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[OS 215] OB-GYN E3 > Samplex 2017 > Flashcards

Samplex 2017 Flashcards

1
Q

A 26-year-old female patient presents with a very movable non-tender solid breast mass with well-defined border. There are no palpable axillary lymph nodes. The primary clinical diagnosis:

a. Breast abscess
b. breast cancer
c. Fibroadenoma
d. fibrocystic changes
e. Benign phyliodes tumor

A

C

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2
Q

A 31-year-old female patient presents with a hard breast mass with ill-defined border, fixed, with a palpable ipsilateral axillary lymph node. The primary clinical diagnosis is:

a. breast abscess
b. breast cancer
c. Fibroadenoma
d. fibrocystic changes
e. tuberculosis of the breast

A

B

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3
Q

A 4-cm breast mass is fluctuant associated with erythema and tenderness. The most likely diagnosis is

a. mastitis
b. breast abscess
c. tuberculosis of the breast
d. gross cyst
e. inflammatory breast cancer

A

B

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4
Q

A 22-year-old female patient has marked asymmetry of the breasts of the breasts but without a palpable mass on the enlarged breast. The most likely diagnosis for the enlarged breast is

a. virginal hypertrophy
b. galactocoele
c. breast cancer
d. physiologic asymmetry
e. fibroadenoma

A

B

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5
Q

There is a lesion on the nipple of one breast in a 50-year-old female patient. The most likely diagnosis is

a. allergy
b. dermatitis
c. paget’s disease of the nipple
d. human bite
e. infection of the montgomery glands

A

C

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6
Q

A 40-year-old patient has a sanguinous nipple discharge with NO palpable mass. The most likely diagnosis is

a. Intraductal carcinoma
b. intraductal papilloma
c. Paget’s disease of the nipple
d. Fibrocystic changes
e. ductal ectasia

A

B

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7
Q

Breast abscess is usually caused by what organism?

a. Staphylococcus aureus
b. Mycobacteria tuberculosis
c. Streptococcus
d. E. coli
e. Pseudomonas aeruginosa

A

A

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8
Q

In a patient with a palpable breast mass where a paraclinical diagnosis procedure is needed to be more definite on a probable cancer diagnosis, what is the most cost effective procedure at present?

a. Needle biopsy
b. open biopsy
c. mammography
d. ultrasound
e. monitoring and observation

A

A

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9
Q

In a patient with a humpy or nodular breast in which a fibrocystic change is strongly suspected, what is the recommended paraclinical diagnostic procedure at present?

a. needle biopsy
b. open biopsy
c. mammography
d. ultrasound
e. monitoring and observation

A

E

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10
Q

Surgery, radiotherapy, and chemotherapy, singly or in a combination is usually used for which of the following breast disorder?

a. malignant neoplasm
b. benign neoplasm
c. infection
d. aberration in normal development and involution
e. immune disease

A

A

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11
Q

observation and monitoring is usually used for which of the following breast disorder?

a. malignant neoplasm
b. benign neoplasm
c. infection
d. aberration in normal development and involution
e. immune disease

A

D

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12
Q

The presence of BRCA1 to a sister of a female patient with breast cancer will give her a lifetime risk of also developing breast cancer of about:

a. 10-20%
b. 30-40%
c. 40-60%
d. 60-80%

A

D

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13
Q

The most common histological subtype of breast cancer according to the WHO classification of breast cancer is:

a. mucinous carcinoma
b. infiltrating lobular carcinoma
c. infiltrating ductal carcinoma
d. intraductal carcinoma

A

C

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14
Q

The type of staging for breast cancer that guides the choice for primary therapy is:

a. clinical stage
b. surgical stage
c. pathologic stage
d. autopsy stage

A

A

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15
Q

Additional systemic treatment after surgery that is given to a patient with 4x2 cm breast cancer with axillary lymph node metastasis is called:

a. Neoadjuvant treatment
b. adjuvant treatment
c. palliative treatment
d. primary chemotherapy

A

B

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16
Q

Palliative treatment option/s for a patient with stage IV breast cancer is/ are:

a. supportive treatment
b. systemic chemotherapy
c. hormonal therapy
d. all of the above

