Wall Quiz #4 Flashcards
1
Q
Which of the following is a smooth muscle tumor of the uterus with low grade tumor composed of malignant mesenchymal component and benign epithelium and rarely metastasizes? A. Leiomyosarcoma B. Adenosarcoma C. Carcinosarcoma D. Endometrial stromal sarcoma E. Smooth muscle tumor
A
B. Adenosarcoma
2
Q
A 72-year-old is status post stereotactic biopsy that reveals Ductal Carcinoma in Situ. What is the next step? A. Sentinel node biopsy B. Chemotherapy and mastectomy C. Mastectomy simple D. Tamoxifen E. Breast radiation
A
C. Mastectomy simple
3
Q
Which of the following trophoblastic diseases is noted for systemic metastases that commonly develops early? A. Partial mole B. Complete mole C. Choriocarcinoma D. Placental site trophoblastic tumor E. Mixed mullerian tumor
A
C. Choriocarcinoma
4
Q
A 51-year-old presents status post bilateral salpingo-oophorectomy. Her pathology report reveals bilateral grade 1 endometroid adenocarcinoma. The most appropriate next step in management after complete surgical staging is: A. IV chemotherapy B. Intraperitoneal Chemotherapy C. Re-examination in 3 months D. Oral melphalan E. Aromatase inhibitor
A
C. Re-examination in 3 months
5
Q
All the following are maternal risk factors that predispose a newborn to macrosomia EXCEPT? A. GDM B. Gestational weight gain C. Dyslipidemia D. Cushing's disease E. Post term pregnancy
A
D. Cushing’s disease
6
Q
Which muscle contributes most to the anal canal’s resting pressure and fecal continence at rest? A. puborectalis B. Coccygeous C. Pubococcygeus D. External anal sphincter E. Internal anal sphincter
A
E. Internal anal sphincter
7
Q
Which of the following is the best medical treatment for overflow fecal incontinence associated with constipation? A. Cholestyramine B. Methyl cellulose C. Loperamide D. Polyethylene glycol E. Bismuth sulfate
A
D. Polyethylene glycol
8
Q
Meperidine is not generally recommended for peripartum analgesia due to which of the following? A. Nausea and vomiting B. Intraoperative toxicity C. Prolonged respiratory depression D. Loss of variability in FHR E. Cannot be antagonize by naloxone
A
E. Cannot be antagonize by naloxone
9
Q
Which of the following drugs should be avoided in patients receiving a full opioid agonist treatment course during labor? A. Fentanyl B. Morphine C. Butorphanol D. Remifentanil E. Meperidine
A
C. Butorphanol
10
Q
Which of the following findings is diagnostic of early pregnancy loss?
A. CRL of 7mm or greater and no heartbeat
B. Mean sac diameter of 16-24 mm with no embryo
C. Absence of embryo for 6 weeks or longer after last menstrual period
D. Empty amnion
E. Enlarged Yolk sac
A
A. CRL of 7mm or greater and no heartbeat
11
Q
What percent of early pregnancy loss are due to fetal chromosomal abnormalities/aneuploidies? A. 25% B. 50% C. 60% D. 75% E. Depends on Maternal age
A
B. 50%
12
Q
Which of the following is not a common risk factor for diabetic ketoacidosis in pregnancy? A. Influenza B. UTI C. Poor compliance D. Treatment with Magnesium sulfate E. Antenatal corticosteroids
A
D. Treatment with Magnesium sulfate
13
Q
What percent of the diet should be obtained from protein when managing a diabetic patient in pregnancy? A. 5-10% B. 10-15% C. 15-30% D. 30-40% E. 50%
A
C. 15-30%
14
Q
Which of the following is the leading cause of blindness in the U. S. in individuals aged 24-74 years? A. Narrow angle Glaucoma B. Retinopathy C. Cataracts D. Macular degeneration E. Wide Angle Glaucoma
A
B. Retinopathy
15
Q
During childbirth which of the following is the most common site of laceration? A. Labia minora B. Labia majora C. Vaginal vestibule D. Clitoris E. Perineal body
A
E. Perineal body
16
Q
VBAC is associated with lower rates of all the following EXCEPT: A. Infection B. Thromboembolism C. Placental previa D. Hemorrhage E. Recovery time
A
C. Placental previa
17
Q
