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Patho OB > bonus > Flashcards

bonus Flashcards

1
Q

question

A

answer

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2
Q

For single dose methotrexate therapy, resolution time is defined as serum b-hcg of

A. <100 miu/ml
B. <50 miu/ml
C. 20 miu/ml
D. 15 miu/ml

A

D. 15 miu/ml

How well did you know this?
1
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3
Q

A previous salphigectomy is a sp. Risk factor for this kind of ectopic pregnancy

A. Abdominal
B. Interstitial
C. Cervical
D. Ovarian

A

B. Interstitial

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4
Q

This type of congenital abnormality seen on sagittal view of an ultrasound showing a defect on dorsal aspect of cranio-axial view

A. Sacrococcygeal Teratoma
B. Lipoma
C. Open Neural Tube Defect

A

C. Open Neural Tube Defect

Sacrococcygeal Teratoma - sonographically
appears as a solid and/or cystic mass that arises
from the anterior sacrum and usually extends
inferiorly and externally as it grow
Neural Tube Defects include anencephaly,
myelomeningocele (also called spina bifida),
cephalocele, and other rare spinal fusion (or
schisis) abnormalities. They result from
incomplete closure of the neural tube by the
embryonic age of 26 to 28 days.
Women currently have the option of neural-tube
defect screening with MSAFP, sonography, or
both. Targeted sonography is the preferred
diagnostic test, and in addition to characterizing
the neural-tube defect, it may identify other
abnormalities or conditions that also result in
MSAFP elevation.

How well did you know this?
1
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2
3
4
5
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5
Q

What is the detection rate in quadruple testing (MSAFP, Estriol, HCG and dimeric inhibin) in younger than 35 y.o patient

A. 65% (screen + 5%)
B. 75 % (screen + 5%)
C.85 % (screen + 5%)
D. 80% (screen + 5%)

A

A. 65% (screen + 5%)

How well did you know this?
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6
Q

MSAFP is best measured during this time:
A. 12-14 weeks
B. 14-16 weeks

A

B. 14-16 weeks

MSAFP

  • Routinely measured as a screening test for NTDs from 15-20 wks
  • After 12th wk- maternal serum level of AFP will now begin to rise
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7
Q

Based in FIGO what is the low risk for gestational tropho neoplasia

A. less than 4
B. less than 6
C. Less than 8
D. Less than 10

A

B. less than 6

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8
Q

Marked trophoblast atypia

A. Partial Mole
B. Complete Mole
C. Invasive Mole
D. Choriocarcinoma

A

B. Complete Mole

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9
Q

35y/o G3P2 (2002), 30 wks AOG. First pregnancy was delivered vaginally and second pregnancy by cesarian section because of footling breech presentation. She wants to know if she can undergo VBAC (vaginal birth after CS) and she asks her chance of having breech presentation again.

A. 1%
B. 5%
C. 10%
D. 28%

A

C. 10%

the recurrence rate for a second breech presentation was 10 percent, and for a subsequent third breech it was 28 percent

How well did you know this?
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10
Q

Vaginal delivery a breech baby, requesting ultrasound findings should associate w/ the ff. EXCEPT:

A. Fetal size
B. Degree of neck extension
C. Measurement of midpelvis is >/= 10cm
D. Type of breech

A

C. Measurement of midpelvis is >/= 10cm

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11
Q

Parametrial phlegmon that suppurates anteriorly may involve the

A. Urinary bladder
B. Iliac fossa
C. Vesicouterine fold
D. Poupart’s ligament

A

D. Poupart’s ligament

How well did you know this?
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2
3
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12
Q

Septic thromboplebitis

A. Spiral arteries
B. Radial artery
C. Ovarian arteries

A

C. Ovarian arteries

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13
Q

This enzyme secreted by GBS degrades the cervical epithilium barrier favoring ascending infection to cause ptb

A. Glycosaminidase
B. Hyaluronidase
C. Neuraminidase
D. Glycan dessolvent

A

B. Hyaluronidase

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2
3
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5
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14
Q

Most common cause of acute glomerulonephritis

A. IgA nephropathy
B. Acute
C. PKD
D. HTN GN

A

A. IgA nephropathy

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15
Q

Acute kidney damage

A.diabetes
B. Hypermesis
C. Septicemia
C. Hypovolemia
D. Diabetes
A

C. Septicemia

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16
Q

What is the lower limit of uterine contraction pressure required to dilate the cervix

A. 45mmHg
B. 35mmHg
C. 25mmHg
D. 15mmHg

A

D. 15mmHg

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17
Q

Protraction disorder in cervical dilation

A

<1.2cm in nulli, <1.5cm in multi

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18
Q

How many hours after giving protaglandin gel can you start oxytocin

A. 30mins
B. 1hr
C. 2hrs
D. 6hrs

A

D. 6hrs

How well did you know this?
1
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19
Q

Use of oxytocin for induction of labor is contraindicated in

A. Fetal demise
B. Hypertonic uterine contraction
C. Hypotonic uterine contraction

A

C. Hypotonic uterine contraction

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20
Q

Which of the following would lead to a diagnosis of an incompetent cervix?

