Obgyn - Infertility(33) Flashcards
OBG - 6.1
We can talk about sterility when conception does not occur in the course of regular sex life without using any contraceptive method:
A) within 1 year
B) within 6 months
C) within 2 years
D) within 10 regular cycles
ANSWER
A) within 1 year
EXPLANATION
In a physiologic case, the real chance of conception is within 2 years, the physiologic pregnancy rate is about 80% within 1 year, it is 50% in the 2nd year, then the chance of spontaneous conception significantly decreases. Obviously if there is a factor causing sterility (for example amenorrhea), it is unnecessary to postpone the examination to the end of the above-mentioned period; likewise over the age of 35, when the inclination for conception is much smaller than in the above mentioned case.
OBG - 6.2
Which of the complications listed below is the most common after in vitro fertilization (IVF)?
A) Pelvic inflammatory disease
B) Chronic anovulation
C) Ovarian hyperstimulation syndrome
D) Asherman syndrome
ANSWER
C) Ovarian hyperstimulation syndrome
EXPLANATION
In case of in vitro fertilisation, we try to have several, 6-10 follicles ripened so that several oocytesare will be available to carry out insemination. The stimulation treatment needed to carry it out can result in abnormal hyperstimulation more often than the treatments applied to induce ovulation.
OBG - 6.3
Postpartum galactorrhea-amenorrhea syndrome:
A) Morgagni syndrome
B) Sheehan syndrome
C) Chiari-Frommel syndrome
D) Schmidt syndrome
ANSWER
C) Chiari-Frommel syndrome
EXPLANATION
The functional disorder of the hypothalamus lies behind the Chiari-Frommel syndrome in the first place. It causes an enhanced prolactin production, which triggers the major symptoms of the syndrome: galatorrhea, raro-, amenorrhea, sterility.
OBG - 6.4
Which of the groups of medicine listed below contains clomifen citrat, which is used to treat infertility?
A) Progesteron
B) Antiprogesteron
C) Oestrogen
D) Antioestrogen
E) GnRh-agonist
ANSWER
D) Antioestrogen
EXPLANATION
Clomiphen citrate is the competitive antagonist of estrogens on estrogen receptors
OBG - 6.5
Which of the following options is not true of the Stein-Leventhal syndrome?
A) Obesity
B) Hirsutism
C) Primer amenorrhoea
D) X-linked inheritance
ANSWER
D) X-linked inheritance
EXPLANATION
No X-linked disorder occurs typically in case of Stein-Leventhal syndrome. However, obesity, hirsutism and anovulation –often together with amenorrhea- are the major symptoms of the clinical picture.
OBG - 6.6
When detecting hyperprolactinaemia, the first examination to be carried out is:
A) Skull X-ray
B) Measuring the serum FSH level
C) Sella-CT or –MRI
D) Pelvic ultrasound
E) Measuring the serum estradiol level
ANSWER
C) Sella-CT or –MRI
EXPLANATION
In case of hyperprolactinaemia the most important issue is to detach the functional or tumour origin, the first step of which is the imaging of the sella turcica.
OBG - 6.7
Medications used to induce ovulation, except for:
A) Clomiphene citrate
B) hMG
C) hCG
D) cyproproteron-acetat
ANSWER
D) cyproproteron-acetat
EXPLANATION
Stimulating folliculogenesis is impossible only with Diane 35 out of the listed ones.
Cyproterone acetate is a steroid used in combination with ethinyl estradiol to treat women with severe acne and symptoms of androgenization
is an antiandrogen and progestin medication used in the treatment of androgen-dependent conditions such as acne, excessive body hair growth, early puberty, and prostate cancer, as a component of feminizing hormone therapy for transgender individuals, and in birth control pills.
OBG - 6.8
Which of the following cannot cause hyperprolactinaemia?
A) Prolactine-producing hypophysis tumour
B) Neuroleptics
C) Pregnancy
D) Hyperthyreosis
ANSWER
D) Hyperthyreosis
EXPLANATION
Hyperprolactinaemia cannot be observed only in case of hyperthyreosis – out of the listed ones.
