Old Wall Quiz #2 Flashcards
1
Q
- Which of the following tumor markers is
most affected by pregnancy?
A. LDH B. Inhibin C. HE4 D. CA 19-9 E. CA 125
A
e
2
Q
2. Which of the following antepartum complications is associated with bacterial pneumonia in pregnancy? A. PROM B. Preterm labor C. Vaginal bleeding D. Placental abruption E. Placental previa
A
b
3
Q
3. Which of the following is the most likely cause of IUGR before 26 weeks gestation? A. Gestational diabetes B. Aneuploidy C. Chorioangioma D. Renal insufficiency E. Pregestational diabetes
A
b
4
Q
4. Which thrombophilia is inherited in an autosomal recessive fashion? A. Factor V Leiden B. Anti-thrombin III deficiency C. Protein C deficiency D. Protein S deficiency E. Hyperhomocysteinemia
A
e
5
Q
5. Where does thrombosis associated with pulmonary embolism in pregnant women frequently originate? A. Popliteal veins B. Femoral veins C. Iliac veins D. Vena cava E. Uterine vein
A
c
6
Q
6. Which of the following is the most common cause of hemorrhage after a second trimester abortion? A. Retained products B. Uterine atony C. Uterine perforation D. Infection E. Laceration
A
b
7
Q
7. What is the most common fetal neonatal consequence of ABO incompatibility with anemia? A. Early death B. Respiratory distress syndrome C. Hydrops fetalis D. Intraventricular Hemorrhage E. Hyperbilirubinemia
A
e
8
Q
8. Your patient is RH negative and her husband, a Caucasian is RH positive(D-positive) heterozygous, what is the risk their fetus is at risk for hemolytic disease? A. 15% B. 20% C. 25% D. 50% E. 100%
A
d
9
Q
- Your patient has anti-Kell antibodies (titer 1:8) presumably from a blood transfusion 5 years ago. She has a 16-week gestation. What is your initial management?
A. Cordocentesis for fetal blood type
B. Maternal plasmapheresis
C. Paternal Kell antigen status determination
D. Pregnancy termination
E. Middle cerebral artery Doppler
A
c
10
Q
10. One 300 microgram dose of D-immune globulin will protect the mother against what volume of fetal maternal hemorrhage? A. 5 ml B. 10 ml C. 30 ml D. 50 ml E. 90 ml
A
c
11
Q
- A 27-year-old G1P0 at 32 weeks gestation has a breast mass . Ultrasound and mammography reports BIRADS-4. Which of the following would be the most appropriate approach?
A. Await delivery at term and evaluate further
postpartum
B. Deliver preterm when fetal lungs mature and evaluate further postpartum
C. Perform core needle biopsy
D. Repeat U/S and mammogram in 4 weeks
E. Reassurance and observation
A
c
12
Q
12. Which of the following perinatal infections has the highest mortality rate when the fetus is infected at term? A. CMV B. Influenza C. Varicella D. Rubella E. Parvovirus
A
c
13
Q
13. Which of the following techniques is best for the diagnosis of fetal cytomegalovirus infection? A. Amniotic fluid for PCR B. Chorionic villus sampling C. Serial Ultrasounds D. MRI E. CMV IgG avidity testing
A
a
14
Q
14. Late-onset group B streptococcal infection in the neonate classically manifests as which of the following? A. Necrotizing enterocolitis B. Meningitis C. Respiratory distress syndrome D. Septicemia E. Stillbirth
A
b
15
Q
15. What is the most common symptom associated with intestinal obstruction in pregnancy? A. Nausea B. Vomiting C. Abdominal pain D. Diarrhea E. Fever
A
c
16
Q
- What is the most common cause of a
bowel obstruction in pregnancy?
