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[OS 215] OB-GYN E2 > Samplex 2014 A > Flashcards

Samplex 2014 A Flashcards

1
Q

The following are indications for delivery in patient with pregnancy-induced hypertension EXCEPT

A. mature gestation
B. platelet count

A

D

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2
Q

The diagnosis of superimposed preeclampsia is highly likely in the following findings:

A.	women with hypertension and no proteinuria early in pregnancy (prior to 20 gestation)
B.	new onset proteinuria
C.	thrombocytopenia
D.	increase in AST or ALT levels
E.	all of the above
A

E

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3
Q

How is the pathophysiology of preeclampsia characterized?

A. vasodilation
B. vasospasms
C. hemodilution
D. hypervolemia

A

B

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4
Q

Magnesium

A. slows or blocks neuromuscular and cardiac conducting system transmission
B. it decreases smooth muscle contractility
C. it causes decreased uterine and myocardial contractility
D. depression or deep tendon reflexes occurs at serum concentration lower than those associated with adverse cardiac and respiratory effects
E. all of the above

A

E

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5
Q

The following statements are true EXCEPT:

A. Preeclampsia can develop before the 20th week of gestation in two situations: extensive hydatidiform changes in the chorionic villi or in the presence of lupus anticoagulant
B. Chronic hypertension in the presence of persistent hypertension, of whatever cause, before the 20th week of gestation or persistent hypertension beyond 6 weeks postpartum
C. Altered consciousness and scotomata are two of the criteria for severe preeclampsia
D. None of the above

A

D

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6
Q

A patient is said to have severe preeclampsia if she manifests any of the following:

A.	Thrombocytopenia
B.	Proteinuria > 5 g / 24 hours
C.	microangiopathic hemolysis
D.	elevated serum creatinine
E.	all of the above
A

E

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7
Q

A 35 year-old G1P0 at 37 weeks AOG complaining of epigastric pain consulted at the OB Admitting Section with blood pressure of 150/100 with a negative stat albumin. She has the history of hypertension prior to pregnancy or during antenatal consult at the local health center.

What is the admitting diagnosis?

A. gestational hypertension
B. preeclampsia
C. chronic hypertension
D. chronic hypertension with superimposed preeclampsia

A

A

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8
Q

A 35 year-old G1P0 at 37 weeks AOG complaining of epigastric pain consulted at the OB Admitting Section with blood pressure of 150/100 with a negative stat albumin. She has the history of hypertension prior to pregnancy or during antenatal consult at the local health center.

Results of the 24 hour urine collection showed a total protein spillage of 2 grams with all the other laboratory results within normal limits. She had an unremarkable delivery, but had persistent blood pressure elevation postpartum controlled by Metoprolol and Felodipine. She was discharged after 1 week.

What is the discharge diagnosis?

A. Gestational hypertension
B. Preeclampsia, severe
C. Chronic hypertension
D. Chronic hypertension with superimposed preeclampsia

A

B

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9
Q

What is the Magnesium level necessary to prevent convulsions?

A. 1-3 mEq/L
B. 4-7 mEq/L
C. 8-10 mEq/L
D. 10-12 mEq/L

A

B

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10
Q

A 29 year old G2P0 on her 24th week AOG consults for nape pain. On vital signs, you note her blood pressure to be 150/90. There are good fetal heart tones with no evident urine contractions. You do an albumin dipstick test: the result is +1. Basic laboratory procedures which have to be done on the patient include the following EXCEPT:

A. Bleeding parameters
B. Complete blood count
C. 24 hour urine collection
D. Chest X-ray

A

D

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11
Q

The appropriate administration of MgSO4 in our local setting is:

A. Loading: 4-6 mg IV slow + 5 mg IM; Maintenance: 5 mg IM drip every 6-8 hrs
B. Loading: 4-6 mg IV in 20 min, Maintenance: 2 mg/hr IV drip
C. Loading: 4-6 g IV slow + 5 mg IM; Maintenance: 5 g IM drip every 6-8 hrs
D. Loading: 4-6 g IV in 20 min, Maintenance: 2 g/hr IV drip

A

C

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12
Q

What is observed in patients with preeclampsia?