Androgen sensitive skin areas include all of the following EXCEPT: A. Thighs B. Face C. Back D. Axillary E. Sternum
A
D. Axillary
18
Q
The greatest number of report allegations of sexual misconduct involves physicians who practice all the following field of medicine EXCEPT: A. OBGYN B. Internal medicine C. Psychiatry D. Anesthesia E. Family medicine
A
D. Anesthesia
19
Q
When should maternal HIV testing be repeated in high risk patients with an initial negative HIV test in the first trimester? A. Second trimester B. 37 weeks to 40 weeks C. Post partum D. Does not need to be repeated E. Before 36 weeks
A
E. Before 36 weeks
20
Q
Which of the following is not a sign or symptom of Zika Virus? A. Fever B. Rash C. Arthralgia D. Lymphadenopathy E. Conjunctivitis
A
D. Lymphadenopathy
21
Q
All are indications a patient may be involved with Human trafficking EXCEPT: A. Medical neglect B. Hostile behavior C. Avoiding eye contact D. Sexual promiscuity E. No identification
A
D. Sexual promiscuity
22
Q
A 16-year-old presents to your office for contraception with her guardian. She lacks eye contact and is unable to answer any questions regarding her history. What is best step in management after her examination is complete?
A. Contact law enforcement with your concerns and have the patient be interviewed.
B. Refer to social services after patient gives you her consent
C. Discuss with guardian her living conditions
D. Report to the Human trafficking hotline
E. Build trust with patient to identify if mandatory reporting is necessary
A
E. Build trust with patient to identify if mandatory reporting is necessary
23
Q
Which of the following is NOT a risk factor for surgical site infection?
A. Perioperative hypoglycemia
B. BMI >30
C. Vaginal colonization with Gardnerella vaginalis
D. Current UTI
E. THC use
A
E. THC use
24
Q
Which of the following maternal risk factors carries the highest risk of stillbirth? A. Systemic lupus erythematosus B. Cholestasis of pregnancy C. Chronic Hypertension D. Prior stillbirth E. Inherited thrombophilia
A
A. Systemic lupus erythematosus
25
```
Relative risk is increased for which of the following cancers with combination oral contraception?
A. Ovarian
B. Cervical
C. Endometrial
D. Hepatocellular carcinoma
```
B. Cervical
26
```
Which of the following is defined as two or more cell populations with different chromosomal complements present within the same embryo?
A. Imprinting
B. Uniparental disomy
C. Mosaicism
D. Single gene disorder
E. Multifactoral
```
C. Mosaicism
27
```
All of the following are the most critical portions of the evaluation of chronic pelvic pain EXCEPT:
A. Medical history
B. Gynecologic history
C. Thorough physical exam
D. Diagnostic testing
E. Surgical history
```
D. Diagnostic testing
28
```
Which of the following medications have been shown to treat chronic neuropathic pain?
A. Gabapentin and nortriptyline
B. Nortriptyline
C. Desipramine
D. Amitriptyline
E. Gabapentin and pregabalin
```
E. Gabapentin and pregabalin
29
```
Which of the following factors have been found to be associated with a later menopause?
A. High parity
B. Smoking
C. History of hysterectomy
D. High BMI
E. Low socioeconomic background
```
A. High parity
30
```
A 43-year-old presents AUB bleeding and an 8mm endometrial stripe on ultrasound was found, what is the next step?
A. D&C
B. Hysteroscopy D&C
C. RepeatU/S
D. Progesterone treatment
E. Sonohysterography
```
E. Sonohysterography
31
```
What is the most practical marker of reproductive aging?
A. FSH
B. Mullerian inhibiting substance
C. Inhibin B
D. Estradiol
E. LH
```
B. Mullerian inhibiting substance
32
```
Which of the following medical therapies has been associated with the modest decrease in the incidence of preeclampsia in women with increased risk?
A. ASA
B. Metformin
C. Enoxaparin
D. Heparin sulfate
E. VitaminE
```
A. ASA
33
```
What appears to be the gestational threshold for lung hypoplasia in women with early membrane rupture?