A. Infection B. Adhesions C. Cancer D. Mechanical compression from the uterus E. Inflammatory bowel disease
A
b
17
Q
17. Which of the following findings is most associated with cerebral palsy? A. pH – 7.2 B. Low birth weight of 500-1500 grams C. Apgar <3 at 5 minutes D. Base excess less than 12 E. Intraventricular hemorrhage
A
c
18
Q
18. When is the peak anti-factor Xa activity in a woman taking enoxaparin sodium (Lovenox)? A. 1 hour after dosing B. 2 hour after dosing C. 3.5 hours prior to dosing D. 3.5 hours after dosing E. 5.0 hours prior to dosing
A
d
19
Q
19. During what gestational period does high dose ionizing radiation exposure pose the most serious risk of mental retardation? A. 4-7 weeks B. 8-15 weeks C. 20-26 weeks D. 28 -32 weeks E. 34-36 weeks
A
b
20
Q
- A 22 year old G1P0 at 28 weeks presents with a 5 cm mass on her cervix confirmed as squamous cell carcinoma. What is the next best step in management?
A. Steroids and immediate delivery by CD
B. Start chemotherapy, and steroids and
delivery at 32 weeks
C. Immediate TAH and staging with fetus in situ
D. Delay treatment, steroids and delivery at 34 weeks
E. Trachelectomy and cerclage
A
d
uptodate disagrees: Stage IB2 or higher — For women with a larger tumor ≥2 cm, there is a lack of data on treatment delay and outcomes. Some oncologists have suggested that treatment not be postponed for patients with tumors exceeding 4 cm, which also includes patients with positive lymph nodes (confirmed or clinically suspected) [58]. However, if the patient prefers not to deliver early, we would advocate for the administration of neoadjuvant chemotherapy until delivery rather than a delay of treatment.
21
Q
21. Which of the following thyroid parameters decrease in pregnancy? A. Free T4 B. Free thyroxine index C. Total T4 D. Total T3 E. Resin T3U
A
e
22
Q
22. Which fetal weight is it appropriate to scheduled cesarean delivery at 39 weeks on a non- diabetic? A. 4,000 g B. 4,500 g C. 5,000 g D. 5,500 g E. 6,000 g
A
c
23
Q
24. Which of the following anticonvulsants have been linked to Asperger’s syndrome? A. Phenytoin B. Valporic acid C. Carbamazine D. Topiramate E. Levetiracetam
A
b
24
Q
- Your 33 week patient is fully dilated +3
station with an OA presentation. The FHT is Category III and maternal pushing effort is poor. What is your next step?
A. Cesarean delivery
B. Vacuum extractor
C. Simpson forceps delivery
D. Tucker McLane forceps delivery
E. Continue pushing and generous episiotomy
A
c
25
Q
26. Patients with subinvolutional bleeding may be treated by any of the following EXCEPT: A. Ergonovine B. Azithromycin C. Oral estrogen D. Methylergonovine E. Doxycycline
A
c
26
Q
27. Which of the following is most likely associated with a home birth? A. Neonatal death B. 4th degree laceration C. Labor induction D. Episiotomy
A
b
27
Q
28. Which of the following drugs is not used to facilitate sexual assault? A. Ketamine B. Alcohol C. LSD D. THC E. Rohypnol
A
c
28
Q
- Which of the following medications is
recommended for the treatment of Listeria
during pregnancy if the patient is allergic to
ampicillin?
A. Amoxicillin
B. Erythromycin
C. Cefoxitin
D. Azithromycin
E. Trimethoprim sulfamethoxazole
A
e
29
Q
30. Which of the following SSRI’s has been linked to cardiac malformations when the fetus is exposed in the first trimester? A. Fluoxetine B. Sertraline C. Paroxetine D. Citalopram E. Alprazolam
A
c
30
Q
- In order to limit fetal exposure to mercury
the food and drug administration (FDA)
recommends that women limit total fish or
shellfish consumption to 6 ounces per week.
Limitation of which fish in particular is
recommended?
A. pollack
B. salmon
C. Canned light tuna
D. catfish
E. White albacore Tuna
A
e
31
Q
32 A 48 year old with a known history of Levonorgestrel IUD undergoes an endometrial biopsy. What would be the most likely finding on histology? A. Disorganized glands B. Proliferative endometrium C. Secretory endometrium D. Inflammation E. Atrophy
A
e
32
Q
- A 29 year old with a known history of
hyperthyroidism is currently on PTU in her first
trimester. Which of the following is the most
likely outcome of her neonate after delivery?
