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FINALS-OB > BM4 LQs > Flashcards

BM4 LQs Flashcards

1
Q

Which genetic syndrome belongs to the other types of diabetes mellitus according to MODY?

a. Edward syndrome
b. Klinefelter syndrome
c. Marfan syndrome
d. Noonan syndrome

A

b. Klinefelter syndrome

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2
Q

Which statement is true regarding incidence of Pregestational diabetes?

a. overt DM incidence is similar to obesity
b. >3000 new cases are diagnosed each year
c. women with type 2 DM have undiagnosed GDM
d. 15% of GDM are found to have diabetes after birth

A

a. overt DM incidence is similar to obesity

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3
Q

The diagnosis of pregestational diabetes is based on which criteria?

a. random plasma glucose level >200 mg/dL and history of unexplained fetal loss
b. fasting glucose level >125mg/dL plus polydipsia
c. hemoglobin A1c of at least 6.5% plus plasma glucose of mmol/L
d. random plasma glucose of at least 11.1 mmol/L plus persistent glucosuria

A

b. fasting glucose level >125mg/dL plus polydipsia

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4
Q

One of which is the fetal effects of Overt diabetes with HbA1c concentrations >12%

a. cardiomyopathy
b. hyperglycemia
c. hypercalcemia
d. oligohydramnios

A

a. cardiomyopathy

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5
Q

Incidence of macrosomia rises significantly when mean maternal blood glucose concentrations chronically exceed what level?

a. 115 mg/dL
b. 120 mg/dL
c. 125 mg/dL
d. 130 mg/dL

A

d. 130 mg/dL

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6
Q

This statement is true regarding the maternal effect of diabetes mellitus?

a. microalbuminuria which is more than 300 mg/24 hours develops in patients destined to have end-stage renal disease
b. diabetic nephropathy commonly regreses due to improved glucose control
c. neovascularization begins on the vitreous and out into the retinal surface in response to ischemia
d. Peripheral symmetrical sensorimotor diabetic neuropathy is common in diabetic pregnant women

A

b. diabetic nephropathy commonly regreses due to improved glucose control

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7
Q

What is the maintenance dose of low dose IV insulin in the management of ketoacidosis?

a. 2-8 U/hour
b. 4-6 U/hour
c. 2-10 U/hour
d. 4-12 U/hour

A

c. 2-10 U/hour

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8
Q

Which long acting insulin is commonly used in pregnant women with diabetes?

a. Lispro
b. Regular
c. Aspart
d. Glargine

A

d. Glargine

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9
Q

How do we manage overt diabetes during third trimester and delivery?

a. according to ACOG fetal surveillance should start at 28-32 weeks AOG
b. fetal kick counts should be done starting 34 weeks AOG
c. labor induction and delivery is planned at 39 weeks gestation (planned at 38 weeks)
d. reducing dose of long-acting insulin to be given on the day of delivery

A

d. reducing dose of long-acting insulin to be given on the day of delivery

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10
Q

According to ACOG, screening and diagnosis of gestational diabetes should be a two-step approach. Which is the recommended threshold value for its diagnosis?

a. FBS = 5.1 mmol/L
b. 1hour OGTT = 150 mg/dL
c. FBS = 95 mg/dL
d. 2hour OGTT = 9 mmol/L \

A

a. FBS = 5.1 mmol/L

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11
Q

Screening with 50g OGCT should be performed at what AOG?

a. 12 weeks AOG
b. 20 weeks AOG
c. 24 weeks AOG
d. 30 weeks AOG

A

c. 24 weeks AOG

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12
Q

According to the Fifth International Workshop Conference on Gestational, screening strategy for high risk patients should include

a. Strong family history of type 2 diabetes
b. One-step procedure: diagnostic 100-g OGTT performed on all subjects
c. Age < 25 years
d. Member of an ethnic group with prevalence of GDM

A

a. Strong family history of type 2 diabetes

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13
Q

Which proinsulin like polypeptide is a risk factor for fetal macrosomia in GDM?

a. epidermal growth factor
b. fibroblast growth factor
c. platelet-derived growth factor
d. insulin-like growth factor

A

d. insulin-like growth factor

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14
Q

What is the recommended treatment of GDM with insulin according to ACOG?