A. increased thromboxane, decreased prostacyclin, decreased prostaglandin E2
B. decreased thromboxane, decreased prostacyclin, decreased prostaglandin E2
C. increased thromboxane, increased prostacyclin, decreased prostaglandin E2
D. increased thromboxane, increased prostacyclin, increased prostaglandin E2

A

C

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13
Q

The following pathophysiologic changes occur in pre-eclampsia EXCEPT:

a. increased blood volume
b. increased vascular resistance
c. decreased GFR
d. increased fibrinolytic activity

A

A

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14
Q

Studies have been done to prevent preeclampsia for the following except:

A. asipirin
B. Calcium
C. High potassium dosage
D. night primrose oil

A

C

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15
Q

Outpatient management of pre-eclamplsia may be done when

a. BP 160/90
b. 24 hour urine 500mg
c. fetal weight below 10th percentile
d. platelets < 100 000

A

B

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16
Q

high risk for gestational diabetes mellitus:

a. hypotension
b. prior birth weight of 2500 grams
c. family history of diabetes
d. BMI of 25

A

C

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17
Q

The following are congenital malformations in infants of women with overt diabetes:

A. Pelvocallectasia
B. Ototoxicity
C. Macrosomia
D. Caudal regression

A

C

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18
Q

Which of the following are considered abnormal values for the 100g OGTT?

A. 110 mg/dL for the fasting blood glucose
B. 170 mg/dL for the 1hr postprandial glucose
C. 150 mg/dL for the 2hr postprandial glucose
D. 120 mg/dL for the 3hr postprandial glucose

A

A

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19
Q

Impaired glucose tolerance can be diagnosed with ___ elevated values in 100g OGTT:

A. 1
B. Greater than or equal to 1
C. 2
D. Greater than or equal to 2
E. None of the above
A

A

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20
Q

Which of the following principles is correct in managing labor and delivery in patients with heart disease?

A. Tachycardia is managed with beta blockers
B. Analgesia is minimized due to potential depressant effect
C. Cesarian section is reserved for obstetric indications
D. Patients should be on pulse oximeter during labor

A

C

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21
Q

For lupus patients, pregnancy outcome is better if lupus activity has been quiescent for at least

A. 3 months
B. 6 months
C. 8 months
D. 12 months

A

B

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22
Q

What is the complication of epidural anesthesia that is most hazardous and potentially lethal in patients with preload sensitive cardiac lesions?

A. Respiratory depression
B. Arrhythmia
C. Ischemia
D. Hypotension

A

D

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23
Q

Which of the following characteristizes functional residual capacity during pregnancy?

A. deceases by approximately 500 mL
B. stays unchanged compared with non-pregnant values
C. increases by approximately 500 mL
D. increases by approximately 1 L

A

A

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24
Q

When the inlet is round, pelvic sidewalls are straight, spines are not prominent, and the pelvic arch is wide, the pelvis is described as:

A. gynecoid
B. android
C. anthropoid
D. platypelloid

A

A

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25
Q

The cervical findings in a term primigravid in labor showed the following: 8-9cm cervical dilatation, ruptured bag of waters, and through it was felt malar eminences and a mouth with the chin near the sacrum. What is the presentation?

A. face – mento anterior
B. face – mento posterior
C. brow
D. vertex

A

B

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26
Q

The midpelvis is likely to be constricted if the sum of the interischial spinous and the posterior sagittal diameter is equal to or less to which of the following?

A. 9.5 cm
B. 11.5 cm
C. 12.5 cm
D. 13.5cm

A

A

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27
Q

As a fetal effect during difficult labor/vaginal delivery, the following entity characterized by scalp edema overlying the fetal occiput may develop:

A. cephalhematoma
B. caput succedaneum
C. molding
D. contusion

A

B

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28
Q

Successful vaginal delivery requires the interplay of 3 P’s except:

A. power
B. passage
C. passenger
D. pushing

A

D

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29
Q

This type of uterine dysfunction is characterized by asynchronous uterine contractions from each uterine cornu

A. hypertonic uterus
B. hypotonic uterus
C. dysfunctional uterus
D. uterine atony

A

A

30
Q

You admitted Mrs. AA, a 27 year old primigravid, to the laboring unit because she complained of regular uterine contractions. She is presently on her 38th week of gestation. On internal examination, her cervix is 2 cm dilated, beginning effacement, with fetal head at station -1. Your diagnosis at this point is

A. protracted cervical dilatation
B. protracted descent
C. prolonged latent phase
D. arrest of cervical dilatation

A

B

31
Q

You admitted Mrs. AA, a 27 year old primigravid, to the laboring unit because she complained of regular uterine contractions. She is presently on her 38th week of gestation. On internal examination, her cervix is 2 cm dilated, beginning effacement, with fetal head at station -1.

