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GYNE 4TH BI > LONG EXAM 2 Puberty, Amenorrhea, Menopause, Preoperative Evaluation, Postoperative Management,CIN,VIN > Flashcards

LONG EXAM 2 Puberty, Amenorrhea, Menopause, Preoperative Evaluation, Postoperative Management,CIN,VIN Flashcards

1
Q

What is the potential effect of Ma Huang when given with halothane?

Bleeding
Myocardial ischemia
Hypotension
Ventricular arrhythmias

A

Ventricular arrhythmias

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2
Q

Which BMI of a patient gives clear evidence of malnutrition?

24
22
20
18

A

18

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3
Q

Which one is a correct recommendation for prophylaxis against Bacterial endocarditis?

Amoxicillin 1g IV
Azithromycin 500mg PO
Clindamycin 300 mg IV
Cefazolin 2g PO

A

Azithromycin 500mg PO

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4
Q

This is a non-operative post-hysterectomy infection:

Phlebitis
Abscess
Cellulitis
Myonecrosis

A

Phlebitis

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5
Q

Incidence of wound infection could be decreased by:

Decreasing operative time as much as possible
Patient must shower before surgery
Shaving of the wound site
Proper surgical technique should be done

A

Decreasing operative time as much as possible

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6
Q

What is the most common cause of colonic obstruction in postoperative gynecologic surgery patients?

Ileus secondary of electrolyte imbalance
Advanced ovarian carcinoma
Postoperative adhesion
Bowel ischemia and perforation

A

Advanced ovarian carcinoma

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7
Q

Which statement is true regarding low molecular weight heparin:

Half-life is 2 hours
Has less effect on partial thromboplastin time
Eliminated by the liver
Has less anti-Xa and more antithrombin activity

A

Has less effect on partial thromboplastin time

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8
Q

What is the recommended management of postoperative DVT with a Caprini Risk Score of 2?

Graded compression stocking
Early ambulation
Pneumatic compression
Low dose heparin

A

Graded compression stocking

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9
Q

What is the standard technique in the diagnosis of DVT?

Doppler ultrasound B-mode duplex
Magnetic resonance venography
Venography
Computed tomography scanning

A

Venography

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10
Q

Which one is the recommended treatment of Pulmonary embolism?

Rivaroxaban 20 mg BID
Apixaban 25 mg OD
Dagibatran 150 mg BID
Edoxaban 600 mg once daily

A

Dagibatran 150 mg BID

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11
Q

The current criteria for diagnosis of diabetes include

Weight loss even with increase appetite
Random blood glucose of >250 mg/dL
Fasting glucose < 126 mg/dL
Hemoglobin A1c >6.0%

A

Weight loss even with increase appetite

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12
Q

The preoperative goal is by avoiding ketoacidosis and hypoglycemia and
hyperglycemia which includes:

One-third of usual daily dose of NPH insulin is given prior to surgery
Short-acting insulin without oral intake should be given
Infusion of 5% dextrose should be restricted while on insulin
Additional regular insulin can be administered one day prior to surgery

A

One-third of usual daily dose of NPH insulin is given prior to surgery

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13
Q

A euthyroid state should be maintained for how many months before elective surgery?

2 months
3 months
4 months
5 months

A

3 months

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14
Q

Which statement is true regarding management of hypothyroidism

T4 can be given by the intramuscular or intravenous route after 5 days

Starting dose of thyroxin is 1.6 ug/kg for thyroid hormone replacement

Thyroxin dosage of 0.025 mg OD every 4-6 weeks for elderly patients

T4 therapy can be held for 5 to 7 days once with bowel movement

A

Starting dose of thyroxin is 1.6 ug/kg for thyroid hormone replacement

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15
Q

Which is an intermediate clinical predictor of increased perioperative cardiovascular risk?

Prior ischemic cardiac disease
Decompensated congestive heart failure
Advanced age
Uncontrolled systemic hypertension

A

Prior ischemic cardiac disease

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16
Q

This method may be used to overcome the limitations of exercise stress testing?

