Wall Quiz #12 Flashcards
1
Q
Which of the following histologic types of vulvar cancer has the most favorable prognosis?
A. Squamous cell carcinoma arising from a Bartholin gland
B. Basal cell carcinoma
C. Merkel cell carcinoma
D. Melanoma 4 mm in thickness
E. Paget’s disease with underlying apocrine gland adenocarcinoma
A
B. Basal cell carcinoma
2
Q
What is the most common pelvic retroperitoneal mass related to the urinary tract? A. Pelvic kidney B. Urinoma C. Nerve sheath tumor D. Bladder diverticulum E. Lower urethral carcinoma
A
A. Pelvic kidney
3
Q
A 49-year-old presents with urinary incontinence and a 13-pack year smoking history. Her urine dip specimen reveals +1 hematuria. What is the best next step in her evaluation? A. Cough stress test B. Cystoscopy C. RenalU/S D. Microscopic urinalysis E. Clean catch urine dip
A
D. Microscopic urinalysis
4
Q
What is the weekly caloric deficit necessary to lose one pound in one week? A. 500 B. 2000 C. 2500 D. 3000 E. 3500
A
E. 3500
5
Q
All the following are effective in first line therapy to relieve vasomotor symptoms EXCEPT: A. Gabapentin B. Topical progestin C. Clonidine D. Dang gui bu xue tang E. Paroxetine
A
B. Topical progestin
6
Q
Which of the following is the preferred treatment for Turner syndrome with no secondary sexual characteristics? A. Continuous oral contraceptives B. Cyclical oral contraceptives C. Hydroxyprogesterone acetate D. Oral progesterone E. Transdermal estradiol
A
E. Transdermal estradiol
7
Q
A 48 year old women presents with symptoms and biopsy findings consistent with invasive vulvar Paget's disease. What is the next step in management? A. Ultrapotent corticosteroid ointment B. Radical partial vulvectomy C. Total simple vulvectomy D. Excisional biopsy E. Topical steroid cream
A
B. Radical partial vulvectomy
8
Q
A 48-year-old status post TAH, with an EBL of 1500 mL. Vital signs are stable. Orthostatic BP test is positive. Post operative Hgb is 8 mg/dL 24 hours after surgery. What is the initial treatment? A. Crystalloid infusion 1-2 liters B. Packed red Cells 1-2 units C. Colloid solution 50-100ml 25% albumin D. Central venous catheterization E. Observation
A
A. Crystalloid infusion 1-2 liters
9
Q
Oliguric prerenal azotemia is characterized by:
A. Hyponatremic hyperchloremic metabolic acidosis
B. Urine plasma creatinine ratio <40mE/L/24hr
C. Urine sodium excretion <20mEq/L/24hr
D. Fractional excretion of sodium >1%
E. Low urine osmolarity <500mOsm
A
C. Urine sodium excretion <20mEq/L/24hr
10
Q
What is the most common adverse effect of copper IUD use? A. Pregnancy B. Expulsion C. Bleeding D. Uterine perforation E. Ectopic pregnancy
A
C. Bleeding
11
Q
What is the largest diameter of the fetal head at term? A. Bitemporal B. Occipital-frontal C. Biparietal D. Supra-Occipital-mental E. Suboccipital-bregmatic
A
D. Supra-Occipital-mental
12
Q
A biopsy specimen shows single cell with many intracytoplasmic Donovan bodies. What is the treatment? A. Tetracycline B. Cefixime C. Cefazolin D. Azithromycin E. Doxycycline
A
D. Azithromycin
13
Q
All of the following are appropriate ways to perform a pediatric gynecologic examination in a 3 year old patient EXCEPT? A. Frog leg B. Lateral decubitus C. Knee chest D. Prone E. Lithotomy on mother’s lap
A
B. Lateral decubitus
14
Q
Which of the following is the best test for the evaluation of Post-Partum thyroiditis? A. TT4 and TSH B. Anti-thyroid antibodies C. Free thyroxine Index D. FT4 and TSH E. RT3U and TSH
A
D. FT4 and TSH
15
Q
Meningomyelocele is associated with all the following chromosomal abnormalities EXCEPT: A. 69 XXX B. Trisomy 13 C. Turners syndrome D. 22q 11.2 deletion syndrome E. Trisomy 18
A
C. Turners syndrome
16
Q
A 22 year old at 35 weeks and 4 days presents with pre- labor rupture of membranes. What is the first step in evaluation? A. Antibiotics B. Bedrest C. Start Pitocin D. Ultrasound E. Culture for GBS
