Practice Questions Flashcards
The indifferent embryo begins phenotypic sexual differentiation during:
A. Week 3 of development B. Week 5 of development C. Week 7 of development D. Week 12 of development E. Week 20 of development
C. Week 7 of development
The indifferent embryo completes phenotypic sexual differentiation during:
A. Week 3 of development B. Week 5 of development C. Week 7 of development D. Week 12 of development E. Week 20 of development
E. Week 20 of development
After the sinovaginal bulbs have proliferated and fused, they form a solid core of endodermal cells called the:
A. Vestibule of the vagina B. Uterovaginal primordium C. Urogenital sinus D. Vaginal plate E. Clitoris
D. Vaginal plate
A structure found within the adult female pelvis formed from the gubernaculum is the
A. Broad ligament B. Suspensory ligament of the ovary C. Round ligament of the uterus D. Medial umbilical ligament E. Median umbilical ligament
C. Round ligament of the uterus
One day a 9 y/o girl tells her mother that she is a boy. The mother is shocked but does not act on the comment. During the next few years, the mother notices some tomboyish behavior and difficulty in social adjustment at school. When the girl is 12 years old, puberty starts with striking virilization of external genitalia. The mother is extremely concerned and seeks medical attention. What is the most likely cause?
A. Male pseudo-intersexuality B. Female pseudo-intersexuality C. Congenital adrenal hyperplasia D. Testicular feminization E. Illegal use of anabolic steroids
A. Male pseudo-intersexuality
The most common cause of female pseudo-intersexuality is
A. A 46,XO genotype B. A 47,XXY genotype C. Lack of androgen receptors D. Congenital adrenal hyperplasia E. Inadequate production of testosterone and MIF
D. Congenital adrenal hyperplasia
Bilateral cryptorchidism usually results in
A. Impotence B. Sterility C. Male pseudo-intersexuality D. Female pseudo-intersexuality E. Testicular feminization syndrome
B. Sterility
Which of the following correctly describes the true pelvis?
A. It is superior to the pelvic brim and occupied by the abdominal viscera
B. It does not include the sacrum and coccyx, as those are part of the false pelvis
C. It is bordered superiorly by the pelvic brim and inferiorly by the muscular pelvic diaphragm
D. It is bordered superiorly by the pelvic brim and inferiorly by the lines drawn between the greater trochanter
C. It is bordered superiorly by the pelvic brim and inferiorly by the muscular pelvic diaphragm
What is the significance of the puborectalis muscle?
A. It helps to externally rotate the thigh
B. It tightens during urination and defecation
C. It helps maintain fecal continence by relaxing
D. Sitting down will fully relax the muscle and allow colon to empty quickly
C. It helps maintain fecal continence by relaxing
A 25 y.o. white female presents to your clinic with c/c of RLQ pain, nausea and vomiting for one day. She says the pain began suddenly during a rec league soccer game. She rates the pain a 9/10. The patient undergoes laparoscopic surgery for suspected appendicitis but the surgical team finds that the right ovary is necrotic secondary to an ovarian torsion. In what structure is the ovarian artery located?
A. Broad ligament B. Round ligament C. Uterosacral ligament D. Suspensory ligamnt E. Cardinal ligament
D. Suspensory ligament
[contains ovarian vessels and may be considered part of broad ligament]
A 25 y.o. white female presents to your clinic with c/c of RLQ pain, nausea and vomiting for one day. She says the pain began suddenly during a rec league soccer game. She rates the pain a 9/10. The patient undergoes laparoscopic surgery for suspected appendicitis but the surgical team finds that the right ovary is necrotic secondary to an ovarian torsion. What vessel(s) do the ovarian arteries branch off of?
A. anterior division of the internal iliac a.
B. Aorta
C. External iliac a.
D. Posterior division of the internal iliac a.
E. Uterine a.
F. Common iliac a.
B. Aorta
A 32 y.o. Hispanic G1P1 woman presents to your clinic 3 months after the birth of her first child with c/c of urinary incontinence. She says this began soon after her son was born and is most noticeable when she laughs and sneezes. She tells you her son weighed 9 lbs 2 oz at birth and that she had a long delivery during which an episiotomy had to be performed. You suspect a problem with the external urethral sphincter. What nerve supplies this muscle?
A. Inferior hypogastric plexus B. Superior hypogastric plexus C. Inferior rectal n. D. Dorsal n. of the clitoris E. Perineal branch of the pudendal n.
E. Perineal branch of the pudendal n.
A 65 y.o. African American woman presents to your clinic with c/c of a mass on her right labia minora. She says that the mass has been slowly getting bigger for many years and that it is extremely itchy. You have a high suspicion of vulvar cancer. If a cancer in this location has spread through the lymphatic system (direct extension) what lymph node group would be the first to be affected?