A. Choanal atresia
B. Aplasia cutis
C. No effect on the neonate
D. Fetal hypothyroidism
E. Hepatoxicity
A
c
33
Q
34. Cystic hygroma is the result of which of the following? A. Meningeal herniation B. Arterial aneurysm formation C. Cystic degeneration of the sternocleidomastoid muscle D. Lymphatic obstruction E. Cardiac anomaly
A
d
34
Q
35. Which antibiotic is associated with increased rates of necrotizing enterocolitis? A. Amoxicillin-clavulanate B. Erythromycin C. Amoxicillin D. Azithromycin E. TMP-SMX
A
a
35
Q
- A 19 y/o presents to L&D in active labor
and delivers a term stillbirth. What is the best
for evaluation if patient refuses an autopsy?
A. TORCH titers
B. KB test
C. Placental evaluation
D. Thrombophilia evaluation
E. Fetal imaging
A
c
36
Q
37. Which of the following patients will have the highest risk of a post-operative MI and death following hysterectomy? A. Chronic bronchitis B. THC use C. Elevated LDL D. Obstructive Sleep Apnea E. Emphysema
A
d
37
Q
38. Which nerve roots are responsible for the pain of vaginal delivery? A. T10 - T11 B. T11-T12 C. T10 - L1 D. S2 - S4 E. T9 - T10
A
d
38
Q
39. What is the most common complication of paracervical block during pregnancy? A. Maternal hypotension B. CNS toxicity C. Fetal bradycardia D. Bleeding E. Nausea and vomiting
A
c
39
Q
- A 29 year old G2P1 is positive for Hepatitis B
Surface antigen (HBsAg). Which of the following
serologic tests results would confirm she is
chronically infected?
A. HBsAg
B. HBeAg
C. Anti-HBc
D. IgM Anti-HBc
E. Anti-HBs
A
c
40
Q
41. What is the optimal timing for a gravida to receive the Tdap Vaccination? A. Any trimester B. Before 12 weeks gestation C. Between 12-24 weeks gestation D. 27-36 weeks gestation E. Not indicated during pregnancy
A
d
41
Q
42. What is the biological half life of Oxytocin? A. 4 minutes B. 10 minutes C. 12 minutes D. 14 minutes E. 18 minutes
A
a
42
Q
- A 21 year old nulliparous D-negative patient
at 36 weeks gestation undergoes an external
version for breech presentation. Which of the
following should be given?
A. Magnesium sulfate
B. Oxytocin
C. Anti-D immune globulin
D. Nifedipine
E. Heparin
A
c
43
Q
44. Which of the following is the most likely event associated with external cephalic version? A. Rupture of membranes B. Umbilical cord prolapse C. Changes in Fetal heart rate D. Stillbirth E. Labor
A
c
44
Q
- Which of the following is the most
important predictor of neurological outcome
of the survivor after death of a co-twin?
A. Gestational age at time of demise
B. Malformations present in the deceased twin
C. Length of time between demise and delivery
D. Chorionicity
E. Percent of discordance
A
d
45
Q
- A 19-year-old G1 at 39 weeks presents
stating she was exposed to varicella. What is
the next step in management?
A. Offer vaccination
B. Defer VZV serology testing and proceed with
Varizig administration
C. Test for VZV serology and administer Varzig if
results are negative
D. Test for VZV serology and give Varizig and
varivax if results negative
A
c
46
Q
47. Which of the following is not a common cause of non-immune fetal hydrops: A. Renal agenesis B. Cardiac anomaly C. Chromosomal anomaly D. Twin to twin transfusion E. Parvovirus B19
A
A
47
Q
- A 24 y/0 G2P1 at 20 weeks’ gestation
presents with asthma exacerbation. Her FEV1
is 50%, PCO2 is normal range and her P02
decreased. These values are concerning and
likely reflect which of the following?
A. Respiratory failure
B. Metabolic acidosis
C. Normal PC02 indicates fatigue and early CO2
retention
D. A fetus cannot survive when the mothers’
FEV1 is less than 50%
E. Normal findings
A
c
48
Q
49. Which of the following immunizations should not be given postpartum. A. Diphtheria - tetanus and Acellular pertussis B. Rabies C. Measles mumps rubella vaccination D. Influenza E. No restrictions for any of these
A
e
49
Q
50. Which cells of the dominant follicle are responsible for estrogen production during the follicular phase of the menstrual cycle? A. Theca B. Decidual C. Granulosa D. Endometrial E. Theca-lutein cell
A
c
