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[OS 215] OB-GYN E3 > Samplex 2015 > Flashcards

Samplex 2015 Flashcards

1
Q

If you are suspecting invasive ductal carcinoma of the breast, the least invasive biopsy technique to confirm it will be:

a. Fine needle aspiration biopsy
b. Core needle biopsy
c. Excision biopsy
d. Incision biopsy

A

B

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2
Q

A 40-y.o. asymptomatic female consulted because of a 3x2cm hard movable mass without overlying skin dimpling. Ipsilateral internal mammary and axillary lymph node was palpated. FNAB revealed ductal carcinoma. The clinical stage is:

a. T2N1M0
b. T2N2M0
c. T2N3M0
d. T2N4M0

A

C

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3
Q

The most common site of distant metastasis from breast cancer involves what organ:

a. Lungs
b. Bones
c. Liver
d. Brain
A

B

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4
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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5
Q

A 28 y.o. female with a 2x2 cm hard movable left upper outer breast mass. No axillary nodes palpated nor any other signs or symptoms. FNAB revealed ductal cancer. The next test to know if she is a good candidate for breast conservation surgery is:

a. chest x-ray
b. breast ultrasound
c. mammography
d. bone scan
A

C

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6
Q

the stage of breast cancer that guides the choice of primary treatment is:

a. clinical stage
b. pathologic stage
c. re-treatment stage
d. autopsy stage
A

A

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7
Q

The clinical manifestation of advanced breast cancer whereby dermal lymphatic are invaded by the tumor causing skin edema.

a. Satellite skin nodule
b. Peau d’orange skin
c. Skin ulceration
d. extremity lymphedema
A

B

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8
Q

Among the different histopathologic type of breast cancer, which one is the most common according to the WHO classification?

a. infiltrating ductal cancer
b. medullary cancer
c. mucinous cancer
d. tubular cancer

A

A

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9
Q

Which one will complete the breast conservation treatment as local therapy for breast cancer after lumpectomy and axillary dissection?

a. Adjuvant chemotherapy
b. adjuvant hormonal therapy
c. radiotherapy of the ipsilateral preserved breast
d. radiotherapy of the contralateral breast

A

C

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10
Q

Gene mutation at chromosome 17 that results to about 60% lifetime risk in developing breast cancer

a. BRCA 1
b. BRCA 2
c. BRCA 3
d. BRCA 4

A

A

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11
Q

Which of the following is TRUE regarding PSA (Prostatic Specific Antigen) testing?

a. It is currently the best test to use for prostate cancer screening
b. It is more sensitive than DRE in screening for prostate cancer
c. A patient with acute prostatis can also have elevated PSA
d. all of the above

A

C

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12
Q

The IPSS questionnaire is used to assess the severity of :

a. lower urinary tract symptoms from prostate disease
b. renal disease brought about by stone disease
c. vesicoburethral reflux damage to the kidneys
d. erectile dysfunction

A

A

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13
Q

which of the following diagnostic tests must ALWAYS be performed in evaluating urinary tract infections?

a. urodynamics
b. KUB - IVP
c, urine cytology
d. urinalysis

A

D

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14
Q

Which of the following statements is TRUE regarding lower urinary tract symptoms (LUTS)?

a. LUTS is only found in men with benign prostatic enlargement
b. LUTS is a common presentation in women with recurrent episodes of urinary tract infection
C. all men with benign prostatic enlargmeent have LUTS
d. hematuria is a component of LUTS

A

B

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15
Q

Which of the following statements is TRUE regarding serum PSA?

a. serum elevation is always correlated with prostatic cancer
b. serum levels vary with prostatic volume, inflammation and the amount of cancer in the gland.
c. PSA determination should be performed in all males regardless of age
D. PSA has no role in monitoring patients who underwent radical prostatectomy for prostate cancer

A

B

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16
Q

A 25 year old male complaining of dysuria, frequency and urgency was found to have a tender and boggy prostate on digital rectal exam. The most likely diagnosis is:

a. acute bacterial prostatitis
b. benign prostatic enlargment
c. prostate adenocarcinoma
d. urethritis