A
D. Ultrasound
17
Q
Which of the following bones make the peroneal nerve susceptible to injury during dorsal lithotomy position? A. Tibia B. Femoral head C. Lateral epicondyle of the tibia D. Fibular head E. Metatarsals
A
D. Fibular head
18
Q
Membrane Sweeping decreases the risk of: A. Colonization with Group B Streptococcus B. Ruptured membranes C. Chorioamnionitis D. Late term pregnancy E. Vaginal Bleeding
A
D. Late term pregnancy
19
Q
Your patient is 48 hours post-CD, The RN reports a temperature of 103 degrees F. She received an indwelling epidural catheter. The most likely cause of her fever is? A. Atelectasis B. Epidural Fever C. Endometritis D. Pyelonephritis E. Breast engorgement
A
C. Endometritis
20
Q
22 y/o type I diabetic presents for her preconceptional visit. Her HgbA1C is 9.4 mg/dL. Which complication is least likely to occur? A. Renal Agenesis B. Macrosomia C. Cardiac anomaly D. Fetal Demise E. Spontaneous Abortion
A
A. Renal Agenesis
21
Q
Lower urinary tract symptoms with pyuria and a sterile urine culture are likely due to which of the following pathogens? A. Escherichia coli B. Proteus mirabilis C. Chlamydia trachomatis D. Kleibsella pneumonia E. Enterobacter
A
C. Chlamydia trachomatis
22
Q
The best treatment of a cervical pregnancy at 7 weeks gestation is: A. Hysterectomy B. Uterine artery embolization C. D&C D. Methotrexate E. Hypogastric artery Ligation
A
D. Methotrexate
23
Q
Which ovarian cancer resembles cervical glands? A. Mucinous B. Serous C. Hilus Cell D. Granulosa Cell E. Sertoli-leydig
A
A. Mucinous
24
Q
A 17 y/o 5 ft 6 inch female with primary amenorrhea and infantile sexual development is most likely : A. Turner’s Syndrome B. Kallman’s syndrome C. Androgen insensitivity D. Swyers syndrome E. Gonadal dysgenesis
A
B. Kallman’s syndrome
25
```
Which of these is NOT a beneficial effect of regular exercise?
A. Reduced weight
B. Lower blood pressure
C. Improved blood sugar control
D. Increased LDL cholesterol
E. Prevents osteoporosis
```
D. Increased LDL cholesterol
26
```
Which of the following is the most common major midline structural defect?
A. Neural tube defect
B. Cardiac defect
C. Skeletal defect
D. Cleft palate
E. Gastrochisis
```
A. Neural tube defect
27
```
What is the most common endocrine disorder in reproductive age women?
A. Diabetes
B. PCOS
C. Hypothyroidism
D. Addison’s
E. Cushing’s
```
B. PCOS
28
```
Which of the following maternal infections can be treated antenatally to decrease the incidence of fetal death?
A. Parvovirus
B. Herpesgestationalis
C. Toxoplasmosis
D. Cytomegalovirus
E. Hepatitis
```
C. Toxoplasmosis
29
```
The most serious side effect of vacuum assisted vaginal delivery is:
A. Retinal hemorrhage
B. Cephalohematoma
C. Subgaleal hematoma
D. Hyperbilirubinemia
E. Clavicular fracture
```
C. Subgaleal hematoma
30
```
A 75-year-old presented with a vulvar lesion that then showed biopsy proven Paget’s disease. Which of the following is the best treatment?
A. Wide local excision
B. Tacrolimus
C. Corticosteroids
D. Radical vulvectomy
E. Cyclosporine
```
A. Wide local excision
31
```
How does ulipristal acetate differ from the levonorgestrel only regimen for post coital contraception?
A. Delays ovulation
B. Inhibits follicular rupture
C. Prevents implantation
D. Inhibits LH surge
E. Interrupts sperm viability
```
B. Inhibits follicular rupture
32
```
All of the following are signs/symptoms of Type I hypersensitivity reaction EXCEPT?
A. Urticaria
B. Anaphylaxis
C. Sneezing
D. Hives
E. Contact dermatitis
```
E. Contact dermatitis
33
```
Which of the following has the highest risk of incontinence after vaginal surgery?
A. Untreated ISD
B. Urge incontinence
C. Recurrent UTI
D. Stage 4 cystocele
E. Urinary retention
```
A. Untreated ISD
34
Which two muscles are targeted for midline reapproximation during perineorrhaphy?