A. painless vaginal bleeding

b. cramping abdominal painc
c. dysuria, fever, and vaginal bleeding
d. watery vaginal discharge

A

A. painless vaginal bleeding

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21
Q

Which of the following directly stimulates myometrium?

Mifepristone
methotrexate
misoprostol
mithramycin

A

misoprostol

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22
Q

What is the most common indication of therapeutic abortion?

A

fetal deformity

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23
Q

Which is associated with first trimester abortion?

A. intraamnionic hyperosmotic fluid

b. menstrul aspiration, oxytocin
c. vaccum aspiration, prostaglandin
d. hysterotomy, laparotomy

A

c. vaccum aspiration, prostaglandin

How well did you know this?
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24
Q

Management for patient with incompetent cervix?

A. mcdonald at 8 weeks
b. shirodkar at 12 weeks

A

b. shirodkar at 12 weeks

any cerclage should be done 12-14 weeks

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25
Q

What are the causes of preterm brith

A

. Spontaneous preterm labor with intact membranes
. Idiopathic preterm premature rupture of membranes
. Delivery for maternal or fetal indications
. Twins and higher-order multifetal births

How well did you know this?
1
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2
3
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5
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26
Q

What are the 3 most common reasons for preterm birth?

A

. Spontaneous pretern labor, 40-45%

. Indicated and preterm membrane rupture

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27
Q

Which causes of preterm labor often have multiple factors?

A

PPROM and spontaneous

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28
Q

What genetic alteration may lead to preterm birth?

A

inherited mutations in genes regulating collagen assembly may lead to cervical insufficiency or PPROM

How well did you know this?
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29
Q

How many preterm births are due to higher order pregnancy?

A

1 in 6

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30
Q

When is group b streptococcal prophylaxis not recommended?

> 34 weeks
32-33 weeks
24-31 weeks
<24 weeks

A

<24 weeks

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31
Q

Sepsis due to this responds well to prolonged antimicrobial therapy?

A

group b streptococcus

How well did you know this?
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32
Q

define PPROM

A

spontaneous rupture before 37 weeks and before labor onset

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33
Q

what are major predisposing events to PPROM

A

infection, oxidative stress-induced DNA damage, premature cellular senescence

How well did you know this?
1
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2
3
4
5
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34
Q

What are risk factors for PPROM?

A

socioeconomic status, BMI <19.8, nutritional deficiency, smoking, and prior PPROM

How well did you know this?
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2
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35
Q

apoptosis in PPROM is likely regulated by

A

bacterial endotoxin, IL-ib, and TNF-a

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is the likely reason why gbs predisposes to preterm birth?

A

ability to secrete hyaluronidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

moa of b-adrenergic receptor agonist in preterm labor

A

reducee intracellular ionized calcium level and prevent activation of myometrial contractile proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

moa of magnesium sulfate

A

calcium agonist that can alter myometrial contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

moa of prostagladin inhibitors

A

act by inhibiting prostagladin synthesis or by blocking their action on target organs; prostagladin synthase is responsible for the conversation of free arachidonic acid to prostagladin

aetylsalicylate and indomethacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

moa of NO donors

A

potent smooth muscle relaxants affect the vasculature, gut, and uterus;

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

moa of calcium channel blockers

A

myometrial activity is directly related to cytoplasmic free calcium and reduced calcium concentrations inhibit contractions; inhbit calcium entry through cell membrane channels

42
Q

substance released by streptococcus that can result in preterm birth

a. hyaluronic acid
b. hyaluronidase

A

b. hyaluronidase

43
Q

With an intact membrane, the chance for preterm birth is high when fetal fibronectin level is ___

a. 60
b. 28

A

a. 60

44
Q

at 31 weeks, Mrs. X was given 2 doses of 12 mg corticosteroid therapy for fetal lung maturity every 24 hours. What type of steroid did she receive?

a. Dexamethasone
b. betamethasone

A

b. betamethasone

45
Q

pregnant women who indulge in Zumba exercises are at increased risk for preterm labor

a. true
b. false

A

a. true

46
Q

shape of the cervix which has a higher risk for cervical dilatation

a. U shape
b. Y shape

A

a. U shape

47
Q

A neuroprotective agent given to pregnant women at risk for preterm birth

a. Nifedipine
b. MgSO4

A

b. MgSO4

48
Q

most important risk factor for preterm birth

a. Maternal infection
b. Prior TB

A

b. Prior TB

49
Q

Uterine stretch from multifetal pregnancy activates
this substance to cause preterm labor

a. Interleukin B
b. CRH

A

b. CRH

50
Q

management of preterm birth due to cervical insufficiency

a. McDonalds procedure
b. Micronized progesterone

A

a. McDonalds procedure

51
Q

question

A

answer

52
Q

For single dose methotrexate therapy, resolution time is defined as serum b-hcg of