OBG - 6.9
The following methods have an important role in the modern sterility examination, except for:
1) Hysterosalpingography
2) Ultrasound folliculometry
3) Laparoscopy with chromopertubation
4) CTG
A) only options 1, 2, and 3 are correct
B) only options 1 and 2 are correct
C) only options 2 and 4 are correct
D) only option 4 is correct
E) all the 4 options are correct
ANSWER
D) only option 4 is correct
EXPLANATION
Only CTG (out of the listed ones) plays no role in the examination of sterility as CTG is used for monitoring the foetus.
OBG - 6.10
Which one or ones of the conditions listed below can cause infertility?
1) Endometriosis
2) Corpus luteum insufficiency
3) PCO syndrome
4) Hyperprolactinaemia
A) only answers 1, 2 and 3 are correct
B) only answers 1 and 3 are correct
C) only answers 2 and 4 are correct
D) only answer 4 is correct
E) all the 4 answers are correct
ANSWER
E) all the 4 answers are correct
EXPLANATION
By different mechanisms, but each of the listed clinical pictures can be a cause of sterility.
OBG - 6.11
Which of the following medicines are suitable for inducing ovulation?
1) HMG
2) pure FSH
3) Clomiphene citrate
4) pure LH
A) only options 1, 2, and 3 are correct
B) only options 1 and 2 are correct
C) only options 2 and 4 are correct
D) only option 4 is correct
E) all the 4 options are correct
ANSWER
A) only options 1, 2, and 3 are correct
EXPLANATION
The first three medicines are suitable for inducing ovulation by stimulating folliculogenesis. However, LH has its first independent role in the rupture of the dominant folliculus, it is not suitable for stimulating folliculogenesis in itself.
OBG - 6.12
Which one(s) is/are typical of normal ejaculation:
1) Volume: 2-5 ml
2) Motility: at least two-third of the sperms are moving
3) Morphology: at least 60 % is normal-shaped sperms
4) Concentration: 8-10 million sperms/ml
A) only answers 1, 2 and 3 are correct
B) only answers 1 and 2 are correct
C) only answers 2 and 4 are correct
D) only answer 4 is correct
E) all the 4 answers are correct
ANSWER
A) only answers 1, 2 and 3 are correct
EXPLANATION
The first three parameters are the main characteristics of physiological ejaculatum, however, the minimum physiological sperm count is 20 million/ml.
OBG - 6.13
The following diagnostic methods are used to verify the cervical factor in infertility evaluation / testing:
1) post-coital cervical mucus test
2) „Spinnbarkeit” test
3) Sims-Huhner test
4) Ultrasound examination
A) only options 1, 2, and 3 are correct
B) only options 1 and 2 are correct
C) only options 2 and 4 are correct
D) only option 4 is correct
E) all the options are correct
ANSWER
A) only options 1, 2, and 3 are correct
EXPLANATION
Only the ultrasound examination –out of the listed diagnostic methods-does not give help to characterize the cervical factor.
OBG - 6.14
Determining the serum progesterone level to verify ovulation is suggested in the following cycle:
1) 1st-3rd days
2) 4th-6th days
3) 1st-13th days
4) 19th-23rd days
A) only options 1, 2, and 3 are correct
B) only options 1 and 2 are correct
C) only options 2 and 4 are correct
D) only option 4 is correct
E) all the options are correct
ANSWER
D) only option 4 is correct
EXPLANATION
Examining the serum progesterone can be performed only in the luteal phase to verify ovulation, the other cycles are not suitable for that.
OBG - 6.15
The following procedures can be used to examine the possible blockage of the fallopian tubes:
1) Hysterosalpingography
2) Laparoscopy + chromo pertubation
3) Chromo pertubation + Douglas puncture
4) Hystero-salpingo-sonography
A) only answers 1, 2, and 3 are correct
B) only answers 1 and 2 are correct
C) only answers 2 and 4 are correct
D) only answer 4 is correct
E) all the 4 answers are correct
ANSWER
E) all the 4 answers are correct
EXPLANATION
All the methods listed are suitable for verifying the blockage of the fallopian tubes.