Final

Question 1

Your patient presents to the dental office and complains of sensitivity to hot and cold food and beverages, spicy food and alcohol. Her oral presentation is red, thin and ulcerated. Sometimes white stripes (Wickham’s striae) are present at the periphery. She explains she also experiences this same appearance on her vulva. What oral and vulvar lesion must she be experiencing?
Candida
Lichen Planus
metabolic disorder
Leiomyoma

Answer 1

Lichen planus

Question 2

A 29 year old female patient was worried about her recent absence of menses. She has no remarkable medical history although she has recently been experiencing minor fatigue, tender breasts, and increased urination. What would you say about her current medical condition?
a. Ovarian origin minor cyst or neoplasm
b. Abnormal balance of female hormones
c. Patient is pregnant and recommend a hCG test
d. Peritoneal origin minor cyst or neoplasm

Answer 2

C

Question 3

If Implantation occurs, the outer layer of placenta produces what hormone?
hCG
GnRH
LH
FSH

Answer 3

hCG

Question 4

What are all steroid hormones derived from?
Testosterone
Cholesterol
Amino Acid
Fatty acids

Answer 4

Cholesterol

Question 5

Your patient is expecting a child! She mentions she has nausea, vomiting, and headaches. Her obstetrician mentioned this is because of higher estrogen levels. Your patient doesn’t fully understand. Which estrogen produced during pregnancy is causing her symptoms?
Estrone (E1)
Estradiol (E2)
Estriol (E3)
Estratetraenol (EST)

Answer 5

Estriol E3

Question 6

A 15-year-old male patient walks into the emergency room with severe, acute pain in his groin. He complains of nausea and vomiting over the past few hours and says it appears his testicle is swollen and tender. Upon examination you find that his testis is showing signs of a “high riding” testis. What disorder is this young male experiencing?
Hydrocele
Varicocele
Testicular Torsion
Hernia

Answer 6

Torsion

Question 7

Which of the following occurrences would make you concerned for your elderly patient’s mentation?
Gait instability
Repeating the same question in a short period of time
Macular degeneration
Incontinence

Answer 7

Repeating the same question in a short period of time

Question 8

A 25-year-old male patient comes to our Dental Office for a regular checkup. As a dentist we start to do external oral exam and find enlarged lymph node on the base of the neck of the patient. On the medical history of the patient, we see he has been diagnosed with cryptorchidism when he was 12 months of age. Also, he has lost weight since last year checkup. We decide to refer the patient to visit a physician. What is your diagnosis for our patient?
Acute epididymitis
Testicular cancer
Varicocele
Prostate cancer

Answer 8

Testicular Cancer

Question 9

Which of these are NOT associated problems of PCOS?
Type 2 diabetes
Hypertension
Dyslipidemia (high LDL cholesterol)
Lichen Sclerosis

Answer 9

Lichen Sclerosis

Question 10

After graduation, you are volunteering overseas in a rural community providing healthcare service to a female who is concerned about her increased blood discharge over the past few months, especially after intercourse. You conducted a PAP smear because you are concerned about a malignancy that is common worldwide, yet preventable…
Cervical malignancy
Endometrial carcinoma
Squamous cell carcinoma
Epithelial ovarian malignancy

Answer 10

Cervical malig

Question 11

Which class of hormones are synthesized as prohormones that require additional processing to become active?

Peptide hormones
Steroid hormones
Thyroid hormones
Endocrine hormones

Answer 11

Peptide hormones

Question 12

A woman presents with a lot of pain that is very debilitating! Her condition has been developing slowly over many years and has spread outward towards the pelvic walls into the bladder. This condition was caused by HPV. What is most likely her diagnosis?

Leiomyosarcoma
Granulosa cell tumor
Epithelial ovarian malignancy
Cervical cancer

Answer 12

Cervical Cancer

Question 13

Which of the following is NOT associated with how a progestin IUD works?
Thickens the cervical mucus
Prevents ovulation by preventing a LH surge
Makes the uterine lining unable to sustain pregnancy
Creates an inflammatory state in the endometrium and the endometrial cavity

Answer 13

Creates an inflammatory state in the endometrium and the endometrial cavity

Question 14

What should you NOT do when treating a patient with COPD?
Put them in a semisupine or upright position
Use a rubber dam for proper isolation
Limit epinephrine if significant cardiovascular disease is present
If supplemental oxygen is needed, use a low flow rate of 1-3 L/min

Answer 14

Use a rubber dam for proper isolation

Question 15

A 35-year-old, female patient, comes into your clinic for a cleaning. They have not come into the clinic for several years, as they have struggled to schedule appointment and find the time outside of work to get their 2x annual cleaning. During the initial patient intake, they mention that they have had problems with their weight, where they have gained weight in the past couple of years. They also have seen their doctor and it was mentioned they are insulin resistant and they are undergoing further tests and visits about this. Additionally, this patient has been on birth control for more than 2 years. What birth control might this patient be on, based on the information presented to you?
Depo-Provera (DMPA)
Long-Acting Reversible Contraception (LARC)
Progestin
Natural Family Planning

Answer 15

Depo-prover

Question 16

What is true about human placental lactogen (hPL) in pregnancy?