A

B

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17
Q

Which of the following is a risk factor in the development of squamous cell carcinoma of the penis?

a. phimosis
b. N. gonorrhea
c. Chlamydia trachomatis
d. chronic irritation caused by retained smegma

A

D

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18
Q

Prostate adenocarcinoma is usually found in which zone of the prostate?

a. fibromuscular stroma
b. periurethral zone
c. transition zone
d. peripheral zone

A

D

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19
Q

The most common cell tumor of the testis is

a. embryonal cell
b. seminoma
c. yolk sac tumor
d. teratoma

A

B

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20
Q

Which of the following statetements is TRUE regarding benign prostatic enlargement?

a. all men with BPE will eventually develop bothersome lower urinary tract symptoms.
b. a patient with a 50g prostate will develop more lower urinary tract symptoms than a patient with a 25g prostate
c. cysto-TURP is indicated in all patients diagnosed with BPE
d. renal failure is possible complication of BPE

A

D

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21
Q

The following is NOT a hormonal change in

a perimenopause woman

a. decreased inhibin
b. increased fsh
c. increased lh
d. increased estradiol
e. all changes are correct

A

C

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22
Q

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

a. all hysterectomized women should receive estrogen only for hormonal 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 the abnormal bleeding
d. the risks and benefits of HRT differ from women around the time of menopause compared to those for older women

A

D

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23
Q

the following is an indication for HRT use as recommended by the FDA

a. prevention of osteoporosis
b. treatment of mild vasomotor symptoms
c. treatment of mild vaginal dryness
d. prevention of cardiovascular disease

A

A

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24
Q

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

a. controlled hypertension
b. chronic hepatitis
c. suspected breast cancer
d. all of the above

A

C

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25
Q

. a 66y/o female underwent Dual Energy Xray Arter___petry screening test showin T-scores of -2.9 at the spine and -2-2 at the hip. What is the diagnosis based on the WHO definitions

a. normal
b. osteopenia
c. osteoporosis
d. severe osteoporosis (osteoporosis with fractures)

A

C

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26
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

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27
Q

The following are used for the prevention of post menopausal osteoporosis

a. hormone therapy (prevention)
b. calcitonin (treatment)
c. SERMs (prevention and treatment)
d. NOTA

A

C

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28
Q

The following are typical side effects of progestational hormones except

a. breast tenderness
b. palpitations
c. depression
d. bloating

A

B

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29
Q

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

a. effective for treatment of vasomotor symptoms
b. effective for prevention of bone loss
c. protects endometrium from hyperplasia
d. AOTA

A

A

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30
Q

The following effects of estrogen deficiency from perimenopause to advanced age

a. early - menstrual irregularity
b. intermediate - insomnia
c. late - urge-stress incontinence
d. AOTA

A

A

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31
Q

The following is true during the erect state of the penis:

a. the sinusoids of the corpora cavernosa are empty
b. the penile smooth muscles are contracted
c. the arteries within the corpora cavernosa are constricted
d. the subtunical venous plexuses are compressed

A

D

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32
Q

the proposed mechanism for psychogenic dysfunction is

a. sympathetic overactivity
b. parasympathetic inhibition
c. cortical inhibition of testosterone release
d. endorphin depletion

A

A

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33
Q

Mr. Santos underwent radical prostatectomy for prostate cancer. Postoperatively, he complained of inability to obtain and maintain an erection. He most probably has this type of erectile dysfunction:

a. psychogenic
b. neurogenic
c. vasogenic
d. hormonal

A

B

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34
Q

. Mr. Cruz is diagnosed to have pituitary tumor after he is found to have elevated prolactin levels. He is referred to a urologist because of his ED. This may be treated with:

a. estrogen receptor blockers
b. antidepressants
c. testosterone supplements
d. phenylephrine