Your next step in the preceding case of Mrs. AA would be to:

A. Do a Ceasarian section
B. Administer oxytocin as a sidedrip
C. Advise rest and observation
D. Discharge her
E. Perform amniotomy
A

C

32
Q

For the diagnosis of a protracted cervical dilatation of a nullipara, the rate should be less than

A. 1.0 cm per hour
B. 1.2 cm per hour
C. 1.5 cm per hour
D. 2.0 cm per hour

A

B

33
Q

A fetus whose presenting part is its buttocks, with both hips and knees flexed is a

A. incomplete breech
B. complete breech
C. frank breech
D. footling breech

A

B

34
Q

The most logical step to take in failure of descent is

A. Therapeutic rest
B. Oxytocin administration
C. Administer sedatives or analgesia
D. Do a caesarian section

A

D

35
Q

You are on duty in the delivery room and were tasked to deliver a parturient who came in fully dilated. She is a gestational diabetic with poor compliance in terms of diet and prenatal care. You have delivered the fetal head and are now trying to deliver the rest of the baby, but it has been approximately 25 seconds and the shoulders seem to be lodged. The first thing you should do in this case is

A. Call for help
B. Do the McRobert’s maneuver
C. Perform gentle rocking of the fetal shoulders
D. Have general anesthesia performed

A

A

36
Q

A 7 y/o patient was brought in by her mother for gynaecologic check-up. The mother noted a vulvar mass. On PE, there was note of a 3x3cm reddish mass at the left labia majora. What is the most likely diagnosis?

A. Hematoma
B. Melanoma
C. Hemangioma
D. AOTA

A

A

37
Q

In which of the following drugs for endometriosis is bone pains a common complaint?

A. GnRH agonist
B. Danazol
C. DMPA
D. Oral contraceptive

A

B

38
Q

Which of the following must be included to make a histological diagnosis of endometriosis?

A. Atypical cells invading the myometrium
B. Dysplastic cells
C. Presence of endometrial glands

A

C

39
Q

A 30 y/o came in with an ultrasound finding of a cystic structure at the adnexal area measuring 3x4x3cm. This was done on the 17th day of her cycle. What is the most likely diagnosis?

A. Ovarian fibroma
B. Corpus luteum cyst
C. Serous cystadenocarcinoma
D. Any of the above

A

B

40
Q

What is the best management for a 16 y/o GO patient who complains of a mass at the vulva? On PE, there was a note of 2x2cm movable, cystic, non-tender mass at the 7o’clock position.

A. Observe the mass
B. Do excision
C. Marsupialization
D. AOTA

A

D

41
Q

A 30 y/o G2P2 (2002) amenorrheic for 6 weeks complained of severe hypogastric pains. Pregnancy test was not available. IE showed (+) cervical motion tenderness, (+) right adnexal tenderness, (+) right adnexal mass 3x3cm. What is the diagnosis?

A. Ruptured ectopic pregnancy
B. Corpus luteum hemoprrhagicum
C. Appendiceal abscess
D. Any of the above

A

A

42
Q

Which of the following myomas is heavy menstrual flow a prominent symptom?

A. Parasitic
B. Intraligamentary
C. Intramural
D. Submucous

A

D

43
Q

A 38 y/o G3P3 (3003) complained of secondary dysmenorrhea. LMP August 25-31, 2010. Internal examination showed a corpus enlarged to 12-14 weeks AOG. Transvaginal scan showed a thickened myometrium with coarse echoes. What is the most likely diagnosis?

A. Myoma
B. Ovarian fibroma
C. Endometioma
D. Adenomyosis

A

D

44
Q

What is the best management for this asymptomatic 21 y/o? She is a G0 who came in with an ultrasound finding of a tubular cystic structure located near the fimbriated ends.

A. Exploratory laparotomy
B. Observe further
C. Laparoscopy
D. Hysteroscopy

A

C

45
Q

What is the most probable cause for the infertility of a 29 y/o G0 who complained of monthly hypogastric pains? The hypogastric pain would begin 2 days prior to menses. Internal examination noted corpus slightly enlarged and retroverted. Sonohysterosalpingogram showed blocked fallopian tubes.

A. Ovarian new growth
B. Pelvic endometriosis
C. Myoma
D. Paratubal cysts

A

B

46
Q

The most common type of degeneration to occur within a myoma is

A. calcific
B. red
C. hyaline
D. myxomatous
E. sarcomatous
A

C

47
Q

Permitted examinations in the staging of cervical cancer:

A. palpation
B. ultrasound
C. hysteroscopy
D. intravenous urography

A

C

48
Q

A 38 y.o. G3P3 consulted for vaginal bleeding. Speculum examination showed a fungating necrotic cervical mass measuring 2 x 3 x 1 cm. The vagina was smooth and the parametria were smooth and pliable. Histopath showed squamous cell cancer. What is the stage of the disease?

