Old Wall Quiz #1

Question 1

1. A 23 year old presents for preconception
   counseling for infertility. Family history is
   significant for male relatives with azospermia.
   Genetic testing should include:

A. Chromosome studies
B. Cystic fibrosis screening
C. Pre-implantation genetics to avoid an AD
condition
D. Tay Sachs screening
E. Gauchers disease

Answer 1

b

Question 2

Which of the following is a FDA approved
medication for Osteoporosis treatment that
works by increasing osteoblast numbers and
stimulating bone formation?
A. Calcitonin
B. Alendronate
C. Recombinant Parathyroid hormone
D. Zoledronate
E. Denosumab

Answer 2

c

Question 3

3. A patient presents with a third trimester
ultrasound finding of a maximum vertical
pocket of 18 cm. The most likely cause is:
A. Normal finding
B. Idiopathic
C. Hydrops fetalis
D. Diabetes
E. Thyroid disease

Answer 3

b

Question 4

A 44-year-old female undergoes Robotic
laparoscopic resection of stage IV
endometriosis. Which of the following is most
valuable in detecting a gas embolus
intraoperatively?
A. Hypotension
B. Tachycardia
C. Cardiac arrythmia
D. End tidal CO2
E. Pulse oximetry

Answer 4

d

Question 5

When comparing Tamoxifen to Aromatase
inhibitors, the most likely specific adverse effect
of an Aromatase inhibitor is:
A. Deep venous thrombosis
B. Hot flushes
C. Arthralgia
D. Decreased libido
E. Vaginal dryness

Answer 5

c Arthralgia

Question 6

6. Which of the following best describes the
mechanism of action of bisphosphonates?
A. Stimulation of osteoblasts
B. Inhibition of osteoblasts
C. Stimulation of osteoclast resorption
D. Inhibition of osteoclast resorption
E. Inhibition of osteoblast resorption

Answer 6

d

Question 7

A 19-year-old female presents with no breast
or uterine development. Karotype is 46XY, FSH-
47, testosterone is in normal female range. No
gonads are palpable on exam. What is the most
likely diagnosis?
A. 17 alpha Hydroxylase deficiency
B. 17-20 Desmolase deficiency
C. Androgen insensitivity
D. Mullerian agenesis
E. Turners syndrome

Answer 7

b

Question 8

8. A post menopausal patient has a DEXA and is
   found to have a T-score of -3.0. Which of the
   following treatments is least likely to result in
   bone formation?
   A. Alendronate
   B. Estrogen
   C. Raloxifene
   D. Parathyroid hormone
   E. Calcitonin

Answer 8

b

Question 9

9. Which of the following medications is most
likely to result in bone resorption?
A. Diuretics
B. Calcium channel blockers
C. Digoxin
D. Lithium
E. Insulin

Answer 9

d

Question 10

10. In a normal pregnancy, what typically
    happens to the umbilical artery resistance?
    A. Progressively decreases throughout
    pregnancy
    B. Progressively increases throughout pregnancy
    C. Increase only in the first trimester
    D. Decreases in the second trimester then
    increases in the third trimester
    E. Does not change

Answer 10

a

Question 11

12. A patient comes to your office after her
mother developed ovarian cancer and was
found to have the BRCA-1 gene. What is her risk
of inheriting the gene?
A. 5%
B. 10%
C. 25%
D. 50%
E. 100%

Answer 11

d

Question 12

14. Four days after a TVH a 36 y/o patient
    returns to ED complaining of right flank pain,
    fever, and a vaginal watery discharge. The next
    best step will be:
    A. Diagnostic Laparoscopy
    B. Renal Ultrasound
    C. Percutaneous ureteral stent
    D. Ureterneocystotomy
    E. Retrograde pyelography with retrograde
    ureteral stent

Answer 12

e

Question 13

15. Several months after a vaginal delivery, your
    patient complains of occasional involuntary
    passage of air per vagina, she denies vaginal
    passage of stool. What is the most appropriate
    confirmatory test?
    A. Charcoal by mouth
    B. Methylene blue rectally
    C. Barium enema
    D. Sigmoidoscopy
    E. Sterile milk douche

Answer 13

b

Question 14

16. The most common cause of endometrial
bleeding in a post menopausal patient is?
A. Atrophic endometrium
B. Endometrial carcinoma
C. Simple endometrial hyperplasia
D. Complex endometrial hyperplasia
E. Sarcoma