A. <100 miu/ml
B. <50 miu/ml
C. 20 miu/ml
D. 15 miu/ml

A

D. 15 miu/ml

53
Q

A previous salphigectomy is a sp. Risk factor for this kind of ectopic pregnancy

A. Abdominal
B. Interstitial
C. Cervical
D. Ovarian

A

B. Interstitial

54
Q

This type of congenital abnormality seen on sagittal view of an ultrasound showing a defect on dorsal aspect of cranio-axial view

A. Sacrococcygeal Teratoma
B. Lipoma
C. Open Neural Tube Defect

A

C. Open Neural Tube Defect

Sacrococcygeal Teratoma - sonographically
appears as a solid and/or cystic mass that arises
from the anterior sacrum and usually extends
inferiorly and externally as it grow
Neural Tube Defects include anencephaly,
myelomeningocele (also called spina bifida),
cephalocele, and other rare spinal fusion (or
schisis) abnormalities. They result from
incomplete closure of the neural tube by the
embryonic age of 26 to 28 days.
Women currently have the option of neural-tube
defect screening with MSAFP, sonography, or
both. Targeted sonography is the preferred
diagnostic test, and in addition to characterizing
the neural-tube defect, it may identify other
abnormalities or conditions that also result in
MSAFP elevation.

55
Q

What is the detection rate in quadruple testing (MSAFP, Estriol, HCG and dimeric inhibin) in younger than 35 y.o patient

A. 65% (screen + 5%)
B. 75 % (screen + 5%)
C.85 % (screen + 5%)
D. 80% (screen + 5%)

A

A. 65% (screen + 5%)

56
Q

MSAFP is best measured during this time:
A. 12-14 weeks
B. 14-16 weeks

A

B. 14-16 weeks

MSAFP

  • Routinely measured as a screening test for NTDs from 15-20 wks
  • After 12th wk- maternal serum level of AFP will now begin to rise
57
Q

Based in FIGO what is the low risk for gestational tropho neoplasia

A. less than 4
B. less than 6
C. Less than 8
D. Less than 10

A

B. less than 6

58
Q

Marked trophoblast atypia

A. Partial Mole
B. Complete Mole
C. Invasive Mole
D. Choriocarcinoma

A

B. Complete Mole

59
Q

35y/o G3P2 (2002), 30 wks AOG. First pregnancy was delivered vaginally and second pregnancy by cesarian section because of footling breech presentation. She wants to know if she can undergo VBAC (vaginal birth after CS) and she asks her chance of having breech presentation again.

A. 1%
B. 5%
C. 10%
D. 28%

A

C. 10%

the recurrence rate for a second breech presentation was 10 percent, and for a subsequent third breech it was 28 percent

60
Q

Vaginal delivery a breech baby, requesting ultrasound findings should associate w/ the ff. EXCEPT:

A. Fetal size
B. Degree of neck extension
C. Measurement of midpelvis is >/= 10cm
D. Type of breech

A

C. Measurement of midpelvis is >/= 10cm

61
Q

Parametrial phlegmon that suppurates anteriorly may involve the

A. Urinary bladder
B. Iliac fossa
C. Vesicouterine fold
D. Poupart’s ligament

A

D. Poupart’s ligament

62
Q

Septic thromboplebitis

A. Spiral arteries
B. Radial artery
C. Ovarian arteries

A

C. Ovarian arteries

63
Q

This enzyme secreted by GBS degrades the cervical epithilium barrier favoring ascending infection to cause ptb

A. Glycosaminidase
B. Hyaluronidase
C. Neuraminidase
D. Glycan dessolvent

A

B. Hyaluronidase

64
Q

Most common cause of acute glomerulonephritis

A. IgA nephropathy
B. Acute
C. PKD
D. HTN GN

A

A. IgA nephropathy

65
Q

Acute kidney damage

A.diabetes
B. Hypermesis
C. Septicemia
C. Hypovolemia
D. Diabetes
A

C. Septicemia

66
Q

What is the lower limit of uterine contraction pressure required to dilate the cervix

A. 45mmHg
B. 35mmHg
C. 25mmHg
D. 15mmHg

A

D. 15mmHg

67
Q

Protraction disorder in cervical dilation

A

<1.2cm in nulli, <1.5cm in multi

68
Q

How many hours after giving protaglandin gel can you start oxytocin

A. 30mins
B. 1hr
C. 2hrs
D. 6hrs

A

D. 6hrs

69
Q

Use of oxytocin for induction of labor is contraindicated in

A. Fetal demise
B. Hypertonic uterine contraction
C. Hypotonic uterine contraction

A

C. Hypotonic uterine contraction

70
Q

Which of the following would lead to a diagnosis of an incompetent cervix?

