Wall Quiz #2 Flashcards
1
Q
While doing clinical pelvimetry, you note the diagonal conjugate is 12.0 cm. What is the obstetrical conjugate? A. 9.0 cm B. 9.5 cm C. 10.5 cm D. 11.0 cm E. 11.5cm
A
C. 10.5 cm
2
Q
Which of the following medications are most likely employed for adolescent obesity which is not responding to lifestyle changes? A. Sibutramine B. Bupropion C. Venlafaxine D. Metformin E. Tetrahydrolipstatin
A
E. Tetrahydrolipstatin
3
Q
While performing a sacrospinous ligament fixation, which space is entered in order to identify the sacrospinous ligament? A. Paracervicalspace B. Pararectal fossa C. Ischiorectalfossa D. Pouch of douglass E. Presacralspace
A
B. Pararectal fossa
4
Q
The main goal of therapy in the treatment of precocious puberty is:
A. Slow skeletal maturation
B. Involution of secondary sex characteristics
C. Precipitate amenorrhea
D. Increase skeletal maturation
E. Decrease vitamin deficiencies
A
A. Slow skeletal maturation
5
Q
Which of the following is the most predictive ultrasound finding in a patient with placental accreta?
A. Myometrial striations
B. Increase in placental lacunae
C. Thinning of the myometrium
D. Increase and myometrial striations
E. Loss of hypoechoic features in the placenta
A
B. Increase in placental lacunae
6
Q
Measles infection during pregnancy is associated with all the following risks to the fetus EXCEPT: A. Spontaneous Abortion B. Stillbirth C. Low birth weight D. Risk of preterm delivery E. Congenital malformations
A
E. Congenital malformations
7
Q
All of the following chemotherapeutic alkylating agents increase the risk of ovarian failure or dysfunction EXCEPT: A. Chlorambucil B. Ifosfamide C. Cisplatin D. Busulfan E. Cyclophosphamide
A
C. Cisplatin
8
Q
Increased rates of which complication have been linked to binge drinking during pregnancy? A. Stillbirth B. Preterm birth C. Postpartum depression D. Fetal growth restriction E. Cleft palate
A
A. Stillbirth
9
Q
A 43 y/o presents post operative day 1 status post TAH. She complains of weakness in her right leg. On physical exam, +1/4 patellar reflexes are noted. This finding correlates with which nerve injury? A. Obturator B. Genital femoral C. Tibial D. Femoral E. Peroneal
A
D. Femoral
10
Q
Which of the following is NOT a transient cause of urinary incontinence? A. Restricted mobility B. Fistula C. Diabetes mellitus D. Atrophy E. Stool impaction
A
B. Fistula
11
Q
A 4-year-old presents an acute onset genital pruritis and vaginal discharge. Which of the following is the most common likely cause? A. Respiratory organisms B. Rectal organisms C. Sexual transmitted disease D. Viral infection E. Pinworms
A
A. Respiratory organisms
12
Q
Abnormal findings on chest radiograph include all of the following in a patient with pulmonary embolism EXCEPT: A. Enlarged pulmonary artery B. Pleural effusion C. Left ventricular enlargement D. Airspace opacity E. Elevated hemi-diaphragm
A
C. Left ventricular enlargement
13
Q
Which of the following nerves can be inadvertently injured during a suprapubic TVT (transvaginal tape)? A. Perineal B. Ilioinguinal C. Femoral D. Obturator E. Iliohypogastric
A
B. Ilioinguinal
14
Q
Which of the following is an effective means to treat EIN (endometrial intraepithial neoplasia) surgically?
A. Simple hysterectomy
B. SupracervicalTAH
C. Hysterectomy with lymph node dissection
D. Fractional dilation and curettage
E. Megestrolacetate (Megace©)
A
A. Simple hysterectomy
15
Q
Which fetal complication is associated with indomethacin use?
