 38 weeks of gestation
g) Symphysis fundal height appropriate for 36 weeks of gestation
f) Symphysis fundal height appropriate for 38 weeks of gestation
A hard-balloted structure can be felt on the upper pole just below the sternum/epigastric
region (the idea is something was hard and felt above the umbilicus/below the sternum
which is most likely the fetus head)
a) Transverse lie
b) Oblique lie
c) Horizontal lie
d) Cephalic presentation
e) Breach presentation
f) Symphysis fundal height appropriate for 38 weeks of gestation
g) Symphysis fundal height appropriate for 36 weeks of gestation
e) Breach presentation
the fetal spine/back at pelvic brim
a) Transverse lie
b) Oblique lie
c) Horizontal lie
d) Cephalic presentation
e) Breach presentation
f) Symphysis fundal height appropriate for 38 weeks of gestation
g) Symphysis fundal height appropriate for 36 weeks of gestation
a) Transverse lie
What is the reason behind the development of anti-sperm antibodies in males?
spermatogenesis happens after the immune system develops tolerance to self Ag
Which of the following metabolic changes takes place during the second half of pregnancy?
a) increased lipogenesis
b) increased insulin sensitivity
c) Increased postprandial amino acid levels
c) Increased postprandial amino acid levels
Humoral mediated cause for recurrent spontaneous miscarriage/unexplained miscarriage
a) Antiphospholipid Antibodies
b) Maternal Th1 cytokines
c) Anti-sperm antibodies
d) Zona pellucida antibodies
e) Maternal Th2 cytokines
f) Anti-ovarian antibodies
g) Immunosuppression
h) Endometrial antibodies
a) Antiphospholipid Antibodies
Cell mediated cause for recurrent spontaneous miscarriage/unexplained miscarriage
a) Antiphospholipid Antibodies
b) Maternal Th1 cytokines
c) Anti-sperm antibodies
d) Zona pellucida antibodies
e) Maternal Th2 cytokines
f) Anti-ovarian antibodies
g) Immunosuppression
h) Endometrial antibodies
b) Maternal Th1 cytokines
What test is used to check for anti-sperm antibodies:
Sperm immunofluorescence
Which of the following ovarian cancers is associated with a mutation in BRCA1?
a) Mucinous
b) Endometrioid
c) Serous
d) Clear cell
e) Transitional cell
c) Serous
In pregnancy, free serum thyroxine remains the same but total thyroxine increases. What is reason behind this increase?
a) Thyroid binding globulin
b) estrone
c) HCG
d) progesterone
e) cortisol
a) Thyroid binding globulin
A tumor with malignant epithelial and mesenchymal components.
a) Clear cell carcinoma
b) Serous carcinoma
c) Endometrial carcinoma
d) Carcinosarcoma (also known as malignant mixed Mullerian tumor)
d) Carcinosarcoma (also known as malignant mixed Mullerian tumor)
A woman with uterine/cervical cancer presented with hydroureter which lymph node is most likely involved?
a) External iliac
b) Internal iliac
c) Paracervical
d) Paraortic
c) Paracervical
A woman presented with swollen lower limbs, upon further investigations it was found that she has uterine cancer/cervical cancer. Which lymph nodes are likely to be involved?
a) External iliac
b) Internal iliac
c) Paracervical
d) Paraortic
a) External iliac
What does the fascia transversalis give rise to?
a) Cremasteric fascia
b) internal spermatic fascia
c) external spermatic fascia
b) internal spermatic fascia
A young boy had his routine medical examination and was diagnosed with cryptorchidism. What is the most likely location of the testes?
a) At saphenous opening
b) In front of pubic symphysis
c) Inguinal canal
d) At anterior superior iliac spine
c) Inguinal canal
What is the source of alkaline phosphatase in semen?
