Old Wall Quiz #5 Flashcards
1
Q
1. All of the following diagnostic tests are typically obtained during the initial evaluation of abnormal uterine bleeding EXCEPT: A. TSH B. Pregnancy test C. Cervical cytology D. Complete blood count E. Liver function test
A
e
2
Q
2. Starting at age 55, which medications has been shown to be the most beneficial? A. Clopidogrel (Plavix) B. Low dose Aspirin C. Vitamin D and Calcium D. Daily Multivitamin with Iron E. Metamucil
A
b
3
Q
- After a complicated vaginal delivery a baby is
noted to have low APGAR’s and a umbilical
artery sample is taken. Which of the following
will be the most likely value to indicate fetal
metabolic acidosis?
A. PH - 7.10
B. PCO2 - 75
C. PO2 – 22
D. Base deficit -16 mmol/L
E. HCO3
- 26
A
d
4
Q
4. Which variable puts neonates at the lowest risk for mortality from meconium aspiration? A. IUGR B. Oropharyngeal suctioning C. Intubation and suctioning beneath the glottis D. Post term pregnancy E. Amnioinfusion
A
c
5
Q
5. Which of the following mutations is associated with an autosomal dominant disorder that is characterized by a predisposition for breast cancer, endometrial cancer, thyroid cancer and benign mucocutaneous lesions? A. MLH1-MSH2 over expression B. BRCA1 Mutation C. BRCA2 Mutation D. PTEN Mutation E. TP53 Mutation
A
d
6
Q
- A 22 year old presents four days post partum
from a SVD and 4th degree repair. On evaluation
you note her repair is broken down completely
and there is purulent discharge and foul
smelling necrotic tissue. What is the next best
step?
A. Immediate repair in OR
B. Debride in OR with delayed repair and
antibiotics
C. Wait 8 weeks and repair
D. Wet to dry dressing changes and wait to
close by secondary intention
E. Observation
A
b
7
Q
7. Which of the following is the likely physiologic cause of fecal impaction in the elderly? A. Altered diet B. Neglected care from providers C. Constant inhibition of the internal anal sphincter D. Indwelling catheters E. Immobility
A
c
8
Q
- Which of the following surgical preparation
are an acceptable alternative for the vaginal
surface if patient is allergic to iodine?
A. 1% Chlorhexidine gluconate
B. 4% Chlorhexidine gluconate with 4%
isopropyl alcohol
C. 4% Chlorhexidine gluconate
D. 2% Chlorhexidine gluconate with 1%
isopropyl alcohol
E. Povidone-iodine
A
b
9
Q
- A 54 year old presents with a history of recurrent spontaneous leakage of urine. All of
the lifestyle modifications will decrease her
incontinence EXCEPT:
A. Weight loss B. Pelvic floor exercises C. Systemic HRT D. Bladder training E. Fluid management
A
c
10
Q
10. A patient presents with Post Lyme’s disease syndrome. What is the most likely treatment? A. Doxycycline B. Amoxicillin C. Ceftriaxone D. Cefotaxime E. Symptomatic therapy
A
e
11
Q
- All of the following are contraindications
to prescribing oral contraceptives EXCEPT?
A. Smoking over age 35
B. SLE
C. Active hepatitis
D. Migraine without aura greater than 35 y/o
E. Insulin dependent diabetes
A
d
12
Q
12. A 21 year old G1P0 at 10 weeks gestation presents with hyperemesis gravidarum. Which of the following treatments is least helpful? A. Vitamin B6 - pyridoxine B. Ondansetron (Zofran) C. Ginger D. Alprazolam (Xanax) E. Dimenhydrinate (Dramamine)
A
d
13
Q
- A 27 G2P1 presents with a fetal demise at
36 weeks. A concealed placental abruption and
shoulder presentation is confirmed at bedside
ultrasound. What is the first step in
management?
A. Immediate Cesarean delivery
B. Observation
C. Evaluate for coagulopathy
D. Transfuse 2 units packed red cells
E. Aminotomy and oxytocin infusion
A
c
14
Q
- Your patient presents in labor at term. She
is a known carrier of Group B streptococcus and
has shortness of breath with penicillin. What is
the best treatment?
A. Cefazolin
B. Clindamycin
C. Erythromycin
D. Ampicillin
E. Vancomycin
A
e
15
Q
15. During a robotic hysterectomy the anesthesiologist reports your patients blood pressures have dropped and a mill wheel murmur is noted on auscultation of her heart. What is the first treatment maneuver? A. Central line placement B. Swan Ganz catheter C. 100% fraction inspired Oxygen D. Place patient in steep Trendelenburg E. Release of pneumoperitoneum
A
e
16
Q
16. Which mode of contact has the highest risk of transmission of Hepatitis C? A. Vaginal intercourse B. Tattooing C. Nipple piercings D. Cryoprecipitate transfusion E. Intravenous drugs
A
e
17
Q
- A 29 year old G1P1 presents to your office
with a history of recent unsatisfactory cytology.