a. insulin is considered if 1-hour postprandial levels persistently exceed 130 md/dL
b. insulin crosses placenta and is safe during pregnancy
c. insulin is added if fasting levels persistently exceed 95 mg/dL
d. regular insulin is helpful in postprandial glucose management

A

c. insulin is added if fasting levels persistently exceed 95 mg/dL

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15
Q

One of the side effects of metformin when given in pregnancy is:

a. PROM
b. phototherapy
c. stillbirth
d. 5-minute Apgar score ≤5

A

b. phototherapy

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16
Q

What is the effect of thyroid disorders on pregnancy?

a. increased preterm birth
b. increased prenatal morbidity
c. increased postpartum thyroiditis
d. increased GDM

A

c. increased postpartum thyroiditis

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17
Q

Which hormone is structurally similar to TSH?

a. human chorionic gonadotropin
b. luteinizing hormone
c. follicle stimulating hormone
d. adrenocorticotropic hormone

A

a. human chorionic gonadotropin

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18
Q

At what gestational age will thyrotropin releasing hormone be detectable in the fetal serums?

a. 12 weeks AOG
b. 16 weeks AOG
c. 20 weeks AOG
d. 24 weeks AOG

A

c. 20 weeks AOG

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19
Q

This is known to be the stem cell interchange that can lead to engraftment in several maternal tissue

a. autoimmune thyroid disease
b. fetal-to-maternal cell trafficking
c. thyroid peroxidase antibodies
d. fetal microchimerism

A

d. fetal microchimerism

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20
Q

Which one is a clinical finding of hyperthyroidism?

a. hypertension
b. increased T3 levels
c. markedly depressed TSH levels
d. failure to gain weight

A

d. failure to gain weight

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21
Q

Which condition is included in methimazole embryopathy?

a. choanal atresia
b. esophageal constrictions
c. fetal leucopenia
d. neonatal agranulocytosis

A

a. choanal atresia

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22
Q

This is true regarding surgical management of thyrotoxicosis in pregnancy

a. medical abortion is necessary for radioactive iodine exposure
b. pregnancy is avoided within 3 months post radioablative therapy
c. breastfeeding cessation for 3 months after irradiation surgery
d. surgery can be done anytime during pregnanc

A

c. breastfeeding cessation for 3 months after irradiation surgery

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23
Q

This perinatal complication of thyrotoxicosis is secondary to the fetal exposure to maternally administered thionamides

a. Goitrous thyrotoxicosis
b. Goitrous hypothyroidism
c. Nongoitrous hypothyroidism
d. Nongoitrous thyrotoxicosis

A

b. Goitrous hypothyroidism

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24
Q

This drug is given to further block peripheral conversion of T4 to T3

a. PTU
b. methimazole
c. dexamethasone
d. propranolol

A

c. dexamethasone

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25
Q

What is the pregnancy outcome when there is presence of autoantibodies toTPO and thyroglobulin?

a. greater risk of previa
b. increased stillbirth
c. increased abortion
d. greater risk for hypertension

A

c. increased abortion

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26
Q

What is the recommended daily dose of iodine intake according to institute of medicine during breastfeeding?

a. 220 μg/d
b. 260 μg/d
c. 290 μg/d
d. 320 μg/d

A

c. 290 μg/d

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27
Q

During pregnancy, what is the source of parathyroid hormone?

a. parathyroid glands
b. placental tissue
c. fetal parathyroid gland
d. maternal bones

A

b. placental tissue

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28
Q

Which is an indication for parathyroidectomy in pregnancy?

a. serum calcium level 1.0 mg/dL
b. age > 60 years
c. creatinine clearance < 50 mL/min
d. osteoporosis

A

a. serum calcium level 1.0 mg/dL

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29
Q

Which medication is given to block tubular calcium reabsorption with hyperparathyroidism?

a. calcitonin
b. furosemide
c. magnesium
d. mithramycin

A

b. furosemide

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30
Q

Which statement is true regarding Cushing syndrome in pregnancy?

a. most adenomas are macroadenomas measuring >1mm
b. There are more males affected than females
c. It is occasionally associated with hyperandrogenism
d. Fatigability and weakness are common symptoms during pregnancy

A

c. It is occasionally associated with hyperandrogenism

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31
Q

Which is an acquired etiology of anemia?

