LONG EXAM 2 Puberty, Amenorrhea, Menopause, Preoperative Evaluation, Postoperative Management,CIN,VIN Flashcards
What is the potential effect of Ma Huang when given with halothane?
Bleeding
Myocardial ischemia
Hypotension
Ventricular arrhythmias
Ventricular arrhythmias
Which BMI of a patient gives clear evidence of malnutrition?
24
22
20
18
18
Which one is a correct recommendation for prophylaxis against Bacterial endocarditis?
Amoxicillin 1g IV
Azithromycin 500mg PO
Clindamycin 300 mg IV
Cefazolin 2g PO
Azithromycin 500mg PO
This is a non-operative post-hysterectomy infection:
Phlebitis
Abscess
Cellulitis
Myonecrosis
Phlebitis
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
Decreasing operative time as much as possible
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
Advanced ovarian carcinoma
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
Has less effect on partial thromboplastin time
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
Graded compression stocking
What is the standard technique in the diagnosis of DVT?
Doppler ultrasound B-mode duplex
Magnetic resonance venography
Venography
Computed tomography scanning
Venography
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
Dagibatran 150 mg BID
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%
Weight loss even with increase appetite
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
One-third of usual daily dose of NPH insulin is given prior to surgery
A euthyroid state should be maintained for how many months before elective surgery?
2 months
3 months
4 months
5 months
3 months
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
Starting dose of thyroxin is 1.6 ug/kg for thyroid hormone replacement
Which is an intermediate clinical predictor of increased perioperative cardiovascular risk?
Prior ischemic cardiac disease
Decompensated congestive heart failure
Advanced age
Uncontrolled systemic hypertension
Prior ischemic cardiac disease
This method may be used to overcome the limitations of exercise stress testing?
Dobutamine stress echocardiography
Exercise stress testing
Dipyridamole-thallium scanning
Angiography
Dipyridamole-thallium scanning
What is the treatment for congestive heart failure with the presence of cardiogenic asthma?
Furosemide
Morphine sulfate
Oxygen
Aminophylline
Aminophylline
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
Decreased systolic blood pressure
Treatment for bradycardia that is less than 45 beats per minute is
Propranolol
Atropine
Epinephrine
Digoxin
Atropine
Which one is true regarding predictor of postoperative pulmonary complications?
FEV1 = >1L
PaCO2 = >50 mmHg
PaO2 = < 60 mmHg
Maximal breathing capacity = 50% predicted
PaO2 = < 60 mmHg
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
6-7 years old
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
Occurs 2 years after breast budding
What is the main factor that influences the onset of puberty?
Genetic
Body weight
General health
Altitude
Genetic
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. The brain starts the process with the production of GnRH
What is the hormone responsible for pubarche in girls?
Testosterone
Estrogen
Androgen
Progesterone
Androgen
Which among the etiology of secondary amenorrhea is the cause when there is presence of secondary sexual characteristics
Androgen insensitivity
Hyperprolactinemia
Hypopituitarism
Gonadal failure
Androgen insensitivity
This phase of puberty occurs progressively in late childhood from about 6-7 to adolescence
Thelarche
Pubarche
Menarche
Adrenarche
Adrenarche
Which character does a child with precocious puberty manifest during adulthood?
Premature menopause
Normal menstrual cycle
Infertility
Low verbal IQ score
Normal menstrual cycle
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
4-8 years old
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
d. GnRH agonist treatment is effective for precocious pseudo-puberty
bonus question ni pero sa answer key ni doc is D
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. Increased estradiol level, increased gonadal size, decreased basal FSH and LH, GnRH levels are flat
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
McCune Albright Syndrome
This hormone is considered critical for the growth of children
Estrogen
Thyroid hormone
Growth hormone
Adrenal androgen
Estrogen
What is the chromosomal pattern in Turner syndrome?
46XO
45XO
45XX
46XY
45XO
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
b. Women with amenorrhea without estrogen deficiency are at increased risk of endometrial hyperplasia
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
Acanthosis nigricans
The most common cause of hyperprolactinemia is
Prolactinoma
Nonfunctioning pituitary tumor
Drug induced
Breast tumor
Prolactinoma
fter how many months of progesterone use will a woman experience amenorrhea
3 months
6 months
9 months
12 months
12 months
Which one is a primary reason menopausal women seek care from a clinician
Vaginal bleeding
Dyspareunia
Hot flashes
Abdominal mass
Hot flashes
This drug which is a selective serotonin reuptake inhibitor inhibits the enzyme system that converts tamoxifen to its active form
Paroxetine
Venlafaxine
Escitalopram
Bazedoxifene
Paroxetine
The oral agent approved for the treatment of moderate to severe dyspareunia associated with VVA.
DHEA
Estrogen
Ospemifene
Sildenafil Citrate
Ospemifene
What is the primary technique for bone mineral density assessment
Dual x-ray absorptiometry
T-scoring technique
Serum calcium assessment
Fracture risk assessment tool
Dual x-ray absorptiometry
What is the female most likely to develop CIN
after menopause
During pregnancy
During menarche
after menstruation
During menarche
This refers to squamous epithelial cells that undergone number of structural changes due to an HPV infection?
Metaplasia
Dysplasia
Neoplasia
Koilocytes
Koilocytes
Microorganisms found in women with either malignant or negative intraepithelial lesion
Gonorrhea
Chlamydia
Trichomonas
Staphylococcus
Trichomonas
a simplest method of determining the presence of CIN especially on low resource setting
Papanicolaou test
Visual inspection acetic acid test
Colposcopy
Cervicography
Visual inspection acetic acid test
???
An abnormal pattern of small blood vessel suggesting a confluence of tile or chicken with reddish borders is called
Mosaicism
Chimerism
Leucoplasia
Metaplasia
Mosaicism
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
b. Protection against HPV 6 and 11 is directed for genital warts
Description of unifocal type of VIN includes
Premenopausal women
Postmenopausal women
Associated with HPV
HPV 31 is involved
Postmenopausal women
The goal of treatment of VIN is
Wide excision vulvectomy
Preservation of vulvar function
Prevention of metastasis
Expectant management
Preservation of vulvar function
