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[OS 215] OB-GYN E3 > Samplex 2014 A > Flashcards

Samplex 2014 A Flashcards

1
Q

A 54 year old asymptomatic female consulted because of left breast mass. P.E. revealed a 5x3 cm firm, movable non-tender mass with irregular borders and overlying peau d’orange skin. Nonpalpable axillary nor supraclavicular lymph node. Core needle biopsy revealed invasive ductal carcinoma. The most likely clinical stage is:

A. Stage III
B. Stage III A
C. Stage III B
D. Stage IV

A

C

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2
Q

The least invasive biopsy technique to determine stromal invasion from ductal breast cancer is:

A. Fine needle aspiration biopsy
B. Core needle biopsy
C. Excision biopsy
D. Incision biopsy

A

B

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3
Q

The surgical technique for primary operable breast cancer that involves total mastectomy with axillary dissection is:

A. Lumpectomy plus radiotherapy
B. Breast conservation surgery
C. Modified radical mastectomy
D. Subcutaneous mastectomy

A

C

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4
Q

A 40 y.o. asymptomatic female consulted because of a 6x5 cm hard fixed and ulcerated mass with multiple satellite skin nodules. No axillary lymph node was palpated. FNAB revealed ductal carcinoma. The primary treatment based on her clinical stage is:

A. Surgery
B. Palliative radiotherapy
C. Palliative hormonal therapy
D. Neoadjuvant chemotherapy

A

D

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5
Q

A mutation in this gene that congers an 80% lifetime risk in the development of breast cancer is:

A. Chromosome 10
B. Chromosome 14
C. Chromosome 17
D. Chromosome 20

A

C

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6
Q

A surgical procedure for primary operable breast cancer with superior cosmetic outcome and comparable survival rate to modified radical mastectomy is:

A. Lumpectomy plus radiotherapy
B. Breast conservation surgery
C. Lumpectomy only
D. Axillary dissection only

A

B

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7
Q

The therapeutic strategy to destroy any distant occult micrometastasis after curative modified radical mastectomy for localized ER/PR negative breast cancer is best achieved by:

A. Adjuvant chemotherapy
B. Adjuvant radiotherapy
C. Neoadjuvant chemotherapy
D. Induction radiotherapy

A

B

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8
Q

A 28 y.o. female with a 2x2 cm hard movable left upper outer breast mass. No axillary node palpated but with associated persistent mild to moderate headache and dizziness. FNAB revealed ductal cancer. The next best step in the management will be:

A. Chest x-ray
B. CT scan of the head
C. Mammography
D. Liver ultrasound

A

B

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9
Q

The pathologic basis in the diagnosis of peau d’orange skin is:

A. Dermal neovascularization
B. Proliferation of inflammatory cells
C. Tumor blockage of dermal lymphatics
D. Invasion of Cooper’s ligament

A

C

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10
Q

Among the different histopathologic type of breast cancer, which one is the most common?

A. Invasive ductal cancer
B. Medullary cancer
C. Mucinous cancer
D. Tubular cancer

A

A

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11
Q

A 40 yo female with no palpable breast mass was found to have suspicious microcalcification on screening mammography. Needle localization biopsy revealed ductal carcinoma in situ. Her clinical stage will be:

A. 0
B. I
C. IIA
D. IIB

A

A

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12
Q

Another local regional intervention for advanced breast cancer other than surgery:

A. Chemotherapy
B. Radiotherapy
C. HRT
D. electrocautery

A

B

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13
Q

A 30 y.o. male presented with a solid nontender testicular mass. Biopsy of this mass would probably most reveal:

A. Leydig cell tumor
B. Embryonal cell carcinoma
C. Seminoma
D. Teratoma

A

C

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14
Q

A patient who underwent radical orchiectomy for a testicular malignancy showed increased LDH levels on follow up. To diagnose lymphatic recurrence and spread of the tumor, you must do:

A. inguinal lymph node biopsy
B. chest CT scan
C. abdominal CT scan
D. supraclavicular node aspiration biopsy

A

C

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15
Q

The following combination of events lead to prostatic enlargement

A. Increase in DHT levels and transfroming growth factor
B. Decline in the epidermal growth factor and transforming growth factor
C. Agein and a decline in the testosterone levels
D. Inrease in the epidermal growth factor and DHT levels

A

D

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16
Q

What is the most important diagnostic test for prostatic enlargement?