A. Polyhydramnios
B. Pulmonary valve atresia
C. Bronchopulmonary dysplasia
D. Premature closure of ductus arteriosus
A
D. Premature closure of ductus arteriosus
16
Q
Which of the following is NOT caused by multifactorial inheritance? A. Androgen insensitivity B. Mullerian agenesis C. Cleft lip D. Neural tube defect E. Diabetes
A
A. Androgen insensitivity
17
Q
Which of the following is not used to adjust maternal serum analytes? A. Maternal age B. Gestational age C. Maternal weight D. Maternal ethnicity
A
D. Maternal ethnicity
18
Q
A 49-year-old presents complaining of leaking urine with coughing. On exam a positive cough stress test is elicited. What is the next step in evaluation? A. Pelvic floor physical therapy B. Measurement of post void residual C. Multichannel testing D. Cystoscopy E. Transvaginal tape procedure
A
B. Measurement of post void residual
19
Q
A 31-year-old presents for her first prenatal visit at 8 weeks. She has no known history of substance abuse. When should this patient be screened for illicit drugs? A. No testing necessary B. At this visit C. On admission to L&D D. At 36 weeks gestation E. At 16weeks gestation
A
B. At this visit
20
Q
Which minimum ovarian pelvic radiation dosage has no effect on the ovaries in females younger than 40 years old? A. 0.6 Gy B. 1.5 Gy C. 2.0 Gy D. 2.5 Gy E. 3.0Gy
A
B. 1.5 Gy
21
Q
Which of the following is NOT associated with postpartum depression? A. Older maternal age B. Antenatal depression C. Physical or verbal abuse D. Hyperemesis gravidarum E. Smoking
A
A. Older maternal age
22
Q
Which of the following is NOT a treatment for bipolar disorder? A. Lithium B. Valproic acid C. Amitriptyline D. Carbamazepine E. Olanzapine (Zyprexa)
A
C. Amitriptyline
23
Q
Which drug is most appropriate to be taken when necessary in patients diagnosed with migraine with aura in pregnancy?
A. Propranolol and Calcium channel blocker
B. Amitriptyline
C.Magnesium oxide and promethazine
D. Acetaminophen
E. Triptans
A
D. Acetaminophen
24
Q
Which of the following is the most common maternal complication that occurs in women with Cushing syndrome? A. Hypertension B. Fracture C. Pre-eclampsia D. Diabetes E. Cardiac Failure
A
A. Hypertension
25
```
The transgender male is at increased risk of endometrial and ovarian cancer due to:
A. Androgen therapy
B. GnRH therapy
C. Estrogen therapy
D. Spironolactone treatment
E. Tamoxifen treatment
```
A. Androgen therapy
26
```
All of the following medications are indicated in a rape case EXCEPT:
A. Azithromycin
B. Penicillin G
C. Ceftriaxone
D. Metronidazole
E. Plan B
```
B. Penicillin G
27
For the occiput anterior position of the fetal head, appropriately applied forceps blades are:
A. Equidistant from the sagittal and lambdoidal suture
B. Equidistant on the parietal bones
C. Symmetrical to the to the coronal suture
D. Symmetrical to the sagittal and coronal suture
E. One blade over the occiput and other on the brow
A. Equidistant from the sagittal and lambdoidal suture
28
```
Your patient presents with primary amenorrhea, no secondary sex characteristics and an XY karyotype. The most likely mutation consistent with this syndrome is?
A. Mutation in FOG2
B. Mutation in ZFPM2
C. Mutation in SRY gene
D. Mutation in WNT1
E. Mutation in MSH1
```
C. Mutation in SRY gene
29
```
Patient presents for CT urogram and has a creatinine of 2.4 mg/dL and GFR is 42 mL/min. Which of the following is the correct management prior to her CT?
A. Ace inhibitors
B. Alpha blocking agents
C. N-acetylcystine
D. Hydralazine
E. Intravenous hydration
```
E. Intravenous hydration
30
```
30. Your patient is 4 days post op from a CD and has purulent discharge from her incision. What is the next step in management?
A. Open wound vac
B. CT scan
C. Wound debridement
D. Wound exploration
E. MRI
```
D. Wound exploration
31
```
A 74-year-old G2P2 presents with a 10cm adnexal mass and post- menopausal bleeding. She recently underwent an endometrial biopsy showing EIN. Which of the following tumor markers would likely be positive?
A. Lactate dehydrogenase
B. Alpha-fetoprotein
C. Human Epididymal 4
D. Estradiol
E. Inhibin
```
E. Inhibin
32
```
Which of the following anomaly is associated with Kallman’s syndrome X-linked mutations?
A. Cardiac defect
B. Cleft lip and palate
C. Scoliosis
D. Renal anomaly
E. Ophthalmic
```
B. Cleft lip and palate
33
```
Which of the following is the next best step if a patient presents with primary amenorrhea, elevated FSH and no secondary sex characteristics?
A. U/S of Pelvis
B. Karyotype
C. LH
D. HCG
E. MRI of the brain
```
B. Karyotype
34
```
What is the treatment of choice for a patient with a confirmed diagnosis of Adult onset Congenital Adrenal Hyperplasia?