a. Thalassemia
b. Megaloblastic anemia
c. sickle-cell hemoglobinopathies
d. hemolytic anemia

A

b. Megaloblastic anemia

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32
Q

Which clinical finding will confirm iron deficiency anemia?

a. serum ferritin levels of < 10mg/L
b. hemoglobin levels of < 8mg/dL
c. hematocrit levels of < 20%
d. serum iron levels of < 100mg/L

A

a. serum ferritin levels of
< 10mg/L

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33
Q

During pregnancy vitamin B12 levels are lower than nonpregnant values because of decreased levels of which binding proteins?

a. cyanocobalamins
b. transcobalamins
c. calmodulin binding protein
d. GC globulin

A

b. transcobalamins

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34
Q

What is the most common complication of Paroxysmal Hemoglobinuria?

a. venous thromboses
b. Maternal death
c. hypertension
d. Budd-Chiari syndrome Nocturnal

A

a. venous thromboses

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35
Q

Which inherited condition can cause aplastic anemia

a. Thalassemia A
b. Fanconi anemia
c. Gaucher disease
d. G6PD deficiency

A

b. Fanconi anemia

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36
Q

What is the usual cause of secondary polycythemia?

a. gene mutation
b. stem cell disorder
c. cigarette smoking
d. drug interactions

A

c. cigarette smoking

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37
Q

What is the pathophysiology of Sickle hemoglobin?

a. prior sickle-cell hemoglobin C disease
b. substitution of glutamic acid by valine
c. chronic transfusion therapy
d. substitution of glutamic acid by lysine

A

b. substitution of glutamic acid by valine

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38
Q

The hallmark or the predominant symptoms of sickle cell crisis is:

a. high grade fever
b. severe anemia
c. hemolytic anemia
d. severe pain

A

d. severe pain

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39
Q

What drug is given to gravida with sickle cell hemoglobinopathy support rapid red blood cell turnover?

a. erythropoetin
b. hydroxyurea
c. ferrous fumarate
d. folic acid

A

d. folic acid

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40
Q

The common cause of severe childhood anemia in Southeast Asia due to hemoglobinopathy?

a. heterozygous E-β thalassemia
b. hemoglobin EE hemoglobinpathy
c. Homozygous hemoglobin E
d. Hemoglobin E plus Alpha
thalassemia

A

a. heterozygous E-β thalassemia

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41
Q

Which is the genotype of a silent carrier of alpha thalassemia?

a. αα/α_
b. αα/αα
c. _ /α
d. _ _/αα

A

a. αα/α_

42
Q

How do we diagnose Hemoglobin Bart?

a. by DNA analysis
b. by capillary electrophoresis
c. by Molecular genetic testing
d. by Targeted mutation analysis

A

b. by capillary electrophoresis

43
Q

The pathophysiology of Hemoglobin H disease (β4) is?

a. heterozygous state for a0- plus α+- thalassemia with deletion of three or four alpha genes (–/-α)
b. α+- thalassemia minor in which one gene is deleted from each chromosome (-α/-α)
c. have α0-thalassemia minor inherited with both gene deletions typically from the same chromosome (–/αα)
d. deletion of all four α-globin chain genes (–/–) characterizes homozygous α-thalassemia

A

a. heterozygous state for a0- plus α+- thalassemia with deletion of three or four alpha genes (–/-α)

44
Q

This is known as the Homozygous
β-thalassemia:

a. β-thalassemia minor
b. Cooley anemia
c. Hemoglobin Bart (γ4)
d. Thalassemia intermedia

A

b. Cooley anemia

45
Q

This is characterized by lack of platelet membrane glycoprotein and causes severe dysfunction:

a. May-Hegglin anomaly
b. Idiopathic Thrombocytopenic Purpura
c. Bernard-Soulier syndrome
d. Primary or essential thrombocytopenia

A

c. Bernard-Soulier syndrome

46
Q

What is the recommended treatment for Thrombocytosis in pregnancy?

a. aspirin
b. plasma transfusion
c. warfarin
d. dexamethasone

A

a. aspirin

47
Q

This condition is caused by severe deficiency of factor IX and has similar genetic and clinical features with factor VIII:

a. Hemophilia A
b. Hemophilia B
c. von Willebrand disease
d. Stuart-Prower factor deficiency

A

b. Hemophilia B

48
Q

Which immunologic criteria is included in the diagnosis of SLE?

