Practice Exam Review/Guiding Qs Flashcards
a woman is infertile because of an absence of ova. where might primordial ova have failed to differentiate?
hindgut endoderm
where in male is junction of urethra derived from UG sinus and surface ectoderm?
penile urethra and navicular fossa in the glans
“intermittent” UPJ obstruction likely caused by ….
a crossing vessel
when should orchiplexy for undescended testes at birth be performed?
6 months old
what do aromatase inhibitors do?
inhibition of aromatase → ↓ conversion of androstenedione to estrone, ↓ conversion of testosterone to estradiol → ↓ tumor growth
can induce ovulation
associated with vaginal dryness
what is the lymphatic drainage of lesion in anal canal below pectinate line?
superficial inguinal lymph nodes
A 32-year-old male has infertility of one year duration. His semen testing reveals mild oligospermia (low sperm concentration). His serum hormone testing is normal except for two low morning testosterone values of 210 ng/dL and 230 ng/dL respectively (normal > 300 ng/dL). He wishes to optimize his semen parameters in order to facilitate chances for conception by natural means. The next step is treament with:
oral clomiphene citrate
51 year-old woman presents with a single painful lesion on her vulva. She noticed it a few days ago. You order some labs, and she has a positive nontreponemal test. The test that will likely be positive is
Gram stain
A 17-year-old who presents with primary amenorrhea is diagnosed with Turner’s Syndrome (45X). Which of the following serum hormone level is MOST common in this patient?
High FSH, low estrogen
A 17-year-old girl presents for evaluation of primary amenorrhea. She reports beginning breast development around age 10 years. On exam she has Tanner 3 breast development, scant Tanner 2 pubic hair, no axillary hair, and no palpable gonads. You recommend an evaluation including karyotype, ultrasound and endocrine testing and diagnose a specific condition. What results fit with this history and exam?
46,XY karyotype; bilateral abdominal testicles and no uterus; high testosterone
Which of the following is potentially beneficial for the management of patients with intermediate to high risk metastatic kidney cancer?
use of a PD-1 and CTLA-4 inhibitor
what type of penile cancer will 9-valent HPV vaccine NOT prevent
It will not prevent penile cancers associated with balanitis xerotica obliterans.
A 32-year-old woman presents to her gynecologist with abdominal pain. Imaging and laboratory findings are significant for a right ovarian mass and an elevated serum alpha fetoprotein (AFP). The patient undergoes surgical resection of the mass, and you identify the following histologic finding within the tumor. What is the most likely diagnosis?
Yolk sac tumor
A 25-year-old stopped her oral contraception nine months prior given that she would like to conceive. She has been haivng regular intercourse but has not had a menstrual cycle since stopping her contraception. What evaluation should be performed initially?
Ovarian reserve testing
A patient presents with a 1cm renal pelvis stone faintly visible on KUB. The patient was treated with ESWL. Intravenous contract was necessary to help define the stone under fluoroscopy for ESWL. After stone analysis, the patient is started on oral potassium citrate. The patient developed a new stone one year later, as noted on his yearly KUB. The new stone is most likely:
Calcium phospate
they alkalize the urine w/ potassium citrate, making him more susceptible to calcium phosphate stones that precipitate at a higher pH.
Varicoceles arise because of venous stasis and incompetence of the valves within the involved pampiniform plexus. They occur most often on the left side due to the longer length of the left gonadal vein; perpendicular entry of the left gonadal vein into the left renal vein; and because of extrinsic compression of the left renal vein by which of the following visceral arteries?
Superior mesenteric
The highest risk for puncture of the urethra in the male via the insertion of a catheter is in which of the following locations?
At the junction of the membranous and bulbous urethra
A 54 year old woman with multiple sclerosis. After a recent flare of her disease, she has new bladder symptoms. She feels the sudden, severe urge to urinate, but she is unable to void when she sits on the toilet. She has been taught to self-catheterize in order to empty her bladder because her urethral sphincter will not relax, even when her bladder is full and her detrusor muscle contracts. Where in her central nervous system did she sustain damage during her recent MS flare?