a) Seminal vesicles
b) Vas deferens
c) Epididymis
a) Seminal vesicles
Which of the tumors mentioned above is associated with the following tumor marker: AMH
a) Dysgerminoma
b) Yolk sac tumor (endodermal sinus tumor)
c) Choriocarcinoma
d) Gonadoblastoma
e) Granulosa cell tumor
f) Thecoma – fibroma
g) Mature cystic teratoma
e) Granulosa cell tumor
Which of the tumors mentioned above is associated with the following tumor marker: Alpha fetoprotein
a) Dysgerminoma
b) Yolk sac tumor (endodermal sinus tumor)
c) Choriocarcinoma
d) Gonadoblastoma
e) Granulosa cell tumor
f) Thecoma – fibroma
g) Mature cystic teratoma
b) Yolk sac tumor (endodermal sinus tumor)
Which of the following embryonic structures is responsible for the development of Cervix, uterus, & upper vagina
a) Mesonephric duct
b) Paramesonephric duct
c) Mullerian system
d) Vaginal cord
e) Sinovaginal bulb
f) Vesicourethral canal
b) Paramesonephric duct
(choice B is the one in the model answer, but C was also counted correct, but it will be removed from the question bank in the future)
Which of the following embryonic structures is responsible for the development of Lower 1/3 of vagina (distal part of vagina)
a) Mesonephric duct
b) Paramesonephric duct
c) Mullerian system
d) Vaginal cord
e) Sinovaginal bulb
f) Vesicourethral canal
e) Sinovaginal bulb
Encysted hydrocele of the spermatic cord is caused by persistence of which structure?
a) Processus vaginalis
b) Tunica vaginalis
a) Processus vaginalis
Which of the following is the most common site for ectopic pregnancy?
a) Isthmus of fallopian tube
b) Cervix of uterus
c) Ampulla of fallopian tube
d) Abdominal cavity
c) Ampulla of fallopian tube
Which of the following is a remnant of the medial umbilical ligament?
a) Superior gluteal artery
b) Inferior gluteal artery
c) Superior vesical artery
d) Inferior vesical artery
e) Obturator artery
c) Superior vesical artery
What is the maximum variability possible in the days of the menstrual cycle?
a) 5
b) 10
c) 15
d) 20
c) 15
Breast tumor with nests and cords of cells and gland formation with minimal pleomorphism. Positive E cadherin. What is the likely diagnosis? (check answer)
a) Ductal carcinoma
b) Lobular carcinoma
c) Proliferative breast disease
d) Fibroadenoma
e) Phyllodes tumor
f) DCIS
a) Ductal carcinoma
A 38-year-old woman was advised to do a prophylactic surgery which involves bilateral mastectomy and bilateral salpingo-oophorectomy after finding out that she has BRCA1 mutation. However, the doctor told her that she still has a risk for another type of cancer which is?
a) Peritoneal cancer
b) Appendiceal cancer
c) Pancreas cancer
d) Ovarian cancer
a) Peritoneal cancer
During a vaginal delivery, a surgeon performed median episiotomy in which he cuts too far through the perineal body into the structure immediately posterior to it. What structure/muscle is most likely affected?
a) External urethral sphincter
b) External anal sphincter
c) Bulbospongiosus muscle
d) Ischiocavernosus muscle
b) External anal sphincter
During a vaginal delivery, a surgeon performed mediolateral episiotomy. What structure did he cut through?
a) Superficial transverse perinei
b) Bulbospongiosus
c) Ischiocavernosus
b) Bulbospongiosus
Which of the following is a content of the deep perineal pouch?
a) Deep transverse perinei
b) External anal sphincter
c) External urethral sphincter
a) Deep transverse perinei
c) External urethral sphincter
(both were counted correct)
Mutation of WNT4 or DAX1 in a 46, XX fetus can result in which of the following anomalies?
a) Cryptorchidism
b) Absence of ovaries
b) Absence of ovaries
What does cortical reaction result in?
a) Sperms are mobile
b) Sperms are super mobile
c) Only one sperm can fertilize the ovum
c) Only one sperm can fertilize the ovum
Which of the following is commonly found in patients with ovarian tumors upon presentation?
Ascites
A cervical biopsy from a 45-year-old female with vaginal bleeding showed infiltrating glandular epithelium with cellular atypia and increased mitosis. What is likely the diagnosis?
a) Squamous cell carcinoma
b) Cervical adenocarcinoma
c) CIN3
b) Cervical adenocarcinoma
Menstrual periods that are characterized by scanty blood for few days are called?
a) Oligomenorrhea
b) Hypomenorrhea
b) Hypomenorrhea
A gynecologist examined a female by a digital rectal examination. A firm structure was palpated on the anterior wall of the rectum in the midline. What is this structure?
a) Vagina
b) Fundus
c) Cervix
c) Cervix
What dimension of the fetal head is independent of fetal attitude?