a. thrombocytopenia (< 100,000/mm3)
b. Low complement C3 and C4
c. Leukopenia (< 3,000/mm3)
d. Anticardiolipin antibody (ACA)

A

b. Low complement C3 and C4

49
Q

To prevent preeclampsia in patients with SLE, Aspirin is given at 50-150 mg daily. When is the recommended start of treatment?

a. on initial prenatal consult
b. 12 weeks AOG
c. 16 weeks AOG
d. 20 weeks AOG

A

b. 12 weeks AOG

50
Q

The main change in the 2006 laboratory criteria recommendation for screening of APS is:

a. screening should be done at least in two or more occasions
b. IgM and IgM is done after 6 weeks
c. screening should be done at 12 weeks apart
d. confirmatory tests should show medium to high titer

A

c. screening should be done at 12 weeks apart

51
Q

When is pulmonary embolism shown to be most common during gestation?

a. Second trimester
b. Between 32-33 weeks AOG
c. On the 6 weeks postpartum
d. Immediately after delivery

A

c. On the 6 weeks postpartum

52
Q

Which of the statements is true regarding hypercoagulability of blood during pregnancy?

a. There is progressive increase of Factor XI
b. There is an increase in resistance to activated protein C
c. Fibrinolytic Inhibitors activity is decreased during pregnancy
d. Protein S increases progressively during pregnancy

A

b. There is an increase in resistance to activated protein C

53
Q

Which thromboembolic disorder is considered lethal?

a. Homozygous Antithrombin deficiency
b. Heterozygous Prothrombin G20210A mutation
c. Homozygous Protein C or S deficiency
d. Heterozygous Factor V inheritance

A

a. Homozygous Antithrombin deficiency

54
Q

Which vitamin is associated with elevated homocysteine levels secondary to autosomal recessive inheritence of C6671 ____ table mutation

a. Vit B1
b. VitD
c. Vit B9
d. Vit B6

A

c. Vit B9

answer key ni doc

55
Q

One of the adverse pregnancy complications of antiphospholipid antibody syndrome

a. abruptio placenta
b. gestational diabetes
c. postpartum hemorrhages
d. perinatal death

A

d. perinatal death

56
Q

Which one is an obstetrical risk factor for thromboembolism?

a. connective tissue disorder
b. obesity
c. multiparity
d. thrombophilia

A

c. multiparity

57
Q

What coagulation factor does Protein S inactivate?

a. Factor VIIa
b. Factor VIIIa
c. Factor IXa
d. Factor Xa

A

b. Factor VIIIa

58
Q

When is the best time to perform screening for thrombophilia?

a. At the first trimester
b. During hormonal therapy
c. When patient is not pregnant
d. At the early third trimester

A

c. When patient is not pregnant

59
Q

The most common location of deep vein thrombosis is:

a. iliac vein
b. iliofemoral vein
c. calf vein
d. saphenous vein

A

b. iliofemoral vein

60
Q

What is the common side effect of warfarin treatment as its anti-protein C effects?

a. Paradoxical thrombosis
b. hemorrhage
c. Decreased INR activity
d. Fetal malformation

A

a. Paradoxical thrombosis

61
Q

One of which is a vascular change in pregnancy

a. Melasma
b. Palmar erythema
c. Striae gravidarum
d. Linea nigra

A

b. Palmar erythema

62
Q

Which among these diseases is improved during pregnancy?

a. Porphyria cutanea tarda
b. pseudoxanthoma elasticum
c. Hidradenitis suppurativa
d. Acrodermatitis enteropathica

A

c. Hidradenitis suppurativa

63
Q

These are characterized as 1-5mm pruritic red papules on the extensor surfaces and trunk

a. Eczema of pregnancy
b. Pruritic folliculitis of pregnancy
c. Pemphigoid gestationis
d. Prurigo of pregnancy

A

d. Prurigo of pregnancy

64
Q

What body part does pemphigoid gestationis begin to occur?

a. extremities
b. face
c. palms
d. Abdomen

A

a. extremities

65
Q

Differential diagnosis of pemphigoid gestationis

a. Atopic dermatitis
b. Urticarial allergic reactions
c. Erythema multiforme
d. Viral Exanthema

A

c. Erythema multiforme

66
Q

Where do we usually see lesions of PUPPP?