A. Prostate specific antigen (PSA)
B. Digital Rectal Exam (DRE)
C. KUB Xray
D. Ultrasound

A

B

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17
Q

Alpha adrenergic receptors are used for LUTS because of this mechanism:

A. prevents conversion of testosterone to DHT
B. stimulate smooth muscle contraction
C. stimulate apoptosis
D. increased vasodilation

A

B

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18
Q

The most common pathophysiology of orchitis is:

A. Local spread of perianal microflora
B. Contiguous spread from urethritis
C. Hematogenous spread from the urinary tract
D. Lymphatic spread from inguinoscrotal infections

A

B

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19
Q

An exophytic enlarging growth at the area of the penile glans would present on histopathology as:

A. Pseudoepitheliomatous hyperkeratosis
B. Balanitil xerotica obliterans
C. Squamous cell carcinoma
D. Leukoplakia

A

C

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20
Q

Prostate cancer commonly arises in which zone of the prostate?

A. Peripheral
B. Periurethral
C. Transitional
D. Central

A

A

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21
Q

A 67 y.o. male presenting with LUTS and DRE findings of enlarged, nodular prostate must be screened for:

A. benign prostatic hyperplasia
B. prostatic calcification
C. prostatic ca
D. tuberculous prostatitis

A

C

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22
Q

A 6 y.o. boy underwent radical orchiectomy. His biopsy result will most probably be:

A. immature teratoma
B. embryonal cell ca
C. seminoma
D. yolk sac tumor

A

D

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23
Q

Which of the following is a characteristic of priapism?

A. it occurs during sexual stimulation
B. it resolves during ejaculation
C. both the glans and the shaft are rigid on palpation
D. the penis is often painful and tender

A

D

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24
Q

A patient has true premature ejaculation if he reaches orgasm and ejaculates

A. within 10 minutes
B. prior to insertion of the penis into the vagina
C. earlier than his partner
D. in the absence of sexual stimulation

A

B

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25
Q

The primary hormone responsible for male sexual behavior is:

A. estrogen
B. progesterone
C. testosterone
D. prolactin

A

C

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26
Q

Hyperthyroidism can cause erectile dysfunction because of:

A. increased prolactin level
B. decreased estrogen level
C. increased estrogen level
D. impaired penile perfusion

A

C

27
Q

Which of the following statement is true regarding erectile dysfunction?

A. psychogenic ED is the most common cause of ED
B. there is a higher risk of ED in men with CVD, hypertension and diabetes
C. less than 50% of patients have organic cause for their ED
D. it is normal in the elderly and doesn’t warrant treatment

A

B

28
Q

Which of the following occurs with Sildenafil intake?

A. cavernous muscle constriction
B. PDE-5 stimulation
C. increase cGMP
D. penile detumescence

A

C

29
Q

Which of the following demonstrates a possible organic cause of erectile dysfunction?

A. px A has good erections during masturbation but poor erections during sexual intercourse with a partner
B. px B claims to have good erections with certain partners but not with all of his partners
C. px C complains of gradual loss of erection in span of 1 yr
D. px D has difficulty achieving good erections after a long day’s work at the office

A

C

30
Q

Priapism is a prolonged erection that persist for

A. greater than 1 hour
B. greater than 2 hours
C. greater than 3 hours
D. greater than 4 hours

A

D

31
Q

Erectile dysfunction resulting from penile fracture is a form of:

A. Neurogenic ED
B. Hormonal ED
C. Arterial ED
D. Cavernosal ED

A

D

32
Q

Which of the following is most important in the evaluation of a patient with erectile dysfunction?

