Rosh questions

Question 1

What is the most frequent TRISOMY resulting in early pregnancy loss?

Answer 1

Trisomy 16

Question 2

What is the most frequent kind of aneuploidy resulting in early pregnancy loss?

Answer 2

Trisomy

Question 3

What is the most common SINGLE aneuploidy resulting in early pregnancy loss?

Answer 3

Monosomy X (Turner’s Syndrome)

Question 4

After what gestational age is delivery recommended for oligohydramnios?

Answer 4

After 36+0, delivery by 37+6

Question 5

Signs of lidocaine toxicity?

Answer 5

Metallic taste, tinnitus, perioral tingling

Question 6

Which uterotonic agent is contraindicated in HIV? Why?

Answer 6

Methergine (methylergonovine)

Can result in severe vasoconstriction if given in combination with protease inhibitors or combicistat

Question 7

Which drug characteristic favors transport by passive diffusion?
A - high plasma binding property
B - large molecular weight
C - presence of ionizable compounds
D - presence of lipophilic compounds

Answer 7

D - presence of lipophilic compounds
(more lipid soluble can cross membranes)

Lipophilicity measured by octanol/water partition coefficient

Question 8

Preferred specimen type for GC/CT detection? (vaginal, rectal, cervical, urine)

Answer 8

Vaginal swab - as sensitive as cervical swab, no difference in specificity, and can be self-collected

Question 9

Which chemotherapy agent MOA is most likely to cause premature ovarian insufficiency?

Answer 9

Alkylating agents - like ifosfamide

Question 10

What percent of US population has low health literacy?

Answer 10

25%

Question 11

Mechanism of thrombus formation in FVL thrombophilia?

Answer 11

Decreased degradation of activated factor V

Question 12

Which mechanism can cause non-immune hydrops fetalis?
A - decreased capillary permeability 
B - decreased CVP 
C - hyperalbuminemia
D - increased right heart pressure

Answer 12

D - increased right heart pressure
Structural heart defects –> increased R heart pressure –> increased CVP

Cardiovascular anomalies are the MOST common type of nonimmune hydrops fetalis

Question 13

What finding on diagnostic testing would you expect for a patient with sepsis?
A - Echo with EF 40%
B - Hgb 9
C - PTT 7sec
D - Lactate of 1

Answer 13

A - Echo with EF 40%
Sepsis leads to vasodilation, decreased intravascular volume, tachycardia, hypotension. Causes disruption of cardiac function, decreased systolic and diastolic function. Over half of sepsis patients will have EF<45%.

Question 14

At what age can you discontinue routine colonoscopy?

Answer 14

Age 75+

Question 15

Which beta blocker is most commonly associated with fetal growth restriction?

Answer 15

Atenolol

Question 16

What are the effects of menopause on cognitive function?

Answer 16

delayed verbal memory

Question 17

What must you be cautious about in hysteroscopy for a menopausal patient?

Answer 17

higher risk of uterine perforation

Question 18

What is the most common aneuploidy associated with nonimmune hydrops?

Answer 18

Monosomy X (Turner's)
Frequently associated with cardiac defects - coarctation of the aorta, bicuspid aortic valve.
Also cystic hygromas.

Question 19

What is the main maternal risk in pregnancy for a patient with Turner’s?

Answer 19

aortic dissection (due to coarctation of the aorta)

Question 20

Adjuvant treatment for a pregnant patient s/p surgical staging for germ cell tumor in first trimester?

Answer 20

BEP after the first trimester

bleomycin, etoposide, cisplatin