Old Wall Quiz #8

Question 1

1. Which of the following is the correct
calculation for MAP (mean arterial pressure)?
A. (Diastolic + Systolic)/ 2
B. (Diastolic + 2 x systolic)/3
C. (Systolic – Diastolic) x2/ 3
D. (Systolic – Diastolic)/ 2
E. (2x Diastolic + Systolic)/3

Answer 1

e

Question 2

2. A 21 y/o G1P0 presents for her first annual
   visit. Her Hgb is 9.8g/dL and the MCV is 84.
   What is the next step in her evaluation?
   A. Serum ferritin level
   B. Hemoglobin electrophoresis
   C. Serum B12 level
   D. Serum Folate level
   E. Reticulocyte count

Answer 2

e

Question 3

4. A 38 y/o G2P0 at 6 weeks gestation has a
   history of a first generation mechanical heart
   valve since age 7. Which anticoagulant is
   deemed necessary during pregnancy to prevent
   a thrombosis?
   A. Low molecular weight heparin
   B. warfarin
   C. Aspirin
   D. Plavix
   E. Heparin

Answer 3

b

Question 4

7. Which of the following is a short term benefit
   of Cesarean Delivery on maternal request
   compared with planned vaginal delivery?
   A. Decreased subsequent placenta accreta
   B. Decreased subsequent uterine rupture
   C. Decreased hospital stay
   D. Decreased risk for maternal hemorrhage
   E. Decreased risk for neonatal respiratory
   morbidity

Answer 4

d

Question 5

8. Which of the following is not a metabolic
   change identified in women taking oral
   contraceptives?
   A. Elevated serum fibrinogen levels
   B. Lowered serum free testosterone levels
   C. Increased serum levels of triglycerides
   D. Decreased total cholesterol
   E. Elevated total plasma T4

Answer 5

d

Question 6

11. Which of the following is TRUE regarding pre-
exposure prophylaxis (PREEP) for HIV?

A. The majority of newly diagnosed HIV
infections are heterosexual men
B. Most new HIV cases occurred in Caucasian
women
C. ACOG recommends all women 12-50 get HIV
tested once in their life
D. PREEP consists of a single pill, a reverse
transcriptase inhibitor

Answer 6

d

Question 7

12. A 29y/o G1P1 is prescribed Orlistat (Xenical)
for weight management. Which of the following
vitamins may have inhibited absorption?
A. C
B. B12 (cobalamin)
C. D
D. Zinc
E. B1 (thiamin)

Answer 7

c

Question 8

13. A 56 y/o woman was exposed to DES in
    utero. Her recent colposcopy showed signs of
    punctuation and mosaicism of the anterior
    vaginal fornix. The most likely histologic
    diagnoses is:
    A. Micro invasive squamous cell carcinoma
    B. Clear cell adenocarcinoma
    C. Adenocarcinoma
    D. Severe dysplasia
    E. Metaplasia

Answer 8

b

Question 9

14. Tamoxifen may reduce breast cancer by
    greater than 60 percent in which condition?
    A. Li-Fraumeni syndrome
    B. BRCA1
    C. Cowden syndrome
    D. BRCA2
    E. Ataxia Telangiectasia

Answer 9

d

Question 10

16. Toxoplasmosis infection can be acquired by:
    A. Consuming poorly washed vegetables
    B. Consuming unpasteurized milk
    C. Getting bitten by fleas that have fed on cats
    D. Having sexual contact with someone who
    has toxoplasmosis
    E. Providing care for someone with
    toxoplasmosis infection

Answer 10

a

Question 11

17. A 32 y/o G1P0 at 38 weeks gestation presents
    in active labor. She has a known history of
    asymptomatic Aortic Stenosis. Which of the
    following is the first step in her management?
    A. Pulmonary artery catheterization
    B. Epidural anesthesia
    C. Close observation
    D. Initiate Beta blocker therapy
    E. Initiate diuretic therapy

Answer 11

c

Question 12

19. Twenty four hours after a TVH a 75 y/o
    woman is calling the police. She was noted
    to be coherent earlier in the morning. She is
    now being restrained for combative behavior
    toward staff. The most likely diagnosis is:

A. Alcohol withdrawal
B. Anxiety
C. Delirium
D. Dementia
E. Paranoid schizophrenia

Answer 12

c

Question 13

23. On average, epidural analgesia prolongs the
active phase of labor in a nulliparous by how
many minutes?
A. 60 minutes
B. 90 minutes
C. 120 minutes
D. 160 minutes
E. 180 minutes

Answer 13

a

Question 14

25. A 29 y/o is admitted with bilateral ruptured
    TOA’s. After completing the hysterectomy, you
    note gross contamination of the abdominal
    incision. After irrigating with saline, how would
    you close the subcutaneous fat and skin?
    A. Staples
    B. Smead-Jones closure
    C. Leave open and pack with antibiotic gauze
    D. Subcuticular closure with 4-0 nylon
    E. Staples and closed suction drains

Answer 14

c

Question 15

27. A neonate is diagnosed with a left brachial
plexus nerve injury, what was the most likely
fetal presentation at delivery?
A. Left occiput anterior
B. Mentum posterior
C. Right occiput anterior
D. Right occiput transverse
E. Occiput posterior

Answer 15

c

Question 16

29. In the treatment of thyroid storm, all of the
    following are appropriate management EXCEPT:
    A. PTU 1000mg load, then 600mg q6hr
    B. Iodine 1-2 hrs. after PTU administration
    C. Beta blocker (i.e. Labetalol)
    D. Steroid (mineralocorticoid)
    E. ICU admission and supportive care

Answer 16

d

Question 17

34. Compared with tamoxifen citrate,
    aromatase inhibitors are least likely to:
    A. Be associated with deep venous thrombosis
    B. Reduced sexual desire
    C. Increase incidence of flushing
    D. Be associated with bone loss
    E. Increase incidence of myalgias

Answer 17

a. Be associated with deep venous thrombosis

Question 18

43. A 18 year old, G1P1 presents to your office
    with a known history panhypopituitarism. Which
    of the following is the most likely treatment?
    A. Aldosterone
    B. ACTH
    C. Cortisol
    D. ADH
    E. Thyroxine

Answer 18

c

Question 19

44. A woman is concerned that her 6 year old
daughter is beginning puberty. The least
important step in your evaluation is :
A. Serum estradiol level test
B. Bone age
C. A gonadotropic releasing hormone challenge
test
D. Pelvic ultrasound
E. Karyotype

Answer 19

e