A

D

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17
Q

Another locoregional treatment modality aside from surgery that is more commonly used in advanced breast cancers is:

a. radiotherapy
b. hormonal therapy
c. chemotherapy
d. electro therapy

A

C

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18
Q

The rationale for axillary lymph node dissection for breast cancer is/are:

a. provide prognostic information
b. guide for adjuvant treatment
c. provide regional control
d. all of the above

A

D

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19
Q

The best timing to perform breast self examination is

a. 7-10 days after 1st day of menstruation
b. 10-14 days before menstruation
c. day before menstruation
d. any day

A

A

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20
Q

A 10-year old male presented with a solid non-tender testicular mass. Biopsy of the mass would most probably reveal:

a. Leydig cell tumor
b. Yolk sac tumor
c. seminoma
d. teratoma

A

B

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21
Q

A patient diagnosed with left testicular cancer should undergo this diagnostic test to determine lymph node metastasis of the malignancy:

a. inguinal lymph node biopsy
b. chest CT scan
c. Abdominal CT scan
d. Supraclavicular node aspiration biopsy

A

C

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22
Q

The following combination of events lead to prostatic enlargement

a. increase in dihydroxytestosterone levels and transforming growth factor
b. decline in the epidermal growth factor and transforming growth factor
c. Ageing and a decline in the testosterone levels
d. increase in the epidermal growth factor and dihydroxytestosterone levels

A

D

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23
Q

The most important test to confirm prostatic enlargement is:

a. PSA
b. Digital rectal examination
c. KUB IVP
d. Urinalysis

A

B

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24
Q

Alpha-adrenergic blockers is used in the management of LUTS because of this mechanism of action:

a. Prevention of conversion of testosterone to dihydroxytestosterone
b. Blockage of receptors on prostatic smooth muscles to cause relaxation
c. stimulation of the receptors that increases apoptosis
d. Increased vasodilatation improving prostatic blood flow

A

B

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25
Q

The pathophysiology of orchitis associated with tuberculosis is:

a. local spread of perianal bacterial flora due to decline in immunity
b. contiguous spread from urethritis
c. hematogenous spread from the primary site of infection
d. lymphatic spread from the parotid

A

C

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26
Q

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

a. Pseudoepitheliomatous hyperkeratosis
b. Balaritis xerotica obliterans
c. squamous cell carcinoma
d. leukoplakia

A

C

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27
Q

Benign prostatic hyperplasia commonly involves which zone of the prostate:

a. peripheral zone
b. periurethral zone
c. transition zone
d. central zone

A

C

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28
Q

A 67 year old male presenting with LUTS and DRE findings of an enlarged, nodular prostate must be screened for:

a. Benign prostatic hyperplasia
b. Prostatic calcification
c. Prostatic cancer
d. Tuberculous prostatitis

A

C

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29
Q

In the early stages of obstruction from an enlarged prostate, the following symptom may be expected because of changes in the bladder:

a. urinary retention
b. frequency
c. hesitancy
d. weak urinary stream

A

B

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30
Q

Which of the following changes in sexual function are observed in healthy aging men?

a. complete absence of nocturnal penile erections
b. longer refractory period
c. libido is maintained due to slight increase in serum testosterone
d. increase in ejaclation volume

A

C

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31
Q

Which of the following statement/s is/are TRUE regarding erectile dysfunction (ED)?

a. ED may be an indicator for the later development of life-threatening cardiovascular disease
b. Psychogenic ED is the most common cause of ED
c. Heavy alcohol intake improves erection and libido because of vasodilatation
d. All of the above

A

A

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32
Q

Which of the following is/are absolute contraindications in prescribing PDES inhibitors?

a. men in whom sexual intercourse is not advised due to cardiovascular risk factors
b. men on nitrate medication
c. men diagnosed with psychogenic ED
d. A and B only

A

D

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33
Q

Which of the following occurs during erection?

a. relaxation of the penile smooth muscles
b. increase in intracellular calcium causes erection
c. nitric oxide exits the cell membrane during erection
d. the enzyme phosphodiesterase (PDE) converts guanosine triphosphate (GTP) to cyclic guanosine monophosphate (cGMP)