A. Oral contraceptives
B. Testosterone injections
C. Clomiphene citrate
D. Dexamethasone
E. Letrozole
```
D. Dexamethasone
35
```
Which of the following Aromatase inhibitors is most likely to cause osteoporosis in patients being treated for Breast Cancer?
A. Letrozole
B. Anastrozole
C. Exemestane
D. Clomiphene citrate
E. Tamoxifen citrate
```
B. Anastrozole
36
Which of the following medications cause the flare effect?
A. GnRH agonists
B. GnRH antagonists
C. Aromatase inhibitors
D. Selective estrogen receptor modulators
E. Depo medroxyprogesterone
A. GnRH agonists
37
```
Which of the following perinatal infections account for most cases of fetal growth restriction world-wide?
A. Rubella
B. Syphilis
C. Malaria
D. Varicella
E. Toxoplasmosis
```
C. Malaria
38
```
Small for gestational age newborns are predisposed to all the of the following complications EXCEPT:
A. Hypoglycemia
B. Hypothermia
C. IVH
D. RDS
E. Acid base disorders
```
E. Acid base disorders
39
```
In adolescent patients with symptoms of androgen excess, the least likely diagnoses would be?
A. PCOS
B. Sertoli Leydig tumor
C. Hyperandrogenism of puberty
D. Idiopathic hyperandrogenism
```
B. Sertoli Leydig tumor
40
All of the following are medical treatments for acute menstrual bleeding in adolescents EXCEPT:
A. Conjugated equine estrogens
B. Medroxyprogesterone acetate
C. Tranexamic acid
D. Combined oral contraceptives
E. Depo-medroxyprogesterone acetate (DMPA)
E. Depo-medroxyprogesterone acetate (DMPA)
41
```
How many milliliters of blood does a super plus tampon hold?
A. 5 cc
B. 10 cc
C. 15-18 cc
D. 20-25 cc
E. >25cc
```
C. 15-18 cc
42
```
Which of the following medications can adversely interact with reverse transcriptase inhibitors to cause severe vasoconstriction?
A. Ergot alkaloids
B. Antifibrinolytics
C. Carboprost
D. Misoprostol
E. Beta Agonists
```
A. Ergot alkaloids
43
```
All of the following bacteria are involved in septicemia associated with puerperal infection EXCEPT?
A. Escherichia coli
B. Clostridum perfringes
C. Group A Streptococcus pyogenes
D. C. sordellii
E. Staph aureus
```
A. Escherichia coli
44
```
During a vasectomy, which of the following structures is ligated?
A. Epididymis
B. Spermatic cord
C. Efferent ductile
D. Ductus deferens
E. Seminal Vesicle
```
D. Ductus deferens
45
```
Which of the following suture is most used to complete a pomeroy tubal ligation?
A. 0-Chromic
B. 0-Plain catgut
C. 1-Vicryl
D. Silastic rings
E. Filshie clip
```
B. 0-Plain catgut
46
```
Which of the following is an absorbable monofilament suture?
A. Poliglecaprone 25
B. Polyglactin 910
C. Nylon suture
D. Polypropylene suture
E. Polyvinylidene fluoride suture
```
A. Poliglecaprone 25
47
```
In a patient with primary amenorrhea, laboratory evaluation should begin with all the following EXCEPT:
A. FSH
B. hCG
C. Prolactin levels
D. Karyotype
E. TSH
```
D. Karyotype
48
Which of the following describe how progestins work to treat endometrial hyperplasia?
A. Activating progesterone receptors which results in stromal decidualization
B. Increase in estrogen production and “down regulation of receptors”
C. Activation of Gonadotropin releasing hormone
D. Stimulation of the FSH and LH receptors
E. Inhibits hydroxylase enzyme to stop
the conversion of estradiol to estrone
A. Activating progesterone receptors which results in stromal decidualization
49
```
Advantages of Rivaroxaban over warfarin in the management of thrombosis includes all of the following EXCEPT:
A. Rapid onset/offset action
B. Less drug interactions
C. Predictable pharmacokinetics
D. Narrow therapeutic window
E. Lower incidence of bleeding
```
D. Narrow therapeutic window
50
```
Which of the following is the most common treatment procedure for an endometrioma?
A. Oral contraceptives
B. Oophorectomy
C. Excision/stripping
D. GnRH agonist
E. GnRH antagonist
```
C. Excision/stripping