Follow-up cytology 2 months later reports LSIL,
what is the next best step in her management?
A. HPV testing
B. Excisional procedure
C. colposcopy
D. Cotesting in 1 year
E. Routine screening
A
c
18
Q
- A 65 year old presents with metastatic
ovarian cancer. Which cell type is most likely?
A. Mucinous carcinoma
B. Serous cystadenocarcinoma
C. Endometroid cancer
D. Germ cell
E. Clear cell
A
b
19
Q
19. All of the following periodic testing should be performed on a 60 year old presenting for annual exam EXCEPT? A. Urinalysis B. Lipid panel C. Colonoscopy D. Glucose screening E. Mammography
A
a
UA is annual starting at 65
20
Q
- A 65 year old whose DEXA scan T score is
-1.2. What is the best exercise for building
bone?
A. Elliptical trainers
B. Yoga
C. Pole Fitness
D. Step aerobics
E. Swimming
A
d
21
Q
- A patient with infertility is undergoing
induction of ovulation with gonadotropins and
HCG. All of the following are likely with
ovarian hyperstimulation syndrome EXCEPT:
A. Abdominal pain
B. Ascites
C. Oliguria
D. Hemoconcentration
E. Decreased vascular permeability
A
e
22
Q
- A 22 year old G2P1 with a previous normal
pregnancy presents at 20 weeks with a anti-D
titer of 1:16. What is the next best step?
A. Amniocentesis
B. Cordocentesis
C. MCA Doppler’s
D. Repeat titer in one month
E. Bilirubin level
A
c
23
Q
23. Which of the following is most likely to develop chronic hepatitis? A. Hepatitis A B. Hepatitis B C. Hepatitis D D. Hepatitis E E. Hepatitis C
A
e. hep c
24
Q
- A patient presents with chronic Hidranitis
Suppurativa of the mons pubis. She has been
treated with multiple therapies without success.
The affected area is noted beneath the
subcutaneous tissue. What is the next best
management?
A. Intravenous antibiotics
B. Incision and drainage of sinuses
C. Excision with clean margins
D. Accutane (isotretinoin)
E. Cyclosporine
A
c
25
Q
- Which of the following is least likely
associated with Congenital Rubella Syndrome:
A. Patent ductus arteriosus
B. Sequela of fetal infection being worst during
organogenesis
C. Sensorineural deafness
D. Limb deformities
E. CNS defects
A
d
26
Q
- A 41 year old presents with a bartholin gland
infection. All the following would prompt you to
excise the gland and duct EXCEPT:
A. Multiple recurrences of abscesses
B. Persistent deep infection
C. Age over 40 with gland enlargement
D. Recurrent enlargement of gland age > 40 y/o
E. Bartholin cysts with solid components
A
c
27
Q
27. A 19 year old is diagnosed with Androgen Insensitivity Syndrome, on evaluation she will exhibit all of the following EXCEPT: A. Breast development B. Blind vaginal pouch C. Virilization D. Elevated testosterone E. Testes
A
c
28
Q
- A 32 year old presents to your office with a
history of rapidly progressing virilization over
the past year. What is the best diagnostic test to
order first?
A. Testosterone level
B. DHEA
C. Sex hormone binding globulin
D. Pelvic ultrasound
E. DHEA-S
A
a
29
Q
- After undergoing hysteroscopic resection of a grade II submucosal leiomyoma, patients are
encouraged to delay conception attempts for
what length of time?
A. 1 year B. 6 months C. Three menstrual cycles D. Menstrual cycle after resection E. Do not need to delay
A
c
30
Q
30. Which of the following it the best way to prevent preterm delivery? A. Periodontal care B. 17-hydroxyprogesterone C. Fetal fibronectin weekly D. Cervical lengths E. Early access to prenatal care
A
e
31
Q
31. All of the following are recommended for 40 year old patients EXCEPT: A. Mammogram annually B. Breast awareness monthly C. Clinical breast exam annually D. Self-breast exam monthly E. Breast MRI for patients positive for BRCA1 and BRCA2 mutation
A
d
32
Q
32. Which of the following factors does not contribute to nerve injuries during gynecological procedures? A. Regional anesthesia B. Patient positioning C. Incision approach D. Surgical procedure performed E. Retractor use
A
a
33
Q
33. A 60 year old postmenopausal woman presents for evaluation of reported uterine bleeding, which is confirmed by physical exam. Which procedure is the next step in her evaluation? A. Colposcopy B. Diagnostic hysteroscopy C. Endometrial biopsy D. Saline infused sonography E. Transvaginal sonogram
A
e
34
Q
- A patient presents 2 weeks after a vaginal
hysterectomy(TVH) and notes light vaginal
spotting. On exam there is a small 1 cm cuff
separation. What is your next step?