A. painless vaginal bleeding

b. cramping abdominal painc
c. dysuria, fever, and vaginal bleeding
d. watery vaginal discharge

A

A. painless vaginal bleeding

71
Q

Which of the following directly stimulates myometrium?

Mifepristone
methotrexate
misoprostol
mithramycin

A

misoprostol

72
Q

What is the most common indication of therapeutic abortion?

A

fetal deformity

73
Q

Which is associated with first trimester abortion?

A. intraamnionic hyperosmotic fluid

b. menstrul aspiration, oxytocin
c. vaccum aspiration, prostaglandin
d. hysterotomy, laparotomy

A

c. vaccum aspiration, prostaglandin

74
Q

Management for patient with incompetent cervix?

A. mcdonald at 8 weeks
b. shirodkar at 12 weeks

A

b. shirodkar at 12 weeks

any cerclage should be done 12-14 weeks

75
Q

What are the causes of preterm brith

A

. Spontaneous preterm labor with intact membranes
. Idiopathic preterm premature rupture of membranes
. Delivery for maternal or fetal indications
. Twins and higher-order multifetal births

76
Q

What are the 3 most common reasons for preterm birth?

A

. Spontaneous pretern labor, 40-45%

. Indicated and preterm membrane rupture

77
Q

Which causes of preterm labor often have multiple factors?

A

PPROM and spontaneous

78
Q

What genetic alteration may lead to preterm birth?

A

inherited mutations in genes regulating collagen assembly may lead to cervical insufficiency or PPROM

79
Q

How many preterm births are due to higher order pregnancy?

A

1 in 6

80
Q

When is group b streptococcal prophylaxis not recommended?

> 34 weeks
32-33 weeks
24-31 weeks
<24 weeks

A

<24 weeks

81
Q

Sepsis due to this responds well to prolonged antimicrobial therapy?

A

group b streptococcus

82
Q

define PPROM

A

spontaneous rupture before 37 weeks and before labor onset

83
Q

what are major predisposing events to PPROM

A

infection, oxidative stress-induced DNA damage, premature cellular senescence

84
Q

What are risk factors for PPROM?

A

socioeconomic status, BMI <19.8, nutritional deficiency, smoking, and prior PPROM

85
Q

apoptosis in PPROM is likely regulated by

A

bacterial endotoxin, IL-ib, and TNF-a

86
Q

what is the likely reason why gbs predisposes to preterm birth?

A

ability to secrete hyaluronidase

87
Q

moa of b-adrenergic receptor agonist in preterm labor

A

reducee intracellular ionized calcium level and prevent activation of myometrial contractile proteins

88
Q

moa of magnesium sulfate

A

calcium agonist that can alter myometrial contractility

89
Q

moa of prostagladin inhibitors

A

act by inhibiting prostagladin synthesis or by blocking their action on target organs; prostagladin synthase is responsible for the conversation of free arachidonic acid to prostagladin

aetylsalicylate and indomethacin

90
Q

moa of NO donors

A

potent smooth muscle relaxants affect the vasculature, gut, and uterus;

91
Q

moa of calcium channel blockers

A

myometrial activity is directly related to cytoplasmic free calcium and reduced calcium concentrations inhibit contractions; inhbit calcium entry through cell membrane channels

92
Q

substance released by streptococcus that can result in preterm birth

a. hyaluronic acid
b. hyaluronidase

A

b. hyaluronidase

93
Q

With an intact membrane, the chance for preterm birth is high when fetal fibronectin level is ___

a. 60
b. 28

A

a. 60

94
Q

at 31 weeks, Mrs. X was given 2 doses of 12 mg corticosteroid therapy for fetal lung maturity every 24 hours. What type of steroid did she receive?

a. Dexamethasone
b. betamethasone

A

b. betamethasone

95
Q

pregnant women who indulge in Zumba exercises are at increased risk for preterm labor

a. true
b. false

A

a. true

96
Q

shape of the cervix which has a higher risk for cervical dilatation

a. U shape
b. Y shape

A

a. U shape

97
Q

A neuroprotective agent given to pregnant women at risk for preterm birth

a. Nifedipine
b. MgSO4

A

b. MgSO4

98
Q

most important risk factor for preterm birth

a. Maternal infection
b. Prior TB

A

b. Prior TB

99
Q

Uterine stretch from multifetal pregnancy activates
this substance to cause preterm labor

a. Interleukin B
b. CRH

A

b. CRH

100
Q

management of preterm birth due to cervical insufficiency

a. McDonalds procedure
b. Micronized progesterone

A

a. McDonalds procedure

Patho OB (12 decks)

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