A. It is a hormone that raises the maternal blood glucose level so that excess glucose can be transported to the fetus as an energy source, but has the consequence of increasing the risk of gestational diabetes due to insulin resistance

B. hPL increases the mother’s insulin sensitivity so that she can effectively utilize glucose during pregnancy
C. Has been associated to cause fetal
hypoglycemia, fetal hyperinsulinism, and neonatal hyperglycemia after delivery
D. It is a hormone that increases during the 1st trimester of pregnancy

Answer 16

A

Question 17

Your 50-year-old female patient presents to you for a cleaning and suddenly has a hot flash. She then tells you she noticed she has menstrual irregularity and has trouble sleeping due to night sweats. Given her age and symptoms, which hormone do you suspect is the lowest?
Estrone (E1)
Estradiol (E2)
Estriol (E3)
Testosterone (T)

Answer 17

Estradiol E2

Question 18

A patient presents to you for a routine dental cleaning. When you ask her if there are any changes in medical history, she says she was recently diagnosed with endometriosis and is worried about her fertility. You tell her

a. Endometriosis does not impact fertility so she should not worry

b. Endometriosis does impact fertility and the degree of endometriosis IS correlated with fertility

c. Endometriosis does impact fertility but the degree of endometriosis is NOT correlated with fertility

d. Endometriosis causes endometrial cancer and thus impacts fertility

Answer 18

C

Question 19

What hormone causes fast changes in protein activity by acting at the surface of the cell?
Steroid hormones
Peptide hormones
Thyroid hormones
Amine hormones

Answer 19

Peptide Hormone

Question 20

These are medical treatments for benign prostatic hyperplasia except
Alpha blockers
5 alpha-reductase inhibitors
Decongestants
PDE5 inhibitor

Answer 20

Decongestants

Question 21

In a female, when do her germ cells complete Meiosis 1?

Before birth
When she is 6 months old
Just before ovulation
When the germ cell is fertilized

Answer 21

Just before Ovulation

Question 22

A 19-year-old female patient is home visiting from her first semester in college and comes in for a cleaning. During the exam you notice multiple small wart-like lesions in her mucosa. You don’t know what it is but decide to ask her if she has been vaccinated for HPV, to which she replies that she hasn’t been. You also find out that she recently became sexually active in college. How should you proceed?

A. Inform her that she probably has squamous cell carcinoma from oral sex.
B. Explain to her that HPV can present in some mucosal tissues like the mouth and vagina, and both locations have the potential to transform into cancer.
C. Tell her that these warts are normal and that no further intervention is required.
D. Remove the warts completely so that the tissue will be healed by the time she returns to college.

Answer 22

B

Question 23

Which is the correct finding if a person has too much total body sodium or salt? [see the chart on review of physiology]

Hypernatremia
Hyponatremia
Edema
Volume Depletion

Answer 23

Edema

Question 24

In the ovaries, Where do the granulosa cells get the androgens from for estradiol production?

Thecal cells
Ovum germ cells
Corpus luteum
Corpus albicans

Answer 24

Thecal

Question 25

You and your gym bro, who is 18, are lifting legs. Suddenly your partner yells in pain, “ouch! My testicles hurt!” You touch his cremaster area and there is no reflex. You tell him to rush the ER because you suspect… Testicular Torsion Hydrocele Varicocele Testicular cancer

Answer 25

Testicular torsion

Question 26

Which one of the following is the correct homologous pairing in males and females? A. Clitoral hood and the prostate gland B. Skene’s gland and prostate gland C. Pudendal nerve and the vagus nerve D. Corpus spongiosum and corpus bobiosum

Answer 26

B

Question 27

Why are ovarian malignancies the most deadly gynecological cancer in the USA? a. The ovaries the are the site of follicle production and egg maturation which is important in female reproduction. b. There are vague symptoms and it’s not usually detected until it is late stage cancer. c.The USA does not have medication for these malignancies making it difficult to treat. d. The ovarian malignancies spread faster then other cancers.