A. 1A
B. 1B1
C. 1B2
D. 2A

A

B

49
Q

Risk factors for cervical cancer EXCEPT:

A. Coitrarche < 16 years old
B. High parity
C. PCOS
D. Cigarette smoking

A

C

50
Q

Greatest relative risk for endometrial carcinoma:

A. PCOS
B. DM
C. Obesity
D. Atypical hyperplasia

A

D

51
Q

Most common histology of endometrial carcinoma

A. Serous
B. Mucinous
C. Endometrioid
D. Clear cell

A

C

52
Q

Surgery for stage II ndometrial carcinoma EXCEPT

A. Partial omentectomy
B. Peritoneal fluid cytology
C. Total hysterectomy with bilateral salpingooophorectomy
D. Lymph node sampling

A

D

53
Q

A 43 G0 underwent exploration for endometrial carcinoma. The mass had >50% myometrial invasion There were no adnexal extension. The fluid was positive and the left external ilac nodes were positive. What stage of the disease?

A. Ic
B. IIb
C. IIIa
D. IIIc

A

B

54
Q

Established screening test for ovarian cancer:

A. ultrasound
B. CA-125
C. CEA
D. None of the above

A

B

55
Q

An OB GYN resident examined a 17 year old nulligravid complaining of an abdominal mass. On PE, she noted that the patient had virilizing signs and symptoms. Even before doing an internal examination, her working impression is an ovarian new growth probably:

A. Epithelial tumor
B. Germ cell tumor
C. Sex cord stromal tumor
D. Metastatic tumor

A

B

56
Q

When APGAR score is <7, additional scores are taken every 5min for up to

A. 20 mins
B. 10 mins
C. 30 mins
D. 1 hr

A

A

57
Q

The following should be prioritized in Neonatal Resuscitation

A. Respiration
B. Heart Rate
C. Color
D. All of the above

A

D

58
Q

The diving relex is an attempt of the asphyxiated infant to do the following, EXCEPT:

A. Accentuate or restore fetal type of circulation
B. Increase pulmonary blood flow
C. Increase blood flow to the brain and heart
D. Increase pulmonary vasoconstriction

A

B

59
Q

All of the following can cause respiratory distress EXCEPT:

A. Hypothermia
B. Hyperthermia
C. Anemia
D. None of the above

A

D

60
Q

Meconium aspiration syndrome pathophysiology, EXCEPT

A.	Mechanical obstruction
B.	Chemical inflammation
C.	Surfactant inactivation
D.	All
E.	none
A

E

61
Q

Vertical modes of transmission in sepsis neonatorum, EXCEPT:

A. transplacental
B. ascending intraamniotic infection
C. environmental fomites
D. passage through a colonized vaginal canal

A

NA

62
Q

The predominant organism in the vaginal ecosystem of a normal adult female is

A. Anaerobes
B. Lactobacilli
C. Chlamydia
D. Enterococci

A

B

63
Q

To avoid several adverse pregnancy outcomes and infectious morbidity following gynecological surgery, one must diagnose and treat bacterial vaginosis by actively searching for

A. foul discharge
B. fever
C. urethral discharge
D. vaginismus

A

A

64
Q

A critical characteristic of antibiotic regimen for abdominal delivery on a background of Intra-amniotic Infection (IAI) to avoid severe puerperal sepsis is:

A. ability to concentrate in PMNs
B. no antibiotic gap
C. anti-anaerobic activity
D. broad spectrum

A

B

65
Q

The main reason why it is important to treat PID within 4 days of onset of pain is to:

A. lessen duration of therapy
B. minimize patient discomfort
C. save on cost of therapy
D. prevent tubal damage

A

D

66
Q

If you were to invest the limited money of the patient with PID on just one laboratory test, which would it be?

A. gonorrhea culture
B. transvaginal ultrasound
C. Chlamydia PCR
D. urinalysis

A

B

67
Q

Which of the following is not a realistic achievement in the medical therapy of a pelvic abscess?

A. microbiologic eradication
B. symptomatic relief
C. normal fertility
D. hormonal function preservation

A

C

68
Q

A patient diagnosed to have genital herpes

A. can be cured by Acyclovir
B. should be tested for HIV
C. is usually asymptomatic
D. does not need a biopsy

A

D

69
Q

A patient with vaginal discharge whose risk assessment is negative should not be treated against:

A. trichomoniasis
B. bacterial vaginosis
C. gonorrhea
D. candidiasis

A

B

70
Q

Penicillin, in appropriate doses, can solve the problem with

A. gonorrhea
B. genital herpes
C. syphilis
D. trichomoniasis

A

C

71
Q

If the hepatitis B vaccine is the first anti-cancer vaccine ever developed, what is the second developed anti-cancer vaccine?

A. Epstein-Barr virus
B. Varicella zoster virus
C. Human papilloma
D.MMR

A

C

[OS 215] OB-GYN E2 (6 decks)

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