A. Lumbar B. External iliac C. Internal iliac D. Deep inguinal E. Superficial inguinal
E. Superficial inguinal
A 65 y.o. African American woman presents to your clinic with c/c of a mass on her right labia minora. She says that the mass has been slowly getting bigger for many years and that it is extremely itchy. You have a high suspicion of vulvar cancer. An infection or cancer in which location would NOT spread to the superficial inguinal nodes?
A. Vaginal vestibule B. Vagina C. Cervix D. Uterine fundus E. Fallopian tubes
E. Fallopian tubes [drain to lumbar nodes]
After a long and painful delivery a 23 y.o. white female gives birth to her first child, a boy. The infant has APGAR scores of 8 after delivery and 10 at 5 minutes. During development, which of the following is directly responsible for the formation of the penis, scrotum, and prostate in males?
A. Testosterone from fetal Leydig cells B. Testosterone from Sertoli cells C. DHT from fetal Leydig cells D. DHT from Sertoli cells E. AMH from fetal Leydig cells F. AMH from fetal Sertoli cells
C. DHT from fetal Leydig cells
After a long and painful delivery a 23 y.o. white female gives birth to her first child, a boy. The infant has APGAR scores of 8 after delivery and 10 at 5 minutes. The same patient has another baby 3 years later, this time a healthy baby girl. During development of the internal female reproductive tract, what event forms the uterus?
A. Fusion of superior paramesonephric ducts
B. Fusion of inferior paramesonephric ducts
C. Fusion of superior mesonephric ducts
D. Fusion of inferior mesonephric ducts
B. Fusion of inferior paramesonephric ducts
A 15 y.o. female presents to your primary care clinic for a sports physical. She has normal breast development, normal external genitalia, but has not yet had her first menstrual period. Her mother reports that the patient had normal external genitalia at birth. Further testing shows that she has high levels of testosterone and an US reveals absent uterus and absent upper vagina. Which of the following would also be expected about this patient?
A. XX genotype B. Undescended testes found on US C. Deficiency in 21-hydroxylase D. Deficiency in 5 alpha-reductase E. Gonads with testicular and ovarian tissue
B. Undescended testes found on US
During a particularly difficult labor, the OBGYN you are working with considers making a surgical incision in the area between the vagina and anus. During the repair, what order do you place the sutures in?
A. The muscular layer, the vaginal wall, the skin
B. The vaginal wall, the subcutaneous fascia, the muscle layers
C. The vaginal wall, the muscle layer, and the subcutaneous fascia
D. The rectal mucosa, the anal sphincter, and the perineal mm
C. The vaginal wall, the muscle layer, and the subcutaneous fascia
The blood supply to the scrotum and penis in the male, and the labia majora and clitoris is via branches of which artery?
A. Internal pudendal a. B. Internal iliac a. C. Deep femoral a. D. Femoral a. E. Perineal a.
D. Femoral a. [external pudendal is a branch off femoral that sends both deep and superficial branches to structures above]
A 2 month old male is brought to your clinic because his parents believe his genitals are not developing correctly. All routine genetic tests are normal. The infant is not in distress; the mother assures you she did not take any teratogenic drugs during pregnancy. Serum testosterone levels are normal. You suspect a less common problem may be affecting the child. What is the most likely dx?
A. Congenital absence of sex hormone binding globulin B. Decreased LH/FSH secretion C. Defect in side chain cleavage enzyme D. Defect in 5 alpha-reductase E. A genotype of 47,XXY
D. Defect in 5 alpha-reductase
A 2 month old male is brought to your clinic because his parents believe his genitals are not developing correctly. All routine genetic tests are normal. The infant is not in distress; the mother assures you she did not take any teratogenic drugs during pregnancy. Serum testosterone levels are normal. 5 alpha-reductase activity is nonexistent. US of lower abdomen, pelvis, and genitals shows no structural abnormalities. His testosterone, being normal, was most likely in which form in his blood?
A. Free (unbound) B. Bound to androgen binding protein C. Bound to sex hormone binding globulin D. Bound to albumin E. Bound to cortisol binding globulin
C. Bound to sex hormone binding globulin
A 2 month old male is brought to your clinic because his parents believe his genitals are not developing correctly. All routine genetic tests are normal. The infant is not in distress; the mother assures you she did not take any teratogenic drugs during pregnancy. Serum testosterone levels are normal. 5 alpha-reductase activity is nonexistent. US of lower abdomen, pelvis, and genitals shows no structural abnormalities. His enzymatic deficiency would normally be found in what location of the body?
A. Leydig cells B. Sertoli cells C. Peripherally D. Adrenal gland E. Seminiferous tubules
C. Peripherally