a. Arms
b. Umbilicus
c. Striae
d. Legs

A

c. Striae

67
Q

What is the pathophysiology of PUPP?

a. Increase level of fetal DNA
b. Binding of the IgG antibodies to
the lumina lucida
c. Mutation of genes encoding for protein transport
d. Hormonally mediated

A

a. Increase level of fetal DNA

68
Q

Which is a differential diagnosis of Intrahepatic cholestasis of pregnancy?

a. Uremia
b. Atopic dermatitis
c. Pemphigoid gestationis
d. Erythema multiforme

A

a. Uremia

69
Q

Which statement is true regarding pruritic folliculitis of pregnancy?

a. Lesions often spares the umbilicus
b. The cause is unknown
c. One of the differentials is PUPP
d. Treatment includes antihistamine

A

b. The cause is unknown

70
Q

This condition is characterized as erythematous plaques with pustules seen on the inner thigh and spread to the trunk:

a. Pemphigoid gestationis
b. Intrahepatic cholestasis
c. Impetigo herpetiformis
d. Erythema multiforme

A

c. Impetigo herpetiformis

71
Q

Multiparous women have low risk for which type of malignancies?

a. Ovarian cancer
b. Cervical cancer
c. Lymphoma
d. Thryoid cancer

A

a. Ovarian cancer

72
Q

Exposure to radiotherapy during pregnancy would lead to CNS disorders in the fetus, what is the threshold dose for intellectual disability at 20 weeks AOG?

a. 0.01 Gy
b. 0.05 Gy
c. 0.10 Gy
d. 0.25 Gy

A

d. 0.25 Gy

73
Q

To prevent undue risk for infection what is the recommended management for chemotherapy

a. Should be avoided at first trimester
b. Patient should be given empirical dose of antibiotics
c. withheld 3 weeks prior to delivery
d. Start immediately postpartum

A

c. withheld 3 weeks prior to delivery

74
Q

This therapy inhibits the human epidermal growth factor type 2

a. Targeted Tyrosine kinase
b. Monoclonal antibodies
c. Small molecular inhibitors
d. Molecular therapy

A

b. Monoclonal antibodies

75
Q

One of these malignancies can metastasize to the placenta:

a. breast cancer
b. endometrial cancer
c. uterine sarcoma
d. ovarian cancer

A

a. breast cancer

76
Q

This is a ferric substance that can be applied with pressure to the stalk stub for hemostasis after polypectomy

a. policresulen concentrate
b. albothyl ointment
c. Monsel paste
d. Cryoprecipitation

A

c. Monsel paste

77
Q

Which statement is true regarding screening guidelines for epithelial neoplasia?

a. HPV cytology should be done starting at 31 years old
b. screening should start at 21 years old or once sexually active
c. cytology should be done every year from 21-29 years of age
d. cytology co-testing is done every 3 years onward after 30 years old

A

a. HPV cytology should be done starting at 31 years old

78
Q

What is the management for a 25 y/o pregnant woman at 30 weeks AOG with stage 2A cervical carcinoma?

a. radical hysterectomy after chemotherapy
b. neoadjuvant therapy prior to surgery
c. hysterotomy then radical hysterectomy
d. delay treatment until term then chemoradiation

A

b. neoadjuvant therapy prior to surgery

79
Q

The most common type of fibroid degeneration during pregnancy is:

a. hyaline
b. myxomatous
c. calcific
d. carneous

A

d. carneous

80
Q

What is the recommended diagnostic modality for pregnancy luteoma?

a. MRI
b. ultrasonography
c. serum testosterone
d. doppler/color flow

A

c. serum testosterone

81
Q

Which organ is primarily involved in Hodgkin’s lymphoma stage 2?

a. spleen
b. thymus
c. mediastinum
d. bone marrow

A

c. mediastinum

82
Q

What is the recommended treatment for acute myeloid leukemia in pregnancy?

a. delay therapy until delivery
b. chemotherapy at any trimester
c. early abortion
d. multiagent chemotherapy after
first trimester

A

c. early abortion

83
Q

What is the strongest determinant of survival in malignant melanoma during pregnancy?

a. age of gestation of diagnosis
b. clinical stage of the disease
c. prompt and early treatment
d. timing of therapeutic abortion