A

C

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35
Q

The diagnosis of an ED can be made in the ff situation:

a. The patient reports absence of nocturnal penile tumescence
b. Onset of the problem is acute and sudden
c. The occurrence of the problem is inconsistent and erratic
d. Non coital erection is rigid

A

A

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36
Q

The first line treatment of ED allows sustained smooth muscle relaxation through

a. sustained high levels of intracellular calcium
b. prevention of cGMP degradation
c. enhanced entry of nitric oxide into the cell
d. prevention of GTP production

A

B

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37
Q

The following is a characteristic of priapism:

a. erection lasting for 2 hours
b. non tender rigidity of the penis
c. prolonged erection relieved by ejaculation
d. erection unrelated to sexual stimulation

A

D

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38
Q

The ff type of priapism is considered a urologic emergency:

a. Venoocclusive
b. arterial
c. stuttering
d. high flow

A

A

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39
Q

The ff is a characteristic of ischemic priapism:

a. presents with previous history of penile trauma
b. chronic tumescence without full rigidity
c. abnormal cavernous blood gases
d. rarely associated with penile pain

A

C

40
Q

The following type of medication may cause retrograde ejaculation:

a. antidepressants
b. 5 alpha reductase inhibitors
c. pseudoephedrine
d. alpha adrenergic blockers

A

D

41
Q

The ff are MR and CT signs of ovarian malignancy EXCEPT:

a. thin wall
b. nodularity
c. vegetations
d. solid components

A

A

42
Q

MRI is usually preferred to CT for staging cervical CA. On T2WIs, the tumor is ______ signal compared to the lower signal of normal cervical tissue.

a. lower
b. higher
c. intermediate
d. variable

A

B

43
Q

In adenomyosis, ultrasound finding will usually show a _______ echotecture of the myometrium.

a. homogenous
b. heterogenous
c. hyperechoic
d. hypoechoic

A

B

44
Q

__________ appear as a single or multiple adnexal masses with diffuse low-level echoes.

a. paratubal cysts
b. endometrioma
c. dermoid cyst
d. serous cystadenoma

A

B

45
Q

In MR, endometriomas will exhibit homogenous _____ intensity on T1WIs and characteristically _____ signal on T2.

a. low, low
b. high, high
c. high, low
d. low, high

A

C

46
Q

Seminomas will appear _____ and non-seminomas will appear _____ on ultrasound

a. homogenous, homogenous
b. heterogenous, heterogenous
c. homogenous, heterogenous
d. hetergenous, homogenous

A

C

47
Q

Testicular infarction may result from torsion or trauma. The infarct may appear as a density area or a diffuse _____ density of the entire testis

a. high
b. low
c. intermediate
d. variable

A

B

48
Q

On MR, T2WIs, prostate cancers appear as areas of _____ signal within the high-signal peripheral zone

a. high
b. low
c. intermediate
d. variable

A

B

49
Q

The major indication in performing a transrectal prostate US

a. as a screening examination for prostate cancer
b. to guide needle biopsy for diagnosis of prostate cancer
c. to stage prostate cancer
d. as part of treatment of prostate cancer

A

B

50
Q

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

a. atypical cells invading the myometrium
b. presence of trophoblasats
c. dysplastic cells at the base
d. presence of endometrial glands

A

D

51
Q

The most common complication of a cystic teratoma is

a. infection
b. torsion
c. rupture
d. hemorrhage

A

B

52
Q

A 49-yr old asymptomatic patient is found to have an 8 week size irregular myomatous uterus. Appropriate management should be:

a. reevaluate
b. GnRH
c. myomectomy
d. hysterectomy

A

B

53
Q

The following factors increases the risk for ovarian epithelial cancers EXCEPT:

a. age
b. family history-risk factor
c. infertility
d. pregnancy
e. ovulatory drugs

A

D

54
Q

The following is true:

a. The staging of ovarian cancer is clinical.
b. Tumor markers such as CCEA, AFP, CA125 may serve to monitor the progress of a patient undergoing treatment or detect any recurrence
c. Epithelial ovarian cancers comprise about 10% of all ovarian cancers.
d. Ovarian carcinoma spread solely by direct extension.
e. Ovarian carcinoma is associated with high parity.