A

A

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34
Q

The most common cause of prolonged painful erection of 5 hours duration in a 20 year old male diagnosed to have leukemia is

a. failure of venous blood to drain from the erectile chamber due to obstruction
b. overstimulation of the dorsal nerve
c. increased libido
d. fistula formation between cavernous artery and the corpora cavernosa

A

C

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35
Q

Which of the following suggests an organic cause of erectile dysfunction?

a. sudden loss of erection
b. good erections with masturbation but not with sexual intercourse
c. good erection 8 out of 10 times of sexual intercourse
d. loss of nocturnal erections

A

D

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36
Q

Which of the following anatomical changes occur during erection?

a. the penile smooth muscles are contracted
b. constriction of the helicine arteries
c. subtunical venous plexuses are compressed against the tunica albuginea
d. emissary veins remain open

A

C

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37
Q

What is the most appropriate treatment for 60 year old male who is taking isosorbide nitrate and is complaining of erectile dysfunction?

a. vacuum constriction device
b. sildenafil
c. tadalafil
d. vardenafil

A

A

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38
Q

A 65-year-old male is complaining of erectile dysfunction when he attempts to have sex with his wife but has full erections with his mistress. Which is the most likely diagnosis?

a. depression
b. psychogenic ED
c. metabolic syndrome
d. organic ED

A

B

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39
Q

Support of the proximal urethra and bladder base are provided by the interaction of the ff EXCEPT:

a. Anterior vaginal wall
b. Levator ani muscles
c. Arcus tendineus fascia pelvis
d. urogenital diaphragm

A

D

40
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 urogential shincter
d. none of the above

A

D

41
Q

The cystometrogram (CMG) is helpful in the diagnosis of the ff EXCEPT:

a. Genuine Stress Incontinence
b. Detrusor Instability
c. Vesicovaginal fistula
d. Overflow incontinence

A

C

42
Q

The gold standard urodynamic test is:

a. Uroflowmetry
b. Cystometrogram (CMG)
c. Vesicocystourethrogram (VSU)
D. Cystourethroscopy

A

B

43
Q

The most common cause of female urinary incontinence is:

a. Genuine Stress Incontinence
b. Urge incontinence
c. Mixed incontinence
d. Overflow incontinence

A

D

44
Q

The anatomical displacement and “sagging” of the urethra and the associated vafinal wall in the the vaginal lumen is known as:

a. cystocoele
b. enterocoele
c. urethrocoele
d. uterovaginal prolapse

A

C

45
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

46
Q

The most prevalent uterine position is:

a. Anterior
b. Posterior
c. Midway
d. Superior

A

A

47
Q

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

a. Vesicovaginal
b. rectovaginal
c. urethrovaginal
d. rectocervical

A

A

48
Q

Imaging modality used for screening the abdominal and pelvic organs

a. CT scan
b. MRI
c. Ultrasound
d. X-ray

A

C

49
Q

Imaging modality used to stage and follow-up pelvic malignancies in pregnant patients

a. CT scan
b. MRI
c. Ultrasound
d. X-ray

A

B

50
Q

Usual imaging modality used to supplement ultrasound by providing additional characterization of lesions

a. CT scan
b. KUB-IVP
c. MRI
d. X-ray

A

C

51
Q

Imaging modality used for 1st trimester obstetric examinations

a. CT scan
b. MRI
c. Transabdominal ultrasound
d. Transvaginal ultrasound

A

D

52
Q

A 60 year old male experiences urinary flow problems and pelvic pain, what is the imaging modality that should be ordered?

a. CT scan
b. endoluminal ultrasound
c. MRI
d. Transabdominal ultrasound

A

A

53
Q

A 16 year old female still have not experienced manarche and is experiencing pelvic pain. What is the imaging modality to be requested?

a. Hysterosalpingogram
b. Transabdominal ultrasound
c. Transrectal ultrasound
d. Transvaginal ultrasound

A

A

54
Q

Imaging modality used to investigate lower abdominal pain in 28 week pregnant patient

a. CT scan
b. KUB-IVP
c. MRI
d. Ultrasound

A

D

55
Q

A 45 year old female experiences repeated bouts of urinary tract infection and on ultrasound shows pelvocaliectasia, what is the cost effective imaging modality that should be requested?