A

b. clinical stage of the disease

84
Q

When do we expect fetal antibodies level to be same with the mother’s antibodies?

a. 9-15 weeks AOG
b. 16 weeks AOG
c. 12-14 weeks AOG
d. 26 weeks

A

d. 26 weeks

85
Q

When does fetal infection occur with cytomegalovirus?

a. During amniocentesis
b. At Third trimester
c. During delivery
d. Immediate Postpartum

A

c. During delivery

86
Q

How would you interpret the CMV serological test with high IgG avidity but non-reactive with IgM?

a. Primary infection
b. Infection is unlikely
c. Low risk for infection
d. Past infection

A

d. Past infection

87
Q

What is the incubation period of Varicella Zoster Infection in pregnant women?

a. 4 days prior to lesions
b. 14 days
c. 2 days
d. 7 days

A

b. 14 days

88
Q

Recommended diagnostic test for Herpes simplex infection in pregnancy?

a. Polymerase chain reaction
b. Indirect fluorescent antibodies
c. Latex agglutination
d. Fluorescent antibodies

A

a. Polymerase chain reaction

89
Q

This viral infection is caused by an RNA togavirus with a period of infectivity of 1 week before rashes occur:

a. Rubella
b. Herpes Simplex
c. Rubeola
d. Varicella Zoster

A

a. Rubella

90
Q

The risk of congenital malformation with vertical transmission of Congenital Rubella syndrome at weeks AOG is:

a. 33%
b. 90%
c. 11%
d. 50%

A

?? parang 15 weeks ung question

d. 50%

91
Q

The mainstay test for the diagnosis of rubella infection is:

a. Rapid agglutination assay
b. Direct fluorescent antibody test
c. Hemagglutination Inhibition assay
d. Immune adherence agglutination test

A

c. Hemagglutination Inhibition assay

92
Q

The main congenital anomaly that can be seen in mumps infection is

a. Endocardial fibro elastosis
b. Microcephaly
c. Chorioretinitis
d. Hepatosplenomegaly

A

a. Endocardial fibro elastosis

93
Q

Transmission of syphilis to the fetus usually occur at what AOG

a. 15 weeks AOG
b. 17 weeks AOG
c. 19 weeks AOG
d. 21 weeks AOG

A

b. 17 weeks AOG

94
Q

Which other condition can also manifest reactivity to non-treponemal test?

a. Herpes
b. Leukemia
c. Lymphoma
d. Tuberculosis

A

c. Lymphoma

95
Q

What medication can be given to neonates born to mother with active pulmonary tuberculosis

a. Etambutol
b. Pyrazinamide
c. Isoniazid
d. Rifampicin

A

c. Isoniazid

96
Q

What is the recommendation for vaccination of pregnant women?

a. Varicella vaccine can be given after the first trimester
b. Tetanus toxoid should be given at 27 weeks AOG
c. HepA vaccine is recommended if otherwise indicated
d. LAV influenza is recommended at any trimester

A

c. HepA vaccine is recommended if otherwise indicated

97
Q

This is true regarding tetanus vaccine

a. Should be given to infants starting 5 months
b. Booster dose should be given to children at 4 years old
c. Additional booster of tetanus vaccine should be given at 12 years old
d. Continued booster doses should be given every 5 years

A

c. Additional booster of tetanus vaccine should be given at 12 years old

98
Q

Tdap immunization at 27 weeks AOG should be given as follows:

a. Booster if more than 3 years after last dose of tetanus toxoid
b. Should replace TD at 24-26 weeks AOG
c. Should be started at 4 weeks AOG for those with unknown immunization
d. For those with complete TD dose at 30 weeks AOG

A

b. Should replace TD at 24-26 weeks AOG

99
Q

Hepatitis B vaccination is recommended for high-risk pregnant patients such as :

a. young individuals
b. had history of blood transfusion
c. with promiscuous partner
d. HIV positive patients

A

c. with promiscuous partner

100
Q

Which is true regarding general recommendation if immunization during pregnancy?

a. Inactivated and Live Vaccine can be given with precaution
b. Immunization of household members is a must to prevent infection
c. Termination of pregnancy warrants prevention of congenital infections
d. Pregnancy test is a must before giving immunizations

A

b. Immunization of household members is a must to prevent infection

FINALS-OB (7 decks)

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