A

B

55
Q

Ventilatory support of the fetus

a. Fetal lungs
b. Liver
c. Placenta
d. Amnion

A

C

56
Q

Blood vessel with the highest oxygen saturation during the fetal life

a. Inferior Vena Cava
b. Pulmonary Artery
c. Pulmonary Vein
d. Umbilical Artery

A

A

57
Q

Parameter that is first affected during a hypoxic insult

a. Respiratory rate
b. Heart rate
c. Blood pressure
d. Femoral pulses

A

A

58
Q

Components of ACOG/AAP definition of asphyxia

a. Apgar score of 5
b. Metabolic alkalosis
c. Evidence of end organ damage
d. Evidence of postnatal distress

A

C

59
Q

In asphyxia, the baby is converted to a 3-organ organism which are

a. brain, heart, lungs
b. brain, adrenal glands, heart
c. brain, lungs, adrenal glands
d. lungs, heart, adrenal glands

A

B

60
Q

Injury from asphyxia may be due to the cytotoxic effects of free radicals through

a. Tissue hypoxia
b. Latent phase
c. Reperfusion phase
d. Induction phase

A

C

61
Q

Complications of perinatal asphyxia after resuscitation

a. Acute tubular necrosis
b. Hyperoxia
c. Prematurity
d. Hypertension

A

A

62
Q

A term infant born to a drug-dependent mother was born limp, cyanotic, apneic and tachycardic. Immediate resuscitation was performed Apgar score was 1 at 1 minute at 5 minutes of life. Cord pH was 6.9. Baby was transferred to NICU. At the NICU, baby developed seizures controlled by Phenobarbital. Baby improved after 3 days and went home on the 5th day. What would you advise the parents

a. High risk of cerebral palsy
b. High risk of mental retardation
c. No increased risk of cerebral palsy and mental retardation
d. 20% risk of cerebral palsy and mental retardation

A

D

63
Q

This phase of injury is characterized by low levels of ATP and tissue acidosis

a. Primary energy failure
b. Latent phase
c. Secondary energy failure
d. Reperfusion injury

A

A

64
Q

Therapeutic window during which neuroprotective strategies may be employed

a. 0-6 hours
b. 6-12 hours
c. 12-18 hours
d. 19-24 hours

A

A

65
Q

During Kegel’s exercise, the muscles being strengthened include the following EXCEPT

a. puborectalis
b. iliococcygeus
c. pubococcygeus
d. coccygeus
e. obturator internus

A

D

66
Q

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

a. intrinsic urethral sphincter
b. extrinsic urethral sphincter
c. pubourethral ligament
d. none of the above

A

C

67
Q

The following are connective tissue supporting structures of the bladder EXCEPT:

a. pubourethral ligament
b. Buck’s fascia
c. arcus tendineous fascia pelvis
d. pubococcygeus
e. pubocervical fascia

A

B

68
Q

Pelvic floor nomenclature is innervated by the pudendal nerves via sacral roots S2 to S4. The integrity of this neural supply can be tested clinically by:

a. clitoris-anal reflex
b. bulbocavernous reflex
c. cough reflex
d. plantar toe reflex

A

B

69
Q

. Continence is maintained by the following EXCEPT:

a. stimulation of the beta receptors in the bladder wall
b. stimulation of the alpha receptors in the bladder neck
c. stimulation of the efferent fibers of the pelvic nerve
d. stimulation of the somatic nerves
e. contraction of the striated urethral sphincter muscle

A

C

70
Q

During a resuscitation, the team makes decisions about the baby’s progress primarily based on 3 findings. Which findings are used?

a. respirations, heart rate, color
b. blood pressure, color, heart rate
c. tone, color, heart rate
d. respiration, blood pressure, heart rate