Answer 27

B

Question 28

Your hygienist has been worrying about her mother’s one year long amenorrhea since she is only in her early 40s. Which of the following symptoms would her mother be most likely experiencing? Urinary urgency Night sweats Chancre Mucopurulent discharge

Answer 28

Nights Sweats

Question 29

Your patient comes into your office looking to start a form of birth control. She has previous history of stroke and is currently a smoker. You are most likely to prescribe this type of medication to your patient as a contraceptive: a. Combined pill with estrogen AND progestin b. Mini pill with progestin ONLY c. An androgen d. Warfarin

Answer 29

B

Question 30

A patient comes into your office for restorative fillings. After doing the fillings, she tells you the big news about how she is planning to get pregnant! After reiterating her medical history, you noticed that has a history of deep vein thrombosis and has been taking coumadin, as well as a history of acne and has been taking Accutane. As a dental provider what are your next steps? A. Continue with coumadin and make sure that her INR is less than 3.5 in her next visit. B. Refer her to her PCP to get her off coumadin and Accutane C. Continue with coumadin and prescribe her an antiplatelet such as clopidrogel D. Increase the dosage of Accutane after noticing more zits on her face

Answer 30

B

Question 31

Which of the following is not considered a germ cell cancer? Yolk Sac Choriocarcinoma Leydig cell Embryonal

Answer 31

Leydig cell

Question 32

A woman is learning about various tests at her doctor, and they mention something about testing hCG…. A positive hCG test indicates which of the following events? Ovulation Implantation Menopause Puberty

Answer 32

Implantation

Question 33

Which of the following is not one of the 4 focuses of geriatric care? Mobility Medication Mentation What matters Maintenance

Answer 33

Maintenance

Question 34

A female patient in her twenties presents to your office and upon examination you see a pustule on her upper lip. You ask the patient if she is aware of it and the patient replies that they have it every now and then, it hurts a bit but they don't know why. You would: a. Stop the exam and refer them to the infectionist and contact CDC to report the case b: Tell them you suspect a viral infection and ask the assistant to bring you a viral swab test c. Continue the exam and the treatment since more than ¼ of the US population has the disease D. Tell them they have an STI and lecture on safe sex practices

Answer 34

B

Question 35

What is the basic physiological concept that allows for Prolactin to promote lactogenesis in a mother following delivery? a. Loss of Prolactin inhibition b. Increasing levels of Prolactin agonist c. Sustained high levels of Prolactin d. Decreased degradation of Prolactin

Answer 35

a

Question 36

The 32 years old woman who had a labor is now having a problem of ejection of milk. She checked the hormone levels which showed the low level of estrogen & progesterone, and high level of prolactin. This hormones result is normal for lactation. Which of the following hormone will be required for ejection of milk in this case? Or (as showing on Dr. Garcia’s List the question reads as): A 32-year-old woman who just had a baby is now having a problem with lactation. Her hormone levels were checked which show low estrogen, low progesterone, and high prolactin. These hormone levels are normal for lactation. Which of the following hormone is required for milk ejection that was not checked? hCG Testosterone Oxytocin Cortisol

Answer 36

Oxytocin

Question 37

A patient presents with debilitating pain and bleeding. Upon further examination, it is found that there is endometrial tissue found within the myometrium and that the only cure is through hysterectomy or menopause. What gynecologic disease does this patient have? Fibroids Adenomyosis PCOS Friable cervix

Answer 37

Adenomyosis

Question 38

A 16-year-old girl comes into your clinic with concerns about her recent weight gain. She says she usually skips 5-6 months in between her periods which is awesome but she feels insecure because she is gaining weight, developing acne that won’t go away, hair growth on her chest (hirsutism), and has intense mood changes. What are some tests that you would like to conduct to confirm your differential? A. Pap smear B. Blood test to check for high level of androgens C. Biopsy of the uterus D. Pregnancy test

Answer 38

B

Question 39

You are going into the operatory to do a hygiene exam on your patient who was recently pregnant the last time you saw her 6 months ago. She is now much further in her pregnancy and the hygienist notes that her blood pressure is 150/100 this time, but it was usually around 120/80 at every visit prior. You tell the patient: A. This is just gestational hypertension, and she shouldn’t be concerned. B. That high blood pressure during pregnancy could go away after birth, but it could also be of concern if there is protein in the urine, as this could be a sign of preeclampsia and she should talk to her OBGYN to have it monitored. C. Ask her if she has been having headaches, because if so, she has preeclampsia. D. This a high-risk pregnancy and should have it monitored.