A. A good psychosexual and medical history
B. Penile tumescence testing
C. Audiovisual sexual stimulation
D. Vibratory stimulation

A

A

33
Q

Which of the following is considered first line treatment for erectile dysfunction?

A. PDE5 inhibitors
B. Vacuum constriction device
C. Intracavernous injection with alprostadil
D. Penile prosthesis

A

A

34
Q

The urethral sphincters involved in the maintenance of continence during stress include the ff EXCEPT:

A. Intrinsic urethral sphincter
B. Extrinsic urethral sphincter
C. Striated urogenital sphincter
D. None of the above

A

B

35
Q

The gold standard urodynamic test is:

A. Uroflowmetry
B. Cystometrogram (CMG)
C. Videocystourethrogram (VCU)
D. Cystourethroscopy

A

B

36
Q

The standard treatment of choice for women with GSI is the Burch colposuspension. This involves attachment of the paraurethral/paravaginal tissues to which of the following:

A. Symphysis pubis
B. Iliopectineal ligaments
C. Anterior rectus fascia
D. Endopelvic fascia

A

B

37
Q

A 65 y/o G7P7 complaining of recurrent foul-smelling vaginal discharge was seen to have abnormal proximity between the introitus and the anus because of attenuation of the perineal body. The rest of the pelvic examination was normal. The most likely diagnosis is:

A. Uterovaginal prolapse
B. Relaxed vaginal outlet
C. Cystocoele
D. Enterocoele

A

D

38
Q

The type of fistula which is commonly encountered in obstructed prolonged labor:

A. Vesicovaginal
B. Rectovaginal
C. Urethrovaginal
D. Rectocervical

A

A

39
Q

Which of the ff will give the most support to the uterus?

A. Broad ligament
B. Infundibulopelvic ligament
C. Cardinal ligament
D. Uterosacral ligament

A

C

40
Q

Kegel’s exercise is recommended in mild cases of stress incontinence to strengthen which muscle?

A. Puborectalis
B. Pubococcygeus
C. Ischiocavernosus
D. Ischiococcygeus

A

B

41
Q

Which phase of the sexual response cycle is characterized by the full development of the orgasmic platform?

A. Desire phase
B. Arousal/Excitement phase
C. Plateau phase
D. Orgasmic phase

A

C

42
Q

The female sexual response is affected by aging due to certain anatomic changes that include the ff EXCEPT:

A. Thinning of the vaginal walls
B. Reduced vaginal size
C. Increase clitoral size
D. Sensory changes in the nipples

A

C

43
Q

The following structures give pelvic support EXCEPT:

A. Endopelvic fascia
B. Infundibulopelvic ligament
C. Cardinal ligament
D. Urogenital diaphragm

A

B

44
Q

Hormonal changes in a perimenopausal woman

A. Decreased inhibin, increased FSH, normal LH, slightly increased estradiol
B. Decreased inhibin, increased FSH, normal LH, slightly decreased estradiol
C. Decreased inhibin, increased FSH and LH, slightly decreased estradiol
D. Decreased inhibin, decreased FSH and LH, slightly increased estradiol

A

B

45
Q

Choose the CORRECT statement regarding the principles in the use of HRT

A. all hysterectomized women should receive estrogen only for hormone replacement
B. HRT may be used for as long as the patient desires it
C. HRT should be started in women with postmenopausal bleeding to resolve abnormal bleeding
D. The risks and benefits of HT differ for women around the time of menopause compared to those older women

A

D

46
Q

The following is an indication for HRT use as recommended by the PDA

A. treatment of osteoporosis
B. treatment of mild vasomotor symptoms
C. treatment of moderate vaginal dryness
D. prevention of cardiovascular disease

A

C

47
Q

Absolute contraindication/s to the use of HRT include/s:

A. endometrial hyperplasia, on treatment with high dose progestins
B. controlled hypertension
C. recent myocardial infarction
D. all of the above

A

D

48
Q

A 60 y/o female patient underwent Dual Energy X-ray Absorptiometer screening test showing T-scores of -1.9 at the spine and -2.8 at the hip. What is the diagnosis based on WHO definition?