A. Bulbospongiosus and Pubococcygeus
B. Ischiocavernosus and Pubococcygeus
C. Bulbocavernosis and superficial transverse perineal
D. Ischiocavernosus and superficial perineal
E. Pubococcygeus and ileococcygeus
C. Bulbocavernosis and superficial transverse perineal
35
```
Which of the following procedures is it recommended to give prophylactic antibiotics?
A. Diagnostic laparoscopy
B. Laparotomy for ectopic pregnancy
C. Surgical abortion
D. Urodynamics
E. Tubal sterilization
```
C. Surgical abortion
36
```
Before 28 weeks of gestation, the most efficient method of labor induction is:
A. Prostin
B. Dinopristone (E2)
C. Pitocin
D. Misoprostol (E1)
E. Intracervical foley balloon
```
D. Misoprostol (E1)
37
```
A woman presents to L&D at term, in active labor. She is 8 cm dilated, mentum anterior presentation. Two hours later she is completely dilated. What is the next best step?
A. Cesarean Delivery
B. Foceps rotation to occiput anterior
C. Fundal pressure
D. Observation
E. Vacuum assisted delivery when pushing
```
D. Observation
38
Dumping syndrome after Gastric bypass procedures is a result of:
A. Ingestion of High fat content foods
B. Ingestion of high glycemic carbohydrate foods
C. Lack of Fat absorbing vitamins in GI tract
D. Vitamin B12 deficiency
E. Laxative effect of surgical procedure
B. Ingestion of high glycemic carbohydrate foods
39
```
The vaginal artery is a branch from which vessel?
A. Uterine artery
B. Umbilical
C. Middle rectal
D. Obturator
E. Internal pudendal
```
A. Uterine artery
40
```
The LEAST common symptom of early cervical carcinoma is:
A. Watery vaginal discharge
B. Intermittent spotting
C. Pelvic pain
D. Post coital bleeding
E. No symptoms
```
C. Pelvic pain
41
```
The most common indication for hospital admission during the first part of pregnancy is:
A. Pyelonephritis
B. First trimester bleeding
C. Hyperemesis gravidarum
D. Chronic hypertension
E. Ectopic pregnancy
```
C. Hyperemesis gravidarum
42
```
Which of the following diagnostic tests are least likely part of the maternal evaluation at the time of fetal demise?
A. Parvovirus B19
B. Complete blood count
C. Lupus anticoagulant
D. TSH
E. Parental karyotype
```
E. Parental karyotype
43
```
A 46-year-old with a history of post partum sterilization undergoes an endometrial ablation for AUB. She now complains of recurring cyclic pain. Which of the following is the best management?
A. GnRH agonist
B. Hysteroscopic decompression
C. Total abdominal hysterectomy
D. NSAID pain management
E. Laparoscopic bilateral salpingectomy
```
C. Total abdominal Hysterectomy
44
```
Which of the following most warrants obtaining a karyotype?
A. Single umbilical artery
B. Club feet
C. Gastroschisis
D. Polyhydramnios
E. Cystic hygroma
```
E. Cystic hygroma
45
The diagnoses of osteoporosis is best accomplished by?
A. Vitamin D level
B. Urinary calcium level
C. DEXA of thoracic spine
D. DEXA of greater trochanter of the femur
E. DEXA of Lumbar spine
E. DEXA of Lumbar spine
46
```
The least likely contraindication to the induction of labor is:
A. Vasa previa
B. Prior vertical uterine incision
C. Active genital herpes
D. Placental abruption
E. StageIII B cervical cancer
```
D. Placental abruption
47
```
Of the following proposed strategies for the prevention of obstetrical lacerations, which one has shown a decrease in rates of perineal lacerations?
A. Manual perineal support
B. Maternal perineal massage
C. Warm compresses
D. Delayed pushing
E. Birthing positions
```
C. Warm compresses
48
The American Cancer Society (ACS) recommends that routine cervical cytology may be discontinued at what age:
A. After 65 with 3 consecutive normal tests in past 10 years
B. After 70 with 3 consecutive normal screening tests in past 10 years
C. After 60 with 2 consecutive normal screening tests in past 5 years
D. Not sexually active after age 60
E. No history of CIN after age 55
A. After 65 with 3 consecutive normal tests in past 10 years
49
```
All the following are examples of Imprinting EXCEPT:
A. Prader-Willi Syndrome
B. Angelman Syndrome
C. Ovarian teratoma
D. Ehlers Danlos syndrome
E. Complete Mole
```
D. Ehlers Danlos syndrome
50
```
Which of the following generally occurs first among the major developmental events of female puberty?
A. Menarche
B. Closure epiphyseal plates
C. Thelarche
D. Pubarche
E. Adrenarche
```
C. Thelarche