Answer 39

B

Question 40

A 26 year old male consults his PCP about a chronic dull ache he has been experiencing in the recent months. On physical examination, the provider examines the patients testicles and notices a “bag of worms” appearance. The likely cause of the patients dull ache is Varicocele Testicular Torsion Epididymitis Benign Prostatic Hyperplasia

Answer 40

Variocele

Question 41

A female patient that has recently given birth has had issues breastfeeding their child for the past 5 days. The infant has had no issue with latching. The mother’s milk production has not occurred yet. What issue is most likely the problem? Low estrogen High testosterone Low prolactin Breast cancer

Answer 41

Low Prolactin

Question 42

A 25-year old female patient says she has an ovarian abnormality but can’t quite remember what it’s called. She says it does not bleed and is a germ cell dermoid tumor. What ovarian abnormality does she have? Teratoma Endometriosis PCOS Leiomyoma

Answer 42

Teratoma

Question 43

One of your patients tells you that they have an abnormal condition that is due to a decreased production of gonadotropins. You know there condition is hypogonadotropism and results in a(n); a. Decrease in gametes/decrease in gonadal hormones b. Increase in gametes/increase in gonadal hormones c. Decrease in LH/FSH d. Increase in LH/FSH

Answer 43

C

Question 44

Where is GnRH secreted from? Anterior pituitary Hypothalamus Gonads Posterior pituitary

Answer 44

Hypothalamus

Question 45

A patient comes into your office for a normal dental cleaning. As you take health history from her, she states that she has had prolonged vaginal bleeding that seems “irregular.” You note this down, and as you continue reading her history you see that she has hypertension, insulin resistance and seems to be obese. You recall what you have learned in Lifecycles and take a closer look to see if she has hirsutism (increased hair) and acne – which she does. From the following list, what gynecological pathology do you believe she may have? Lichen planus Fibroids PCOS (polycystic ovarian syndrome) Atrophic endometrium

Answer 45

C

Question 46

46. Which one is not reversible contraception? Vasectomy Birth control pill LARC Depo-Provera

Answer 46

Vasectomy

Question 47

Let’s assume there was a female patient that presents with a condition in which Luteinizing Hormone production was completely stopped. The result of this condition ultimately is causing a lack of estrogen production in the patient. What cells in this patient are losing their estrogen production function as a result of the decrease in LH? Leydig cells Granulosa cells Sertoli cells Thecal cells

Answer 47

Granulosa

Question 48

Which of the following is considered a symptom of a congenital treponema pallidum infection? Gumma Neurosyphilis Aortic aneurysm Hutchinson’s Triad

Answer 48

Hutchinsons Triad

Question 49

POV: You’re a kid on the Magic School Bus and Ms. Frizzle is taking you on a tour through the bloodstream. Since this is an episode on hormones, Ms. Frizzle points out all the carrier proteins that hormones hop on for transportation to a different part of the body (similar to the bus you’re on). Which hormone would not require a carrier protein? Cortisol Estrogen Luteinizing Hormone Testosterone

Answer 49

C

Question 50

Your pregnant patient is telling you about their pregnancy. They are in their third trimester and mention that they have started having headaches. They also state the once or twice they seem to remember seeing a few stars during their headache. Based on this information what would suspect is going on with your patient? Pre-term birth Nothing, headaches are normal Pre-eclampsia Gestational diabetes

Answer 50

Pre-eclampsia

Question 51

Kallmann Syndrome, a form of secondary hypogonadism, is a result of what? a. A result of an X-linked recessive mutation of the ANOS1 gene which causes the malfunction of axonal guiding protein, anosmin-1, to properly guide GnRH neurons to hypothalamus during embryogenesis b, Inconsistent secretion of GnRH needed to sustain LH and FSH secretion from pituitary gonadotropes c. Continuous secretion of GnRH which down-regulates GnRH receptors leading to a marked decrease in secretion of pituitary LH and FSH and impairment of reproductive function D. Overuse of therapeutic GnRH analogues (agonists and antagonists) which ultimately impairs long term gonadotropin secretion

Answer 51

A

Question 52

. A 25-year-old pregnant female comes into your office and is just there for a routine checkup. On exam you see no signs of caries and great overall oral health, but her dental chart displays a message that this patient is due for radiographs. You should: a) Conduct the radiographs because there is no evidence that it will harm the fetus b) Ask the patient to sign a waiver and take the radiographs c) Postpone the radiographs to a later date because diagnostic radiologic procedures should not be performed during pregnancy unless the information to be obtained from them is necessary for the care of the patient and cannot be obtained by any other means according to the American College of Obstetricians and Gynecologists d) You should take the radiographs because the patient is due, but make sure the patient has lead apron and thyroid collar during the exposure