Answer 14

a

Question 15

23. A 17 y/o patient presents to your office
with a positive GC test and negative
chlamydia. What is the best treatment?
A. Ceftriaxone and azithromycin
B. Ceftriaxone
C. Ampicillin and gentamycin
D. Cefixime
E. Azithromycin

Answer 15

a

Question 16

24. Your patient presents for genetic
    counseling. She states she has the hemophilia gene. What is the chance one of her sons will have the disease?
    A. 0%
    B. 25%
    C. 50%
    D. 75%
    E. All of her children will have hemophilia

Answer 16

c

Question 17

25. A woman taking combined oral
contraceptive pills for three years develops a deep vein thrombosis. The least helpful test in
her evaluation is:
A. Clotting time
B. Protein C
C. Protein S
D. Antithrombin III
E. Anticardiolipin antibody

Answer 17

a

Question 18

26. A postmenopausal woman s/p anterior
colporrhaphy presents with complaints of stress urinary incontinence. She is found to have a low urethral closure pressure. She is a good candidate for which procedure?
A. Retropubic sling procedure
B. Kelly plication
C. Paravaginal repair
D. Repeat anterior colporrhaphy
E. Uterosacral ligament suspension

Answer 18

a

Question 19

Hormone replacement therapy is known to decrease the incidence of which cancer?

A. Lung
B. Thyroid
C. Breast
D. Colon
E. Cervix

Answer 19

d

Question 20

29. As compared with the general population, obese woman with Polycystic ovarian syndrome (PCOS) are not at higher risk for:
A. Endometrial Cancer
B. Hyperlipidemia
C. Diabetes mellitus
D. Thyroid disease
E. Infertility

Answer 20

d

Question 21

30. Which uterine anomaly is most likely
responsible for recurrent pregnancy loss:
A. Didelphys
B. Bicornuate
C. Unicornuate
D. Septate
E. Arcuate

Answer 21

d

Question 22

31. Hypovolemic shock is best characterized
    by:
    A. Decreased PCWP, Decreased SVR, Decreased CO
    B. Decreased PCWP, Decreased SVR, Increased CO
    C. Decreased PCWP, Increased SVR, Increased CO
    D. Decreased PCWP, Increased SVR, Decreased CO
    E. Increased PCWP, Increased SVR, Decreased CO

Answer 22

d

Question 23

32. Of the following, tension headache is
most characterized by:
A. Abrupt onset
B. Greater than 4 hours duration
C. Nausea
D. Aura
E. Frontal and occipital location

Answer 23

e

Question 24

33. The most likely fetal response to exercise
is:
A. Decreased variability
B. Growth restriction
C. Increase in fetal heart rate
D. Variable decelerations
E. Respiratory alkalosis

Answer 24

c

Question 25

35. The most common cause of a shoulder
presentation is?
A. Prematurity
B. Android pelvis
C. Placental location
D. Fibroid tumors
E. Septate uterus

Answer 25

a

Question 26

39. What is the first fetal indication of a
ruptured uterus?
A. Maternal tachycardia
B. Abnormal change in fetal heart rate
C. Loss of station
D. Heavy vaginal bleeding
E. Abdominal pain

Answer 26

b

Question 27

41. Which of the following is the most significant risk of an amniocentesis?
A. Vaginal spotting
B. Limb defects
C. Pregnancy loss
D. PROM
E. Chorioamnionitis

Answer 27

c

Question 28

45. What is the most likely cause of a
persistent or chronic cough?
A. Pneumonia
B. Bronchitis
C. Gastroesophageal reflux disease
D. TB
E. Peptic ulcer disease

Answer 28

c

Question 29

46. What is the most serious outcome if a
    patient in labor undergoes artificial rupture of membranes (AROM)?
    A. Chorioamnionitis
    B. Arrest of labor
    C. Hemorrhage
    D. Umbilical cord prolapse
    E. Cesarean section

Answer 29

d

Question 30

47. A patient is referred to your office with a diagnosis of Androgen insensitivity syndrome. On physical exam you are most likely to see?
A. Temporal balding
B. Clitormegaly
C. Small uterus
D. Blind vaginal pouch
E. Tanner 1 stage breasts

Answer 30

d