A

A

71
Q

A 55 year-old housewife underwent vaginal hysterectomy 1 year ago for procidentia uteri. Soon after, she noted a mass bulging from her vagina. On consult, vaginal examination showed a grade 1-2 cystourethrocoele and the vaginal cuff was noted to be at the level of the hymen (TVL = 6cms). Which vaginal supporting structure is most likely compromised?

a. arcus tendineus fascia
b. endopelvic fascia
c. uterosacral cardinal ligaments
d. round ligaments
e. rectovaginal fascia

A

C

72
Q

The most sexually sensitive part of the female anatomy is/are:

a. nipples
b. vagina
c. clitoris
d. areola
e. labia minora

A

C

73
Q

Recurrent or persistent genital pain induced by non-coital sexual stimulation is called

a. dyspareunia
b. vaginismus
c. priapism
d. non-coital sexual pain disorder
e. genital sexual arousal disorder

A

D

74
Q

The effects of menopause on female sexual function include the ff. EXCEPT:

a. absent sexual flush
b. clitoral enlargement
c. pronounced lengthening of the vagina
d. decreases number of rhythmic contractions
e. rapid decrease in vasocongestion

A

C

75
Q

Vaginismus can be managed by the ff ways EXCEPT:

a. Kegel’s exercises
b. Rubber dilators
c. Propanolol therapy
d. Hypnosis
e. Vaginal estrogen cream

A

C

76
Q

In the evaluation of women with sexual dysfunction, various tests may be employed and include the ff. EXCEPT:

a. serum FSH and LH
b. vaginal pH
c. genital vibration profile
d. Doppler ultrasound of clitoris and labia
e. Vaginal compliance

A

C

77
Q

J.O. is a 55yo G2P2 chronic smoker who consults you for a 4-year history of urinary leakages during coughing, sneezing, walking, and dancing. She also goes to the toilet every half hour, wakes up to urinate 4 times a night, and occasionally she leaks before making to the toilet. As such, she presently needs to use 4-5 pads a day for the leakages. She is a diabetic and a hypertensive on maintenance medications. Previous surgeries include a THBSO for CIN III about 15 years ago and a Colposuspension for SUI about 5 years ago. Physical examination shows a BMI of 25 kg/m2 but is otherwise unremarkable. On pelvic exam, the vaginal vault is intact, atrophic, and with a well-supported bladder neck. There is no adnexal mass/ tenderness. Cough stress test is positive. ICS scoring is as ff: Aa -2, Ba -2, C -4 , GH 4, PB 3, TVL 6, Ap -2, Bp -2.

What is your clinical diagnosis for her urinary condition?

a. Stress urinary incontinence (SUI)
b. Overactive Bladder (OAB)
c. Mixed urinary incontinence
d. Bladder outlet obstruction
e. Diabetic cystopathy

A

C

78
Q

J.O. is a 55yo G2P2 chronic smoker who consults you for a 4-year history of urinary leakages during coughing, sneezing, walking, and dancing. She also goes to the toilet every half hour, wakes up to urinate 4 times a night, and occasionally she leaks before making to the toilet. As such, she presently needs to use 4-5 pads a day for the leakages. She is a diabetic and a hypertensive on maintenance medications. Previous surgeries include a THBSO for CIN III about 15 years ago and a Colposuspension for SUI about 5 years ago. Physical examination shows a BMI of 25 kg/m2 but is otherwise unremarkable. On pelvic exam, the vaginal vault is intact, atrophic, and with a well-supported bladder neck. There is no adnexal mass/ tenderness. Cough stress test is positive. ICS scoring is as ff: Aa -2, Ba -2, C -4 , GH 4, PB 3, TVL 6, Ap -2, Bp -2.