a. CT scan
b. KUB-IVP
c. Plain x-ray
d. Stenogram

A

B

56
Q

A 55 year old male experienced urinary problems and the ultrasound shows a complex mass in the right kidney, what is the best imaging study to assess the lesion prior to surgery?

a. CT scan
b. KUB-IVP
c. MRI
d. Repeat ultrasound

A

A

57
Q

A multigravid patient consults for dysmenorrhea. Pregnancy test is negative. On internal examination, the cervix is closed, firm and smooth. The uterus is symmetrically enlarged to 14-15 weeks size. There are no adnexal masses or tenderness. What is your diagnosis?

a. Endometrial polyp
b. Subserous myoma
c. endometrioma
d. adenomyosis
e. none of the above

A

C

58
Q

Which of the following myoma is most prone to menorrhagia?

a. intramural myoma
b. Cervical myoma
c. Submucous myoma
d. parasitic myoma
e. subserous myoma

A

C

59
Q

A 30 year old G5P5( 5005) presents with a 20 week size irregular pelvic mass, which you suspect is a uterine myoma. Which is the most cost effective single imaging technique?

a. MRI
b. Ultrasound imaging
c. Pelvic CT scan
d. Hysteroscopy

A

B

60
Q

Dysgerminomas are radiosensitive

a. True
b. False

A

A

61
Q

The staging of ovarian cancer is clinical

a. True
b. False

A

B

62
Q

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

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

A

C

63
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

64
Q

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

a. Provide oxygen
b. Perform check compressions
c. ventilate the lungs
d. Give epinephrine

A

C

65
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

66
Q

Evaluation and decision-making during resuscitation are primarily based on which combination of signs?

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

A

C

67
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 umbilicus?
b. Is the baby of term gestation? Is the amniotic fluid clear? I s the baby breathing or crying? Does the baby have a good muscle tone?
c. Is the baby of low birth weight? Is the amniotic fluid clear? I s the baby breathing or crying? Is the baby pink?
d. Is the baby warm? Is the amniotic fluid clear? I s the baby breathing or crying? Is the baby breastfeeding?

A

B

68
Q

Which of the following is NOT a major change that normally occurs at birth allowing a 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 constrict, forcing blood to go through faster and in greater quantities

A

D

69
Q

An apneic newborn has not responded to suctioning, drying, and rubbing of 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 term gestation
d. Begin positive-pressure ventilation

A

D

70
Q

Which is not an acceptable method of stimulating a newborn to breath?

a. dry with a warm towel
b. Shake the newborn vigorously
c. Rub the newborn’s back gently
d. Flick the soles of the feet

A

B

71
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

72
Q

A heart rate less than ___ warrants PPV and chest compression

a. <120/min

A

C

73
Q

The following should be prioritized in Neonatal resuscitation:

a. Respiration
b. Heart rate
c. Color
d. All of the above

A

D

74
Q

Indication/s for bag mask ventilation:

a. Apnea
b. HR < 100/min
c. A and B are correct
d. None of the above

A

C

75
Q

The ff. are true regarding APGAR score EXCEPT:

a. Objective method of quantifying the newborn condition
b. conveys information about the newborn general status and response to resuscitation
c. used to decide how and when to resuscitate
d. All are correct

A

D

76
Q

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

a. 20 mins
b. 25 mins
c. 30 mins
d. 1 hr

A

C

77
Q

Characteristics of Hyaline Membrane Disease EXCEPT:

a. Decreased surfactant production
b. With poor lung compliance
c. Characterized by hypoxemia and hypercarbia
d. Increased risk seen in babies of diabetic mothers

A

C

78
Q

The following changes occur during delivery EXCEPT:

a. Clamping of the cord eliminates the placenta
b. Expansion of the lungs causes decreased pulmonary vascular resistance
c. Increase in the right atrial pressure leads to closure of the foramen ovale
d. Increased systemic vascular pressure causes closure of the ductus arteriosus