A. Normal
B. Osteopenia
C. Osteoporosis
D. Severe osteroporosis

A

C

49
Q

The use of estrogen replacement therapy

A. protects against endometrial cancer
B. protects against cervical cancer
C. protects against colorectal cancer
D. protects against ovarian cancer

A

C

50
Q

The following are used for the treatment of post-menopausal osteoporosis EXCEPT

A.	hormone therapy
B.	STEAR
C.	Calcitonin
D.	SERMS
E.	None of the above
A

B

51
Q

The following are typical effects on progestational hormones EXCEPT

A. breast tenderness
B. palpitations
C. depression
D. bloating

A

B

52
Q

The advantage/s of using low dose formulation to start HRT include/s

A. effective for prevention of vasomotor symptoms
B. effective for treatment of bone loss
C. protects endometrium from hyperplasia
D. all of the above

A

A

53
Q

The following effects of estrogen deficiency from perimenopause to advanced age

A. early - hot flushes, dyspareunia
B. intermediate - psychological symptoms
C. late - osteoporosis
D. all of the above

A

C

54
Q

Who is the father of radiology?

A. Chairs Leonard
B. Wilhelm Conrad Roentgen
C. Thomas Edison
D. Alexander Graham Bell

A

B

55
Q

Radiologic modality which uses radiation, except:

A. Computed tomography pelvimetry
B. Fluoroscopy
C. X-ray pelvimetry
D. Sonography

A

D

56
Q

Radiologic modality which introduces iodinated contrast media through openings in the pelvic area to determine congenital abnormalities

A. hysterosalpingography
B. genitogram
C. arteriography
D. hysterosalpingocontrast sonography

A

B

57
Q

Contraindications for hysterosalpingogram, except:

A. Active uterine bleeding
B. Uterine surgery within the last 3 days
C. Pregnancy
D. None of the above

A

D

58
Q

Advantage of sonography over other radiologic modalities

A. Non-invasive, simple, and inexpensive
B. No ionizing radiation
C. Diagnosis is made during the procedure
D. All of the above

A

D

59
Q

Disadvantage of sonography over other radiologic modalities

A. Operator-dependent
B. Cannot penetrate air or bone
C. Requires good contact of transducer with skin
D. All of the above

A

D

60
Q

Considered an initial diagnostic tool in the evaluation of infertility and reproductive assistance, early pregnancy, ectopic pregnancy, and pregnancy-related conditions during the first trimester

A. Transvaginal sonography
B. CT scan
C. MRI
D. PET scan

A

A

61
Q

On transvaginal ultrasound, a post-menopausal patient with vaginal bleeding shows an 8 mm endometrium. What is the least of your differential diagnosis?

A. Endometrial hyperplasia
B. Submucous myoma
C. Endometrial carcinoma
D. Adenomyosis

A

D

62
Q

Differentials for a pregnancy-related thickened hyper-echoic endometrial stripe, except:

A. Normal pregnancy
B. Ectopic pregnancy
C. Complete abortion
D. Molar pregnancy

A

C

63
Q

Radiologic tests used in diagnosis of undescended testis

A. Ultrasound
B. MRI
C. CT scan
D. All of the above

A

D

64
Q

A property of sound waves used in sonography that pertains to the number of vibrations or oscillations that a particle performs per second when it is struck by sound

A. Wavelength
B. Amplitude
C. Frequency
D. None of the above

A

C

[OS 215] OB-GYN E3 (4 decks)

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