Dobutamine stress echocardiography
Exercise stress testing
Dipyridamole-thallium scanning
Angiography

A

Dipyridamole-thallium scanning

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17
Q

What is the treatment for congestive heart failure with the presence of cardiogenic asthma?

Furosemide
Morphine sulfate
Oxygen
Aminophylline

A

Aminophylline

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18
Q

Which one is a sign or symptoms of aortic stenosis?

Diastolic murmur at the apex
Suffused face and lips
Decreased systolic blood pressure
Chest radiography with left atrial dilatation

A

Decreased systolic blood pressure

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19
Q

Treatment for bradycardia that is less than 45 beats per minute is

Propranolol
Atropine
Epinephrine
Digoxin

A

Atropine

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20
Q

Which one is true regarding predictor of postoperative pulmonary complications?

FEV1 = >1L
PaCO2 = >50 mmHg
PaO2 = < 60 mmHg
Maximal breathing capacity = 50% predicted

A

PaO2 = < 60 mmHg

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21
Q

drenarche occurs progressively in late childhood, at what age does this usually start?

6-7 years old
7-8 years old
10-12 years old
12-13 years old

A

6-7 years old

22
Q

What is the normal characteristic of growth spurt in girls?

It usually occur at 13 years old
Growth usually doubles at increments of 5cm
Occurs 2 years after breast budding
Menarche follows after 2 years

A

Occurs 2 years after breast budding

23
Q

What is the main factor that influences the onset of puberty?

Genetic
Body weight
General health
Altitude

A

Genetic

24
Q

This statement best describe the physiology of puberty

a. The brain starts the process with the production of GnRH
b. Testosterone is somewhat responsible for the development of secondary sexual characteristics
c. Estrogen is responsible for the follicular development
d. The ovaries produces hormones responsible for the maintenance of puberty

A

a. The brain starts the process with the production of GnRH

25
Q

What is the hormone responsible for pubarche in girls?

Testosterone
Estrogen
Androgen
Progesterone

A

Androgen

26
Q

Which among the etiology of secondary amenorrhea is the cause when there is presence of secondary sexual characteristics

Androgen insensitivity
Hyperprolactinemia
Hypopituitarism
Gonadal failure

A

Androgen insensitivity

27
Q

This phase of puberty occurs progressively in late childhood from about 6-7 to adolescence

Thelarche
Pubarche
Menarche
Adrenarche

A

Adrenarche

28
Q

Which character does a child with precocious puberty manifest during adulthood?

Premature menopause
Normal menstrual cycle
Infertility
Low verbal IQ score

A

Normal menstrual cycle

29
Q

At what age do FSH and LH show very low amplitude of episodic release?

4-8 years old
8-13 years old
13-17 years old
1-4 years old

A

4-8 years old

30
Q

Which statement is true regarding treatment of precocious puberty GnRH analogues?

a. The dose of GnRH agonist treatment is monitored by serum FSH levels
b. Treatment is stopped when the epiphyses are matched to age
c. Discontinuation of therapy may cause premature adrenarche
d. GnRH agonist treatment is effective for precocious pseudo-puberty

A

d. GnRH agonist treatment is effective for precocious pseudo-puberty

bonus question ni pero sa answer key ni doc is D

31
Q

Which among the findings suggest a precocious puberty caused by McCune Albright syndrome?

a. Increased estradiol level, increased gonadal size, decreased basal FSH and LH, GnRH levels are flat
b. Increased estradiol level, decreased gonadal, GnRH levels are decreased, increased basal FSH and LH
c. GnRH levels are flat, decreased estradiol level, increased basal FSH and LH, increasde gonadal size
d. Decreased gonadal size, increased basal FSH and LH, decreased estradiol level, GnRH levels are increased

A

a. Increased estradiol level, increased gonadal size, decreased basal FSH and LH, GnRH levels are flat

32
Q

This is a rare genetic disorder that affects the skin color and bones and causes hormonal problems

McCune Albright Syndrome
Congenital adrenal hyperplasia
Autoimmune hypothyroidism
Premature Adrenarche Syndrome

A

McCune Albright Syndrome

33
Q

This hormone is considered critical for the growth of children

Estrogen
Thyroid hormone
Growth hormone
Adrenal androgen

A

Estrogen

34
Q

What is the chromosomal pattern in Turner syndrome?

