Old Wall Quiz #4

Question 1

1. An Rh-negative pregnant woman at 18
   weeks gestation was found to have a titer of
   1:32 anti-Lewis antibodies and no other
   evidence of sensitization to red cell antigens.
   What is the best management?
   A. Repeat titer at 4 weeks
   B. Advise termination of pregnancy
   C. Plan serial amniocentesis starting at 24
   weeks
   D. Middle cerebral artery velocity at 24 weeks
   E. Give Rh D immunoglobulin at 28 weeks

Answer 1

e

Question 2

2. Which of the following hormones selectively
inhibits FSH secretion and is secreted by the
granulosa cells?
A. Activin
B. Follistatin
C. Inhibin
D. Leptin
E. Ghrelin

Answer 2

c

Question 3

3. On post op day 5 a 22 y/o G2P2 s/p hysterectomy
   and BSO, due to bilateral TOA’s, complains of dyspnea.
   On evaluation she is noted to be hypoxic and is
   subsequently intubated. Her Chest x-ray shows
   bilateral infiltrates. The most likely cause of the
   hypoxia is:
   A. Acute respiratory distress syndrome
   B. Cardiogenic shock
   C. Drug reaction
   D. Pulmonary embolus
   E. Secondary lung infection

Answer 3

a

Question 4

4. A 43 y/o G2P2 with a family history of colon
   cancer is seen for routine evaluation. On
   bimanual exam you palpate a 7 cm left adnexal
   mass. Her stool guaiac is negative. The next
   step in management:
   A. BRCA-1 mutation screening
   B. Colonoscopy
   C. MRI of pelvis
   D. Serum CA 125 measurement
   E. Endovaginal U/S

Answer 4

e

Question 5

5. 35 y/o has been taking a combination oral
   contraceptive. What is the advantage of
   multiphasic contraception versus monophasic
   contraception?
   A. Better contraceptive protection
   B. Less breakthrough bleeding
   C. Less metabolic effect of the progestin
   component
   D. Less risk of cervical and breast cancer
   E. Lower cost

Answer 5

c

Question 6

8. A 36 y/o G1P0 13 wks gestation underwent
   a D&C for a complete molar pregnancy. U/S
   intraoperatively shows bilateral ovarian cystic
   masses 5 cm. The next best step in
   management is:
   A. Hysterectomy, BSO
   B. Bilateral Ovarian cystectomy
   C. Bilateral salpingo-oophorectomy
   D. Multi-agent chemotherapy
   E. No further surgical management

Answer 6

e

Question 7

10. When treating polycystic ovarian syndrome,
    what is the beneficial physiologic effect of the
    ethinyl estradiol component of combine oral
    contraceptives?
    A. Increasing angiotensinogen production.
    B. Stimulates endometrial proliferation
    C. Increases LH production
    D. Increase SHBG production
    E. Decreasing progesterone production

Answer 7

d

Question 8

13. The most common form of congenital
adrenal hyperplasia results from a deficiency of
which enzyme?
A. 17-20 desmolase
B. 17-alpha Hydroxylase
C. 21 – Hydroxylase
D. 3 Beta-Hydroxysteriod dehydrogenase
E. 18-Hydroxysteriod dehydrogenase

Answer 8

c

Question 9

20. A 49 y/o G2P2 recently underwent a
    hysterectomy and BSO, is seen in your office to
    discuss the risks and benefits of hormone
    therapy. According to the most current data,
    estrogen therapy alone will most significantly:
    A. Decrease of colon cancer
    B. Decrease risk of death
    C. Increase risk of breast cancer
    D. Increase risk of coronary heart disease
    E. Increase risk of stroke

Answer 9

e

Question 10

35. A pregnant woman is concerned about her
    risk for fetal aneuploidy and expresses interest in first trimester serum analyte screening. You
    explain to her that adding ultrasonographic measurement of nuchal translucency to first-
    trimester analyte screening is beneficial because it:
    A. Increases the detection rate for trisomy 13
    B. Increases the detection rate for trisomy 21
    C. Increases the detection rate for Klinefelter’s
    syndrome
    D. Eliminates the need for second trimester AFP
    E. Eliminates the need for second trimester U/S

Answer 10

b

Question 11

36. A 26 y/o nulliparous patient underwent
    colposcopy for LGSIL. Colposcopy biopsy
    demonstrated adenocarcinoma in situ. She
    wishes to maintain child bearing potential. The
    most appropriate step is:
    A. Close observation with pap tests every 3
    months
    B. Cervical cone biopsy
    C. Laser ablation
    D. Simple Hysterectomy
    E. A type II radical hysterectomy with node
    dissection

Answer 11

b

Question 12

44. The most common abnormality found
during laparoscopy for chronic pelvic pain:
A. Appendiceal abscess
B. Diverticulitis
C. Endometriosis
D. Leiomyomata
E. Pelvic inflammatory disease

Answer 12

c