a) Biparietal diameter
b) Submentobregmatic diameter
c) Mentovertical diameter
a) Biparietal diameter
The fundus of the uterus of a pregnant woman in week 12 of gestation was palpated just above the pubic symphysis. Which of the following is true?
a) The fundal symphysis height is proper for the gestational age
b) The fundal symphysis height can’t be correlated with the gestational age until week 26
c) The fundal symphysis height is small for the gestational age
a) The fundal symphysis height is proper for the gestational age
Which of the following is an early complication of menopause?
a) Hot flushes
b) Vaginal atrophy
c) Osteoporosis
d) Pelvic organs prolapse
e) Urinary incontinence
a) Hot flushes
Which of the following is an early benefit for a lactating mother?
Prolonged anovulation period
A woman with a history of breast cancer presented with skin dimpling. A breast biopsy showed foamy histocytes, disrupted fatty tissue, necrosis and giant cells. What is the diagnosis?
a) Fibrocystic changes
b) Fibroadenoma
c) Fat necrosis
c) Fat necrosis
A woman who had a recent delivery developed a cancer that showed cytotrophoblasts and syncytiotrophoblasts proliferation with no villi formation. What is the diagnosis?
a) Yolk sac
b) Hydatidiform mole
c) Gestational choriocarcinoma
c) Gestational choriocarcinoma
Which of the following reaches its highest level in the first trimester of pregnancy?
a) Human chorionic gonadotrophin
b) Testosterone
c) Human placental lactogen
a) Human chorionic
A young female presented with axillary swelling. The swelling increases in size and becomes painful during the menstrual cycle. What is the diagnosis?
a) Enlarged lymph nodes
b) Polythelia
c) Accessory axillary breast tissue
c) Accessory axillary breast tissue
The pelvis of a pregnant woman was found to have a triangular inlet, prominent ischial spines, and a subpubic angle of less than 90 degree. What type of pelvis does she have?
a) Android
b) Gynecoid
a) Android
A 27-year-old pregnant woman in her 37 week of gestation had strong painful uterine contractions in the labor room. An epidural anesthesia was administered. What sympathetic nerve roots should be blocked to decrease the pain?
a) thoracic 8 - lumbar 1
b) thoracic 10 - lumbar 1
c) thoracic 10 - lumbar 2
b) thoracic 10 - lumbar 1
A cervical biopsy of a 44-year-old female showed atypical dark nuclei involving the full thickness of the cervical epithelium. What is the diagnosis?
CIN III
Which of the following is a complication of gestational diabetes mellitus?
Macrosomia
What is the first easily measured parameter that reflects the decreasing number of follicular pool?
a) inhibin a
b) inhibin b
c) high FSH
d) high LH
b) inhibin b
A female with a history of breast cancer was found to have a CDH1 mutation. What other cancer is she at risk to have?
Hereditary diffuse gastric cancer
What is the classic condition that is caused by TORCH infections?
Chronic inflammation of the chorionic villi
Which of the following is true regarding the lipid profile in a pregnant woman?
a) Decrease in beta oxidation
b) Increase in TG/ cholesterol ratio
c) Increase in VLDL
c) Increase in VLDL
A female patient with thyroid cancer, breast cancer and some skin lesions were found to have a mutation in PTEN gene. What syndrome does she most likely have?
Cowden syndrome
Choose the most likely cause of infertility for a woman with dark velvety discoloration around her neck and in the armpit.
a) PCOS
b) uncontrolled juvenile diabetes
c) Hypothyroidism
d) Balanced translocation in the genome
e) Fibroids
f) Bicornuate uterus
g) Antiphospholipid syndrome
a) PCOS
Choose the most likely cause of infertility for a woman with a history of recurrent pulmonary embolism and deep vein thrombosis.
a) PCOS
b) uncontrolled juvenile diabetes
c) Hypothyroidism
d) Balanced translocation in the genome
e) Fibroids
f) Bicornuate uterus
g) Antiphospholipid syndrome
g) Antiphospholipid syndrome
Choose the most likely cause of infertility for a young female who gave birth to a baby with trisomy 21.
a) PCOS
b) uncontrolled juvenile diabetes
c) Hypothyroidism
d) Balanced translocation in the genome
e) Fibroids
f) Bicornuate uterus
g) Antiphospholipid syndrome
d) Balanced translocation in the genome
What investigation should be done to rule out/diagnose imperforate hymen?