A. Exploratory Laparotomy and close the cuff
B. Laparoscopic repair
C. Observation
D. Silver nitrate
E. Vaginal repair
A
c
35
Q
- Your patient is status post a 3 hour TVH.
Post-op she complains of numbness in the
anterior and lateral aspect of her right thigh.
Which of the following would most likely explain
her symptoms?
A. Prolonged hip flexion during surgery
B. Use of vaginal retractors
C. Presence of a vaginal hematoma
D. Effect of her spinal anesthesia
E. Effect of surgical assistant resting on medial
calf
A
a
36
Q
37. Which of the following is not a clinical abnormality of the metabolic syndrome? A. Diabetes B. Dyslipidemia C. Hypertension D. Obesity E. Polycystic Ovaries
A
e
37
Q
- Which of the following is the least ideal
management of a 33 year old G2P2 with normal
pelvic exam, menorrhagia and normal secretory
endometrial biopsy?
A. Hysterectomy
B. Endometrial ablation
C. Oral contraceptives
D. Levonorgestrel IUD (Mirena)
E. Progesterone
A
a
38
Q
40. Which clinical scenario is associated with the following hemodynamic profiles: Cardiac index – increased SVR –decreased PCWP – decreased SVO2 - increased A. Cardiogenic shock B. Septic Shock C. Congestive heart failure D. Hypovolemic shock E. Hemorrhagic shock
A
b
39
Q
41. When comparing the Transobturator to the Retropubic approach for the treatment of incontinence, the TOT has a significantly lower risk of all of the following EXCEPT A. Bladder perforation B. Vaginal perforation C. Urinary symptoms D. Anesthetic complications E. Hematoma
A
d
40
Q
- A 35 year old status post TVH two years ago presents with pain and vaginal bleeding. The
vaginal cuff has been treated multiple times
with silver nitrate and the problem recurs. What
is the most likely diagnosis?
A. Granulation tissue
B. Prolapsed fallopian tube
C. Hematoma of the vaginal cuff
D. Vaginal atrophy
E. Vaginal wall cyst
A
b
41
Q
- What percent of women experience vaginal
spotting or bleeding in the first trimester?
A. 5%
B. 25%
C. 45%
D. 55%
E. 65%
A
b
42
Q
44. Which of the following methods is the most effective in smoking cessation? A. Meditation B. Acupuncture C. Group therapy D. Pharmacotherapy E. Hypnosis
A
d
43
Q
45. Hyperglycemia in pregnancy is related to which placental transfer route? A. Bulk flow B. Facilitated diffusion C. Active transport D. Endocytosis E. Simple diffusion
A
b
44
Q
46. What percent of women who experience vaginal spotting or bleeding in the first trimester, spontaneously abort? A. 3% B. 23% C. 43% D. 53% E. 65%
A
c
45
Q
- An 18 year old nulligravida presents with
primary amenorrhea. She reports no vaginal
bleeding following estrogen and progesterone
treatment. Which of the following is most likely?
A. Congenital adrenal hyperplasia
B. Hypothalamic amenorrhea
C. Mullerian agenesis
D. Polycystic ovaries
E. Ovarian failure
A
c
46
Q
48. All of the following are considered the most useful tests when evaluating a patient with secondary amenorrhea EXCEPT: A. Prolactin B. 17-hydroxyprogesterone C. TSH D. Beta HCG E. FSH
A
b
47
Q
49 What is the first line treatment for women with heavy menstrual bleeding and Von Willebrand's disease? A. Endometrial ablation B. Dilation and Curettage C. Nonsteriodal anti-inflammatory drugs D. Transexamic acid E. Combination oral contraceptive pills
A
e
48
Q
- A 15 year old complains of asymmetrical
labia. She desires surgery to make her “look
normal”. All of the following topics should be
discussed EXCEPT:
A. Normal variations in anatomy can occur
B. Offer surgery at age 17
C. Labia minora can be asymmetrical
D. Labialplasty can be associated with
complications
E. Labial hypertrophy can be managed with
support garments
A
b