Following the POP-Q, the proper diagnosis of her prolapse is:

a. Pelvice Organ Prolapse Stage 0
b. Pelvice Organ Prolapse Stage I
c. Pelvice Organ Prolapse Stage II
d. Pelvice Organ Prolapse Stage III
e. Pelvice Organ Prolapse Stage IV

A

A

79
Q

Most common etiologic agent in late onset sepsis (USA data)

a. group B Streptococci
b. coagulase negative Staph
c. S. aureus
d. Gm (-) enteric bacilli

A

B

80
Q

Common pathogens in early onset sepsis, EXCEPT:

a. Group B Streptococci
b. E. coli
c. Salmonella
d. S. aureus

A

C

81
Q

Risk factors for sepsis neonatorum, EXCEPT

a. Prematurity
b. low birth weight
c. rupture of membranes 10 hour
d. resuscitation at birth

A

C

82
Q

All of the following can cause respiratory distress EXCEPT:

a. hypothermia
b. hyperthermia
c. anemia
d. all of the above
e. none

A

D

83
Q

Characteristics of HMD

a. decreased surfactant production
b. there is associated V/Q mismatch
c. hypoxemia and hypercarbia may result from atelectasis
d. none
e. all

A

A

84
Q

Features of Meconium Aspiration Syndrome

a. common among term infants
b. risk factors include fetal depression, post maturity and meconium staining
c. meconium aspiration is brought about the relaxation of anal sphincter and gasping respirations
d. all
e. none

A

C

85
Q

An asphyxiated infant started to have seizures in the first 24 hours of life. Possible etiologies are

a. hypocalcemia
b. hypoglycemia
c. thrombosis
d. hypoxic encephalopathy

A

D

86
Q

Definitive diagnosis of sepsis

a. (+) urine culture
b. (+) blood culture
c. (+) stool culture
d. (+) CSF culture

A

B

87
Q

A heart rate less than _____ warrants PPV and chest compression

a. < 60/min
b. < 80/min
c. < 100/min
d. < 120/min

A

A

88
Q

Risk factors for perinatal asphyxia EXCEPT

a. Meconium stained amniotic fluid
b. Prematurity
c. Difficult delivery
d. Infection

A

C

89
Q

Approximately what percent of newborns require some assistance to begin breathing at birth?

a. 1%
b. 5%
c. 10%
d. 30%

A

B

90
Q

What percent of newborns require initial assessment to determine whether resuscitation is required?

a. 1% (one out of 100)
b. 10% (one out of 10%)
c. 50% (one out of 2)
d. 100% (all)

A

D

91
Q

What is the most important and effective action in a neonate requiring resuscitation?

a. provide oxygen
b. perform chest compressions
c. ventilate the lungs
d. give epinephrine

A

C

92
Q

What are the ABCs of resuscitation?

a. Apgar, bicarbonate, and chest compressions
b. Assess, blame and criticize
c. apnea, blood volume, and care coordination
d. airway, breathing and circulation

A

D

93
Q

At the time of birth, which 4 questions should you ask about the newborn while you are assessing the need for resuscitation?

a. Is the baby of singleton gestation? Is the amniotic fluid clear? Is the baby breathing or crying? Does the baby have a 3-vessel ubilical?
b. Is the baby of term gestation? Is the amniotic fluid clear? Is the baby breathing or crying? Does the baby have good muscle tone?
c. Is the baby of low birth weight? Is the amniotic fluid clear? Is the baby breathing or crying? Is the baby pink?
d. Is the baby warm? Is the amniotic fluid clear? Is the baby breathing or crying? Is the baby breastfeeding?

A

B

94
Q

Which of the ff is NOT a major change that normally occurs at birth allowing the baby to get oxygen into the lungs?

a. The fluid in the alveoli is absorbed into the lung tissue and replaced by air.
b. Umbilical arteries and veins constrict and then are clamped.
c. The blood vessels in the lung tissue relax, decreasing resistance to blood flow
d. The blood vessels in the lung tissue constrict, forcing blood to go through faster and in greater quantities

A

D

95
Q

An apneic newborn has not responded to suctioning, drying and rubbing the back. What is the appropriate next action?

a. provide supplemental oxygen
b. flick the soles of the feet
c. assess whether the baby is of term gestation
d. begin positive-pressure ventilation

A

D

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

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