The high thoracic spinal cord
A chromophobe renal cell carcinoma is correctly linked with which of the following features?
Derivation from intercalated cells in the distal nephron
Routine prenatal labs demonstrate the presence of anti-D antibodies in maternal blood. Which risk factor best accounts for the presence of these antibodies?
Rh-negative patient who suffered a placental abruption in her prior pregnancy and did not receive Rh immune globulin.
Which of the following is the best management option for this patient who is exhibiting rising post-orchiectomy tumor markers despite normal imaging studies?
Start platinum-based chemotherapy
A 25-year-old man was kicked in the scrotum and presents to the emergency room the next day with significant right hemi-scrotal pain. Examination shows a tender right testis with a palpable defect. He has a normal left testis on exam. The next step is:
Scrotal exploration
A 42 year-old woman undergoes a total abdominal hysterectomy through a pfannensteil incision. On POD #1 she notes inability to walk. On exam, she has a patellar reflex. The nerve roots of the nerve injured at the time of surgery are
L2, L3, L4
A man fractures his ischiopubic ramus in a car accident, and the attached crus is lacerated along with the artery contained within it. Which of the following would have its blood supply greatly diminished as a result?
Corpus cavernosum
A 65-year-old woman undergoes hysterectomy for a a large endometrial tumor. On histologic exam, the tumor demonstrates both markedly atypical epithelium and markedly atypical stroma, as pictured below:
Carcinosarcoma
is immunosuppression a risk factor for cervical cancer?
yes
Colle’s fascia lining the scrotum is continuous with which of the following?
Scarpa’s fascia
The rate of acquisition or spread of an STI (Ro) is equal to (β) x (c) x (D). What is (β), (c) and (D) and explain how each impacts the rate of spread of an STI.
Ro=case reproduction ratio
β=efficiency of transmission(will be different for each pathogen)
c=rate of change of sexual partners (sexual concurrency & sexual networks are important, not just total number)
D=duration of infectiousness (Ro increases for STIs w/ a long duration of infection like HIV)
how do we use gravidity and parity?
Technically the G is the number of times a woman has been pregnant, P is the outcomes of those pregnancies. The P is further divided into TPAL (term, preterm, abortus, and live). With a twin pregnancy, the G always counts as one, but the L counts as 2. Example- A woman who has had 1 term twin pregnancy, G1P1002.
Which of the following should be administered first in a CaP patient with symptomatic bone metastases? A. Antiandrogen B. LHRH agonist C. Radiation therapy D. Chemotherapy
A. antiandrogen
How would you manage a septic patient with
Hydronephrosis and an obstructing stone in the proximal ureter?
Ureteral stent or percutaneous nephrostomy tube.
What is the classification of hypercalciuria?
Absorptive (from GI tract), Renal Leak, and Primary Hyperparathyroidism
what is a useful clinical landmark for anesthetizing the pudendal nerve?
ischial spine
when monozygotic twins split before 2d what is the chorion/amnion situation?
di/di
when monozygotic twins split between 2-8d what is the chorion/amnion situation?
monochorionic diamniotic
when monozygotic twins split after 8d what is the chorion/amnion situation?
mono/mono
what effects does progesterone have during pregnancy? (different symptoms that pregnant people might experience)
smooth muscle relaxation leading to GERD, constipation
decreased gallbladder motility leading to gallstone
what hormone causes nausea/vomiting in pregnancy?
b hCG
Imaging the pelvis of a woman revealed cystic structures in the broad ligament of the uterus. These are most likely to be remnants of what structure?
mesonephric duct
what endometrial tumor has markedly atypical epithelium and markedly atypical stroma?
carcinosarcoma
52 year-old woman undergoes a hysterectomy as part of a prolapse procedure. You note this cystic structure stemming from the fallopian tube. (hydatid cyst of morgangi) What is the embryologic source of this?
either Wolffian duct or Mullerian duct
A woman experienced pain during sexual intercourse due to lack of lubrication from what turned out to be an infected greater vestibular gland. Where was the infection located?
Superficial perineal pouch