Answer 52

C

Question 53

What method is best recommended by health professionals in regards to contraception for young adults? Condoms Pull-out method Oral progesterone pills IUD

Answer 53

IUD

Question 54

A 24-year-old male became a new patient in your office. Through casual chairside conversation, the patient mentioned that he promotes the withdrawal method of contraception (also known as the pull-out method, which happens when you take the penis out of the vagina and ejaculate outside the vagina to try to prevent pregnancy) based on life experience and school sex education. Based on your knowledge, what should be your best scientific response? a. Assume the patient is from Idaho. b. As a learning opportunity, interview the patient about the special techniques in enhancing the withdrawal method of contraception. c. Inform the patient that the barrier method is the best contraceptive method since it is advertised as 99% effective. d. Educate the patient about long-acting reversible contraception.

Answer 54

d

Question 55

Your friend Baker Allebad has received some questionable instruction regarding birth control and is asking you about the most effective methods of contraception. You tell them that _____________ is in the first line contraceptive and would be a good choice for someone not ready to start a family. LARC (IUD or Implant) Natural Family Planning Barrier (Condom, etc.) Progestin Mini-Pill

Answer 55

LARC

Question 56

A hormone produced by the hypothalamus that controls the release of the hormones for menstruation by the anterior pituitary gland is: FSH Somatostatin GnRH LH

Answer 56

GnRH

Question 57

For this gynecologic malignancy, MOST people are in stage 3 or 4 when they are FIRST diagnosed: A. Epithelial ovarian malignancy b. Endometrial carcinoma c. Cervical cancer d. Leiomyosarcoma

Answer 57

A

Question 58

Which of the explanations is incorrect about GnRH? a. GNRH is Secreted by GnRH neurons b. GnRH is transported to anterior pituitary c. GnRH is acts on Ion channal linked receptor on gonadotropes in the anterior pituitary d. GnRH Stimulates LH and FSH secretion

Answer 58

C

Question 59

Your male roommate knocks on your door and tells you he is in severe pain, particularly in the groin area, and just vomited, but he has no fever. He noticed the unusual swelling or lump in his groin (unilateral enlarged scrotum), but the external scrotal skin looked normal. What is your diagnosis, and what should you tell him next? a. You suspect acute epididymitis, and you informed him that he needs supportive care (NSAIDS, ice, rest, elevation) and that the pain and swelling will go away in the next few days. b. You suspect hernia, and you tell him to go to general surgery or ER as soon as possible because you are concerned about his bowel strangulation. c. You suspect testicular torsion, and you informed him that he is in pain because of reduced blood flow to the area, and such sudden pain will go away without treatment. d. You suspect testicular cancer, and you tell him that he is currently experiencing “B symptoms”, which are significant to the prognosis and staging of the disease.

Answer 59

B

Question 60

What is the pathway of sperm in the correct order? a. Epididymis -> Vas Deferens -> Ejaculatory duct -> Prostate b. Vas Deferans -> Epididymis -> Ejaculatory Duct -> Prostate c. Epididymis -> Vas Deferens -> Prostate -> Ejaculatory duct d. Ejaculatory duct -> Vas Deferens -> Epididymis-> Prostate

Answer 60

A

Question 61

In 2014 a dentist had a boards investigation because they prescribed this drug to a pregnant woman [this drug is category D by the FDA]: Tetracycline Aspirin Tylenol Folic Acid

Answer 61

Tetracycline

Question 62

A pregnant woman walks into your office and is worried because she has been hearing how awful these teratogens are on the development of an embryo or fetus. After you review her health history, she is a perfectly healthy patient, you reassure her that she has nothing to worry about. Which of the following teratogens is considered the “worst”? Alcohol Marijuana Adequate Vitamin C intake Nicotine

Answer 62

Nicotine

Question 63

There is a 23-year-old dental student that is always stressing out about his grades in life cycles. Even take-home exams could not decrease the amount of stress he is going through! He also got diagnosed with COPD and started using daily supplemental oxygen last year. One day during Dr. Garcia’s lecture about STI he felt disoriented and experienced shortness of breath! What is the solution: A. Turn up the oxygen to the maximum level B. Turn down the oxygen because it’s loud C. None of the above D. Use epinephrine right away

Answer 63

C

Question 64

47. A 52-year-old male patient suffers from nocturia, poor stream, and prolonged micturition. A doctor prescribed him medication. Which one of these medications is not likely to be prescribed for the patient? Alpha blockers 5 a-reductase inhibitors PDE 5 inhibitors Antihistamine

Answer 64

Antihistamine