a) MRI of abdomen and pelvis
b) Hysterosalpingography
c) diagnostic laparoscopy
d) diagnostic hysteroscopy
e) progesterone stimulation
e) progesterone stimulation
A 44-year-old male complained of loss of sensation on the medial side of the thigh and part of the scrotum. Which nerve is most likely be injured?
a) Genitofemoral
b) Illioinguinal
c) Illiohypogastric
d) Pudendal
e) Lateral cutaneous
b) Illioinguinal
A 30-year-old female came to the gynecological clinic for a regular checkup. Her cervical Pap smear showed dark irregular nuclei, binucleation, and a perinuclear halo. What is the diagnosis?
a) Low grade squamous intraepithelial lesion
b) High grade squamous intraepithelial lesion
c) Carcinoma in situ
d) Squamous cell carcinoma
e) Adenocarcinoma
a) Low grade squamous intraepithelial lesion
An ovarian tumor removed from a 20-year-old female showed characteristic Schiller-duval bodies. What is the diagnosis?
Yolk sac tumor
What changes can you see in a bacterial infection of the placenta?
Immune cells infiltration of the amnion and chorion
A 53-year-old female was investigated for abnormal uterine bleeding. Her uterus was abnormally thick on ultrasound. The uterine biopsy showed proliferation of the glands with no invasion. On further investigations, her ovary was enlarged and measured 2x3x4 cm. What is the most likely pathology that is found in the ovary?
Granulosa cell tumor
Which of the following is a characteristic of drugs during breast feeding?
a) Most drugs pass though simple diffusion
b) Ionized drugs cross more easily than non-ionized drugs
c) Benzodiazepines are safe
d) Diffusion to the milk depends on drug half life
a) Most drugs pass though simple diffusion
A young woman had urinary incontinence after delivery. Her obstetrician advised her to strengthen the muscle around the vagina and urethra, increasing its tone and exerting pressure on the urethra. What muscle was strengthened?
a) Ischiocavernosus
b) Coccygeus
c) Obturator externus
d) Pubovaginalis
d) Pubovaginalis
The concentration of which of the following hormones doesn’t change during pregnancy?
a) Prolactin
b) ACTH
c) hPL
d) Estrogen
b) ACTH
What is responsible for decreasing GI motility in a pregnant woman?
Decreased motilin
A female complained of dysmenorrhea and abnormal uterine bleeding. Ultrasound showed enlarged ovary. Upon ovarian removal, a cyst was found that was filled with dark chocolate like material. What is the diagnosis?
a) Functional cyst
b) Endometriosis
b) Endometriosis
An enlarged ovary that was excised was completely replaced by one unilocular cyst with flat epithelium with cilia lining it. What is the diagnosis?
a) Serous cystadenoma
b) Serous cystadenocarcinoma
c) Mucous cystadenoma
d) Mucous cystadenocarcinoma
a) Serous cystadenoma
An ovarian mass was found to have a transitional-like epithelium. What is the diagnosis?
Brenner tumor
An ovarian mass was detected on US. The mass was resected and under microscopy it showed cells with signet cell morphology. What is the most likely diagnosis?
krukenberg tumor
Hypospadias is a result of anomaly of which structure?
Urethral folds
Li Fraumeni syndrome is characterized by mutation in what gene?
P53
What is the reason for O2 transport from mother to fetus despite the small gradient?
High affinity of fetal Hb to O2 (or fetal hemoglobin shifts oxygen dissociation curve to the left)
What is the mechanism of action of inflammatory cytokines in recurrent pregnancy loss?
Inhibit trophoblast growth
How are amino acids transported via placenta?
Active transport
A 37-year-old woman presented with abnormal uterine bleeding. Endometrial biopsy showed spindle shaped pink cells with cigar shaped nuclei. There was no mitosis, atypia, or necrosis. What is the diagnosis?
a) Leimyosarcoma
b) Leiomyoma
c) Endometrial carcinoma
b) Leiomyoma
Head of fetus in the right hypochondrium, and lower limbs in the left iliac region.
Oblique lie
Resp changes if pregnancy?/ Why VC doesn’t change in pregnancy?
Increase in TV and minute ventilation