A. 19 Weeks
B. 21 weeks
C. 23 weeks
D. 25 weeks
E. 27 weeks
```
C. 23 weeks
34
Why does uteroplacental blood flow decrease when intraperitoneal insufflation pressures exceed 15 mmHG?
A. Induces uterine contractions
B. Places pressure on the uterine wall
C. Increases placental vessel resistance
D. Constriction of the umbilical arteries
E. Dilation of the umbilical veins
C. Increases placental vessel resistance
35
```
The most common gynecological malignancy in preadolescent females is?
A. Ovarian fibroma
B. Germ cell tumor
C. Epithelial tumor
D. Sex chord stromal tumor
E. Physiological cyst
```
B. Germ cell tumor
36
```
Risk factors for back pain due to a vertebral fracture include all of the following EXCEPT:
A. Age > 70 years
B. History of Osteoporosis
C. Recent severe trauma
D. History of Rheumatoid arthritis
E. Use of corticosteroids
```
D. History of Rheumatoid arthritis
37
```
Pregnant women with chlamydia infection should have a test of cure how many weeks after treatment?
A. 1 week
B. 2 weeks
C. 3-4 weeks
D. 6 weeks
E. 12 weeks
```
C. 3-4 weeks
38
```
All of the following are risk factors for the development of post operative delirium in geriatric patients EXCEPT:
A. Age Greater than 65 years
B. Known Cognitive impairment
C. Hearing or vision impairment
D. Osteoporosis
E. Infection
```
D. Osteoporosis
39
```
Hepatitis C testing should be offered to all patients born between:
A. 1955-1975
B. 1945-1965
C. 1965-1975
D. 1975-1985
E. 1935-1955
```
B. 1945-1965
40
```
Which of the following is the best measure of chronic asthma severity?
A. FEV1
B. Chest radiograph
C. Arterial blood gas
D. Pulse Oximetry less than 90%
E. Spirometry
```
A. FEV1
41
```
What is the most common complication of influenza?
A. Rash
B. Pneumonia
C. Renal failure
D. Thrombocytopenia
E. Shortness of Breath
```
B. Pneumonia
42
```
All Except which of the following is an aspect of Virchow’s triad?
A. Stasis
B. Local trauma
C. Immobilization
D. Hypercoagulability
```
C. Immobilization
43
```
Which of the following is most likely to lead to end stage renal disease?
A. Diabetes
B. Hypertension
C. Glomerulonephritis
D. Polycystic kidney disease
E. Renal transplant
```
A. Diabetes
44
```
Which finding is more specific to Crohn’s disease as compared to ulcerative colitis?
A. Diarrhea
B. Toxic megacolon
C. Rectal involvement
D. Perianal involvement
E. Erythema nodosum
```
D. Perianal involvement
45
```
One of the most maternal life-threatening complications of Herpes Simplex virus is:
A. Viral sepsis
B. Pneumonitis
C. Aplastic anemia
D. Encephalitis
E. HSV hepatitis
```
E. HSV hepatitis
46
```
Decreased fetal movement is defined as:
A. Less than 10 movements in 60 minutes
B. Less than 8 movements in 90 minutes
C. Less than 10 movements in 120 minutes
D. Less than 8 movements in 20 minutes
E. No fetal breathing for 30minutes
```
C. Less than 10 movements in 120 minutes
47
```
Most commonly reported risk of using a gelatin thrombin matrix hemostatic agent is:
A. Continued bleeding
B. Fever of unknown origin
C. Postoperative abscess
D. Persistent hematoma
E. Suture degradation
```
C. Postoperative abscess
48
```
All of the following are potential side-effects of intracervical vasopressin includes all except:
A. Bradycardia
B. Hypotension
C. Hyperpyrexia
D. Hypertension
E. Cardiac Arrest
```
C. Hyperpyrexia
49
```
In the patient that is unanesthetized, which of the following is the most common symptom of air embolus?
A. Chest pain
B. Left arm pain
C. Nausea
D. Headache
E. Palpitations
```
A. Chest pain