46XO
45XO
45XX
46XY

A

45XO

35
Q

Which statement is true regarding complications and prognosis of amenorrhea?

a. All women with history of amenorrhea are at significant risk of developing osteoporosis
b. Women with amenorrhea without estrogen deficiency are at increased risk of endometrial hyperplasia
c. Women with amenorrhea generally do not conceive
d. Women with polycystic ovary syndrome are at risk of DM type 2

A

b. Women with amenorrhea without estrogen deficiency are at increased risk of endometrial hyperplasia

36
Q

The hyperpigmented thickening of the skin folds of the axilla and neck is a sign of profound insulin resistance and is associated with polycystic ovary syndrome (PCOS) and obesity

Acanthosis nigricans
Discoid rash
Malar rash
Dark neck syndrome

A

Acanthosis nigricans

37
Q

The most common cause of hyperprolactinemia is

Prolactinoma
Nonfunctioning pituitary tumor
Drug induced
Breast tumor

A

Prolactinoma

38
Q

fter how many months of progesterone use will a woman experience amenorrhea

3 months
6 months
9 months
12 months

A

12 months

39
Q

Which one is a primary reason menopausal women seek care from a clinician

Vaginal bleeding
Dyspareunia
Hot flashes
Abdominal mass

A

Hot flashes

40
Q

This drug which is a selective serotonin reuptake inhibitor inhibits the enzyme system that converts tamoxifen to its active form

Paroxetine
Venlafaxine
Escitalopram
Bazedoxifene

A

Paroxetine

41
Q

The oral agent approved for the treatment of moderate to severe dyspareunia associated with VVA.

DHEA
Estrogen
Ospemifene
Sildenafil Citrate

A

Ospemifene

42
Q

What is the primary technique for bone mineral density assessment

Dual x-ray absorptiometry
T-scoring technique
Serum calcium assessment
Fracture risk assessment tool

A

Dual x-ray absorptiometry

43
Q

What is the female most likely to develop CIN

after menopause
During pregnancy
During menarche
after menstruation

A

During menarche

44
Q

This refers to squamous epithelial cells that undergone number of structural changes due to an HPV infection?

Metaplasia
Dysplasia
Neoplasia
Koilocytes

A

Koilocytes

45
Q

Microorganisms found in women with either malignant or negative intraepithelial lesion

Gonorrhea
Chlamydia
Trichomonas
Staphylococcus

A

Trichomonas

46
Q

a simplest method of determining the presence of CIN especially on low resource setting

Papanicolaou test
Visual inspection acetic acid test
Colposcopy
Cervicography

A

Visual inspection acetic acid test
???

47
Q

An abnormal pattern of small blood vessel suggesting a confluence of tile or chicken with reddish borders is called

Mosaicism
Chimerism
Leucoplasia
Metaplasia

A

Mosaicism

48
Q

This statement is true regarding HPV Vaccination?

a. Quadrivalent vaccine includes protection against HPV 16 and 18 only
b. Protection against HPV 6 and 11 is directed for genital warts
c. Booster doses should be given 10 years after the last dose
d. Catch up vaccination is recommended for girls starting 8 years old

A

b. Protection against HPV 6 and 11 is directed for genital warts

49
Q

Description of unifocal type of VIN includes

Premenopausal women
Postmenopausal women
Associated with HPV
HPV 31 is involved

A

Postmenopausal women

50
Q

The goal of treatment of VIN is

Wide excision vulvectomy
Preservation of vulvar function
Prevention of metastasis
Expectant management

A

Preservation of vulvar function

GYNE 4TH BI (14 decks)

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