A

C

79
Q

A 28 year old primigravid delivered by cesarean section to a post term baby due to fetal distress. Intraoperatively, there was not of scanty, thickly meconium-stained amniotic fluid. Complications of meconium aspiration syndrome except

a. Chemical pneumonitis
b. Transient tachypnea of the newborn
c. Pneumothorax
d. Persistent pulmonary hypertension

A

B

80
Q

True of apnea EXCEPT:

a. Causes include both respiratory and non-respiratory
b. A common presentation of illness in neonates
c. Related to prematurity and control of respiration
d. Metabolic causes include hyperglycemia and acidosis

A

D

81
Q

Characteristics of neonatal pneumonia EXCEPT

a. May be diagnosed by clinical course and exclusion
b. Can mimic any other lung disease in presentation
c. Findings on chest X-ray are specific for pneumonia
d. May occur pre, peri and post-natally

A

A

82
Q

The following are criteria to define an intrapartum event sufficient to cause cerebral palsty EXCEPT

a. Evidence of metabolic acidosis to fetal umbilical cord arterial blood
b. Early onset of severe neonatal encephalopathy in infants born > 34 weeks AOG
c. Multiorgan dysfunction during the first 24 hours of life
d. Cerebral palsy of spastic quadriplegic type

A

D

83
Q

The following are strategies to prevent reperfusion injury

a. Head cooling
b. hydration
c. hyperthermia
d. hyperoxia

A

A

84
Q

Risk factors for perinatal asphyxia EXCEPT

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

A

D

85
Q

Definitive diagnosis of sepsis:

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

A

B

86
Q

Risk factors for sepsis neonatorum, EXCEPT:

a. prematurity
b. low birth weight
c. rupture of membranes 10 hours
d. resuscitation at birth

A

D

87
Q

Age of menopause may be determined by

a. race and socio-economic status
b. BMI
c. age at menarche
d. age of menopause of the patient’s mother
e. all of the above

A

D

88
Q

The hormonal changes after menopause include

a. decreased inhibin, increased FSH, normal LH, slightly decreased estradiol
b. decreased inhibin, increased FSH and LH, decreased estradiol
c. decreased inhibin, decreased FSH and LH, slightly increased estradiol
d. decreased inhibin, increased FSH, normal LH, slightly increased estradiol

A

D

89
Q

The following effects of estrogen deficiency from perimenopause to advanced age

a. early- hot flushes, dyspareunia
b. intermediate-abnormal uterine bleeding
c. late-coronary heart disease
d. all of the above

A

C

90
Q

Which statement is incorrect?

a. The lifetime risk of death in a postmenopausal woman with coronary artery disease is 31% and the lifetime risk of death in a postmenopausal woman with breast cancer is 3%
b. HDL CHOLESTEROL is the strongest predictor of heart disease in women
c. In healthy postmenopausal women, HRT reduces the risk of CHD events while in older women, HRT increases, then decreases the risk overtime
d. None of the above

A

B

91
Q

Choose the CORRECT statement/s regarding the management of perimenopause and menopause

a. HRT is not used for cycle control in a perimenopause woman since HRT dosages are not enough to control abnormal uterine bleeding
b. HRT remains the most effective therapy for hot flushes and estrogen urogenital symptoms
c. The risks and benefits of HT for women around the time of menopause compared to those for older women
d. all of the above

A

D

92
Q

The following is/are indication/s for HRT use as recommended by the FDA except

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

A

C

93
Q

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

a. Porphyria cutanea tarda
b. Active liver disease
c. Untreated endometrial hyperplasia
d. all of the above

A

D

94
Q

The route of administration of HRT recommended for a patient with hypertriglyceridemia complaining of severe dyspareunia

a. oral tablet
b. capsule
c. transdermal
d. vaginal tablet

A

C

95
Q

Tibolone is a viable alternative to HRT because

a. It may protect against cervical cancer
b. It may protect against colorectal cancer
c. It may protect against breast cancer
d. It may protect against ovarian cancer

A

C

96
Q

The following agents that are used for the prevention of post-menopausal osteoporosis to reduce the incidence of vertebral hip fractures

a. Estrogen
b. Risedronate
c. Raloxifene
d. A and B
e. all of the above

A

E

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

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